ABSTRACT
INTRODUCTION: Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) is one of the strongest prodromal markers of alpha-synucleinopathies. We aimed to investigate non-invasive clinical and quantitative predictors of phenoconversion from iRBD to parkinsonism. PATIENTS AND METHODS: We prospectively followed-up a total of 45 patients (57.8% men) for eight years. Clinical assessments, Sniffin' Sticks Odor Identification Test, Farnsworth-Munsell 100 Hue Color Vision test, Beck Depression Inventory and Rome III Criteria for constipation were performed. Polysomnographic parameters, sleep spindles, electroencephalographic (EEG) spectral analysis, heart rate variability (HRV) were analyzed. RESULTS: Eight patients (17.8%) showed phenoconversion to parkinsonism after a mean duration of 3.2 ± 1 years. Odds ratio for predicting phenoconversion was highest for patients =60 years of age with anosmia and constipation -44.8 (4.5-445.7); kappa = 4.291-. Duration, frequency or density of sleep spindles failed to demonstrate significant correlations. In EEG spectral analysis, lower alpha power in occipital region during wakefulness and REM sleep was significantly correlated with phenoconversion. Slowing in EEG spectrum power, together with age =60 years, anosmia and constipation, resulted in the highest odds ratio -122.5 (9.7-1543.8); kappa = 3.051-. CONCLUSIONS: It is of great importance to have a world-wide perspective of phenoconversion rates from iRBD to overt neurodegeneration, since racial and geographical factors may play important modifying roles. Relatively younger age and shorter disease duration may also be confounding factors for lower rate in our study. Neurophysiological biomarkers seem to be important predictors of phenoconversion, though more research is needed to establish subtypes of iRBD with different probabilities of evolution to overt synucleinopathy.
TITLE: Estratificación del riesgo de fenoconversión al parkinsonismo en pacientes con trastorno de conducta del sueño REM aislado. Estudio de seguimiento en un centro de Turquía.Introducción. El trastorno aislado de la conducta del sueño con movimientos oculares rápidos (iRBD) es uno de los marcadores prodrómicos más potentes de las alfa-sinucleinopatías. Nuestro objetivo fue investigar los predictores clínicos y cuantitativos no invasivos de la fenoconversión de iRBD a parkinsonismo. Pacientes y métodos. Se siguió prospectivamente a un total de 45 pacientes (57,8% hombres) durante ocho años del período de estudio. Se realizaron evaluaciones clínicas, la prueba de identificación de olores Sniffin' Sticks, la prueba Farnsworth-Munsell 100 Hue Color Vision, el inventario de depresión de Beck y los criterios de Roma III para el estreñimiento. Se analizaron parámetros polisomnográficos, husos del sueño, análisis espectral electroencefalográfico (EEG) y variabilidad de la frecuencia cardíaca. Resultados. Ocho pacientes (17,8%) mostraron fenoconversión a parkinsonismo después de una duración media de seguimiento de 3,2 ± 1 año. La odds ratio para predecir la fenoconversión fue más alta para los pacientes =60 años con anosmia y estreñimiento 44,8 (4,5-445,7); kappa = 4,291. La disminución de la potencia del espectro EEG, junto con la edad =60 años, la anosmia y el estreñimiento, dio como resultado el índice de odds más alto 122,5 (9,7-1543,8); kappa = 3,051. Conclusiones. Es de gran importancia tener una perspectiva mundial de las tasas de fenoconversión de iRBD a neurodegeneración manifiesta, ya que los factores raciales y geográficos pueden desempeñar importantes papeles modificadores. Los biomarcadores neurofisiológicos parecen ser predictores importantes de la fenoconversión, aunque se necesita más investigación para establecer subtipos de iRBD con diferentes probabilidades de evolución hacia una sinucleinopatía manifiesta.
