Pub Date : 2020-01-29eCollection Date: 2020-01-01DOI: 10.1155/2020/5621461
Olivier Mukuku, Pascal Nawej, Marcellin Bugeme, Frank Nduu, Paul Makan Mawaw, Oscar Numbi Luboya
Background: Epilepsy is one of the most common neurological conditions, but the majority of epilepsy patients in sub-Saharan countries do not receive appropriate treatment. In the Democratic Republic of Congo (DRC), particularly in Lubumbashi, very few epidemiological studies on epilepsy have emerged. This study aims to analyze demographic characteristics, semiology of epileptic seizures, and their etiologies in patients followed in hospital.
Methods: This is a prospective descriptive study that enrolled 177 epileptic patients who performed a neurological consultation at the Centre Médical du Centre Ville (CMDC) in Lubumbashi (DRC) from January 1, 2016, to December 31, 2017.
Results: The mean age of the patients was 20.0 years (range: 5 months and 86 years). The male sex was predominant (57.1%). The mean age at the seizure onset was 13.1 years, and the mean duration between onset of seizures and consultation was 83.5 months. The family history of epilepsy was present in 27.7%. Generalized tonic-clonic seizures were the most frequent (58.2%), followed by atonic generalized seizures (9.6%) and focal clonic seizures (8.5%). The etiology was found in 68 (38.4%) patients and was dominated by neurocysticercosis (26.5%), meningitis (25%), perinatal pathologies (20.6%), and head injury (20.6%).
Conclusion: This study is a useful starting point from which health programs and health professionals can work to improve the diagnosis and quality of epilepsy management in our community.
{"title":"Epidemiology of Epilepsy in Lubumbashi, Democratic Republic of Congo.","authors":"Olivier Mukuku, Pascal Nawej, Marcellin Bugeme, Frank Nduu, Paul Makan Mawaw, Oscar Numbi Luboya","doi":"10.1155/2020/5621461","DOIUrl":"https://doi.org/10.1155/2020/5621461","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy is one of the most common neurological conditions, but the majority of epilepsy patients in sub-Saharan countries do not receive appropriate treatment. In the Democratic Republic of Congo (DRC), particularly in Lubumbashi, very few epidemiological studies on epilepsy have emerged. This study aims to analyze demographic characteristics, semiology of epileptic seizures, and their etiologies in patients followed in hospital.</p><p><strong>Methods: </strong>This is a prospective descriptive study that enrolled 177 epileptic patients who performed a neurological consultation at the Centre Médical du Centre Ville (CMDC) in Lubumbashi (DRC) from January 1, 2016, to December 31, 2017.</p><p><strong>Results: </strong>The mean age of the patients was 20.0 years (range: 5 months and 86 years). The male sex was predominant (57.1%). The mean age at the seizure onset was 13.1 years, and the mean duration between onset of seizures and consultation was 83.5 months. The family history of epilepsy was present in 27.7%. Generalized tonic-clonic seizures were the most frequent (58.2%), followed by atonic generalized seizures (9.6%) and focal clonic seizures (8.5%). The etiology was found in 68 (38.4%) patients and was dominated by neurocysticercosis (26.5%), meningitis (25%), perinatal pathologies (20.6%), and head injury (20.6%).</p><p><strong>Conclusion: </strong>This study is a useful starting point from which health programs and health professionals can work to improve the diagnosis and quality of epilepsy management in our community.</p>","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"2020 ","pages":"5621461"},"PeriodicalIF":1.5,"publicationDate":"2020-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5621461","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37939679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-07eCollection Date: 2019-01-01DOI: 10.1155/2019/7397491
David Czell, Christoph Neuwirth, Markus Weber, Sabine Sartoretti-Schefer, Andreas Gutzeit, Carolin Reischauer
Objective: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease with involvement of the upper and lower motor neurons. Since the loss of fine motor skills is one of the earliest signs of ALS, the hypothesis was tested if the nine hole PEG test (NHPT) and transcranial magnet stimulation (TMS) with resting-motor threshold (RMT) could be useful in monitoring disease progression.
Methods: We examined 28 ALS patients and 27 age-matched healthy controls. ALS patients and healthy controls underwent the nine hole peg test (NHPT) and TMS with RMT. Measurements in patients were repeated after three and six months.
Results: At baseline, the median NHPT durations were 1,4-fold longer (p < 0.001), and TMS scores showed a significant 0.8-fold smaller score in ALS patients compared with healthy controls (p < 0.001). The comparison of three and six months versus baseline revealed significant differences for NHPT durations and ALSFRS-R in patients, whereas TMS scores did not significantly differ in the patients.
Conclusion: NHPT seems to be a good tool to evaluate dexterity of the hand and the progression of the disease in ALS patients. TMS RMT to the hand muscles seems to be poorly qualified to evaluate the dexterity of the hand function and the course of the disease.
