Subjective and psychological well-being in Parkinson's Disease: A systematic review.

OBJECTIVES: The aim of this review is to summarize studies investigating subjective and psychological well-being in patients with Parkinson's disease (PD). MATERIALS AND METHODS: A systematic and integrative review according to PRISMA criteria was performed with a literature search from inception up to September 2017 in multidisciplinary databases (PubMED, Scopus, Web of Knowledge) by combining together key words related to PD and well-being. Studies were included if: their full-text was available; they involved PD patients; focused on the selected positive dimensions; written in English. Case studies, conference proceedings, abstract, dissertations, book chapters, validation studies and reviews were excluded. Data extracted from the studies included sample characteristics, the positive dimension investigated, type of measure, study aims, design and results. One reviewer extracted details and commented results with other reviewers. The studies' quality was assessed following Kmet, Lee, and Cook. RESULTS: Out of 1425 studies extracted, 12 studies (9 quantitative, 2 qualitative, 1 mixed methods) involving 2204 patients with PD were included. Most of the studies had a cross-sectional design and/or evaluated the effect of physical rehabilitation on well-being. Articles documented that the illness could impair well-being for its progressive impact on patients' motor autonomy. Preserving motor and musculoskeletal functioning facilitate patients' experience of well-being, social contribution and the maintenance of their job. CONCLUSIONS: Research on positive resources in PD is still scarce compared to other chronic illnesses. The few available investigations suggest the need of preserving motor abilities by proper rehabilitation programs for maintaining and/or promoting patients' well-being and life engagement.

Glycolysis gene expression analysis and selective metabolic advantage in the clinical progression of colorectal cancer.

Production of lactate even in the presence of sufficient levels of oxygen (aerobic glycolysis) seems the prevalent energy metabolism pathway in cancer cells. The analysis of altered expression of effectors causing redirection of glucose metabolism would help to characterize this phenomenon with possible therapeutic implications. We analyzed mRNA expression of the key enzymes involved in aerobic glycolysis in normal mucosa (NM), primary tumor (PT) and liver metastasis (LM) of colorectal cancer (CRC) patients (pts) who underwent primary tumor surgery and liver metastasectomy. Tissues of 48 CRC pts were analyzed by RT-qPCR for mRNA expression of the following genes: hexokinase-1 (HK-1) and 2 (HK-2), embryonic pyruvate kinase (PKM-2), lactate dehydrogenase-A (LDH-A), glucose transporter-1 (GLUT-1), voltage-dependent anion-selective channel protein-1 (VDAC-1). Differences in the expression of the candidate genes between tissues and associations with clinical/pathologic features were studied. GLUT-1, LDH-A, HK-1, PKM-2 and VDAC-1 mRNA expression levels were significantly higher in PT/LM tissues compared with NM. There was a trend for higher expression of these genes in LM compared with PT tissues, but differences were statistically significant for LDH-A expression only. RAS mutation-positive disease was associated with high GLUT-1 mRNA expression levels only. Right-sided colon tumors showed significantly higher GLUT-1, PKM-2 and LDH-A mRNA expression levels. High glycolytic profile was significantly associated with poor prognosis in 20 metastatic, RAS-mutated pts treated with first-line chemotherapy plus Bevacizumab. Altered expression of effectors associated with upregulated glucose uptake and aerobic glycolysis occurs in CRC tissues. Additional analyses are warranted for addressing the role of these changes in anti-angiogenic resistance and for developing novel therapeutics.

Clinical impact of the HGF/MET pathway activation in patients with advanced gastric cancer treated with palliative chemotherapy.

In gastric cancer, available clinical studies focusing on the activated hepatocyte growth factor (HGF)/MET pathway are limited to surgical and often heterogeneous series. MET copy number gain (CNG) and an activating truncation in the HGF promoter (deoxyadenosine tract element, DATE+) were studied in tumors of 95 patients with advanced gastric cancer treated with palliative chemotherapy. Associations with overall survival (OS) and the pattern of metastatic disease were studied. Median OS was 9.7 months in 80 MET CNG <5 copies cases (MET-), and 6.4 months in 15 MET CNG was ⩾5 copies cases (MET+) (P=0.001). MET+ status confirmed the adverse prognostic effect in the multivariate model. A significantly different distribution of MET+/DATE+ and MET-/DATE- cases was observed between patients with and without peritoneal carcinomatosis (PC). MET+ status confirms its adverse prognostic role in advanced gastric cancer patients. The activated MET/HGF axis seems to be associated with PC. These findings are relevant to the development of anti-MET/HGF compounds.

Periduroscopy: general review of clinical features and development of operative models.

