Examining the frequency of dysphagia and the predictive factors of dysphagia that require attention in patients with Parkinson's disease

Introduction. Due to the prevalence of dysphagia in patients with Parkinson's disease (PD) and its complications such as aspiration pneumonia, which is the main cause of death in these patients, PD-related disability can be prevented by early diagnosis and treatment of dysphagia. Objective. The present study was aimed at investigating the frequency of dysphagia in PD patients. Materials and methods. This cross-sectional study included 150 PD patients visiting a Neurology Clinic. The severity of PD was determined based on the Unified Parkinson Disease Rating Scale (UPDRS) and modified Hoen and Yahr (HYS) Scale. The Munich Dysphagia Test-Parkinson's disease (MDT-PD) questionnaire was used to assess dysphagia. Comparisons were made using generalized Fisher exact, Chi-square, ANOVA, and KruskalWallis tests. Predictive factors were analyzed using logistic regression. Statistical analyses were performed at significance level of 0.05. Results. Out of all 150 patients referred to the Clinic, the prevalence of dysphagia requiring attention was 25.3% (n = 38). The patients of the three groups according to the MDT-PD (no noticeable dysphagia, noticeable oropharyngeal, and dysphagia with aspiration risk) had a significant difference only in terms of the PD duration (p 0.001). In the predicting of dysphagia, the longer PD duration (p = 0.011) and homemaker occupation (p = 0.033) were protective factors, while female gender was a risk factor (p = 0.011). Conclusion. The prevalence of dysphagia requiring attention in the studied patients was 25.3%. It decreased with the longer duration of the disease, and its prevalence was lower in homemaker patients, while the odds of dysphagia was 5.8 times higher in women than in men

Hemoglobin Q-Iran detected in family members from Northern Iran: a case report

<p>Abstract</p> <p>Introduction</p> <p>Hemoglobin Q-Iran (α75Asp→His) is an important member of the hemoglobin Q family, molecularly characterized by the replacement of aspartic acid by histidine. The first report of hemoglobin Q-Iran and the nomenclature of this hemoglobinopathy dates back to 1970. Iran is known as a country with a high prevalence of α- and β-thalassemia and different types of hemoglobinopathy. Many of these variants are yet to be identified as the practice of molecular laboratory techniques is limited in this part of the world. Applying such molecular methods, we report the first hemoglobin Q-Iran cases in Northern Iran.</p> <p>Case presentation</p> <p>An unusual band was detected in an isoelectric focusing test and cellulose acetate electrophoresis of a sample from a 22-year-old Iranian man from Mazandaran Province. Capillary zone electrophoresis analysis identified this band as hemoglobin Q. A similar band was also detected in his mother's electrophoresis (38 years, Iranian ethnicity). The cases underwent molecular investigation and the presence of a hemoglobin Q-Iran mutation was confirmed by the amplification refractory mutation system polymerase chain reaction method. Direct conventional sequencing revealed a single guanine to cytosine missense mutation (c.226G > C; <it>G</it>AC ><it>C</it>AC) at codon 75 in the α-globin gene in both cases.</p> <p>Conclusion</p> <p>The wide spectrum and high frequency of nondeletional α-globin mutations in Mazandaran Province is remarkable and seem to differ considerably from what has been found in Mediterranean populations. This short communication reports the first cases of patients with hemoglobin Q found in that region.</p

Detection of Rare Beta Globin Gene Mutation [+22 5UTR(G>A)] in an Infant, Despite Prenatal Screening

Background. Beta thalassemia is one of the most common hereditary disorders worldwide. In Iran, it is frequently reported from northern and southern provinces. In order to prevent child birth to be affected by this complication, prenatal screening and diagnosis are carried out nationwide. However, in some instances, this program is unable to identify rare mutations leading to thalassemia. Case Presentation. A married couple, who took part in prenatal screening and diagnosis, gave birth to a child who is affected by thalassemia major. After several molecular examinations, a rare mutation [+22 5UTR (G>A)] in compound heterozygote state along with a common mutation [codon 8 (-AA)] was found. Conclusion. This case study suggests that more advanced molecular evaluations must be integrated in prenatal screening programs to identify rare mutations and antenatal diagnosis of thalassemia cases

Mechanisms Underlying Dopamine-Induced Risky Choice in Parkinson’s Disease With and Without Depression (History)

Patients with Parkinson’s disease (PD) are often treated with dopaminergic medication. Dopaminergic medication is known to improve both motor and certain nonmotor symptoms, such as depression. However, it can contribute to behavioral impairment, for example, by enhancing risky choice. Here we characterize the computational mechanisms that contribute to dopamine-induced changes in risky choice in PD patients with and without a depression (history). We adopt a clinical–neuroeconomic approach to investigate the effects of dopaminergic medication on specific components of risky choice in PD. Twenty-three healthy controls, 21 PD patients with a depression (history), and 22 nondepressed PD patients were assessed using a well-established risky choice paradigm. Patients were tested twice: once after taking their normal dopaminergic medication and once after withdrawal of their medication. Dopaminergic medication increased a value-independent gambling propensity in nondepressed PD patients, while leaving loss aversion unaffected. By contrast, dopaminergic medication effects on loss aversion were associated with current depression severity and with drug effects on depression scores. The present findings demonstrate that dopaminergic medication increases a value-independent gambling bias in nondepressed PD patients. Moreover, the current study raises the hypothesis that dopamine-induced reductions in loss aversion might underlie previously observed comorbidity between depression and medication-related side effects in PD, such as impulse control disorder

Is Quantitative HBsAg Measurement a Reliable Substitute for HBV DNA Quantitation?

Background: Hepatitis B surface antigen (HBsAg) is one of the main proteins of HBV envelop and its serum quantitative measurement is the most common quantitative test for monitoring the progress of Chronic Hepatitis B. Although measurement of serum HBV DNA copy number is a gold standard method for displaying viral load, the test is relatively expensive and it is not readily available everywhere in the world, while quantitative detection of HBsAg is fairly easy and inexpensive. The aim of this study was to investigate the correlation between serum HBsAg level and HBV DNA copy number in patients with chronic HB. Materials and Methods: Quantitative HBsAg, quantitative HBV DNA, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) serum levels were tested in 74 patients with chronic hepatitis B infection - who were HBsAg-positive for more than 6 months. In order to find any correlation between the results of these methods, Spearman and Kruska-Wallis correlation coefficient tests were applied. Results: No significant correlation was observed between quantitative HBsAg and HBV DNA measurements. Also, we could not find any correlation between serum HBsAg and ALT levels. But, serum HBV DNA content and AST level had a significant positive correlation. Conclusion: There are many factors affecting the correlation between serum HBV DNA copy number and HBsAg level such as genotype of HBV virus, phase of infection, methods of measurement, HBeAg status, and drug and types of treatment procedures. Therefore, these factors should be considered in further studies dealing with the correlation between quantitative HBV DNA and HBsAg tests