Purpose: Autonomic failure has a major impact on the quality of life of individuals with Parkinson's disease (PD), especially in advanced stages of the disease. Levodopa/carbidopa intestinal gel (LCIG) infusion is a well-established treatment for advanced PD with severe motor fluctuations and provides substantial benefit in managing some non-motor symptoms (NMS), such as sleep, fatigue, and neuropsychiatric issues. The effect of LCIG on autonomic symptoms is by contrast not well known. Here we performed a systematic review on the influence of LCIG therapy on autonomic dysfunction in PD individuals.
Methods: Following the PRISMA guidelines, we systematically searched for studies that included autonomic outcome measures in LCIG-treated PD individuals, limiting the search to articles written in English and published between January 2005 and June 2023. We evaluated improvement, stability, or worsening of gastrointestinal, urinary, and cardiovascular symptoms at six different timepoints according to clinimetric scale changes compared to baseline. Data on autonomic adverse events (AEs) possibly related to LCIG treatment were also collected.
Results: Of the 1476 studies identified in the initial search, 16 ultimately met the inclusion criteria and underwent quality assessment and data extraction, with data from 1361 PD patients (18.3 months mean follow-up). Thirteen studies reported improvement or stability of gastrointestinal, urinary, and cardiovascular symptoms over the interventional period. One study found a worsening of cardiovascular symptoms and two of urological symptoms. Regarding safety, seven studies reported gastrointestinal (8.4%), urinary (0.5%), and cardiovascular (1.1%) autonomic LCIG-related AEs.
Conclusions: LCIG infusion may help to reduce the burden of autonomic symptoms in advanced PD. Prospective studies specifically addressing the effect of LCIG on autonomic function in advanced PD are warranted.
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http://dx.doi.org/10.1007/s10286-024-01090-9 | DOI Listing |
JAMA Netw Open
January 2025
Department of Radiology, Keio University School of Medicine, Tokyo, Japan.
Importance: The integration of patient-reported outcome (PRO) assessments in cardiovascular care has encountered considerable obstacles despite their established clinical relevance.
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Design, Setting, And Participants: This open-label, multicenter, pilot randomized clinical trial was phase 2 of a multiphase study that was conducted from October 2022 to October 2023 and focused on the implementation and evaluation of an ePRO monitoring system in outpatient clinics in Japan.
Cell Regen
January 2025
Guangzhou National Laboratory, Guangzhou, 510005, China.
Organoid technology provides a transformative approach to understand human physiology and pathology, offering valuable insights for scientific research and therapeutic development. Human gastric organoids, in particular, have gained significant interest for applications in disease modeling, drug discovery, and studies of tissue regeneration and homeostasis. However, the lack of standardized quality control has limited their extensive clinical applications.
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January 2025
Onassis Cardiac Surgery Center, Athens, Greece.
Purpose Of Review: Our purpose was to discuss the advantages and disadvantages of various noninvasive imaging modalities in the evaluation of cardiovascular disease (CVD) in patients with autoimmune rheumatic diseases (ARDs). The detailed knowledge of imaging modalities will facilitate the diagnosis and follow up of CVD in ARDs.
Recent Findings: Autoimmune Rheumatic Diseases (ARDs) are characterized by alterations in immunoregulatory system of the body.
Neurosurg Rev
January 2025
Kobayashi Hospital, 510 Imaichi, Izumo City, Shimane, 693-0001, Japan.
Adverse effects of advanced age and poor initial neurological status on outcomes of patients with aneurysmal subarachnoid hemorrhage (SAH) have been documented. While a predictive model of the non-linear correlation between advanced age and clinical outcome has been reported, no previous model has been validated. Therefore, we created a prediction model of the non-linear correlation between advanced age and clinical outcome by machine learning and validated it using a separate cohort.
View Article and Find Full Text PDFClin Exp Med
January 2025
Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Shebeen Elkoom, Menoufia, Egypt.
The diagnostic criteria for Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) and Metabolic Associated Steatotic Liver Disease (MASLD) aim to refine the classification of fatty liver diseases previously grouped under Non-Alcoholic Fatty Liver Disease (NAFLD). This study evaluates the applicability of the MAFLD and MASLD frameworks in NAFLD patients, exploring their clinical utility in identifying high-risk patients. A total of 369 NAFLD patients were assessed using MAFLD and MASLD diagnostic criteria.
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