Marika Falla - Academia.edu (original) (raw)

Papers by Marika Falla

Research paper thumbnail of Surgical masks and filtering facepiece class 2 respirators (FFP2) have no major physiological effects at rest and during moderate exercise at 3000-m altitude: a randomised controlled trial

Journal of Travel Medicine

BackgroundDuring the COVID-19 pandemic, the use of face masks has been recommended or enforced in... more BackgroundDuring the COVID-19 pandemic, the use of face masks has been recommended or enforced in several situations; however, their effects on physiological parameters and cognitive performance at high altitude are unknown.MethodsEight healthy participants (four females) rested and exercised (cycling, 1 W/kg) while wearing no mask, a surgical mask or a filtering facepiece class 2 respirator (FFP2), both in normoxia and hypobaric hypoxia corresponding to an altitude of 3000 m. Arterialised oxygen saturation (SaO2), partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2), heart and respiratory rate, pulse oximetry (SpO2), cerebral oxygenation, visual analogue scales for dyspnoea and mask’s discomfort were systematically investigated. Resting cognitive performance and exercising tympanic temperature were also assessed.ResultsMask use had a significant effect on PaCO2 (overall +1.2 ± 1.7 mmHg). There was no effect of mask use on all other investigated parameters except for dyspnoe...

Research paper thumbnail of Re: “Stroke at Moderate and High Altitude” by Syed et al

High Altitude Medicine & Biology

Research paper thumbnail of Recommendations for traveling to altitude with neurological disorders

Journal of Central Nervous System Disease, 2021

Background Several neurological conditions might worsen with the exposure to high altitude (HA). ... more Background Several neurological conditions might worsen with the exposure to high altitude (HA). The aim of this review was to summarize the available knowledge on the neurological HA illnesses and the risk for people with neurological disorders to attend HA locations. Methods A search of literature was conducted for several neurological disorders in PubMed and other databases since 1970. The neurological conditions searched were migraine, different cerebrovascular disease, intracranial space occupying mass, multiple sclerosis, peripheral neuropathies, neuromuscular disorders, epileptic seizures, delirium, dementia, and Parkinson’s disease (PD). Results Attempts were made to classify the risk posed by each condition and to provide recommendations regarding medical evaluation and advice for or against traveling to altitude. Individual cases should be advised after careful examination and risk evaluation performed either in an outpatient mountain medicine service or by a physician wit...

Research paper thumbnail of Low Ambient Temperature Exposition Impairs the Accuracy of a Non-invasive Heat-Flux Thermometer

Frontiers in Physiology, 2022

BackgroundIndirect core body temperature (CBT) monitoring from skin sensors is gaining attention ... more BackgroundIndirect core body temperature (CBT) monitoring from skin sensors is gaining attention for in-field applications thanks to non-invasivity, portability, and easy probe positioning. Among skin sensors, heat-flux devices, such as the so-called Double Sensor (DS), have demonstrated reliability under various experimental and clinical conditions. Still, their accuracy at low ambient temperatures is unknown. In this randomized cross-over trial, we tested the effects of cold temperature exposition on DS performance in tracking CBT.MethodsTwenty-one participants were exposed to a warm (23.2 ± 0.4°C) and cold (−18.7 ± 1.0°C) room condition for 10 min, following a randomized cross-over design. The accuracy of the DS to estimate CBT in both settings was assessed by quantitative comparison with esophageal (reference) and tympanic (comparator) thermometers, using Bland–Altman and correlation analyses (Pearson’s correlation coefficient, r, and Lin’s concordance correlation coefficient, C...

Research paper thumbnail of Travel to altitude with neurological disorders — recommendation of the UIAA Medical Commission

Health Promotion & Physical Activity, 2021

The present review examines several neurological conditions and the problems posed by travelling ... more The present review examines several neurological conditions and the problems posed by travelling to high altitude, and in particular whether the underlying disease is likely to worsen. The neurological conditions include migraine and other types of headaches, transient ischemia of the brain, occlusive cerebral artery diseases, intracranial haemorrhage and vascular malformations, intracranial space occupying mass, multiple sclerosis, peripheral neuropathies, neuromuscular disorders, epileptic seizures, dementia and Parkinson’s disease. Attempts will be made to classify the risk posed by each condition and to provide recommendations regarding medical evaluation, advice for or against travelling to altitude and effective prophylactic measures. Some individual cases should only be advised after careful examination and risk evaluation either in an outpatient mountain medicine service or by a physician with knowledge of travelling and high altitude risks. Recent developments in diagnostic...