BACKGROUND: Myeloscopy is a useful approach for both diagnosis and treatment of back pain. However clinicians have underestimated its potential. From the nineties myeloscopy has been used only as a diagnostic tool, without any improvement of the technique. Racz's method is nowadays still used for the lysis of adherence by applying medical solutions without a direct vision inside the spinal channel. In 1998 we showed the limitations of Racz's approach, and in 1999 we developed a new technique, introducing a Fogarty balloon to remove the occlusions of the spinal canal and the resaflex for the lysis of adherence at low temperature (Raffaeli-Righetti technique). In this paper we report a general review of our experience with periduroscopy for the treatment of failed back surgery syndrome (FBSS) and spinal stenosis. METHOD: A Fogarty balloon was used to remove fat and/or mild fibrosis occluding the spinal canal, reducing by 50% the volume of the saline solution used in periduroscopy. The Resaflex was subsequently used to lyse adherence and to allow reaching the site of pain origin, using a low temperature (> 50°C). FINDINGS: the fibrosis morphologies of epidural space (ES) were grouped on the basis of common macroscopic and organizational characteristics, which were revealed during myeloscopy. A year after myeloscopy, 59% of FBSS patients, and 67% of patients with stenosis reported a general improvement of their painful pathology, with a pain reduction above 50 in 56% of patients. Forty-eight percent of patients used minor analgesics and 67% of patients went back to work. Only few complications were observed (4%). CONCLUSIONS: myeloscopy technique enlightens pain-triggering mechanisms otherwise unrevealed; it has specific therapeutic value, whereas on the diagnostic side it has not revealed relevant pathologies. Its effectiveness in FBSS patients is high, with the advantage of its relatively easy implementation, limited invasiveness and repeatability.

Thyroid incidentalomas. Prevalence by palpation and ultrasonography.

BACKGROUND: Thyroid nodules are commonly identified on autopsy examination. There are relatively few descriptions, however, of the frequency with which thyroid nodules are encountered incidentally during the course of other investigations. METHOD: Prospective study to examine the prevalence of thyroid nodules in asymptomatic North American subjects, with palpation findings compared with findings on high-resolution ultrasonography. RESULTS: Palpable nodules were identified in 21 (21%) of 100 subjects, with nine solitary nodules (9%) and 12 multiple nodules (12%). In comparison, only 33 subjects were found to be free of any nodules by ultrasonography. Of the 67 subjects with abnormal ultrasound findings, 22 had solitary nodules (22%) and 45 had multiple nodules (45%). The prevalence of nodules was greater in women (72%) than in men (41%) (P < .02). A concordance rate of 49% was noted between ultrasound and findings by palpation. CONCLUSIONS: The data indicate that thyroid abnormalities are very common incidental findings, emphasizing the need for a conservative approach when such lesions are encountered incidentally.

Detection of thymoma in myasthenia gravis.

Twenty patients with myasthenia gravis had chest radiography, conventional tomography, and computed tomography (CT) of the thorax within 1 month of thymectomy. Four of the six macroscopic tumors were detected on routine chest radiography; conventional tomography provided no additional information. CT detected all six macroscopic tumors and provided additional information that was not available by other procedures. However, 18 patients (90%) had anterior mediastinum densities on CT, which could not be distinguished preoperatively from thymic tumors. All six patients with macroscopic tumors had serum antistriational muscle antibody titers; this test was negative in 10 of 11 patients (91%) without thymoma. Chest radiography, CT of the thorax, and antistriational antibodies are the tests recommended for detection of a thymoma in patients with myasthenia gravis.

Chromosome findings in 2,500 second trimester amniocenteses.

We have analyzed the chromosome abnormalities found in 2,500 amniocenteses for prenatal diagnosis; 1,887 (75%) were performed because the maternal age was 34 years or more. Chromosome abnormalities were detected in 1.80% of those referred for advanced maternal age, 1.2% between ages 34 and 39 years and 4.6% 40 years and over. Of these, four occurred in women who would have been 34 years at delivery (2.9%). Trisomy 21 accounted for 50% of the chromosome abnormalities; sex chromosome abnormalities, for 25%; the remaining 25% was divided equally between trisomy 18 and partial trisomies and mosaics. Unexpected translocations were found in 0.4%, of which two-thirds were balanced and identified in one parent. The accuracy was 99.6%.

Follow-up of 2000 second-trimester amniocenteses.

The authors analyzed the outcome of 2000 consecutive second-trimester amniocenteses. Seventy-three percent were performed for maternal age of 34 years or more. The risk of spontaneous abortion before 28 weeks' gestation was 1.3% and for stillbirth or neonatal death, 1.4%. Total fetal loss was 2.7%, compared with 2.2% in a control population. Congenital malformations were found in 1.6% of the study group and in 1.9% of controls; no increase in skeletal problems was observed. Prematurity, defined as a birth weight of less than 2500 g, was noted in 3.6%, compared with 3.7% and 3.9% in 2 control populations. Respiratory difficulties persisting for more than 24 hours were observed in 0.8% of patients, compared with 0.7% of controls. Analyses of the outcome of amniocenteses performed at a single large center do not show an increase in perinatal complications or malformations.

[Transanal ultrasonography for diagnosis of obstetric anal sphincter trauma]. / Mozliwosci ultrasonografii przezodbytniczej w diagnostyce uszkodzen polozniczych zwieraczy odbytu.

