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Scorza FA, Guimarães-Marques M, Nejm M, de Almeida ACG, Scorza CA, Fiorini AC, Finsterer J. Sudden unexpected death in Parkinson's disease: Insights from clinical practice. Clinics (Sao Paulo) 2022; 77:100001. [PMID: 35152167 PMCID: PMC8900653 DOI: 10.1016/j.clinsp.2021.100001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/04/2021] [Indexed: 01/21/2023] Open
Abstract
Classified as the second most common neurodegenerative disorder associated with aging after Alzheimer's disease, Parkinson's disease (PD) is the most common movement disorder. In the last decade, despite advances in treatment, mortality rates linked with PD continued to reach significant figures. Available studies have shown that compared with healthy controls, patients with PD are accompanied by high rates of premature death. This is usually caused by factors such as pneumonia and cerebrovascular and cardiovascular diseases. Recently, it has been demonstrated that a significant proportion of patients with PD die suddenly. This is referred to as a sudden and unexpected death in PD (SUDPAR). Here, we focus on the magnitude of SUDPAR. Finally, it is important to learn more about SUDPAR for the implementation of effective prevention strategies.
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Affiliation(s)
- Fulvio A Scorza
- Neuroscience Discipline, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Neuroscience Center of the Woman Health "Professor Geraldo Rodrigues de Lima", Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
| | - Marcia Guimarães-Marques
- Neuroscience Discipline, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Mariana Nejm
- Neuroscience Discipline, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Antônio Carlos G de Almeida
- Neuroscience Center of the Woman Health "Professor Geraldo Rodrigues de Lima", Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Laboratory of Experimental and Computational Neuroscience, Department of Biosystems Engineering, Universidade Federal de São João del-Rei (UFSJ), São João del-Rei, MG, Brazil
| | - Carla A Scorza
- Neuroscience Discipline, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Neuroscience Center of the Woman Health "Professor Geraldo Rodrigues de Lima", Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Ana C Fiorini
- Neuroscience Center of the Woman Health "Professor Geraldo Rodrigues de Lima", Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Department of Phonoaudiology, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Phonoaudiology Post graduation Program, Pontifícia Universidade Católica de São Paulo (PUC-SP), São Paulo, SP, Brazil
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Fijačko N, Masterson Creber R, Gosak L, Štiglic G, Egan D, Chaka B, Debeljak N, Strnad M, Skok P. Evaluating Quality, Usability, Evidence-Based Content, and Gamification Features in Mobile Learning Apps Designed to Teach Children Basic Life Support: Systematic Search in App Stores and Content Analysis. JMIR Mhealth Uhealth 2021; 9:e25437. [PMID: 34283034 PMCID: PMC8335615 DOI: 10.2196/25437] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/12/2020] [Accepted: 05/07/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Globally, 3.7 million people die of sudden cardiac death annually. Following the World Health Organization endorsement of the Kids Save Lives statements, initiatives to train school-age children in basic life support (BLS) have been widespread. Mobile phone apps, combined with gamification, represent an opportunity for including mobile learning (m-learning) in teaching schoolchildren BLS as an additional teaching method; however, the quality of these apps is questionable. OBJECTIVE This study aims to systematically evaluate the quality, usability, evidence-based content, and gamification features (GFs) of commercially available m-learning apps for teaching guideline-directed BLS knowledge and skills to school-aged children. METHODS We searched the Google Play Store and Apple iOS App Store using multiple terms (eg, cardiopulmonary resuscitation [CPR] or BLS). Apps meeting the inclusion criteria were evaluated by 15 emergency health care professionals using the user version of the Mobile Application Rating Scale and System Usability Scale. We modified a five-finger mnemonic for teaching schoolchildren BLS and reviewed the apps' BLS content using standardized criteria based on three CPR guidelines. GFs in the apps were evaluated using a gamification taxonomy. RESULTS Of the 1207 potentially relevant apps, only 6 (0.49%) met the inclusion criteria. Most apps were excluded because the content was not related to teaching schoolchildren BLS. The mean total scores for the user version of the Mobile Application Rating Scale and System Usability Scale score were 3.2/5 points (95% CI 3.0-3.4) and 47.1/100 points (95% CI 42.1-52.1), respectively. Half of the apps taught hands-only CPR, whereas the other half also included ventilation. All the apps indicated when to start chest compressions, and only 1 app taught BLS using an automated external defibrillator. Gamification was well integrated into the m-learning apps for teaching schoolchildren BLS, whereas the personal and fictional, educational, and performance gamification groups represented most GFs. CONCLUSIONS Improving the quality and usability of BLS content in apps and combining them with GFs can offer educators novel m-learning tools to teach schoolchildren BLS skills.