Research paper thumbnail of Re: “Incidence of Mild Cognitive Impairment with Ascending Altitude” by Algaze et al

High Altitude Medicine & Biology, 2020

Research paper thumbnail of Freezing of gait: overview on etiology, treatment, and future directions

Research paper thumbnail of Kinematic and Diffusion Tensor Imaging Definition of Familial

Background: Marcus Gunn jaw-winking synkinesis (MGJWS) is characterized by eyelid ptosis, which d... more Background: Marcus Gunn jaw-winking synkinesis (MGJWS) is characterized by eyelid ptosis, which disappears during jaw movement. Familial MGJWS is an extremely rare condition. Some authors suggested that MGJWS is due to neural misdirection in the brainstem whereas others suggested that aberrant reinnervation or ephapse may be responsible for synkinetic activity. Pathogenesis of this condition is therefore still unclear. Methodology/Principal Findings: To investigate pathogenetic mechanism in familial MGJWS we performed neurophys-iological (EMG, Blink Reflex, Recovery cycle of the R2 component of the blink reflex, Masseter inhibitory reflex, BAEPS and kinematic analysis) and neuroradiological (MRI, Diffusion Tensor Imaging) investigations in a member of a multigenerational family with autosomal dominant Marcus Gunn jaw-winking synkinesis (MGJWS). Kinematic analysis of eyelid and jaw movements disclosed a similar onset and offset of the eyelid and jaw in both the opening and closing ph...

Research paper thumbnail of A Prospective Evaluation of the Acute Effects of High Altitude on Cognitive and Physiological Functions in Lowlanders

Frontiers in Physiology, 2021

Cognitive function impairment due to high altitude exposure has been reported with some contradic... more Cognitive function impairment due to high altitude exposure has been reported with some contradictory results regarding the possible selective cognitive domain involvement. We prospectively evaluated in 36 lowlanders, exposed for 3 consecutive days to an altitude of 3,269 m, specific cognitive abilities (attention, processing speed, and decision-making) required to safely explore the mountains, as well as to work at altitude. We simultaneously monitored the physiological parameters. Our study provides evidence of a reduced processing speed in lowlanders when exposed to altitude in the first 24 h. There was a fairly quick recovery since this impairment was no more detectable after 36 h of exposure. There were no clinically relevant effects on decision-making, while psychomotor vigilance was unaffected at altitude except for individuals with poor sleep. Significant changes were seen in physiological parameters (increased heart rate and reduced peripheral oxygen saturation). Our result...

Research paper thumbnail of The Role of Social Cognition Abilities in Parkinson's Disease in the Era of COVID-19 Emergency

Frontiers in Psychology

Introduction: Parkinson's Disease (PD) is characterized by motor and non-motor symptoms, amon... more Introduction: Parkinson's Disease (PD) is characterized by motor and non-motor symptoms, among which deficits in social cognition might affect ~20% of patients. This study aims to evaluate the role of social cognitive abilities in the perceived impact of COVID-19 emergency, and the effects of lockdown measures on patients' social network and caregivers' burden.Methods: Fourteen PD patients performed a neuropsychological battery including sociocognitive tasks before the introduction of COVID-19 restrictive measures (i.e., social distancing and isolation). A structured interview through an online platform was performed in the last 2 weeks of the first lockdown phase to assess patients' health status, perception of COVID-19 emergency, changes in caregivers' burden, and patients' social isolation. Non-parametric analyses were performed to evaluate the association between social skills and patients' COVID-19 perception, as well as the effects of restrictive me...

Research paper thumbnail of Effect of Acute Exposure to Altitude on the Quality of Chest Compression‐Only Cardiopulmonary Resuscitation in Helicopter Emergency Medical Services Personnel: A Randomized, Controlled, Single‐Blind Crossover Trial

Journal of the American Heart Association

Background Helicopter emergency medical services personnel operating in mountainous terrain are f... more Background Helicopter emergency medical services personnel operating in mountainous terrain are frequently exposed to rapid ascents and provide cardiopulmonary resuscitation (CPR) in the field. The aim of the present trial was to investigate the quality of chest compression only (CCO)‐CPR after acute exposure to altitude under repeatable and standardized conditions. Methods and Results Forty‐eight helicopter emergency medical services personnel were divided into 12 groups of 4 participants; each group was assigned to perform 5 minutes of CCO‐CPR on manikins at 2 of 3 altitudes in a randomized controlled single‐blind crossover design (200, 3000, and 5000 m) in a hypobaric chamber. Physiological parameters were continuously monitored; participants rated their performance and effort on visual analog scales. Generalized estimating equations were performed for variables of CPR quality (depth, rate, recoil, and effective chest compressions) and effects of time, altitude, carryover, altitu...

