A Randomized Controlled Pilot Study to Evaluate a Technology Platform for the Assisted Living of People with Dementia and their Carers.

The use of telemedicine is becoming increasingly popular in assisting with the home management of People with Dementia (PwD) by offering services to the carers that may enhance their ability to care for their relative for longer. A computerized platform, ALADDIN, was evaluated in its usefulness to reduce carer burden and distress and to improve their quality of life, in an attempt to delay institutionalization of PwD. ALADDIN offers educational material about dementia to carers and provides the opportunity to contact other carers and clinicians. ALADDIN also facilitates remote monitoring of the PwD and their carers by the clinicians to enable speedy delivery of appropriate intervention. The ALADDIN platform was piloted at three European sites, and used by thirty carers of PwD living in the community (platform group). The platform group and a control group of thirty PwD and their carers were assessed at baseline, 3 months, and 6 months. The results showed a significant improvement in the quality of life of the carers in the platform group, with some reduction in carer burden and distress. The platform was useful in monitoring the patients and facilitating contact with other professionals. Access to and use of the ALADDIN platform was rated positively by carers and clinicians. The ALADDIN platform's usefulness and applicability for prolonging the home management of PwD are discussed

Peripheral serotoninergic response to physical exercise in athletic horses

The purpose of this study was to evaluate the influence of exercise on plasma tryptophan (TRP) and free serotonin (f5-HT), whole blood-5-HT (WB-5-HT) and f5-HT/WB-5-HT ratio in Italian Saddle horses. Six clinically healthy Italian Saddle horses were subjected to a 450 meters obstacles course. Blood samples were collected from each horse by jugular venipuncture using vacutainer tubes with K3-EDTA at rest, immediately after exercise, and after 30 min. TRP, f5-HT and WB-5-HT were analyzed by HPLC. Immediately after exercise, statistically significant increases of f5-HT (p<0.001) and WB-5-HT (p<0.001) were observed. After 30 min, f5-HT and WB-5-HT decreased compared to immediately after exercise, but were still significantly higher than rest values (p<0.01 and p<0.05, respectively). A significant linear regression between f5-HT and WB-5-HT was observed during experimental conditions. f5-HT and WB-5-HT modifications after exercise suggest an important role of peripheral serotoninergic markers in response to physical activity. The possible source of extra serotonin detected after show jumping should be clarified by further investigation

Multiplex assessment of a panel of 16 serum molecules for the differential diagnosis of Alzheimer's disease

One of the current challenge in Alzheimer's disease (AD) is the identification of reliable biomarkers that might improve diagnostic accuracy, possibly correlating with the disease progression and patient's response to therapy. As the clinically validated AD biomarkers evaluate cerebrospinal fluid (CSF) parameters, the need for less invasive diagnostic markers is well evident. To this respect, blood circulating cytokines or growth factors have provided some encouraging results, even though no clinically validated to date. In 2007 Ray et al suggested a panel of 18 circulating molecules that might increase AD diagnostic accuracy. In an attempt of replicating their data, we designed a multiplex fluorimetric assay comprising 16 independent analytes and covering 15 out of the 18 described proteins. We collected serum samples from three diagnostic groups: probable AD (n=33), matched healthy controls (CNT, n=23) and non AD demented (NAD, n=14). After correction for age, we found an increased level of EGF-1 in AD in comparison to CNT and NAD, while an increase of TRAIL-R4 was found in NAD. However, evaluation of specificity/sensitivity by ROC curve analysis gave weak evidence of diagnostic accuracy (area under the curve = 0.63 and 0.66 for EGF and TRAIL-R4, respectively). Finally, we tried to find a diagnostic classifier by a multivariate algorithm. We found indication of diagnostic evidence for AD only, while NAD samples did not show a diagnostic pattern

