Miracle-dz/UniFAR-FTUs huggingface dataset:
A comparative study of physical performance measures in Parkinson's disease

The objective of this study is to compare physical performance measures for their ability to discriminate between levels of disability and disease severity in Parkinson's disease (PD). Disability in PD is commonly assessed by patient self‐report, which may be limited by patient insight. Methods: Seventy‐nine patients with PD were tested with seven performance measures: Physical Performance Test (PPT), modified Physical Performance Test (mPPT), Short Physical Performance Battery (SPPB), Performance Test of Activities of Daily Living (PADL), Berg Balance Scale (BBS), Timed Up and Go (TUG), and Functional Reach (FR). These measures were compared with patient‐reported disability on the Older Americans Resource and Services Disability subscale (OARS) and disease severity on the Unified Parkinson's Disease Rating Scale (UPDRS). The performance measures were more sensitive to levels of disease severity than disability. Four measures discriminated across quartiles of disability (PPT, mPPT, BBS, TUG: P < 0.05), whereas all seven measures discriminated across quartiles of the Total UPDRS (PPT, mPPT, BBS, TUG, FR: P < 0.01; SPPB, PADL: P < 0.05). However, no measure consistently discriminated between subgroups with a range of early and advanced disease severity. The seven physical performance measures showed different profiles of strengths and weaknesses in assessing disability and disease severity. The results of this study will facilitate choosing performance measures for clinical care and clinical trials in PD. © 2008 Movement Disorder Society
Association of regional cerebral oxygen saturation and postoperative pulmonary complications in pediatric patients undergoing one-lung ventilation: A propensity score matched analysis of a prospective cohort study

Background Previous studies of the relationship of regional cerebral oxygen saturation (rScO2) and postoperative pulmonary complications (PPCs) in pediatric patients are not well established, and further investigation is warranted. The aim of this prospective study was to determine whether a decrease in intraoperative rScO2 is associated with PPCs in children undergoing thoracoscopic surgery requiring one-lung ventilation (OLV). Methods One hundred and six children of ages 3 months to 8 years who received one-lung ventilation were enrolled in the study. Upon entering the operating room, regional cerebral oxygen saturation was continuously monitored bilaterally by near-infrared spectroscopy. Patients were divided into low rScO2 (L-rScO2) or high rScO2 (H- rScO2) groups according to whether the lowest intraoperative rScO2 value was 15% lower than the baseline value. Outcome is defined as PPCs occurring within 7 days after surgery. Results After propensity score matching, 23 pediatric patients with decreased rScO2 and 46 pediatric patients without a decrease in rScO2 were included in this study. According to logistic regression analysis, patients in the H- rScO2 group were less likely to have PPCs than those in the L-rScO2 group (OR = 3.16; 95% CI = 1.05–9.5; P = 0.04). Moreover, intraoperative rScO2 reduction was associated with an increase in the severity of PPCs (OR = 3.90; 95% CI = 1.19–12.80; P = 0.025). Conclusions The decrease in regional cerebral oxygen saturation during surgery increases the likelihood of postoperative pulmonary complications.
Repetitive transcranial magnetic stimulation for levodopa‐induced dyskinesias in Parkinson's disease

In a placebo‐controlled, single‐blinded, crossover study, we assessed the effect of “real” repetitive transcranial magnetic stimulation (rTMS) versus “sham” rTMS (placebo) on peak dose dyskinesias in patients with Parkinson's disease (PD). Ten patients with PD and prominent dyskinesias had rTMS (1,800 pulses; 1 Hz rate) delivered over the motor cortex for 4 consecutive days twice, once real stimuli and once sham stimulation were used; evaluations were done at the baseline and 1 day after the end of each of the treatment series. Direct comparison between sham and real rTMS effects showed no significant difference in clinician‐assessed dyskinesia severity. However, comparison with the baseline showed small but significant reduction in dyskinesia severity following real rTMS but not placebo. The major effect was on dystonia subscore. Similarly, in patient diaries, although both treatments caused reduction in subjective dyskinesia scores during the days of intervention, the effect was sustained for 3 days after the intervention for the real rTMS only. Following rTMS, no side effects and no adverse effects on motor function and PD symptoms were noted. The results suggest the existence of residual beneficial clinical aftereffects of consecutive daily applications of low‐frequency rTMS on dyskinesias in PD. The effects may be further exploited for potential therapeutic uses. © 2008 Movement Disorder Society
Otomastoiditis caused by non-tuberculous mycobacteria: report of 16 cases, 3 with infection intracranially.

