scholarly journals Acupuncture Treatment Reduces Incidence of Parkinson's Disease in Patients With Depression: A Population-Based Retrospective Cohort Study in Taiwan

2020 ◽  
Vol 12 ◽  
Author(s):  
Cheng-Hao Huang ◽  
Mei-Chen Lin ◽  
Ching-Liang Hsieh
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cumulative Incidence ◽  
Acupuncture Treatment ◽  
Rank Test ◽  
Research Database ◽  
Propensity Score Method ◽  
Log Rank Test ◽  
Number Of Patients ◽  
Objective Evidence

Depression is a risk factor for subsequent Parkinson's disease (PD). Some patients with depression undergo acupuncture treatment because of other diseases in Taiwan. Therefore, the present study used data from Taiwan's National Health Insurance Research Database (NHIRD) to investigate the incidence of PD in patients having depression with and without acupuncture treatment. We conducted a retrospective study of a matched cohort of 48,981 patients with newly diagnosed depression between 2000 and 2012 who were selected from the NHIRD. The 1:1 propensity score method was utilized to match an equal number of patients (N = 9,189) in the acupuncture and non-acupuncture cohorts. We employed Cox proportional hazard models to evaluate the risk of PD. The cumulative incidence of PD in both cohorts was estimated using the Kaplan–Meier method, and the difference was examined through a log-rank test. Patients with depression who received acupuncture treatment demonstrated a lower risk of PD [adjusted hazard ratio (aHR) = 0.39, 95% confidence interval = 0.31–0.49] than those who did not undergo acupuncture treatment, after adjusting for age, sex, insurance amount, geographic region, urbanization levels, comorbidities, and drugs. The cumulative incidence of PD was significantly lower in the acupuncture cohort than in the non-acupuncture cohort (log-rank test, p < 0.001). The database did not indicate the severity of depression and acupoints. The results suggest that acupuncture treatment significantly reduced the development of PD in patients with depression; however, a future study should be conducted to provide more objective evidence.

scholarly journals The Effect of Cholecystectomy on the Risk of Colorectal Cancer in Patients with Gallbladder Stones

Cancers ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 550 ◽  
Author(s):  
Chien-Hua Chen ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Cumulative Incidence ◽  
Positive Association ◽  
Rank Test ◽  
Study Cohort ◽  
Research Database ◽  
Gallbladder Stones ◽  
Log Rank Test

To evaluate the risk of colorectal cancer (CRC) after cholecystectomy for gallbladder stones (GBS). Methods: This nationwide population-based cohort study analyzed the inpatient data from the Taiwan National Health Insurance Research Database. The study cohort comprised of 83,963 patients aged ≥ 20 years undergoing cholecystectomy for GBS between 2000 and 2010. The control cohort comprised the GBS patients without cholecystectomy, who were propensity matched with the study cohort at a 1:1 ratio based on age, sex, comorbidities, and the index date for cholecystectomy. Results: The cumulative incidence of CRC within 6 months of follow-up was higher in the cholecystectomy cohort than that in the non-cholecystectomy cohort (aHR (adjusted hazard ratio) = 7.90, 95% confidence interval (CI) = 6.27–9.94; log-rank test, p < 0.001). The cumulative incidence of CRC after 6 months of follow-up was lower in the cholecystectomy cohort than that in the non-cholecystectomy cohort (aHR = 0.66, 95% CI = 0.60–0.73; log-rank test, p < 0.001), but the reduced risk of CRC for the cholecystectomy cohort was statistically significant only in rectal cancer after separately considering females (aHR = 0.64, 95% CI = 0.46–0.88) and males (aHR = 0.59, 95% CI = 0.44–0.79). Conclusions: The positive association between cholecystectomy and the CRC risk within the first 6 months after cholecystectomy might be due to a detection bias or pre-existing CRC. However, cholecystectomy is associated with a decreased risk of rectal cancer, rather than proximal or distal colon cancer, after more than 6 months of follow-up.

scholarly journals Correlates of the discrepancy between objective and subjective cognitive functioning in non-demented patients with Parkinson’s disease

2021 ◽  
Author(s):  
Mattia Siciliano ◽  
Lugi Trojano ◽  
Rosa De Micco ◽  
Valeria Sant’Elia ◽  
Alfonso Giordano ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Linear Regression ◽  
Cognitive Functioning ◽  
Rating Scale ◽  
Regression Analyses ◽  
Chi Square ◽  
Cognitive Measure ◽  
Objective Evidence ◽  
Cognitive Discrepancy

