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Volumetric Assessment of Extratemporal Structures in Patients With Temporal Lobe Epilepsy 颞叶癫痫患者颞外结构的容量评估
Pub Date : 2022-01-14 DOI: 10.34172/icnj.2022.02
Marjan Asadollahi, E. Rahimian, A. Asadi-Pooya, M. Tahsini, H. Huppertz, N. Akbari, Leila Simani
Background: We assessed the presence of brain volume loss in the extratemporal structures in patients with temporal lobe epilepsy (TLE). The associations between brain volume loss in these structures and epilepsy duration, magnetic resonance imaging (MRI) findings, and occurrence of focal to bilateral tonic-clonic seizures (TCS) were assessed. Methods: In this cross-sectional study, all adult patients with drug-resistant TLE, who were admitted to the epilepsy monitoring unit at Loghman-Hakim Hospital, Tehran, Iran, during 2016-2020, were included. For all the participants, brain MRI was performed and patients with TLE were divided into two subgroups of those with hippocampal sclerosis (TLE-HS) and patients with normal-appearing brain MRI findings (TLE-no). Independent sample t test was applied to compare quantitative variables in the study groups. Pearson correlation test examined the correlation between the clinical and volumetric features. Results: 203 participants (81 patients with TLE and 122 healthy controls) were studied. Compared with healthy controls, patients with TLE showed a decrease in their midbrain (P=0.02) and thalamus (P=0.01) volume. The degree of thalamic atrophy was more significant in TLE-HS (P=0.03). Moreover, the degree of midbrain volume loss was more significant (P=0.07) in patients who had TCS in the past two years (N=31) compared with those who did not (N=50). The volume of the thalamus (r: -0.252, P=0.02) and pallidum (r: -0.255, P=0.02) had inverse correlations with the epilepsy duration. Conclusion: Patients with TLE have lower midbrain and thalamus volume compared with the healthy controls, which may be attributed to the seizure-induced injury. Midbrain atrophy may theoretically increase the risk of sudden unexpected death in epilepsy (SUDEP) because of the enhanced autonomic dysfunction.
背景:我们评估了颞叶癫痫(TLE)患者颞外结构中脑容量损失的存在。评估这些结构的脑容量损失与癫痫持续时间、磁共振成像(MRI)结果以及局灶性到双侧强直阵挛发作(TCS)的发生之间的关系。方法:在这项横断面研究中,纳入了2016-2020年期间在伊朗德黑兰Loghman-Hakim医院癫痫监测部门住院的所有成年耐药TLE患者。对所有参与者进行脑MRI检查,并将TLE患者分为海马硬化(TLE- hs)和脑MRI表现正常(TLE-no)两组。采用独立样本t检验比较各研究组的数量变量。Pearson相关检验检验临床特征与体积特征之间的相关性。结果:203名参与者(81名TLE患者和122名健康对照)进行了研究。与健康对照组相比,TLE患者中脑(P=0.02)和丘脑(P=0.01)体积减小。TLE-HS患者丘脑萎缩程度更显著(P=0.03)。此外,在过去两年内有TCS的患者(N=31)中脑容量损失程度比没有TCS的患者(N=50)更显著(P=0.07)。丘脑体积(r: -0.252, P=0.02)和苍白球体积(r: -0.255, P=0.02)与癫痫持续时间呈负相关。结论:与健康对照相比,TLE患者中脑和丘脑体积较低,这可能与癫痫致损伤有关。中脑萎缩可能在理论上增加癫痫(SUDEP)猝死的风险,因为增强的自主神经功能障碍。
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引用次数: 0
Middle Cerebellar Peduncle Lesions and Their Relation to Affective and Cognitive Impairment in Multiple Sclerosis 多发性硬化症小脑中佩德病变及其与情感和认知障碍的关系
Pub Date : 2022-01-10 DOI: 10.34172/icnj.2022.01
Eman Hamdy, I. Ramadan, J. Mekky, D. Gaber, Aya Abdel Gleel
