Efficacy of Noninvasive Ventilation With Expiratory Washout in Stable COPD Patients.

Background: A noninvasive ventilation (NIV) mask has been designed to deliver NIV with expiratory washout to improve efficacy of ventilation by optimizing clearance of expired gases from the anatomic dead space. This study compared the performance and comfort of a novel investigational mask with expiratory washout with a conventional mask during NIV therapy.

Methods: In this pilot crossover study, participants with severe stable COPD attended a single visit to receive bi-level NIV through 2 masks; the investigational mask with expiratory washout and a conventional mask.

Automated oxygen titration with non-invasive ventilation in hypoxaemic adults with cardiorespiratory disease: a randomised cross-over trial.

Background: Closed-loop oxygen control systems automatically adjust the fraction of inspired oxygen (FiO) to maintain oxygen saturation (SpO) within a predetermined target range. Their performance with low and high-flow oxygen therapies, but not with non-invasive ventilation, has been established. We compared the effect of automated oxygen on achieving and maintaining a target SpO range with nasal high flow (NHF), bilevel positive airway pressure (bilevel) and continuous positive airway pressure (CPAP), in stable hypoxaemic patients with chronic cardiorespiratory disease.

DIGIPREDICT: physiological, behavioural and environmental predictors of asthma attacks-a prospective observational study using digital markers and artificial intelligence-study protocol.

Introduction: Asthma attacks are a leading cause of morbidity and mortality but are preventable in most if detected and treated promptly. However, the changes that occur physiologically and behaviourally in the days and weeks preceding an attack are not always recognised, highlighting a potential role for technology. The aim of this study 'DIGIPREDICT' is to identify early digital markers of asthma attacks using sensors embedded in smart devices including watches and inhalers, and leverage health and environmental datasets and artificial intelligence, to develop a risk prediction model to provide an early, personalised warning of asthma attacks.

START CARE: a protocol for a randomised controlled trial of step-wise budesonide-formoterol reliever-based treatment in children.

Background: Asthma is the most common chronic childhood respiratory condition globally. Inhaled corticosteroid (ICS)-formoterol reliever-based regimens reduce the risk of asthma exacerbations compared with conventional short-acting β-agonist (SABA) reliever-based regimens in adults and adolescents. The current limited evidence for anti-inflammatory reliever therapy in children means it is unknown whether these findings are also applicable to children.

COVID-19 vaccination and the skin to deltoid MUSCLE distance in adults with diabetes.

Objectives: To estimate the proportion of adult diabetics with a skin to deltoid muscle distance (SDMD) of > 25 mm, representing a distance greater than the standard needle length used for intramuscular COVID-19 vaccination, and to assess whether anthropometric measurements predict ultrasound SDMD measurements.

Design: Non-interventional cross-sectional study.

Setting: Single site, non-clinical setting, Wellington, New Zealand.

Determination of oxygen saturation compared to a prescribed target range using continuous pulse oximetry in acutely unwell medical patients.

Background: Both inadequate and excessive administration of oxygen to acutely unwell patients results in risk of harm. Guidelines recommend titration of oxygen to achieve a target oxygen saturation (SpO) range. Information regarding whether this is being achieved is limited.

Diabetes mellitus contributes to higher cerebrospinal fluid tau levels selectively in Alzheimer's disease patients with the APOE4 genotype.

Background And Purpose: Diabetes mellitus (DM) is considered a risk factor for Alzheimer's disease (AD) and shares some pathological pathways, such as activation of amyloid cascade and tau phosphorylation. The aim of the present study was to investigate to what extent DM could impact on neurodegeneration within the AD continuum, using β amyloid (A: Aβ ) and phosphorylated tau (T: p-tau) biomarkers to discriminate patients by Alzheimer's pathological change (A+/T-) and AD (A+/T+), according to the National Institute on Aging and Alzheimer's Association classification. In addition, we aimed to evaluate whether APOE genotype interacts with tau protein and glucose metabolism dysfunction to affect the pathological process.

Clinical Outcomes of Switching to Insulin Glargine 300 U/ml from Other Basal Insulins in People with Type 2 Diabetes in Italy: A Real-World Study.

Introduction: Primary aim was to provide real-world evidence of the outcomes after the switch to glargine 300 U/ml (Gla-300) from other basal insulins (first or second generation) in Italy.

Methods: Multicenter, observational, retrospective study based on electronic medical records.

Results: Overall, 953 T2DM insulin ± OAD treated people switched to Gla-300 or Gla-100 from January 2015 to July 2018.

