Pub Date : 2021-01-01DOI: 10.36648/2171-6625.21.12.385
Aditi Chaturvedhi
Objective: The purpose of this study was to evaluate the use, statistical validity, and sensitivity, of the two minute step test as predictor of aerobic capacity in institutionalized elderly for neurological rehabilitation. Method: An observational type study of 60 subjects between the age group of 60- 94 was carried out, the data analysis was done on the basis of normative values calculated for each age group and we compared heart rate, oxygen saturation and perceived exertion obtained during performance of 2 MST with those obtained during the 6 MWT. Results: According to the age group, normal values of steps were correlated with the two- minutes step test. The more number of steps performed during the twominute step test was associated with higher values of peak oxygen consumption. Comparing 2 MST and 6 MWT in 60 subjects for validity, r=0.935 (P<0.0001). They were statistically equivalent in heart rate (97 ± 4 and 95 ± 4 bpm), oxygen saturation (97 ± 0.5 and 96 ± 0.6%), rating of perceived exertion (13.6 ± 0.4 and 12.4 ± 0.4), and blood pressure (130 ± 4/62 ± 3 and 128 ± 3/62 ± 2 mmHg), (mean ± SE, 2 MST and 6 MWT, respectively). Sensitivity of the 2 MST was high, based both on the number of steps achieved by inpatients (37 ± 13 steps, mean ± SD), and healthy subjects (54 ± 18 steps) (P<0.001), Results suggest that two minute step test has potential as one of the vital tool for aerobic and physical capacity in elderly population which in turn could be a major indicator for the neurological rehabilitation protocols. Conclusion: Although the benefits of two-minutes step test as indicator for aerobic and physical capacity in elderly looks promising, general guidelines for the clinical use of two-minutes step test and its normative values is difficult to make. Future research should explore the normative values for different populations, factors affecting the use of two-minute step test, effects of two-minute step test alone on various systems without in combination with other tests.
{"title":"Validation of the Two Minute Step Test as Predictor of Aerobic Capacity in Institutionalized Elderly for Neurological Rehabilitation","authors":"Aditi Chaturvedhi","doi":"10.36648/2171-6625.21.12.385","DOIUrl":"https://doi.org/10.36648/2171-6625.21.12.385","url":null,"abstract":"Objective: The purpose of this study was to evaluate the use, statistical validity, and sensitivity, of the two minute step test as predictor of aerobic capacity in institutionalized elderly for neurological rehabilitation. Method: An observational type study of 60 subjects between the age group of 60- 94 was carried out, the data analysis was done on the basis of normative values calculated for each age group and we compared heart rate, oxygen saturation and perceived exertion obtained during performance of 2 MST with those obtained during the 6 MWT. Results: According to the age group, normal values of steps were correlated with the two- minutes step test. The more number of steps performed during the twominute step test was associated with higher values of peak oxygen consumption. Comparing 2 MST and 6 MWT in 60 subjects for validity, r=0.935 (P<0.0001). They were statistically equivalent in heart rate (97 ± 4 and 95 ± 4 bpm), oxygen saturation (97 ± 0.5 and 96 ± 0.6%), rating of perceived exertion (13.6 ± 0.4 and 12.4 ± 0.4), and blood pressure (130 ± 4/62 ± 3 and 128 ± 3/62 ± 2 mmHg), (mean ± SE, 2 MST and 6 MWT, respectively). Sensitivity of the 2 MST was high, based both on the number of steps achieved by inpatients (37 ± 13 steps, mean ± SD), and healthy subjects (54 ± 18 steps) (P<0.001), Results suggest that two minute step test has potential as one of the vital tool for aerobic and physical capacity in elderly population which in turn could be a major indicator for the neurological rehabilitation protocols. Conclusion: Although the benefits of two-minutes step test as indicator for aerobic and physical capacity in elderly looks promising, general guidelines for the clinical use of two-minutes step test and its normative values is difficult to make. Future research should explore the normative values for different populations, factors affecting the use of two-minute step test, effects of two-minute step test alone on various systems without in combination with other tests.","PeriodicalId":91329,"journal":{"name":"Journal of neurology and neuroscience","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69700779","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}
Pub Date : 2021-01-01DOI: 10.36648/2171-6625.12.1.349
A. Kumar
Background: Drugs primarily affect the way individuals think, feel and behave. Illicit substances such as crystal methamphetamine show a strong association to abnormalities in the process of neurotransmission. Objective: The main aim of this review is to analyse substance abuse and abnormalities in neurotransmission focusing on crystal methamphetamine and its physiological, psychological and social implications. Methods: Extensive systematic electronic databases (EBSCOhost, JSTOR, ProQuest Science, Science Direct, Research Gate, Google Scholar and PubMed) were used. Research articles and books were searched using the keywords ‘effects of crystal methamphetamine’, ‘neurotransmission in substance abuse’, ‘substance abuse by homosexual males’. Discussion and Conclusion: This thematic review draws close attention to the physiological changes, psychological disorders and abuse of crystal methamphetamine among homosexual men tested positive for Human Immunodeficiency Virus (HIV) as well as a need for better social care services and treatment in order to overcome homophobic stigmatization.
