Bulbar involvement in amyotrophic lateral sclerosis (ALS) is often related to a worse prognosis on account of the higher risk of pulmonary aspiration and undernutrition due to dysphagia. The aim of our study was to assess the effects of... more
Bulbar involvement in amyotrophic lateral sclerosis (ALS) is often related to a worse prognosis on account of the higher risk of pulmonary aspiration and undernutrition due to dysphagia. The aim of our study was to assess the effects of enteral feeding by percutaneous endoscopic gastrostomy (PEG) in a long-term follow-up of ALS patients. We report the results of PEG in 31 ALS patients with bulbar involvement. The patients were observed at 3-monthly intervals over a period of 2 years after PEG. All the data were compared with those obtained from a control group of 35 ALS patients who refused PEG. Mortality did not differ significantly between the two groups of patients during the first 6 months of observation, whereas after this period it was lower in the PEG group. In the patients who had had PEG, the body mass index showed a mild but statistically significant improvement after tube insertion while in the control group it decreased significantly. The findings of this study demonstrate that PEG can improve survival in elderly and young ALS patients with bulbar involvement; it enhances their quality of life and helps their integration in their social and family surroundings. We think that PEG should be included symptomatic treatment of all ALS patients with bulbar involvement from the onset of symptoms.
Research Interests: Neurology, Quality of life, Endoscopy, Amyotrophic Lateral Sclerosis, Humans, and 15 moreFemale, Male, Statistical Significance, Body Mass Index, Clinical Sciences, Aged, Middle Aged, Adult, Survival Rate, Enteral Feeding, Gastrostomy, Neurosciences, Control Group, Enteral Nutrition, and Case Control Studies
Clinical upper motor neuron (UMN) involvement is sometimes difficult to detect in motor neuron disease (MND). For this reason we performed transcranial magnetic stimulation (TMS) to find out whether this technique may be useful in... more
Clinical upper motor neuron (UMN) involvement is sometimes difficult to detect in motor neuron disease (MND). For this reason we performed transcranial magnetic stimulation (TMS) to find out whether this technique may be useful in revealing signs of pyramidal tract impairment. Fifty-five MND patients, clinically divided into 22 amyotrophic lateral sclerosis (ALS), 18 ALS with probable UMN signs (ALS-PUMNS), 10 pure lower motor neuron syndrome (LMNS), and 5 progressive bulbar palsy (PBP), underwent standard TMS, recording from abductor digiti minimi and flexor allucis muscles. Prolongation of cortical motor evoked potential (MEP) latency and central conduction time (CCT) and absent MEP were considered as pathologic. ALS-PUMNS and LMNS patients were clinically reclassified after 1 year. TMS was abnormal in 95.4% of ALS, 72.2% of ALS-PUMNS, 50% of LMNS and 20% of PBP. Correlations between TMS parameters and both clinical signs of UMN involvement and disease severity were highly significant. TMS showed a high sensitivity, but lacked specificity. After 1 year, 11 patients among the ALS-PUMNS group were clinically reclassified as definite ALS: all of them had shown TMS abnormalities at the first examination. In conclusion, TMS provides important diagnostic information for an early prediction of ALS in those MND patients presenting with clinically equivocal UMN impairment.
Research Interests:
Research Interests:
Research Interests: Neuroscience, Psychology, Cognitive Science, Amyotrophic Lateral Sclerosis, Cell line, and 15 moreHumans, Weight Loss, Female, Male, Disease Severity, Solubility, Middle Aged, Cytotoxic Activity, Tumor necrosis factor-alpha, Prognosis, Neurodegenerative Disease, Biological activity, Neurosciences, Enzyme Linked Immunosorbent Assay, and Predictive value of tests
Research Interests: Genetics, Family, Adolescent, Neurobiology, Amyotrophic Lateral Sclerosis, and 21 moreItaly, Humans, Mutation, Female, Male, Young Adult, Pedigree, Phenotype, Clinical Sciences, Aged, Middle Aged, Adult, Disease Progression, Neurobiology of Aging, Indexation, Upper Limb, Gene Family, Neurosciences, Age of Onset, Cohort Studies, and DNA mutational analysis
Research Interests: Mechanical Engineering, Sports Medicine, Skeletal muscle biology, Treatment Outcome, Creatine, and 30 moreAmyotrophic Lateral Sclerosis, Diarrhea, Humans, Female, Male, Statistical Significance, Arm, Exercise, Follow-up studies, Dietary Supplements, The, Body Mass Index, Clinical Sciences, Aged, Middle Aged, Neuromuscular Disease, Adult, Vital Capacity, Sex Factors, Leg, Muscle Fatigue, Curriculum and Pedagogy, Age Factors, Lower limb, Endurance Training, Medicine and Science In Sports and Exercise, Exercise Test, Neurosciences, Isometric Contraction, and Phosphocreatine
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Research Interests: Cognitive Science, Neurology, Amyotrophic Lateral Sclerosis, Italy, Prospective studies, and 16 moreHumans, Female, Male, Population based study, Time Delay, Young Adult, Incidence, Clinical Sciences, Aged, Prevalence, Middle Aged, Adult, Capture recapture, Neurosciences, Confidence Interval, and Cohort Studies
... Mark Gildersleeve, SIudent Menrher, IEEE, Hassan Pooya Forghani-zadeh, Sn&e,rf Member, IEEE, and Gabriel A. Rincon-Mora, Senioi. ... at very high frequencies, thus substantially reducing the size and \\,eight of the convcrter... more
... Mark Gildersleeve, SIudent Menrher, IEEE, Hassan Pooya Forghani-zadeh, Sn&e,rf Member, IEEE, and Gabriel A. Rincon-Mora, Senioi. ... at very high frequencies, thus substantially reducing the size and \\,eight of the convcrter [3]. However, it is difficult to ensure proper dead ...
Research Interests:
Research Interests:
Current sensing is one of the most important functions on a smart power chip. Conventional current-sensing methods insert a resistor in the path of the current to be sensed. This method incurs significant power losses, especially when the... more
Current sensing is one of the most important functions on a smart power chip. Conventional current-sensing methods insert a resistor in the path of the current to be sensed. This method incurs significant power losses, especially when the current to be sensed is high. Lossless current-sensing methods address this issue by sensing the current without dissipating the power that passive resistors do. Six available lossless current sensing techniques are reviewed. A new scheme for increasing the accuracy of current sensing when the discrete elements are not known is introduced. The new scheme measures the inductor value during the DC-DC controller startup.