1,721,194 research outputs found
Levodopa-carbidopa intestinal gel in a subgroup of patients with dyskinesia at baseline from the GLORIA Registry
No full text
Age/disease duration influence on activities of daily living and quality of life after levodopa-carbidopa intestinal gel in Parkinson's disease
No full text Aim: To determine if age and Parkinson's disease duration at therapy initiation influence the efficacy of levodopa-carbidopa intestinal gel (LCIG) on quality of life and activities of daily living. Patients & methods: This post hoc analysis assessed subgroups of patients stratified by baseline age, disease duration, hours/day of ‘off’ time and levodopa equivalent dose. Patients’ data were collected from the GLORIA study, a 24-month observational registry evaluating long-term effectiveness of LCIG. Results & conclusion: LCIG therapy led to sustained improvements in quality of life irrespective of patient age and disease duration at baseline. Improvements in activities of daily living were observed across all subgroups, particularly in younger patients, patients with shorter disease duration and in patients with the highest baseline levodopa equivalent dose. </jats:p
Mavoglurant in Parkinson's patients with l-Dopa-induced dyskinesias: Two randomized phase 2 studies
No full textBackgroundTwo phase 2 randomized, double-blind studies were designed to evaluate efficacy and safety of immediate-release (study 1) and modified-release (study 2) mavoglurant formulations in PD l-dopa-induced dyskinesia. MethodsPatients were randomized to mavoglurant 100-mg or placebo (4:3) groups (study 1) and mavoglurant 200-mg, mavoglurant 150-mg, or placebo (2:1:1) groups (study 2). Primary outcome was antidyskinetic efficacy, as measured by change from baseline to week 12 in modified Abnormal Involuntary Movement Scale total score. ResultsDifferences in least-squares mean (standard error) change in modified Abnormal Involuntary Movement Scale total score in week 12 did not reach statistical significance in either study (study 1: mavoglurant 100 mg twice a day versus placebo, 1.7 [1.31]; study 2: mavoglurant 150 mg twice a day (-1.3 [1.16]) and 200 mg twice a day (-0.2 [1.03]) versus placebo). Adverse events incidence was higher with mavoglurant than with placebo. ConclusionsBoth studies failed to meet the primary objective of demonstrating improvement of dyskinesia with mavoglurant treatment. (c) 2016 International Parkinson and Movement Disorder SocietyNovartis Pharma AG, Basel, Switzerlan
Diagnostic value of the REM sleep behavior disorder screening questionnaire in Parkinson's disease
No full textObjective: We aimed to validate the rapid eye movement (REM) sleep behavior disorder (RBD) screening questionnaire (RBDSQ) in 2 independent samples of patients with Parkinson's disease (PD) using different settings when performing the investigations. Methods: The RBDSQ was administered to two independent samples of 52 and 75 consecutive PD patients investigated with video-polysomnography (vPSG). Results: In sample A, the RBDSQ identified 46/52 (88.5%) patients correctly. In sample B, 50/75 (66.7%) patients were identified correctly. Considering a cut-off score of >= 5 as a positive test result, sample A showed a sensitivity of 0.90 and a specificity of 0.87, sample B showed a sensitivity of 0.68 and a specificity of 0.63. Main differences between both groups were that patients of sample A underwent a sleep history including RBD assessment prior to administration of the RBDSQ, whereas in sample B the RBDSQ was administered during routine work-up. Conclusions: The diagnostic value of the RBDSQ strongly depends on the clinical setting and may be influenced by the individual's awareness on RBD. This finding is a critical issue which deserves clarification before use of this and other questionnaires can be recommended in epidemiological studies. (C) 2014 Elsevier B.V. All rights reserved
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
Variations on the Author
Full text link“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
Full text linkWe 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
Früh- und Differentialdiagnose von Parkinson-Syndromen unter besonderer Berücksichtigung des Steele-Richardson-Olszewski-Syndroms