OBJECTIVE To analyse the clinical presentation, treatment and outcome in patients diagnosed with otomastoiditis caused by non-tuberculous mycobacteria. METHODS A retrospective case review of 16 patients diagnosed with otomastoiditis caused by non-tuberculous mycobacteria from 2000 to 2012 was conducted in a hospital and tertiary referral centre in Sweden. The main outcome measures were microbiology findings, and surgical and medical interventions and outcomes. In addition, the relevant literature was reviewed. RESULTS In three patients with otomastoiditis, the disease had spread intracranially. The bacteriological findings revealed Mycobacterium abscessus (n = 12), Mycobacterium fortuitum (n = 2) and Mycobacterium avium complex (n = 2). Surgical treatment was undertaken in all but three patients, including exploration of the temporal lobe in one patient. Systemic antibiotic treatment was given to all but one patient. Eight patients healed completely. Eight patients developed hearing loss. Two patients had relapse of the mycobacterial infection several months after the antibiotic treatment had been discontinued. CONCLUSION Non-tuberculous otomastoiditis is a severe ear disease with challenging considerations, and should be treated aggressively in order to avoid morbidity.
Clinically deployable Kinesia™ technology for automated tremor assessment

The objective was to design, build, and assess Kinesia™, a wireless system for automated assessment of Parkinson's disease (PD) tremor. The current standard in evaluating PD is the Unified Parkinson's Disease Rating Scale (UPDRS), a qualitative ranking system typically completed during an office visit. Kinesia integrates accelerometers and gyroscopes in a compact patient‐worn unit to capture kinematic movement disorder features. Objectively quantifying PD manifestations with increased time resolution should aid in evaluating efficacy of treatment protocols and improve patient management. In this study, PD subjects performed the tremor subset of the UPDRS motor section while wearing Kinesia. Quantitative kinematic features were processed and highly correlated to clinician scores for rest tremor (r2 = 0.89), postural tremor (r2 = 0.90), and kinetic tremor (r2 = 0.69). The quantitative features were used to develop a mathematical model that predicted tremor severity scores for new data with low errors. Finally, PD subjects indicated high clinical acceptance. © 2009 Movement Disorder Society
Development of natural tolerance and induced desensitization in cow’s milk allergy

Cow’s milk allergy (CMA) affects 2–3% of infants. It resolves in the great majority spontaneously during childhood. CMA encompasses a spectrum of clinical and immunologic characteristics. Non‐IgE‐mediated allergy typically resolves earlier than IgE‐mediated allergy. The most documented prognostic characteristic is that intense‐specific IgE response predicts persistence of CMA. Low serum levels of cow’s milk (CM)‐specific IgG4 are also associated with persistent CMA. Natural development of tolerance involves an immunologic shift where Th2 responses diminish, and Th1 as well as T regulatory cell responses strengthen. Accordingly, specific IgE levels decrease and specific IgG4, possibly also IgA, levels increase in serum. Specific oral immunotherapy (OIT) with CM induces desensitization in most cases where spontaneous recovery has not yet occurred. Data on long‐term tolerance induction are still scarce. According to current research data, the immunologic changes induced by OIT resemble those seen during natural development of tolerance.
Clinical and physiological assessments for elucidating falls risk in Parkinson's disease

