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1.
Chem Rev ; 123(15): 9327-9355, 2023 Aug 09.
Article in English | MEDLINE | ID: mdl-37294781

ABSTRACT

In response to the current trend of miniaturization of electronic devices and sensors, the complementary coupling of high-efficiency energy conversion and low-loss energy storage technologies has given rise to the development of photocapacitors (PCs), which combine energy conversion and storage in a single device. Photovoltaic systems integrated with supercapacitors offer unique light conversion and storage capabilities, resulting in improved overall efficiency over the past decade. Consequently, researchers have explored a wide range of device combinations, materials, and characterization techniques. This review provides a comprehensive overview of photocapacitors, including their configurations, operating mechanisms, manufacturing techniques, and materials, with a focus on emerging applications in small wireless devices, Internet of Things (IoT), and Internet of Everything (IoE). Furthermore, we highlight the importance of cutting-edge materials such as metal-organic frameworks (MOFs) and organic materials for supercapacitors, as well as novel materials in photovoltaics, in advancing PCs for a carbon-free, sustainable society. We also evaluate the potential development, prospects, and application scenarios of this emerging area of research.

2.
Rev. neuro-psiquiatr. (Impr.) ; 84(2): 144-148, abr.-jun. 2021.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1341581

ABSTRACT

RESUMEN Se describe el caso de una paciente adolescente con diagnóstico de Síndrome de Arteria Mesentérica Superior causado por emaciación resultante de un Trastorno de Conducta Alimentaria (Anorexia Nerviosa, AN) cuya evolución fue severamente acentuada por la pandemia de COVID-19. El Síndrome se debe a la compresión de la tercera porción del duodeno entre la arteria mesentérica superior y la aorta. Se describen las características clínicas, etiopatogénicas y diagnósticas más saltantes de la AN, cuyo diagnóstico precoz es fundamental para mejorar un pronóstico complicado por las consecuencias de baja de peso y desnutrición. La comorbilidad ansiosa y depresiva asociada al estrés causado por el confinamiento y los rasgos de personalidad obsesiva de la paciente requirieron de un tratamiento conjunto de los servicios de Pediatría y de Psiquiatría del Niño y Adolescente, este último con intervenciones psicoterapéuticas individual y familiar.


SUMMARY The case of an adolescent patient diagnosed with Superior Mesenteric Artery Syndrome caused by emaciation resulting from an eating disorder (Anorexia Nervosa, AN) es described. Its clinical course was severely accentuated by the COVID-19 pandemic. The Syndrome is due to the compression of the third portion of the duodenum between the superior mesenteric artery and the aorta. The main clinical, etiopathogenic and diagnostic characteristics of AN are described; its early diagnosis is essential to improve a prognosis complicated by the consequences of weight loss and malnutrition. Anxious and depressive comorbidities associated with the stress caused by the confinement, and the patient's obsessive personality traits required a joint treatment by the Pediatry and Child and Adolescent Psychiatry Services, the latter with individual and family psychotherapy interventions.

3.
Inorg Chem ; 59(20): 15154-15166, 2020 Oct 19.
Article in English | MEDLINE | ID: mdl-33012162

ABSTRACT

Hole-transport materials (HTMs) are key electronic components for the functioning of perovskite solar cells (PSCs) as they extract the photogenerated holes from the perovskite to be transported subsequently to the back electrode while minimizing the loss from electron recombination. Herein, we report the synthesis and characterization of novel germanium-based compounds with [{HC(CMeNAr)2}GeNCS] (2), [{HC(CMeNAr)2}Ge(S)NCS] (3), and [{HC(CMeNAr)2}Ge(Se)NCS] (4) compositions, with Ar = 2,6-iPr2C6H3 and the photovoltaic performance of 3 and 4 that is the same as for HTM in PSC. All compounds displayed excellent thermal properties and an appropriate alignment of energy levels for the perovskite with maximum optical absorption in the near-UV region. As revealed by space-charge limited-current (SCLC) measurements, compounds 3 and 4 have competing hole mobilities of about 1.37 × 10-4 and 4.88 × 10-4 cm2 V-1 s-1, respectively. Upon assessing PSC devices using 3 and 4 with triple-cation perovskite absorber Cs0.05(MA0.17FA0.83)0.95Pb(I0.83Br0.17)3, the power conversion efficiencies (PCEs) were about 13.03 and 9.23%, respectively, both without doping and additives, and were compared with benchmark HTM spiro-OMeTAD (2,2',7,7'-tetrakis(N,N-di-p-methoxyphenylamine)-9,9'-spirobifluorene). Quantum chemical calculations with DFT showed that the optoelectronic properties are strongly influenced by the combined contributions of the germanium atom, the pseudohalide moiety (NCS-), and chalcogenides (S2- or Se2-). Fine tuning the electronic properties of germanium is thus a good strategy for the targeted synthesis of potential conducting molecules in PSCs.