Research paper thumbnail of Impact of Nutritional Intervention on Taste Perception—A Scoping Review

Foods

The aim of the present scoping review was to evaluate the impact of experimental meal loads or ob... more The aim of the present scoping review was to evaluate the impact of experimental meal loads or observational diet changes/habits on taste tests in both healthy subjects and patients. A systematic search performed in PubMed, Scopus, and Institute for Scientific Information (ISI) Web of Science electronic databases retrieved, respectively 2981, 6258, and 7555 articles from January 2000 to December 2020. A total of 17 articles were included for full-text review. Literature results were stratified according to the observational/interventional approach, the involvement of healthy subjects or patients, the taste test, and the meal/dietary changes. The present scoping review reinforced the notions postulating that certain taste tests (for example focusing on fatty acid, salt, or sugar) might be specifically influenced by the nutritional intervention and that other ones might be susceptible to a wide span of changes beyond the extent of tastant included in the specific food changes. This co...

Research paper thumbnail of High-altitude cerebral edema: its own entity or end-stage acute mountain sickness?

Journal of Applied Physiology

High-altitude cerebral edema (HACE) and acute mountain sickness (AMS) are neuropathologies associ... more High-altitude cerebral edema (HACE) and acute mountain sickness (AMS) are neuropathologies associated with rapid exposure to hypoxia. However, speculation remains regarding the exact etiology of both HACE and AMS and whether they share a common mechanistic pathology. This review outlines the basic principles of HACE development, highlighting how edema could develop from 1) a progression from cytotoxic swelling to ionic edema or 2) permeation of the blood brain barrier (BBB) with or without ionic edema. Thereafter, discussion turns to the available neuroimaging literature in the context of cytotoxic, ionic, or vasogenic edema in both HACE and AMS. Although HACE is clearly caused by an increase in brain water of ionic and/or vasogenic origin, there is very little evidence that this type of edema is present when AMS develops. However, cerebral vasodilation, increased intracranial blood volume, and concomitant intracranial fluid shifts from the extracellular to the intracellular space, ...

Research paper thumbnail of Genetic variants in levodopa-induced dyskinesia (LID): A systematic review and meta-analysis

Parkinsonism & Related Disorders

INTRODUCTION Levodopa-induced dyskinesia frequently complicates long-term Parkinson's disease... more INTRODUCTION Levodopa-induced dyskinesia frequently complicates long-term Parkinson's disease. More in-depth knowledge regarding the role of genetic factors in dyskinesia development may be important to identify parkinsonian patients who are more prone to developing dyskinesia and clarify the molecular mechanisms underlying this condition. For this reason, we systematically reviewed studies investigating genetic factors involved in dyskinesia. METHODS A systematic search of genetic factors in Parkinson's disease dyskinesia was performed using the MEDLINE (through PubMed up to June 2019) and EMBASE databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A meta-analysis was conducted using a random effect model. RESULTS The literature search retrieved 33 studies assessing genes and variants possibly associated with dyskinesia in Parkinson's disease. The studies were published between 1984 and 2019 and included a total of 27,092 subjects of different ethnicities. Overall, 37 genes were analyzed in the studies reviewed, of which 22 were possibly associated with dyskinesia. The studies reported a total of 158 variants, of which 94 were possibly related to dyskinesia. CONCLUSION The studies reviewed demonstrated inconsistent results, possibly due to differences in screening methods and in the comparison of clinical data in a large variety of genetically- and ethnically-diverse populations. The meta-analysis failed to demonstrate any association between the rs6280 in the DRD3 gene, rs1799836 in the MAO-B, rs4680 in the COMT gene, rs34637584 in the LRRK2 gene and LID susceptibility. The role of genetic factors in LID susceptibility is still unclear and further studies are required.

