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Marina di Pisa, Italy

Morgante L.,Messina University | Colosimo C.,University of Rome La Sapienza | Antonini A.,Parkinson Institute | Meco G.,University of Rome La Sapienza | And 14 more authors.
Journal of Neurology, Neurosurgery and Psychiatry | Year: 2012

Objective: To evaluate the prevalence of psychosis associated with Parkinson's disease (PSY-PD) in its early stages, its incidence over a 24 month follow-up period and the association with motor and non-motor clinical features. Methods: PRIAMO is a 2 year longitudinal observational study that has enrolled patients with parkinsonism in 55 Italian centres. A cohort of 495 patients with early disease stage PD (baseline Hoehn and Yahr score ≤2, disease's duration (median) 3.4 years) were followed for 2 years. PSY-PD was evaluated by means of a clinician rated questionnaire and defined as the presence of at least one of the following symptoms occurring for at least 1 month: illusions, hallucinations, jealousy ideas and persecutory ideas. Patients with and without PSY-PD were compared on several clinical variables, encompassing motor and non-motor features. Results: The prevalence of PSY-PD at baseline was 3%; the incidences at 12 and 24 months were 5.2% and 7.7%, respectively. Longer disease duration and prescription of dopamine agonists at baseline were associated with the development of PSY-PD over the 24 month period. At this follow-up time, worse disease severity, decline in cognitive performances, presence of depressive symptoms and anxiety were more frequently observed in PSY-PD. Conclusions: Psychotic type symptoms may occur in the early stages of PD although less frequently than in later stages. Beyond dopaminergic treatment, there are disease related factors, such as disease severity and the occurrence of cognitive and depressive symptoms, which may underlie the onset of psychotic type symptoms from the earliest stages.

Introduction. Traumatic brain injury is an important cause of morbidity, decease an costs. The adecuate atention gives best chance in surveillance and diminishes the secuels at short and long range. The use of scales in form of cuestionaries in an emergency room World be useful for the clasification and identification of patients that need inmediate treatment and could be egressed. Poblation. Pregraduated medicine students, rotatory doctors and speciality residents were evaluated in how well clasificate patients with traumatic brain injury. Material and method. With the Becker scale as a base, three sections were proponed: Glasgow coma scale, loss of conciousness and neurologic defect. Results. The great part of medical personal evaluated answerd well the cuestionaries. But there were differences between groups that depended on the medical experience. For that the proposed cuestionary is applicable only rests validate it.

Galletti F.,University of Perugia | Sarchielli P.,University of Perugia | Hamam M.,Neuroradiologia | Costa C.,University of Perugia | And 6 more authors.
Cephalalgia | Year: 2011

Background: Headache has been reported to be the first clinical presentation in several patients with cerebral arteriovenous malformations (AVMs). Headache associated with AVMs often shows characteristics of migraine with and without aura. Angiographic characteristics of AVMs, such as their location, could determine the 'migraine-like' features of attacks.Methods: We performed an observational study of the clinical and angiographic characteristics of a cohort of 40 consecutive patients with AVMs who had been admitted to our institute for endovascular embolization over a 4-year period. Headache was characterized according to ICHD-II criteria. The relationship between headaches and the angioarchitectural features of AVMs was also analysed.Results: Migraine-like headache was the first clinical manifestation in 22.5% of patients. The location of the malformation was significantly associated with migraine-like presentation (p = 0.03) and the occipital lobe was the predominant site.Conclusions: An occipital location may be linked with spreading depression, a pathogenic mechanism of migraine. Headache associated with arteriovenous malformations in the occipital lobe, although secondary in nature, could have clinical features similar to migraine. © International Headache Society 2011.

Introduction: In the last years have witnessed a growing interest on the topic of Quality of Life (QoL), however there are still few studies in hemato-oncology patients and are no studies on the influence of socio-demographic and clinical data in this type patients. Objectives: Evaluation of QoL of hemato-oncologyc patients and its relationship with socio-demographic and clinical factors. Methods: Application of QoL Questionnaire of the European Organization for Research and Treatment of Cancer version 3.0 (EORTC QLQ-C30) and the Social Class of Graffar questionnaire to 74 hemato-oncologyc patients, and collection of socio-demographic and clinical data. Results: Older age was associated with worse physical function (p±0.05). Married patients had less fatigue (p=0.017). Higher than required education was associated with better physical (p=0.02), social (p=0.028) and performance (p=0.044) functions. The upper social class had higher scores in physical function (p=0.004), the middle social class had higher emotional function (p=0.003) and higher financial impact (p=0.004), and the low social class higher pain (p=0.021). It appears that patients with Non-Hodgkin Lymphoma diagnostic have better social function (p=0.015) than the other pathologies, and patients with 1 or more recurrences have higher level of anorexia (p=0.012). Patients on chemotherapy have worse performance function (p=0.09), worse social function (p=0.025) and more constipation (p=0.03). Patients with higher number of cytotoxic treatments have higher levels of pain (p=0.023). Lower hemoglobin levels were associated with worse outcomes in functional scales. Discussion/Conclusion: Socio-demographic and clinical factors affect areas of QoL of hemato-oncology patients. These data highlight the need for knowledge and understanding of the impact of oncologic pathology in different aspects of QoL is an important step in developing strategies to improve the welfare of patients. © ArquiMed, 2010.

Cancela J.M.,University of Vigo | Ayan C.,University of Vigo | Do Nascimento C.,University of Sao Paulo | Seijo-Martinez M.,Neurologia
Revista de Neurologia | Year: 2013

Aim. To determine the effects of an aquatic-based physical exercise program on gait parameters of patients with Parkinson'S disease (PD). Patients and methods. A total of nine patients diagnosed with idiopathic PD (stages I-III according to the Hoehn & Yahr scale) carried out an aquatic physical exercise program which lasted for five months, with one session per week. A three-dimensional biomechanical analysis was used to determine the effects of the program on several kinematic variables (walking speed, cadence, stride length, step time, single and double support time, angles of the hip, knee and ankle joints) which were assessed by a treadmill-walking test. Results. At the end of the program, significant improvement in walking speed, stride length and on the relationship between single and double support time (p < 0,05). Although improvements in all tested ranges of motion were obtained, these did not reach statistical significance. Conclusions. Aquatic-based physical exercise seems to have positive effects in some aspects of the gait kinematics parameters present in the typical gait pattern of patients with PD. ©2013 Revista de Neurología.

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