Full text linkIn der Differentialdiagnose von Parkinson-Syndromen wurden in frühen und in fortgeschrittenen Stadien insgesamt 138 Patienten mit der Verdachtsdiagnose eines Morbus Parkinson und mit der Verdachtsdiagnose einer progressiven supranukleären Blickparese untersucht. Es wurden klinische Verlaufsbeobachtungen sowie die dopaminerge Stimulation mit Apomorphin, die Kernspintomographie und die single photon emission computed tomography (SPECT) mit dem Liganden Jodobenzamid für die Untersuchungen eingesetzt. Die Ergebnisse der zu untersuchenden Hypothesen können wie folgt zusammengefaßt werden: Bei bis dato unbehandelten Patienten mit akinetisch-rigiden Syndromen kann mittels einer Testinjektion von 3 -5 mg Apomorphin mit einer Sensitivität und Spezifität von etwa 90 % das Ansprechen auf eine L-Dopa-Langzeittherapie korrekt vorhergesagt werden. Das IBZM-SPECT ist in der Lage, mit einem positiven Vorhersagewert von 72 % und einem negativen Vorhersagewert von 89 % das Ansprechen auf eine spätere orale L-Dopa-Therapie korrekt vorherzusagen. In der Langzeitbeobachtung entwickeln sich aus den 10 Patienten im Frühstadium, die nach den klinischen Kriterien nicht eindeutig zuzuordnen waren, die eine verminderte Ligandenaufnahme haben, und die nicht auf Apomorphin reagieren, 7 ein "atypisches" Parkinson-Syndrom im Sinne einer MSA (n = 5), einer PSP (n = 1) oder einer CBGD (n = 1) Von diesen 7 Patienten hatten 5 bereits in der Erstdiagnostik eine verminderte IBZM-Bindung im SPECT. Vaskuläre Syndrome entwickeln nicht nur das klinische Bild des "lower body parkinsonism", sondern auch Zeichen einer vertikalen Blickparese mit Demenz bei akinetisch-rigidem Syndrom. Bei gut 30 % der untersuchten Patienten mit der klinischen Diagnose der PSP wurden vaskulär gedeutete Läsionen im MRT in der weißen Substanz und in den Basalganglien gefunden; diese hatten signifikant häufiger eine normale Bindung im IBZM-SPECT und unterschieden sich von degenerativen PSP-Patienten mit erniedrigter IBZM-Bindung. Wir deuten diese Patienten als eine andere nosologische Entität. Außerdem konnte erstmals gezeigt werden, daß bei Patienten, die klinisch wahrscheinlich oder möglicherweise eine PSP hatten, der antero-posteriore Durchmesser des Mittelhirns nach kernspintomographischer Messung mit der Ligandenaufnahme im IBZM-SPECT korreliert. Dies gilt für die Gesamtgruppe der untersuchten Patienten, aber auch für die Untergruppe, die keine hyperintensen T2-Läsionen haben. Diese Ergebnisse bedeuten für den klinische Alltag, daß nach einer sorgfältigen klinischen Untersuchung von Patienten mit Parkinson-Syndromen, die die gültigen Kriterien für die klinische Diagnose des Morbus Parkinson, der progressiven supranukleären Blickparese und auch der Multi-System-Atrophie beachtet, das Kernspintomogramm und das IBZM-SPECT notwendige Untersuchungen in der korrekten ätiologischen Zuordnung von Parkinson-Syndromen, insbesondere auch der progressiven supranukleären Blickparese sind. Dies ist für die weitere Planung insbesondere von neuroprotektiven Strategien bei diesen Krankheitsbildern von essentieller Bedeutung.One hundred thirty eight patients, in whom the diagnoses of Parkinson's disease or progressive supranuclear palsy (PSP) was suspected, were examined in order to improve the differential diagnosis of these syndromes. We observed the clinical course, tested for the dopaminergic response to the dopamine receptor agonist apomorphine, and used the technical measures of MRI and single photon emission computed tomography (SPECT) with the ligand 123[I] Iodobenzamide (IBZM) in all patients. Apomorphine correctly predicts the response to long term levodopa therapy with a sensitivity and specificity of approximately 90 % in previously untreated parkinsonian patients. The positive predictive value and negative predictive value of IBZM SPECT are 72 % and 89 % respectively. Ten early stage patients, who could not explicitly be assigned according to the clinical criteria, who had reduced IBZM SPECT binding and who did not respond to apomorphine, developed atypical parkinsonian syndromes in the sense of multiple system atrophy (MSA, n = 5), PSP (n = 1) or corticobasal degeneration (n = 1). Five of these 7 patients had a reduced IBZM binding in SPECT already during the early stage. Vascular syndromes depict not only the clinical picture of lower body parkinsonism, but also of supranuclear palsy, dementia and akinetic-rigid syndrome. We found MRI lesions within the white matter and the basal ganglia in about 30 % of our patients with the clinical diagnosis of PSP; we interpreted these lesions as vascular. In contrast to patients without these MRI lesions, who had decreased IBZM binding in SPECT, these patients with vascular disorders had significantly more frequently a normal binding. We interpret our results in that way that these patients represent another nosological entity. In addition, we showed for the first time that the anteroposterior diameter (measured in midbrain MRI scans) correlates to ligand binding measured by IBZM SPECT. This applies as well to all PSP patients as well to the sub-group without hyperintense MRI lesions. The in vivo diagnosis of bradykinetic syndromes relies on clinical examination; after careful observation of valid criteria for Parkinson's disease, PSP and MSA, MRI and IBZM SPECT are mandatory for the correct differential diagnosis, especially for PSP. This applies in particular, if neuroprotective therapies are to be investigated
- …