Background: Cerebellum has long been known to modulate not only motor coordination but also affective and cognitive functions. This study aimed to assess the impact of middle cerebellar peduncle (MCP) lesions on affective and cognitive function in patients with multiple sclerosis (MS). Methods: This was a cross-sectional study conducted on patients with relapsing-remitting MS (RRMS). All patients were subjected to 3-Tesla magnetic resonance imaging (3T MRI), brief international cognitive assessment for MS (BICAMS), and Depression, Anxiety, and Stress Score-21 (DASS-21) upon recruitment. Results: Of the 30 patients recruited, 33.3% and 36.7% had right and left MCP lesions, respectively. Patients with right MCP lesions had significantly worse symbol digit modality test (SDMT) scores (P=0.036), worse California verbal learning test (CVLT) immediate recall scores (P=0.011), and worse CVLT delayed free recall scores (P=0.049), whereas patients with left MCP lesions had lower DASS-21 scores (P<0.005). On multivariate regression analysis, the presence of left MCP lesion was associated with an 8.9-point reduction in DASS-21 scores (CI: -16.985- -0.805, P=0.033), whereas right MCP lesions did not have an independent effect on BICAMS scores after adjustment for age and educational level. Conclusion: Left MCP lesions were associated with significantly lower DASS-21 scores, whereas none of the MCP lesions had an independent impact on cognition.
背景:众所周知,小脑不仅调节运动协调,还调节情感和认知功能。本研究旨在评估多发性硬化症(MS)患者小脑中脚(MCP)病变对情感和认知功能的影响。方法:这是一项针对复发-缓解型多发性硬化症(RRMS)患者的横断面研究。招募时,所有患者均接受3特斯拉磁共振成像(3T MRI)、MS简短国际认知评估(BIAMS)和抑郁、焦虑和压力评分-21(DAS-21)。结果:在招募的30名患者中,右侧和左侧MCP病变分别占33.3%和36.7%。右侧MCP病变患者的符号-数字模态测试(SDMT)得分显著较差(P=0.036),加利福尼亚言语学习测试(CVLT)即时回忆得分较差(P=0.011),CVLT延迟自由回忆得分较差(P=0.049),而左侧MCP病变患者DAS-21分较低(P<0.005)。在多变量回归分析中,左侧MCP病变的存在与DAS-21评分降低8.9分有关(CI:16.985--0.805,P=0.033),而右侧MCP病变在调整年龄和教育水平后对BIAMS评分没有独立影响。结论:左侧MCP病变与DAS-21评分显著降低有关,而MCP病变对认知没有独立影响。
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引用次数: 1
Migraine Headache as a Presenting Feature of Multiple Sclerosis: A Case Report 偏头痛作为多发性硬化症的表现特征:1例报告
Pub Date : 2021-10-30 DOI: 10.34172/icnj.2021.41
M. Rabiei, Z. Cheraghi, Mahtab Ramezani, H. Pakdaman
Multiple sclerosis (MS) is a chronic inflammatory disease, causing neuronal demyelination and axonal damage in the central nervous system. Symptoms of MS vary widely because of different grades of sensory, motor, and cognitive dysfunctions. Although headache as the initial symptom of MS is rare, it is a common comorbidity that affects most patients. However, it is unclear that the headache manifestation in newly diagnosed people with MS should be considered as an MS attack or merely a comorbid condition. We report the case of a 31-year-old woman with newly diagnosed MS who presented with exacerbation of headache episodes without any abnormal neurological exam findings. The headaches did not respond to nonsteroidal anti-inflammatory drugs and triptans. After administration of methylprednisolone, the headaches were significantly improved, and during 3 months of follow-up receiving glatiramer acetate, no episode of headache has occurred. This case demonstrates the possible relationship between migraine and MS in newly diagnosed patients. New-onset headaches, a change in the pattern of previous episodes, and inadequate clinical drug response to headache treatment should all be taken seriously and warrant further investigation. Thereby, early diagnosis and proper treatment for patients with MS could improve their quality of life.