{"title":"Nine Hole Peg Test and Transcranial Magnetic Stimulation: Useful to Evaluate Dexterity of the Hand and Disease Progression in Amyotrophic Lateral Sclerosis.","authors":"David Czell, Christoph Neuwirth, Markus Weber, Sabine Sartoretti-Schefer, Andreas Gutzeit, Carolin Reischauer","doi":"10.1155/2019/7397491","DOIUrl":"https://doi.org/10.1155/2019/7397491","url":null,"abstract":"<p><strong>Objective: </strong>Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease with involvement of the upper and lower motor neurons. Since the loss of fine motor skills is one of the earliest signs of ALS, the hypothesis was tested if the nine hole PEG test (NHPT) and transcranial magnet stimulation (TMS) with resting-motor threshold (RMT) could be useful in monitoring disease progression.</p><p><strong>Methods: </strong>We examined 28 ALS patients and 27 age-matched healthy controls. ALS patients and healthy controls underwent the nine hole peg test (NHPT) and TMS with RMT. Measurements in patients were repeated after three and six months.</p><p><strong>Results: </strong>At baseline, the median NHPT durations were 1,4-fold longer (<i>p</i> < 0.001), and TMS scores showed a significant 0.8-fold smaller score in ALS patients compared with healthy controls (<i>p</i> < 0.001). The comparison of three and six months versus baseline revealed significant differences for NHPT durations and ALSFRS-R in patients, whereas TMS scores did not significantly differ in the patients.</p><p><strong>Conclusion: </strong>NHPT seems to be a good tool to evaluate dexterity of the hand and the progression of the disease in ALS patients. TMS RMT to the hand muscles seems to be poorly qualified to evaluate the dexterity of the hand function and the course of the disease.</p>","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"2019 ","pages":"7397491"},"PeriodicalIF":1.5,"publicationDate":"2019-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/7397491","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37449394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. G. Mugendi, M. Kubo, D. Nyamu, L. Mwaniki, S. Wahome, J. Haberer
Background HIV-associated neurocognitive disorders (HAND) represent a spectrum of cognitive abnormalities affecting attention, concentration, learning, memory, executive function, psychomotor speed, and/or dexterity. Our objectives in this analysis are to determine the prevalence of HAND and the covariates in a Kenyan population. Methods We conducted a cross-sectional study in a convenient sample of people living with HIV on antiretroviral therapy (ART) attending routine care visits at the Kenyatta National Hospital HIV clinic between July and August 2015. Baseline demographics were obtained using interviewer-administered questionnaires; clinical data were abstracted from patient records. Trained research clinicians determined the neurocognitive status by administration of the International HIV Dementia Scale (IHDS), the Montreal Cognitive Assessment (MOCA) scale, and the Lawton Instrumental Activities of Daily Living (IADL) scale. Cognitive impairment was defined as a score of ≤26 on the MOCA and ≤10 on the IHDS. Descriptive analysis and logistic regression to determine predictors of screening positive for HAND were done with the significance value set at <0.05. Results We enrolled 345 participants (202 men; 143 women). The mean age of the study population was 42 years (±standard deviation (SD) 9.5). Mean duration since HIV diagnosis and mean duration on ART were 6.3 (±SD 3.7) and 5.6 years (±SD 3.4), respectively. Median CD4 count at interview was 446 cells/mm3 (interquartile range (IQR) 278–596). Eighty-eight percent of participants screened positive for HAND, of whom 87% had asymptomatic neurocognitive impairment (ANI) and minor neurocognitive disorders (MND) grouped together while 1% had HIV-associated dementia (HAD). Patients on AZT/3TC/EFV were 3.7 times more likely to have HAND (OR = 3.7, p=0.03) compared to other HAART regimens. In the adjusted analysis, women were more likely to suffer any form of HAND than men (aOR = 2.17, 95% CI: 1.02, 4.71; p=0.045), whereas more years in school and a higher CD4 count (aOR = 0.58, 95% CI: 0.38, 0.88; p=0.012), (aOR = 0.998, 95% CI 0.997, 0.999; p=0.013) conferred a lowered risk. Conclusion Asymptomatic and mild neurocognitive impairment is prevalent among people living with HIV on treatment. Clinical care for HIV-positive patients should involve regular screening for neurocognitive disorders while prioritizing women and those with low education and/or low CD4 counts.