Abstract Background Subjective complaints of cognitive deficits are not necessarily consistent with objective evidence of cognitive impairment in Parkinson’s disease (PD). Here we examined the factors associated with the objective-subjective cognitive discrepancy. Methods We consecutively enrolled 90 non-demented patients with PD who completed the Parkinson’s Disease Cognitive Functional Rating Scale (subjective cognitive measure) and the Montreal Cognitive Assessment (MoCA; objective cognitive measure). The patients were classified as “Overestimators”, “Accurate estimators”, and “Underestimators” on the basis of the discrepancy between the objective vs. subjective cognitive measures. To identify the factors distinguishing these groups from each other, we used chi-square tests or one-way analyses of variance, completed by logistic and linear regression analyses. Results Forty-nine patients (54.45%) were classified as “Accurate estimators”, 29 (32.22%) as “Underestimators”, and 12 (13.33%) as “Overestimators”. Relative to the other groups, the “Underestimators” scored higher on the Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), and Parkinson Anxiety Scale (p < 0.01). Logistic regression confirmed that FSS and BDI scores distinguished the “Underestimators” group from the others (p < 0.05). Linear regression analyses also indicated that FSS and BDI scores positively related to objective-subjective cognitive discrepancy (p < 0.01). “Overestimators” scored lower than other groups on the MoCA’s total score and attention and working memory subscores (p < 0.01). Conclusion In more than 45% of consecutive non-demented patients with PD, we found a ‘mismatch’ between objective and subjective measures of cognitive functioning. Such discrepancy, which was related to the presence of fatigue and depressive symptoms and frontal executive impairments, should be carefully evaluated in clinical setting.

scholarly journals Frequency of non-motor symptoms in Peruvian patients with Parkinson's disease

2013 ◽  
Vol 71 (4) ◽  
pp. 216-219 ◽  
Author(s):  
Carlos Cosentino ◽  
Yesenia Nuñez ◽  
Luis Torres
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Progressive Increase ◽  
Motor Symptoms ◽  
Number Of Patients ◽  
Progression Of Disease ◽  
The Mean ◽  
Relationship Of ◽  
The Relationship ◽  
Non Motor Symptoms

Introduction: Non-motor symptoms in Parkinson's disease are often not well recognized in clinical practice. Non-motor symptoms questionnaire (NMSQuest) is a simple instrument that allows patients or caregivers to report non-motor symptoms in a practical manner. Objective: We attempted to determine the prevalence of non-motor symptoms in three hundred Parkinson's disease outpatients. Results: The mean total non-motor symptoms was 12.41, ranging from 0 to 27 of a maximum of 30. At least one was present in 99.3% of patients. A progressive increase in mean total score was observed across each 5-year interval. Depression domain scored the most “positive” answers while urinary and anxiety /memory were secondly and thirdly most prevalent respectively. Conclusion: The large number of patients included in this study allowed evaluation of the occurrence of non-motor symptoms in early and advanced disease in addition to the relationship of these kinds of symptoms with progression of disease.

scholarly journals Outcomes following deep brain stimulation lead revision or reimplantation for Parkinson’s disease

2019 ◽  
Vol 130 (6) ◽  
pp. 1841-1846 ◽  
Author(s):  
Leonardo A. Frizon ◽  
Sean J. Nagel ◽  
Francis J. May ◽  
Jianning Shao ◽  
Andres L. Maldonado-Naranjo ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Device Failure ◽  
Suboptimal Outcome ◽  
Number Of Patients ◽  
The Mean ◽  
Lead Location ◽  
Deep Brain

OBJECTIVEThe number of patients who benefit from deep brain stimulation (DBS) for Parkinson’s disease (PD) has increased significantly since the therapy was first approved by the FDA. Suboptimal outcomes, infection, or device failure are risks of the procedure and may require lead removal or repositioning. The authors present here the results of their series of revision and reimplantation surgeries.METHODSThe data were reviewed from all DBS intracranial lead removals, revisions, or reimplantations among patients with PD over a 6-year period at the authors’ institution. The indications for these procedures were categorized as infection, suboptimal outcome, and device failure. Motor outcomes as well as lead location were analyzed before removal and after reimplant or revision.RESULTSThe final sample included 25 patients who underwent 34 lead removals. Thirteen patients had 18 leads reimplanted after removal. There was significant improvement in the motor scores after revision surgery among the patients who had the lead revised for a suboptimal outcome (p = 0.025). The mean vector distance of the new lead location compared to the previous location was 2.16 mm (SD 1.17), measured on an axial plane 3.5 mm below the anterior commissure–posterior commissure line. When these leads were analyzed by subgroup, the mean distance was 1.67 mm (SD 0.83 mm) among patients treated for infection and 2.73 mm (SD 1.31 mm) for those with suboptimal outcomes.CONCLUSIONSPatients with PD who undergo reimplantation surgery due to suboptimal outcome may experience significant benefits. Reimplantation after surgical infection seems feasible and overall safe.

