We performed a multicenter survey using a semistructured interview in 1,072 consecutive patients with Parkinson's disease (PD) enrolled during 12 months in 55 Italian centers to assess the prevalence of nonmotor symptoms (NMSs), their association with cognitive impairment, and the impact on patients' quality of life (QoL). We found that 98.6% of patients with PD reported the presence of NMSs. The most common were as follows: fatigue (58%), anxiety (56%), leg pain (38%), insomnia (37%), urgency and nocturia (35%), drooling of saliva and difficulties in maintaining concentration (31%). The mean number of NMS per patient was 7.8 (range, 0-32). NMS in the psychiatric domain were the most frequent (67%). Frequency of NMS increased along with the disease duration and severity. Patients with cognitive impairment reported more frequently apathy, attention/memory deficit, and psychiatric symptoms. Apathy was the symptom associated with worse PDQ-39 score but also presence of fatigue, attention/memory, and psychiatric symptoms had a negative impact on QoL. These findings further support a key role for NMS in the clinical frame of PD and the need to address them specifically in clinical trials using dedicated scales.
In the early '80s, evidence was provided that, rather than a dye (red okra), hemoglobin was indeed responsible for the alleged blood stains of the Turin Shroud. Such stains were shown to belong to an MNS positive individual of the AB group, and the halos surrounding the blood stains were compatible with serum containing trace amounts of bilirubin, albumin and immunoglobulins. However, being only based on indirect and circumstantial evidence, most of these data were challenged. In the late '90s, together with the evidence of the gene coding β-globin, contamination between male and female DNA was documented on the Turin Shroud. Although the presence of male was more noticeable than female DNA, these data were considered null and void. These days, to establish that blood indisputably belongs to an MNS positive individual of the AB group, and to exclude DNA contamination, high-specificity techniques with monoclonal antibodies and molecular studies on nuclear and mitochondrial DNA are needed. Indeed, consistent with DNA contamination on the Turin Shroud, sequences from multiple subjects of different ethnic origins have been recently detected on the human mitochondrial genome extracted from dust particles of the linen. Innovative concepts are likely to come up using modern research approaches to evaluate the issue of blood stains of the Turin Shroud. Nor can we rule out the possibility that religious implications of the new findings on the Turin Shroud might be envisaged. Conceivably enough, the ongoing debate will be fierce and passionate, especially in the media.
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