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Affiliation(s)
- Nino Fijačko
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
| | - Ruth Masterson Creber
- Healthcare Policy and Research, Division of Health Informatics, Weill Cornell Medicine, New York, NY, United States
| | - Lucija Gosak
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
| | - Gregor Štiglic
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Maribor, Slovenia
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Dominic Egan
- School of Nursing and Healthcare Leadership, University of Bradford, Bradford, United Kingdom
| | - Brian Chaka
- School of Allied Health Professions and Midwifery, University of Bradford, Bradford, United Kingdom
| | - Nika Debeljak
- Faculty of Health Sciences, University of Maribor, Maribor, Slovenia
| | - Matej Strnad
- Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Pavel Skok
- Faculty of Medicine, University of Maribor, Maribor, Slovenia
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Zribi M, Ennouri H, Turki M, Ben Amar W, Grati MA, Hammami Z, Ayadi F, Maatoug S. Diagnostic value of high-sensitivity troponin T in postmortem diagnosis of sudden cardiac death. J Forensic Leg Med 2021; 78:102127. [PMID: 33601325 DOI: 10.1016/j.jflm.2021.102127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/21/2021] [Accepted: 01/27/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Ischemic heart disease is the most common cause of sudden cardiac death. By autopsy, there may be no histologic evidence of acute myocardial damage few hours after death. The use of cardiac troponins in the postmortem diagnosis of sudden cardiac death is well known in the forensic setting. However, high-sensitivity cardiac troponin T (Hs-TnT) assay in cadaver fluids was tested in few studies. The aim of this study is to assess the diagnostic value of postmortem dosage of Hs-TnT in the diagnosis of sudden cardiac death. MATERIAL AND METHODS Our study is prospective, dealing with cadavers autopsied at the Department of Forensic Medicine of the University Hospital Habib Bourguiba of Sfax-Tunisia from December 2016 to April 2018. Were excluded from the study resuscitated cases, severely traumatized victims and cadavers that were examined more than 36 h after death. Levels of Hs-TnT were measured in pericardial fluid, cardiac blood and peripheral blood. RESULTS A total of 80 cases were identified with an average age of 44.5 ± 19 years. Hs-TnT levels in pericardial fluid and heart blood were correlated significantly between cardiac and non-cardiac groups with a p-value respectively at 0.14 and 0.04. Receiver-operator characteristic curves analysis showed that the pericardial fluid had the best sensibility (75%) and specificity (64%) with a cut-off level at 17.72 ng/ml and an area under the curve at 0.747. We found also a significant correlation between postmortem interval and Hs-TnT levels in pericardial fluid, cardiac and peripheral blood. CONCLUSION Our data indicate that determination of cardiac troponin T by a highly sensitive assay in pericardial fluid may be a powerful aid in the postmortem diagnosis of sudden cardiac death.