scholarly journals Anesthetics and long-term survival after cancer surgery—total intravenous versus volatile anesthesia: a retrospective study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Boohwi Hong ◽  
Sunyeul Lee ◽  
Yeojung Kim ◽  
Minhee Lee ◽  
Ann Misun Youn ◽  
...  
Keyword(s):  
Overall Survival ◽  
Cancer Patients ◽  
Cancer Surgery ◽  
Trial Registration ◽  
Favorable Effect ◽  
Rank Test ◽  
Intravenous Anesthesia ◽  
Term Survival ◽  
Log Rank Test ◽  
Number Of Patients

Abstract Background Intravenous anesthesia has been reported to have a favorable effect on the prognosis of cancer patients. This study was performed to analyze data regarding the relation between anesthetics and the prognosis of cancer patients in our hospital. Methods The medical records of patients who underwent surgical resection for gastric, lung, liver, colon, and breast cancer between January 2006 and December 2009 were reviewed. Depending on the type of anesthetic, it was divided into total intravenous anesthesia (TIVA) or volatile inhaled anesthesia (VIA) group. The 5-year overall survival outcomes were analyzed by log-rank test. Cox proportional hazards modeling was used for sensitivity. Results The number of patients finally included in the comparison after propensity matching came to 729 in each group. The number of surviving patients at 5 years came to 660 (90.5%) in the TIVA and 673 (92.3%) in the VIA. The type of anesthetic did not affect the 5-year survival rate according to the log-rank test (P = 0.21). Variables associated with a significant increase in the hazard of death after multivariable analysis were male sex and metastasis at surgery. Conclusions There were no differences in 5-year overall survival between two groups in the cancer surgery. Trial registration Trial registration: CRIS KCT0004101. Retrospectively registered 28 June 2019.

Complementary Acupuncture Treatment Increases Cerebral Metabolism in Patients with Parkinson's Disease

2009 ◽  
Vol 119 (8) ◽  
pp. 1190-1197 ◽  
Author(s):  
Yong Huang ◽  
Xuemei Jiang ◽  
Ying Zhuo ◽  
Anwu Tang ◽  
Gustav Wik
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Acupuncture Treatment ◽  
Cerebral Metabolism

scholarly journals Higher Coated-Platelet Levels are Associated with Stroke Recurrence following Nonlacunar Brain Infarction

2012 ◽  
Vol 33 (2) ◽  
pp. 287-292 ◽  
Author(s):  
Calin I Prodan ◽  
Julie A Stoner ◽  
Linda D Cowan ◽  
George L Dale
Keyword(s):  
Ischemic Stroke ◽  
Cumulative Incidence ◽  
Recurrent Stroke ◽  
Brain Infarction ◽  
Large Vessel ◽  
Rank Test ◽  
Stroke Recurrence ◽  
Additional Tool ◽  
Log Rank Test ◽  
Dual Agonist

Coated-platelets are procoagulant platelets observed upon dual-agonist stimulation with collagen and thrombin. Coated-platelet levels are elevated in patients with nonlacunar (large-vessel) ischemic stroke and decreased in patients with spontaneous intracerebral hemorrhage as compared with controls. The purpose of this study was to investigate a possible relationship between coated-platelet levels and stroke recurrence in patients with nonlacunar ischemic stroke. We assayed coated-platelet levels in 190 consecutive patients with nonlacunar stroke who were followed for up to 12 months; 20 subjects experienced recurrent stroke. Subjects were categorized into tertiles of coated-platelet levels. The distributions of time-to-recurrent stroke were estimated for each tertile using cumulative incidence curves and compared statistically using a log-rank test. The cumulative incidence of recurrent stroke at 12 months differed among the coated-platelet tertiles: 2% for the first tertile (lowest coated-platelet levels), 18% for the second tertile, and 17% for the third tertile (overall log-rank test, P = 0.019). These data suggest that higher levels of coated-platelets, measured shortly after a nonlacunar stroke, are associated with an increased incidence of stroke recurrence. This observation offers an additional tool for identifying patients at highest risk for stroke recurrence following a nonlacunar (large-vessel) infarct.

scholarly journals Neurocognitive and psychosocial correlates of ventroposterolateral pallidotomy surgery in Parkinson's disease

1997 ◽  
Vol 2 (3) ◽  
pp. E9 ◽  
Author(s):  
Henry J. Riordan ◽  
Laura A. Flashman ◽  
David W. Roberts
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Globus Pallidus ◽  
Cognitive Flexibility ◽  
Psychosocial Functioning ◽  
Surgical Outcome ◽  
Verbal Learning ◽  
Objective Evidence ◽  
Before And After