多发性硬化症(MS)是一种慢性炎症性疾病,引起中枢神经系统的神经元脱髓鞘和轴突损伤。由于感觉、运动和认知功能障碍的程度不同,多发性硬化症的症状差别很大。虽然头痛作为多发性硬化症的初始症状是罕见的,但它是一种常见的合并症,影响大多数患者。然而,尚不清楚新诊断的多发性硬化症患者的头痛表现应被视为多发性硬化症发作或仅仅是一种合并症。我们报告的情况下,31岁的妇女与新诊断的MS谁提出头痛发作加剧,没有任何异常的神经学检查结果。非甾体抗炎药和曲坦类药物对头痛没有反应。给予甲基强的松龙治疗后,头痛症状明显改善,在服用醋酸格拉替雷默3个月的随访中,未发生头痛发作。本病例表明偏头痛与新诊断患者多发性硬化症之间的可能关系。新发头痛,以前发作模式的改变,以及对头痛治疗的临床药物反应不充分都应该受到重视,并值得进一步调查。因此,对MS患者的早期诊断和适当的治疗可以提高其生活质量。
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引用次数: 0
Spontaneous Spinal Epidural Hematoma: Report of Two Cases and Literature Review 自发性脊髓硬膜外血肿2例报告并文献复习
Pub Date : 2021-10-30 DOI: 10.34172/icnj.2021.39
Duc Duy Tri Tran, Q. Nguyen, V. T. Truong, Thai Duong Truong, Dinh Thanh Phan, T. Nguyen
Spontaneous spinal epidural hematoma (SSEH) is a rare disease but may lead to life-threatening consequences if not timely diagnosed and managed. Emergent hematoma evacuation is indicated before neurological deficits become irreversible. We report two cases. The first case was a 45-year-old man brought to hospital because of an acute onset of quadriparesis and urinary incontinence. His cervical magnetic resonance imaging (MRI) showed an epidural hematoma at the C5-C6 level with severe spinal cord compression. He underwent an emergency C5-C6 right hemi-laminotomy to remove the clot and decompress the cord. Postoperatively, his left-sided deficits immediately resolved. His urinary function returned to normal two weeks after the surgery. He could independently walk two months later. The second case was a 57-year-old man admitted to the hospital because of severe neck pain and paresthesia in both arms. He had been using an antiplatelet for two months. His MRI revealed an epidural hematoma from C2 to C4 with spinal cord compression on the right. This patient was successfully treated with conservative treatment. If SSEH is left undiagnosed and untreated, the neurological deficits may be permanent. Early emergent hematoma evacuation contributes to a favorable outcome. Conservative management is reasonable if neurological deficits are not severe.
自发性脊髓硬膜外血肿(SSEH)是一种罕见的疾病,但如果不及时诊断和治疗,可能会导致危及生命的后果。在神经功能缺损变得不可逆转之前,需要紧急清除血肿。我们报告了两个案例。第一个病例是一名45岁的男子,他因急性四肢瘫痪和尿失禁被送往医院。他的颈部磁共振成像(MRI)显示C5-C6级别的硬膜外血肿,伴有严重的脊髓压迫。他接受了紧急C5-C6右半椎板切开术,以清除血栓并对脊髓减压。手术后,他的左侧赤字立即得到解决。手术后两周,他的泌尿功能恢复正常。两个月后,他可以独立行走了。第二个病例是一名57岁的男子,他因严重的颈部疼痛和双臂感觉异常入院。他已经使用抗血小板药物两个月了。核磁共振成像显示C2至C4段硬膜外血肿,右侧脊髓受压。该患者通过保守治疗获得成功。如果SSEH未得到诊断和治疗,神经系统缺陷可能是永久性的。早期紧急血肿清除有助于获得良好的结果。如果神经功能缺损不严重,保守治疗是合理的。
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引用次数: 0
Fungal Central Nervous System Infections in Patients With COVID-19 COVID-19患者中枢神经系统真菌感染
Pub Date : 2021-10-30 DOI: 10.34172/icnj.2021.32
M. Rabiei, A. Zali, Sara Rahmati Roodsari, Zahra Arab-Mazar, E. Lotfali
Recent studies have indicated that fungal co-infections have a major impact on the morbidity and mortality of patients with COVID-19. In these patients, the excessive production of inflammatory cytokines and the reduction in CD4 + T and CD8 + T cell count entails susceptibility to fungal infections.1 In addition to impaired cell-mediated immunity, comorbidities and immunosuppressive medications have a significant role in the development of fungal infections and have serious impacts on clinical outcomes.1-3.