Subject(s)
Parkinsonian Disorders , REM Sleep Behavior Disorder , Male , Humans , Middle Aged , Female , REM Sleep Behavior Disorder/diagnosis , Follow-Up Studies , Turkey , Anosmia , Constipation , Risk AssessmentABSTRACT
Ovarian cancer is the third most common female cancer, with poor survival in later stages of metastatic spread. We test a chimeric virus consisting of genes from Lassa and vesicular stomatitis viruses, LASV-VSV; the native VSV glycoprotein is replaced by the Lassa glycoprotein, greatly reducing neurotropism. Human ovarian cancer cells in immunocompromised nude mice were lethal in controls. Chemotherapeutic paclitaxel and cisplatin showed modest cancer inhibition and survival extension. In contrast, a single intraperitoneal injection of LASV-VSV selectively infected and killed ovarian cancer cells, generating long-term survival. Mice with human ovarian cancer cells in brain showed rapid deterioration; LASV-VSV microinjection into brain blocked cancer growth, and generated long-term survival. Treatment of immunocompetent mice with infected mouse ovarian cancer cells blocked growth of non-infected ovarian cancer cells peritoneally and in brain. These results suggest LASV-VSV is a viable candidate for further study and may be of use in the treatment of ovarian cancer.
Subject(s)
Lassa virus/immunology , Oncolytic Virotherapy/methods , Ovarian Neoplasms/therapy , Vesiculovirus/immunology , Animals , Cell Line, Tumor , Female , Humans , Mice , Mice, NudeABSTRACT
Following the declaration by the World Health Organization (WHO) of human cases of infection with a new influenza A(H1N1)v virus of swine origin, the Turkish Ministry of Health launched a case-based reporting of influenza A(H1N1)v throughout the country on 27 April 2009. The index case was detected on 15 May 2009. As of 17 July 2009 the number of laboratory-confirmed cases of influenza A(H1N1)v totaled 128 of whom 38 were indigenous cases.
Subject(s)
Influenza A Virus, H1N1 Subtype , Influenza, Human/epidemiology , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Influenza A Virus, H1N1 Subtype/pathogenicity , Influenza, Human/diagnosis , Influenza, Human/physiopathology , Male , Middle Aged , Population Surveillance/methods , Reverse Transcriptase Polymerase Chain Reaction , Travel , Turkey/epidemiology , Young AdultABSTRACT
AIM: It has been previously shown that pulmonary function (PF) is significantly diminished in patients with osteoporosis (OP). But there are few data about the relationship between PF and aerobic capacity of osteoporotic patients and the severity of thoracic kyphosis and time since the diagnosis of OP. The aim of the present study was to investigate the resting spirometric values and cardiopulmonary test (CPET) results of women with osteoporosis and to evaluate the effects of the various degrees of OP on these parameters. METHODS: Fifty six outpatient subjects were included in the study. All patients underwent a standardized interview, physical examination, bone mineral density (BMD), anteroposterior and lateral x-rays of thoracic spine, resting PF test and CPET evaluation. To evaluate the effects of the severity of osteoporosis on these parameters patient group divided according to diagnosis time of OP, degree of kyphosis, and spinal deformity index. Demographic and clinical data were compared between the groups with the use of independent-sample t test analysis (two groups) and analysis of variance (ANOVA) was used to estimate the between-group differences and changes by severity of osteoporosis and regression analyses to find predictors for changes. Correlation coefficients were used to examine the relationship between variables. RESULTS: According to diagnosis time, newly diagnosed groups; according to degree of kyphosis, the kyphotic groups; according to spinal deformity index, the higher spinal deformity index groups showed statistically significant and declining results in PF tests and CPET parameters. CONCLUSION: This study pointed out a significant impaired PF, aerobic capacity and a serious deconditioning for various reasons in these OP patients Therefore, the evaluation of CPET should be included in the management of OP patients and in these patients ventilatory muscle training and aerobic exercises may offer a potential therapeutic adjunct to current OP therapies in the future.
