Freezing of gait and fall detection in Parkinson’s disease using wearable sensors:a systematic review

Despite the large number of studies that have investigated the use of wearable sensors to detect gait disturbances such as Freezing of gait (FOG) and falls, there is little consensus regarding appropriate methodologies for how to optimally apply such devices. Here, an overview of the use of wearable systems to assess FOG and falls in Parkinson’s disease (PD) and validation performance is presented. A systematic search in the PubMed and Web of Science databases was performed using a group of concept key words. The final search was performed in January 2017, and articles were selected based upon a set of eligibility criteria. In total, 27 articles were selected. Of those, 23 related to FOG and 4 to falls. FOG studies were performed in either laboratory or home settings, with sample sizes ranging from 1 PD up to 48 PD presenting Hoehn and Yahr stage from 2 to 4. The shin was the most common sensor location and accelerometer was the most frequently used sensor type. Validity measures ranged from 73–100% for sensitivity and 67–100% for specificity. Falls and fall risk studies were all home-based, including samples sizes of 1 PD up to 107 PD, mostly using one sensor containing accelerometers, worn at various body locations. Despite the promising validation initiatives reported in these studies, they were all performed in relatively small sample sizes, and there was a significant variability in outcomes measured and results reported. Given these limitations, the validation of sensor-derived assessments of PD features would benefit from more focused research efforts, increased collaboration among researchers, aligning data collection protocols, and sharing data sets

Ciprofloxacin-loaded calcium alginate wafers prepared by freeze-drying technique for potential healing of chronic diabetic foot ulcers

Calcium alginate (CA) wafer dressings were prepared by lyophilization of hydrogels to deliver ciprofloxacin (CIP) directly to the wound site of infected diabetic foot ulcers (DFUs). The dressings were physically characterized by scanning electron microscopy (SEM), texture analysis (for mechanical and in vitro adhesion properties), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR). Further, functional properties essential for wound healing, i.e., porosity, in vitro swelling index, water absorption (Aw), equilibrium water content (EWC), water vapor transmission rate (WVTR), evaporative water loss (EWL), moisture content, in vitro drug release and kinetics, antimicrobial activity, and cell viability (MTT assay) were investigated. The wafers were soft, of uniform texture and thickness, and pliable in nature. Wafers showed ideal wound dressing characteristics in terms of fluid handling properties due to high porosity (SEM). XRD confirmed crystalline nature of the dressings and FTIR showed hydrogen bond formation between CA and CIP. The dressings showed initial fast release followed by sustained drug release which can inhibit and prevent re-infection caused by both Gram-positive and Gram-negative bacteria. The dressings also showed biocompatibility (> 85% cell viability over 72 h) with human adult keratinocytes. Therefore, it will be a potential medicated dressing for patients with DFUs infected with drug-resistant bacteria

Is There Any Difference in the Plasma Homocysteine Levels of Diabetes Mellitus Type Ii Patients, Impaired Glucose Tolerance Subjects and Normal People?

Introduction: Hyperhomocysteinemia is associated with an increased risk of cardiovascular disease in diabetic patients. The aim of this study was to determine plasma homocysteine levels in diabetics and compare with control persons and also evaluation of correlation between plasma homocysteine concentration and diabetic related variables. Methods: This study was done on 39 type II diabetic patients, 27 subjects with impaired glucose tolerance and 23 normal persons referring to Endocrine and Metabolism Research Center of Medical university of Isfahan. Physical characteristics were recorded. After an overnight fast, a blood sample was drawn for determination of FPG, HbA1c – homocysteine, Cr. Cholesterol – Triglyceride and HDL- Cholesterol. Mean plasma homocysteine levels in the groups were compared by one way ANOVA. The Correlation of different parameters was tested by Pearson’s correlation. Results: There was no statistically significant difference in the plasma homocysteine levels of all the groups.(P=0.71). Correlation between homocysteine levels and HbA1c was not significant (P=0.42) in diabetic patients. Conclusions: The findings suggest that diabetes does not influence plasma homocysteine levels.Also, there is no correlation between plasma homocysteine levels and HbA1c in diabetic patient

The influence of parathyroidectomy on cardiometabolic risk factors in patients with primary hyperparathyroidism: a systematic review and meta-analysis

