Pisa Syndrome in Parkinson's Disease Is Associated With Specific Cognitive Alterations

Background: Pisa syndrome (PS) is a lateral flexion of the trunk frequently associated with Parkinson's disease (PD). The pathophysiology of PS remains unclear, but the role of cognitive deficits has been postulated.Methods: We included 12 consecutive PD patients with PS (PS+) and 12 PD patients without PS (PS–) matched for gender, age, level of education, PD duration, and PD stage. As primary aim, we compared the neuropsychological scores of 16 tests evaluating 6 cognitive domains between PS+ and PS–. Additionally, we evaluated the presence of misperception of the trunk position in PS+, defined as a mismatch between the objective vs. subjective evaluation of the trunk bending angle >5°, and analyzed whether a correlation exists between the misperception of the trunk position and alterations in the visual-spatial abilities.Results: PS+ group showed significantly worse performances in the visual-spatial abilities (p: 0.008), attentional domain (p: 0.001), and language domain (p: 0.023). No differences were found in the other cognitive domains nor in the general cognitive assessment. All PS+ patients showed a misperception of the trunk position, with an average underestimation of the trunk bending angle of 11.7° ± 4.3. The degree of misperception of the trunk position showed a trend toward a correlation with the visual-spatial scores (p: 0.089).Conclusions: The study reveals an association between PS and specific cognitive alterations, suggesting a possible link between the abnormal posture of PD patients with PS and their cognitive functions

Beyond 10 years of levodopa intestinal infusion experience: Analysis of mortality and its predictors

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Variation in seed mineral elements profile and yield in field bean (Vicia faba L. var. minor) genotypes

Field bean (Vicia faba L. var. minor) is one of the major leguminous crops cultivated in the world and mainly destined for animal feed. Although its seed is generally recognised as a good protein source, little is known about its mineral elements profile, which is an important aspect for a balanced animal diet. Therefore, the aim of the present work was to assess the seed mineral elements composition, along with some key production parameters, in eight field bean genotypes grown in a Mediterranean environment, without intensive management, over two years (2009/10 and 2010/11). Independently of the year, the seed of Chiaro di Torre Lama was the richest in phosphorus (P), magnesium, calcium and iron contents, while that of Sint 6 and Motta Chiaro 69 were the most effective accumulators of potassium and zinc, respectively. While all the genotypes yielded better in the second year (with more rainfall), the seasonal effect on seed mineral elements composition depended on the genotype. Indeed, the P content was 46% lower in Chiaro di Torre Lama, Motta Chiaro 69 and Sint 6 in the second year, while there was only a negligible seasonal effect for Sint 8 with respect to Fe content. Overall, this crop is reasonably productive under a low management regime and its seed can supply significant amounts of certain minerals (particularly P) in feed formulations. Both aspects are important in a perspective of optimising field bean production in the Mediterranean area and, hence, improving farmers’ income

Mammographic density: Comparison of visual assessment with fully automatic calculation on a multivendor dataset

To compare breast density (BD) assessment provided by an automated BD evaluator (ABDE) with that provided by a panel of experienced breast radiologists, on a multivendor dataset. Methods Twenty-one radiologists assessed 613 screening/ diagnostic digital mammograms from nine centers and six different vendors, using the BI-RADS a, b, c, and d density classification. The same mammograms were also evaluated by an ABDE providing the ratio between fibroglandular and total breast area on a continuous scale and, automatically, the BI-RADS score. A panel majority report (PMR) was used as reference standard. Agreement (κ) and accuracy (proportion of cases correctly classified) were calculated for binary (BI-RADS a-b versus c-d) and 4-class classification. Results While the agreement of individual radiologists with the PMR ranged from κ=0.483 to κ=0.885, the ABDE correctly classified 563/613 mammograms (92 %). A substantial agreement for binary classification was found for individual reader pairs (κ=0.620, standard deviation [SD]=0.140), individual versus PMR (κ=0.736, SD=0.117), and individual versus ABDE (κ=0.674, SD=0.095). Agreement between ABDE and PMR was almost perfect (κ=0.831). Conclusions The ABDE showed an almost perfect agreement with a 21-radiologist panel in binary BD classification on a multivendor dataset, earning a chance as a reproducible alternative to visual evaluation