10851
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Szilasiova J, Krokavcova M, Gdovinova Z, Rosenberger J, Van Dijk JP. Quality of life in patients with multiple sclerosis in Eastern Slovakia. Disabil Rehabil 2010; 33:1587-93. [PMID: 21174630 DOI: 10.3109/09638288.2010.540292] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Quality of life (QoL) is an important measure of the burden of disease and could be useful in evaluating patient management and practical interventions. The aim of this study was to explore the association of psychological and clinical variables with QoL in patients with multiple sclerosis (MS). METHODS One hundred and fourteen consecutive patients (mean age 36.1 ± 10.3 years, 72% female) from one MS centre completed the Hospital Anxiety and Depression Scale, the Fatigue Severity Scale and the Short-Form-36 Health Survey (SF-36). Functional disability was assessed using the Expanded Disability Status Scale. Multiple linear regression analyses were performed to analyse demographic, psychological and clinical data. RESULTS Functional disability, depression and fatigue were found to be related inversely to the physical health subscale. Disease course, anxiety and depression were associated negatively with the mental health subscale. CONCLUSIONS Functional disability, depression and fatigue were the main variables related to the perceived physical health subscale, and disease course, anxiety and depression to the perceived mental health subscale in the group of patients with MS. Thus, effective treatment of fatigue, anxiety and depression could be assumed to increase a patient's QoL.
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Affiliation(s)
- Jarmila Szilasiova
- Department of Neurology, University of PJ Safarik, Tr. SNP 1, Kosice 04001, Slovakia.
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10852
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Khuwaja AK, Lalani S, Dhanani R, Azam IS, Rafique G, White F. Anxiety and depression among outpatients with type 2 diabetes: A multi-centre study of prevalence and associated factors. Diabetol Metab Syndr 2010; 2:72. [PMID: 21171976 PMCID: PMC3022608 DOI: 10.1186/1758-5996-2-72] [Citation(s) in RCA: 139] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Accepted: 12/20/2010] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Anxiety and depression contribute to poor disease outcomes among individuals with diabetes. This study aimed to assess the prevalence of anxiety and depression and to identify their associated factors including metabolic components among people with type 2 diabetes. METHODS We conducted a cross-sectional, multi-center study in four out-patient clinics in Karachi, Pakistan. In all, 889 adults with type-2 diabetes were included in this study. Anxiety and depression were measured by using the Hospital Anxiety and Depression Scale (HADS). Multivariable analysis using multiple logistic regression was carried out to evaluate the combined effect of various factors associated with anxiety and depression, while adjusting for confounding variables. RESULTS Overall, 57.9% (95% CI = 54.7%, 61.2%) and 43.5% (95% CI = 40.3%, 46.8%) study participants had anxiety and depression respectively. Factors found to be independently associated with anxiety were physical inactivity, having hypertension and ischemic heart disease. For depression, being female, of older age, having hypertension and ischemic heart disease were significantly associated. Metabolic components found to be independently associated with both anxiety and depression were systolic blood pressure, fasting blood glucose and fasting blood triglycerides. Body mass index was independently associated with depression but not with anxiety. CONCLUSION This study identified that a large proportion of adults with diabetes had anxiety and/or depression, and identified factors associated with these entities. These results alert clinicians to identify and treat anxiety and depression as common components of diabetes care. Additional studies are needed to establish the directional nature of this relationship and to test interventions.
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Affiliation(s)
- Ali Khan Khuwaja
- Department of Family Medicine, Aga Khan University, Karachi - 74880, Pakistan
| | - Saima Lalani
- Medical College, Aga Khan University, Karachi, Pakistan
| | - Raheem Dhanani
- Department of Family Medicine, Aga Khan University, East Africa
- Department of Family Medicine, McGill University, Canada
| | | | | | - Franklin White
- Pacific Health & Development Sciences Inc., Victoria, Canada
- Community Health & Epidemiology, Dalhousie University, Halifax, Canada
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10853
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Tripathi M, Vibha D. Stroke in young in India. Stroke Res Treat 2010; 2011:368629. [PMID: 21234342 PMCID: PMC3017944 DOI: 10.4061/2011/368629] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 11/10/2010] [Indexed: 01/13/2023] Open
Abstract
Stroke in young has special significance in developing countries. This is so because some etiologies like cardioembolic infections are more common than in developed countries, and the affection of economically productive group adds further to the overall disease burden. The paper discusses the burden of stroke in young and its implications in a developing country like India along with an approach to identifying different causes that are known to occur in this age group.
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Affiliation(s)
- Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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10854
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Dantuma E, Merchant S, Sugaya K. Stem cells for the treatment of neurodegenerative diseases. Stem Cell Res Ther 2010; 1:37. [PMID: 21144012 PMCID: PMC3025439 DOI: 10.1186/scrt37] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Stem cells offer an enormous pool of resources for the understanding of the human body. One proposed use of stem cells has been as an autologous therapy. The use of stem cells for neurodegenerative diseases has become of interest. Clinical applications of stem cells for Alzheimer disease, Parkinson disease, amyotrophic lateral sclerosis, and multiple sclerosis will increase in the coming years, and although great care will need to be taken when moving forward with prospective treatments, the application of stem cells is highly promising.
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Affiliation(s)
- Elise Dantuma
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, 6900 Lake Nona Boulevard, Orlando, FL 32827, USA.
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10855
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10856
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de Carvalho JF, da Mota LMH, Bonfa E. Fatal rhabdomyolysis in systemic lupus erythematosus. Rheumatol Int 2010; 31:1243-5. [PMID: 21127876 DOI: 10.1007/s00296-010-1674-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Accepted: 11/14/2010] [Indexed: 12/18/2022]
Abstract
The authors describe herein the sixth lupus case that evolved with rhabdomyolysis. A 36-year-old woman with systemic lupus erythematosus was admitted to our hospital with malaise, myalgia, dysphagia, fever, preserved muscle strength, leukocytosis (15,600 cells), and increased creatine kinase of 1,358 IU/L that reached 75,000 IU/L in few days. She denied the use of myotoxic drugs and alcohol. Urine 1 showed false positive for hemoglobinuria (myoglobin) without erythrocytes in the sediment, confirming the diagnosis of rhabdomyolysis. Secondary causes were excluded. She was treated with hyperhydration and alkalinization of urine. Despite treatment, the patient developed pulmonary congestion and she died. The authors also review in this article rhabdomyolysis in patients with systemic lupus erythematosus.
