453 research outputs found

    Prevalence of parkinsonism and Parkinson's disease in Europe: the EUROPARKINSON collaborative study

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    Malaltia de Parkinson; Prevalència; Distribució per edatsEnfermedad de Parkinson; Prevalencia; Distribución de edadParkinson Disease; Prevalence; Age DistributionObjectives: To assess and compare the prevalence of parkinsonism and Parkinson's disease in five European populations that were surveyed with similar methodology and diagnostic criteria.Methods: Joint analysis of five community surveys--Gironde (France), eight centres in Italy, Rotterdam (The Netherlands), Girona (Spain), and Pamplona (Spain)--in which subjects were screened in person for parkinsonism. Overall, these surveys comprised 14,636 participants aged 65 years or older.Results: The overall prevalence (per 100 population), age adjusted to the 1991 European standard population, was 2.3 for parkinsonism and 1.6 for Parkinson's disease. The overall prevalence of parkinsonism for the age groups 65 to 69, 70 to 74, 75 to 79, 80 to 84, and 85 to 89 years was respectively, 0.9, 1.5, 3.7, 5.0, and 5.1. The corresponding age specific figures for Parkinson's disease were 0.6, 1.0, 2.7, 3.6, and 3.5. After adjusting for age and sex, the prevalence figures did not differ significantly across studies, except for the French study in which prevalence was lower. Prevalence was similar in men and women. Overall, 24% of the subjects with Parkinson's disease were newly detected through the surveys.Conclusions: Prevalence of both parkinsonism and Parkinson's disease increased with age, without significant differences between men and women. There was no convincing evidence for differences in prevalence across European countries. A substantial proportion of patients with Parkinson's disease went undetected in the general population

    African Bush Viper Envenomation: A Case Report

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    Atheris squamigera envenomation is an infrequently documented occurrence in the United States (US). Cases of envenomation may induce severe coagulopathies, renal failure, and potentially life-threatening hemorrhage. Currently, there are no antivenoms specific to the Atheris genus, but there have been documented cases of the use of antivenoms for other species. A 26-year-old man presented to the emergency department (ED) complaining of swelling and discomfort in his left foot after being bitten by an Atheris squamigera that he kept as a pet.After performing a physical exam, it was noted that the patient’s envenomation was likely mild. Throughout his hospital stay, he developed lab abnormalities, most notably an elevated D-dimer and low fibrinogen. His clinical symptoms improved after a short stay, and he did not require antivenom treatment. This case highlights a rare, but potentially life-threatening envenomation that may be encountered in the US due to the continued practice of exotic pet ownership and sales. Moreover, procurement of antivenom for non-native species poses a unique challenge to US physicians responsible for treating these patients

    A Proton Recoil Telescope for the characterisation of the neutron beam at n TOF

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    The neutron induced fission cross section of 235U is extensively used as a reference for neutron fluence measurements in various applications. At intermediate energies, the 235U(n,f) cross section plays an important role also for fundamental nuclear physics. Despite its widespread use, no data exist on neutroninduced fission of 235U above 200 MeV. Hence, there is a clear and long-standing demand from the International Atomic Energy Agency (IAEA) to complement the experimental database from 20 MeV to 1 GeV. For this purpose at the neutron facility n TOF at CERN the measurement of 235U(n,f) cross section was planned in October 2018, taking advantage of the intense neutron beam with a wide energy spectrum available in the experimental area. The cross section measurement will be performed relative to the elastic neutron-proton scattering, a very well known reaction generally accepted as primary reference. A prototype of the Proton Recoil Telescope detector, that will be used to measure the incident neutron flux, has been built and tested at n TOF in 2017

    Highly predictive genetic markers distinguish drug-type from fiber-type cannabis sativa L

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    Genetic markers can be used in seeds and in plants to distinguish drug-type from fiber-type Cannabis Sativa L. varieties even at early stages, including pre-germination when cannabinoids are not accumulated yet. With this aim, this paper reports sequencing results for tetrahydrocannabinolic acid synthase (THCAS) and cannabidiolic acid synthase (CBDAS) genes from 21 C. sativa L. varieties. Taking into account that THCAS- and CBDAS-derived enzymes compete for the same substrate, the novelty of this work relies in the identification of markers based on bothTHCASandCBDASrather than THCAS alone. Notably, in our panel, we achieved an adequate degree of discrimination (AUC 100%) between drug-type and fiber-type cannabis samples. Our sequencing approach allowed identifying multiple genetic markers (single-nucleotide polymorphisms\u2014SNPs\u2014and a deletion/insertion) that effectively discriminate between the two subgroups of cannabis, namely fiber type vs. drug type. We identified four functional SNPs that are likely to induce decreased THCAS activity in the fiber-type cannabis plants. We also report the finding on a deletion in the CBDAS gene sequence that produces a truncated protein, possibly resulting in loss of function of the enzyme in the drug-type varieties. Chemical analyses for the actual concentration of cannabinoids confirmed the identification of drug-type rather than fiber-type genotypes. Genetic markers permit an early identification process for forensic applications while simplifying the procedures related to detection of therapeutic or industrial hemp

