A Guide for the Differential Diagnosis of Multiple System Atrophy in Clinical Practice.

Multiple system atrophy (MSA) is a sporadic and progressive neurodegenerative disorder with a complex differential diagnosis. A range of disorders- also of nondegenerative etiology- can mimic MSA, expanding its differential diagnosis. Both misdiagnosis and diagnostic delays are relatively common in clinical practice.

Validation of quantitative gait analysis systems for Parkinson's disease for use in supervised and unsupervised environments.

Background: Gait impairments are among the most common and impactful symptoms of Parkinson's disease (PD). Recent technological advances aim to quantify these impairments using low-cost wearable systems for use in either supervised clinical consultations or long-term unsupervised monitoring of gait in ecological environments. However, very few of these wearable systems have been validated comparatively to a criterion of established validity.

Feasibility of a Mobile-Based System for Unsupervised Monitoring in Parkinson's Disease.

Mobile health (mHealth) has emerged as a potential solution to providing valuable ecological information about the severity and burden of Parkinson's disease (PD) symptoms in real-life conditions. : The objective of our study was to explore the feasibility and usability of an mHealth system for continuous and objective real-life measures of patients' health and functional mobility, in unsupervised settings. : Patients with a clinical diagnosis of PD, who were able to walk unassisted, and had an Android smartphone were included.

Cardiovascular and cerebrovascular risk markers in Parkinson's disease: Results from a case-control study.

Background: The relationship between Parkinson's disease (PD) and cardiovascular and cerebrovascular disease is not yet well established. Recent data suggest an increased risk of myocardial infarction and stroke in PD patients. Therefore, we designed a study to assess surrogate markers of cardiovascular and cerebrovascular risk in PD.

Challenges and Perspectives in the Management of Late-Stage Parkinson's Disease.

Parkinson's disease (PD) is a common neurodegenerative disorder, with a continuously increasing prevalence. With improved clinical and therapeutic management of PD, more patients reach later stages of the disease, meaning they may face new clinical problems that were not commonly approached. This gave way to the description of a new PD stage, late-stage PD (LSPD), which is clinically discernible from the advanced-stage one.

Intravenous Thrombolysis for Acute Ischemic Stroke After Recent Myocardial Infarction: Case Series and Systematic Review.

Background and Purpose- The safety of IV r-tPA (intravenous tissue-type plasminogen activator) for acute ischemic stroke (AIS) treatment after recent myocardial infarction (MI) is still a matter of debate. We studied the safety of delivering IV r-tPA to AIS patients with a MI within the preceding 3 months. Methods- Retrospective review of consecutive AIS admitted to 2 tertiary university hospitals' and systematic literature review for AIS patients with history of MI in the previous 3 months.

Red Ear: Syndrome or Symptom?

Red ear syndrome (RES) is a rare disorder characterized by attacks of unilateral ear pain during which the ear becomes red. Episodes can occur spontaneously, or be triggered, in most cases, by rubbing or touching the ear. Both duration and frequency are variable.

Abdominal Aortic Calcifications Predict Survival in Peritoneal Dialysis Patients.

Background: Peripheral arterial disease and vascular calcifications contribute significantly to the outcome of dialysis patients. The aim of this study was to evaluate the prognostic role of severity of abdominal aortic calcifications and peripheral arterial disease on outcome of peritoneal dialysis (PD) patients using methods easily available in everyday clinical practice.

Methods: We enrolled 249 PD patients (mean age 61 years, 67% male) in this prospective, observational, multicenter study from 2009 to 2013.

Bone histomorphometry and indicators of bone and mineral metabolism in wait-listed dialysis patients.

Aims: The aim of this study was to evaluate the associations between bone histomorphometry and bone volume measured by dual-energy X-ray absorptiometry (DXA) in wait-listed dialysis patients. Further, the circulating markers of mineral metabolism and bone turnover were compared.

Material And Methods: Bone biopsies were performed on 61 wait-listed dialysis patients.

Atherosclerosis and disc degeneration/low-back pain--a systematic review.

Objectives: Atherosclerosis can obstruct branching arteries of the abdominal aorta, including four paired lumbar arteries and the middle sacral artery that feed the lumbar spine. The diminished blood flow could result in various back problems. The aim of this systematic literature review was to assess associations between atherosclerosis and disc degeneration (DD) or low-back pain (LBP).

Abdominal aortic calcification in dialysis patients: results of the CORD study.

Background: Patients with chronic kidney disease stage 5 have a high prevalence of vascular calcification, but the specific anatomical distribution and severity of abdominal aortic calcification (AAC), in contrast to coronary calcification, is less well documented. AAC may be recorded using plain radiographs. The present report is an analysis of baseline data on AAC in patients enrolled in the CORD (Calcification Outcome in Renal Disease) study.