The study aims were to devise (1) a fall risk screen for people with PD using routine clinical measures and (2) an explanatory (physiological) fall risk assessment for guiding fall prevention interventions. One hundred thirteen people with PD (age 66 ± 95% CI 1.6 years) underwent clinical assessments and quantitative tests of sway, gait, strength, reaction time, and lower limb sensation. Participants were then followed up for 12 months to determine fall incidence. In the follow‐up year, 51 participants (45%) fell one or more times whereas 62 participants (55%) did not fall. Multivariate analyses of routine clinical measures revealed that a fall in the past year, abnormal axial posture, cognitive impairment, and freezing of gait were independent risk factors for falls and predicted 38/51 fallers (75%) and 45/62 non‐fallers (73%). A multivariate model combining clinical and physiological measures that elucidate the pathophysiology of falls identified abnormal posture, freezing of gait, frontal impairment, poor leaning balance, and leg weakness as independent risk factors. This model correctly classified 39/51 fallers (77%) and 51/62 non‐fallers (82%). Patients with PD at risk of falls can be identified accurately with routine clinical assessments and quantitative physiological tests. Many of the risk factors identified are amenable to targeted intervention. © 2009 Movement Disorder Society
Measurement of free Ca2+ concentration in the lumen of neuronal endoplasmic reticulum.

Cold Spring Harb Protoc; Natasha Solovyova and Alexei Verkhratsky Reticulum Concentration in the Lumen of Neuronal Endoplasmic 2+ Measurement of Free Ca Service Email Alerting click here. Receive free email alerts when new articles cite this article Categories Subject Cold Spring Harbor Protocols. Browse articles on similar topics from (72 articles) Visualization of Organelles (463 articles) Visualization (164 articles) Video Imaging / Time Lapse Imaging (37 articles) Patch Clamping (245 articles) Neuroscience, general (48 articles) Neural Cell Culture (300 articles) Labeling for Imaging (538 articles) Imaging/Microscopy, general (269 articles) Imaging for Neuroscience (274 articles) Fluorescence, general (405 articles) Fluorescence (462 articles) Cell Imaging (242 articles) Cell Culture (1037 articles) Cell Biology, general (79 articles) Calcium Imaging
A visitor's view of Madison's Program for Assertive Community Treatment (PACT)

Before commencing work on the Daily Living Pro gramme at the Maudsley Hospital, in London, to compare the benefits of community care with stan dard hospital admission for patients with serious mental illness, a visit to Madison was arranged, where some ten years ago a similar study had been carried out (Stein & Test, 1980). We had the im pression from the substantial literature which has appeared on the mental health service in Madison (Stein & Test, 1985) that they have implemented in practice their positive research findings on com munity care. It was felt that their lengthy experience with such a service could be beneficial to the UK, where such services are now being developed. This visit included PACT (Program for Assertive Community Treatment); a research programme in vestigating the long-term prognosis of mainly schizo phrenic patients, and the various units of the mental health services in Madison. Madison, the state capital of Wisconsin, has a population of some 175,000 persons, which is increased during term periods by some 50,000 stu dents attending its much acclaimed university. Madison is situated in Dane County, one of 72 coun ties making up the state of Wisconsin. The mental health services have a county catchment area. Laws and guidelines pertaining to mental health are di rected from the Wisconsin State Department of Health and Social Services. Public funds for mental health are provided by the state to the county. PACT is a state supported research project which has been taking responsibility for the long-term care of its patients since 1979. Entry criteria to the PACT programme are: age 18-30, a diagnosis of schizo phrenia, schizo-affective disorder, or schizotypal personality disorder, and less than 12 months of accumulated time in psychiatric and penal insti tutions. Patients are then randomly assigned either to the research programme or to the standard mental health services in Madison. These services are them selves quite community based, and this might well be a confounding factor in the eventual analysis. Evalu ation is regularly undertaken by a research team, looking at clinical, social, and economic factors. PACT is a multi-disciplinary team with a staffpatient ratio of 1:10. The PACT centre is staffed seven days a week and a telephone on-call system is in operation at night, with home visits being made at night, if necessary. The approach is rehabilitation, with an emphasis on work and skills teaching. This seems influenced by the vocational counsellors, whose ethos is that work and regular, structured daily activities are as therapeutically important (if not more so) as symptom control and medication. About 40% of all clients are employed in the competitive job market. In all, 90% are regularly employed in some way. Most jobs have been obtained with the help of staff; indeed an appar ently successful job creation approach is to take employers' numbers from the Yellow Pages and cite
Prevalence of anxiety disorders and anxiety subtypes in patients with Parkinson's disease