{"title":"Biopsychosocial Implications of Crystal Methamphetamine Abuse: A Review of Literature","authors":"A. Kumar","doi":"10.36648/2171-6625.12.1.349","DOIUrl":"https://doi.org/10.36648/2171-6625.12.1.349","url":null,"abstract":"Background: Drugs primarily affect the way individuals think, feel and behave. Illicit substances such as crystal methamphetamine show a strong association to abnormalities in the process of neurotransmission. Objective: The main aim of this review is to analyse substance abuse and abnormalities in neurotransmission focusing on crystal methamphetamine and its physiological, psychological and social implications. Methods: Extensive systematic electronic databases (EBSCOhost, JSTOR, ProQuest Science, Science Direct, Research Gate, Google Scholar and PubMed) were used. Research articles and books were searched using the keywords ‘effects of crystal methamphetamine’, ‘neurotransmission in substance abuse’, ‘substance abuse by homosexual males’. Discussion and Conclusion: This thematic review draws close attention to the physiological changes, psychological disorders and abuse of crystal methamphetamine among homosexual men tested positive for Human Immunodeficiency Virus (HIV) as well as a need for better social care services and treatment in order to overcome homophobic stigmatization.","PeriodicalId":91329,"journal":{"name":"Journal of neurology and neuroscience","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69698880","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}
Pub Date : 2021-01-01DOI: 10.36648/2171-6625.21.12.387
J. Kalyani
This study focuses on the diagnosis and management of pain in Parkinson’s disease. Separating Parkinson’s disease related pain from pain of other origin is very difficult. They all come under one umbrella among the different forms of Parkinson’s disease related pain, musculoskeletal pain is the most common form accounting for 40% in PD. Pain occurs in about 60% of Parkinson’s disease patients, two to three times more frequent in this population than in age matched healthy individuals. It is an early and potentially disabling symptom that can precede motor symptoms by several years. The lower back and lower extremities are the most commonly affected areas. The most used classification for pain in PD defines musculoskeletal, dystonic, central, or neuropathic/radicular forms. Its different clinical characteristics, variable relationship with motor symptoms and inconsistent response to dopaminergic drugs suggest that the mechanism underlying pain in Parkinson’s disease is complex and multifaceted, involving the peripheral nervous system, generation and amplification of pain by motor symptoms and neuro-degeneration of areas related to pain. The basal ganglion processes somatosensory information differently. Increased subjective pain sensitivity with lower electrical and heat pain threshold has been reported in Parkinson’s disease patients. The mechanism is assumed to be diminished activity of the descending inhibitory system of the basal ganglia. Promising perspectives for this have come from studies using different pain scales in Parkinson’s disease. Selection criteria- “King’s Parkinson’s disease pain scale,” which was proposed by a multicenter group that included King’s College Hospital in London, is officially advocated by the “International Parkinson’s and Movement Disorder Society Non-Motor PD Study Group” for evaluating pain in Parkinson’s disease treatment prevalence.
本研究的重点是帕金森病疼痛的诊断和治疗。将帕金森病相关的疼痛与其他原因的疼痛区分开来是非常困难的。它们都属于不同形式的帕金森病相关疼痛，肌肉骨骼疼痛是最常见的形式，占帕金森病的40%。大约60%的帕金森氏病患者会出现疼痛，这一人群的疼痛频率是同龄健康人的两到三倍。这是一种早期和潜在的致残症状，可能比运动症状早几年。下背部和下肢是最常见的受累部位。PD中最常用的疼痛分类定义为肌肉骨骼、肌张力障碍、中枢或神经性/神经根性疼痛。其不同的临床特征、与运动症状的不同关系以及对多巴胺能药物的不一致反应表明，帕金森病疼痛的机制是复杂而多方面的，涉及周围神经系统、运动症状对疼痛的产生和放大以及疼痛相关区域的神经退行性变。基底神经节处理体感觉信息的方式不同。据报道，帕金森病患者主观疼痛敏感性增加，电痛阈和热痛阈降低。其机制被认为是基底神经节下降抑制系统的活性降低。在帕金森氏症中使用不同疼痛量表的研究对此提出了有希望的观点。选择标准——“King’s Parkinson’s disease pain scale”由包括伦敦King’s College Hospital在内的多中心小组提出，被“国际帕金森病与运动障碍学会非运动PD研究小组”正式提倡，用于评估帕金森病治疗中疼痛的流行程度。
{"title":"Clinical Study on the Incidence of Pain in Parkinson's Disease","authors":"J. Kalyani","doi":"10.36648/2171-6625.21.12.387","DOIUrl":"https://doi.org/10.36648/2171-6625.21.12.387","url":null,"abstract":"This study focuses on the diagnosis and management of pain in Parkinson’s disease. Separating Parkinson’s disease related pain from pain of other origin is very difficult. They all come under one umbrella among the different forms of Parkinson’s disease related pain, musculoskeletal pain is the most common form accounting for 40% in PD. Pain occurs in about 60% of Parkinson’s disease patients, two to three times more frequent in this population than in age matched healthy individuals. It is an early and potentially disabling symptom that can precede motor symptoms by several years. The lower back and lower extremities are the most commonly affected areas. The most used classification for pain in PD defines musculoskeletal, dystonic, central, or neuropathic/radicular forms. Its different clinical characteristics, variable relationship with motor symptoms and inconsistent response to dopaminergic drugs suggest that the mechanism underlying pain in Parkinson’s disease is complex and multifaceted, involving the peripheral nervous system, generation and amplification of pain by motor symptoms and neuro-degeneration of areas related to pain. The basal ganglion processes somatosensory information differently. Increased subjective pain sensitivity with lower electrical and heat pain threshold has been reported in Parkinson’s disease patients. The mechanism is assumed to be diminished activity of the descending inhibitory system of the basal ganglia. Promising perspectives for this have come from studies using different pain scales in Parkinson’s disease. Selection criteria- “King’s Parkinson’s disease pain scale,” which was proposed by a multicenter group that included King’s College Hospital in London, is officially advocated by the “International Parkinson’s and Movement Disorder Society Non-Motor PD Study Group” for evaluating pain in Parkinson’s disease treatment prevalence.","PeriodicalId":91329,"journal":{"name":"Journal of neurology and neuroscience","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69700432","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}
