Does Natalizumab Induce or Aggravate Psoriasis? A Case Study and Review of the Literature

Psoriasis is a relatively common immune-mediated chronic inflammatory skin disease. It is well known that interferon-beta, a drug used in the management of relapsing-remitting multiple sclerosis, could exacerbate or induce de novo psoriasis. There is limited evidence in the literature based only on case reports that natalizumab could induce or aggravate psoriasis. In this case study, we present a 33-year-old patient who developed plaque psoriasis during natalizumab treatment

Effects of controlled dehydration on sleep quality and quantity: A polysomnographic study in healthy young adults

Dehydration is associated with several alternations in body homeostasis involving both physiological and mental aspects. In addition some studies have reported a negative effect of dehydration on subjectively assessed sleep-related parameters. The aim of the current study was to examine for the first time the effect of controlled dehydration on sleep quality and quantity using the gold-standard method of polysomnography. Twelve healthy male volunteers participated in this study (23.4 ± 0.8 years). Participants performed an in-house full polysomnographic assessment in two different occasions taking place in random order: (i) in a dehydrated state; and (ii) in a euhydrated state. In the dehydration scenario, the participants were allowed to consume only 1.25 L of non-caffeinated fluids, while during the euhydrated state participants had to drink at least 3 L of non-caffeinated fluids during the last 24 hr before the polysomnographic study. Urine specific gravity was assessed by refractrometry on collection day in order to assess hydration status. Participants who did not fulfil the hydration criteria were rescheduled. All participants successfully completed the two polysomnographic studies without any complaints or adverse effects reported. No significant differences were found in any of the examined indices of sleep quality and quantity between the dehydration and euhydration scenarios (p > .05). This is the first study to show that controlled mild dehydration does not seem to affect sleep quality and quantity in young healthy adults. More research is necessary to further verify these conclusions and assess whether other parameters are involved in the manifestation of sleep disturbances

Restless legs syndrome is contributing to fatigue and low quality of life levels in hemodialysis patients

AIM: To examine whether hemodialysis (HD) patients with restless legs syndrome (RLS) are subjects of greater fatigue and impaired quality of life (QoL) compared to HD patients without RLS. METHODS: Eighty five stable HD patients participated in this study. According to their RLS status, the patients were divided into the RLS group (n = 23) and the non-RLS group (n = 62). QoL, fatigue, sleep quality, daily sleepiness and depression symptoms were assessed by using various questionnaires. Finally, biochemical parameters including iron, ferritin, hemoglobin, hematocrit and parathormone were assessed. RESULTS: The HD patients with RLS scored worse in all the questionnaires used in the study (P < 0.05). The patients with RLS were more likely to receive the HD therapy on the morning shift, whilst 43.5% of the RLS patients reported to experience the RLS symptoms also during HD. The severity of RLS was correlated with fatigue, depression score and sleep quality (P < 0.05). CONCLUSION: HD patients with RLS are subject to lower QoL related parameters and greater fatigue compared to HD patients without RLS. RLS should be successfully managed in order to improve the QoL of the sufferers

Restless legs syndrome in Multiple Sclerosis patients: a contributing factor for fatigue, impaired functional capacity, and diminished health-related quality of life

Objectives Restless legs syndrome (RLS) symptoms are common in Multiple Sclerosis (MS) patients. The aim of the current study was to examine for the first time whether RLS could affect the functional capacity and various contributing parameters related to quality of life and fatigue in MS patients. Methods According to their RLS status, 50 relapsing-remitting MS patients were divided into the RLS (n = 10) and non-RLS groups (n = 40). Specific questionnaires were used in order to assess the health-related quality of life (HRQoL), fatigue levels, sleep quality, daily sleepiness, and depression symptoms of the patients. Functional capacity was examined using a battery of functional tests. Total body and visceral fat levels were assessed via bioelectrical impedance analyzers. Results Sleep quality, depression, fatigue, and HRQoL levels were found to be significantly worse in the patients with RLS compared to their free-RLS counterparts (P < 0.05). In addition, patients with RLS were found to exhibit further impairments in their performance in various functional tests related mainly with strength levels of lower extremities (P < 0.05). Finally, the patients with RLS were found to have significantly higher both total and trunk fat levels compared to patients without RLS (P < 0.05). A strong correlation was observed between the severity of RLS symptoms, sleep quality, fatigue, and QoL levels. Discussion It seems that RLS contributes even further to impairments on sleep quality, fatigue, functional capacity, and therefore HRQoL levels in relapsing-remitting MS patients, whilst for the first time a link between high fat levels has been revealed

An automated speech analysis system for the detection of cognitive decline in elderly