Fecal incontinence affects up to 2% of the general population. The major cause of it is related to the birth trauma of the anal sphincters. In this paper the possibilities of transanal endosonography in the assessment of the anal canal muscles defects after deliveries were presented. Anal canal sonographic anatomy together with the technique of the examination with the use of rotating endoprobe were presented. Transanal rotating endoprobe was compared with exoanal probes for visualization of the anal canal. Ultrasonic images of internal and external anal sphincters defects were shown with specific patterns of defects allowing differentiation between morphological and neurological damages of the sphincters. Anal endosonography was compared with clinical examination, electromyography and manometry in the assessment of the integrity of the anal sphincters.

[Diagnostic possibilities of anal endosonography in proctology. Part 1]. / Mozliwosci diagnostyczne ultrasonografii przezodbytniczej w proktologii. Cz. 1.

On the basis of literature and own experience, the usefulness of endosonographic examination with the use of axial endoprobe was presented. The first part was devoted to the description of the endosonographic anatomy of normal rectum, examination technique and its usefulness in diagnosis of anal sphincters disorders. The endosonographic examinations have been performed in Poland for many years, mainly for prostate diagnostics with the use of multiplane transducers. We present a diagnostic possibilities of axial endoprobe of high frequency equipped with hard plastic cone and water balloon.

[Diagnostic possibilities of anal endosonography in proctology. Part II]. / Mozliwosci diagnostyczne ultrasonografii prezezodbytniczej w proktologii. Czesc II.

In the second part of the paper, we present advantages and drawbacks of transanal endosonography with the use of axial endoprobe in the diagnostics of perianal and perirectal abscesses and fistulas and also for tumours of the rectum. Typical images of the fistula nad abscess were shown. Ultrasonographic staging for the rectum malignancies was presented together with possibilities of assessment perirectal lymph nodes involvement by ultrasonography. Diagnosis of local recurrence by anal endosonography was presented and compared with other methods.

[Endosonography of the rectum and other imaging methods in the diagnosis of bowel inflammatory diseases]. / Endosonografia odbytnicy i inne badania obrazowe w rozpoznawaniu nieswoistych zapalnych chorób jelit.

This paper presents the usefulness of rectal endosonography in the diagnostics of the rectal wall and anorectal lesions in patients with inflammatory bowel diseases, mainly with Crohn's disease. Value of endosonography, computed tomography and magnetic resonance imaging were compared.

Rapid development and spontaneous regression of pancreatic pseudocysts documented by ultrasound.

Three cases of pancreatic pseudocyst were followed serially by ultrasound examination. The entity was found to be more dynamic than has been generally thought. The rapid development and spontaneous regression of pancreatic pseudocysts was documented. The timing of surgical intervention in these cases must be reevaluated.

Computed body tomography and gray scale ultrasonography: anatomic correlations and pitfalls in the upper abdomen.

From over 1,000 computed body tomographic and 10,000 gray scale ultrasonographic studies of the abdomen, a number of close anatomic relationships leading to the commonest pitfalls in diagnosis are reviewed. Scanning techniques developed to prevent interpretive errors are described.

Computed tomography and gray scale ultrasonography of the adrenal gland: a comparative study.

A prospective analysis of computed tomography and gray scale ultrasonography of the adrenal gland in 34 patients is presented. The diagnostic probabilities were similar for both modalities. Pitfalls common to both procedures and specific to one technique are demonstrated. The relative role of computed tomography and gray scale ultrasonography in evaluation of adrenal abnormalities is discussed in light of specific pathologies and other noninvasive imaging procedures.

The ultrasonic findings in intussusception of the blind loop in a jejunoileal bypass for obesity.

A 34 year old woman with bowel bypass surgery and persistent abdominal pain had intussusception of the blind loop, which was visualized on an abdominal ultrasound examination. The ultransonic and radiographic findings are compared and presented. Ultrasound should prove to be an invaluable tool in evaluating abdominal pain in bowel bypass patients.

Static grey-scale parathyroid ultrasonography: is high-resolution real-time technique required?

Ultrasound has been used with varying success to localise parathyroid adenomas pre-operatively. We have reviewed 61 patients with pre-operative contact-scanning grey-scale parathyroid ultrasonography and subsequent surgical exploration of all four parathyroid glands. Diagnostic accuracy was 91% considering glands examined and 63% considering patients examined. There was one false positive diagnosis. False negative diagnoses (17 adenomas and five ectopic mediastinal tumours) were mainly due to upper pole adenomas, adenomas less than 10 mm X 7 mm in size and ectopic mediastinal adenomas. Static grey-scale ultrasonography is adequate for the pre-operative localisation of parathyroid adenomas, especially when high-resolution technique is not available. In fact, the overall accuracy is comparable to the recently reported diagnostic accuracy rates with high-resolution real-time systems.

Reexamination of the deleterious effects of gastrointestinal contrast material on abdominal echography.

Diagnostic ultrasound examinations of the abdomen are usually performed prior to barium studies due to deleterious effects of gastrointestinal contrast material on abdominal echography, as demonstrated by Leopold. The authors repeat the classic in vitro study, extending the time of the experiment. As barium settles, ultrasound is able to penetrate barium filled masses. A clinical case of barium filled stomach secondary to gastric outlet obstruction is presented in support of the in vitro findings. Patients with persistent collections of barium of one or two days' duration may undergo abdominal ultrasonic examinations.