Pub Date : 2021-01-01DOI: 10.36648/2171-6625.12.2.351
Ehsan Esmaili Sh, Iz, C. Bertmar, S. Day, D. Griffiths, E. O’Brien, M. Krause
Background: Despite technologic advances, stroke remains a difficult clinical diagnosis. We aimed to investigate the rate and characteristics of stroke mimics (SM) and missed strokes (MS). Research Methodology: We used data of consecutive “suspected stroke” admissions in a tertiary academic Hospital from January 2016 to July 2018. Diagnosis of SM was based on the absence of an ischaemic infarct on neuroimaging plus the presence an alternate discharge diagnosis. MS were defined as any patient with a discharge diagnosis of stroke whose stroke-like symptoms were missed in the Emergency Department (ED). Findings: Of 1745 patients reviewed, 63% were ischaemic stroke, 18% Intra-Cranial Haemorrhage (ICH), and 18% SM. We detected 95 MS. Stroke risk factors were significantly less common among SM and MS compared to stroke patients. Younger age, female gender, dizziness, ataxia, absence of limb weakness, and absence of certain vascular risk factors were predictors of SM. For MS, the predicting factors were young age (<55), confusion at presentation, hypercholesterolemia, and absence of hypertension. Conclusion: Atypical presenting symptoms can cause over and under-diagnosis of stroke. MS and SM are similar in many aspects. These diagnostic errors occur more often in younger patients with less severe neurological symptoms and symptoms attributable to posterior circulation.
{"title":"Challenges in Diagnosis of Ischaemic Stroke: A Descriptive Study of Stroke Mimics and Missed Strokes","authors":"Ehsan Esmaili Sh, Iz, C. Bertmar, S. Day, D. Griffiths, E. O’Brien, M. Krause","doi":"10.36648/2171-6625.12.2.351","DOIUrl":"https://doi.org/10.36648/2171-6625.12.2.351","url":null,"abstract":"Background: Despite technologic advances, stroke remains a difficult clinical diagnosis. We aimed to investigate the rate and characteristics of stroke mimics (SM) and missed strokes (MS). Research Methodology: We used data of consecutive “suspected stroke” admissions in a tertiary academic Hospital from January 2016 to July 2018. Diagnosis of SM was based on the absence of an ischaemic infarct on neuroimaging plus the presence an alternate discharge diagnosis. MS were defined as any patient with a discharge diagnosis of stroke whose stroke-like symptoms were missed in the Emergency Department (ED). Findings: Of 1745 patients reviewed, 63% were ischaemic stroke, 18% Intra-Cranial Haemorrhage (ICH), and 18% SM. We detected 95 MS. Stroke risk factors were significantly less common among SM and MS compared to stroke patients. Younger age, female gender, dizziness, ataxia, absence of limb weakness, and absence of certain vascular risk factors were predictors of SM. For MS, the predicting factors were young age (<55), confusion at presentation, hypercholesterolemia, and absence of hypertension. Conclusion: Atypical presenting symptoms can cause over and under-diagnosis of stroke. MS and SM are similar in many aspects. These diagnostic errors occur more often in younger patients with less severe neurological symptoms and symptoms attributable to posterior circulation.","PeriodicalId":91329,"journal":{"name":"Journal of neurology and neuroscience","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69698988","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}
Pub Date : 2021-01-01DOI: 10.36648/2171-6625.12.2.353
N. Tutar, H. Kucukoglu, A. Koksal
Objective: Uric acid (UA) is a molecule known as an antioxidant. However, studies conducted in recent years indicate that elevated serum UA levels are an independent risk factor for stroke. The aim of our study is to determine the relationship between UA and acute ischemic stroke and subtypes. Methods: We retrospectively analyzed 110 patients with acute ischemic stroke within the first 24 hours who were admitted to Bakirkoy Prof Dr. Mazhar Osman, Mental and Neurological Diseases Training and Research Hospital (Istanbul, Turkey) between August 2016 and August 2017. The control group was composed of 82 healthy volunteers who were compatible with the patient group in terms of age and gender. Serum UA levels were estimated and stroke subtypes were determined by Bamford classification according to clinical findings and TOAST classification according to etiology. Results: Mean serum UA levels were found 5,5 mg/dL in the patient group versus 4,8 mg/dL in the control group. There was a statistically significant difference between patients and controls (p<0,0019). As for the stroke subtypes, elevated serum UA was found to be associated with all stroke subtypes except lacunar stroke according to Bamford classification and small vessel disease according to TOAST classification. In Multiple Logistic Regression Analysis, serum UA levels higher than 5,6 mg/dL were identified as independent risk factors for ischemic stroke. Conclusion: In our study, high UA levels were seen as an independent risk factor for stroke. Determination of UA as an etiological factor responsible for the pathogenesis of vascular diseases including stroke may also bring the treatment of hyperuricemia such as hyperlipidemia or hypertension, which are routinely treated after stroke.