4.
Neuropharmacology ; 126: 70-83, 2017 Nov.
Article in English | MEDLINE | ID: mdl-28807674

ABSTRACT

The N-methyl-d-aspartate receptor (NMDA) co-agonist d-serine is a substrate for the neutral amino acid transporters ASCT1 (SLC1A4) and ASCT2 (SLC1A5). We identified l-phenylglycine (PG) and its analogs as inhibitors of ASCT1 and ASCT2. PG analogs were shown to be non-substrate inhibitors of ASCT1 and ASCT2 with a range of activities relative to other amino acid transport systems, including sodium-dependent glutamate transporters, the sodium-independent d-serine transporter asc-1 and system L. L-4-chloroPG was the most potent and selective ASCT1/2 inhibitor identified. The PG analogs facilitated theta-burst induced long-term potentiation in rat visual cortex slices in a manner that was dependent on extracellular d-serine. For structurally-related PG analogs, there was an excellent correlation between ASCT1/2 transport inhibition and enhancement of LTP which was not the case for inhibition of asc-1 or system L. The ability of PG analogs to enhance LTP is likely due to inhibition of d-serine transport by ASCT1/2, leading to elevated extracellular levels of d-serine and increased NMDA receptor activity. These results suggest that ASCT1/2 may play an important role in regulating extracellular d-serine and NMDA receptor-mediated physiological effects and that ASCT1/2 inhibitors have the potential for therapeutic benefit.


Subject(s)
Amino Acid Transport System ASC/antagonists & inhibitors , Glycine/analogs & derivatives , Long-Term Potentiation/drug effects , Visual Cortex/drug effects , Animals , Astrocytes/drug effects , Astrocytes/metabolism , Glutamate Plasma Membrane Transport Proteins/metabolism , Glycine/pharmacology , HEK293 Cells , Humans , Minor Histocompatibility Antigens , Rats, Wistar , Receptors, N-Methyl-D-Aspartate , Visual Cortex/physiology
5.
J Educ Health Promot ; 6: 24, 2017.
Article in English | MEDLINE | ID: mdl-28584824

ABSTRACT

BACKGROUND: The relationship between cigarette smoking and development of Alzheimer's disease (AD) is not fully determined, and previous reports disagree, with some studies suggesting an increased relative risk and others a decreased odds ratio. Consequently, we wanted to determine if the prevalence of past cigarette smoking observed in a community-based clinic sample of patients with AD would be more consistent with the expected value obtained from a model using either an increased relative risk or a decreased odds ratio to estimate the effect of smoking on development of AD. MATERIALS AND METHODS: Retrospective cross-sectional analysis of all patients treated for AD in a community-based Neurology Clinic during a 2-year period. Estimates of expected past smoking prevalence were calculated based on published values for either an increased relative risk or a decreased odds ratio and compared to the past smoking prevalence observed in the clinic sample. RESULTS: The observed past smoking prevalence in the clinic population was 29.17%. The expected past smoking prevalence calculated using the increased relative risk was 30.07% (95% confidence interval [CI] = 27.67-32.32%), and using the decreased odds ratio was 12.54% (95% CI = 6.32-24.81%). CONCLUSION: The observed past smoking prevalence among the patients being treated for AD in a community-based clinic falls within the expected 95% CI for the increased relative risk model and outside of the expected 95% CI for the decreased odds ratio model. These results support the contention that the relationship between cigarette smoking and development of AD is the best characterized by an increased relative risk.