Research paper thumbnail of Insight into the use of tympanic temperature during target temperature management in emergency and critical care: a scoping review

Journal of Intensive Care

Background Target temperature management (TTM) is suggested to reduce brain damage in the presenc... more Background Target temperature management (TTM) is suggested to reduce brain damage in the presence of global or local ischemia. Prompt TTM application may help to improve outcomes, but it is often hindered by technical problems, mainly related to the portability of cooling devices and temperature monitoring systems. Tympanic temperature (TTy) measurement may represent a practical, non-invasive approach for core temperature monitoring in emergency settings, but its accuracy under different TTM protocols is poorly characterized. The present scoping review aimed to collect the available evidence about TTy monitoring in TTM to describe the technique diffusion in various TTM contexts and its accuracy in comparison with other body sites under different cooling protocols and clinical conditions. Methods The scoping review was conducted following the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews (PRISMA-ScR). PubMed, Scopus...

Research paper thumbnail of Effects of hypothermia, hypoxia, and hypercapnia on brain oxygenation and hemodynamic parameters during simulated avalanche burial: a porcine study

Journal of Applied Physiology

Avalanche patients who are completely buried but still able to breathe are exposed to hypothermia... more Avalanche patients who are completely buried but still able to breathe are exposed to hypothermia, hypoxia, and hypercapnia (triple H syndrome). In a porcine model, there was no clinically relevant reduction in cerebral oxygenation during hypothermia and initial reduction of fraction of inspiratory oxygen ([Formula: see text]), as observed during hypercapnia. Hypercapnia may be the main cause of cardiovascular instability, which seems to be the major trigger for a decrease in cerebral oxygenation in triple H syndrome despite severe hypothermia.

Research paper thumbnail of Hypoxia and hypercapnia effects on cerebral oxygen saturation in avalanche burial: A pilot human experimental study

Research paper thumbnail of The Effect of Cold Exposure on Cognitive Performance in Healthy Adults: A Systematic Review

International Journal of Environmental Research and Public Health

Several aspects of cognition can be affected after cold exposure, but contradictory results have ... more Several aspects of cognition can be affected after cold exposure, but contradictory results have been reported regarding affected cognitive domains. The aim of the current systematic review was to evaluate the effects of specific cold exposure on cognitive performance in healthy subjects. A systematic search was performed using MEDLINE (through PubMed), EMBASE (Scopus) and PsycINFO databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were healthy subjects exposed to a cold environment (either simulated or not) and cognitive performance related to cold exposure with an experimental design. The literature search identified 18 studies, eight studies investigated the effect of cold air exposure and ten the effect of cold water immersion on cognitive performance of healthy subjects. There were several differences among the studies (environmental temperature reached, time of exposure, timing, and type of cognitive tes...

Research paper thumbnail of Lockdown effects on Parkinson’s disease during COVID-19 pandemic: a pilot study

Acta Neurologica Belgica

The coronavirus-disease 2019 (COVID-19) outbreak precipitated prolonged lock-down measures. The s... more The coronavirus-disease 2019 (COVID-19) outbreak precipitated prolonged lock-down measures. The subsequent social distancing, isolation, and reduction in mobility increased psychological stress, which may worsen Parkinson’s disease (PD). Therefore, telemedicine has been proposed to provide care to PD patients. To evaluate the effects of lock-down on motor and nonmotor symptoms in PD patients during the COVID-19 pandemic and the feasibility of telemedicine. Motor and nonmotor aspects were longitudinally assessed using structured questionnaires at baseline (in-person, February 2020) and at follow-up (remote web-based video, lock-down) evaluation. Of the seventeen PD patients evaluated at baseline, fourteen agreed to participate in, and completed follow-up evaluations. There was an impairment of nonmotor aspects measured with the MDS-UPDRS part I (p

Research paper thumbnail of Long-Term Sequelae of Frostbite—A Scoping Review

International Journal of Environmental Research and Public Health

Frostbite is tissue damage caused by freezing temperatures and constitutes an important cause of ... more Frostbite is tissue damage caused by freezing temperatures and constitutes an important cause of morbidity in cold climate zones and high altitude. The direct effects of sub-zero temperatures lead to tissue freezing, electrolyte shifts and pH alterations, microvascular damage, and eventually to cell death. Upon rewarming, inflammatory reperfusion injury and thrombosis may lead to further tissue damage. Several studies and various case reports show that many patients suffer from long-term sequelae such as vasomotor disturbances (associated with susceptibility to refreezing), and neuropathic and nociceptive pain, as well as damage to skeletal structures. There are still many uncertainties regarding the pathophysiology of these sequelae. It has been shown that the transient receptor potential channel (TRP) family plays a role in cold allodynia. Botulinum Toxin type A (BTX-A) injections have been reported to be beneficial in vasomotor and neuropathic disturbances secondary to frostbite....

