Patient’s point of view on the use of telemedicine in multiple sclerosis: a web-based survey

Neurological Sciences - Restrictions in the access to healthcare facilities during COVID-19 pandemic have raised the need for remote monitoring of chronic medical conditions, including multiple...     

Higher levels of neuroticism in older adults predict lower executive functioning across time: the mediating role of perceived stress

Neuroticism has been associated with individual differences across multiple cognitive functions. Yet, the literature on its specific association with executive functions (EF) in older adults is scarce, especially using longitudinal designs. To disentangle the specific influence of neuroticism on EF and on coarse cognitive functioning in old adulthood, respectively, we examined the relationship between neuroticism, the Trail Making Test (TMT) and the Mini-Mental State Examination (MMSE) in a 6-year longitudinal study using Bayesian analyses. Data of 768 older adults (M_age?=?73.51 years at Wave 1) were included in a cross-lagged analysis. Results showed no cross-sectional link between neuroticism and TMT performance at Wave 1 and no longitudinal link between neuroticism at Wave 1 and MMSE at Wave 2. However, neuroticism at Wave 1 predicted TMT performance at Wave 2, indicating that the more neurotic participants were, the lower they performed on the TMT six years later. Additional analyses showed that this relation was fully mediated by participants’ perceived stress. Our results suggest that the more neurotic older adults are the more stress they may perceive six years later, which in turn negatively relates to their EF. In sum, this study demonstrates that neuroticism may lead to lower EF in older age across six years. It further suggests older adults’ perceived stress as mediator, thereby providing novel insights into the mechanisms underlying this relation. Possible intervention approaches to counter these effects are discussed.

     

Postmortem CT pulmonary findings in SARS-CoV-2-positive cases: correlation with lung histopathological findings and autopsy results

International Journal of Legal Medicine - Postmortem computed tomography (PMCT) is a valuable tool for analyzing the death of patients with SARS-CoV-2 infection. The purpose of this study was to...     

Cutaneous vascular patterns in psoriasis

Microvascular abnormalities are a characteristic feature of psoriasis and play a crucial role in its pathogenesis. Investigational studies have shown that activated keratinocytes in lesional skin undergo an accelerated epidermal cell turnover and are a major source of pro‐angiogenic cytokines, like as VEGF, ESAF, PDECGE/TP, TNF‐α, TGF‐α and PDGF, suggesting that the epidermis is capable of inducing vascular proliferation. On the other hand, microvascular alterations are essential for the development and persistence of the psoriatic lesions as they provide cellular and tissue nutrition to hyperplastic keratinocytes and promote inflammatory cell migration. Also, dilated and slightly tortuous blood vessels within dermal papillae represent one of the earliest detectable histological changes for all stages of lesional development. Videodermatoscopy is a new non invasive imaging technique able to identify modifications of microvascular architecture in vivo and such evaluation will be useful for the dermatologist both for diagnostic and prognostic evaluation, as well as for post‐therapeutic follow‐up. In this review, the role of microvascular abnormalities in the pathogenesis of psoriasis as well as the mechanisms underlying vascular changes and their primary therapeutic implications will be reviewed and discussed.     

Neuroendocrine tumours of the urinary system and male genital organs: clinical significance

Two basic types of neuroendocrine (NE) tumours with diverse clinicopathological features and outcome are identified in the urinary system and male genital organs: carcinoid tumour and neuroendocrine carcinoma. Carcinoid, a rare tumour, occurs in the kidney, bladder, prostate and testis. It is morphologically, histochemically, immunohistochemically and ultrastructurally similar to its counterpart in other organs, such as lung or gastrointestinal tract. Metastases can be detected at the initial evaluation, although they have been reported up to several years after removal, emphasizing the need for a long‐term follow‐up. NE carcinoma occurs in the kidney, bladder and prostate, and includes small cell carcinoma (SCC) and large cell NE carcinoma (LCNEC), the latter being exceedingly rare. Both show the morphology and immunophenotype of NE carcinoma originating in other organs. Although the occurrence is rare, it is highly aggressive.     

Altered recovery of macular function after bleaching in Stargardt's disease-fundus flavimaculatus: pattern VEP evidence

PURPOSE: To evaluate recovery of pattern visual evoked potentials (VEPs) after macular bleaching in patients with Stargardt's disease-fundus flavimaculatus (STD/FF). METHODS: Sixteen unrelated patients with STD/FF (age, 26-52 years; visual acuity, 0.2-1.0; phenotype I, n = 6; phenotype II, n = 8; or phenotype III, n = 2) and 15 age-matched control subjects were evaluated. VEPs were recorded in response to counterphased (two reversals per second) checkerboards (check size, 15 minutes; mean luminance, 80 cd/m(2); contrast, 80%; stimulus field size, 18 degrees ) in baseline condition and at 20, 40, and 60 seconds after a 30-second exposure to a bleaching light (3.58 log photopic trolands), presented to the central (6 degrees field) retina. In all patients, macular focal electroretinograms (FERGs) to an 18 degrees uniform field, flickering at 41 Hz, were also recorded in separate sessions. RESULTS: At every postbleaching time, VEPs were delayed and suppressed in amplitude, compared with prebleaching values, in both patients and control subjects. However, the amount of delay and suppression was, on average, more pronounced (P < 0.001) in patients than in control subjects. This difference was not accounted for by eccentric fixation in patients (n = 8) with central scotoma and was still substantial when only patients (n = 8) with normal visual field and acuity were considered. In individual patients, baseline FERG amplitudes correlated (r = -0.6, P < 0.01) with the suppression of VEP amplitude at 40-seconds after bleaching. CONCLUSIONS: The results indicate an altered recovery of pattern VEPs after macular bleaching in STD/FF and suggest adaptation abnormalities in macular cone photoreceptors, occurring at disease stages with relatively preserved central visual field and acuity.