最近的研究表明,真菌合并感染对新冠肺炎患者的发病率和死亡率有重大影响。在这些患者中,炎性细胞因子的过度产生以及CD4+T和CD8+T细胞计数的减少会导致真菌感染的易感性。1除了细胞介导的免疫力受损外,合并症和免疫抑制药物在真菌感染的发展中也起着重要作用,并对临床结果产生严重影响。1-3。
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引用次数: 0
Effectiveness of Emotion Regulation Training and Assertiveness Training on Resilience and Clinical Symptoms of Students with Generalized Anxiety Disorder 情绪调节训练和自信训练对广泛性焦虑障碍学生心理弹性和临床症状的影响
Pub Date : 2021-10-30 DOI: 10.34172/icnj.2021.37
Masoud Ahmadi, M. Ghasemi, Mansoureh Shahriari Ahmadi
Background: Generalized anxiety disorder is among the most common psychiatric disorders. We aimed to compare the effectiveness of emotion regulation training and assertiveness training on resilience and clinical symptoms of students with generalized anxiety disorder. Methods: This study was a quasi-experimental pretest-posttest study with a control group. The statistical population included all 16-18 years old male high school students in Karaj who were studying in the academic year 2019-2020, of whom 75 were selected by multi-stage random sampling and assigned to two groups of 25. Participants in experimental group 1 received eight sessions of assertiveness training for 60 minutes per week. Participants in experimental group 2 received five sessions of emotion regulation training for 60 minutes per week, and participants in the control group did not receive any intervention. The Generalized Anxiety Disorder and Resilience questionnaires were used to collect data. Results: Multivariate analysis of covariance (MANCOVA) showed that both assertiveness and emotion regulation training programs increased resilience and reduced clinical signs of generalized anxiety disorder in the experimental groups (P<0.001). Moreover, there was no significant difference between the effectiveness of the two training programs. Conclusion: It is suggested that assertiveness and emotion regulation training be provided for students and included in their curriculum, to enhance assertiveness and emotion regulation skills.
背景:广泛性焦虑症是最常见的精神疾病之一。我们旨在比较情绪调节训练和自信训练对广泛性焦虑症学生的恢复力和临床症状的有效性。方法:本研究为准实验性前后测研究,设对照组。统计人群包括卡拉杰所有在2019-2020学年学习的16-18岁男性高中生,其中75人是通过多阶段随机抽样选出的,分为两组,每组25人。实验组1的参与者接受了八次自信训练,每周60分钟。实验组2的参与者每周接受5次60分钟的情绪调节训练,对照组的参与者没有接受任何干预。广泛性焦虑症和恢复力问卷用于收集数据。结果:多变量协方差分析(MANCOVA)显示,自信和情绪调节训练项目都能提高实验组的复原力,减少广泛性焦虑症的临床症状(P<0.001)。此外,两种训练项目的有效性没有显著差异。结论:建议对学生进行自信和情绪调节训练,并将其纳入课程中,以提高自信和情绪调控技能。
{"title":"Effectiveness of Emotion Regulation Training and Assertiveness Training on Resilience and Clinical Symptoms of Students with Generalized Anxiety Disorder","authors":"Masoud Ahmadi, M. Ghasemi, Mansoureh Shahriari Ahmadi","doi":"10.34172/icnj.2021.37","DOIUrl":"https://doi.org/10.34172/icnj.2021.37","url":null,"abstract":"Background: Generalized anxiety disorder is among the most common psychiatric disorders. We aimed to compare the effectiveness of emotion regulation training and assertiveness training on resilience and clinical symptoms of students with generalized anxiety disorder. Methods: This study was a