6.
AIDS ; 31(8): 1083-1089, 2017 05 15.
Article in English | MEDLINE | ID: mdl-28358738

ABSTRACT

OBJECTIVE: The study set out to determine if the HIV protease inhibitor, indinavir, alters responsiveness of α7-nicotinic acetylcholine receptors to acetylcholine. DESIGN: Treatment with HAART has dramatically reduced development of HIV-associated dementia and more severe forms of cognitive impairment. However, many individuals continue to experience cognitive decline of uncertain cause. Previous studies have failed to demonstrate significant alterations of functional brain connectivity, structural brain changes, or changes in cerebral blood flow sufficient to explain cognitive decline in virally suppressed individuals. This suggests that the mechanisms underlying development and progression of cognitive problems likely occurs at a micro rather than macro level, such as disruptions in neurotransmitter system signaling. MATERIALS AND METHODS: Indinavir's effects on α7-nicotinic acetylcholine receptor activity was tested using a ScreenPatch IonWorks Barracuda-based assay in a mammalian cell model. RESULTS: At low concentrations (0.0003-10 µmol/l) indinavir acts as a positive allosteric modulator (EC50 = 0.021 µmol/l), whereas at concentrations greater than 10 µmol/l (30-100 µmol/l) indinavir acts as an inhibitor of the α7-nicotinic acetylcholine receptor. CONCLUSION: At concentrations greater than 10 µmol/l indinavir reduces synaptic transmission in the acetylcholine neurotransmitter system, which could possibly contribute to cognitive dysfunction. These results suggest that further experiments should be considered to assess whether patients might benefit from treatment with cholinesterase inhibitors that counteract the effects of indinavir.


Subject(s)
Cognitive Dysfunction , HIV Infections/complications , HIV Infections/drug therapy , HIV Protease Inhibitors/adverse effects , Indinavir/adverse effects , Nicotinic Antagonists/adverse effects , alpha7 Nicotinic Acetylcholine Receptor/drug effects , Animals , CHO Cells , Cricetulus , HIV Protease Inhibitors/administration & dosage , Indinavir/administration & dosage , Nicotinic Antagonists/administration & dosage , Patch-Clamp Techniques
7.
Pharm Res ; 34(1): 1-6, 2017 01.
Article in English | MEDLINE | ID: mdl-27620174

ABSTRACT

How do we inspire new ideas that could lead to potential treatments for rare or neglected diseases, and allow for serendipity that could help to catalyze them? How many potentially good ideas are lost because they are never tested? What if those ideas could have lead to new therapeutic approaches and major healthcare advances? If a clinician or anyone for that matter, has a new idea they want to test to develop a molecule or therapeutic that they could translate to the clinic, how would they do it without a laboratory or funding? These are not idle theoretical questions but addressing them could have potentially huge economic implications for nations. If we fail to capture the diversity of ideas and test them we may also lose out on the next blockbuster treatments. Many of those involved in the process of ideation may be discouraged and simply not know where to go. We try to address these questions and describe how there are options to raising funding, how even small scale investments can foster preclinical or clinical translation, and how there are several approaches to outsourcing the experiments, whether to collaborators or commercial enterprises. While these are not new or far from complete solutions, they are first steps that can be taken by virtually anyone while we work on other solutions to build a more concrete structure for the "idea-hypothesis testing-proof of concept-translation-breakthrough pathway".


Subject(s)
Drug Discovery , Neglected Diseases/drug therapy , Neglected Diseases/therapy , Animals , Cooperative Behavior , Drug Industry/methods , Humans , Laboratories , Research , Therapeutics/methods
8.
Vision Res ; 127: 35-48, 2016 10.
Article in English | MEDLINE | ID: mdl-27461280