The effect of 50% oxygen on PtCO in patients with stable COPD, bronchiectasis, and neuromuscular disease or kyphoscoliosis: randomised cross-over trials.

Background: High-concentration oxygen therapy causes increased arterial partial pressure of carbon dioxide (PaCO) in patients with COPD, asthma, pneumonia, obesity and acute lung injury. The objective of these studies was to investigate whether this physiological response to oxygen therapy occurs in stable patients with neuromuscular disease or kyphoscoliosis, and bronchiectasis.

Methods: Three randomised cross-over trials recruited stable patients with neuromuscular disease or kyphoscoliosis (n = 20), bronchiectasis (n = 24), and COPD (n = 24).

Serum periostin levels in adults of Chinese descent: an observational study.

Background: Periostin has been shown to be a marker of Type 2 airway inflammation, associated with airway eosinophilia. It has a potential role in identifying asthmatics who may be responsive to treatment with monoclonal antibody therapy directed against Type 2 cytokines, such as interleukin (IL)-13, IL-4 receptor subunit-α and immunoglobulin E. The clinical utility of periostin measurements depends on better understanding of factors that may affect serum periostin levels, such as race.

Observational clinical and nerve conduction study on effects of a nutraceutical combination on painful diabetic distal symmetric sensory-motor neuropathy in patients with diabetes type 1 and type 2.

Background: Painful distal symmetric polyneuropathy (pDSPN) is one of the most common and invalidating complications of diabetes mellitus, both of type 1 and type 2. Mechanisms responsible for the occurrence of the pDSPN are multifactorial and involve metabolic pathways regulating inflammation, microvessel circulation, axonal degeneration and so on. Several therapeutic approaches have been proposed to treat pain and each of them showed positive effects associated to drug-related side effects.

Serum periostin levels following small bone fractures, long bone fractures and joint replacements: an observational study.

Background: In asthma, serum periostin may potentially be used as a biomarker in the management of patients with Type-2 eosinophilic airway inflammation. However, serum periostin may be influenced by factors other than Type 2 inflammation, potentially confounding its interpretation. We aimed to measure change in periostin following bone injury.

Change in biomarkers of type-2 inflammation following severe exacerbations of asthma.

We investigated the time course of change of type-2 asthma biomarkers after a severe asthma exacerbation. Blood eosinophils were lowest immediately after treatment was initiated (0.07 vs 0.

Type 2 Biomarkers and Prediction of Future Exacerbations and Lung Function Decline in Adult Asthma.

Background: Type 2 biomarkers that predict both likelihood of future severe exacerbations and response to mAb therapy in asthma would be useful clinically in identifying patients both at greater risk of hospitalization and most likely to benefit from mAb therapy.

Objective: To describe the association between type 2 biomarkers, blood eosinophils, fractional exhaled nitric oxide (Feno), serum periostin, and serum IgE, and time to severe exacerbation in a broad asthma population.

Methods: Participants from 2 adult asthma cohorts with baseline measurements of blood eosinophils, Feno, serum periostin, and serum IgE were reviewed after at least 12 months to obtain an exacerbation history, corroborated with general practitioner and hospital medical records.

Insulin and the Future Treatment of Alzheimer's Disease.

Alzheimer's disease is a neurodegenerative disorder leading to dementia. Scientific efforts in the last decade focused mainly on understanding pathophysiology of disease and possible pharmacological approach to alleviate cognitive decline symptoms. Amyloid cascade hypothesis though criticized, remains the leading hypothesis to understand pathogenic mechanisms of cognitive decline.

Homotaurine induces measurable changes of short latency afferent inhibition in a group of mild cognitive impairment individuals.

Current treatment options for patients with Alzheimer's disease (AD) are limited at providing symptomatic relief, with no effects on the underlying pathophysiology. Recently, advances in the understanding of the AD pathogenesis highlighted the role of ABeta (Aβ) oligomers particularly interfering with mechanisms of cortical plasticity such as long-term potentiation (LTP) and long-term depression (LTD). These findings led to the development of potential anti-amyloid therapies, and among them homotaurine, a glycosaminoglycan mimetic designed to interfere with the actions of Aβ early in the cascade of amyloidogenic events, and by its γ-aminobutyric acid type (GABA) A receptor affinity.

Ageing as a Trait de Union between diabetes and dementia for frailty.

A frail patient is one who carries a sum of poly-pathologies, whose co-existence may shorten his life expectation. Diabetes mellitus type 2 and metabolic syndrome play a substantial role in it, but dementia has increasingly risen in importance. Interestingly, the insulin pathway was suggested to be responsible for the metabolic cascade that leads to amyloid-beta deposit and pathology.

