Predicting Bleeding Events in Anticoagulated Patients With Atrial Fibrillation: A Comparison Between the HAS-BLED and GARFIELD-AF Bleeding Scores.

Background Patients with atrial fibrillation (AF) treated with oral anticoagulants may be exposed to an increased risk of bleeding events. The HAS-BLED (Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile INRs, Elderly, Drugs or alcohol) score is a simple, well-established, clinical bleeding-risk prediction score. Recently, a new algorithm-based score was proposed, the GARFIELD-AF (Global Anticoagulant in the Field-AF) bleeding score.

On the molecular and morphological evolution of continental and insular species, with an additional description of (Talitridae).

Semi-terrestrial talitrid amphipods of the genus (sensu Lowry and Fanini 2013) associated with freshwater-soaked leaf litter were known to occur in inland lakes of Turkey and at the shores of the Black Sea. Before 2013 they had been reported as and later as . In our phylogenetic tree, inferred from a mitochondrial and nuclear gene dataset (cytochrome oxidase I (COI), and histone H3 (H3), respectively), we show that these Turkish populations belong to , a common and widespread continental species, which is closely related to (endemic to Cyprus) and (endemic to Rhodes).

MiR-21 role in aspirin-dependent PPARα and multidrug resistance protein 4 upregulation.

Background: A mechanism involved in high on-aspirin treatment residual platelet reactivity is platelet multidrug resistance protein 4 (MRP4) overexpression. Aspirin enhances platelet MRP4 expression with a PPARα-dependent mechanism and reduces miR-21 expression that, in turn, downregulates PPARα expression.

Objective: The aim of our study was to verify the relationship between miR-21 and MRP4-PPARα levels induced by aspirin treatment.

c.3140A>G mutation in a patient with suspected Proteus Syndrome: a case report.

We present a patient with suspected Proteus Syndrome, an overgrowth disorder associated with mutation. NGS analysis detected mutation in the patient's affected tissue allowing for PROS (PIK3CA-related overgrowth spectrum) diagnosis. The overlapping clinical features in overgrowth disorders highlight the importance of molecular testing for a correct diagnosis.

Quick Flicks: Association of Paroxysmal Kinesigenic Dyskinesia and Tics.

Background: Paroxysmal kinesigenic dyskinesia (PKD) is a rare disorder characterised by brief attacks of chorea, dystonia, or mixed forms precipitated by sudden movement.

Methods: Observational study with a cohort of 14 PKD patients and genetic testing for mutations.

Results: In a series of 14 PKD patients seen in our clinic at the National Hospital of Neurology, Queen Square, from 2012-2017, we noted tics in 11 patients (79%), which stand in stark contrast to the estimated lifetime prevalence of tics estimated to reach 1%.

Population genomics of the Asian tiger mosquito, : insights into the recent worldwide invasion.

, the "Asian tiger mosquito," is an aggressive biting mosquito native to Asia that has colonized all continents except Antarctica during the last ~30-40 years. The species is of great public health concern as it can transmit at least 26 arboviruses, including dengue, chikungunya, and Zika viruses. In this study, using double-digest Restriction site-Associated DNA (ddRAD) sequencing, we developed a panel of ~58,000 single nucleotide polymorphisms (SNPs) based on 20 worldwide populations representing both the invasive and the native range.

Visceral leishmaniasis triggering an adult-onset Still's disease: a unique case.

Adult-onset Still's disease (AOSD) due to visceral leishmaniasis (VL) has not been previously reported. This case report analyzes a single episode of AOSD probably due to a visceral leishmaniasis successfully treated with pentamidine isethionate and prednisone.

A pilot study on the effects of probiotic supplementation on neuropsychological performance and microRNA-29a-c levels in antiretroviral-treated HIV-1-infected patients.

Introduction: The gut microbiota is involved in the regulation of cognition, mood, anxiety, and pain, and can impact cognitive functions by producing neuroactive substances or releasing bacterial by-products and metabolites. No information is available on the effects of a probiotic supplementation on brain function of HIV+ subjects. In light of the above considerations, we performed a pilot study in cART-treated HIV-1-positive patients with long-term virologic suppression.

Effect of habitat degradation on competition, carrying capacity, and species assemblage stability.

Changes in species' trophic niches due to habitat degradation can affect intra- and interspecific competition, with implications for biodiversity persistence. Difficulties of measuring species' interactions in the field limit our comprehension of competition outcomes along disturbance gradients. Thus, information on how habitat degradation can destabilize food webs is scarce, hindering predictions regarding responses of multispecies systems to environmental changes.

