Artistic productivity and creative thinking in Parkinson's disease

Background and purpose: Creative drive and enhanced artistic‐like production may emerge in patients with Parkinson’s disease (PD) during dopaminergic therapy. However, it has not been described to date whether this artistic‐like production results from dopaminergic drugs triggering innate skills or it could be considered as a repeated behavior possibly associated with impulse control disorders (ICDs). Methods: We investigated creative drive in a cohort of cognitively preserved patients with PD by means of the Torrance Test of Creative Thinking (TTCT). We also investigated a putative association between creative drive and ICDs in 36 PD patients with (PD‐c) or without (PD‐nc) increased artistic‐like production and 36 healthy controls (HC). We considered artistic‐like productivity to be enhanced if patients reported working on any form of art more than 2 h per day after the introduction of dopaminergic treatment. The TTCT, the Barratt Impulsiveness Scale (BIS‐11A), the Minnesota Impulsive Disorders Interview (MIDI), and the Punding Rating Scale were applied. Results: Mean TTCT score of PD‐c was found to be similar to HC (169.4 ± 51.6 vs. 170.2 ± 69.7, respectively), and both PD‐c and HC had significantly higher TTCT scores than patients with PD‐nc (125.4 ± 46.1 P < 0.05). TTCT did not correlate with any demographic or clinical data in both PD subgroups. No correlation was found between TTCT, BIS‐11A, and MIDI. Conclusions: Our study suggests that newly acquired artistic‐like production in patients with PD is not associated with impulsivity or ICDs. Artistic‐like production might represent the emerging of innate skills in a subset of predisposed patients with PD on dopaminergic therapy.     

Therapy for recurrent acute pericarditis: a rheumatological solution?

OBJECTIVE: To assess the efficacy of a multidrug protocol in recurrent acute pericarditis. We tried also to assess the specific role of colchicine. METHODS:We studied 58 patients (34 males) in the largest monocentric observational study. All patients received prolonged courses of non-steroidal anti-inflammatory drugs; generally we do not start a corticosteroid in recurrent acute pericarditis, but if a steroid had already been started, we planned a very slow tapering; if necessary azathioprine, hydroxychloroquine, and other immunosuppressive drugs were used; 44 patients (27 males, 61.4%) were treated also with colchicine and 14 patients (7 males, 50%) were not given this drug. RESULTS: After starting our protocol recurrences dropped from 0.48 to 0.03 attacks/patient/month (p < 0.00001) within 12 months and remained at the same level till the end of the follow-up (mean 8.1 years) in the whole cohort. In the 44 patients treated with colchicine recurrences dropped from 0.54 to 0.03 attacks/patient/month (p < 0.00001) within 12 months, and in 14 patients not given colchicine recurrences decreased from 0.31 to 0.06 attacks/patient/month (p = 0.002). In patients treated with colchicine the decrease was significantly higher (0.51) than in patients not taking this drug (0.25) (p = 0.006). Colchicine was discontinued by 16.3% of patients because of side effects. CONCLUSION: A multidrug protocol including non-steroidal anti-inflammatory drugs at high dosage, slow tapering of corticosteroid, colchicine, reassurance and close clinical monitoring is very effective in recurrent pericarditis; this improvement is more dramatic in colchicine treated patients, but also patients who do not tolerate it can achieve good control of the disease.     

Environmental Effects of BPA: Focus on Aquatic Species

Research on bisphenol A (BPA) as an environmental contaminant has now major regulatory implications toward the ecosystem health, and hence it is incumbent on scientists to do their research to the highest standards possible, in order that the most appropriate decisions are made to mitigate the impacts to aquatic wildlife. However, the contribution given so far appears rather fragmented. The present overview aims to collect available information on the effects of BPA on aquatic vertebrates and invertebrates to provide a general scenario and to suggest future developments toward more comprehensive approaches useful for aquatic species protection.     