{"title":"The Relationship between Serum Uric Acid Level and Ischemic Stroke and its Subtypes","authors":"N. Tutar, H. Kucukoglu, A. Koksal","doi":"10.36648/2171-6625.12.2.353","DOIUrl":"https://doi.org/10.36648/2171-6625.12.2.353","url":null,"abstract":"Objective: Uric acid (UA) is a molecule known as an antioxidant. However, studies conducted in recent years indicate that elevated serum UA levels are an independent risk factor for stroke. The aim of our study is to determine the relationship between UA and acute ischemic stroke and subtypes. Methods: We retrospectively analyzed 110 patients with acute ischemic stroke within the first 24 hours who were admitted to Bakirkoy Prof Dr. Mazhar Osman, Mental and Neurological Diseases Training and Research Hospital (Istanbul, Turkey) between August 2016 and August 2017. The control group was composed of 82 healthy volunteers who were compatible with the patient group in terms of age and gender. Serum UA levels were estimated and stroke subtypes were determined by Bamford classification according to clinical findings and TOAST classification according to etiology. Results: Mean serum UA levels were found 5,5 mg/dL in the patient group versus 4,8 mg/dL in the control group. There was a statistically significant difference between patients and controls (p<0,0019). As for the stroke subtypes, elevated serum UA was found to be associated with all stroke subtypes except lacunar stroke according to Bamford classification and small vessel disease according to TOAST classification. In Multiple Logistic Regression Analysis, serum UA levels higher than 5,6 mg/dL were identified as independent risk factors for ischemic stroke. Conclusion: In our study, high UA levels were seen as an independent risk factor for stroke. Determination of UA as an etiological factor responsible for the pathogenesis of vascular diseases including stroke may also bring the treatment of hyperuricemia such as hyperlipidemia or hypertension, which are routinely treated after stroke.","PeriodicalId":91329,"journal":{"name":"Journal of neurology and neuroscience","volume":"31 4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69699156","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}
Vertigo is a complicated symptom caused mainly by a dysfunctional vestibular system, either central or peripheral. Benign paroxysmal positional vertigo (BPPV), vestibular migraine (VM) and posterior circulation ischemia (PCI) are the three common causes of vertigo, all of which are related to abnormal calcium function. As a calcium antagonist, flunarizine has a multitude of mechanisms of action in vertigo treatment. The drug exerts neuroprotective effects on brain, endothelial and hair cells of the inner ear; reduces angiospasm, normalizes blood viscosity, improves the circulation of blood flow to the brain and inner ear; protects and restores injured neuronal or vascular cells from hypoxic-ischaemic damage; accelerates vestibular function recovery and inhibits cortical spreading depression (CSD). Many studies showed flunarizine to be effective especially against vertiginous attacks resulting from BPPV, VM and PCI with few serious side effects, probably due to its multiple mechanisms of action.
