International multicenter pilot study of the first comprehensive self-completed nonmotor symptoms questionnaire for Parkinson's disease: the NMSQuest study.

Nonmotor symptoms (NMS) of Parkinson's disease (PD) are not well recognized in clinical practice, either in primary or in secondary care, and are frequently missed during routine consultations. There is no single instrument (questionnaire or scale) that enables a comprehensive assessment of the range of NMS in PD both for the identification of problems and for the measurement of outcome. Against this background, a multidisciplinary group of experts, including patient group representatives, has developed an NMS screening questionnaire comprising 30 items. This instrument does not provide an overall score of disability and is not a graded or rating instrument. Instead, it is a screening tool designed to draw attention to the presence of NMS and initiate further investigation. In this article, we present the results from an international pilot study assessing feasibility, validity, and acceptability of a nonmotor questionnaire (NMSQuest). Data from 123 PD patients and 96 controls were analyzed. NMS were highly significantly more prevalent in PD compared to controls (PD NMS, median = 9.0, mean = 9.5 vs. control NMS, median = 5.5, mean = 4.0; Mann-Whitney, Kruskal-Wallis, and t test, P < 0.0001), with PD patients reporting at least 10 different NMS on average per patient. In PD, NMS were highly significantly more prevalent across all disease stages and the number of symptoms correlated significantly with advancing disease and duration of disease. Furthermore, frequently, problems such as diplopia, dribbling, apathy, blues, taste and smell problems were never previously disclosed to the health professionals.     

Endocrine changes in Alzheimer's disease

In conclusion, at present, no consistent endocrine abnormalities can be detected in patients suffering from Alzheimer's disease. However, assessment of neuroendocrine function might help identify subpopulations of patients with particular neurotransmission abnormalities who are likely to benefit from a specific pharmacologic strategy. For example, patients in whom cholinomimetic drugs produce the greatest elevation in plasma cortisol concentration appear to derive the most symptomatic benefit from these drugs.     

MR imaging of spinal cord hemangioblastoma associated with syringomyelia

A case of isolated spinal cord hemangioblastoma with associated extensive syringohydromyelia, which was evaluated by myelography, postmyelographic CT, magnetic resonance (MR), and angiography is presented. The specific preoperative and postoperative advantages of MR are given as well as a brief review of the literature.     

Giant right atrial diverticulum: an unusual cause of Wolff-Parkinson-White syndrome.

A case of a giant right atrial diverticulum associated with neonatal supraventricular tachycardia is reported. The electrocardiogram in sinus rhythm showed pre-excitation that may have been caused by the right atrial diverticulum adhering to the right ventricle.     

Biology of genital tract human papillomaviruses.

A large number of HPV types infect humans. They infect squamous epithelia of the skin and mucous membranes. Infections are widespread in sexually active populations. Some HPV types have oncogenic potential. Infections with HPV-16, HPV-18, and some additional types are risk factors for cervical cancer. The HPV-6 and HPV-11 types are responsible for most of the genital condylomas and nearly all respiratory papillomas. The immunologic responses to HPVs are not well understood.