quasi-experimental pretest-posttest study with a control group. The statistical population included all 16-18 years old male high school students in Karaj who were studying in the academic year 2019-2020, of whom 75 were selected by multi-stage random sampling and assigned to two groups of 25. Participants in experimental group 1 received eight sessions of assertiveness training for 60 minutes per week. Participants in experimental group 2 received five sessions of emotion regulation training for 60 minutes per week, and participants in the control group did not receive any intervention. The Generalized Anxiety Disorder and Resilience questionnaires were used to collect data. Results: Multivariate analysis of covariance (MANCOVA) showed that both assertiveness and emotion regulation training programs increased resilience and reduced clinical signs of generalized anxiety disorder in the experimental groups (P<0.001). Moreover, there was no significant difference between the effectiveness of the two training programs. Conclusion: It is suggested that assertiveness and emotion regulation training be provided for students and included in their curriculum, to enhance assertiveness and emotion regulation skills.","PeriodicalId":33222,"journal":{"name":"International Clinical Neuroscience Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47674290","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}
引用次数: 0
A Novel Spike-Wave Discharge Detection Framework Based on the Morphological Characteristics of Brain Electrical Activity Phase Space in an Animal Model 基于动物脑电活动相空间形态特征的新型尖峰波放电检测框架
Pub Date : 2021-10-30 DOI: 10.34172/icnj.2021.36
Saleh Lashkari, A. Moghimi, H. Kobravi, M. A. Younessi Heravi
Background: Animal models of absence epilepsy are widely used in childhood absence epilepsy studies. Absence seizures appear in the brain’s electrical activity as a specific spike wave discharge (SWD) pattern. Reviewing long-term brain electrical activity is time-consuming and automatic methods are necessary. On the other hand, nonlinear techniques such as phase space are effective in brain electrical activity analysis. In this study, we present a novel SWD-detection framework based on the geometrical characteristics of the phase space. Methods: The method consists of the following steps: (1) Rat stereotaxic surgery and cortical electrode implantation, (2) Long-term brain electrical activity recording, (3) Phase space reconstruction, (4) Extracting geometrical features such as volume, occupied space, and curvature of brain signal trajectories, and (5) Detecting SDWs based on the thresholding method. We evaluated the approach with the accuracy of the SWDs detection method. Results: It has been demonstrated that the features change significantly in transition from a normal state to epileptic seizures. The proposed approach detected SWDs with 98% accuracy. Conclusion: The result supports that nonlinear approaches can identify the dynamics of brain electrical activity signals.
