It is recommended that policy makers should create a trustful and non-discriminating environment and services integrating physical and mental healthcare.”
“In this study, we investigated the effect of dopaminergic medication on reactive stepping

responses to forward and backward balance perturbations in patients with moderately severe Parkinson’s disease (PD). Twelve PD patients, Hoehn and Yahr stage ranging from 2 to 3, and 15 healthy controls were exposed to multidirectional translational stance perturbations on a moveable platform. Perturbations were unpredictable in terms of amplitude, timing and direction. Patients were tested in the medication ON and OFF (at least 12 h of dopaminergic medication withdrawal) IWR-1-endo state on two separate days. Forward and backward stepping responses were quantified in terms of (1) presence, onset and amplitude of anticipatory Staurosporine in vitro postural adjustments (APAs); (2) spatiotemporal step variables (step onset, length and velocity); and (3) leg inclination angle at first stepping-foot contact. When perturbed forward, patients performed worse than controls in terms of step length (0.32 +/- A 0.07 vs. 0.38 +/- A 0.05 m, p = 0.01) and step

velocity (1.21 +/- A 0.16 vs. 1.37 +/- A 0.13 m/s, p = 0.01), while step onset was not different. The number of steps with an APA was larger in patients in the OFF state than in controls which was, however, only significant after forward perturbations (43 vs. 20 %, p = 0.01). Following backward perturbations, leg angles at foot contact were smaller in patients compared to controls (-2.71A degrees A A +/- A 4.29A degrees vs. 0.26A degrees A A +/- A 2.80A degrees, p = 0.04) reflecting a poorer mechanical efficiency of the step. Dopaminergic medication CDK activity had no significant

effect on any of these outcomes. In conclusion, dopaminergic medication does not improve underscaling of stepping responses in PD. Therefore, other interventions are needed to improve these important defense postural reactions.”
“Brain edema continues to be a major cause of mortality after diverse types of brain pathologies such as major cerebral infarcts, hemorrhages, trauma, infections and tumors. The classification of edema into vasogenic, cytotoxic, hydrocephalic and osmotic has stood the test of time although it is recognized that in most clinical situations there is a combination of different types of edema during the course of the disease. Basic information about the types of edema is provided for better understanding of the expression pattern of some of the newer molecules implicated in the pathogenesis of brain edema. These molecules include the aquaporins, matrix metalloproteinases and growth factors such as vascular endothelial growth factors A and B and the angiopoietins. The potential of these agents in the treatment of edema is discussed.