Background: Gastrointestinal symptoms are one of the most common non-motor features of Parkinson’s disease (PD). Recently, a report from Taiwan revealed that irritable bowel syndrome (IBS) may be associated with an increased risk of developing PD; however, the prevalence of IBS in PD patients has not been fully evaluated. Rome III criteria are widely assessed with a questionnaire to determine functional gastrointestinal disorders.Objective: We assessed the prevalence of constipation and IBS in PD patients in our cohort using Rome III criteria.Methods: Between October 2014 and April 2015, 118 patients with PD were treated at Fukuoka University Hospital and were enrolled in this study. Rome III criteria were used to diagnose constipation and IBS.Results: Constipation and IBS were detected in 32 (27.1%) and 20 patients (17.0%), respectively. The most common symptom related to constipation was straining during defecation (77.1%). Among constipation symptoms, patients’ self-awareness of constipation was mostly related to straining during defecation (odds ratio 5.27, 95% confidence interval 1.475–18.811). The number of constipation symptoms was correlated with the severity of the Hoehn-Yahr Stage (p < 0.05) and total levodopa equivalent dose (p < 0.05).Conclusions: This is the first report to investigate the prevalence of IBS in PD patients with Rome III criteria. We found a higher prevalence of IBS compared with the general population. The prevalence of constipation based on Rome III criteria was much lower than that reported in previous studies. Further studies are warranted to evaluate gastrointestinal symptoms in PD patients using comparable questionnaires.

Background COVID‐19 had spread all over the world by the end of 2019. In Japan, the government declared a state of emergency in March 2020. Although no study has reported it in detail, patients with Parkinson's disease (PD) can be vulnerable to COVID‐19, because they have poor respiratory excursion. Telemedicine is a very effective way of reducing the risk of COVID‐19 infection, as well as reducing the physical, economic, and psychological burden on patients. Aim To evaluate PD patients’ inclinations to use telemedicine during the COVID‐19 pandemic, because the start of telemedicine in our hospital was being considered. Methods The subjects were 103 PD patients who visited Fukuoka University Hospital between April 1 and May 8, 2020. These patients completed a 15‐item questionnaire survey about telemedicine. Results A majority of the patients were aware of the availability of telemedicine (77%) and were inclined to use it (60%). Credit card users (P < .001), smartphone users (P = .006), and those who lived in a region distant from the hospital (P = .006) were significantly inclined to use telemedicine. Conclusion In this study, there was an inclination to use telemedicine in a majority of patients with PD during the COVID‐19 pandemic. We believe that the introduction of telemedicine has a multitude of advantages during the pandemic period and beyond.

a critical role in the arteriolar vasodilation and high cardiac The effects of endoscopic variceal ligation (EVL) on output of cirrhosis. 10 It has been documented that cirrhotic systemic hemodynamics are unknown. This study was patients have a significant increase in the concentration of conducted to determine whether the obliteration of porserum nitrate/nitrite, metabolites of NO, 11 compared with tal-systemic collaterals by EVL affects systemic hemodycontrol subjects. 12,13 The role of NO in the regulation of sysnamics and serum nitrate concentrations in patients temic hemodynamics in cirrhosis, however, is unclear. cate that EVL decreased cardiac output via a reductionProphylactic EVL was administered when the patients had esopha- in cardiac preload (central venous return). Blood flowgeal varices with endoscopic findings predictive of a high risk of through portal-systemic collaterals has an important bleeding, such as enlarged tortuous varices (F2) or largest sized varirole in the enhanced cardiac preload of cirrhotic pa-ces (F3) with a severe red-color sign.14 The patients were a subgroup tients. The sudden decrease in serum nitrate concentra-of a prospective trial comparing the effectiveness of EVL in the pretions suggests that endogenous nitric oxide may be in-vention of first bleeding and reduction of mortality in patients with volved in the regulation of systemic hemodynamics in high-risk esophageal varices. Patients with alcoholic cirrhosis (n Å 2) were excluded from the study to avoid the potential effects of patients with compensated cirrhosis. (HEPATOLOGY abstinence on systemic and splanchnic hemodynamics. 15 In addition, 1996;24:47-52.)patients were also excluded because of inadequate cardiac imaging preventing echocardiographic assessment (n Å 1) and renal failure Portal hypertension and arteriolar vasodilation are im-(n Å 1). Thus, 17 patients were enrolled in this study. To evaluate portant hemodynamic alterations that lead to a high cardiac the possible hemodynamic effects of endoscopy, a control group of cirrhotic patients receiving gastroscopy were matched by systemic output and stroke volume, associated with a low peripheral hemodynamics, age, severity of liver damage, and grade of varices. vascular resistance, in patients with cirrhosis.1-3 Recent inAll subjects had histologically proven cirrhosis of the liver and were vestigations have shown an enhanced left ventricular diamefree of edema and ascites ascertained by ultrasonography.ter and cardiac output together with a direct correlation be-EVL. Endoscopic variceal ligation was carried out through flexible tween both parameters in cirrhotic patients. [4][5][6] These findings endoscopy (GIF Q-20, Olympus Corp., Tokyo, Japan), a plastic endosuggest that an increased cardiac preload may play an im-scopic esophageal overtube and an endoscopic ligation device (Varioportant role in the increased cardiac output of cirrhosis. In-ligator, Top Corp., Tokyo, Japan). To avoid the hemodynamic effects creased circulating blood volume and portal-syst...

Constipation is one of the most common non-motor symptoms in multiple system atrophy (MSA); however, it has not been evaluated according to the standard diagnostic criteria for constipation in patients with MSA. We evaluated the characteristics of constipation in patients with MSA by using Rome criteria (Rome III), which has been validated and the widely used for gastrointestinal disorders. Fifty-one patients with MSA (29 female) were enrolled in the study. Based on the Rome III criteria, constipation was diagnosed in 29 patients (56.9%); irritable bowel syndrome was not detected. Thirty-seven patients (72.5%) were aware of their constipation. The most common constipation symptom was the sensation of anorectal obstruction (68.6%). Patients’ self-awareness of constipation was most strongly correlated to the sensation of incomplete evacuation (odds ratio: 7.377, 95% confidence interval: 1.402–38.817). The number of constipation-related symptoms was correlated with the total levodopa equivalent dose (p < 0.05). Rome criteria, which can detect various constipation symptoms, are useful for evaluating constipation in MSA, and these findings may greatly impact personalized medicine.