Apathy as marker of frail status.

Frailty is a complex and dynamic condition associated with aging. This condition is characterised by the difficult adaptation of an old subject to new challenges occurring during life. Frailty is supposed to be due to the progressive decrease of physiological reserves and multiorgan and multisystem change.

Gait impairment in neurological disorders: a new technological approach.

Gait recovery is considered one of the main objectives of rehabilitation interventions in neurological disabilities, as restricted movement can significantly reduce an individual's ability to take part in normal activities of daily living. Locomotor training has been shown to improve gait rehabilitation. Studies have recently been published on the use of robots and other devices in patients with gait disabilities, particularly in the rehabilitation of the lower limbs.

Kyphoplasty: a new opportunity for rehabilitation of neurologic disabilities.

Using percutaneous kyphoplasty, we treated a patient with a diagnosis of Guillain-Barré syndrome who complained of an unremitting pain in the spine, refractory to the conventional medical therapy, elicited by pressure over the spinous process, and in absence of neurologic deficits. The method provided swift midline back pain relief associated with an evident augmentation in the stability and in the vertebral body's height. The injection of polymethylmethacrylate was effective and safe, no cement leakages were observed, and no complications such as pulmonary embolism, toxicity, or infection were observed.

A mixed D1 and D2 antagonist does not replay pattern electroretinogram alterations observed with a selective D2 antagonist in normal humans: relationship with Parkinson's disease pattern electroretinogram alterations.

The human retina produces a tuned response to stimuli of increasing spatial frequency reversed at a steady state. The peak amplitude response, at medium spatial frequencies, is decreased in Parkinson's disease and in normal subjects (n = 18) treated with a D2 dopaminergic antagonist (l-sulpiride). Here, we report that a mixed D1-D2 receptor antagonist (haloperidol) in normal subjects (n = 18) does not produce an amplitude decrease of medium spatial frequencies (SFs) responses but it decreases low-frequency response.

Does pattern electroretinogram spatial tuning alteration in Parkinson's disease depend on motor disturbances or retinal dopaminergic loss?

Systemic decrease of dopaminergic cells, such as in Parkinson's disease may produce visual alterations in humans. In order to show possible pattern electroretinogram (PERG) spatial tuning function (STF) alterations due to impaired dopaminergic transmission in humans, we studied a group of Parkinson's disease patients before and during treatment with the dopamine precursor, levodopa, and compared their performances with those of an age-matched control group. Moreover, in order to exclude the possible involvement of motor disabilities to produce PERG alterations, we also investigated PERG responses in post-traumatic parkinsonian patients who exhibited motor abnormalities as a consequence of focal lesions of basal ganglia, in the absence of systemic dopaminergic degeneration.

Age and stage dependency of P300 latency alterations in non-demented Parkinson's disease patients without therapy.

Acoustic P300 was recorded from Fz, Cz and Pz by means of an 'odd-ball' paradigm in 44 non-demented de novo Parkinson's disease patients (PD) or PD patients under treatment withdrawal, and in 31 age-matched normal subjects, to evaluate whether a P300 latency increase was present in PD patients. The influence of age and disease stage on latency was successively verified by subgrouping PD patients according to different age ('young' and 'old') and disease stage ('early' or 'advanced'). PD patient data were compared to data of normal subjects subgrouped into 'young' and 'old' or, to eliminate the age-dependent shift of latency, this latter was adjusted to 60 years in all the examined subjects.

SEPs N30 amplitude in Parkinson's disease and in pharmacologically induced rigidity: relationship with the clinical status.

The frontal N30 wave amplitude of somatosensory evoked potentials (SEPs) has been studied in 41 Parkinson's disease (PD) patients (pts) in a basal condition and compared to that of 30 normal subjects; moreover the N30 amplitude and clinical motor score have been evaluated in a subgroup of 30 PD pts before and during apomorphine infusion and in a second subgroup of 22 PD pts also during levodopa chronic therapy. The data show that N30 amplitude is decreased in PD pts in basal condition and increased following both treatments by a percentage proportional to the clinical improvement Analysis by non parametric correlations showed that the increase is well correlated to the clinical score amelioration induced by apomorphine in the more affected side. The best correlation was to rigidity score amelioration in the group of PD pts in medium stage (Hohen and Yahr stage between 2 and 3), suggesting a relationship between the rigidity and N30 amplitude decrease.