Anticoagulant therapy with fondaparinux in a liver transplant patient with thrombosis and liver fibrosis: a case report.

The treatment with fondaparinux is the effective and safe anticoagulant therapy in liver transplant patient on immunosuppressive therapy with arterial thrombosis, and it seems able to reduce liver fibrosis. Although this treatment is not generalizable, further prospective large studies need to confirm this case report.

Levosimendan improves exercise performance in patients with advanced chronic heart failure.

Aims: Cardiopulmonary exercise test (CPET) provides parameters such as peak VO and ventilation/CO production (VE/VCO) slope, which are strong prognostic predictors in patients with stable advanced chronic heart failure (ADHF). The study aim was to evaluate the effects of the inodilator levosimendan on CPET in patients with ADHF under stable clinical conditions.

Methods And Results: We enrolled patients with ADHF (peak VO < 12 mL/min/kg) in a double-blind, placebo-controlled protocol.

ACT-ONE - ACTION at last on cancer cachexia by adapting a novel action beta-blocker.

Novel action beta-blockers combine many different pharmacological effects. The espindolol exhibits effects through β and central 5-HT1α receptors to demonstrate pro-anabolic, anti-catabolic, and appetite-stimulating actions. In the ACT-ONE trial, espindolol reversed weight loss and improved handgrip strength in patients with cachexia due to non-small cell lung cancer or colorectal cancer.

Effect of the specific proteasome inhibitor bortezomib on cancer-related muscle wasting.

Background: Muscle wasting, a prominent feature of cancer cachexia, is mainly caused by sustained protein hypercatabolism. The enhanced muscle protein degradation rates rely on the activity of different proteolytic systems, although the Adenosine triphosphate (ATP)-ubiquitin-proteasome-dependent pathway and autophagy have been shown to play a pivotal role. Bortezomib is a potent reversible and selective proteasome and NF-κB inhibitor approved for the clinical use, which has been shown to be effective in preventing muscle wasting in different catabolic conditions.

Elastic Abdominal Binders Attenuate Orthostatic Hypotension in Parkinson's Disease.

Background And Methods: To investigate the possible efficacy of an elastic abdominal binder to control orthostatic hypotension (OH) associated with Parkinson's disease (PD), 15 patients with PD and OH were enrolled in a single-blind crossover study with elastic abdominal versus placebo binder on two different days, separated by a 1-day interval, followed by a 4-week open-label follow-up.

Results: Intervention significantly reduced blood pressure fall upon tilting. The mean difference (standard deviation; 95% confidence intervals) between abdominal binder versus placebo was +10 mm Hg (10.

How Do I Examine Blepharospasm?

Blepharospasm, which is the most frequent cranial dystonia, is characterized clinically by bilateral, synchronous, and symmetric involuntary orbicularis oculi muscle contractions. Assessment of motor abnormalities in patients with blepharospasm is an important issue in the clinical practice of movement disorders. This video highlights the most important aspects in the clinical evaluation of blepharospasm.

Cognitive Behavioral Therapy in Movement Disorders: A Review.

In addition to motor symptoms, patients with movement disorders often complain of psychiatric disturbances, including mood, anxiety, and impulse-control disorders and psychosis. These abnormalities are often misdiagnosed and left untreated, thus resulting in a worse prognosis and lower quality of life. Besides the use of standard pharmacological treatments, psychiatric abnormalities can be treated by means of nonpharmacological approaches.

Spread of Muscle Spasms in Hemifacial Spasm.

Hemifacial spasm (HFS) is a clinical condition characterized by involuntary contractions in facial muscles. The aim of the study was to investigate, systematically in 178 patients with HFS, the frequency of spread from the site of origin to other facial muscles. Patients enrolled underwent a complete neurological examination and a face-to-face interview.

Congenital Mirror Movements in a New Italian Family.

Mirror movements (MMs) occur on the contralateral side of a limb being used intentionally. Because few families with congenital MMs and no other neurological signs have been reported, the underlying mechanisms of MMs are still not entirely clear. We report on the clinical, genetic, neurophysiological and neuroimaging findings of 10 of 26 living members of a novel four-generation family with congenital MMs.

Detection of coronary artery stenoses using breath-hold magnetic resonance coronary angiography. Comparison with conventional x-ray angiography.

Purpose: To detect coronary artery stenoses, we compare breath-hold magnetic resonance coronary angiography (MRCA) to conventional coronary angiography (CA).

Materials And Methods: Sixty-five patients with suspected coronary artery disease underwent MRCA and CA within one week. MRCA examination was performed by using the two-dimensional (2D) breath-hold technique with a fast spoil gradient-echo sequence/spiral.