Research paper thumbnail of Surgical masks and filtering facepiece class 2 respirators (FFP2) have no major physiological effects at rest and during moderate exercise at 3000-m altitude: a randomised controlled trial

Journal of Travel Medicine

BackgroundDuring the COVID-19 pandemic, the use of face masks has been recommended or enforced in... more BackgroundDuring the COVID-19 pandemic, the use of face masks has been recommended or enforced in several situations; however, their effects on physiological parameters and cognitive performance at high altitude are unknown.MethodsEight healthy participants (four females) rested and exercised (cycling, 1 W/kg) while wearing no mask, a surgical mask or a filtering facepiece class 2 respirator (FFP2), both in normoxia and hypobaric hypoxia corresponding to an altitude of 3000 m. Arterialised oxygen saturation (SaO2), partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2), heart and respiratory rate, pulse oximetry (SpO2), cerebral oxygenation, visual analogue scales for dyspnoea and mask’s discomfort were systematically investigated. Resting cognitive performance and exercising tympanic temperature were also assessed.ResultsMask use had a significant effect on PaCO2 (overall +1.2 ± 1.7 mmHg). There was no effect of mask use on all other investigated parameters except for dyspnoe...

Research paper thumbnail of Re: “Stroke at Moderate and High Altitude” by Syed et al

High Altitude Medicine & Biology

Research paper thumbnail of Recommendations for traveling to altitude with neurological disorders

Journal of Central Nervous System Disease, 2021

Background Several neurological conditions might worsen with the exposure to high altitude (HA). ... more Background Several neurological conditions might worsen with the exposure to high altitude (HA). The aim of this review was to summarize the available knowledge on the neurological HA illnesses and the risk for people with neurological disorders to attend HA locations. Methods A search of literature was conducted for several neurological disorders in PubMed and other databases since 1970. The neurological conditions searched were migraine, different cerebrovascular disease, intracranial space occupying mass, multiple sclerosis, peripheral neuropathies, neuromuscular disorders, epileptic seizures, delirium, dementia, and Parkinson’s disease (PD). Results Attempts were made to classify the risk posed by each condition and to provide recommendations regarding medical evaluation and advice for or against traveling to altitude. Individual cases should be advised after careful examination and risk evaluation performed either in an outpatient mountain medicine service or by a physician wit...

Research paper thumbnail of Low Ambient Temperature Exposition Impairs the Accuracy of a Non-invasive Heat-Flux Thermometer

Frontiers in Physiology, 2022

BackgroundIndirect core body temperature (CBT) monitoring from skin sensors is gaining attention ... more BackgroundIndirect core body temperature (CBT) monitoring from skin sensors is gaining attention for in-field applications thanks to non-invasivity, portability, and easy probe positioning. Among skin sensors, heat-flux devices, such as the so-called Double Sensor (DS), have demonstrated reliability under various experimental and clinical conditions. Still, their accuracy at low ambient temperatures is unknown. In this randomized cross-over trial, we tested the effects of cold temperature exposition on DS performance in tracking CBT.MethodsTwenty-one participants were exposed to a warm (23.2 ± 0.4°C) and cold (−18.7 ± 1.0°C) room condition for 10 min, following a randomized cross-over design. The accuracy of the DS to estimate CBT in both settings was assessed by quantitative comparison with esophageal (reference) and tympanic (comparator) thermometers, using Bland–Altman and correlation analyses (Pearson’s correlation coefficient, r, and Lin’s concordance correlation coefficient, C...

Research paper thumbnail of Travel to altitude with neurological disorders — recommendation of the UIAA Medical Commission

Health Promotion & Physical Activity, 2021

The present review examines several neurological conditions and the problems posed by travelling ... more The present review examines several neurological conditions and the problems posed by travelling to high altitude, and in particular whether the underlying disease is likely to worsen. The neurological conditions include migraine and other types of headaches, transient ischemia of the brain, occlusive cerebral artery diseases, intracranial haemorrhage and vascular malformations, intracranial space occupying mass, multiple sclerosis, peripheral neuropathies, neuromuscular disorders, epileptic seizures, dementia and Parkinson’s disease. Attempts will be made to classify the risk posed by each condition and to provide recommendations regarding medical evaluation, advice for or against travelling to altitude and effective prophylactic measures. Some individual cases should only be advised after careful examination and risk evaluation either in an outpatient mountain medicine service or by a physician with knowledge of travelling and high altitude risks. Recent developments in diagnostic...

