Mechanisms and therapeutic applications of electromagnetic therapy in Parkinson's disease

© 2015 Vadalà et al. Electromagnetic therapy is a non-invasive and safe approach for the management of several pathological conditions including neurodegenerative diseases. Parkinson's disease is a neurodegenerative pathology caused by abnormal degeneration of dopaminergic neurons in the ventral tegmental area and substantia nigra pars compacta in the midbrain resulting in damage to the basal ganglia. Electromagnetic therapy has been extensively used in the clinical setting in the form of transcranial magnetic stimulation, repetitive transcranial magnetic stimulation, high-frequency transcranial magnetic stimulation and pulsed electromagnetic field therapy which can also be used in the domestic setting. In this review, we discuss the mechanisms and therapeutic applications of electromagnetic therapy to alleviate motor and non-motor deficits that characterize Parkinson's disease

Dos pactos políticos à política dos pactos na saúde

Este artigo tem como objeto a política de pactuação do Sistema Único de Saúde (SUS). Os poucos trabalhos na literatura sobre pactos na saúde frequentemente os relacionam à consolidação dos princípios do SUS, especificamente à implantação da descentralização. Aqui são evidenciadas as raízes dessa política, mostrando-se como estão articuladas ao movimento de reestruturação do próprio Estado brasileiro, ocorrido nas últimas décadas do século XX, por meio da reconstrução da democracia, do federalismo e da Reforma do Estado. Neste período, são identificados avanços na democracia política, porém pouca evolução na consolidação da democracia social. Os pactos na saúde articulam-se aos pactos sociais e políticos, estes últimos essenciais para tornar possível a vida em sociedade, garantir a legitimidade dos governos, a governabilidade e a efetividade das políticas públicas. A pactuação é um mecanismo de gestão que compreende negociação permanente, buscando a superação dos conflitos intergovernamentais, pautada pela responsabilização solidária. Por meio da negociação de metas, indicadores e ações, os pactos se constituem numa forma de accountability e transparência, capaz de favorecer o controle social e o do próprio governo.The object of this article is the pact policy of the Unified Health System (SUS). The few works available in the literature about health pacts frequently relates them to the principles of SUS consolidation, specifically to the implantation of decentralization. Here, the roots of this policy are evidenced showing how they are linked with the restructuration movement of the proper Brazilian State in the last decades from the 20th century, by democracy rebuilding, federalism and State Reform. During this period, some advances in politics democracy were identified, however a few results in consolidation of social democracy were identified. Health pacts are articulated with social and political pacts, which are essential to make life possible in society, guarantee government legitimacy, governance and public policies effectiveness. Pact is a management mechanism that comprehends permanent negotiation, looking for surpasses intergovernmental conflicts, moderate by solidary responsibility. Throughout negotiation of goals, indicators and actions, pacts consist in a way of accountability and transparency, able to promote social control, and the own government control

Bilateral deep brain stimulation of the pedunculopontine and subthalamic niclei in severe Parkinson's disease

Gait disturbances and akinesia are extremely disabling in advanced Parkinson’s disease. It has been suggested that modulation of the activity of the pedunculopontine nucleus (PPN) may be beneficial in the treatment of these symptoms.We report the clinical affects of deep brain stimulation (DBS) in the PPN and subthalamic nucleus (STN). Six patients with unsatisfactory pharmacological control of axial signs such as gait and postural stability underwent bilateral implantation of DBS electrodes in the STN and PPN. Clinical effects were evaluated 2^6 months after surgery in the OFF- and ON-medication state, with both STNand PPN stimulation ON or OFF, or with only one target being stimulated. Bilateral PPN-DBS at 25Hz in OFF-medication produced an immediate 45% amelioration of the motor Unified Parkinson’s Disease Rating Scale (UPDRS) subscale score, followed by a decline to give a final improvement of 32% in the score after 3^6 months. In contrast, bilateral STN-DBS at 130^185Hz led to about 54% improvement. PPN-DBS was particularly effective on gait and postural items. In ON-medication state, the association of STN and PPN-DBS provided a significant further improvement when compared to the specific benefit mediated by the activation of either single target. Moreover, the combined DBS of both targets promoted a substantial amelioration in the performance of daily living activities.These findings indicate that, in patientswith advanced Parkinson’s disease, PPN-DBS associated with standard STN-DBS may be useful in improving gait and in optimizing the dopamine-mediated ON-state, particularly in those whose response to STNonly DBS has deteriorated over time.This combination of targets may also prove useful in extra-pyramidal disorders, such as progressive supranuclear palsy, for which treatments are currently elusive

Reconstructing paleoclimate and paleoecology using fossil leaves

Plants are strongly influenced by their surrounding environment, which makes them reliable indicators of climate and ecology. The relationship between climate, ecology, plant traits and the geographic distribution of plants based on their climatic tolerances have been used to develop plant-based proxies for reconstructing paleoclimate and paleoecology. These proxies are some of the most accurate and precise methods for reconstructing the climate and ecology of ancient terrestrial ecosystems and have been applied from the Cretaceous to the Quaternary. Despite their utility, the relationships between plant traits and climate that underlie these methods are confounded by other factors such as leaf life-span and phylogenetic history. Work focused on better understanding these confounding factors, incorporating the influence of phylogeny and leaf economic spectrum traits into proxies, expanding modern leaf trait-climate and ecology calibration datasets to additional biogeographic areas and climate regimes, and developing automated computer algorithms for measuring leaf traits are important growing research areas that will help considerably improve plant-based paleoclimate and paleoecological proxies

Vocal Patterns in Infants with Autism Spectrum Disorder: Canonical Babbling Status and Vocalization Frequency

Canonical babbling is a critical milestone for speech development and is usually well in place by 10 months. The possibility that infants with ASD show late onset of canonical babbling has so far eluded evaluation. Rate of vocalization or “volubility” has also been suggested as possibly aberrant in infants with ASD. We conducted a retrospective video study examining vocalizations of 37 infants at 9–12 and 15–18 months. Twenty-three of the 37 infants were later diagnosed with ASD and indeed produced low rates of canonical babbling and low volubility by comparison with the 14 typically developing infants. The study thus supports suggestions that very early vocal patterns may prove to be a useful component of early screening and diagnosis of ASD