Background: Among non-motor symptoms of Parkinson's disease (PD), anxiety occurs in up to 67% of patients. Clinically, PD patients report worsening of tremors in anxiogenic situations. Objective: The aim of this study was to evaluate the association between motor symptoms and anxiety in PD patients and compare their performances with those of healthy volunteers. Methods: Fifteen volunteers with PD and 15 healthy volunteers without clinically significant psychiatric disorders were evaluated. Both groups were subjected to a simulated public speaking test (SPST). The following parameters were measured: visual analog mood scale (VAMS), items related to tremors of UPDRS, bradykinesia tests, blood pressure, and heart rate. Results: Results of repeated measures ANOVA indicated a significant effect on group × phase interaction (F 3.7,105.6 = 2.56; p = 0.046) for VAMS anxiety factor. Regarding tremors, ANOVA indicated significant differences in group × phase interaction (F 4.5,121 = 2.88; p = 0.021) and between the groups (F 1,27 = 45.88, p < 0.001), with differences in the anticipatory phase, performance, and post-speech, compared with those in the baseline. There were no significant differences between the groups with regard to other factors of VAMS, physiological measurements, and bradykinesia. Discussion: Worsening of tremors occurred during SPST, particularly in phases with higher anxiety scores.
Purpose to study 75 familial adenomatous polyposis (FAP) patients treated in a single institution in Ribeirão Preto/SP, from January 1981 to December 2011.
Methods this is a retrospective study and the following data were collected: gender, age, main symptoms, familial history, coexisting malignancies, surgical treatment, surgical morbidity and mortality, factors related to life quality.
Results median age was 29 years. Male-to-female ratio was 1.2:1. Bleeding was the most common symptom (62.6%). Colorectal cancer incidence was 25.5% (n = 19). Extracolonic neoplasia incidence was 8%. Colectomy with ileorectal anastomosis (IRA) was performed in 72% of the patients. Eighteen patients (24%) were submitted to proctocolectomy with “J-pouch” ileoanal anastomosis. In three patients (4%) proctocolectomy with terminal ileostomy was performed. Early and late complication rate were similar (22.7% × 24%). Ileal pouch surgery exhibited tendency to a higher morbidity and mortality but no significance could be found. Overall mortality rate was 7.46%. Malignant neoplasia was the main cause of mortality, accounting for 60% of deaths.
Conclusion FAP is a rare pathology in our country. Genetic counseling and proper screening programs are essential tools to early diagnosis and follow-up. Surgery is the most effective treatment and the best option to prevent malignant neoplasia.
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