Serum lipids in relation to sciatica among Finns.

Objectives: Atherosclerosis of arteries supplying the lumbar region has been suggested as a mechanism leading to intervertebral disc degeneration and sciatica. The study described here examined whether serum lipid levels or pharmacologically treated hyperlipidemia were associated with sciatica.

Methods: A nationally representative sample (n=8028) of Finns aged 30 years or over was interviewed and examined.

MR aortography and serum cholesterol levels in patients with long-term nonspecific lower back pain.

Study Design: A cross-sectional analysis of the feeding arteries of the lumbar spine and cholesterol levels on patients with long-term nonspecific lower back pain.

Objectives: To evaluate whether occlusion of lumbar and middle sacral arteries or serum cholesterol levels are associated with lower back pain and/or with disc degeneration.

Summary Of Background Data: Atherosclerosis in the wall of the abdominal aorta usually develops at the ostia of branching arteries and the bifurcation, and may obliterate orifices of lumbar and middle sacral arteries.

Bone loss and the progression of abdominal aortic calcification over a 25 year period: the Framingham Heart Study.

Vascular calcification and osteoporosis are common age-related processes that are prominently displayed on routine lateral lumbar spine radiographs as dense calcium mineral deposits of the aorta that lie adjacent to osteopenic vertebrae. Using a population-based cohort of older men and women, we tested the hypothesis that the progression of vascular calcification of the abdominal aorta should be greatest in those individuals with the greatest amount of bone loss. From the original population-based Framingham Heart Study cohort, 364 women and 190 men had lateral lumbar spine and hand radiographs performed between 1966 and 1970 and repeated between 1992 and 1993.

Abdominal aortic calcific deposits are an important predictor of vascular morbidity and mortality.

Background: The impact of abdominal arterial calcific deposits on the prediction of cardiovascular disease (CVD) over a long follow-up interval deserves greater scrutiny.

Methods And Results: Lateral lumbar radiographs were studied as a predictor of incident coronary heart disease (CHD), CVD, and CVD mortality in 1049 men and 1466 women (mean age, 61 years) who were followed from 1967 to 1989. Anterior and posterior wall calcific deposits in the aorta at the level of the first through fourth lumbar vertebrae were graded according to increasing severity using a previously validated rating scale for abdominal aortic calcium (AAC) that ranges from 0 to 24 points.

The GPIIIa Pl(A) polymorphism in the progression of abdominal aortic atherosclerosis.

Glycoprotein IIIa is expressed in platelets as part of the fibrinogen receptor and also in vascular endothelium where it mediates smooth muscle cell proliferation. The association between the glycoprotein GPIIIa Pl(A) polymorphism and the stage of atherosclerosis in the abdominal aorta was studied in a prospective autopsy study series of 300 middle-aged men (33-69 years). The Pl(A) genotype was determined by RFLP-PCR.

Degenerative displacement of lumbar vertebrae. A 25-year follow-up study in Framingham.

Study Design: The authors assessed degenerative lumbar displacement in a population-based cohort of 217 men and 400 women who had lateral lumbar radiographs performed at the mean age of 54 years and again at 79 years, and who had completed interviews on back symptoms and functional performance in connection with the follow-up examination.

Objectives: To assess the prevalence and incidence of degenerative slippage and its association with back pain and physical disability.

Summary Of Background Data: Degenerative displacement of lumbar vertebrae may cause instability, nerve root compression, and spinal stenosis.

Postmortem pancreatic angiography in 45 subjects with non-insulin-dependent diabetes mellitus and 51 controls.

We evaluated, from 96 postmortem angiographs, the main feeding arteries and degree of vascularity of the pancreas to discover to what extent atherosclerosis affects pancreatic blood supply in subjects with and without non-insulin-dependent diabetes mellitus (NIDDM). Patients with NIDDM more often showed intrapancreatic arteries with irregularities in the body-tail of the pancreas (p = 0.050) and more frequently demonstrated decreased vascularity in both the body-tail and the head of the pancreas (p < 0.

Prevalence of stenotic changes in arteries supplying the lumbar spine. A postmortem angiographic study on 140 subjects.

Objectives: To study the prevalence of arterial diseases in the arteries supplying the lumbar spine and their relation to other vascular diseases, as well as to chronic low back pain.

Methods: Five pairs of the lumbar arteries and the middle sacral artery were evaluated from 140 postmortem aortograms, performed in connection with routine medicolegal necropsies on subjects ranging from 16 to 89 years of age. For information about low back pain history, a close relative of each of the deceased was interviewed two to four weeks after the necropsy.