{"title":"Prevalence and Correlates of Neurocognitive Disorders among HIV Patients on Antiretroviral Therapy at a Kenyan Hospital","authors":"A. G. Mugendi, M. Kubo, D. Nyamu, L. Mwaniki, S. Wahome, J. Haberer","doi":"10.1155/2019/5173289","DOIUrl":"https://doi.org/10.1155/2019/5173289","url":null,"abstract":"Background HIV-associated neurocognitive disorders (HAND) represent a spectrum of cognitive abnormalities affecting attention, concentration, learning, memory, executive function, psychomotor speed, and/or dexterity. Our objectives in this analysis are to determine the prevalence of HAND and the covariates in a Kenyan population. Methods We conducted a cross-sectional study in a convenient sample of people living with HIV on antiretroviral therapy (ART) attending routine care visits at the Kenyatta National Hospital HIV clinic between July and August 2015. Baseline demographics were obtained using interviewer-administered questionnaires; clinical data were abstracted from patient records. Trained research clinicians determined the neurocognitive status by administration of the International HIV Dementia Scale (IHDS), the Montreal Cognitive Assessment (MOCA) scale, and the Lawton Instrumental Activities of Daily Living (IADL) scale. Cognitive impairment was defined as a score of ≤26 on the MOCA and ≤10 on the IHDS. Descriptive analysis and logistic regression to determine predictors of screening positive for HAND were done with the significance value set at <0.05. Results We enrolled 345 participants (202 men; 143 women). The mean age of the study population was 42 years (±standard deviation (SD) 9.5). Mean duration since HIV diagnosis and mean duration on ART were 6.3 (±SD 3.7) and 5.6 years (±SD 3.4), respectively. Median CD4 count at interview was 446 cells/mm3 (interquartile range (IQR) 278–596). Eighty-eight percent of participants screened positive for HAND, of whom 87% had asymptomatic neurocognitive impairment (ANI) and minor neurocognitive disorders (MND) grouped together while 1% had HIV-associated dementia (HAD). Patients on AZT/3TC/EFV were 3.7 times more likely to have HAND (OR = 3.7, p=0.03) compared to other HAART regimens. In the adjusted analysis, women were more likely to suffer any form of HAND than men (aOR = 2.17, 95% CI: 1.02, 4.71; p=0.045), whereas more years in school and a higher CD4 count (aOR = 0.58, 95% CI: 0.38, 0.88; p=0.012), (aOR = 0.998, 95% CI 0.997, 0.999; p=0.013) conferred a lowered risk. Conclusion Asymptomatic and mild neurocognitive impairment is prevalent among people living with HIV on treatment. Clinical care for HIV-positive patients should involve regular screening for neurocognitive disorders while prioritizing women and those with low education and/or low CD4 counts.","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"8 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2019-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84884080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective While administration of intravenous tissue plasminogen activator (IV-tPA) is the standard of care in acute ischemic stroke and has been shown to have statistically significant benefit, there can also be potentially life-threatening complications; however, there is no standard informed consent approach. The purpose of this study was to present a parental, technical, and general model of informed consent for IV-TPA and to determine which approach was preferred. Methods Survey respondents were asked to hypothetically decide whether or not to provide consent for their family member to receive IV-tPA. Respondents were presented with 3 informed consent models: one emphasizing parental qualities, one emphasizing statistical data, and one representing a general consent statement. After being presented each model, the respondents had to select their preferred consent model, as well as rate their level of agreeability toward their family member receiving the medication following each approach. Results The results of 184 surveys showed respondents were equally as likely to give consent for their family member to receive IV-TPA following all three approaches; however, respondents were significantly more likely to prefer the parental approach compared to a technical or general approach. Conclusion Our results indicate that while paternalism is generally discouraged in the medical community, some degree of parental language may be preferred by patients in tough decision-making situations toward consent to receive medical interventions.
{"title":"Utilization of a Parental Approach to Informed Consent in Intravenous Tissue Plasminogen Activator Administration Decision-Making: Patient Preference and Ethical Considerations","authors":"Ann M Murray, A. Petrone, Amelia K. Adcock","doi":"10.1155/2019/9240603","DOIUrl":"https://doi.org/10.1155/2019/9240603","url":null,"abstract":"Objective While administration of intravenous tissue plasminogen activator (IV-tPA) is the standard of care in acute ischemic stroke and has been shown to have statistically significant benefit, there can also be potentially life-threatening complications; however, there is no standard informed consent approach. The purpose of this study was to present a parental, technical, and general model of informed consent for IV-TPA and to determine which approach was preferred. Methods Survey respondents were asked to hypothetically decide whether or not to provide consent for their family member to receive IV-tPA. Respondents were presented with 3 informed consent models: one emphasizing parental qualities, one emphasizing statistical data, and one representing a general consent statement. After being presented each model, the respondents had to select their preferred consent model, as well as rate their level of agreeability toward their family member receiving the medication following each approach. Results The results of 184 surveys showed respondents were equally as likely to give consent for their family member to receive IV-TPA following all three approaches; however, respondents were significantly more likely to prefer the parental approach compared to a technical or general approach. Conclusion Our results indicate that while paternalism is generally discouraged in the medical community, some degree of parental language may be preferred by patients in tough decision-making situations toward consent to receive medical interventions.","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"5 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2019-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83119832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clinical trials have demonstrated that novel oral anticoagulants (NOACs) are noninferior to warfarin in preventing nonvalvular atrial fibrillation- (nvAF-) related stroke and systemic embolism. However, in these trials, NOACs initiation was delayed for a variable period after stroke. Herein, we aimed to investigate the variability in early initiation of NOACs after nvAF-related stroke among stroke neurologists in Saudi Arabia. A standardized questionnaire was distributed electronically to all the stroke neurologists and fellows in Saudi Arabia. The questionnaire primarily focused on the timing of NOACs initiation after an nvAF-related stroke, according to stroke size (small, medium, and large) and location (anterior or posterior circulation). Thirty-six (85.7%) of the 42 stroke neurologists, who were contacted, participated in the survey. All participants would initiate NOACs in the first 3 days after a TIA; most of them initiate NOACs within 7 days after a small stroke, 4–14 days after a medium stroke, and ≥12 days after a large stroke, regardless of stroke location. Presence of a symptomatic intracranial hemorrhage further delayed initiation of NOACs. Additionally, 77.8% of the participants would bridge with antiplatelets before initiation of NOACs, and 55.6% would use a single antiplatelet agent. In conclusion, the practice of stroke neurologists is consistent with and supports the available evidence from observational studies on the time of initiation of NOACs. Our findings provide a guide for clinicians who manage nvAF-related stroke until more robust evidence from randomized controlled trials is available.