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Affiliation(s)
- Jozélio Freire de Carvalho
- Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Cerqueira César, São Paulo, SP, 01246-903, Brazil.
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10857
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ST-elevation myocardial infarction or neurogenic-stunned myocardium — Diagnostic and treatment dilemma following acute ischemic stroke. Int J Cardiol 2010; 145:561-2. [DOI: 10.1016/j.ijcard.2010.05.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Accepted: 05/17/2010] [Indexed: 11/18/2022]
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10858
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Raju RS, Sarma PS, Pandian JD. Psychosocial Problems, Quality of Life, and Functional Independence Among Indian Stroke Survivors. Stroke 2010; 41:2932-7. [DOI: 10.1161/strokeaha.110.596817] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Rinu Susan Raju
- From the Stroke Unit (R.S.R., J.P.), Christian Medical College, Ludhiana, Punjab, India; Achutha Menon Centre for Health Science Studies (P.S.S.), Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Prabhakaran S. Sarma
- From the Stroke Unit (R.S.R., J.P.), Christian Medical College, Ludhiana, Punjab, India; Achutha Menon Centre for Health Science Studies (P.S.S.), Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
| | - Jeyaraj D. Pandian
- From the Stroke Unit (R.S.R., J.P.), Christian Medical College, Ludhiana, Punjab, India; Achutha Menon Centre for Health Science Studies (P.S.S.), Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
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10859
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Barten LJ, Allington DR, Procacci KA, Rivey MP. New approaches in the management of multiple sclerosis. DRUG DESIGN DEVELOPMENT AND THERAPY 2010; 4:343-66. [PMID: 21151622 PMCID: PMC2998807 DOI: 10.2147/dddt.s9331] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Multiple sclerosis (MS) is a central nervous system chronic inflammatory disease that is characterized by an extensive and complex immune response. Scientific advances have occurred in immunology, pathophysiology, and diagnostic and clinical assessment tools, and recent discovery of unique therapeutic targets has spurred numerous Phase II and Phase III clinical trials. Reductions in MS relapse rates and improvements in T2 or gadolinium-enhancing lesion burdens have been reported from Phase III trials that include fingolimod, alemtuzumab, cladribine, and rituximab. Promising Phase II trial data exist for teriflunomide, daclizumab, laquinimod, and fumarate. The optimism created by these favorable findings must be tempered with evaluation of the adverse effect profile produced by these new agents. Given the discovery of progressive multifocal leukoencephalopathy with the use of natalizumab, ongoing vigilance for rare and life-threatening reactions due to new agents should be paramount. Patients with MS often experience difficulty with ambulation, spasticity, and cognition. Recent clinical trial data from two Phase III dalfampridine-SR trials indicate certain patients receive benefits in ambulation. This article provides an overview of data from clinical trials of newer agents of potential benefit in MS.
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Affiliation(s)
- Laurie J Barten
- The University of Montana and Community Medical Center, Missoula, MT, USA
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10860
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Opara JA, Jaracz K, Brola W. Quality of life in multiple sclerosis. J Med Life 2010; 3:352-8. [PMID: 21254730 PMCID: PMC3019078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
An overall aim of treatment in multiple sclerosis is to lower the negative impact of the disease on functioning and quality of life of patients. Therefore, a measurement of functioning and quality of life should be included in the evaluation of the effectiveness of treatment. The most commonly used quality of life questionnaires, either generic or specific, were presented in this paper,. Information about clinical and functional status is useful in the interpretation of the quality of life assessment results. Because of that, instruments for the assessment of depression, cognitive functions, functional ability and fatigue in multiple sclerosis were also described.
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Affiliation(s)
- JA Opara
- Academy of Physical Education in KatowicePoland
| | - K Jaracz
- Medical University in PoznanPoland
| | - W Brola
- District Hospital in KonskiePoland
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10861
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10862
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Cortical language mapping using electrical cortical stimulation for Mandarin-speaking patients with epilepsy: a report of six case studies. Epilepsy Behav 2010; 19:343-7. [PMID: 20797912 DOI: 10.1016/j.yebeh.2010.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2010] [Revised: 07/10/2010] [Accepted: 07/21/2010] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The goal of this study was to summarize the results of language cortex mapping using electrical cortical stimulation with modified language tasks for Mandarin-speaking patients with epilepsy. METHODS Electrical currents were delivered through implanted subdural electrodes to six Mandarin-speaking patients before epilepsy surgery. The current intensities inducing any language disturbance during comprehension, repetition, and speech tasks were recorded, and individual cortical mapping was completed to guide subsequent resection, with the distance between mapped language sites and resected zones kept at a minimum of 0.5 cm. Language function was reassessed and followed up after surgery. RESULTS Language cortices were successfully identified in three patients, but demonstrated great variability in distribution. There seemed to be no difference in the intensity threshold that induced language interference. None of the six patients exhibited language deficits postsurgery. CONCLUSIONS Electrical cortical stimulation with modified language tasks is valid for identification of cortices underlying Mandarin processing. The great variability in language cortex distribution enhances the necessity of individual language cortical mapping in epilepsy surgery.
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10863
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Lv S, Zhang Y, Steinmann P, Zhou XN, Utzinger J. Helminth infections of the central nervous system occurring in Southeast Asia and the Far East. ADVANCES IN PARASITOLOGY 2010; 72:351-408. [PMID: 20624537 DOI: 10.1016/s0065-308x(10)72012-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Although helminth infections of the central nervous system (CNS) are rare, their public health implications must not be neglected. Indeed, several helminth species can cause cerebrospinal infections, especially if humans serve as intermediate or non-permissive host. The diagnosis of cerebrospinal helminthiases is difficult, and the detection of parasites in cerebrospinal fluid is rarely successful. Cerebrospinal helminth infections therefore often remain undetected, and hence prognosis is poor. Increases in tourism and population movements are risk factors for cerebrospinal helminthiases and infections pose particular challenges to clinicians in non-endemic areas. In this review, we focus primarily on food-borne helminthiases that are endemic and often emerging in Southeast Asia and the Far East, namely angiostrongyliasis, gnathostomiasis, sparganosis, paragonimiasis and cysticercosis. Additionally, we discuss neuroschistosomiasis, a disease that is transmitted through human-water contact. For each disease, we describe the pathogen, its transmission route and possible mechanisms for entering the CNS. We also summarise common signs and symptoms, challenges and opportunities for diagnosis, treatment, clinical management, geographical distribution and epidemiology. The adoption of a comprehensive set of diagnostic criteria for different cerebrospinal helminthiases is proposed, including epidemiological history, typical signs and symptoms, neuroimaging and laboratory findings. Finally, risk factors, and research needs for enhanced patient management and population-based control measures are discussed.