Research paper thumbnail of Re: “Incidence of Mild Cognitive Impairment with Ascending Altitude” by Algaze et al

High Altitude Medicine & Biology, 2020

Research paper thumbnail of Freezing of gait: overview on etiology, treatment, and future directions

Research paper thumbnail of Kinematic and Diffusion Tensor Imaging Definition of Familial

Background: Marcus Gunn jaw-winking synkinesis (MGJWS) is characterized by eyelid ptosis, which d... more Background: Marcus Gunn jaw-winking synkinesis (MGJWS) is characterized by eyelid ptosis, which disappears during jaw movement. Familial MGJWS is an extremely rare condition. Some authors suggested that MGJWS is due to neural misdirection in the brainstem whereas others suggested that aberrant reinnervation or ephapse may be responsible for synkinetic activity. Pathogenesis of this condition is therefore still unclear. Methodology/Principal Findings: To investigate pathogenetic mechanism in familial MGJWS we performed neurophys-iological (EMG, Blink Reflex, Recovery cycle of the R2 component of the blink reflex, Masseter inhibitory reflex, BAEPS and kinematic analysis) and neuroradiological (MRI, Diffusion Tensor Imaging) investigations in a member of a multigenerational family with autosomal dominant Marcus Gunn jaw-winking synkinesis (MGJWS). Kinematic analysis of eyelid and jaw movements disclosed a similar onset and offset of the eyelid and jaw in both the opening and closing ph...

Research paper thumbnail of A Prospective Evaluation of the Acute Effects of High Altitude on Cognitive and Physiological Functions in Lowlanders

Frontiers in Physiology, 2021

Cognitive function impairment due to high altitude exposure has been reported with some contradic... more Cognitive function impairment due to high altitude exposure has been reported with some contradictory results regarding the possible selective cognitive domain involvement. We prospectively evaluated in 36 lowlanders, exposed for 3 consecutive days to an altitude of 3,269 m, specific cognitive abilities (attention, processing speed, and decision-making) required to safely explore the mountains, as well as to work at altitude. We simultaneously monitored the physiological parameters. Our study provides evidence of a reduced processing speed in lowlanders when exposed to altitude in the first 24 h. There was a fairly quick recovery since this impairment was no more detectable after 36 h of exposure. There were no clinically relevant effects on decision-making, while psychomotor vigilance was unaffected at altitude except for individuals with poor sleep. Significant changes were seen in physiological parameters (increased heart rate and reduced peripheral oxygen saturation). Our result...

Research paper thumbnail of The Role of Social Cognition Abilities in Parkinson's Disease in the Era of COVID-19 Emergency

Frontiers in Psychology

Introduction: Parkinson's Disease (PD) is characterized by motor and non-motor symptoms, amon... more Introduction: Parkinson's Disease (PD) is characterized by motor and non-motor symptoms, among which deficits in social cognition might affect ~20% of patients. This study aims to evaluate the role of social cognitive abilities in the perceived impact of COVID-19 emergency, and the effects of lockdown measures on patients' social network and caregivers' burden.Methods: Fourteen PD patients performed a neuropsychological battery including sociocognitive tasks before the introduction of COVID-19 restrictive measures (i.e., social distancing and isolation). A structured interview through an online platform was performed in the last 2 weeks of the first lockdown phase to assess patients' health status, perception of COVID-19 emergency, changes in caregivers' burden, and patients' social isolation. Non-parametric analyses were performed to evaluate the association between social skills and patients' COVID-19 perception, as well as the effects of restrictive me...

Research paper thumbnail of Effect of Acute Exposure to Altitude on the Quality of Chest Compression‐Only Cardiopulmonary Resuscitation in Helicopter Emergency Medical Services Personnel: A Randomized, Controlled, Single‐Blind Crossover Trial

Journal of the American Heart Association

Background Helicopter emergency medical services personnel operating in mountainous terrain are f... more Background Helicopter emergency medical services personnel operating in mountainous terrain are frequently exposed to rapid ascents and provide cardiopulmonary resuscitation (CPR) in the field. The aim of the present trial was to investigate the quality of chest compression only (CCO)‐CPR after acute exposure to altitude under repeatable and standardized conditions. Methods and Results Forty‐eight helicopter emergency medical services personnel were divided into 12 groups of 4 participants; each group was assigned to perform 5 minutes of CCO‐CPR on manikins at 2 of 3 altitudes in a randomized controlled single‐blind crossover design (200, 3000, and 5000 m) in a hypobaric chamber. Physiological parameters were continuously monitored; participants rated their performance and effort on visual analog scales. Generalized estimating equations were performed for variables of CPR quality (depth, rate, recoil, and effective chest compressions) and effects of time, altitude, carryover, altitu...