ABSTRACT

The NMDA subtype of glutamate receptor and its co-agonist d-serine play a key role in synaptic function in the central nervous system (CNS), including visual cortex and retina. In retinal diseases such as glaucoma and macular degeneration, a loss of vision arises from malfunction of retinal cells, resulting in a glutamate hypofunctional state along the visual pathway in the affected parts of the visual field. An effective strategy to remedy this loss of function might be to increase extracellular levels of d-serine and thereby boost synaptic NMDA receptor-mediated visual transmission and/or plasticity to compensate for the impairment. We tested this idea in brain slices of visual cortex exhibiting long-term potentiation, and in rodent models of visual dysfunction caused by retinal insults at a time when the injury had stabilized to look for neuroenhancement effects. An essential aspect of the in vivo studies involved adapting sweep VEP technology to conscious rats and rabbits and combining it with intracortical recording while the animals were actively attending to visual information. Using this technology allowed us to establish complete contrast sensitivity function curves. We found that systemic d-serine dose-dependently rescued the contrast sensitivity impairment in rats with blue light-induced visual dysfunction. In rabbits with inner retinal dysfunction, both systemic and intravitreal routes of d-serine provided a rescue of visual function. In sum, we show that co-agonist stimulation of the NMDA receptor via administration of exogenous d-serine might be an effective therapeutic strategy to enhance visual performance and compensate for the loss of vision resulting from retinal disease.


Subject(s)
Contrast Sensitivity/drug effects , Evoked Potentials, Visual/drug effects , Retinal Diseases/drug therapy , Serine/pharmacology , Visual Cortex/drug effects , Animals , Contrast Sensitivity/physiology , Disease Models, Animal , Male , Rabbits , Rats , Rats, Sprague-Dawley , Retinal Diseases/physiopathology , Visual Cortex/physiology
9.
Curr Aging Sci ; 9(1): 57-60, 2016.
Article in English | MEDLINE | ID: mdl-26412353

ABSTRACT

Parkinson's disease is associated with progressive degeneration of mesolimbic dopaminergic neurons that are involved in reward-based behavior learning, including rewarding effects of food consumption and drugs of abuse. The importance of this pathway in development of addictive behaviors led us to hypothesize that medical disorders related to poor impulse control may occur less frequently among patients with Parkinson's disease than those with other progressive neurodegenerative disorders such as Alzheimer's disease. Retrospective cross-sectional study of all patients treated for Parkinson's disease and Alzheimer's disease in a community based clinic during a two-year period. Associations were summarized using odds ratios (OR) and 95% confidence intervals (95% CI) estimated from logistic regression models, adjusted for differences in gender distribution between the groups. A total of 106 patients with Parkinson's disease and 72 patients with Alzheimer's disease were included. Patients with Parkinson's disease were less likely to have either past substance use (adjusted OR = 0.035, 95% CI = 0.009 - 0.130) or presence of co-morbid medical conditions related to poor dietary choices (adjusted OR = 0.157, 95% CI = 0.062 - 0.397). Co-morbid medical conditions related to poor impulse control occur less frequently among those with Parkinson's disease than those with Alzheimer's disease. These findings are consistent with dysfunction of dopamine dependent pathways involved in addiction during the presymptomatic phase of Parkinson's disease and support a biological basis for addiction.


Subject(s)
Alzheimer Disease/epidemiology , Parkinson Disease/epidemiology , Aged , Alcohol Drinking , Alzheimer Disease/physiopathology , Comorbidity , Female , Humans , Male , Middle Aged , Parkinson Disease/physiopathology , Smoking
10.
Case Rep Neurol Med ; 2014: 428425, 2014.
Article in English | MEDLINE | ID: mdl-25309765

ABSTRACT

Acute onset of psychosis in an older or elderly individual without history of previous psychiatric disorders should prompt a thorough workup for neurologic causes of psychiatric symptoms. This report compares and contrasts clinical features of new onset of psychotic symptoms between two patients, one with an acute basal ganglia hemorrhagic stroke and another with an acute mid-brain ischemic stroke. Delusions and hallucinations due to basal ganglia lesions are theorized to develop as a result of frontal lobe dysfunction causing impairment of reality checking pathways in the brain, while visual hallucinations due to mid-brain lesions are theorized to develop due to dysregulation of inhibitory control of the ponto-geniculate-occipital system. Psychotic symptoms occurring due to stroke demonstrate varied clinical characteristics that depend on the location of the stroke within the brain. Treatment with antipsychotic medications may provide symptomatic relief.

