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Fluctuating Cotard syndrome in a patient with advanced Parkinson disease
No full textIntroduction: Nonmotor fluctuations of psychiatric symptoms in patients suffering from Parkinson disease (PD) represent a very disabling condition, which may seriously interfere with the quality of life of patients and caregivers. In this regard, these disturbances are present with a higher frequency in advanced PD patients with associated motor complications and can appear both in "on" and in "off" period. Here we report on a case of fluctuating Cotard syndrome clearly related to "wearing-off" deterioration and responsive to levodopa treatment in a patient affected by advanced PD. Case Report: A 76-year-old woman presented with a 13-year history of PD. Her caregivers reported that, in the last 2 months, she has developed a sudden onset of nihilistic delusion (Cotard syndrome), mainly during the "wearing-off" condition and associated with end of dose dyskinesias and akathisia. As Cotard syndrome clearly improved with the administration of levodopa, the patient was successfully treated changing the levodopa schedule with the shortening of intervals between levodopa intakes in small doses. Conclusions: Both the appearance of the Cotard syndrome in this patient during the "off" state and the subsequent improvement of psychotic symptoms after levodopa administration strongly suggest an important correlation with the dopaminergic dysregulation. This finding suggests that dopaminergic deficit might play a key factor in the development of Cotard syndrome
Differential roles of splanchnic and peripheral tissues in the pathogenesis ofimpaired glucose tolerance
No full textTo identify the mechanism(s) of the altered glucoregulatory response to a glucose
load in subjects with impaired glucose tolerance, we selectively quantitated the
components of net splanchnic glucose balance, i.e., splanchnic glucose uptake and
hepatic glucose output, as well as peripheral glucose uptake, by combining
[3-3H]glucose infusion with hepatic vein catheterization. After intravenous
glucose infusion (6 mg X kg-1 X min-1 for 90 min), blood glucose rose to 172 +/-
7 mg/dl in controls and 232 +/- 13 mg/dl in subjects with impaired glucose
tolerance (P less than 0.01). The response of plasma insulin did not differ
significantly between the two groups (29 +/- 4 vs. 40 +/- 10 microU/ml at 90 min
in control and in glucose intolerant subjects, respectively; P = NS). In both
groups, glucose infusion caused the net splanchnic glucose balance to switch from
the net output of the basal state to a net glucose uptake. However, this effect
was more marked in subjects with impaired glucose tolerance than in control
subjects (at 90 min: 2.83 +/- 0.53 vs. 1.60 +/- 0.18 mg X kg-1 X min-1,
respectively: P less than 0.05). The different pattern of splanchnic glucose
balance was entirely accounted for by a greater rise in splanchnic glucose uptake
in the group of glucose intolerants , as the suppression of endogenous glucose
output by the glucose load was practically complete in both groups. In contrast,
glucose uptake by peripheral tissues increased considerably less in subjects with
impaired glucose tolerance than in controls (2.2-2.6 vs 3.6-4.1 mg X kg-1 X
min-1, respectively, between 60 and 90 min; P less than 0.01-0.001). Furthermore,
a net splanchnic lactate uptake was present in the basal state, which was
inhibited by the glucose load and switched to a comparable net lactate output in
both groups. These results indicate that the mechanism responsible for the
altered glucoregulation in subjects with impaired glucose tolerance resides
entirely in the peripheral tissues whose ability to dispose of a glucose load is
drastically reduced. On the other hand, no defect is detectable in any of the
explored mechanisms regulating splanchnic glucose metabolism during the disposal
of an exogenous glucose load
Bibbia Guarnacciana, LXI.8.7 (1), Volterra
No full textDescrizione Bibbia di Volterra imparentata con la Bibbia di Calci (secolo XII
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe 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
From Archaeological Discovery to Text Analysis. The Khor chags Monastery Findings and the Manjusrinamasamgiti fragment
No full textResults of an important archaelogical and philological discovery in Western Tibet that has changed in a very relevant way our view of the history of the Tibetan canon
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