{"title":"Practice Variations in the Use of Novel Oral Anticoagulants for Nonvalvular Atrial Fibrillation-Related Stroke among Stroke Neurologists in Saudi Arabia","authors":"M. Alanazy, Taim A. Muayqil","doi":"10.1155/2019/5373250","DOIUrl":"https://doi.org/10.1155/2019/5373250","url":null,"abstract":"Clinical trials have demonstrated that novel oral anticoagulants (NOACs) are noninferior to warfarin in preventing nonvalvular atrial fibrillation- (nvAF-) related stroke and systemic embolism. However, in these trials, NOACs initiation was delayed for a variable period after stroke. Herein, we aimed to investigate the variability in early initiation of NOACs after nvAF-related stroke among stroke neurologists in Saudi Arabia. A standardized questionnaire was distributed electronically to all the stroke neurologists and fellows in Saudi Arabia. The questionnaire primarily focused on the timing of NOACs initiation after an nvAF-related stroke, according to stroke size (small, medium, and large) and location (anterior or posterior circulation). Thirty-six (85.7%) of the 42 stroke neurologists, who were contacted, participated in the survey. All participants would initiate NOACs in the first 3 days after a TIA; most of them initiate NOACs within 7 days after a small stroke, 4–14 days after a medium stroke, and ≥12 days after a large stroke, regardless of stroke location. Presence of a symptomatic intracranial hemorrhage further delayed initiation of NOACs. Additionally, 77.8% of the participants would bridge with antiplatelets before initiation of NOACs, and 55.6% would use a single antiplatelet agent. In conclusion, the practice of stroke neurologists is consistent with and supports the available evidence from observational studies on the time of initiation of NOACs. Our findings provide a guide for clinicians who manage nvAF-related stroke until more robust evidence from randomized controlled trials is available.","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"12 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2019-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76119888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pukovisa Prawiroharjo, Hainah Ellydar, Peter Pratama, R. Edison, S. E. I. Suaidy, N. Amani, Diavitri Carissima
We aimed to find the differences in memory capabilities between pornography-addicted and nonaddicted juveniles. We enrolled 30 juveniles (12–16 y) consisting of 15 pornography addiction and 15 nonaddiction subjects. We used Rey Auditory Verbal Learning Test (RAVLT) to measure verbal memory, Rey–Osterrieth Complex Figure Test (ROCFT) for visual memory, along with Trail Making Test A and B (TMT-A and TMT-B) for attention. We found a significant reduction in the RAVLT A6 result of the addiction group (nonaddiction vs addiction: 13.47 ± 2.00 vs 11.67 ± 2.44, MD = −1.80, p=0.04), but not in ROCFT or attention tests. Analysis in sex subgroups yielded no sex-specific difference. We concluded that pornography addiction may be associated with impaired recent verbal memory in juveniles, regardless of sex and without association to attention.