11.
Neurol Res Int ; 2014: 423602, 2014.
Article in English | MEDLINE | ID: mdl-25574388

ABSTRACT

Background. Patients with progressive dementing disorders associated with cortical cholinergic dysfunction gradually develop cholinergic deficits many years before symptom onset and may begin to smoke cigarettes during midlife as a form of self-medication. The aim of this study was to compare self-reported past smoking rates between those with and without cholinergic dementias, to determine if those who developed cholinergic dementias were more likely to smoke during midlife than those who did not. Methods. Retrospective cross-sectional study of past smoking status among patients treated at an outpatient clinic during a three-year period. Results. A total of 440 patients were evaluated during the study period, including 224 with cholinergic dementias and 216 with noncholinergic dementias and controls. Past smoking rates were greater among those with cholinergic dementias compared to those without cholinergic dementias (43.92% versus 26.96%, P = 0.012). Additionally, smokers with cholinergic dementias reported significantly greater mean pack-years of smoking (P = 0.038). Conclusions. Greater midlife smoking rates and greater pack-years of smoking were associated with cholinergic dementias. These results suggest midlife smoking may be an early indicator for those developing brain cholinergic deficits related to progressive dementing disorders and support initiating treatment prior to symptom onset in cholinergic dementias.

12.
J Neuropsychiatry Clin Neurosci ; 25(4): 319-26, 2013.
Article in English | MEDLINE | ID: mdl-24247858

ABSTRACT

The authors examined associations of various sleep-disturbance symptoms with health-related quality of life (HRQOL) in 153 adults with Parkinson's disease (PD). PD patients reported more snoring, sleep inadequacy, daytime somnolence, and sleep-maintenance problems than the general population. Symptoms having the broadest and strongest unique associations with generic HRQOL (eight scales; two composites of SF-36) were daytime somnolence (five scales; one composite), sleep initiation (eight scales; two composites), and awakening short of breath or with headache (six scales; two composites). Associations of selected sleep-disturbance symptoms--some unanticipated--suggest that assessing specific symptoms is worthwhile in clinical care.


Subject(s)
Health Status , Parkinson Disease/complications , Parkinson Disease/physiopathology , Quality of Life , Sleep Initiation and Maintenance Disorders/complications , Sleep Initiation and Maintenance Disorders/physiopathology , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Parkinson Disease/diagnosis , Sleep Initiation and Maintenance Disorders/diagnosis , Symptom Assessment
13.
Int J Psychiatry Med ; 45(3): 227-36, 2013.
Article in English | MEDLINE | ID: mdl-24066406

ABSTRACT

OBJECTIVE: To compare the prevalence of co-morbid depression between patients with chronic primary headache syndromes and chronic posttraumatic headaches. METHOD: A prospective cross-sectional analysis of all patients presenting sequentially to a community-based general neurology clinic during a 2-year period for evaluation of chronic headache pain was conducted. Headache diagnosis was determined according to the International Headache Society's Headache Classification criteria. Depression was determined through a combination of scores on the clinician administered Hamilton Rating Scale for Depression and patients' self-report. An additional group of patients who suffered traumatic brain injuries (TBI) but did not develop post-traumatic headaches was included for comparison. RESULTS: A total of 83 patients were included in the study: 45 with chronic primary headaches (24 with chronic migraine headaches, 21 with chronic tension headaches), 24 with chronic post-traumatic headaches, and 14 with TBI but no headaches. Depression occurred less frequently among those with chronic post-traumatic headaches (33.3%) compared to those with chronic migraine (66.7%) and chronic tension (52.4%) headaches (Chi-Square = 7.68; df = 3; p = 0.053), and did not significantly differ from TBI patients without headaches. A multivariate logistic regression model using depression as the outcome variable and including headache diagnosis, gender, ethnicity, and alcohol and illicit substance use was statistically significant (Chi-Square = 27.201; df = 10; p < 0.01) and identified primary headache (migraine and tension) diagnoses (Score = 7.349; df = 1; p = 0.04) and female gender (Score = 15.281; df = 1; p < 0.01) as significant predictor variables. The overall model accurately predicted presence of co-morbid depression in 74.7% of the cases. CONCLUSIONS: Co-morbid depression occurs less frequently among patients with chronic post-traumatic headaches and TBI without headaches than among those with chronic primary headaches.