Home Care Systems for the Management of Patients with Mental Disorders

This chapter provides an overview of the various aspects involved in the development of a home care system for the management of dementia, based on the experience of ALADDIN implementation. The ALADDIN platform aims to provide a trustworthy and reliable solution supporting patients and their informal carers in the management of the disease from home. Based on a set of monitoring parameters and measuring scales feeding a reconfigurable Event Detection mechanism used for Risk Assessment and Analysis, the system aims to early detect symptoms predicting decline, avoid emergencies and secondary effects and thus prolong the period that patients can remain safely cared at home. Informal carers are also monitored by the system whereas additional features supporting networking, education and cognitive stimulation are also integrated along with decision support tools for the clinicians. It is an open, secure, interoperable, integrated IT-solution designed according to Service Oriented Architecture principles and credible methodologies for patient follow-up, risk detection and adaptive care. </jats:p

Home Care Systems for the Management of Patients with Mental Disorders

This chapter provides an overview of the various aspects involved in the development of a home care system for the management of dementia, based on the experience of ALADDIN implementation. The ALADDIN platform aims to provide a trustworthy and reliable solution supporting patients and their informal carers in the management of the disease from home. Based on a set of monitoring parameters and measuring scales feeding a reconfigurable Event Detection mechanism used for Risk Assessment and Analysis, the system aims to early detect symptoms predicting decline, avoid emergencies and secondary effects and thus prolong the period that patients can remain safely cared at home. Informal carers are also monitored by the system whereas additional features supporting networking, education and cognitive stimulation are also integrated along with decision support tools for the clinicians. It is an open, secure, interoperable, integrated IT-solution designed according to Service Oriented Architecture principles and credible methodologies for patient follow-up, risk detection and adaptive care. </jats:p

Diagnostic value of serum tumor markers in lung cancer

The case of this study was to assess the usefulness of 4 TM’s in combination with bronchoscopy in order to increase the diagnostic sensitivity of bronchogenic carcinoma. We determined 4 TM’s: CEA, SCC, NSE, TPS concerning the most common forms of lung cancer. Because of their low specificity with the cut-off values provided by the suppliers, we estimated new cut-off values, corresponding to 95% of our patients with benign lung diseases. The combined use of bronchoscopy and serum TM determinations (as a second step) for the discrimination between malignant and benign lung diseases in patients undergoing bronchoscopy resulted in a sensitivity of 92,7% and a specificity 84,7%, obviously better than the use of bronchoscopy alone, where the sensitivity reaches 71%. Only 11/141 patients with malignant disease could not be detected by our approach. Tumor marker determinations are an independent diagnostic tool complementary to bronchoscopy and could be used in combination with it when lung cancer is suspected and bronchoscopy is not diagnostic.Στην εργασία αυτή θελήσαμε να εξετάσουμε αν η συνδυασμένη χρήση βρογχοσκόπησης και επιλεγμένων καρκινικών δεικτών αυξάνει την διαγνωστική ευαισθησία στον καρκίνο του πνεύμονα. Χρησιμοποιήσαμε συνδυασμό 4 καρκινικών δεικτών που καλύπτουν το μεγαλύτερο φάσμα των καρκίνων του πνεύμονα τους SCC, CEA, NSE, TPS. Υπολογίσαμε νέες τιμές αναφοράς των δεικτών που να αντιστοιχούν σε ειδικότητα 95%, διότι οι τιμές της κατασκευάστριας εταιρείας έδιναν πολύ χαμηλή ειδικότητα. Δείξαμε ότι η συνδυασμένη χρήση βρογχοσκόπησης σαν 1ο βήμα και των επιλεγμένων καρκινικών δεικτών με τις «home made» τιμές σαν 2ο βήμα για τη διάκριση μεταξύ καλοήθειας-κακοήθειας έδωσε ευαισθησία 92,7% και ειδικότητα 84,7%, ενώ η βρογχοσκόπηση μόνη της έδινε ευαισθησία 71%. Έτσι μόνο 11/141 ασθενείς με κακοήθεια δεν μπορούν να διαγνωσθούν. Οι καρκινικοί δείκτες αποτελούν ανεξάρτητο εργαλείο, συμπληρωματικό της βρογχοσκόπησης και μπορεί να χρησιμοποιηθούν σε συνδυασμό με αυτή όταν υποψιαζόμαστε καρκίνο πνεύμονα και η βρογχοσκόπηση είναι αρνητική