Anxiety disorders are common in Parkinson's disease (PD), but are not well characterized. This study determined the prevalence and clinical correlates of all DSM‐IV‐TR anxiety disorder diagnoses in a sample of 127 subjects with idiopathic PD who underwent comprehensive assessments administered by a psychiatrist and neurologist. A panel of six psychiatrists with expertise in geriatric psychiatry and/or movement disorders established by consensus all psychiatric diagnoses. Current and lifetime prevalence of at least one anxiety disorder diagnosis was 43% (n = 55) and 49% (n = 63), respectively. Anxiety disorder not otherwise specified, a DSM diagnosis used for anxiety disturbances not meeting criteria for defined subtypes, was the most common diagnosis (30% lifetime prevalence, n = 38). Compared with nonanxious subjects, panic disorder (n = 13) was associated with earlier age of PD onset [50.3 (12.2) vs. 61.0 (13.7) years, P < 0.01], higher rates of motor fluctuations [77% (10/13) vs. 39% (25/64), P = 0.01] and morning dystonia [38% (5/13) vs. 13% (8/62), P < 0.03]. This high prevalence of anxiety disorders, including disturbances often not meeting conventional diagnostic criteria, suggests that anxiety in PD is likely underdiagnosed and undertreated and refined characterization of anxiety disorders in PD is needed. In addition, certain anxiety subtypes may be clinically useful markers associated with disease impact in PD. © 2009 Movement Disorder Society
Ropivacaine Neurotoxicity: A Stab in the Back?

To the Editor:—In a provocative case report, Ganapathy et al. characterize immediate-onset localized low back pain with the transient neurologic symptom label—attributing that hallmark of putative local anesthetic neurotoxicity to the intrathecal administration of ropivacaine (Naropin; AstraZeneca, Mississauga, Ontario, Canada). I beg to differ. Transient radiating radicular pain developed in the patient but did not become symptomatic until 3 days after ropivacaine injection, in the midst of an episode of severe postpuncture headache. The antecedent events in this case differ both temporally and qualitatively from the clinical transient radicular irritation triad of Schneider et al.: radiating lumbosacral radicular pain at first appearing within hours after full sensory recovery, transient duration of the radicular pain lasting from hours to days, and a vexing absence of localizing “hard” neurologic signs. Conversely, in the case presented by Ganapathy et al., nonradiating lower back pain manifested almost instantly, persisted despite dense sensory blockade to T4, and remained little changed during recovery of normal sensation. It has been said that delayed onset and brief duration of classic transient radicular irritation are hallmarks of a mild neural (probably cauda equina) inflammatory reaction to irritant local anesthetic drug—comparable in quality and time course to a first-degree sunburn. Crucial to differentiating this particular case from purely symptomatic transient radicular irritation are four distinctly hard neurologic findings: (1) numbness of the soles of both feet (whereas surgery was unilateral); (2) 3 weeks’ persistence of this troubling sign of neuraxial injury; (3) mild locomotor ataxia; and (4) asymmetry of ankle reflexes. This case report lacks compelling evidence of ropivacaine neurotoxicity. Rather, immediate onset of nonsegmental central pain, persistence of this pain despite complete radicular sensory blockade, and subtle but persistent neurologic abnormalities all indicate a mechanical rather than a pharmacologic neuraxial event—perhaps needle-contact surface trauma to the posterior columns. Trauma to the spinal cord proper is a more plausible consideration because only a centrally located generator could send pain impulses cephalad during spinal anesthesia; impulse traffic originating from spinal rootlets or other sites distal to the cord would have been halted by the neural blockade. Currently, there is no evidence for ropivacaine being a more aggressive myelotoxic local anesthetic than its benign pharmacologic cousins bupivacaine or mepivacaine. In brief, the clinical scenario presented by Ganapathy et al. is consistent more with mechanical (needle) trauma to the spinal cord surface than with chemical (neurotoxic) irritation of cauda equina rootlets.
Effect of cervical dystonia on employment: A retrospective analysis of the ability of treatment to restore premorbid employment status