{"title":"The Role of Calcium in the Pathophysiology of Vertigo and its Treatment with Flunarizine","authors":"Jian-Xiang Yang, Zhao Dong, Mingxin Li, G. Tan, Miao-Miao Jia, Shengyuan Yu","doi":"10.36648/2171-6625.12.2.354","DOIUrl":"https://doi.org/10.36648/2171-6625.12.2.354","url":null,"abstract":"Vertigo is a complicated symptom caused mainly by a dysfunctional vestibular system, either central or peripheral. Benign paroxysmal positional vertigo (BPPV), vestibular migraine (VM) and posterior circulation ischemia (PCI) are the three common causes of vertigo, all of which are related to abnormal calcium function. As a calcium antagonist, flunarizine has a multitude of mechanisms of action in vertigo treatment. The drug exerts neuroprotective effects on brain, endothelial and hair cells of the inner ear; reduces angiospasm, normalizes blood viscosity, improves the circulation of blood flow to the brain and inner ear; protects and restores injured neuronal or vascular cells from hypoxic-ischaemic damage; accelerates vestibular function recovery and inhibits cortical spreading depression (CSD). Many studies showed flunarizine to be effective especially against vertiginous attacks resulting from BPPV, VM and PCI with few serious side effects, probably due to its multiple mechanisms of action.","PeriodicalId":91329,"journal":{"name":"Journal of neurology and neuroscience","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69699338","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}
Pub Date : 2021-01-01DOI: 10.36648/2171-6625.21.12.359
Sarah Alromaih, Hind Alshabanat, Nosaiba Alshanqiti, Almaha Aldhuwaihy, Sarah Abdullah Almohanna, Muna Alqasem, F. Othman, R. Khan
Background: Traumatic brain injury (TBI) is a leading cause of morbidity and mortality globally. Currently, the association between hyperoxia and outcomes in patients with TBI remains debatable. We assessed the effect of hyperoxia on the neurological outcomes and survival of critically ill patients with moderate-severe TBI. Methods: This was a retrospective cohort study of all adults with moderatesevere TBI admitted to the ICU between 1st January 2016 and 31st December 2019 who required invasive mechanical ventilation. We noted ABGs performed with the first 3 hours of intubation, then 6-12 hours and 24-48 hours. The patients were divided into two categories: normoxia (PaO2 60-99 mmHg) and hyeroxia (PaO2 >100 mmHg). Multivariable logistic regression was performed to assess predictors of hospital mortality and good neurologic outcome (Glasgow outcome score [GOS] ≥ 4). In a second analysis the patients were divided into survivors and non-survivors. Results: The study included 308 patients: 23.4% (n=72) in normoxia group and 76.6% (n=236) in hyeroxia group. Hyperoxia was not associated with increased hospital (43% vs. 18%, p=0.20) mortality. Further, the hospital discharge GCS (10 ± 5 vs. 11 ± 4, p=0.10) and GOS (3 ± 1 vs. 3 ± 1, p=0.35) were similar. In multivariable logistic regression analysis, hyperoxia was not associated with increased mortality (adjusted odds ratio [aOR] 0.99, 95% CI 0.99-1.00, p=0.11). PaO2 within different ranges was also not associated with mortality: 100-200 mmHg: aOR 0.60, 95% CI 0.29-1.52; 201-300 mmHg: aOR 0.66, 95% CI 0.29-1.52; 301-400 mmHg: aOR 0.80, 95% CI 0.31-2.09; and >400 mmHg: aOR 0.39, 95% CI 0.14-1.08; reference: PaO2 60-99 mmHg. The Kaplan-Meier survival curve for normoxia verses hyperoxia showed no significant difference for all-cause mortality. In the survivors verse nonsurvivors analysis, the PaO2 were (median, IQT) 199 mmHg (111-329) and 165 mmHg (84-252), respectively. Conclusion: Hyperoxia (PaO2 >100 mmHg) was not associated with increased mortality or poor neurological outcomes (determined by GOS) in moderatesevere TBI patients.