背景:缺席癫痫的动物模型被广泛用于儿童缺席癫痫的研究。失神发作在大脑的电活动中表现为一种特定的尖峰波放电(SWD)模式。回顾长期的脑电活动是耗时的,自动方法是必要的。另一方面,相位空间等非线性技术在脑电活动分析中是有效的。在这项研究中,我们提出了一种新的基于相空间几何特征的SWD检测框架。方法:该方法包括以下步骤:(1)大鼠立体定向手术和皮层电极植入,(2)长期脑电活动记录,(3)相空间重建,(4)提取脑信号轨迹的体积、占用空间和曲率等几何特征,(5)基于阈值法检测SDW。我们用SWD检测方法的准确性对该方法进行了评估。结果:研究表明,在从正常状态到癫痫发作的过渡过程中,癫痫发作的特征发生了显著变化。所提出的方法检测SWD的准确率为98%。结论:该结果支持非线性方法可以识别脑电活动信号的动力学。
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引用次数: 0
Evaluating the Components of Alexithymia in Patients With Obsessive-Compulsive Disorder 评估强迫症患者述情障碍的组成部分
Pub Date : 2021-10-30 DOI: 10.34172/icnj.2021.35
M. Bozorg, C. Rahimi, N. Mohammadi
Background: This study aimed to evaluate the differences in alexithymia components between patients with obsessive-compulsive disorder (OCD) and normal individuals. Methods: In this ex-post facto study, 23 obsessive-compulsive outpatients’ selected by available sampling method and 22 personnel of the same hospitals (Taft Comprehensive Psychiatric Hospital, Imam Ali, Shahid Rahnemoon, and Baghayipoor Clinics) were selected as a control group in 2015 in Yazd, Iran. Yale-Brown Obsessive-Compulsive and Toronto Alexithymia Scale-20 were used in this study. Results: Data were analyzed by multivariate analysis of variance (MANOVA). The results showed that patients with OCD were significantly different from the control group in the total alexithymia score (F=7.232, P=0.01). However, both groups had significant differences only in the subscale of difficulty in identifying feelings. Conclusion: It can be concluded that both groups had significant differences in the total alexithymia score and one of its subscales.
背景:本研究旨在评估强迫症(OCD)患者与正常人述情障碍成分的差异。方法:采用现有抽样方法选取伊朗亚兹德地区2015年强迫症门诊患者23例,同时选取同一医院(Taft综合精神病医院、Imam Ali、Shahid Rahnemoon和Baghayipoor诊所)的22名工作人员作为对照组。本研究采用耶鲁-布朗强迫症量表和多伦多述情障碍量表20。结果:采用多变量方差分析(MANOVA)对数据进行分析。结果显示,强迫症患者述情总分与对照组差异有统计学意义(F=7.232, P=0.01)。然而,两组只有在识别情感困难的子量表上有显著差异。结论:两组在述情障碍总分及其其中一个分量表上均有显著差异。
{"title":"Evaluating the Components of Alexithymia in Patients With Obsessive-Compulsive Disorder","authors":"M. Bozorg, C. Rahimi, N. Mohammadi","doi":"10.34172/icnj.2021.35","DOIUrl":"https://doi.org/10.34172/icnj.2021.35","url":null,"abstract":"Background: This study aimed to evaluate the differences in alexithymia components between patients with obsessive-compulsive disorder (OCD) and normal individuals. Methods: In this ex-post facto study, 23 obsessive-compulsive outpatients’ selected by available sampling method and 22 personnel of the same hospitals (Taft Comprehensive Psychiatric Hospital, Imam Ali, Shahid Rahnemoon, and Baghayipoor Clinics) were selected as a control group in 2015 in Yazd, Iran. Yale-Brown Obsessive-Compulsive and Toronto Alexithymia Scale-20 were used in this study. Results: Data were analyzed by multivariate analysis of variance (MANOVA). The results showed that patients with OCD were significantly different from the control group in the total alexithymia score (F=7.232, P=0.01). However, both groups had significant differences only in the subscale of difficulty in identifying feelings. Conclusion: It can be concluded that both groups had significant differences in the total alexithymia score and one of its subscales.","PeriodicalId":33222,"journal":{"name":"International Clinical Neuroscience Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41931391","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}
引用次数: 1
Factors Associated With Neurogenic Bowel Dysfunction Severity in Spinal Cord Injury: A Cross-sectional Study 脊髓损伤中神经源性肠功能障碍严重程度的相关因素:一项横断面研究
Pub Date : 2021-10-30 DOI: 10.34172/icnj.2021.34
Ida Mohammadi, Mohammadhosein Akhlaghpasand, Roozbeh Tavanaei, M. Golmohammadi, A. Zali, S. Oraee-Yazdani