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Affiliation(s)
- Shan Lv
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
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10864
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10865
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Abstract
The issue of stroke in young in India has long been of interest to neurologists in the country. The age group for stroke in young has been variable between different studies but perhaps should be restricted to 15-49 years as this age group tends to have a unique set of causes and risk factors. There is no evidence indicating higher incidence of stroke in young in India than in other countries. Age-specific incidence rates from recent population-based studies from India are comparable to the western populations. Though the traditional risk factors of stroke play a significant role in young age group also, the presence of high number of cryptogenic strokes, cardioembolic and venous strokes makes diagnostic evaluation in this age group more challenging. This review aims at defining the age group for stroke in young, focuses on incidence of stroke in young on the basis of different population-based studies and details the risk factors and diagnostic approach of different stroke subtypes in young.
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Affiliation(s)
- Kameshwar Prasad
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
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10866
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Cruz GAM, Adami M. Anatomia do plexo braquial de macaco-barrigudo (Lagothrix lagothricha). PESQUISA VETERINARIA BRASILEIRA 2010. [DOI: 10.1590/s0100-736x2010001000012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
O macaco-barrigudo (Lagothrix lagothricha) é um antropóide pertencente à Família Atelidae que possui os maiores primatas neotropicais. Um cadáver fêmea de macaco-barrigudo foi fixado com solução de formaldeído a 10%, posteriormente dissecado com o auxílio de lupa estereoscópica e fotodocumentado. O plexo braquial originou-se dos nervos espinhais C5 a C8 e T1, formando os troncos cranial, médio e caudal, dos quais derivaram os nervos periféricos que se assemelharam na origem e no território de inervação com os plexos de outros primatas, com exceção do nervo musculocutâneo que atravessou o músculo coracobraquial. Pesquisas sobre o plexo braquial de primatas fornecem dados que disponibilizam o acesso a informações valiosas sobre a morfologia destes animais e auxiliam no estabelecimento de parâmetros anatômicos entre as espécies, contribuindo também no tratamento de injúrias e procedimentos anestésicos.
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10867
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Bilateral total cataract as the presenting feature of celiac disease. Int Ophthalmol 2010; 31:47-50. [PMID: 20857173 DOI: 10.1007/s10792-010-9396-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Accepted: 09/04/2010] [Indexed: 01/15/2023]
Abstract
An 18-year-old male presented to the ophthalmology department with bilateral total subluxated cataract. On systemic examination, he was found to have grossly short stature, multiple severe bony deformities, hypogonadism and partial adontia. Detailed work-up revealed a biochemical and radiologic picture consistent with osteomalacia, which had resulted from malabsorption secondary to celiac disease, confirmed histopathologically. To the best of our knowledge, this is the first reported case of bilateral cataract as the presenting feature of celiac disease. Malabsorption leading to hypocalcemia along with chronic diarrhea itself may have contributed to the development of bilateral cataract.
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10868
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González-Andrade F, Alcaraz-Alvarez JL. Disease-modifying therapies in relapsing-remitting multiple sclerosis. Neuropsychiatr Dis Treat 2010; 6:365-73. [PMID: 20856600 PMCID: PMC2938285 DOI: 10.2147/ndt.s11079] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
CLINICAL QUESTION What is the best current disease-modifying therapy for relapsing-remitting multiple sclerosis? RESULTS The evidence shows that the most effective disease-modifying therapy for delaying short- to medium-term disability progression, prevention of relapses, reducing the area and activity of lesions on magnetic resonance imaging, with the least side effects, is high-dose, high-frequency subcutaneous interferon-β1a 44 μg three times per week. IMPLEMENTATION The pitfalls in treatment of MS can be avoided by remembering the following points: The most effective therapy to prevent or delay the appearance of permanent neurological disability with the fewest side effects should be chosen, and treatment should not be delayed.Adherence to treatment should be monitored closely, and needs comprehensive patient information and education to establish long-term adherence, which is a critical determinant of long-term outcome.The correct approach to the disease includes disease management, symptom management, and patient management. A combination of tools is necessary to ease the various symptoms, which fall into three broad categories, i.e. rehabilitation, pharmacological, and procedural.It is important to understand that no treatment modality should be used alone, unless it is in itself sufficient to remedy the particular symptom/problem.
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Affiliation(s)
- Fabricio González-Andrade
- Department of Medicine, Metropolitan Hospital, Av. Mariana de Jesús Oe8 y Occidental, 170125, Quito, Ecuador.
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10869
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Abstract
Ischemic stroke is a recognized complication of varicella-zoster virus infections. We report on an immunocompetent 5-year-old girl who presented with acute neurologic deficits attributed to cerebral infarction, 3 months after varicella-zoster virus infection. Magnetic resonance imaging of the brain showed subacute ischemic lesions in the territory of the right middle cerebral artery. A literature review of 70 similar cases is reported.