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Affiliation(s)
- M Zribi
- Department of Forensic Medicine, Habib Bourguiba Hospital, 3029, Sfax, Tunisia.
| | - H Ennouri
- Department of Forensic Medicine, Habib Bourguiba Hospital, 3029, Sfax, Tunisia.
| | - M Turki
- Biochemistry Laboratory, Habib Bourguiba Hospital, University of Sfax, 3029, Sfax, Tunisia.
| | - W Ben Amar
- Department of Forensic Medicine, Habib Bourguiba Hospital, 3029, Sfax, Tunisia.
| | - M A Grati
- Biochemistry Laboratory, Habib Bourguiba Hospital, University of Sfax, 3029, Sfax, Tunisia.
| | - Z Hammami
- Department of Forensic Medicine, Habib Bourguiba Hospital, 3029, Sfax, Tunisia.
| | - F Ayadi
- Biochemistry Laboratory, Habib Bourguiba Hospital, University of Sfax, 3029, Sfax, Tunisia.
| | - S Maatoug
- Department of Forensic Medicine, Habib Bourguiba Hospital, 3029, Sfax, Tunisia.
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Scorza FA, Fonseca MCM, Finsterer J, Girao MJBC. Letter by Scorza et al Regarding Article "High-Risk Human Papillomavirus Infection and the Risk of Cardiovascular Disease in Korean Women". Circ Res 2019; 125:e13-e14. [PMID: 31318651 DOI: 10.1161/circresaha.119.315473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Fulvio A Scorza
- Disciplina de Neurociência, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
| | - Marcelo C M Fonseca
- Departamento de Ginecologia, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
| | - Josef Finsterer
- Krankenanstalt Rudolfstiftung, Messerli Institute, Vienna, Austria
| | - Manoel J B C Girao
- Departamento de Ginecologia, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
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Nejm MB, Andersen ML, Tufik S, Finsterer J, Scorza FA. Sudden unexpected death in Parkinson’s disease: why do neuroscientists still ignore this condition? Neurol Sci 2018; 40:413-414. [DOI: 10.1007/s10072-018-3581-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 09/14/2018] [Indexed: 10/28/2022]
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Scorza FA, Fiorini AC, Scorza CA, Finsterer J. Cardiac abnormalities in Parkinson's disease and Parkinsonism. J Clin Neurosci 2018; 53:1-5. [PMID: 29706419 DOI: 10.1016/j.jocn.2018.04.031] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 04/09/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Though there is increasing evidence for primary cardiac disease in Parkinson's disease (PD) and Parkinsonism (PS), this evidence is hardly included in the general management of these patients. METHODS Literature review. RESULTS PD is one of the most common age-related neurodegenerative disorders. Epidemiological studies have shown that PD is accompanied by high rates of premature death compared with the general population. In general, death in PD/PS is usually caused by determinant factors such as pneumonia, cerebrovascular, and cardiovascular disease. There is a significant body of literature demonstrating involvement of the heart in PD/PS. Cardiac involvement in PD/PS includes cardiac autonomic dysfunction, cardiomyopathy, coronary heart disease, arrhythmias, conduction defects, and sudden cardiac death (SCD), and sudden unexpected death in Parkinson's disease (SUDPAR). CONCLUSIONS Cardiac abnormalities found in PD/PS are manifold but the most prominent is cardiac autonomic dysfunction. The frequency of coronary heart disease in PD is a matter of debate. Only rarely reported in PD/PS are cardiomyopathies, arrhythmias, and sudden cardiac death, and SUDPAR. It is particularly recommended that PD/PS patients are more intensively investigated cardiologically as soon as the diagnosis is established. Early recognition of cardiac involvement is important for preventing SCD and SUDPAR.
