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Lin H, Wang X, Feng Y, Liu X, Liu L, Zhu K, Shen J, Zhang P, Yu J, Yang T. Acupuncture Versus Oral Medications for Acute/ Subacute Non-Specific Low Back Pain: A Systematic Review and Meta-Analysis. Curr Pain Headache Rep 2024:10.1007/s11916-023-01201-7. [PMID: 38190024 DOI: 10.1007/s11916-023-01201-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 01/09/2024]
Abstract
PURPOSE OF REVIEW Pharmacologic intervention do not always achieve benefits in the treatment of acute/subacute non-specific low back pain (NSLBP). We assessed efficacy and safety of acupuncture for acute/subacute NSLBP as alternative treatment. RECENT FINDINGS We searched PubMed, Web of Science, Embase, Cochrane Library, Scopus, Epistemonikos, CNKI, Wan Fang Database, VIP database, CBMLD, CSTJ, clinical trials, EUCTR, World WHO ICTRP, and ChiCTR for randomized controlled trials, cross-over studies, and cohort studies of NSLBP treated by acupuncture versus oral medication from inception to 23th April 2022. A total of 6 784 records were identified, and 14 studies were included 1 263 participants in this review. The results of the meta-analysis indicated that acupuncture therapy was slightly more effective than oral medication in improving pain (P < 0.00001, I2 = 92%, MD = -1.17, 95% CI [-1.61, -0.72]). According to the results of the meta-analysis, acupuncture therapy exhibited a significant advantage over oral medication with a substantial effect (P < 0.00001, I2 = 90%, SMD = -1.42, 95% CI [-2.22, -0.62]). Based on the results of the meta-analysis, acupuncture therapy was associated with a 12% improvement rate compared to oral medication in patients with acute/subacute NSLBP (P < 0.0001, I2 = 54%, RR = 1.11, 95% CI [1.05, 1.18]). Acupuncture is more effective and safer than oral medication in treating acute/subacute NSLBP. This systematic review is poised to offer valuable guidance to clinicians treating acute/subacute NSLBP and potentially benefit the afflicted patients. REGISTRATION This review was registered in PROSPERO ( http://www.crd.york.ac.uk/prospero ) with registration number CRD42021278346.
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Affiliation(s)
- Huize Lin
- Department of Acupuncture-Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Xiang Wang
- Department of Acupuncture-Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Yixuan Feng
- Department of Acupuncture-Moxibustion, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Xiaoxu Liu
- Department of Acupuncture-Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Lanping Liu
- Department of Acupuncture-Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Kexin Zhu
- Department of Acupuncture-Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Jianghong Shen
- Department of Acupuncture-Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Pingping Zhang
- Department of Acupuncture-Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Jinna Yu
- Department of Acupuncture-Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| | - Tao Yang
- Department of Acupuncture-Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
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Lee J, Seo GH, Song K. Beyond Acute COVID-19: Investigating the Incidence of Subacute Thyroiditis in Long COVID-19 in Korea. Endocrinol Metab (Seoul) 2023; 38:455-461. [PMID: 37550861 PMCID: PMC10475963 DOI: 10.3803/enm.2023.1711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/19/2023] [Accepted: 07/10/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGRUOUND The correlation between acute coronavirus disease 2019 (COVID-19) and subacute thyroiditis (SAT) has not been clearly investigated in "long COVID" patients. We aimed to investigate the incidence of SAT during convalescence and after the acute phase of COVID-19, comparing with that of the general population. METHODS Data from a total of 422,779 COVID-19 patients and a control group of 2,113,895 individuals were analyzed. The index date was defined as the date 3 months after confirmation of COVID-19. The incidence rate (IR) of SAT and hazard ratios (HRs) were calculated per 100,000 persons. Subgroup analysis included analysis of HRs 90-179 and 180 days post-COVID-19 diagnosis; and additional analysis was conducted according to hospitalization status, sex, and age group. RESULTS The IR of SAT was 17.28 per 100,000 persons (95% confidence interval [CI], 12.56 to 23.20) in the COVID-19 group and 8.63 (95% CI, 6.37 to 11.45) in the control group. The HR of COVID-19 patients was 1.76 (95% CI, 1.01 to 3.06; P=0.045). The HR of SAT was 1.39 (95% CI, 0.82 to 2.34; P=0.220) up to 6 months after the index date and 2.30 (95% CI, 1.60 to 3.30; P<0.001) beyond 6 months. The HR for SAT among COVID-19 patients was 2.00 (95% CI, 1.41 to 2.83) in hospitalized patients and 1.76 (95% CI, 1.01 to 3.06) in non-hospitalized patients compared to the control group. The IR of SAT was 27.09 (95% CI, 20.04 to 35.82) for females and 6.47 (95% CI, 3.34 to 11.30) for males. In the 19 to 64 age group, the IR of SAT was 18.19 (95% CI, 13.70 to 23.67), while the IR was 9.18 (95% CI, 7.72 to 10.84) in the 65 to 69 age group. CONCLUSION SAT could be a potential long-term complication of COVID-19. Long-term surveillance for thyroid dysfunction is needed especially in hospitalized, female and young-aged subjects.