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10870
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Aggarwal A, Kumar R, Sharma RC, Sharma DD. Escitalopram and Ischemic Stroke: Cause or Chance Association? Ann Pharmacother 2010; 44:1508-9. [DOI: 10.1345/aph.1p185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Ashish Aggarwal
- Department of Psychiatry Indira Gandhi Medical College Himachal Pradesh, India
| | - Ramesh Kumar
- Department of Psychiatry Indira Gandhi Medical College
| | - Ravi C Sharma
- Department of Psychiatry Indira Gandhi Medical College
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10871
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Meena A, Archana A, Reddy G, Ramakrishn D, Rao P. Antiganglioside Antibodies in Sub Types of Guillain-Barre Syndrome in an Indian Population. JOURNAL OF MEDICAL SCIENCES 2010. [DOI: 10.3923/jms.2010.138.142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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10872
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Migliorini CE, New PW, Tonge BJ. Quality of life in adults with spinal cord injury living in the community. Spinal Cord 2010; 49:365-70. [PMID: 20697422 DOI: 10.1038/sc.2010.102] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN The study design used is cross-sectional descriptive survey. OBJECTIVES The aim of this study is to describe the subjective and objective quality of life (QoL) of adults with chronic non-traumatic spinal cord injury (NT-SCI) and to compare the objective and subjective QoL of adults with chronic NT-SCI with adults who have a chronic traumatic spinal cord injury (T-SCI) and the general population. SETTING Living in the general community (non-residential care), Australia. PARTICIPANTS The study included 443 adults with SCI (T-SCI, n=381) (NT-SCI, n=62), all SCI ≥6 months duration. INTERVENTION Not applicable. MAIN OUTCOME MEASURES Objective and subjective QoL domains--Comprehensive QoL Scale for Adults, version 5 (COMQoL-A5); acceptance subscale--the Spinal Cord Lesion Coping Strategies Questionnaire, version 1 Australia (SCL CSQ v1.0 Australia). RESULTS Despite demographic differences, only the objective QoL domain material (higher in NT-SCI) and the subjective QoL domain health (lower in NT-SCI) were significantly different between the SCI subgroups. In contrast, five of the seven objective domains and four of the seven subjective domains were significantly lower in the SCI sample as a whole, compared with the general population. Post hoc analyses suggested that aetiology of the SCI was not responsible for QoL differences within the cohort with SCI. CONCLUSION On the whole, aetiology makes little difference to QoL outcomes after SCI. The QoL of adults with chronic T-SCI and NT-SCI fall significantly below that of the general population in most domains.
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Affiliation(s)
- C E Migliorini
- Centre for Developmental Psychiatry and Psychology, School of Psychology and Psychiatry, Monash University, Clayton, Victoria, Australia.
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10873
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Young JL, Rund D. Psychiatric Considerations in Patients with Decreased Levels of Consciousness. Emerg Med Clin North Am 2010; 28:595-609. [DOI: 10.1016/j.emc.2010.03.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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10874
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Strategy for effective brain drug delivery. Eur J Pharm Sci 2010; 40:385-403. [DOI: 10.1016/j.ejps.2010.05.003] [Citation(s) in RCA: 256] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Revised: 04/15/2010] [Accepted: 05/10/2010] [Indexed: 12/20/2022]
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10875
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Abstract
An 81-year-old female with no previous psychiatric history presented with late-onset obsessive compulsive disorder following an acute right macular hemorrhage and loss of vision. Following a thorough organic screen to exclude a physical cause, various high doses of selective serotonin reuptake inhibitors were tried with no therapeutic benefit. The patient had significant remission of her symptoms following a course of electroconvulsive therapy.
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10876
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Guimarães FAB, Oliveira-Cardoso ÉAD, Mastropietro AP, Voltarelli JC, Santos MAD. Impact of autologous hematopoetic stem cell transplantation on the quality of life of patients with multiple sclerosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2010; 68:522-7. [DOI: 10.1590/s0004-282x2010000400009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Accepted: 02/15/2010] [Indexed: 11/21/2022]
Abstract
OBJECTIVE: To evaluate the impact of autologous hematopoetic stem cell transplantation (autoHSCT) in the health related quality of life (HRQL) in patients with multiple sclerosis. METHOD: The sample consisted of 34 patients, over 18 years old, treated at a University Hospital in the state of São Paulo, Brazil. For data collection MOS SF-36 and EDSS scales were applied at three time points: admission of the patient, hospital discharge and 1 year posttransplantation. RESULTS: 27 patients (79%) showed stabilization or neurological improvement 1 year posttransplantation. At this time point, there was statistically significant improvement in all domains of the HRQoL. When EDSS scores were correlated with the domains of the MOS SF-36 scale, statistically significant correlations were found with physical functioning at the three time points analysed. CONCLUSION: In spite of the high risk of complications of the procedure, the HSCT had positive impact in the health related quality of life.
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10877
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Akhaddar A, Elouennass M, Baallal H, Boucetta M. Focal intracranial infections due to Actinomyces species in immunocompetent patients: diagnostic and therapeutic challenges. World Neurosurg 2010; 74:346-50. [PMID: 21492568 DOI: 10.1016/j.wneu.2010.05.029] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Accepted: 05/03/2010] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Actinomyces spp. are often underestimated as causes of central nervous system infection because they are not looked for routinely and are difficult to detect. We try to determine the optimal management of these problematic intracranial infectious diseases in neurosurgical practice. METHODS Five cases of intracranial suppurations due to Actinomyces spp. treated between December 2007 and February 2009 are reported. The relevant clinicobacteriologic features and treatment outcomes are analyzed. RESULTS There were two brain abscesses, two subdural empyemas, and one frontal sinus pyomucocele with intracranial extension. Among them, three cases were previously operated and two patients were previously treated for otorhinolaryngeal infection. All cases were immunocompetent. In addition to Actinomyces sp., three patients had coinfectious bacteria (Pseudomonas aeruginosa, Staphylococcus warneri, and Escherichia coli). Complete resolution of the infection was achieved by means of aggressive surgical treatment and relatively short course of antibiotic therapy with a full recovery. CONCLUSION Actinomycotic focal cerebral infections may occur with greater frequency than previously recognized. Polymicrobial bacteria may be seen. This rare anaerobic organism should be considered in patients with a history of head trauma, previous surgery, or otorhinolaryngeal infection who present with a long duration of neurologic symptoms with or without an accompanying fever. Patients may be candidates for surgical debridement with relative shorter term of antibiotic therapy (ciprofloxacin).
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Affiliation(s)
- Ali Akhaddar
- Department of Neurosurgery, Mohammed V Military Teaching Hospital, Rabat, Morocco.
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10878
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Nayak S, Kunz A, Kieslinger K, Ladurner G, Killer M. Classification of non-aneurysmal subarachnoid haemorrhage: CT correlation to the clinical outcome. Clin Radiol 2010; 65:623-8. [DOI: 10.1016/j.crad.2010.01.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 12/29/2009] [Accepted: 01/08/2010] [Indexed: 11/29/2022]
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10879
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Hammad LA, Derryberry DZ, Jmeian YR, Mechref Y. Quantification of monosaccharides through multiple-reaction monitoring liquid chromatography/mass spectrometry using an aminopropyl column. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2010; 24:1565-1574. [PMID: 20486252 DOI: 10.1002/rcm.4536] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
A simple, sensitive, and reproducible quantitative liquid chromatography/tandem mass spectrometry (LC/MS/MS) method was designed for the simultaneous quantification of monosaccharides derived from glycoprotein and blood serum using a multiple-reaction monitoring (MRM) approach. Sialic acids and neutral monosaccharides were efficiently separated using an amino-bonded silica phase column. Neutral monosaccharide molecules were detected as their aldol acetate anion adducts [M + CH(3)CO(2)](-) using electrospray ionization in negative ion MRM mode, while sialic acids were detected as deprotonated ions [M-H](-). The new method did not require a reduction step, and exhibited very high sensitivity to carbohydrates with limits of detection of 1 pg for the sugars studied. The linearity of the described approach spanned over three orders of magnitude (pg to ng). The method was validated for monosaccharides originating from N-linked glycans attached to glycoproteins and glycoproteins found in human blood serum. The method effectively quantified monosaccharides originating from as little as 1 microg of glycoprotein and 5 microL of blood serum. The method was robust, reproducible, and highly sensitive. It did not require reduction, derivatization or postcolumn addition of reagents.