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Affiliation(s)
- Fulvio A Scorza
- Disciplina de Neurociência, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil.
| | - Ana C Fiorini
- Programa de Estudos Pós-Graduado em Fonoaudiologia, Pontifícia Universidade Católica de São Paulo (PUC-SP), Brazil; Departamento de Fonoaudiologia, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil.
| | - Carla A Scorza
- Disciplina de Neurociência, Escola Paulista de Medicina/Universidade Federal de São Paulo (EPM/UNIFESP), São Paulo, Brazil
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Gutierrez C, Lindor RA, Baker O, Cutler D, Schuur JD. State Regulation Of Freestanding Emergency Departments Varies Widely, Affecting Location, Growth, And Services Provided. Health Aff (Millwood) 2016; 35:1857-1866. [DOI: 10.1377/hlthaff.2016.0412] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Catherine Gutierrez
- Catherine Gutierrez is a medical student at Harvard Medical School, in Boston, Massachusetts
| | - Rachel A. Lindor
- Rachel A. Lindor is a resident physician in emergency medicine at the Mayo Clinic College of Medicine, in Rochester, Minnesota
| | - Olesya Baker
- Olesya Baker is a statistician in the Department of Emergency Medicine at Brigham and Women’s Hospital, in Boston
| | - David Cutler
- David Cutler is the Otto Eckstein Professor of Applied Economics at Harvard University, in Cambridge, Massachusetts
| | - Jeremiah D. Schuur
- Jeremiah D. Schuur (
) is chief of the Division of Health Policy Research in the Department of Emergency Medicine at Brigham and Women’s Hospital and an assistant professor of emergency medicine at Harvard Medical School
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Scorza FA, Cavalheiro EA, Costa JCD. Sudden cardiac death in epilepsy disappoints, but epileptologists keep faith. ARQUIVOS DE NEURO-PSIQUIATRIA 2016; 74:570-3. [DOI: 10.1590/0004-282x20160086] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 05/16/2016] [Indexed: 11/22/2022]
Abstract
ABSTRACT Sudden unexpected death in epilepsy (SUDEP) is the most common cause of death in people with intractable epilepsy. Probably, optimization of seizure control will prevent some of these deaths. Briefly, we integrated in this paper some data about the epidemiology, risk factors, etiology, and preventative measures in the management of SUDEP.
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Wu Q, Zhang L, Zheng J, Zhao Q, Wu Y, Yin K, Huang L, Tang S, Cheng J. Forensic Pathological Study of 1656 Cases of Sudden Cardiac Death in Southern China. Medicine (Baltimore) 2016; 95:e2707. [PMID: 26844513 PMCID: PMC4748930 DOI: 10.1097/md.0000000000002707] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Sudden cardiac death (SCD) is progressively threatening the lives of young people throughout the world. We conducted a retrospective study of SCD cases identified among sudden death cases based on comprehensive autopsies and pathological examinations in the Center for Medicolegal Expertise of Sun Yat-Sen University to investigate the exact etiological distribution and epidemiological features of SCD. One thousand six hundred fifty-six cases were identified, and SCD accounted for 43.0% of these sudden death cases. The mean age of the SCD cases-where the data of definite ages were accessible-was 38.2 years, and the highest incidence occurred among the 31- to 40-year-old cases (25.6%). The male-to-female ratio among SCD cases was 4.3:1, and this ratio peaked in the 41- to 50-year-old group (7.7:1). The places of death were confirmed in 1411 cases, and predominantly in hospitals (46.3%) and at home (33.8%). SCD occurred throughout the year with a marginally increase in April and May. The major causes of SCD were coronary atherosclerotic disease (CAD, 41.6%), unexplained sudden death (15.1%), and myocarditis (11.8%). Our data indicated that in the age group of younger affected persons (below 35 years old), sudden unexplained death and myocarditis were much more prevalent than CAD. According to anatomical examinations of the CAD-related SCD cases, the proportion of cases with coronary artery stenosis exceeding 75% (grade IV) was 67.2%. Moreover, the percentages of higher grades of coronary atherosclerosis increased with age. Among all branches of the coronary arteries, the left anterior descending branch was the most prone to atherosclerosis; atherosclerosis was present in this branch in 95.4% of the cases with atherosclerosis. Additionally, lesions of multiple branches of the coronary artery were associated with ageing. This is the first study to report the causes of death and basic epidemiological data related to SCD in Southern China.
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Affiliation(s)
- Qiuping Wu
- From the Department of Forensic Pathology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
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