    Metformin plus chemotherapy versus chemotherapy alone in the first-line treatment of HER2-negative metastatic breast cancer. The MYME randomized, phase 2 clinical trial

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    Purpose: To investigate the efficacy of metformin (M) plus chemotherapy versus chemotherapy alone in metastatic breast cancer (MBC). Methods: Non-diabetic women with HER2-negative MBC were randomized to receive non-pegylated liposomal doxorubicin (NPLD) 60 mg/m2 + cyclophosphamide (C) 600 mg/m2 × 8 cycles Q21 days plus M 2000 mg/day (arm A) versus NPLD/C (arm B). The primary endpoint was progression-free survival (PFS). Results: One-hundred-twenty-two patients were evaluable for PFS. At a median follow-up of 39.6 months (interquartile range [IQR] 24.6-50.7 months), 112 PFS events and 71 deaths have been registered. Median PFS was 9.4 months (95% CI 7.8-10.4) in arm A and 9.9 (95% CI 7.4-11.5) in arm B (P = 0.651). In patients with HOMA index < 2.5, median PFS was 10.4 months (95% CI 9.6-11.7) versus 8.5 (95% CI 5.8-9.7) in those with HOMA index ≥ 2.5 (P = 0.034). Grade 3/4 neutropenia was the most common toxicity, occurring in 54.4% of arm A patients and 72.3% of the arm B group (P = 0.019). M induced diarrhea (G2) was observed in 8.8% of patients in Arm A. The effect of M was similar in patients with HOMA index < 2.5 and ≥ 2.5, for PFS and OS. Conclusions: The MYME trial failed to provide evidence in support of an anticancer activity of M in combination with first line CT in MBC. A significantly shorter PFS was observed in insulin-resistant patients (HOMA ≥ 2.5). Noteworthy, M had a significant effect on CT induced severe neutropenia. Further development of M in combination with CT in the setting of MBC is not warranted

    Thermal neutron conversion by high purity 10B-enriched layers: PLD-growth, thickness-dependence and neutron-detection performances

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    Neutron applications and detection are of paramount importance in industry, medicine, scientific research, homeland security, production of extreme UV optics and so on. Neutron detection requires a converter element that, as a result of its interaction with neutrons, produces reaction products (mainly charged particles) whose detection can be correlated with the neutron flux. Reduced availability and increased cost of the most used converter element, 3He, have triggered research efforts for alternative materials, proper deposition methods and new detector architectures. 10B converter is a valid alternative to 3He thanks to its high thermal neutron cross section and relatively high Q value. In this paper we report on the room temperature Pulsed Laser Deposition (PLD) of high quality and uniform 10B films with the expected density, different thickness values (0.5, 1.0, 1.2, 1.5 and 2.0 μm) and uniform thickness over a circular area of about 30 mm in diameter. Additionally, they are adherent to the substrate with a negligible presence of contaminants. The conversion properties of such 10B coatings coupled to a Si solid state detector are studied upon exposure to a neutron flux from an Am-Be neutron source (2.2·106 n/s). The experimental results, compared with spectra simulated by using a GEANT4 code, present a good agreement and efficiencies of the order of a few percent

    The Toxicology Investigators Consortium 2020 Annual Report.

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    The Toxicology Investigators Consortium (ToxIC) Registry was established by the American College of Medical Toxicology in 2010. The registry collects data from participating sites with the agreement that all bedside and telehealth medical toxicology consultation will be entered. This eleventh annual report summarizes the Registry\u27s 2020 data and activity with its additional 6668 cases. Cases were identified for inclusion in this report by a query of the ToxIC database for any case entered from January 1 to December 31, 2020. Detailed data was collected from these cases and aggregated to provide information which included demographics, reason for medical toxicology evaluation, agent and agent class, clinical signs and symptoms, treatments and antidotes administered, mortality, and whether life support was withdrawn. Gender distribution included 50.6% cases in females, 48.4% in males, and 1.0% identifying as transgender. Non-opioid analgesics were the most commonly reported agent class, followed by opioid and antidepressant classes. Acetaminophen was once again the most common agent reported. There were 80 fatalities, comprising 1.2% of all registry cases. Major trends in demographics and exposure characteristics remained similar to past years\u27 reports. Sub-analyses were conducted to describe race and ethnicity demographics and exposures in the registry, telemedicine encounters, and cases related to the COVID-19 pandemic
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