Objective To assess excessive daytime sleepiness (EDS) in patients with Parkinson's disease (PD) using the Epworth Sleepiness Scale (ESS) and to examine the main cause of EDS. Methods 96 consecutive PD patients and 98 age-matched healthy controls participated in the study. The severity of the disease was evaluated by Hoehn and Yahr stage (H&Y) and Unified Parkinson's disease Rating Scale-Ⅲ (UPDRS-Ⅲ), and information of anti-PD medications was collected. The correlations among EDS and age, severity of PD, PQSI score, duration of illness and medications were analyzed. Results The mean ESS score was 6.05 (S.D.3.83) in PD patients and 4.24 (S.D.3.21) in controls (P

BACKGROUND: To evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) creation for the management of portal hypertension in patients with hepatocellular carcinoma (HCC). METHODS: A literature search of the MEDLINE/PubMed and Embase databases was conducted. All articles reporting the outcomes of TIPS creation for variceal bleeding and refractory ascites and hepatic hydrothorax in patients with HCC were included. Exclusion criteria were non-English language, sample size < 5, data not extractable, and data reported in another article. RESULTS: A total of 280 patients (mean age, 48–58; male gender, 66%) from five articles were included. TIPS creation was performed for variceal bleeding in 79% and refractory ascites and/or hepatic hydrothorax in 26% of patients. Technical and clinical success was achieved in 99% and 64% of patients, respectively. Clinical failure occurred in 36% of patients due to rebleeding or recurrent bleeding (n = 77) or no resolution or improvement of refractory ascites and hepatic hydrothorax (n = 24). One percent of patient had major complications, including accelerated liver failure (n = 1) and multi-organ failure resulting from hemorrhagic shock (n = 1), all of which resulted in early (i.e., within 30 days) death. Hepatic encephalopathy occurred in 40% of patients after TIPS creation. Lung metastasis was found 1% of patient 5 months (n = 1) and 72 months (n = 1) after TIPS creation. CONCLUSION: TIPS creation seems to be safe and effective for the management of portal hypertension in patients with HCC.
Ascites ; Carcinoma, Hepatocellular ; Esophageal and Gastric Varices ; Gastrointestinal Hemorrhage ; Hemorrhage ; Hepatic Encephalopathy ; Humans ; Hydrothorax ; Hypertension, Portal ; Liver Failure ; Liver Neoplasms ; Lung ; Male ; Neoplasm Metastasis ; Portasystemic Shunt, Surgical ; Portasystemic Shunt, Transjugular Intrahepatic ; Sample Size ; Shock, Hemorrhagic