Research paper thumbnail of Impact of Nutritional Intervention on Taste Perception—A Scoping Review

Foods

The aim of the present scoping review was to evaluate the impact of experimental meal loads or ob... more The aim of the present scoping review was to evaluate the impact of experimental meal loads or observational diet changes/habits on taste tests in both healthy subjects and patients. A systematic search performed in PubMed, Scopus, and Institute for Scientific Information (ISI) Web of Science electronic databases retrieved, respectively 2981, 6258, and 7555 articles from January 2000 to December 2020. A total of 17 articles were included for full-text review. Literature results were stratified according to the observational/interventional approach, the involvement of healthy subjects or patients, the taste test, and the meal/dietary changes. The present scoping review reinforced the notions postulating that certain taste tests (for example focusing on fatty acid, salt, or sugar) might be specifically influenced by the nutritional intervention and that other ones might be susceptible to a wide span of changes beyond the extent of tastant included in the specific food changes. This co...

Research paper thumbnail of High-altitude cerebral edema: its own entity or end-stage acute mountain sickness?

Journal of Applied Physiology

High-altitude cerebral edema (HACE) and acute mountain sickness (AMS) are neuropathologies associ... more High-altitude cerebral edema (HACE) and acute mountain sickness (AMS) are neuropathologies associated with rapid exposure to hypoxia. However, speculation remains regarding the exact etiology of both HACE and AMS and whether they share a common mechanistic pathology. This review outlines the basic principles of HACE development, highlighting how edema could develop from 1) a progression from cytotoxic swelling to ionic edema or 2) permeation of the blood brain barrier (BBB) with or without ionic edema. Thereafter, discussion turns to the available neuroimaging literature in the context of cytotoxic, ionic, or vasogenic edema in both HACE and AMS. Although HACE is clearly caused by an increase in brain water of ionic and/or vasogenic origin, there is very little evidence that this type of edema is present when AMS develops. However, cerebral vasodilation, increased intracranial blood volume, and concomitant intracranial fluid shifts from the extracellular to the intracellular space, ...

Research paper thumbnail of Genetic variants in levodopa-induced dyskinesia (LID): A systematic review and meta-analysis

Parkinsonism & Related Disorders

INTRODUCTION Levodopa-induced dyskinesia frequently complicates long-term Parkinson's disease... more INTRODUCTION Levodopa-induced dyskinesia frequently complicates long-term Parkinson's disease. More in-depth knowledge regarding the role of genetic factors in dyskinesia development may be important to identify parkinsonian patients who are more prone to developing dyskinesia and clarify the molecular mechanisms underlying this condition. For this reason, we systematically reviewed studies investigating genetic factors involved in dyskinesia. METHODS A systematic search of genetic factors in Parkinson's disease dyskinesia was performed using the MEDLINE (through PubMed up to June 2019) and EMBASE databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A meta-analysis was conducted using a random effect model. RESULTS The literature search retrieved 33 studies assessing genes and variants possibly associated with dyskinesia in Parkinson's disease. The studies were published between 1984 and 2019 and included a total of 27,092 subjects of different ethnicities. Overall, 37 genes were analyzed in the studies reviewed, of which 22 were possibly associated with dyskinesia. The studies reported a total of 158 variants, of which 94 were possibly related to dyskinesia. CONCLUSION The studies reviewed demonstrated inconsistent results, possibly due to differences in screening methods and in the comparison of clinical data in a large variety of genetically- and ethnically-diverse populations. The meta-analysis failed to demonstrate any association between the rs6280 in the DRD3 gene, rs1799836 in the MAO-B, rs4680 in the COMT gene, rs34637584 in the LRRK2 gene and LID susceptibility. The role of genetic factors in LID susceptibility is still unclear and further studies are required.

