No abstract

Background and Objectives: A growing number of studies correlated higher levels of serum uric acid (UA) with both: lower risk of Parkinson’s Disease (PD) occurrence and slower progression of the disease. Similar conclusions were made where studies correlated UA with atypical Parkinsonisms (AP) progression. A few researchers have studied the issue of the influence of serum UA on the occurrence of non-motor symptoms (NMS) in PD and AP. Our systematic review is the first review completely dedicated to this matter. Materials and Methods: A comprehensive evaluation of the literature was performed to review the relationship between UA and NMS in PD and AP. The systematic review was conducted according to PRISMA Statement guidelines. The following databases were searched starting in April 2021: MEDLINE via PubMed, Embase, and Scopus. During the research, the following filters were used: >2010, articles in English, concerning humans. The study was not registered and received no external funding. Results: Seven articles meeting all inclusion criteria were included in this study. Collectively, data on 1104 patients were analyzed. A correlation between serum UA concentration and a few NMS types has been provided by the analyzed studies. In four papers, sleep disorders and fatigue were related to UA for both advanced and early PD. Other commonly appearing NMS domains were Attention/memory (4 studies), Depression/anxiety (3 studies), Cardiovascular (3 studies), Gastrointestinal (1 study), Perceptual (1 study), and Miscellaneous (1 study). For AP, no significant correlation between UA and worsening of NMS has been found. Conclusions: Based on the analyzed studies, a correlation between serum UA level and the occurrence and worsening of NMS in PD and APs cannot be definitively determined. Large-scale studies with a more diverse patient population and with more accurate methods of NMS assessment in Parkinsonism are needed.

Background Morphological assessment and measurement of the residual mass of the breast tumour following neoadjuvant chemotherapy (NACT) is the key to successful surgical treatment. The objective of our study was to evaluate the efficiency of contrast-enhanced spectral mammography (CESM) and conventional mammography (MMG) in detecting CR (complete response) following NACT, as well as to compare the efficiency of conventional mammography and contrast-enhanced spectral mammography is assessing the therapeutic response to NACT in breast cancer patients.Methods A retrospective analysis included 63 breast cancer subjects who had undergone neoadjuvant chemotherapy in the years 2016-2019. The inclusion criteria for the study included diagnosed breast cancer based on a core needle biopsy, a complete set of imaging examinations before the procedure consisted of digital mammography, contrast-enhanced spectral mammography and surgery performed before and after completed neoadjuvant chemotherapy. Results The average size of the tumours prior to neoadjuvant chemotherapy amounted to 34.37 mm for MMG and 34.34 mm for CESM, as well as 17.61 mm for MMG and 8.48 mm for CESM following NACT. The average size of the lesions in histopathological examination was 11.06 mm. Spearman’s analysis revealed a high level of correlation (R=0.89, p<0.01) upon comparing the maximum tumour dimensions prior to neoadjuvant chemotherapy on MMG and CESM, and a moderate level of correlation (R=0.57, p<0.01) upon comparing the maximum tumour dimensions post-NACT on MMG and CESM. While comparing the measurements of the maximum dimensions on MMG and CESM following NACT, with the maximum dimensions in histopathological examination, we can observe a low level of correlation for MMG (R=0.26, p<0.04) and a high level of correlation for CESM (R=0.67, p<0.01). The sensitivity of MMG in forecasting CR amounted to 33.33% and its specificity to 92.86%, whereas the same parameters for CESM were 85.71% and 71.42% respectively.Conclusions CESM demonstrates significantly higher sensitivity than MMG in forecasting CR in female patients receiving NACT due to breast cancer. CESM correlates well with the size of residual lesions in histopathological examination. However, it tends to underestimate the tumour size. In the assessment of post-NACT residual lesions, conventional mammography is an insufficient diagnostic tool.

The study presented here was conducted on post-stroke patients in the years 2014–2017. Data was collected using a survey questionnaire based on single-choice questions, Barthel ADL Index and the modified Rankin Scale (mRS). As many as 128 out of 135 respondents (94.8%) were referred for further treatment after initial rehabilitation. Of these, 33.6% did not continue their rehabilitation. Most of the remaining ones chose outpatient (32.9%) or inpatient rehabilitation in a hospital (29.4%). After the second examination of the physical condition of the patients, improvement was noted in those who participated in long-term rehabilitation. This feeling was also declared by the patients themselves. Out of all respondents, 92 people suffered from speech disorders, of which only 21.7% participated in speech therapy, and in this group 90% noticed a significant improvement in verbal communication. A small percentage of patients with aphasia recognize and follow speech therapy recommendations. Patients and their carers should be informed in more detail about the benefits of rehabilitation and speech therapy.