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The concomitant diagnosis of Parkinson's disease (PD) and Myasthenia Gravis (MG) is rare. The aim of the study was to report our experience of patients with both diagnoses. We performed a retrospective analysis of patients with MG and PD, seen at Neurology Department, Modena, Italy from 2000 to 2020. We encountered 12 patients with both diagnoses. All had late onset MG (LOMG) and low Myasthenia Gravis Foundation of America (MGFA) severity scores at baseline. In respect of PD assessement, clinical signs were followed and summarized with modified Hoehn and Yahr staging (mHY). Patients were ranked as progressive or non-progressive, according to any change in mHY staging. We compared characteristics and outcome of the patients with age matched myasthenic subjects without PD. The male gender significantly prevailed (p < 0.01) as well as the presence of multiple comorbidities (p < 0.001) in patients with MG associated with PD. In respect of clinical course, MG was benign as most of cases remained stable (66.7%). Six cases showed worsening of mHY scores; only one subject became wheelchair bound by the end of follow up. This uneven progression, at least in our hands, might suggest that MG and PD can evolve independently. Clinicians should be alert about the association of PD and MG since early diagnosis and treatment are essential. [ABSTRACT FROM AUTHOR]

Background and purpose: The study aimed to identify predictors of respiratory failure leading to mechanical ventilation (MV) and tracheostomy in Guillain−Barré syndrome (GBS). Methods: Two hundred and thirty adult cases admitted to the Neurology Unit of Modena, Italy, between January 2000 and December 2021 were studied. A cut‐off of MV starting within 8 weeks from onset of weakness was used. Univariable, multivariable logistic and Cox regression analyses were used to determine which pre‐specified clinical and diagnostic characteristics were capable of predicting MV and tracheostomy, due to weaning failure. The model was internally validated within the full cohort. The Erasmus GBS Respiratory Insufficiency Score was retrospectively applied. Results: One hundred and seventy‐six cases (76.5%) were classified as classical sensorimotor GBS and 54 (23.4%) as variants. Thirty‐two patients (13.9%) needed MV: 84.3% required respiratory support within 7 days. Independent predictors of respiratory failure and MV were older age, facial, bulbar, neck flexor weakness, dysautonomia, axonal electrophysiological subtype, cardiovascular comorbidities and higher disability score at entry. There was no association with abnormal spinal fluid parameters nor with positive serology for recent infections. Twenty‐two patients (68.7%) were ventilated for more than 7 days; 4.7% died within 8 weeks. The patients who required MV were treated more often with plasma exchange. Independent predictors of tracheostomy due to weaning trial failure were facial, bulbar, neck flexor weakness, autonomic dysfunction, associated cardiovascular morbidities and axonal electrophysiological subtype on nerve conduction study. Conclusions: Our study indicates distinct predictors of MV and tracheostomy in GBS patients. [ABSTRACT FROM AUTHOR]

Cryoproteinaemia is characterised by the presence of detectable proteins in both serum and plasma that precipitate at 4°C and dissolve at 37°C. Cryoglobulins are constituted by immunoglobulins and are detectable in both serum and plasma, whereas cryofibrinogen is detectable only in plasma. The importance of studying cryoproteinemia was the main theme of the meeting held in Modena in March 2023, entitled: Cryoglobulinemia. Laboratory and clinic, a fruitful collaboration for the correct management of a rare pathology - 4th edition, organised by the Italian Society of Clinical Biochemistry and Molecular Biology (SIBioC) and the Italian Association for the fight against Cryoglobulinaemia (ALCRI). The aim of this conference is to promote a dialogue between clinicians and laboratory professionals, highlighting the information that the clinician expects from the laboratory and the critical points that the laboratory faces when performing a test that is still predominantly performed manually. During the meeting, data from three laboratories were presented and compared, and a group of clinicians who deal with cryoproteinemia in different medical fields -- rheumatologists, nephrologists, haematologists, and neurologists -- contributed their experience in treating patients with cryoproteinemia. The collaboration between laboratory and clinic and the respective scientific societies (SIBioC and ALCRI) have made possible to draw a common line to guide both entities in their daily activity. The road seems long and complex, but a common system is emerging from this interaction, the fruits from which patient will benefit. [ABSTRACT FROM AUTHOR]