我们的目的是找出色情成瘾和非色情成瘾青少年在记忆能力上的差异。我们招募了30名青少年(12-16岁)，包括15名色情成瘾者和15名非成瘾者。我们采用Rey听觉言语学习测验(RAVLT)测量言语记忆，Rey - osterrieth复杂图形测验(ROCFT)测量视觉记忆，并采用Trail Making Test A和Trail Making Test B (TMT-A和TMT-B)测试注意力。我们发现成瘾组的RAVLT A6结果显著降低(非成瘾组vs成瘾组:13.47±2.00 vs 11.67±2.44,MD = - 1.80, p=0.04)，但在ROCFT或注意测试中无显著降低。对性别亚组的分析没有发现性别特异性差异。我们的结论是，色情成瘾可能与青少年近期言语记忆受损有关，与性别无关，也与注意力无关。
{"title":"Impaired Recent Verbal Memory in Pornography-Addicted Juvenile Subjects","authors":"Pukovisa Prawiroharjo, Hainah Ellydar, Peter Pratama, R. Edison, S. E. I. Suaidy, N. Amani, Diavitri Carissima","doi":"10.1155/2019/2351638","DOIUrl":"https://doi.org/10.1155/2019/2351638","url":null,"abstract":"We aimed to find the differences in memory capabilities between pornography-addicted and nonaddicted juveniles. We enrolled 30 juveniles (12–16 y) consisting of 15 pornography addiction and 15 nonaddiction subjects. We used Rey Auditory Verbal Learning Test (RAVLT) to measure verbal memory, Rey–Osterrieth Complex Figure Test (ROCFT) for visual memory, along with Trail Making Test A and B (TMT-A and TMT-B) for attention. We found a significant reduction in the RAVLT A6 result of the addiction group (nonaddiction vs addiction: 13.47 ± 2.00 vs 11.67 ± 2.44, MD = −1.80, p=0.04), but not in ROCFT or attention tests. Analysis in sex subgroups yielded no sex-specific difference. We concluded that pornography addiction may be associated with impaired recent verbal memory in juveniles, regardless of sex and without association to attention.","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"43 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2019-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81906509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sakis Lambrianides, C. Demetriou, Andis Tillyris, E. Kkolou, E. Gaglia, Eleni Agkastinioti, Eleni Leonidou, Y. Christou, S. Papacostas, K. Kleopa, T. Kyriakides, M. Pantzaris
Background and Purpose Progressive multifocal leukoencephalopathy (PML) is a debilitating disease of the central nervous system caused by the ubiquitous polyomavirus JC (JCV) in immunocompromised hosts. In recent years, a new subpopulation of patients at risk for PML has emerged, due to the growing use of immunomodulatory or immunosuppressive therapies in autoimmune diseases such as multiple sclerosis (MS). The anti-JCV antibody index is used as a stratification tool in assessing the risk of developing PML. The objective of this study was to retrospectively describe the prevalence of anti-JCV antibodies in the MS population in Cyprus. Methods We retrospectively collected the demographics of 214 MS patients in Cyprus who were screened for anti-JCV antibodies using the STRATIFY JCV™ assay between September 2011 and June 2018. Logistic regression analysis was used to examine the effect of demographic variables on seropositivity, and bivariate tests were used to assess the association between demographic characteristics and JCV AI index. Results A total of 214 MS patients in Cyprus were tested. Overall anti-JCV antibody prevalence was 45.8% (95% confidence interval 37.2%–55.8%). We could not establish a significant association between seropositivity and increasing age or sex. In the subgroup analysis of natalizumab-treated patients, the annual seroconversion rate was 4.5%. Conclusions Overall seroprevalence of anti-JCV antibodies in MS patients in Cyprus using the STRATIFY JCV assay was lower than the worldwide reported mean. Although previously reported, in our study, the anti-JCV antibody seropositivity was not associated with increasing age or sex.
{"title":"Prevalence of Anti-JC Virus (JCV) Antibodies in the Multiple Sclerosis (MS) Population in Cyprus: A Retrospective Study","authors":"Sakis Lambrianides, C. Demetriou, Andis Tillyris, E. Kkolou, E. Gaglia, Eleni Agkastinioti, Eleni Leonidou, Y. Christou, S. Papacostas, K. Kleopa, T. Kyriakides, M. Pantzaris","doi":"10.1155/2019/3741260","DOIUrl":"https://doi.org/10.1155/2019/3741260","url":null,"abstract":"Background and Purpose Progressive multifocal leukoencephalopathy (PML) is a debilitating disease of the central nervous system caused by the ubiquitous polyomavirus JC (JCV) in immunocompromised hosts. In recent years, a new subpopulation of patients at risk for PML has emerged, due to the growing use of immunomodulatory or immunosuppressive therapies in autoimmune diseases such as multiple sclerosis (MS). The anti-JCV antibody index is used as a stratification tool in assessing the risk of developing PML. The objective of this study was to retrospectively describe the prevalence of anti-JCV antibodies in the MS population in Cyprus. Methods We retrospectively collected the demographics of 214 MS patients in Cyprus who were screened for anti-JCV antibodies using the STRATIFY JCV™ assay between September 2011 and June 2018. Logistic regression analysis was used to examine the effect of demographic variables on seropositivity, and bivariate tests were used to assess the association between demographic characteristics and JCV AI index. Results A total of 214 MS patients in Cyprus were tested. Overall anti-JCV antibody prevalence was 45.8% (95% confidence interval 37.2%–55.8%). We could not establish a significant association between seropositivity and increasing age or sex. In the subgroup analysis of natalizumab-treated patients, the annual seroconversion rate was 4.5%. Conclusions Overall seroprevalence of anti-JCV antibodies in MS patients in Cyprus using the STRATIFY JCV assay was lower than the worldwide reported mean. Although previously reported, in our study, the anti-JCV antibody seropositivity was not associated with increasing age or sex.","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"3 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2019-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74205299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. Sharifi, Hamid Zaferani Arani, M. Olya, Hesam Adin Atashi, Shabnam Movassaghi
