Comorbid disorders and hospitalisation in Parkinson’s disease: a prospective study

Abstract. Parkinsons disease (PD) is often associated with other disorders, typical of the disease or of the age of PD patients, that can lead to hospitalisation, sometimes as emergencies. In this one-year prospective, longitudinal study, we investigated the comorbid events prompting the hospitalisation, or occurring during the planned hospitalisation, of an unselected group of 180 PD patients, admitted to 9 general hospitals in the course of the study. The most frequent acute comorbid events were trauma (30.5%), mostly due to falls, and vascular disorders (29.3%). Comorbidities were closely related to PD in 50% of cases. More than 50% of patients did not require (in addition to PD therapy) specific treatment for the acute comorbid event. Older age was associated with increased risk of complications. The setting up of multidisciplinary networks covering entire territories could help to improve the way in which we tackle the clinical and social problems generated by PD and its comorbidities. *Members of the Parkinsons Disease Comorbidity Study Group D. Porazzi, F. Reverberi, Department of Neurology, Hospital of Busto Arsizio; G. Chiodelli, G. Guarneri, Department of Neurology, Hospital of Cremona; M. B. Zappacosta, Department of Neurology, Hospital of Gallarate; G. Mariani, R. Freschi, Department of Neurology, Hospital of Legnano; F. Sasanelli, G. Molini, Department of Neurology, Hospital of Melegnano; F. Schieroni, M. Di Costanzo, Department of Neurology, Hospital of Merate; G. Bargnani, E. Donati, Department of Neurology, Hospital of Rovato; G. Bono, Department of Neurology, Hospital of Varese; E. Magrotti, Department of Neurology, Hospital of Voghera.     

Pathological gambling in two patients on dopamine replacement therapy for Parkinson’s disease

Abstract. We describe two cases where increases in dopaminergic therapy were initiated by the patients due to perceived deterioration in symptoms of idiopathic Parkinsons disease. Shortly afterwards, both cases also met clinical criteria for pathological gambling. To date, only 29 cases of pathological gambling in patients with Parkinsons disease have been reported. This pathological gambling disorder is an addiction-like behavior triggered by excessive dopaminergic drugs and does not respond to standard therapy for pathological gambling. It only responds to an adjustment of Parkinsons disease therapy.     

Sentinel lymph node mapping of the pleural space

STUDY OBJECTIVES: Although the sentinel lymph node (SLN) concept has traditionally been applied to solid organs, we hypothesized that the pleural space might drain into a specific SLN group. The identification of such a nodal group could assist in the staging and treatment of pleural-based diseases, such as mesothelioma, or other lung cancers with visceral pleural invasion. The purpose of this study was to determine whether the pleural space has an SLN group. DESIGN: Sixteen rats underwent right or left pleural space injection of a novel lymph tracer, quantum dots (QDs), which have a hydrodynamic diameter of 15 nm and fluoresce in the near-infrared (NIR) spectrum. Nodal uptake of the entire thorax was imaged with a custom system that simultaneously acquired color video, NIR fluorescence of the QDs, and a merged picture of the two in real-time. Six pigs underwent right or left pleural space injection of QDs and similar imaging. MEASUREMENTS AND RESULTS: In the rat, the QDs drained solely to the highest superior mediastinal lymph node group, corresponding to lymph node station 1, according the regional lymph node classification for lung of the American Joint Committee on Cancer. In one rat, the injection of QDs in the left pleural space resulted in migration to the contralateral station 1 lymph node group. The injection of QDs in the right or left pleural space of the pig resulted in migration solely to the ipsilateral highest superior mediastinal lymph node group. CONCLUSIONS: NIR fluorescence imaging in two species demonstrated that the highest superior mediastinal lymph nodes of station 1 are the SLNs of the pleural space. This study also provides intraoperative feasibility and proof of the concept for identifying lymph nodes communicating with the pleural space on a patient-specific basis, in real-time, and with high sensitivity.     

Salpingitis associated with the presence of nonmedicated IUDs

Fallopian tube tissue obtained at Pomeroy sterilization of 75 normally cycling women, 75 women 2 to 3 days postpartum and 75 asymptomatic women who had used a nonmedicated IUD for at least a year was examined histologically. There was an increased frequency of tissue edema and congestion in the postparturn group only. The frequency and extent of acute inflammatory changes in the three groups was not significantly different.     

A kinetic study of glucagon-like peptide-1 and glucagon-like peptide-2 truncation by dipeptidyl peptidase IV,in vitro

In vivo inactivation of glucagon-like peptide-1 (GLP-1) and glucagon-like peptide-2 (GLP-2) was found to be associated with the proteolytic removal of their N-terminal dipeptide by the ectopeptidase dipeptidyl peptidase IV (DPP IV). Previous studies suggested that the in vivo metabolism of GLP-1 is much faster than that of GLP-2. In this paper, we investigated the in vitro truncation of GLP-2 and GLP-1 by DPP IV. The slower conversion rate observed for GLP-2 compared to GLP-1 was due to an approximately 10-fold reduction in catalytic rate constant. The selectivity of DPP IV for the glucagon-like peptides was compared with data obtained for other natural substrates using the same enzyme source in identical conditions.     