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Affiliation(s)
- Jeongmin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Gi Hyeon Seo
- Health Insurance Review and Assessment Service, Wonju, Korea
| | - Keeho Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea
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Vazquez O, De Marco G, Gavira N, Habre C, Bartucz M, Steiger CN, Dayer R, Ceroni D. Subacute osteomyelitis due to Staphylococcus caprae in a teenager: A case report and review of the literature. World J Clin Cases 2023; 11:4893-4898. [DOI: 10.12998/wjcc.v11.i20.4893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/11/2023] [Accepted: 05/15/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Staphylococcus caprae (S. caprae) is a human commensal bacterium which can be detected in the nose, nails, and skin. It can be responsible for heterogeneous infections such as bacteremia, endocarditis, pneumonia, acute otitis externa, peritonitis, and urinary tract infections. Bone and joint infections due to S. caprae have also been reported, but most of them resulted from the infection of orthopedic devices, especially joint prostheses and internal osteosynthesis devices. Rare cases of primary osteoarticular infections caused by S. caprae have been described, including osteitis, arthritis, or spondylodiscitis.
CASE SUMMARY We report an unusual case of subacute osteomyelitis in a toe phalanx caused by S. caprae in a 14.5-year-old girl.
CONCLUSION Subacute S. caprae osteomyelitis is a little-known and probably underestimated community-acquired infectious disease. This microorganism’s pathogenicity should be seen as more than a classic nosocomial orthopedic device infection.
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Affiliation(s)
- Oscar Vazquez
- Paediatric Orthopaedics Unit, Geneva Children’s Hospital, Geneva University Hospitals, Geneva 1211, Switzerland
| | - Giacomo De Marco
- Paediatric Orthopaedics Unit, Geneva Children’s Hospital, Geneva University Hospitals, Geneva 1211, Switzerland
| | - Nathaly Gavira
- Paediatric Orthopaedics Unit, Geneva Children’s Hospital, Geneva University Hospitals, Geneva 1211, Switzerland
| | - Celine Habre
- Paediatric Radiology Unit, Geneva Children’s Hospital, Geneva University Hospitals, Geneva 1211, Switzerland
| | - Marcia Bartucz
- Paediatric Orthopaedics Unit, Geneva Children’s Hospital, Geneva University Hospitals, Geneva 1211, Switzerland
| | - Christina N Steiger
- Paediatric Orthopaedics Unit, Geneva Children’s Hospital, Geneva University Hospitals, Geneva 1211, Switzerland
| | - Romain Dayer
- Paediatric Orthopaedics Unit, Geneva Children’s Hospital, Geneva University Hospitals, Geneva 1211, Switzerland
| | - Dimitri Ceroni
- Paediatric Orthopaedics Unit, Geneva Children’s Hospital, Geneva University Hospitals, Geneva 1211, Switzerland
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Vazquez O, De Marco G, Gavira N, Habre C, Bartucz M, Steiger CN, Dayer R, Ceroni D. Subacute osteomyelitis due to Staphylococcus caprae in a teenager: A case report and review of the literature. World J Clin Cases 2023; 11:4897-4902. [PMID: 37583987 PMCID: PMC10424045 DOI: 10.12998/wjcc.v11.i20.4897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/11/2023] [Accepted: 05/15/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Staphylococcus caprae (S. caprae) is a human commensal bacterium which can be detected in the nose, nails, and skin. It can be responsible for heterogeneous infections such as bacteremia, endocarditis, pneumonia, acute otitis externa, peritonitis, and urinary tract infections. Bone and joint infections due to S. caprae have also been reported, but most of them resulted from the infection of orthopedic devices, especially joint prostheses and internal osteosynthesis devices. Rare cases of primary osteoarticular infections caused by S. caprae have been described, including osteitis, arthritis, or spondylodiscitis. CASE SUMMARY We report an unusual case of subacute osteomyelitis in a toe phalanx caused by S. caprae in a 14.5-year-old girl. CONCLUSION Subacute S. caprae osteomyelitis is a little-known and probably underestimated community-acquired infectious disease. This microorganism's pathogenicity should be seen as more than a classic nosocomial orthopedic device infection.