Background Stroke is a major worldwide problem that is leading to a high mortality rate in humans. Ischemia, as the most common type of stroke, is characterized by tissue damage that can occur due to insufficient blood flow to the brain even for a brief duration, leading to the release of inflammatory factors, cytokines, and free radicals. In this study, we investigated the effective dose and injection time of FK506 as an immunophilin ligand for providing a suitable effect on cells of CA2, CA3, and dentate gyrus of the hippocampus. Methods In this in vivo study, a total of 48 male Wistar rats were divided into nine groups. The ischemia model was induced by the ligation of bilateral common carotid arteries. The doses of FK506 (3, 6, and 10 mg/kg) were administered intravenously (IV) at the beginning of reperfusion, followed by repeated injections (10 mg/kg) at 6, 24, 48, and 72 hours after ischemia, respectively. Brains were removed and prepared for Nissl staining and the TdT-mediated dUTP Nick End Labeling method. Results Data showed that global ischemia did not decrease the number of viable pyramidal cells in CA2 and CA3 regions, but significant differences were observed in the number of viable granular cells and apoptotic bodies in the dentate gyrus between the control and ischemia groups. Repeated doses of 6 mg/kg of FK506 at an interval of 48 hours were deemed to be the suitable dose and best time of injection. Conclusions It seems that FK506 can ameliorate the extent of apoptosis and may be a good candidate for the treatment of ischemia-induced brain damage.
中风是导致人类高死亡率的一个世界性的主要问题。缺血是中风最常见的一种类型，其特征是由于短时间内脑部血流量不足而导致组织损伤，导致炎症因子、细胞因子和自由基的释放。在本研究中，我们研究了FK506作为一种亲免疫蛋白配体对海马CA2、CA3和齿状回细胞的有效剂量和注射时间。方法将48只雄性Wistar大鼠分为9组。结扎双侧颈总动脉建立缺血模型。FK506在再灌注开始时静脉注射(3、6和10 mg/kg)，缺血后6、24、48和72小时分别重复注射(10 mg/kg)。取脑组织，制备尼氏染色和tdt介导的dUTP Nick End标记法。结果数据显示，全缺血未使大鼠CA2和CA3区锥体细胞存活数量减少，但齿状回颗粒细胞和凋亡小体存活数量在对照组和缺血组之间存在显著差异。FK506以6mg /kg的剂量间隔48小时重复给药为适宜剂量和最佳注射时间。结论FK506具有改善脑缺血损伤细胞凋亡程度的作用，可能是治疗缺血性脑损伤的良好候选药物。
{"title":"Effect of Different Doses and Times of FK506 on Different Areas of the Hippocampus in the Rat Model of Transient Global Cerebral Ischemia-Reperfusion","authors":"Z. Sharifi, Hamid Zaferani Arani, M. Olya, Hesam Adin Atashi, Shabnam Movassaghi","doi":"10.1155/2019/8047672","DOIUrl":"https://doi.org/10.1155/2019/8047672","url":null,"abstract":"Background Stroke is a major worldwide problem that is leading to a high mortality rate in humans. Ischemia, as the most common type of stroke, is characterized by tissue damage that can occur due to insufficient blood flow to the brain even for a brief duration, leading to the release of inflammatory factors, cytokines, and free radicals. In this study, we investigated the effective dose and injection time of FK506 as an immunophilin ligand for providing a suitable effect on cells of CA2, CA3, and dentate gyrus of the hippocampus. Methods In this in vivo study, a total of 48 male Wistar rats were divided into nine groups. The ischemia model was induced by the ligation of bilateral common carotid arteries. The doses of FK506 (3, 6, and 10 mg/kg) were administered intravenously (IV) at the beginning of reperfusion, followed by repeated injections (10 mg/kg) at 6, 24, 48, and 72 hours after ischemia, respectively. Brains were removed and prepared for Nissl staining and the TdT-mediated dUTP Nick End Labeling method. Results Data showed that global ischemia did not decrease the number of viable pyramidal cells in CA2 and CA3 regions, but significant differences were observed in the number of viable granular cells and apoptotic bodies in the dentate gyrus between the control and ischemia groups. Repeated doses of 6 mg/kg of FK506 at an interval of 48 hours were deemed to be the suitable dose and best time of injection. Conclusions It seems that FK506 can ameliorate the extent of apoptosis and may be a good candidate for the treatment of ischemia-induced brain damage.","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"33 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2019-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74364609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Stroke is a neurological condition which is a major cause of death and disability in many low- and middle-income countries. However, several modifiable risk factors are becoming significant. Hypertension is the most common stroke risk factor globally as well as in our country, Ethiopia. Objective The aim of this