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Affiliation(s)
- Loubna A Hammad
- METACyt Biochemical Analysis Center, Department of Chemistry, Indiana University, Bloomington, IN 47405, USA
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10880
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10881
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Gupta A, Deepika S, Taly AB, Srivastava A, Surender V, Thyloth M. Quality of life and psychological problems in patients undergoing neurological rehabilitation. Ann Indian Acad Neurol 2010; 11:225-30. [PMID: 19893678 PMCID: PMC2771998 DOI: 10.4103/0972-2327.44557] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Revised: 06/30/2008] [Accepted: 07/03/2008] [Indexed: 11/15/2022] Open
Abstract
Aim: To assess the quality of life (QoL) and prevalence of psychological problems (PP) in patients with neurological illness, and their correlation with functional abilities. Materials and Methods: Prospective cross-sectional study conducted in the neurological rehabilitation unit of tertiary research hospital in 30 consecutive hospitalized patients (21 men), age 16-55 years (34.63±11.87). Outcome Measure: WHOQoL-BREF was used to assess QoL. The prevalence of PP was recorded using Hospital Anxiety Depression Scale (HADS) and General Health Questionnaire (GHQ-12). QoL and HADS scores were correlated with functional abilities using mean Barthel Index (BI) Score. Results: The duration of illness was three to 30 months (10.63±7.83) and their primary diagnoses were stroke 12, traumatic spinal cord injury seven and non-traumatic spinal cord lesion 11. Twenty-two patients qualified for GHQ-12 caseness, with 15 patients having distress (score ≥15) and seven having severe problem and psychological distress (score≥20). Twenty five patients had abnormal anxiety and 17 had abnormal depression on HADS (abnormal = 8-21), with moderate to severe anxiety and depression (scores≥11) in nine and three patients respectively. The mean WHOQoL-BREF transformed scores (on WHOQoL 0-100 scale) were (38.83±8.02), (50.76±9.79), (48.53±18.46) and (49.13±10.63) in physical, psychological, social, and environmental domains respectively. The social domain of QoL had significant correlation (P<.05) with functional abilities. Conclusion: Patients with neurological disorders requiring inpatient rehabilitation have impaired QoL that affects all domains of life. There is high prevalence of psychological problems, including anxiety and depression. The social domain of QoL adversely affected functional abilities, but the correlation between PP and functional abilities was insignificant.
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Affiliation(s)
- Anupam Gupta
- Department of Psychiatric and Neurological Rehabilitation, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India.
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10882
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Benign Unilateral Apraxia of Eyelid Opening. Ophthalmology 2010; 117:1265-8. [PMID: 20163871 DOI: 10.1016/j.ophtha.2009.10.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2009] [Revised: 09/20/2009] [Accepted: 10/14/2009] [Indexed: 10/19/2022] Open
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10883
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Wiwanitkit V. Neuropathy due to lead poisoning. Ann Indian Acad Neurol 2010; 13:74. [PMID: 20436756 PMCID: PMC2859596 DOI: 10.4103/0972-2327.61287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Viroj Wiwanitkit
- Wiwanitkit House, Bangkhae, 10160, Bangkok, Thailand 10160. E-mail:
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10884
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Isaac V, Stewart R, Krishnamoorthy ES. Caregiver Burden and Quality of Life of Older Persons With Stroke. J Appl Gerontol 2010. [DOI: 10.1177/0733464810369340] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This article reports a preliminary investigation in India of the association between caregiver burden and quality of life (QOL) in older persons with stroke after controlling for disability, depression, and sociodemographic factors. A cross-sectional analysis was carried out with 46 stroke patients attending a community hospital in India. The primary outcome variable was patient QOL assessed using the World Health Organization Quality of Life questionnaire–short form (WHOQOL-Bref). The primary explanatory variable was caregiver burden, assessed using the Zarit Inventory. Patient economic dissatisfaction ( F = 6.12, p = .04), patient depression ( F = 20.8, p < .001), and caregiver burden ( F = 7.36, p = .009) were found to be associated with lower patient QOL. Caregiver burden was independently associated with lower patient QOL after controlling for patient depression, disability, and economic dissatisfaction (standardized B coefficient = −0.28, p = .03). The level of caregiver burden was a significant correlate of QOL after stroke. Implications for future studies and practice are discussed.
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10885
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Involvement of PPAR-gamma in curcumin-mediated beneficial effects in experimental dementia. Naunyn Schmiedebergs Arch Pharmacol 2010; 381:529-39. [PMID: 20369229 DOI: 10.1007/s00210-010-0511-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2009] [Accepted: 03/06/2010] [Indexed: 12/24/2022]
Abstract
The present study was undertaken to investigate the possible mechanism of curcumin-mediated beneficial effects in memory deficits associated with experimental dementia. Dementia was induced in Swiss albino mice by administering streptozotocin (3 mg kg(-1)) intracerebroventricularly on first and third day. Morris water maze test was employed to assess learning and memory of the animals. Biochemical analysis of brain homogenate was performed to assess brain acetyl cholinesterase (AChE) activity and total oxidative stress. Streptozotocin (STZ) produced a significant decrease in water maze performance of mice indicative of impairment in spatial reference memory. Curcumin (20 mg/kg p.o. daily for 14 days) successfully attenuated STZ-induced memory deficits. Higher levels of brain AChE activity and oxidative stress were observed in STZ-treated animals, which were significantly attenuated by curcumin. Furthermore, the noted beneficial effect of curcumin on STZ-induced dementia was significantly abolished by pretreatment with PPAR-gamma receptor antagonist bisphenol-A-diglycidyl ether, i.e., BADGE (30 mg/kg intraperitoneally (i.p.)). It may be concluded that the beneficial effects of curcumin are mediated through the activation of PPAR-gamma receptors.