The purpose of this study was to characterize the neuropsychological and psychosocial profile of patients with Parkinson's disease before and after they underwent unilateral left or right pallidotomy, to assess specific cognitive and personality changes caused by lesioning the globus pallidus, and to predict favorable surgical outcome based on these measures. Eighteen patients underwent comprehensive neuropsychological assessment before and after left-sided pallidotomy (10 patients) or right-sided pallidotomy (eight patients). The findings support the presence of frontosubcortical cognitive dysfunction in all patients at baseline and a specific pattern of cognitive impairment following surgery, with side of lesion being an important predictor of pattern and degree of decline. Specifically, patients who underwent left-sided pallidotomy experienced a mild decline on measures of verbal learning and memory, phonemic and semantic verbal fluency, and cognitive flexibility. Patients who underwent right-sided pallidotomy exhibited a similar decline in verbal learning and cognitive flexibility, as well as a decline in visuospatial construction abilities; however, this group also exhibited enhanced performance on a delayed facial memory measure. Lesioning the globus pallidus may interfere with larger cognitive circuits needed for processing executive information with disruption of the dominant hemisphere circuit, resulting in greater deficits in verbal information processing. The left-sided pallidotomy group also reported fewer symptoms of depression and anxiety following surgery. This enhanced mood functioning was not seen for the right-sided pallidotomy group. No relationships were noted between cognitive impairment or advanced age at baseline and surgical outcome. This study provides objective evidence for specific changes in neurocognitive and psychosocial functioning following left- and right-sided pallidotomy.

scholarly journals Ageing and MPTP-sensitivity depend on molecular and ultrastructural signatures of Astroglia and Microglia in mice nigra

2020 ◽  
Author(s):  
PL Abhilash ◽  
Upasna Bharti ◽  
Haorei Yarreiphang ◽  
Mariamma Philip ◽  
Rashmi Santhosh Kumar ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Old Age ◽  
Middle Age ◽  
Strain Differences ◽  
Experimental Models ◽  
Data Availability ◽  
Specific Distribution ◽  
Tnf Α ◽  
Objective Evidence

ABSTRACTGlia show region-specific distribution in CNS and often mal-adapt to age-associated alterations in their niche. Some studies on autopsied nigra of Parkinson’s disease (PD) patients and experimental models propose gliosis as a putative trigger of neuronal loss. Epidemiological studies propose an ethnic bias in PD prevalence, as Caucasians are more susceptible than non-whites. Similarly, different mice strains are variably sensitive to MPTP. We had earlier likened divergent MPTP-sensitivity of C57BL/6J and CD-1 mice with differential susceptibility to PD based on differences in neuronal numbers.Here we examined whether the variability was also incumbent to inter-strain differences in glial features. Stereological counts showed more microglia and fewer astrocytes in the nigra of MPTP-susceptible normal C57BL/6J mice, suggesting persistence of an immune-vigilant state. Pronounced MPTP-induced microgliosis and astrogliosis in both strains suggest glial involvement in pathogenesis. ELISA-based estimation of pro-inflammatory cytokines in the ventral midbrain revealed middle-age specific augmentation of TNF-α and IL-6 that reduced at old-age, suggesting middle-age as a critical, inflamm-aging associated time-point. IL-1β levels declined gradually. Inter-strain differences in TNF-α, including that seen post-MPTP, persisted across ageing while IL-6 and IL-1β showed upregulation at old-age. Levels of anti-inflammatory cytokine TGF-β were higher in CD-1. The enzymes MAO-A, MAO-B and iNOS were upregulated in both strains upon MPTP-challenge. Enhancement in fracktalkine and hemeoxygenase-1, post-MPTP, may be neuronal compensatory signals. Most importantly, ultrastructural observations of elongated glial mitochondria vis-à-vis the shrunken ones in neurons, suggest upscaling of glial functions with neurotoxic consequences. Thus, glia could be key modulators of ageing and disease-susceptibility.Significance statementPeople of Caucasians ancestry are more susceptible to Parkinson’s disease, than the Asians, for reasons not completely understood. Surprisingly, their admixed population “the Anglo-Indians” that lives in India; are much less prone. We designed a disease model around two different laboratory mice i.e. C57BL/6 and CD-1 mice and extrapolated the results to the ethnicities, using a neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP). Our study provides objective evidence that astroglia are inherently more and microglia fewer in the mice that resist MPTP. They secret low levels of neuroinflammatory proteins and their gut microbiota is typical. The glial mitochondria may hold the key to cure neurodegeneration.Data availability statementThe data that support the findings of this study are available from the corresponding author upon request.

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