study was to assess hypertensive patients' knowledge of risk factors and warning signs of stroke at Felege Hiwot Referral Hospital, Northwest Ethiopia, 2018. Method An institutional based cross-sectional study design was conducted in May 01–30/2018. A total of 278 hypertensive patients were enrolled and systemic random sampling technique was employed to select the study participants. Data was collected through an interviewer-administered questionnaire. The collected data was entered into Epi info 7 and exported to SPSS version 22 for analysis. Binary and multivariable logistic regressions were used and P value ≤ 0.05 was considered as statistically significant. Result Out of the total 284 selected hypertensive patients, 278 of them responded completely with a response rate of 97.9 %. Of these, more than three fourths, 214 (77%) and 201 (72.3%), of them did not identify any risk factors and warning signs of stroke, respectively, with an overall proportion of only 18.3% of them having good knowledge towards stroke. Risk factor of stroke most commonly known to the respondents was physical inactivity (21.58%), whereas hypertension was the least described risk factor (3.6%). Regarding stroke warning signs, sudden weakness on one side of the body (35.97%) was the most commonly known warning sign of stroke to the respondents. Being able to read and write, being young, urban residence, and having sufficient monthly income were significantly associated with the overall knowledge of hypertensive patients towards stroke. These findings suggest the need for emphasizing on stroke education regarding its risk factors and warning signs through public or social media and health education targeting to low-income high risk subjects.
中风是一种神经系统疾病，在许多低收入和中等收入国家是造成死亡和残疾的主要原因。然而，一些可改变的风险因素正变得越来越重要。高血压是全球以及我国埃塞俄比亚最常见的卒中危险因素。目的了解2018年埃塞俄比亚西北部费利格·希沃特转诊医院高血压患者对脑卒中危险因素及预警信号的认知情况。方法采用基于机构的横断面研究设计，研究时间为2018年5月01 - 30日。采用系统随机抽样方法选择278例高血压患者作为研究对象。数据通过访谈者填写的问卷收集。将收集到的数据输入Epi info 7，导出到SPSS version 22进行分析。采用二元和多变量logistic回归，以P值≤0.05为差异有统计学意义。结果284例高血压患者中，完全缓解278例，有效率为97.9%。其中，超过四分之三的214人(77%)和201人(72.3%)没有认识到中风的危险因素和警告信号，整体上只有18.3%的人对中风有良好的认识。受访者最常知道的中风危险因素是缺乏身体活动(21.58%)，而高血压是描述最少的危险因素(3.6%)。关于中风的预警信号，受访者最常见的中风预警信号是身体一侧突然无力(35.97%)。能够读写、年轻、居住在城市、月收入充足与高血压患者对脑卒中的总体认知显著相关。这些发现表明，需要通过公共或社交媒体加强对中风危险因素和警告信号的教育，并针对低收入高危人群进行健康教育。
{"title":"Hypertensive Patients' Knowledge of Risk Factors and Warning Signs of Stroke at Felege Hiwot Referral Hospital, Northwest Ethiopia: A Cross-Sectional Study","authors":"A. Abate, N. Bayu, Tesfamichael G Mariam","doi":"10.1155/2019/8570428","DOIUrl":"https://doi.org/10.1155/2019/8570428","url":null,"abstract":"Background Stroke is a neurological condition which is a major cause of death and disability in many low- and middle-income countries. However, several modifiable risk factors are becoming significant. Hypertension is the most common stroke risk factor globally as well as in our country, Ethiopia. Objective The aim of this study was to assess hypertensive patients' knowledge of risk factors and warning signs of stroke at Felege Hiwot Referral Hospital, Northwest Ethiopia, 2018. Method An institutional based cross-sectional study design was conducted in May 01–30/2018. A total of 278 hypertensive patients were enrolled and systemic random sampling technique was employed to select the study participants. Data was collected through an interviewer-administered questionnaire. The collected data was entered into Epi info 7 and exported to SPSS version 22 for analysis. Binary and multivariable logistic regressions were used and P value ≤ 0.05 was considered as statistically significant. Result Out of the total 284 selected hypertensive patients, 278 of them responded completely with a response rate of 97.9 %. Of these, more than three fourths, 214 (77%) and 201 (72.3%), of them did not identify any risk factors and warning signs of stroke, respectively, with an overall proportion of only 18.3% of them having good knowledge towards stroke. Risk factor of stroke most commonly known to the respondents was physical inactivity (21.58%), whereas hypertension was the least described risk factor (3.6%). Regarding stroke warning signs, sudden weakness on one side of the body (35.97%) was the most commonly known warning sign of stroke to the respondents. Being able to read and write, being young, urban residence, and having sufficient monthly income were significantly associated with the overall knowledge of hypertensive patients towards stroke. These findings suggest the need for emphasizing on stroke education regarding its risk factors and warning signs through public or social media and health education targeting to low-income high risk subjects.","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"46 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2019-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88177765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Guillain-Barre syndrome is the most common cause of acute flaccid paralysis in the adult population. It occurs at the rate of 0.34 to 4 per 100000 individuals. This study was conducted to determine the clinicoepidemiological profile and outcome of the patients with Guillain-Barre syndrome.