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Affiliation(s)
- Oscar Vazquez
- Paediatric Orthopaedics Unit, Geneva Children’s Hospital, Geneva University Hospitals, Geneva 1211, Switzerland
| | - Giacomo De Marco
- Paediatric Orthopaedics Unit, Geneva Children’s Hospital, Geneva University Hospitals, Geneva 1211, Switzerland
| | - Nathaly Gavira
- Paediatric Orthopaedics Unit, Geneva Children’s Hospital, Geneva University Hospitals, Geneva 1211, Switzerland
| | - Celine Habre
- Paediatric Radiology Unit, Geneva Children’s Hospital, Geneva University Hospitals, Geneva 1211, Switzerland
| | - Marcia Bartucz
- Paediatric Orthopaedics Unit, Geneva Children’s Hospital, Geneva University Hospitals, Geneva 1211, Switzerland
| | - Christina N Steiger
- Paediatric Orthopaedics Unit, Geneva Children’s Hospital, Geneva University Hospitals, Geneva 1211, Switzerland
| | - Romain Dayer
- Paediatric Orthopaedics Unit, Geneva Children’s Hospital, Geneva University Hospitals, Geneva 1211, Switzerland
| | - Dimitri Ceroni
- Paediatric Orthopaedics Unit, Geneva Children’s Hospital, Geneva University Hospitals, Geneva 1211, Switzerland
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Kurisu K, Hokari M, Uchida K, Asaoka K, Ajiki M, Takada T, Itamoto K, Fujimura M. Treatment of aneurysmal subarachnoid hemorrhage in subacute phase; retrospective comparison of treatment in sub- and hyper-acute phases. Clin Neurol Neurosurg 2023; 230:107781. [PMID: 37244196 DOI: 10.1016/j.clineuro.2023.107781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE As soon as possible treatment initiation for aneurysmal subarachnoid hemorrhage (aSAH) is recommended. However, some patients require treatment in "subacute" phase of aSAH, defined in this study as "more than one day after the onset". To establish an optimal treatment strategy for these patients, we retrospectively analyzed the clinical experience of treating ruptured aneurysm with either clipping or coiling in subacute phase. METHODS Patients treated for aSAH between 2015 and 2021were analyzed. Patients were divided into the hyperacute phase (within 24 h) and subacute phase (later than 24 h) groups. The subacute group was analyzed to determine whether the selected procedure and its timing affected postoperative course and clinical outcomes. In addition, we conducted a multivariate logistic regression analysis to determine the independent factors that affect clinical outcomes. RESULTS Of 215 patients, 31 were treated in the subacute phase. While cerebral vasospasm at initial imaging was more frequently observed in subacute group, there was no difference in incidence of postoperative vasospasms. Patients in subacute group seemed to have better clinical outcomes due to the milder severity at the time of treatment initiation. Risk of angiographic vasospasm seemed to be higher in patients treated with clipping than coiling, while no difference was seen in clinical outcomes. Multivariate logistic regression analysis showed that the timing and selected treatment did not significantly affect the clinical outcome or the occurrence of delayed vasospasm. CONCLUSIONS Treatment of aSAH in the subacute phase may also result in favorable clinical outcomes, similar to patients treated in the hyperacute phase with mild presentation. However, further investigations are required to establish the optimal treatment strategies for such patients.
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Affiliation(s)
- Kota Kurisu
- Department of Neurosurgery, Teine Keijinkai Hospital, Maeda 1-12-1-40, Teine-ku, Sapporo, Hokkaido 006-8111, Japan.