背景:外伤性脑损伤(TBI)是全球发病率和死亡率的主要原因。目前，高氧与TBI患者预后之间的关系仍存在争议。我们评估了高氧对中重度TBI危重患者的神经预后和生存的影响。方法:这是一项回顾性队列研究，纳入了2016年1月1日至2019年12月31日期间入住ICU并需要有创机械通气的所有中度TBI成人患者。我们注意到在插管前3小时，然后是6-12小时和24-48小时进行ABGs。患者分为常氧组(PaO2 60 ~ 99 mmHg)和缺氧组(PaO2 60 ~ 100 mmHg)。采用多变量logistic回归来评估医院死亡率和良好神经系统预后(格拉斯哥预后评分[GOS]≥4)的预测因素。在第二次分析中，将患者分为幸存者和非幸存者。结果:308例患者中，常氧组72例(23.4%)，高氧组236例(76.6%)。高氧与住院死亡率增加无关(43%对18%，p=0.20)。出院GCS(10±5比11±4,p=0.10)和GOS(3±1比3±1,p=0.35)相似。在多变量logistic回归分析中，高氧与死亡率增加无关(校正优势比[aOR] 0.99, 95% CI 0.99-1.00, p=0.11)。不同范围内的PaO2也与死亡率无关:100-200 mmHg: aOR 0.60, 95% CI 0.29-1.52;201-300 mmHg: aOR 0.66, 95% CI 0.29-1.52;301-400 mmHg: aOR 0.80, 95% CI 0.31-2.09;400 mmHg: aOR 0.39, 95% CI 0.14-1.08;参考:PaO2 60-99 mmHg。正常氧和高氧的Kaplan-Meier生存曲线显示全因死亡率无显著差异。在幸存者与非幸存者分析中，PaO2(中位，IQT)分别为199 mmHg(111-329)和165 mmHg(84-252)。结论:在中度TBI患者中，高氧(PaO2 >100 mmHg)与死亡率增加或神经预后不良(由GOS确定)无关。
{"title":"The Effect of Hyperoxia in Traumatic Brain Injury Patients in the Intensive Care Unit of a Tertiary Care Center","authors":"Sarah Alromaih, Hind Alshabanat, Nosaiba Alshanqiti, Almaha Aldhuwaihy, Sarah Abdullah Almohanna, Muna Alqasem, F. Othman, R. Khan","doi":"10.36648/2171-6625.21.12.359","DOIUrl":"https://doi.org/10.36648/2171-6625.21.12.359","url":null,"abstract":"Background: Traumatic brain injury (TBI) is a leading cause of morbidity and mortality globally. Currently, the association between hyperoxia and outcomes in patients with TBI remains debatable. We assessed the effect of hyperoxia on the neurological outcomes and survival of critically ill patients with moderate-severe TBI. Methods: This was a retrospective cohort study of all adults with moderatesevere TBI admitted to the ICU between 1st January 2016 and 31st December 2019 who required invasive mechanical ventilation. We noted ABGs performed with the first 3 hours of intubation, then 6-12 hours and 24-48 hours. The patients were divided into two categories: normoxia (PaO2 60-99 mmHg) and hyeroxia (PaO2 >100 mmHg). Multivariable logistic regression was performed to assess predictors of hospital mortality and good neurologic outcome (Glasgow outcome score [GOS] ≥ 4). In a second analysis the patients were divided into survivors and non-survivors. Results: The study included 308 patients: 23.4% (n=72) in normoxia group and 76.6% (n=236) in hyeroxia group. Hyperoxia was not associated with increased hospital (43% vs. 18%, p=0.20) mortality. Further, the hospital discharge GCS (10 ± 5 vs. 11 ± 4, p=0.10) and GOS (3 ± 1 vs. 3 ± 1, p=0.35) were similar. In multivariable logistic regression analysis, hyperoxia was not associated with increased mortality (adjusted odds ratio [aOR] 0.99, 95% CI 0.99-1.00, p=0.11). PaO2 within different ranges was also not associated with mortality: 100-200 mmHg: aOR 0.60, 95% CI 0.29-1.52; 201-300 mmHg: aOR 0.66, 95% CI 0.29-1.52; 301-400 mmHg: aOR 0.80, 95% CI 0.31-2.09; and >400 mmHg: aOR 0.39, 95% CI 0.14-1.08; reference: PaO2 60-99 mmHg. The Kaplan-Meier survival curve for normoxia verses hyperoxia showed no significant difference for all-cause mortality. In the survivors verse nonsurvivors analysis, the PaO2 were (median, IQT) 199 mmHg (111-329) and 165 mmHg (84-252), respectively. Conclusion: Hyperoxia (PaO2 >100 mmHg) was not associated with increased mortality or poor neurological outcomes (determined by GOS) in moderatesevere TBI patients.","PeriodicalId":91329,"journal":{"name":"Journal of neurology and neuroscience","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69700078","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}
Pub Date : 2021-01-01DOI: 10.36648/2171-6625.12.2.352
Dante Valer, Hernan Cañari, Alej, ro Escalaya
Horner syndrome is a constellation of neurological findings consisting of ipsilateral ptosis, miosis and anhidrosis. Partial Horner syndrome, comprising ipsilateral ptosis and miosis in the absence of anhidrosis, is a well-documented but uncommon manifestation of internal carotid artery dissection. Internal carotid artery dissection (ICAD) is a rare entity that either results from traumatic injury or can be spontaneously preceded or not by aminor trauma such as sporting activities, is a common cause of ischaemic stroke in young patients. As many as 40 to 50% of patients with carotid dissection will develop an ipsilateral Horner’s sindrome.