A multicenter cost-of-illness study on rheumatoid arthritis in Italy

OBJECTIVE: Rheumatoid arthritis (RA) is a chronic and disabling disease frequently leading to physical and psychological dependence, with considerable economic consequences. The aim of our study was to perform a cost-of-illness analysis for RA according to the four different levels of functional RA severity. METHODS: Direct costs (hospitalisations, treatments, diagnostics and the non-medical costs), indirect costs (productivity losses and informal care), and intangible costs (deterioration in the quality of life of patients, their families and friends assessed by the Medical Outcome Survey Short Form and the Stanford Health Assessment Questionnaire) were measured in 200 RA patients. RESULTS: The social costs--direct plus indirect costs--increased as RA worsened. The direct costs increase very significantly (p < 0.0005) among the four functional classes (respectively Euro 1643.4 - 2910.2 - 4236.5 - 5696.8), likewise the indirect costs (respectively Euro 2704.9 - 9566.4 - 12183.1 - 17249.2). Moreover social costs, analysed independently from the functional classes, are significantly higher in patients with other concomitant diseases. As far as the intangible costs are concerned, for all the areas explored by the scales used, the high impact of RA on the quality of life of RA patients was markedly evident. Female gender and co-morbidity are associated with higher costs. CONCLUSIONS: In Italy, the indirect costs account for the highest cost for management of RA patients. Considering that costs increase with RA progression, the patients who show a rapid evolution of the functional damages should be identified early based on risk indicators.     

Direct and indirect costs of osteoarthritis of the knee

BACKGROUND: Rheumatic diseases have an economic impact of 1-2.5% of GDP in industrialized countries and osteoarthritis is the most common joint disorder. Osteoarthritis of the knee is especially common and is a major cause of disability requiring extensive utilization of health care resources. OBJECTIVE: To estimate the burden of osteoarthritis of the knee in Italy, we studied retrospectively a cohort of 254 patients over a period of 12 months in 2000-2001. METHODS: Twenty-nine rheumatology institutes took part in the study. A bottom-up approach was used, analytically measuring pro capita consumption. We considered medical (hospitalization, diagnosis, and therapies) and non-medical costs (transport, temporary caregivers, and auxiliary devices) as direct costs. We calculated losses of productivity borne by patients and caregivers, and informal care provided by caregivers as indirect costs. RESULTS: Direct costs came to Euros 934 per patient per year: Euros 233 were spent on hospitalization, Euros 209 on diagnostic procedures (56% on visits and 44% on instrumental and laboratory tests), Euros 146 on therapy (58% on physiotherapy and 42% on drugs), and Euros 346 on non-medical costs (73% on salaries to temporary caregivers, 14% on transport, and 13% on auxiliary devices). It is interesting to point out that at least 37% of costs were charged directly to patients. Indirect costs were almost 30% higher and came to Euros 1236 per patient per year: 31% was due to loss of productivity of patients, 60% due to informal care provided by primary caregivers, and 9% by other caregivers. CONCLUSIONS: This study confirms that the direct and indirect costs attributable to osteoarthritis of the knee are substantial.     

Growth factors stimulate the activity of key glycolytic enzymes in isolated digestive gland cells from mussels (Mytilus galloprovincialis Lam.) through tyrosine kinase mediated signal transduction

Digestive gland cells isolated from mussels (Mytilus) have previously been demonstrated to respond to mammalian EGF with a cytosolic Ca(2+) transient and stimulated DNA synthesis; both responses were mediated by activation of tyrosine kinase receptors. The present study examines the mechanisms involved in further signal progression and possible targets of phosphorylation/dephosphorylation processes. The effects of EGF, IGF-I, and insulin on the activity of two key glycolytic enzymes PFK (phosphofructokinase) and PK (pyruvate kinase) were evaluated. All the peptides tested induced a transient and dose-dependent stimulation of the activity of both PFK and PK, which involved activation of MAPKs. Quantitative immunoelectron microscopy, utilizing monoclonal anti-phosphotyrosine antibodies, revealed that EGF induced a transient increase in tyrosine phosphorylation. The results demonstrate that, in marine invertebrate cells, activation of tyrosine kinase membrane receptors by growth factors triggers signal transduction pathways involving a phosphorylative cascade similar to that of mammalian cells. Moreover, these data suggest that, in mussel cells, growth factors may play a physiological role in the in vivo regulation of glucose metabolism by modulating, through reversible phosphorylation, the activity of key glycolytic enzymes.     

Is the new,noninvasive, continuous cardiorespiratory monitoring reliable during neonatal ECMO?

Background

Advances in cardiorespiratory monitoring have made the extracorporeal membrane oxygenation (ECMO) technique safer for the patient. Noninvasive, continuous tools are available, although data on their applications in the neonatal ECMO setting are lacking.