1,720,981 research outputs found
Obstructive sleep apnea syndrome in parkinson’s disease and other parkinsonisms
No full textAn association of obstructive sleep apnea syndrome (OSAS) and other sleep-disordered breathing (SDB) with Parkinson’s disease (PD) has been reported in some small studies. In the present study we investigated the occurrence of SDB in a large consecutive outpatient series. This is a case-control study in subjects attending a neurological clinic where all patients were screened for SDB by means of sleep-wake history, Epworth Sleepiness Scale, and full-night polysomnography, when indicated. 3194 patients were recruited. Of these, 194 were affected by PD and 77 by other parkinsonisms. Snoring, excessive daytime sleepiness and OSAS were more common in patients with PD or parkinsonisms (40.59, 5.9, and 4.06%) than in controls (35.58, 2.19, and 2.09%). Our study suggests an increased frequency of OSAS and other SDB in PD and parkinsonisms. Early detection and management of these disorders may have a substantial impact on quality of life and survival in these patients
Leukoaraiosis is an independent predictor of intracranial hemorrhage in patients with atrial fibrillation
No full textWe evaluated the predictive value of several clinical, radiological and laboratory parameters on the risk of predict intracranial hemorrhage (ICH) in patients with atrial fibrillation (AF). We conducted a case-control study on a consecutive hospital based series of patients with AF and ICH. A random sample of subjects with AF without ischemic or hemorrhagic stroke was selected from the same hospital in the same period to perform as the control group, with a ratio of two controls per case. All patients underwent the same evaluation protocol. Patients without neuroimaging exams were excluded. During the study period we identified 37 subjects with AF and ICH. 74 subjects without stroke events were randomly chosen among subjects with AF. Among cases 56.8% were female; mean age was 83.1 years. Patients with ICH were more often on anticoagulant therapy (75.7%), compared with controls (45.9%; p = 0.0002). On CT scans, cases had a greater severity of leukoaraiosis at the Blennow scale (p < 0.0001) and a higher frequency of lacunar infarcts (p = 0.006). No significant association was found between MRI parameters or the HAS-BLED score and the occurrence of ICH. CT scan is more useful than MRI and HAS-BLED score to predict ICH in patients with AF on antithrombotic therapy
NOVITA’ NELLA DIAGNOSI E NELLA TERAPIA DELLE DEMENZE VASCOLARI
No full textVascular dementia is a clinical condition relatively common in the elderly representing 15% of all forms of cogni -
tive decline. The term Vascular Cognitive Impairment (VCI) has been recently introduced in order to define the full spectrum
of cognitive disorders, from Mild Cognitive Impairment (MCI) to fully developed dementia, associated with all forms of cere -
bral vascular brain injury. Dysfunction of neurovascular unit and mechanisms regulating cerebral blood flow are important
components of the pathophysiological process underlying VCI. Cerebral amyloid angiopathy is an emerging risk factor for
Alzheimer's disease, microinfarcts, micro-and macrohemorrhages and VCI. In old people, Alzheimer's disease and cerebral
microvascular damage often coexist and may have a synergistic effect on cognitive impairment. Magnetic resonance and other
neuroimaging techniques play an important role in the definition and detection of VCI, since they may also identify white
matter hyperintensities and small deep infarcts. In many cases, stroke and VCI share the same risk factors. These include atrial
fibrillation, hypertension, diabetes mellitus, hypercholesterolemia. These risk factors also favour the onset of Alzheimer's
disease. At present there is no approved specific treatment for the VCI. However, early detection and control of traditional risk
factors and cardiovascular diseases have been found to be effective in the prevention of VCI. Acetylcholinesterase inhibitors
may improve executive functions of patients with VCI, as in Alzheimer disease.La demenza vascolare è una condizione clinica relativamente comune negli anziani rappresentando il 15% di tutte le forme di declino cognitivo. Il termine Vascular Cognitive Impairment (VCI) è stato introdotto di recente per definire l’intero spettro di disordini cognitivi, dal Mild Cognitive Impairment (MCI) alla demenza conclamata, associati a lesioni vascolari cerebrali. La disfunzione dell’unità neurovascolare ed i meccanismi che regolano il flusso ematico cerebrale sono alla base del processo fisiopatologico che determina l’insorgenza di VCI. L’angiopatia amiloide cerebrale è un fattore di rischio emergente per malattia di Alzheimer, microinfarti, micro- e macroemmorragie cerebrali e VCI. In età avanzata la malattia di Alzheimer ed il danno microvascolare cerebrale spesso coesistono e le performance cognitive peggiorano per effetto sinergico. La Risonanza Magnetica ed le altre tecniche di diagnostica per immagini giocano un ruolo importante nel definire e nel diagnosticare il VCI consentendo di evidenziare anche forme subcorticali di VCI, caratterizzate da iperintensità della sostanza bianca, ed infarti profondi di piccole dimensioni. In molti casi l’ictus cerebrale ed il VCI condividono gli stessi fattori di rischio. Questi includono fibrillazione atriale, ipertensione, diabete mellito, ipercolesterolemia. Gli stessi fattori di rischio favoriscono anche l’insorgenza di malattia di Alzheimer. Allo stato attuale non esiste alcun trattamento specifico approvato per il VCI. Tuttavia la diagnosi precoce ed il controllo dei fattori di rischio tradizionali e delle patologie cardiovascolari sono risultati efficaci nella prevenzione del VCI. Gli inibitori dell’acetilcolinesterasi si sono dimostrati efficaci nel migliorare le funzioni esecutive di pazienti affetti da VCI, con effetti sovrapponibili a quelli riscontrati nella demenza di Alzheimer
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
Variations on the Author
Get PDF“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
Get PDFWe 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
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
Adrenal incidentaloma: surgical update.
No full textNowadays, the role of surgery in the treatment of adrenal incidentalomas (AI), considering their biologic behavior, is still debated. Surgery is mandatory in cases of hyperfunctioning adrenal masses, in the presence of suspect radiological malignancy, in cases of discordant computed tomography (CT) and scintigraphy findings and when the maximum diameter is 4 cm or more. On the other hand, studies have suggested relative inaccuracy of conventional CT in evaluating the size. The aim of this paper was to evaluate the safety and effectiveness of laparoscopic adrenalectomy (LA) in the treatment of AI by reviewing our experience. Over the period from 1995 to 2005 we laparoscopically managed 78 AI by anterior transperitoneal approach. Two LA (2.6%) were converted to open surgery. Neither intra- nor post-operative major complications were observed. The mean size of lesions was 5.5 cm (range 3-9). Twenty-one large adrenal lesions (exceeding 6 cm) were removed (27%). Definitive histology resulted as follows: adrenocortical adenoma (63), pheochromocytoma (5), nodular hyperplasia (4), myelolipoma (3), cysts (2), and adrenocortical carcinoma (1, with a size of 3 cm). The patients were followed-up by hormonal and radiological evaluation every 12 months (6 for malignancy); their follow-up (median 60.4 months, range 6-123) was uneventful. Also larger AI were treated safely. Laparoscopy has been safe and effective in the treatment of AI in our experience, according to specific literatur
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