{"title":"Hornerandrsquo;s Syndrome due to a Spontaneous Internal Carotid Artery Dissection treated with Casper Stent","authors":"Dante Valer, Hernan Cañari, Alej, ro Escalaya","doi":"10.36648/2171-6625.12.2.352","DOIUrl":"https://doi.org/10.36648/2171-6625.12.2.352","url":null,"abstract":"Horner syndrome is a constellation of neurological findings consisting of ipsilateral ptosis, miosis and anhidrosis. Partial Horner syndrome, comprising ipsilateral ptosis and miosis in the absence of anhidrosis, is a well-documented but uncommon manifestation of internal carotid artery dissection. Internal carotid artery dissection (ICAD) is a rare entity that either results from traumatic injury or can be spontaneously preceded or not by aminor trauma such as sporting activities, is a common cause of ischaemic stroke in young patients. As many as 40 to 50% of patients with carotid dissection will develop an ipsilateral Horner’s sindrome.","PeriodicalId":91329,"journal":{"name":"Journal of neurology and neuroscience","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69699018","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}
Pub Date : 2021-01-01DOI: 10.36648/2171-6625.12.1.346
C. Batista, Daniel Filipe Borges, P. Coelho, A. Ferreira, T. Pereira, J. Conde
Background: The Electroencephalogram (EEG) is the gold standard technique to assess the epileptogenic cortical activity. However, due to the neurophysiology of the bioelectrical signal and the short duration of the routine EEG (rEEG) and sleepdeprived EEG (sEEG) registers, the sensitivity is low. The 24-hour Ambulatory EEG (aEEG), being a prolonged recording, could significantly improve the diagnostic capability, in an attractive cost-effective way. In this study, we analyzed the aEEG of patients with suspected epilepsy, addressing its specificity and sensitivity for the clinical diagnosis of epilepsy. Additionally, we endeavour to ascertain any other possible predictive factors of diagnosis. Methods and Findings: Retrospective observational study enrolling consecutive patients with suspected epilepsy who underwent aEEG between May 2011 and May 2018 at the Neurophysiology Laboratory from Local Health Unit of Matosinhos – Pedro Hispano Hospital. A sample of 83 individuals was obtained, with a mean age of 44.5 years (79 adults and 4 paediatric). aEEG showed a good diagnostic capacity for the clinical diagnosis of epilepsy with a specificity of 97% and sensitivity of 68%. The rate of false-negatives and false-positives was 7% and 5%, respectively. It’s expected that patients with an indication of syncope or loss of consciousness will not have epilepsy diagnosis. Conclusion: The aEEG can be a useful tool to assess patients with suspected epilepsy and unremarkable routine and sleep-deprived EEGs, or in cases of suspected non-epileptic seizures, particularly to exclude the epilepsy diagnosis given its high specificity. This approach can lessen the time required to identify the diagnosis.
背景:脑电图(EEG)是评估致痫性皮层活动的金标准技术。然而，由于生物电信号的神经生理特性以及常规脑电图(rEEG)和睡眠剥夺脑电图(sEEG)登记的持续时间较短，灵敏度较低。24小时动态脑电图(aEEG)是一种长时间的记录，可以显著提高诊断能力，具有吸引力和成本效益。本研究对疑似癫痫患者的aEEG进行分析，探讨其对癫痫临床诊断的特异性和敏感性。此外，我们努力确定任何其他可能的诊断预测因素。方法和研究结果:回顾性观察研究纳入2011年5月至2018年5月在Matosinhos - Pedro Hispano医院当地卫生单位神经生理学实验室接受aEEG的连续疑似癫痫患者。获得83个个体的样本，平均年龄为44.5岁(79名成人和4名儿科)。aEEG对癫痫的临床诊断具有良好的诊断能力，特异性为97%，敏感性为68%。假阴性和假阳性检出率分别为7%和5%。预计有晕厥或意识丧失迹象的患者不会被诊断为癫痫。结论:aEEG具有较高的特异性，可作为评估疑似癫痫、常规脑电图不明显、睡眠剥夺脑电图或疑似非癫痫性发作的有效工具，尤其可排除癫痫的诊断。这种方法可以减少诊断所需的时间。
{"title":"The Impact of 24-Hour Ambulatory EEG in the Clinical Approach to Patients with Suspected Epilepsy","authors":"C. Batista, Daniel Filipe Borges, P. Coelho, A. Ferreira, T. Pereira, J. Conde","doi":"10.36648/2171-6625.12.1.346","DOIUrl":"https://doi.org/10.36648/2171-6625.12.1.346","url":null,"abstract":"Background: The Electroencephalogram (EEG) is the gold standard technique to assess the epileptogenic cortical activity. However, due to the neurophysiology of the bioelectrical signal and the short duration of the routine EEG (rEEG) and sleepdeprived EEG (sEEG) registers, the sensitivity is low. The 24-hour Ambulatory EEG (aEEG), being a prolonged recording, could significantly improve the diagnostic capability, in an attractive cost-effective way. In this study, we analyzed the aEEG of patients with suspected epilepsy, addressing its specificity and sensitivity for the clinical diagnosis of epilepsy. Additionally, we endeavour to ascertain any other possible predictive factors of diagnosis. Methods and Findings: Retrospective observational study enrolling consecutive patients with suspected epilepsy who underwent aEEG between May 2011 and May 2018 at the Neurophysiology Laboratory from Local Health Unit of Matosinhos – Pedro Hispano Hospital. A sample of 83 individuals was obtained, with a mean age of 44.5 years (79 adults and 4 paediatric). aEEG showed a good diagnostic capacity for the clinical diagnosis of epilepsy with a specificity of 97% and sensitivity of 68%. The rate of false-negatives and false-positives was 7% and 5%, respectively. It’s expected that patients with an indication of syncope or loss of consciousness will not have epilepsy diagnosis. Conclusion: The aEEG can be a useful tool to assess patients with suspected epilepsy and unremarkable routine and sleep-deprived EEGs, or in cases of suspected non-epileptic seizures, particularly to exclude the epilepsy diagnosis given its high specificity. This approach can lessen the time required to identify the diagnosis.","PeriodicalId":91329,"journal":{"name":"Journal of neurology and neuroscience","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69699145","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}