Fourier rebinning (FORE) is the most widely used rebinning algorithm to reorganize 3-D PET data into 2-D sinograms. In Fourier transform (FT) domain, data from oblique sinograms are assigned to transaxial ones at a proper axial displacement given by the frequency-distance relation. Approximation accuracy falls at low frequencies, where only low-copolar angles can be exploited by means of single slice rebinning (SSRB). Usually, an abrupt partition by a square region centered on DC is applied, which does not weight accuracy in the sinogram FT domain and copolar angle dependence, and can introduce artifacts due to the sharp transition. In this work we propose a simple index which maps the frequencydistance relation validity in the sinogram FT domain. Two new criteria were tested on this basis: 1) an abrupt transition based on validity map contours and 2) a gradual transition following the monotonical validity increase with frequency. In both criteria copolar angle dependence was introduced. Standard, abrupt, and gradual partitions were compared on different phantoms acquired with ECAT EXACT HR+ scanner, characterized by a large span = 9 (saved sinograms group 4 or 5 acquired sinograms, by averaging) and by a low maximum copolar angle (6[degrees]). In this condition the methods provided similar tradeoffs of SNR optimization against blur and artifact appearance, thus confirming the validity of the frequency-distance relation at low copolar angles. A simulation study emulating an hypothetical scanner with span = 3 and larger acceptance copolar angle (25.5[degrees]) conversely showed more clear improvements. Index Terms--Frequency-distance relation, image reconstruction, positron emission tomography (PET), rebinning.

Lesion detectability and quantification in fluorine-18-fluorodeoxyglucose positron emission tomography oncological studies are highly affected by space variant blur. The performance of spatial resolution recovery during AWOSEM iterative reconstruction was assessed by including in the system matrix a simple model of point spread function fitted on experimentally acquired point source sinograms. The model described axial, tangential and radial blur; radial asymmetry was taken into account. The algorithm properties in terms of contrast recovery, image noise and object separability were evaluated on scanned sphere phantom studies both in 2-D and 3-D mode. Extensive comparisons of standard and resolution recovery algorithms, over wide parameter ranges with and without post-filtering are presented. Resolution recovery, by delaying noise breakup appearance and by increasing contrast, was able to improve overall accuracy, particularly for small objects and large blur. The recovery of axial blur resulted determinant in 3-D and even more in 2-D mode. The optimal choice of reconstruction parameters was shown to be highly object dependent, thus suggesting an algorithm tuning according to applications. Index Terms--Image reconstructiom, ordered subset expectation maximization (OSEM), positron emission tomography (PET), spatial resolution.

The model presented here describes an economy where a concentrated industrial sector interacts with a financial system in which industrial firms can choose to finance their investments either by issuing bonds on a competitive spot financial market or by borrowing money from the banking sector, where they enjoy some oligopsonistic power. It is shown that, for a given number of production units, an exogenous modification in the degree of concentration in the industrial sector (caused for example by mergers) affects not only the equilibrium level of investments but also the transmission mechanism of monetary policy with composite effects. In the benchmark case of a perfectly `market-oriented' financial system (i.e. where firms raise their funds on frictionless spot financial markets) mergers and acquisitions tend to reduce the short-run impact of monetary policy because they make the industrial sector less reactive to the changes in marginal financial costs determined by open market operations.

Aim of the study: 50%–60% of patients with ocular myasthenia gravis (OMG) progress to generalized myasthenia gravis (GMG) within two years. The aim of our study was to explore factors affecting prognosis of OMG and to test the predictive role of several independent clinical variables. Materials and methods: We reviewed a cohort of 168 Caucasian patients followed from September 2000 to January 2016. Several independent variables were considered as prognostic factors: gender, age of onset, results on electrophysiological tests, presence and level of antibodies against acetylcholine receptors (AChR Abs), treatments, thymic abnormalities. The primary outcome was the progression to GMG and/or the presence of bulbar symptoms. Secondary outcomes were either achievement of sustained minimal manifestation status or worsening in ocular quantitative MG subscore (O-QMGS) or worsening in total QMG score (T-QMGS), assessed by Myasthenia Gravis Foundation of America (MGFA) quantitative scores. Changes in mental and physical subscores of health-related quality of life (HRQoL) were assessed with SF-36 questionnaire. Variance analysis was used to interpret the differences between AChR Ab titers at different times of follow up among the generalized and non-generalized patients. Results: Conversion to GMG occurred in 18.4% of patients; it was significantly associated with sex, later onset of disease and anti-AChR Ab positivity. Antibody titer above the mean value of 25.8 pmol/mL showed no significant effect on generalization. Sex and late onset of disease significantly affected T-QMGS worsening. None of the other independent variables significantly affected O-QMGS and HRQoL. Conclusions: Sex, later onset and anti-AChR Ab positivity were significantly associated with clinical worsening. [ABSTRACT FROM PUBLISHER]