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10886
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Tavakoli M, Asghar O, Alam U, Petropoulos IN, Fadavi H, Malik RA. Novel insights on diagnosis, cause and treatment of diabetic neuropathy: focus on painful diabetic neuropathy. Ther Adv Endocrinol Metab 2010; 1:69-88. [PMID: 23148152 PMCID: PMC3475285 DOI: 10.1177/2042018810370954] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Diabetic neuropathy is common, under or misdiagnosed, and causes substantial morbidity with increased mortality. Defining and developing sensitive diagnostic tests for diabetic neuropathy is not only key to implementing earlier interventions but also to ensure that the most appropriate endpoints are employed in clinical intervention trials. This is critical as many potentially effective therapies may never progress to the clinic, not due to a lack of therapeutic effect, but because the endpoints were not sufficiently sensitive or robust to identify benefit. Apart from improving glycaemic control, there is no licensed treatment for diabetic neuropathy, however, a number of pathogenetic pathways remain under active study. Painful diabetic neuropathy is a cause of considerable morbidity and whilst many pharmacological and nonpharmacological interventions are currently used, only two are approved by the US Food and Drug Administration. We address the important issue of the 'placebo effect' and also consider potential new pharmacological therapies as well as nonpharmacological interventions in the treatment of painful diabetic neuropathy.
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Affiliation(s)
- Mitra Tavakoli
- Mitra Tavakoli, PhD Omar Asghar, MRCP Uazman Alam, MRCP Ioannis N. Petropoulos, MSc Hassan Fadavi, MD Division of Cardiovascular Medicine, University of Manchester, Manchester, M13 9NT, UK
| | - Omar Asghar
- Mitra Tavakoli, PhD Omar Asghar, MRCP Uazman Alam, MRCP Ioannis N. Petropoulos, MSc Hassan Fadavi, MD Division of Cardiovascular Medicine, University of Manchester, Manchester, M13 9NT, UK
| | - Uazman Alam
- Mitra Tavakoli, PhD Omar Asghar, MRCP Uazman Alam, MRCP Ioannis N. Petropoulos, MSc Hassan Fadavi, MD Division of Cardiovascular Medicine, University of Manchester, Manchester, M13 9NT, UK
| | - Ioannis N. Petropoulos
- Mitra Tavakoli, PhD Omar Asghar, MRCP Uazman Alam, MRCP Ioannis N. Petropoulos, MSc Hassan Fadavi, MD Division of Cardiovascular Medicine, University of Manchester, Manchester, M13 9NT, UK
| | - Hassan Fadavi
- Mitra Tavakoli, PhD Omar Asghar, MRCP Uazman Alam, MRCP Ioannis N. Petropoulos, MSc Hassan Fadavi, MD Division of Cardiovascular Medicine, University of Manchester, Manchester, M13 9NT, UK
| | - Rayaz A. Malik
- Mitra Tavakoli, PhD Omar Asghar, MRCP Uazman Alam, MRCP Ioannis N. Petropoulos, MSc Hassan Fadavi, MD Division of Cardiovascular Medicine, University of Manchester, Manchester, M13 9NT, UK
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10887
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Associations between sleep disturbance and primary headaches: the third Nord-Trøndelag Health Study. J Headache Pain 2010; 11:197-206. [PMID: 20224943 PMCID: PMC3451918 DOI: 10.1007/s10194-010-0201-8] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Accepted: 02/10/2010] [Indexed: 12/02/2022] Open
Abstract
The aim of the study was to evaluate the association between sleep disturbance and headache type and frequency, in a random sample of participants in the third Nord-Trøndelag Health Survey. The headache diagnoses were set by neurologists using the ICHD-2 criteria performing a semi structured face-to-face interview. Sleep problems were measured by the two validated instruments Karolinska Sleep Questionnaire (KSQ) and Epworth Sleepiness Scale (ESS). Among 297 participants, 77 subjects were headache-free, whereas 135 were diagnosed with tension-type headache (TTH), 51 with migraine, and 34 with other headache diagnoses. In the multivariate analyses, using logistic regression, excessive daytime sleepiness, defined as ESS ≥ 10, was three times more likely among migraineurs compared with headache-free individuals (OR = 3.3, 95% CI 1.0–10.2). Severe sleep disturbances, defined as KSQ score in the upper quartile, was five times more likely among migraineurs (OR = 5.4, 95% CI 2.0–15.5), and three times more likely for subjects with TTH (OR = 3.3, 1.4–7.3) compared with headache-free individuals. Subjects with chronic headache were 17 times more likely to have severe sleep disturbances (OR = 17.4, 95% CI 5.1–59.8), and the association was somewhat stronger for chronic migraine (OR = 38.9, 95% CI 3.1–485.3) than for chronic TTH (OR = 18.3, 95% CI 3.6–93.0). In conclusion, there was a significant association between severe sleep disturbances and primary headache disorders, most pronounced for those with chronic headache. Even though one cannot address causality in the present study design, the results indicate an increased awareness of sleep problems among patients with headache.
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10888
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Wilson AJ, Sayer RA, Edwards SG, Cartledge JD, Miller RF. A comparison of computed tomography and magnetic resonance brain imaging in HIV-positive patients with neurological symptoms. Int J STD AIDS 2010; 21:198-201. [DOI: 10.1258/ijsa.2009.009323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We reviewed our practice in order to determine the optimum neuroimaging strategy for HIV-infected patients with acute neurological presentations between April 2007 and August 2008. Overall magnetic resonance imaging (MRI) detected cranial abnormalities in more than twice as many patients as did computed tomography (CT) (74% and 32%, n = 54 and 38, respectively). Replacement of CT by first-line MRI for all patients would have required an additional 16 MRI scans, although at a saving of 38 CT scans. Our study highlights the importance of first-line MRI brain imaging in HIV patients with neurological symptoms and reinforces the need for early transfer of patients from centres that do not have rapid access to (or expert interpretation of) MRI scanning, to an appropriate HIV specialist centre.