Subject(s)
Brain Injuries/epidemiology , Depression/epidemiology , Headache Disorders, Primary/epidemiology , Post-Traumatic Headache/epidemiology , Adult , Brain Injuries/diagnosis , Chronic Disease/epidemiology , Comorbidity , Cross-Sectional Studies , Depression/diagnosis , Female , Headache Disorders, Primary/diagnosis , Humans , Logistic Models , Male , Middle Aged , Migraine Disorders/diagnosis , Migraine Disorders/epidemiology , Post-Traumatic Headache/diagnosis , Predictive Value of Tests , Prevalence , Prospective Studies , Psychiatric Status Rating Scales , Severity of Illness Index , Sex Factors , Tension-Type Headache/diagnosis , Tension-Type Headache/epidemiology , Time Factors
14.
Case Rep Neurol Med ; 2013: 860201, 2013.
Article in English | MEDLINE | ID: mdl-23634310

ABSTRACT

Introduction. Pantothenate-kinase-associated neurodegeneration (PKAN) is a rare genetic disease and a form of neurodegeneration with brain iron accumulation (NBIA). It most commonly begins in the first two decades of life but should be considered in the differential diagnosis of patients at any age with an atypical progressive extrapyramidal disorder and cognitive impairment. Few late-adult cases have been reported. Case Report. A 50-year-old woman presented with a history of progressive dysarthria and dysphagia secondary to orolingual dystonia. Initial work-up was normal. There was no family history. Her initial symptoms were followed by the onset of blepharospasm, cervical dystonia, Parkinsonism, and cognitive impairment. Follow-up MRI four years after presentation revealed the diagnostic "eye-of-the-tiger" sign. Genetic testing confirmed a homozygous missense mutation consistent with the diagnosis of PKAN. Conclusion. Although PKAN is a rare genetic disorder most commonly seen in childhood, it should be considered in adult patients with a history of progressive focal dystonia or atypical Parkinsonism. As the radiographic findings are quite characteristic, genetic testing should be performed if the MRI shows evidence of iron accumulation. Optimal treatment strategies are not known, and at the current time therapies should be directed at the specific manifestations of the disease.

15.
Parkinsons Dis ; 2012: 719167, 2012.
Article in English | MEDLINE | ID: mdl-23133789

ABSTRACT

The motor examination section of the unified Parkinson's disease rating scale (UPDRS) is widely used in research but few studies have examined whether subscales exist that tap relatively distinct motor abnormalities. We analyzed data from 193 persons enrolled in a population-based study in Central California. Patients were examined after overnight PD medication washout ("OFF" state) and approximately one hour after taking medication ("ON" state). We performed confirmatory factor analysis of the UPDRS for OFF and ON state examinations; correlations, reliability, and relative validity of resulting subscales were evaluated. A model with five factors (gait/posture, tremor, rigidity, bradykinesia affecting the left extremities, bradykinesia affecting the right extremities) fit the data well, with similar results for OFF and ON states. Internal consistency reliability coefficients were 0.90 or higher for all subscales. The gait/posture subscale most strongly discriminated across levels of patient reported PD symptom severity and of how PD affects them on a daily basis. Compared to the right sided bradykinesia subscale, the left sided bradykinesia subscale had higher discrimination across levels of self-reported PD symptom severity and functional impairment. This supports motor UPDRS containing multiple subscales that can be analyzed separately and provide information distinct from the total score that may be useful in clinical studies.

16.
Parkinsons Dis ; 2011: 967839, 2011.
Article in English | MEDLINE | ID: mdl-22191067

ABSTRACT

We assessed degree of Parkinson disease motor symptom improvement with medication among subjects enrolled in an ongoing, population-based study in Central California. The motor section of the unified Parkinson disease rating scale (UPDRS) was performed on subjects in both OFF and ON medication states, and difference between these scores was used as an indicator of symptomatic benefit. Higher OFF minus ON scores correlated with more severe baseline symptoms. There was equivalent improvement on the motor UPDRS scale for subjects divided according to medication classes used: levodopa alone 7.3 points, levodopa plus other medications 8.5 points, and dopamine agonists but not levodopa 6.1 points. In addition, there was no difference in the magnitude of improvement when subjects were divided according to Parkinson disease subtype, defined as tremor dominant, akinetic-rigid, or mixed. In this community-based sample, these values are within the range of a clinically important difference as defined by previous studies.

