ABSTRACT
The current diagnosis of Parkinson's disease (PD) is based on a subjective assessment by the specialist. The monitoring of the tremor that presents in the hand index fingers in a patient with Parkinson's is one of the most important parameters to diagnose the evolution of the disease in an objective manner. This research analyze the tremor in the hand index fingers of patients with PD with medication and without medication. A sensor based in a triaxial accelerometer was used to acquire the data produced by the acceleration changes of parkinsonian tremor in the case of three activities: postural tremor, action tremor and rest tremor. Acquired data were processed in Matlab; the data were filtered and the spectral power density (PSD) was estimated with the Burg periodogram. It has been verified that the system presented in this article can accurately detect the parkinsonian tremors of the patients evaluated, additionally has been found that with the medication the tremors do not disappear completely, these remained with the same frequencies of PD but with a very small amplitude.
Subject(s)
Parkinson Disease , Tremor , Acceleration , Fingers , HumansABSTRACT
In this work the design and development of a system to monitor tremors in patients with Parkinson's disease based on Arduino open-source prototyping platform is presented. For processing data tremors acquired by the sensor device we have developed an Android application which allows an evaluation of the state of PD patients based on three types of tests that are in the Unified Parkinson's Disease Rating Scale recommended by the Movement Disorder Society (MDS-UPDRS); the tests performed in the application are: postural tremor of the hands, kinetic tremors of the hands and resting tremor amplitude. The results of PD Patients showed that despite receiving medication to minimize symptoms of their disease, patients have a considerable tremor amplitude, which affects the normal development of their daily activities. In addition, the spectral analysis of the tremors shows that two of the patients were correctly diagnosed with PD while the third patient showed spectral characteristics which led us to suggest to the treating physician reconsider the diagnosis.
Subject(s)
Electronics, Medical , Monitoring, Physiologic/instrumentation , Parkinson Disease/diagnosis , Tremor/diagnosis , Adult , Aged , Aged, 80 and over , Female , Hand , Humans , Male , Middle Aged , Severity of Illness IndexABSTRACT
OBJECTIVE: Ictal asystole (IA) is a rare event mostly seen in patients with temporal lobe epilepsy (TLE) and a potential contributor to sudden unexplained death in epilepsy (SUDEP). Clinical and video-electroencephalographic findings associated with IA have not been described, and may be helpful in screening for high risk patients. METHODS: A database search was performed of 6,825 patients undergoing long-term video-EEG monitoring for episodes of IA. RESULTS: IA was recorded in 0.27% of all patients with epilepsy, eight with temporal (TLE), two with extratemporal (XTLE), and none with generalized epilepsy. In 8 out of 16 recorded events, all occurring in patients with TLE, seizures were associated with a sudden atonia on average 42 seconds into the typical semiology of a complex partial seizure. The loss of tone followed after a period of asystole usually lasting longer than 8 seconds and was associated with typical EEG changes seen otherwise with cerebral hypoperfusion. Clinical predisposing factors for IA including cardiovascular risk factors or baseline ECG abnormalities were not identified. CONCLUSION: Ictal asystole is a rare feature of patients with focal epilepsy. Delayed loss of tone is distinctly uncommon in patients with temporal lobe seizures, but may inevitably occur in patients with ictal asystole after a critical duration of cardiac arrest and cerebral hypoperfusion. Further cardiac monitoring in patients with temporal lobe epilepsy and a history of unexpected collapse and falls late in the course of a typical seizure may be warranted and can potentially help to prevent sudden unexplained death in epilepsy.
Subject(s)
Death, Sudden, Cardiac/etiology , Electrodiagnosis/methods , Epilepsy, Temporal Lobe/complications , Epilepsy/complications , Heart Arrest/etiology , Adolescent , Adult , Aged , Autonomic Pathways/physiopathology , Bradycardia/diagnosis , Bradycardia/etiology , Bradycardia/physiopathology , Brain/anatomy & histology , Brain/physiopathology , Brain Ischemia/diagnosis , Brain Ischemia/etiology , Brain Ischemia/physiopathology , Child, Preschool , Death, Sudden, Cardiac/prevention & control , Early Diagnosis , Electrodiagnosis/standards , Electrodiagnosis/trends , Electroencephalography/methods , Electroencephalography/standards , Electroencephalography/trends , Epilepsy/diagnosis , Epilepsy/physiopathology , Epilepsy, Generalized/etiology , Epilepsy, Generalized/physiopathology , Epilepsy, Temporal Lobe/diagnosis , Epilepsy, Temporal Lobe/physiopathology , Female , Heart Arrest/diagnosis , Heart Arrest/physiopathology , Humans , Male , Middle Aged , Monitoring, Physiologic/instrumentation , Monitoring, Physiologic/methods , Monitoring, Physiologic/standards , Predictive Value of Tests , Syncope/diagnosis , Syncope/etiology , Syncope/physiopathology , Video Recording/methods , Video Recording/standards , Video Recording/trendsABSTRACT
El papel clásico endocrino del calcitrol (la,25-dihidroxivitamina D3) en la homeostasis del calcio es bien conocido. Los hallazgos relativamente recientes de la presencia del receptor de calcitrol en monocitos, linfocitos y diversas líneas celulares, y el hallazgo de la producción ectópica y localizada del calcitrol por los macrófagos, sugiere un papel importante de esta vitamina/hormona en eventos de inmunoregulación. A partir de la nueva evidencia experimental, es claro, a diferencia de los planteamientos iniciales que consideraban al calcitrol como un agente inmunosupresor, que esta hormona es capaz de estimular y de suprimir la función inmune, dependiendo de las condiciones de activación y del microambiente inmunológico. La información clínica disponible y la experimentación in vivo e in vitro apoyan un efecto inmunomodulador del calcitrol; éste debe ser considerado, por lo tanto, como uno mas de la larga y creciente lista de moduladores
Subject(s)
Adjuvants, Immunologic/metabolism , Calcitriol , T-LymphocytesABSTRACT
Linguatula serrata is a pentastomid, a cosmopolitan parasite belonging to the Phylum Pentastomida. Humans may act as an intermediate or accidental definitive host of this parasite, manifesting the nasopharyngeal or visceral form, with the latter having been described more frequently. The occurrence of ocular linguatuliasis is extremely rare, but it has been reported in the United States and Israel. The objective of the present paper was to report the first case of ocular linguatuliasis in Ecuador and to extend the morphologic study of L. serrata by morphometric analysis. The patient studied was a 34-year old woman from Guayaquil, Ecuador who complained of ocular pain with conjunctivitis and visual difficulties of two-months duration. Biomicroscopic examination revealed a mobile body in the anterior chamber of the eye. The mobile body was surgically removed. The specimen was fixed in alcohol, cleared using the technique of Loos, stained with acetic carmine, and mounted on balsam between a slide and a coverslip. It was observed with stereoscopic and common light microscopes in combination with an automatic system for image analysis and processing. The morphologic and morphometric characteristics corresponded to the third-instar larval form of L. serrata. To our knowledge, ocular linguatuliasis has not been previously described in South America, with this being the first report for Ecuador and South America. The present study shows that computer morphometry can adequately contribute both to the morphologic study and to the systematic classification of Pentastomids, and L. serrata in particular.