The goal of this study is to develop and test an automated integrated speech analysis system for detecting mild cognitive impairment (MCI) and dementia in spontaneous free speech. During the years 2010–2016, speech recordings (N = 2800) were obtained from 200 Greek Cypriots over the age of 65. These were divided into three groups (G1, G2, and G3) based on the results of their Mini-mental state examination (MMSE): G1:95 normal (NOR) individuals with an MMSE greater than 26; G2:65 MCI subjects with 20 ≤ MMSE ≤ 26; G3:40 dementia subjects with 0 ≤ MMSE < 20. As a result, each speech recording was analyzed for 55 different speech features. The features that could statistically significantly distinguish between the three aforementioned groups were selected using statistical and model multi-classification analysis. Learning-based classifiers were built using the selected features alone or in combination. For each group, statistically significant differences in speech features were detected, which may be used to differentiate the three groups. An overall multi-classification area under the curve (AUC) of 0.92 was attained using only the features identified plus clinical factors. Speech features were extracted, and they were able to discriminate people from the three groups. This study paves the way for the development of an integrated system that uses automatic speech analysis to detect early and progressive signs of cognitive decline (CD) in free speech. In a future study, the proposed method will be developed and integrated into a mobile device

Atherosclerotic carotid plaque segmentation in ultrasound imaging of the carotid artery

In this chapter, we propose and evaluate an integrated system for the segmentation of atherosclerotic plaque in ultrasound imaging of the carotid artery based on normalization, speckle reduction filtering, and four different snakes segmentation methods. These methods are the Williams and Shah, Balloon, Lai and Chin, and the gradient vector flow (GVF) snake. The performance of the four different plaque snakes segmentation methods was tested on 80 longitudinal ultrasound images of the carotid artery using receiver operating characteristic (ROC) analysis and the manual delineations of an expert. All four methods performed very satisfactorily and similarly in all measures evaluated with no significant differences between them; however, the Lai and Chin snakes segmentation method gave slightly better results. Concluding, it is proposed that the integrated system investigated in this study could be used successfully for the automated segmentation of the carotid plaque

Restless legs syndrome in adolescents: Relationship with sleep quality, cardiorespiratory fitness and body fat

The aim of the current study was to investigate the relationship between restless legs syndrome (RLS) and cardiorespiratory fitness, body composition and sleep quality in a sample of adolescents. One hundred fifty seven volunteer adolescents (16.6±0.7 yrs) participated in the study. Sleep quality was assessed by the Pittsburg sleep quality index. Cardiorespiratory fitness was assessed by the 20 m shuttle run test and body composition by bioelectrical impedance analysis. The prevalence of RLS was 5.1%. The adolescents with RLS were found to exhibit significantly higher body fat levels and poorer sleep quality score compared to their free-RLS counterparts

Normal appearing brain white matter changes in relapsing multiple sclerosis: Texture image and classification analysis in serial MRI scans

Objective: There is a clinical interest in identifying normal appearing white matter (NAWM) areas in brain T2-weighted (T2W) MRI scans in multiple sclerosis (MS) subjects. These areas are susceptible to disease development and areas need to be studied in order to find potential associations between texture feature changes and disease progression. Methods: The subjects investigated had a first demyelinating event (Clinically Isolated Syndrome-CIS) at baseline (Time0), and the NAWM0 (i.e. NAWM at Time0) of the brain tissue was subsequently converted to demyelinating plaques (as evaluated in a follow up MRI at Time6–12). 38 untreated subjects that had developed a CIS, had brain MRI scans within an interval of 6–12 months (Time6–12 at follow-up). An experienced MS neurologist manually delineated the demyelinating lesions at Time0 (L0) and at Time6–12 (L6–12). Areas in the Time6–12 MRI scans, where new lesions had been developed, were mapped back to their corresponding NAWM areas on the Time0 MR scans (ROIS0). In addition, contralateral ROIs of similar size and shape were segmented on the same images at Time0 (ROISC0) to form an intra-subject control group. Following that, texture features were extracted from all prescribed areas and MS lesions. Results: Texture features were used as input into Support Vector Machine (SVM) models to differentiate between the following: NAWM0 vs ROISC0, NAWM0 vs NAWM6–12, NAWM0 vs L0, NAWM6–12 vs L6–12, ROIS0 vs L0, ROIS0 vs L6–12 and ROIS0 vs ROISC0, where the corresponding % correct classifications scores were 89%, 95%, 98%, 92%, 85%, 90% and 65% respectively. Conclusions: Texture features may provide complementary information for following up the development and progression of MS disease. Future work will investigate the proposed method on more subjects