Background: Neurogenic bowel dysfunction (NBD) caused by spinal cord injury (SCI) is a major life limiting issue for many patients. However, studies detailing the factors contributing to bowel problems are scarce. The aim of this cross-sectional questionnaire-based study was to evaluate the associations between different aspects of bowel problems and characteristics of SCI, such as time since injury (TSI), level of injury (LOI), and the cause of injury. Methods: Two questionnaires (the NBD score questionnaire and the Cleveland clinic constipation system score questionnaire) were administered to complete, traumatic patients with SCI that matched the designated criteria. The total scores and the subscales were then regressed to TSI and LOI, and the distribution patterns of NBD score severity according to LOI and cause of injury were shown in a diagram. Results: Within the subscales of the NBD score, frequency of defecation, digital stimulation or evacuation of the anorectum, and perianal skin problems were all significantly and positively correlated with the TSI, yet the frequency of fecal incontinence was negatively associated with this variable. Moreover, uneasiness, headache, or perspiration during defecation and regular use of drops against constipation were negatively associated with the LOI. In the diagrams, patterns of NBD score severity were similar according to LOI, but visibly differed according to cause. With respect to the CCCS score (Cleveland Clinic Constipation Scoring System), the score itself was shown to be positively associated with TSI. Within the subscales, difficulty, time spent in lavatory, and duration of constipation were positively correlated with TSI. Furthermore, type of assistance was negatively associated with the LOI. Conclusion: Different characteristics of SCI, TSI, LOI, and cause, each are significantly and distinctly associated with different aspects of the bowel problems that patients with SCI face.
背景:脊髓损伤(SCI)引起的神经源性肠功能障碍(NBD)是许多患者的主要生命限制问题。然而,详细说明导致肠道问题的因素的研究很少。这项基于横断面问卷的研究的目的是评估肠道问题的不同方面与SCI特征之间的关系,如损伤后时间(TSI)、损伤程度(LOI)和损伤原因。方法:对符合指定标准的完整创伤SCI患者进行两份问卷调查(NBD评分问卷和克利夫兰临床便秘系统评分问卷)。然后将总分和分量表回归到TSI和LOI,NBD评分严重程度根据LOI和损伤原因的分布模式如图所示。结果:在NBD评分的分量表中,排便频率、肛门直肠指刺激或排空以及肛周皮肤问题均与TSI呈显著正相关,但大便失禁频率与该变量呈负相关。此外,排便时的不安、头痛或出汗以及经常使用滴剂治疗便秘与LOI呈负相关。在图表中,根据LOI,NBD评分严重程度的模式相似,但根据原因明显不同。关于CCCS评分(克利夫兰诊所便秘评分系统),该评分本身与TSI呈正相关。在分量表中,难度、如厕时间和便秘持续时间与TSI呈正相关。此外,援助类型与LOI呈负相关。结论:SCI的不同特征、TSI、LOI和病因,每一种都与SCI患者面临的肠道问题的不同方面有显著而明显的相关性。
{"title":"Factors Associated With Neurogenic Bowel Dysfunction Severity in Spinal Cord Injury: A Cross-sectional Study","authors":"Ida Mohammadi, Mohammadhosein Akhlaghpasand, Roozbeh Tavanaei, M. Golmohammadi, A. Zali, S. Oraee-Yazdani","doi":"10.34172/icnj.2021.34","DOIUrl":"https://doi.org/10.34172/icnj.2021.34","url":null,"abstract":"Background: Neurogenic bowel dysfunction (NBD) caused by spinal cord injury (SCI) is a major life limiting issue for many patients. However, studies detailing the factors contributing to bowel problems are scarce. The aim of this cross-sectional questionnaire-based study was to evaluate the associations between different aspects of bowel problems and characteristics of SCI, such as time since injury (TSI), level of injury (LOI), and the cause of injury. Methods: Two questionnaires (the NBD score questionnaire and the Cleveland clinic constipation system score questionnaire) were administered to complete, traumatic patients with SCI that matched the designated criteria. The total scores and the subscales were then regressed to TSI and LOI, and the distribution patterns of NBD score severity according to LOI and cause of injury were shown in a diagram. Results: Within the subscales of the NBD score, frequency of defecation, digital stimulation or evacuation of the anorectum, and perianal skin problems were all significantly and positively correlated with the