Pub Date : 2021-01-01DOI: 10.36648/2171-6625.21.10.375
L. Polimeno, L. Lorusso, G. Calamita, A. Tafaro, R. Tamma, M. D. Comite, A. Rizzi, L. Santacroce, D. Ribatti, V. Benagiano
Background: Augmenter of liver regeneration (ALR) is an antioxidant, antiapoptotic and mitochondrial-protective factor. Evidence exists that (i) ALR is variously expressed by many neurons in the central nervous system; (ii) ALR is differently expressed in female and male cells; (iii) neurodegenerative diseases triggered by dysregulation of cell normoxic conditions differently affect the 2 sexes. Aim: Aim of the present study was to analyze the ALR presence in the prosencephalon of female and male mice and evaluate whether differences in expression exist between the two genders. Methods: Harvested prosencephala were investigated by Western blotting and immunohistochemistry to assess ALR expression. Results: Western blotting revealed 2 ALR isoforms, ALR-21 and ALR-23, both more expressed in male prosencephalon. Immunohistochemistry revealed ALRimmunoreactive neurons diffusely distributed in the prosencephalon, but with a significantly higher number in male prosencephalon. Conclusion: The different ALR expression level in female and male mouse prosencephalon may represent a marker of sexual dimorphism. The higher ALR expression seen in male prosencephalic neurons suggests that ALR, an antioxidant factor, could parallel the antioxidant effect of female sex steroid hormones that are known to be more effective compared to the male sexual steroids in protecting against the oxidative stress. These data open new options to study the neurodegenerative diseases, particularly those showing gender differences in terms of epidemiology.
背景:肝再生增强因子(Augmenter of liver regeneration, ALR)是一种抗氧化、抗凋亡和线粒体保护因子。有证据表明(i)中枢神经系统的许多神经元以不同的方式表达ALR;(ii) ALR在女性和男性细胞中的表达不同;(iii)由细胞正常状态失调引发的神经退行性疾病对两性的影响不同。目的:本研究的目的是分析雌性和雄性小鼠前脑中ALR的存在，并评估两性之间是否存在表达差异。方法:采用Western blotting和免疫组化方法检测采收的前脑ALR的表达。结果:Western blot结果显示2种ALR亚型ALR-21和ALR-23在男性前脑中表达较多。免疫组化显示，ALRimmunoreactive神经元弥漫性分布于前脑，但在雄性前脑中数量明显较多。结论:雌性和雄性小鼠前脑中ALR表达水平的差异可能是雌雄异形的标志。男性前脑神经元中较高的ALR表达表明，ALR作为一种抗氧化因子，可能与女性性类固醇激素的抗氧化作用相似，而女性性类固醇激素在抗氧化应激方面比男性性类固醇激素更有效。这些数据为研究神经退行性疾病，特别是那些在流行病学方面表现出性别差异的疾病开辟了新的选择。
{"title":"Expression of Augmenter of Liver Regeneration (ALR) in female and Male Mouse Prosencephalon: A New Approach for the Comprehension of Gender-Related Brain Biology","authors":"L. Polimeno, L. Lorusso, G. Calamita, A. Tafaro, R. Tamma, M. D. Comite, A. Rizzi, L. Santacroce, D. Ribatti, V. Benagiano","doi":"10.36648/2171-6625.21.10.375","DOIUrl":"https://doi.org/10.36648/2171-6625.21.10.375","url":null,"abstract":"Background: Augmenter of liver regeneration (ALR) is an antioxidant, antiapoptotic and mitochondrial-protective factor. Evidence exists that (i) ALR is variously expressed by many neurons in the central nervous system; (ii) ALR is differently expressed in female and male cells; (iii) neurodegenerative diseases triggered by dysregulation of cell normoxic conditions differently affect the 2 sexes. Aim: Aim of the present study was to analyze the ALR presence in the prosencephalon of female and male mice and evaluate whether differences in expression exist between the two genders. Methods: Harvested prosencephala were investigated by Western blotting and immunohistochemistry to assess ALR expression. Results: Western blotting revealed 2 ALR isoforms, ALR-21 and ALR-23, both more expressed in male prosencephalon. Immunohistochemistry revealed ALRimmunoreactive neurons diffusely distributed in the prosencephalon, but with a significantly higher number in male prosencephalon. Conclusion: The different ALR expression level in female and male mouse prosencephalon may represent a marker of sexual dimorphism. The higher ALR expression seen in male prosencephalic neurons suggests that ALR, an antioxidant factor, could parallel the antioxidant effect of female sex steroid hormones that are known to be more effective compared to the male sexual steroids in protecting against the oxidative stress. These data open new options to study the neurodegenerative diseases, particularly those showing gender differences in terms of epidemiology.","PeriodicalId":91329,"journal":{"name":"Journal of neurology and neuroscience","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69699716","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}
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