Using a structured interview method, we sought to address the following questions regarding cervical dystonia (CD) and employment: (1) what is the frequency and severity of job impairment in CD; (2) what are the clinical features that contribute to job impairment; (3) how does the effectiveness of botulinum toxin (BTx) compare to oral medications in restoring employment status. In our population of 155 CD patients, employment was affected by CD in 53.3% (31.2% reduced hours or responsibilities, 3.3% changed to different job, 18.9% loss of employment) and 68.9% of patients reported reduced overall productivity. The likelihood of altered employment (P < 0.0006), reduced productivity (P < 0.0001), and seeking disability benefits (P < 0.003) was significantly associated with the presence of neck pain, but not type of employment, spasmodic head motions, or duration of CD symptoms before treatment with BTx. Treatment with BTx was more likely to improve employment status than oral medications (66.1 vs. 18.5%) and much more likely to restore full employment with normal productivity (12.9 vs. 0.0%). These findings suggest that employment status is frequently affected by CD, particularly in patients withneck pain. BTx is significantly more effective than oral medications in restoring premorbid employment status. © 2009 Movement Disorder Society
The efficacy of submucosal corticosteroid injection and dilatation in subglottic stenosis of different aetiology

Abstract Objective: To determine the long-term efficacy of submucosal corticosteroid injection plus dilatation for subglottic stenosis as a single modality treatment in granulomatosis with polyangiitis and relapsing polychondritis, as compared with idiopathic subglottic stenosis and traumatic subglottic stenosis. Method: Patients who underwent dilatation for autoimmune causes were identified. Corticosteroid injection into the submucosa of a stenotic segment was followed by serial dilatation. Definitive improvement was defined as good airway patency for more than 24 months with no further procedures needed. Clinical, demographic and procedural data were recorded. Results: Patients (n = 45) were divided into three subglottic stenosis groups: traumatic (n = 24), idiopathic (n = 9) and autoimmune (n = 12). Patients were treated with dilatations, with a median follow-up time of 76 months. Six patients were tracheostomy-dependent. There were no statistical differences in the number of final improvements between autoimmune, idiopathic and traumatic groups, with values of 75, 56 and 71 per cent, respectively. There was no statistical difference between granulomatosis with polyangiitis plus relapsing polychondritis and idiopathic subglottic stenosis in terms of decannulation rates. Conclusion: Granulomatosis with polyangiitis and relapsing polychondritis patients have better improvement rates than patients with other subglottic stenosis types.
Social work with children and families: Towards a radical/critical practice

Social work continues to be experiencing changes in its organisation and day-to-day practices. Notions of assessment, monitoring, evaluation and inter-agency coordination are to the fore rather than social work practice itself. In addition, we have seen the rise and now domination of managerialism. All this coincides with ideological changes over the last 35 years leading to the gradual demise of the welfare state. From a radical/critical perspective these are dispiriting developments and scope for radical/critical social work practice, though always limited, has been further reduced. Despite this, I argue that the possibilities for a radical/critical practice still remain.