Purpose: Primary hyperparathyroidism (PHPT) is associated with increased risk of cardiovascular morbidity and mortality. We aim to determine whether parathyroidectomy (PTX) can change cardiometabolic risk factors including serum lipids, glycemic parameters, systolic and diastolic blood pressure, C reactive protein (CRP), and body mass index (BMI). Methods: MEDLINE, Web of Science, Scopus, and Google Scholar were searched for relevant articles published till June 2020. Fixed-effect or random-effects models were used to estimate the weighted mean difference (WMD) and 95 CI for outcomes where applicable. Results: In total, 34 studies were eligible to be included in the current meta-analysis. Our results indicated no favorable change in serum triglyceride (n = 13, WMD = �0.06, 95 CI: �0.15, 0.03 mmol/L), total cholesterol (n = 15, WMD = 0.01, 95 CI: �0.14, 0.16 mmol/L), LDL-C (n = 10, WMD = �0.01, 95 CI: �0.17, 0.19 mmol/L), HDL-C (n = 10, WMD = 0.03, 95 CI: �0.001, 0.06 mmol/L), and CRP (n = 5, WMD = 0.82, 95 CI: �0.01, 1.64 mg/L) after PTX in PHPT patients. However, glucose (n = 24, WMD = �0.16, 95 CI: �0.26, �0.06 mmol/L), serum insulin (n = 12, WMD = �1.11, 95 CI: �1.73, �0.49 µIU/mL), systolic (n = 17, WMD = �10.14, 95 CI: �12.27, �8.01 mmHg), and diastolic (n = 16, WMD = �5.21, 95 CI: �7.0, �3.43 mmHg) blood pressures were decreased after PTX, whilst a significant increase was observed in BMI (n = 13, WMD = 0.35, 95 CI: 0.19, 0.51 kg/m2). Conclusions: PTX could improve glycemic parameters and blood pressure, without any significant change in serum lipoproteins and CRP. © 2020, Springer Science+Business Media, LLC, part of Springer Nature

The prevalence of clinical goiter and urinary iodine concentration in 8-12 years old students of Semirom in 2004 (15 years after execution of national program for eliminationof iodine deficiency disorders)

Background and purpose: With respect to the high prevalence of goiter in Semirom before the initiation of National Program for Elimination of Iodine Deficiency Disorders (NPEIDD), the impact of the program on the prevalence of goiter in 8-12 years old students of Semirom was investigated in this study, after 15 years of sucessful execution of NPEIDD.Materials and Methods: After excluding students with any clinical evidence of hyper- or hypo-thyroidism, 1817 students aged 8-12 years were recruited based on a cluster sampling method. The participants were examined for the presence of goiter by experiencd endocrinologists. Urinary iodine was measured in 182 examined students, too. Chi- Square statistical method was used to analyze the data.Results: Goiter was detected in 36.7% of the students (grade 1: 30.4%, grade 2: 6.3%). The median urinary iodine was 18.5 and mean was 19.37 ± 9.22 μg/dl in collected specimens.Conclusion: The adequacy of urinary iodine in students of Semirom confirms the success of NPEIDD, however, the higher than expected prevalence of goiter in the region suggests the probable role of other goitrogenous or autoimmune factors. Further studies should be performed to investigate the possible causes

Correlation between blood and saliva Glucose level

Background: Diabetic patients need to detect blood glucose level (BGL) foe diagnosis, treatment and flow up. Typically a blood sample for analysis is obtained via intravenous or a finger stick or other such invasive procedures. Often, this procedure cause physical and mental stress to the patient. Thus, it is desirable to use other biologic liquid such as saliva to detect the blood glucose level. The present study attempts to determine the correlation coefficient between blood glucose level and saliva glucose level (SGL) in healthy men.Materials and Methods: It was a cross sectional study. 130 blood and 130 saliva samples were gathered from 10 healthy men in 13 times during a five-day period. Each day samples were taken 3 times, fasting, post parricidal and evening. Samples were analyzed with glucose oxidase method.Results: Mean of fasting blood glucose level was 84.9±3.43 mg/dl (58-118 mg/dl). Mean of saliva glucose level was 1.22±0.81 mg/dl (0.32-4.94 mg/dl). Correlation coefficient between BGC and SGL from the 5 days of measurement was 0.23. Correlation coefficient for each day was 0.38 (First day), 0.29 (Second day), 0.01 (Third day) and 0.37 (Fourth day).Conclusion: Unfortunately with this correlation coefficient and limited range of SGL we can not use saliva to detect BGL