17.
Parkinsonism Relat Disord ; 17(1): 40-5, 2011 Jan.
Article in English | MEDLINE | ID: mdl-21084211

ABSTRACT

PURPOSE: To assess diagnostic accuracy of two self-administered depression measures compared to an interviewer-administered measure in subjects with Parkinson's disease (PD), and to analyze clinical and sociodemographic factors associated with disagreement among the three depression assessment tools. METHODS: We assessed 214 PD subjects using the Patient Health Questionnaire-9 (PHQ-9), the Geriatric Depression Scale-15 (GDS-15), and the Structured Clinical Interview for the DSM-IV depression module (SCID). Diagnostic accuracy of the PHQ-9 and GDS-15 compared to the SCID was evaluated. Multivariate logistic regression was conducted to analyze factors associated with measure disagreement. We compared item agreement between the PHQ-9 and SCID to test the hypothesis that there would be less agreement between items assessing depression symptoms overlapping with common PD symptoms, compared to items having minimal overlap with PD manifestations. RESULTS: Compared to SCID diagnosis of major depression, PHQ-9 sensitivity is 50% and specificity is 93%; GDS-15 sensitivity is 43% and specificity is 96%. The GDS-15 has 85% sensitivity and 79% specificity and the PHQ-9 has 54% sensitivity and 85% specificity compared to SCID diagnosis of minor or major depression. The PHQ-9 and SCID show more agreement on items unrelated to PD manifestations. Pain was the only factor associated with disagreement between the SCID and PHQ-9. CONCLUSION: Compared to the PHQ-9, the GDS-15 had higher sensitivity and similar positive predictive value, suggesting it is a superior screening tool in clinical applications for PD. On future depression screening or diagnostic instruments, consideration should be given to excluding depression items overlapping with PD manifestations.


Subject(s)
Depression/etiology , Depression/psychology , Parkinson Disease/complications , Parkinson Disease/psychology , Aged , Aging/psychology , Cohort Studies , Depression/diagnosis , Depressive Disorder/etiology , Depressive Disorder/psychology , Depressive Disorder, Major/etiology , Depressive Disorder, Major/psychology , Diagnostic and Statistical Manual of Mental Disorders , Female , Follow-Up Studies , Geriatric Assessment , Humans , Interview, Psychological , Male , Neuropsychological Tests , Odds Ratio , Psychometrics , Reproducibility of Results , Socioeconomic Factors , Surveys and Questionnaires
18.
NeuroRehabilitation ; 20(3): 153-60, 2005.
Article in English | MEDLINE | ID: mdl-16340096

ABSTRACT

Parkinson's disease (PD) afflicts more than 1,000,000 people in the United States and over 50,000 veterans obtain their medical care for PD within the Veterans Health Care System. In an effort to improve care for this growing population of veterans suffering from PD, the Veteran's Health Administration established 6 Parkinson's disease Research, Education, and Clinical Centers (PADRECC) based on merit. These 6 centers offer state of the art diagnosis and treatment of PD and other movement disorders. The PADRECC also provide education for both the professional community and patients not only at the 6 sites, but also throughout the VA system through the development of a national consortium. Improving veterans' health care through research is also a priority for the PADRECC. All 6 PADRECC are participating in the largest surgical trial for the treatment of PD ever performed. Heath service researchers have already identified quality of care indicators that are now being used to evaluate care for veterans with PD. Basic researchers at the PADRECC are studying the cause of PD and are developing new therapies including stem cells. The development of the PADRECC has created an important infrastructure and attracted expertise into the VA system. They have already made great improvements in caring for veterans with PD and promises to push the field further with their research efforts.


Subject(s)
Health Facilities , Parkinson Disease , United States Department of Veterans Affairs , Biomedical Research , Health Facility Administration , Humans , United States
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