Research paper thumbnail of Insight into the use of tympanic temperature during target temperature management in emergency and critical care: a scoping review

Journal of Intensive Care

Background Target temperature management (TTM) is suggested to reduce brain damage in the presenc... more Background Target temperature management (TTM) is suggested to reduce brain damage in the presence of global or local ischemia. Prompt TTM application may help to improve outcomes, but it is often hindered by technical problems, mainly related to the portability of cooling devices and temperature monitoring systems. Tympanic temperature (TTy) measurement may represent a practical, non-invasive approach for core temperature monitoring in emergency settings, but its accuracy under different TTM protocols is poorly characterized. The present scoping review aimed to collect the available evidence about TTy monitoring in TTM to describe the technique diffusion in various TTM contexts and its accuracy in comparison with other body sites under different cooling protocols and clinical conditions. Methods The scoping review was conducted following the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews (PRISMA-ScR). PubMed, Scopus...

Research paper thumbnail of Effects of hypothermia, hypoxia, and hypercapnia on brain oxygenation and hemodynamic parameters during simulated avalanche burial: a porcine study

Journal of Applied Physiology

Avalanche patients who are completely buried but still able to breathe are exposed to hypothermia... more Avalanche patients who are completely buried but still able to breathe are exposed to hypothermia, hypoxia, and hypercapnia (triple H syndrome). In a porcine model, there was no clinically relevant reduction in cerebral oxygenation during hypothermia and initial reduction of fraction of inspiratory oxygen ([Formula: see text]), as observed during hypercapnia. Hypercapnia may be the main cause of cardiovascular instability, which seems to be the major trigger for a decrease in cerebral oxygenation in triple H syndrome despite severe hypothermia.

Research paper thumbnail of Hypoxia and hypercapnia effects on cerebral oxygen saturation in avalanche burial: A pilot human experimental study

Research paper thumbnail of The Effect of Cold Exposure on Cognitive Performance in Healthy Adults: A Systematic Review

International Journal of Environmental Research and Public Health

Several aspects of cognition can be affected after cold exposure, but contradictory results have ... more Several aspects of cognition can be affected after cold exposure, but contradictory results have been reported regarding affected cognitive domains. The aim of the current systematic review was to evaluate the effects of specific cold exposure on cognitive performance in healthy subjects. A systematic search was performed using MEDLINE (through PubMed), EMBASE (Scopus) and PsycINFO databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were healthy subjects exposed to a cold environment (either simulated or not) and cognitive performance related to cold exposure with an experimental design. The literature search identified 18 studies, eight studies investigated the effect of cold air exposure and ten the effect of cold water immersion on cognitive performance of healthy subjects. There were several differences among the studies (environmental temperature reached, time of exposure, timing, and type of cognitive tes...

Research paper thumbnail of Lockdown effects on Parkinson’s disease during COVID-19 pandemic: a pilot study

Acta Neurologica Belgica

The coronavirus-disease 2019 (COVID-19) outbreak precipitated prolonged lock-down measures. The s... more The coronavirus-disease 2019 (COVID-19) outbreak precipitated prolonged lock-down measures. The subsequent social distancing, isolation, and reduction in mobility increased psychological stress, which may worsen Parkinson’s disease (PD). Therefore, telemedicine has been proposed to provide care to PD patients. To evaluate the effects of lock-down on motor and nonmotor symptoms in PD patients during the COVID-19 pandemic and the feasibility of telemedicine. Motor and nonmotor aspects were longitudinally assessed using structured questionnaires at baseline (in-person, February 2020) and at follow-up (remote web-based video, lock-down) evaluation. Of the seventeen PD patients evaluated at baseline, fourteen agreed to participate in, and completed follow-up evaluations. There was an impairment of nonmotor aspects measured with the MDS-UPDRS part I (p

Research paper thumbnail of Long-Term Sequelae of Frostbite—A Scoping Review

International Journal of Environmental Research and Public Health

Frostbite is tissue damage caused by freezing temperatures and constitutes an important cause of ... more Frostbite is tissue damage caused by freezing temperatures and constitutes an important cause of morbidity in cold climate zones and high altitude. The direct effects of sub-zero temperatures lead to tissue freezing, electrolyte shifts and pH alterations, microvascular damage, and eventually to cell death. Upon rewarming, inflammatory reperfusion injury and thrombosis may lead to further tissue damage. Several studies and various case reports show that many patients suffer from long-term sequelae such as vasomotor disturbances (associated with susceptibility to refreezing), and neuropathic and nociceptive pain, as well as damage to skeletal structures. There are still many uncertainties regarding the pathophysiology of these sequelae. It has been shown that the transient receptor potential channel (TRP) family plays a role in cold allodynia. Botulinum Toxin type A (BTX-A) injections have been reported to be beneficial in vasomotor and neuropathic disturbances secondary to frostbite....