GRP78、Ki67在胃癌中的表达及与临床参数之间的关系*

目的：应用免疫组织化学技术检测胃癌组织中葡萄糖调节蛋白78（GRP78）及Ki67表达水平,探讨二者与临床各参数之间的关系,二者的相关性及与胃癌疗效和预后的关系。方法：选择胃癌D2术后患者172例手术标本,先制成组织芯片,通过免疫组织化学方法检测GRP78、Ki67的表达,结合临床病理特征及随访资料进行综合分析。结果：172例胃癌组织中GRP78和Ki67表达阳性者分别为117例（68.02%）和103 例（59.88%）。GRP78的表达与浸润深度、分化程度、淋巴结转移、临床分期、脉管癌栓有关,Ki67与浸润深度、分化程度、淋巴结转移、临床分期有关（P<0.05）。GRP78与Ki-67的表达呈正相关（r=0.5025,P<0.05）。 GRP78及Ki67共表达阳性患者的总生存期低于共表达阴性者,差异有统计学意义（P<0.05）。GRP78表达阳性患者使用两药及以上联合化疗方案对比氟尿嘧啶类单药方案总生存时间的差异有统计学意义（P<0.05）。结论：GRP78、Ki67与胃癌各临床参数间关系密切,且二者表达呈正相关,对于胃癌D2术后辅助化疗的总生存有预测意义;GRP78对辅助化疗方案的选择具有判断价值。     

Sulindac sulfide inhibits sarcoendoplasmic reticulum Ca2+ ATPase,induces endoplasmic reticulum stress response,and exerts toxicity in glioma cells: Relevant similarities to and important differences from celecoxib

Malignant gliomas have low survival expectations regardless of current treatments. Nonsteroidal anti‐inflammatory drugs (NSAIDs) prevent cell transformation and slow cancer cell growth by mechanisms independent of cyclooxygenase (COX) inhibition. Certain NSAIDs trigger the endoplasmic reticulum stress response (ERSR), as revealed by upregulation of molecular chaperones such as GRP78 and C/EBP homologous protein (CHOP). Although celecoxib (CELE) inhibits the sarcoendoplasmic reticulum Ca²⁺ ATPase (SERCA), an effect known to induce ERSR, sulindac sulfide (SS) has not been reported to affect SERCA. Here, we investigated these two drugs for their effects on Ca²⁺ homeostasis, ERSR, and glioma cell survival. Our findings indicate that SS is a reversible inhibitor of SERCA and that both SS and CELE bind SERCA at its cyclopiazonic acid binding site. Furthermore, CELE releases additional Ca²⁺ from the mitochondria. In glioma cells, both NSAIDS upregulate GRP78 and activate ER‐associated caspase‐4 and caspase‐3. Although only CELE upregulates the expression of CHOP, it appears that CHOP induction could be associated with mitochondrial poisoning. In addition, CHOP induction appears to be uncorrelated with the gliotoxicity of these NSAIDS in our experiments. Our data suggest that activation of ERSR is primarily responsible for the gliotoxic effect of these NSAIDS. Because SS has good brain bioavailability, has lower COX‐2 inhibition, and has no mitochondrial effects, it represents a more appealing molecular candidate than CELE to achieve gliotoxicity via activation of ERSR. © 2012 Wiley Periodicals, Inc.     

血清MALAT1、ENA-78、HE4表达情况与子宫内膜异位症患者病情诊断的关系研究

目的：探讨血清MALAT1、ENA-78、HE4表达情况与子宫内膜异位症患者病情诊断的关系研究。方法：随机选取2017年4月-2019年10月来我院进行就诊并且确定为子宫内膜异位的患者列为观察组46例。选取同一时期来我院体检的正常健康妇女46例为对照组。对两组患者血清中的ENA-78、HE4及MALAT1因子水平进行比较。结果：观察组的ENA-78、HE4水平显著高于对照组,相反,观察组的MALAT1水平低于对照组,P<0.05。平行联合检测ROC曲线下面积分别为0.761、0.763和0.915,系列联合检测ROC曲线下面积为0.750、0.721和0.904,ENA-78+ MALAT1诊断的ROC曲线下面积显著高于MALAT1+ HE4及ENA-78+HE4,差异具有统计学意义(P＜0.05)。多因素logistic 回归分析显示,ENA-78、HE4与MALAT1均是子宫内膜异位症发病的影响因素(P<0.05)。结论：ENA-78、HE4和MALAT1表达情况对子宫内膜异位症患者存在相关性,而且ENA-78的诊断灵敏度最高,诊断灵敏度最低为HE4,研究结果可以为临床该病阳性诊断提供参考,诊断过程简单而且为非侵入式的,价值较高,值得在临床推广运用。