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    Once-daily pramipexole for the treatment of early and advanced idiopathic Parkinson’s disease: implications for patients

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    Angelo Antonini¹, Daniela Calandrella²¹Department for Parkinson’s Disease, IRCSS San Camillo, Venice, Italy; ²Department for Parkinson’s Disease, Clinic San Pio X, Milan, ItalyAbstract: Immediate-release (IR) pramipexole is indicated for the symptomatic treatment of idiopathic Parkinson’s disease (PD), either alone (without levodopa) or in combination with levodopa, that is, during the entire progress of disease up to the advanced stage. It is also currently indicated for the treatment of moderate-to-severe primary restless legs syndrome (RLS). An extended-release (ER) formulation of pramipexole has been developed to allow a once-daily formulation and to provide more stable dopaminergic stimulation. This review summarized the pharmacokinetic profile of pramipexole for both the IR and ER formulations, and discussed the role of pramipexole in the management of early and advanced PD. The introduction of a once-daily formulation of pramipexole poses significant potential advantages for patients and this is reflected by relatively stable plasma levels. The most obvious benefit is convenience of use and better adherence to treatment schedule. Additional advantages may be represented by the opportunity to provide continuous drug delivery in a fashion that could potentially help minimize dyskinesia risk if the drug is used early in the disease course.Keywords: advanced Parkinson’s disease, continuous drug delivery, early Parkinson’s disease, extended release, immediate release, pramipexol

    Rotigotine transdermal patch in the management of Parkinson’s disease (PD) and its night-time use for PD-related sleep disorders

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    Rotigotine (Neupro®) is a non-ergolinic dopamine agonist available as a transdermal patch that can be applied once daily. To date, it is approved as monotherapy for the treatment of early Parkinson’s disease (PD), and as adjunctive therapy to levodopa in the treatment of PD, including the advanced stage of the disease, when the efficacy of levodopa is reduced or becomes inconsistent and there are fluctuations in the therapeutic effect (end-dose, ‘ON-OFF’ phenomenon). The potential advantages of the rotigotine patch include immediacy of effect onset as intestinal absorption is not needed, constant drug delivery, and ease of use. This review provides an overview of several aspects of the use of the rotigotine transdermal patch, including the important issue of the management of sleep disorders in advanced PD patients, as well as the chemistry, preclinical and clinical pharmacology, efficacy, safety and tolerability of the drug. Furthermore, the rationale for the treatment of PD with the rotigotine transdermal patch is discussed, focusing in particular on the related sleep disorders

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed

    Chronic intrathecal baclofen infusion for spasticity: Relationship between pump and host

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    Twenty patients with chronic intractable spinal spasticity were implanted with a totally implantable programmable pump for intrathecal administration of baclofen. The objective of this study was to evaluate the relationship between pump and the host. Clinical efficacy of the therapy was evaluated by the Ashworth Scale, the Spasms Frequency Scale, and the Functional Independence Measure (FIM) motor scores. All patients were asked to reply to 10 questions regarding discomfort of their refills, the ease of rehabilitation after therapy, their fear of pump failure and onset of alarm signals, their discomfort due to a metallic foreign body (the pump), the attitude of their relatives and other persons regarding their pump system, whether they would undergo this therapy again, and whether, in the absence of public health insurance, whether they would be willing to pay for their pump and therapy. The Ashworth scale, the Spasms Frequency Scale, and the FIM motor score showed a significant improvement in all patients after the onset of therapy with baclofen. The refill procedure was not a problem in all patients while four patients (20%) considered the number of refills "uncomfortable." Rehabilitation was no problem after the pump was implanted in all patients, 10 patients (50%) feared pump failure, while six patients (30%) feared their alarm signals. Three patients (15%) had some discomfort from their pumps rubbing against their belts; two patients (10%) stated that other people were aware of their pumps; all but two patients (10%) were ready to have their implants again; three patients (15%) would pay for the pump in case of absence of public health insurance for the therapy. We conclude that the implant of pumps for chronic intrathecal baclofen infusion is, today, a known effective procedure. Refill of the pump system was not a problem in our patient population, while the number of refills did cause some discomfort in some patients. It was shown by our study that the pump did facilitate rehabilitation in our patients, and a certain degree of dependence on the pump did exist. Fifty percent of the patients were afraid of pump failure and 30% were afraid of their alarm signals going off. The fact that most patients would undergo this therapy again and some would even pay for it directly in the absence of public insurance for the therapy were indices of patient satisfaction with the procedure. Because this was a small study, we believe that larger studies are necessary to corroborate our findings.Twenty patients with chronic intractable spinal spasticity were implanted with a totally implantable programmable pump for intrathecal administration of baclofen. The objective of this study was to evaluate the relationship between pump and the host. Clinical efficacy of the therapy was evaluated by the Ashworth Scale, the Spasms Frequency Scale, and the Functional Independence Measure (FIM) motor scores. All patients were asked to reply to 10 questions regarding discomfort of their refills, the ease of rehabilitation after therapy, their fear of pump failure and onset of alarm signals, their discomfort due to a metallic foreign body (the pump), the attitude of their relatives and other persons regarding their pump system, whether they would undergo this therapy again, and whether, in the absence of public health insurance, whether they would be willing to pay for their pump and therapy. The Ashworth scale, the Spasms Frequency Scale, and the FIM motor score showed a significant improvement in all patients after the onset of therapy with baclofen. The refill procedure was not a problem in all patients while four patients (20%) considered the number of refills "uncomfortable." Rehabilitation was no problem after the pump was implanted in all patients, 10 patients (50%) feared pump failure, while six patients (30%) feared their alarm signals. Three patients (15%) had some discomfort from their pumps rubbing against their belts; two patients (10%) stated that other people were aware of their pumps; all but two patients (10%) were ready to have their implants again; three patients (15%) would pay for the pump in case of absence of public health insurance for the therapy. We conclude that the implant of pumps for chronic intrathecal baclofen infusion is, today, a known effective procedure. Refill of the pump system was not a problem in our patient population, while the number of refills did cause some discomfort in some patients. It was shown by our study that the pump did facilitate rehabilitation in our patients, and a certain degree of dependence on the pump did exist. Fifty percent of the patients were afraid of pump failure and 30% were afraid of their alarm signals going off. The fact that most patients would undergo this therapy again and some would even pay for it directly in the absence of public insurance for the therapy were indices of patient satisfaction with the procedure. Because this was a small study, we believe that larger studies are necessary to corroborate our findings

    Variations on the Author

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    “Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship

    Appropriate Similarity Measures for Author Cocitation Analysis

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    We provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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