TSI, yet the frequency of fecal incontinence was negatively associated with this variable. Moreover, uneasiness, headache, or perspiration during defecation and regular use of drops against constipation were negatively associated with the LOI. In the diagrams, patterns of NBD score severity were similar according to LOI, but visibly differed according to cause. With respect to the CCCS score (Cleveland Clinic Constipation Scoring System), the score itself was shown to be positively associated with TSI. Within the subscales, difficulty, time spent in lavatory, and duration of constipation were positively correlated with TSI. Furthermore, type of assistance was negatively associated with the LOI. Conclusion: Different characteristics of SCI, TSI, LOI, and cause, each are significantly and distinctly associated with different aspects of the bowel problems that patients with SCI face.","PeriodicalId":33222,"journal":{"name":"International Clinical Neuroscience Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44398359","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}
引用次数: 0
The Research Status of Neurological Surgery Residents; A Survey of Iranian Residency Programs 神经外科住院医师的研究现状;伊朗居留计划调查
Pub Date : 2021-10-30 DOI: 10.34172/icnj.2021.38
Mohammad Hossein Khosravi, Afsaneh Mehri, Sama Jabbaripour, F. Kazemi, Zahra Khosravi, Sayedali Ahmadi
Background: Research activities promote the appreciation for evidence-based medicine (EBM), quality patient care and clinical competence of resident physicians. We decided to investigate the research background of Iranian neurological surgery residents and their attitude toward research through a survey. Methods: This cross-sectional study was done on Iranian neurological surgery resident physicians between February and April 2020. We provided an online survey, including 13 questions, using Google form and then sent the link to survey via WhatsApp application. Following the first post, two more reminders were sent to the groups after 2 and 4 weeks. Results: Responses were received from 89 respondents from which about 88% used to spend two hours or less per week for research. Almost equal numbers of resident physicians chose academic position (n=43) or private practice (n=39) as their future job. Only seven respondents stated immigration for assumed future job position. Clinical research (47%) was the most frequent type of research done by participants and clinical research education (43.2%) during medical school was the most common way of obtaining research experience. Agreement with doing research during residency program (45.6%) was more than disagreement (22.4%) and neutral attitude (32%). Conclusion: There is a low tendency among Iranian neurological surgery residents for conducting research projects during their programs. Lack of a proper research curriculum, heavy clinical duties and consequent shortage of time as well as insufficient encouraging points, are the main reasons. Designing a research plan for residency programs may successfully increase the research involvement rate.
背景:研究活动促进了对循证医学(EBM)、优质患者护理和住院医生临床能力的认识。我们决定通过一项调查来调查伊朗神经外科住院医师的研究背景和他们对研究的态度。方法:这项横断面研究是在2020年2月至4月期间对伊朗神经外科住院医师进行的。我们使用谷歌表格提供了一份在线调查,包括13个问题,然后通过WhatsApp应用程序发送了调查链接。继第一条帖子之后,在2周和4周后,又向小组发送了两条提醒。结果:共收到89名受访者的回复,其中约88%的人过去每周花两个小时或更少的时间进行研究。几乎相同数量的住院医生选择学术职位(n=43)或私人执业(n=39)作为他们未来的工作。只有7名受访者表示,未来的工作职位需要移民。临床研究(47%)是参与者进行的最频繁的研究类型,医学院期间的临床研究教育(43.2%)是获得研究经验的最常见方式。同意在住院期间进行研究(45.6%)多于不同意(22.4%)和中立态度(32%)。结论:伊朗神经外科住院医师在项目期间开展研究项目的倾向较低。主要原因是缺乏适当的研究课程、繁重的临床任务和随之而来的时间短缺以及激励点不足。为实习项目设计一个研究计划可以成功地提高研究参与率。
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引用次数: 0
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International Clinical Neuroscience Journal
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