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Affiliation(s)
- A J Wilson
- T8, University College London Hospitals, London NW1 8BU
- Centre for Sexual Health and HIV Research, University College London, London WC1E 6JB
| | - R A Sayer
- T8, University College London Hospitals, London NW1 8BU
- Mortimer Market Centre, Camden Provider Services PCT, London WC1E 6JB, UK
| | - S G Edwards
- T8, University College London Hospitals, London NW1 8BU
- Mortimer Market Centre, Camden Provider Services PCT, London WC1E 6JB, UK
| | - J D Cartledge
- T8, University College London Hospitals, London NW1 8BU
- Mortimer Market Centre, Camden Provider Services PCT, London WC1E 6JB, UK
| | - R F Miller
- T8, University College London Hospitals, London NW1 8BU
- Centre for Sexual Health and HIV Research, University College London, London WC1E 6JB
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10889
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Baghla DP, Shariff S, Dega R. Calcaneal osteomyelitis presenting with acute tarsal tunnel syndrome: a case report. J Med Case Rep 2010; 4:66. [PMID: 20178609 PMCID: PMC2838913 DOI: 10.1186/1752-1947-4-66] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2009] [Accepted: 02/23/2010] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Cases of acute tarsal tunnel syndrome are rare. To the best of our knowledge, we describe the only reported case of acute posterior tibial nerve compression resulting from adjacent haemotogenous pyogenic calcaneal osteomyelitis. CASE PRESENTATION A previously healthy 38-year-old Caucasian woman developed symptoms of acute tarsal tunnel syndrome in her right foot over a six-day period. No antecedent trauma or systemic symptoms were noted. Magnetic resonance imaging and bone scan imaging, followed by surgical decompression and bone biopsy confirmed a diagnosis of Staphylococcus aureus calcaneal osteomyelitis. Her pain and paraesthesia disappeared after the operation, while her inflammatory markers normalised during a 12-week course of antibiotics. After four years she has remained asymptomatic without any indication of recurrence. CONCLUSION This case is not just unique in describing osteomyelitis as a cause of tarsal tunnel syndrome, because haemotogenous calcaneal osteomyelitis is in itself a rare pathology. We recommend considering infection as a differential diagnosis in patients presenting with acute tarsal tunnel syndrome.
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10890
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Odermatt P, Lv S, Sayasone S. Less Common Parasitic Infections in Southeast Asia that can Produce Outbreaks. ADVANCES IN PARASITOLOGY 2010; 72:409-35. [DOI: 10.1016/s0065-308x(10)72013-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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10891
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Salpekar JA, Plioplys S, Siddarth P, Bursch B, Shaw RJ, Asato MR, LaFrance WC, Weisbrot DM, Dunn DW, Austin JK, Olson DM, Caplan R. Pediatric psychogenic nonepileptic seizures: a study of assessment tools. Epilepsy Behav 2010; 17:50-5. [PMID: 19948427 DOI: 10.1016/j.yebeh.2009.10.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2009] [Revised: 09/29/2009] [Accepted: 10/02/2009] [Indexed: 11/28/2022]
Abstract
The goal of this study was to identify assessment tools and associated behavioral domains that differentiate children with psychogenic nonepileptic seizures (PNES) from those with epilepsy. A sample of 24 children with PNES (mean age 14.0 years, 14 female), 24 children with epilepsy (mean age 13.6 years, 13 female), and their parents were recruited from five epilepsy centers in the United States. Participants completed a battery of behavioral questionnaires including somatization, anxiety, and functional disability symptoms. Children with PNES had significantly higher scores on the Childhood Somatization and Functional Disability Inventories, and their parents reported more somatic problems on the Child Behavior Checklist (CBCL). Depression, anxiety, and alexithymia instruments did not differentiate the groups. Measures of somatization and functional disability may be promising tools for differentiating the behavioral profile of PNES from that of epilepsy. Increased somatic awareness and perceived disability emphasize the similarity of PNES to other pediatric somatoform disorders.
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Affiliation(s)
- Jay A Salpekar
- Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, George Washington University School of Medicine, Washington, DC 20010, USA.
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10892
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Saini M, Khurana D. Author's reply. Ann Indian Acad Neurol 2010. [PMCID: PMC2924520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Monica Saini
- Department of Neurology, PGIMER, Chandigarh, India,For correspondence: Dr. Monica Saini, Department of Neurology, PGIMER, Chandigarh, India. E-mail:
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10893
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Tuberculosis in the head and neck — a forgotten differential diagnosis. Clin Radiol 2010; 65:73-81. [DOI: 10.1016/j.crad.2009.09.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2009] [Revised: 08/24/2009] [Accepted: 09/13/2009] [Indexed: 11/18/2022]
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10894
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Abstract
Depression as a disorder has always been a focus of attention of researchers in India. Over the last 50-60 years, large number of studies has been published from India addressing various aspects of this commonly prevalent disorder. The various aspects studied included epidemiology, demographic and psychosocial risk factor, neurobiology, symptomatology, comorbidity, assessment and diagnosis, impact of depression, treatment related issues and prevention of depression in addition to the efficacy and tolerability of various antidepressants. Here, we review data on various aspects of depression, originating from India.
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Affiliation(s)
- Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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10895
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Screening for inborn errors of metabolism using automated electrospray tandem mass spectrometry: study in high-risk Indian population. Clin Biochem 2009; 43:581-8. [PMID: 20026021 DOI: 10.1016/j.clinbiochem.2009.12.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 11/26/2009] [Accepted: 12/08/2009] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Tandem mass spectrometry is a major technological advance in the screening for inborn errors of metabolism. It has the advantage of sensitive and simultaneous multiple disease screening with minimal sample requirement. The diseases detected include aminoacidemias, fatty acid oxidation disorders, and organic acidemias. DESIGN AND METHODS Using automated electrospray tandem mass spectrometry we screened 3550, clinically selected, symptomatic children for inborn errors of metabolism by analyzing amino acids and acylcarnitines in dried blood filter-paper samples. RESULTS Among these, 113 (3.2%) children were identified with a metabolic disorder: 61 (54%) patients had amino acid disorders, 47 (41.6%) had organic acidemias, and 5 (4.4%) children had disorders of fatty acid oxidation. The diagnoses were further confirmed through clinical symptoms, and other biochemical studies. CONCLUSIONS These results show that inherited metabolic disorders are not rare in India, a rapidly developing country with a high birth rate and relatively frequent occurrence of consanguineous marriages.