Materials and methods: We conducted a retrospective study of patients with Guillain-Barre syndrome, presented at B.P. Koirala Institute of Health Sciences, a tertiary care centre in eastern Nepal, from January 2013 to December 2017. All patients diagnosed with Guillain-Barre syndrome were included in this study. The handwritten case record files of the study population were retrieved from medical record section of the institute.
Results: Of 31 patients with Guillain-Barre syndrome, the mean age of patients was 17±12 years. The most common presenting symptom of study population was ascending paralysis (93.5%). Respiratory failure requiring mechanical ventilation occurred in 16.1%. The common variants are AIDP and AMAN. Respiratory tract infection (29%) was the most common antecedent event. The in-hospital mortality of Guillain-Barre syndrome was 6.45%.
Conclusion: Guillain-Barre syndrome is commonly seen in the young population. The most common symptom of Guillain-Barre syndrome was ascending paralysis. The in-hospital mortality rate of patients with GBS was 6.45%.
格林-巴利综合征是成人急性弛缓性麻痹的最常见原因。它的发生率为每10万人中0.34至4人。本研究旨在确定格林-巴利综合征患者的临床流行病学特征和预后。材料和方法:我们对2013年1月至2017年12月在尼泊尔东部三级保健中心B.P.柯伊拉腊健康科学研究所(B.P. Koirala Institute of Health Sciences)就诊的格林-巴利综合征患者进行了回顾性研究。所有诊断为格林-巴利综合征的患者均纳入本研究。研究人群的手写病例记录文件从研究所的医疗记录部分检索。结果:31例格林-巴利综合征患者平均年龄为17±12岁。研究人群中最常见的症状是上升性麻痹(93.5%)。16.1%发生呼吸衰竭需要机械通气。常见的变种是AIDP和AMAN。呼吸道感染(29%)是最常见的前因事件。格林-巴利综合征住院死亡率为6.45%。结论:格林-巴利综合征常见于青年人群。格林-巴利综合征最常见的症状是上升性麻痹。GBS患者住院死亡率为6.45%。
{"title":"Clinical Profile, Functional Outcome, and Mortality of Guillain-Barre Syndrome: A Five-Year Tertiary Care Experience from Nepal.","authors":"Saroj Kumar Bhagat, Shrey Sidhant, Mukesh Bhatta, Ashish Ghimire, Bhupendra Shah","doi":"10.1155/2019/3867946","DOIUrl":"https://doi.org/10.1155/2019/3867946","url":null,"abstract":"<p><strong>Introduction: </strong>Guillain-Barre syndrome is the most common cause of acute flaccid paralysis in the adult population. It occurs at the rate of 0.34 to 4 per 100000 individuals. This study was conducted to determine the clinicoepidemiological profile and outcome of the patients with Guillain-Barre syndrome.</p><p><strong>Materials and methods: </strong>We conducted a retrospective study of patients with Guillain-Barre syndrome, presented at B.P. Koirala Institute of Health Sciences, a tertiary care centre in eastern Nepal, from January 2013 to December 2017. All patients diagnosed with Guillain-Barre syndrome were included in this study. The handwritten case record files of the study population were retrieved from medical record section of the institute.</p><p><strong>Results: </strong>Of 31 patients with Guillain-Barre syndrome, the mean age of patients was 17±12 years. The most common presenting symptom of study population was ascending paralysis (93.5%). Respiratory failure requiring mechanical ventilation occurred in 16.1%. The common variants are AIDP and AMAN. Respiratory tract infection (29%) was the most common antecedent event. The in-hospital mortality of Guillain-Barre syndrome was 6.45%.</p><p><strong>Conclusion: </strong>Guillain-Barre syndrome is commonly seen in the young population. The most common symptom of Guillain-Barre syndrome was ascending paralysis. The in-hospital mortality rate of patients with GBS was 6.45%.</p>","PeriodicalId":19124,"journal":{"name":"Neurology Research International","volume":"2019 ","pages":"3867946"},"PeriodicalIF":1.5,"publicationDate":"2019-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/3867946","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37392519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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