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10896
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Arhan E, Ayçiçek S, Akaln N, Güven A, Köse G. Cardiac effects of carbamazepine treatment in childhood epilepsy. Neurologist 2009; 15:268-73. [PMID: 19741433 DOI: 10.1097/nrl.0b013e31818600a4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Hypotension, bradycardia, and atrioventricular block are well-known cardiovascular effects of carbamazepine (CBZ). However, direct effects of CBZ on ventricular functions have been rarely encountered. We investigated the effect of CBZ on ventricular functions in pediatric patients without previous cardiac disease to determine whether CBZ causes ventricular dysfunction or electrocardiographic changes in therapeutic doses in children. METHODS The study includes 40 patients (31 boys, 9 girls) with epilepsy who had been treated with carbamazepine. Electroencephalography, electrocardiography, echocardiography, and cranial imaging were performed on all patients before treatment and were repeated at the end of the third and 12th months of treatment. The systolic and diastolic thickness of the interventricular septum and the posterior wall of the left ventricle and the systolic and diastolic diameter of the left ventricle were measured during M-mode investigation. The end-systolic and end-diastolic volumes (mL), the stroke volume (mL), fractional shortening (FS), (%) and ejection fraction (EF) (%) measurements were obtained from the computer on the echocardiography device. RESULTS In 1-year follow-up, no electrocardiographic abnormalities were detected. The FS and EF values showing left ventricular function did not show a significant difference (P > 0.05). CONCLUSIONS CBZ seems to be a safe drug in pediatric epileptic patients without any preexisting cardiac disease. We suggest that the risk factors should be defined and followed-up regarding cardiac function when treatment is initiated in groups with risk factors.
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Affiliation(s)
- Ebru Arhan
- Department of Pediatrics, Ankara Dişkapi Children's Hospital, Ankara, Turkey.
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10897
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Lv S, Zhang Y, Chen SR, Wang LB, Fang W, Chen F, Jiang JY, Li YL, Du ZW, Zhou XN. Human angiostrongyliasis outbreak in Dali, China. PLoS Negl Trop Dis 2009; 3:e520. [PMID: 19771154 PMCID: PMC2739427 DOI: 10.1371/journal.pntd.0000520] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Accepted: 08/24/2009] [Indexed: 11/18/2022] Open
Abstract
Background Several angiostrongyliasis outbreaks have been reported in recent years but the disease continues to be neglected in public health circles. We describe an outbreak in Dali, southwest China in order to highlight some key problems for the control of this helminth infection. Methodology/Principal Findings All available medical records of suspected angiostrongyliasis patients visiting hospitals in Dali in the period 1 October 2007–31 March 2008 were reviewed, and tentative diagnoses of varying strengths were reached according to given sets of criteria. Snails collected from local markets, restaurants and natural habitats were also screened for the presence of Angiostrongylus cantonensis. A total of 33 patients met criteria for infection, and 11 among them were classified as clinically confirmed. An additional eight patients were identified through a surveillance system put in operation in response to the outbreak. The epidemic lasted for 8 months with its peak in February 2008. Of the 33 patients, 97.0% complained of severe headache. 84.8% patients had high eosinophil cell counts either in the peripheral blood or in cerebrospinal fluid (CSF). Three-quarters of the patients were treated with a combination of albendazole and corticosteroids, resulting in significantly improved overall conditions. Twenty-two patients reported the consumption of raw or undercooked snails prior to the onset of the symptoms, and approximately 1.0% of the Pomacea canaliculata snails on sale were found to be infected with A. cantonensis. The snails were also found in certain habitats around Dali but no parasites were detected in these populations. Conclusions/Significance The import and sale of infected P. canaliculata is the likely trigger for this angiostrongyliasis outbreak. Awareness of angiostrongyliasis must be raised, and standardized diagnosis and treatment are needed in order to provide clinicians with a guide to address this disease. Health education campaigns could limit the risk, and a hospital-based surveillance system should be established in order to detect future outbreaks. Angiostrongyliasis, caused by the rat lungworm Angiostrongylus cantonensis, is a potentially fatal food-borne disease. It is endemic in parts of Southeast Asia, the Pacific Islands, Australia, and the Caribbean. Outbreaks have become increasingly common in China due to the spread of efficient intermediate host snails, most notably Pomacea canaliculata. However, infections are difficult to detect since the disease has a rather long incubation period and few diagnostic clinical symptoms. Reliable diagnostic tests are not widely available. The described angiostrongyliasis epidemic in Dali, China lasted for eight months. Only 11 of a total of 33 suspected patients were clinically confirmed based on a set of diagnostic criteria. Our results demonstrate that the rapid and correct diagnosis of the index patient is crucial to adequately respond to an epidemic, and a set of standardized diagnostic procedures is needed to guide clinicians. Integrated control and management measures including health education, clinical guidelines and a hospital-based surveillance system, should be implemented in areas where snails are a popular food item.
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Affiliation(s)
- Shan Lv
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Yi Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Shao-Rong Chen
- Institute of Research and Control of Schistosomiasis in Dali Prefecture, Dali, People's Republic of China
| | - Li-Bo Wang
- Yunnan Institute of Parasitic Diseases, Puer, People's Republic of China
| | - Wen Fang
- Institute of Research and Control of Schistosomiasis in Dali Prefecture, Dali, People's Republic of China
| | - Feng Chen
- Institute of Research and Control of Schistosomiasis in Dali Prefecture, Dali, People's Republic of China
| | - Jin-Yong Jiang
- Yunnan Institute of Parasitic Diseases, Puer, People's Republic of China
| | - Yuan-Lin Li
- Institute of Research and Control of Schistosomiasis in Dali Prefecture, Dali, People's Republic of China
| | - Zun-Wei Du
- Yunnan Institute of Parasitic Diseases, Puer, People's Republic of China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
- * E-mail:
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10898
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Affiliation(s)
- R Lane
- Charing Cross Hospital,
Imperial College, London and
| | - P Davies
- John Radcliffe Hospital,
University of Oxford, Oxford, UK
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10899
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Guerri-Guttenberg RA, Ingolotti M. Classifying musculocutaneous nerve variations. Clin Anat 2009; 22:671-83. [DOI: 10.1002/ca.20828] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Prakash R. Author's reply. Indian J Psychiatry 2009; 51:159-60. [PMID: 19823641 PMCID: PMC2755155 DOI: 10.4103/0019-5545.49462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ravi Prakash
- Department of Psychiatry, Central Institute of Psychaitry, Ranchi, India. E-mail:
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