| | - Masaaki Hokari
- Department of Neurosurgery, Teine Keijinkai Hospital, Maeda 1-12-1-40, Teine-ku, Sapporo, Hokkaido 006-8111, Japan
| | - Kazuki Uchida
- Department of Neurosurgery, Teine Keijinkai Hospital, Maeda 1-12-1-40, Teine-ku, Sapporo, Hokkaido 006-8111, Japan
| | - Katsuyuki Asaoka
- Department of Neurosurgery, Teine Keijinkai Hospital, Maeda 1-12-1-40, Teine-ku, Sapporo, Hokkaido 006-8111, Japan
| | - Minoru Ajiki
- Department of Cerebrovascular Medicine, Teine Keijinkai Hospital, Maeda 1-12-1-40, Teine-ku, Sapporo, Hokkaido 006-8111, Japan
| | - Tatsuro Takada
- Department of Cerebrovascular Medicine, Teine Keijinkai Hospital, Maeda 1-12-1-40, Teine-ku, Sapporo, Hokkaido 006-8111, Japan
| | - Koji Itamoto
- Department of Neurosurgery, Teine Keijinkai Hospital, Maeda 1-12-1-40, Teine-ku, Sapporo, Hokkaido 006-8111, Japan
| | - Miki Fujimura
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
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Ikeda N, Morishita K, Tamura A. Transcutaneous electrical nerve stimulation effects on patients with subacute vertebral fracture: a case report using an ABAB study design. J Phys Ther Sci 2023; 35:151-155. [PMID: 36744199 PMCID: PMC9889216 DOI: 10.1589/jpts.35.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/09/2022] [Indexed: 02/04/2023] Open
Abstract
[Purpose] This study investigated the effects of transcutaneous electrical nerve stimulation on trunk extension muscle strength, walking ability, and the Japanese Orthopedic Association Back Pain Evaluation Questionnaire items of gait disturbance in one case of a subacute osteoporotic vertebral fracture. [Participant and Methods] An 88-year-old female with the first and third lumbar vertebral fractures underwent standard physical therapy (A1 and A2 phases) and transcutaneous electrical nerve stimulation to the sclerotome region of the fractured vertebra (B1 and B2 phases). Assessments were performed before the A1 phase and the day after each phase. Assessment items included the Visual Analog Scale scores for pain during rest, getting up, standing up, and walking; isometric trunk extension muscle strength; walking ability (10-meter walking, continuous walking distance); and the Japanese Orthopedic Association Back Pain Evaluation Questionnaire items. [Results] Even though the pain intensity did not change, isometric trunk extension muscle strength, continuous walking distance, and the Japanese Orthopedic Association Back Pain Evaluation Questionnaire items of gait disturbance were improved in phase B compared to phase A. [Conclusion] Standard physical therapy and transcutaneous electrical nerve stimulation to the sclerotome area may improve trunk extension muscle strength, walking ability, and the Japanese Orthopedic Association Back Pain Evaluation Questionnaire items of gait disturbance in patients with subacute osteoporotic vertebral fractures.
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Affiliation(s)
- Naoto Ikeda
- Department of Rehabilitation, Rakusai Shimizu Hospital:
13-107 Oekutsukake-cho, Nishikyo-ku, Kyoto-shi, Kyoto 610-1106, Japan, Present affiliation: Department of Rehabilitation,
Shiraishi Clinic Orthopedics & Internal Medicine & Gastrointestinal Medicine:
1-13-14 Akutagaw-cho, Takatsuki-shi, Osaka 569-1123, Japan,Corresponding author. Naoto Ikeda (E-mail: )
| | - Katsuyuki Morishita
- Department of Physical Therapy, Faculty of Social Work
Studies, Josai International University, Japan, Department of Rehabilitation, Rakusai Shimizu Hospital,
Japan
| | - Atsushi Tamura
- Department of Rehabilitation, Rakusai Shimizu Hospital,
Japan
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Zhao J, Sun H, Zhu H, Chang Q, Wang J. Optic nerve lesion length is a biomarker of visual disability in the pre-chronic phase of Leber's hereditary optic neuropathy. Clin Neurol Neurosurg 2022; 224:107542. [PMID: 36459841 DOI: 10.1016/j.clineuro.2022.107542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The current research aims to investigate relationships between the optic nerve (ON) lesion length with visual function in the pre-chronic phase ( illness duration < 12 months) of LHON. METHODS Orbital MRI was retrospectively analyzed for 45 patients with LHON in the pre-chronic phase. ON lesion length was measured by 2 trained independent readers and it was recorded as multiplication of the number of abnormal MRI slices and slice thickness on T2-STIR sequence in the coronal plane. Decimal visual acuity was converted to the logarithm of minimum angle of resolution. Intra-class correlation coefficients (ICCs) were used to assess intra- and inter-observer agreements. Pearson's correlation analysis and multivariate linear regression models were performed to analyze the correlations of the lesion length with best corrected visual acuity (BCVA) and visual field parameters. RESULTS 81 afflicted eyes were selected. The ICCs for intra-observer and inter-observer analyses were 0.989 and 0.980 respectively. Both Pearson's correlation analysis and multivariate linear regression models indicated a significant positive correlation between the BCVA or mean deviation (MD) and ON lesion length (rBCVA=0.368, PBCVA=0.001; rMD=-0.269, PMD=0.045) with a coefficient of determination (R2) of 0.152 and 0.114 respectively adjusted for patients' sex, age of onset, onset of vision loss to performance of MRI, mitochondrial DNA mutations. CONCLUSION ON length with T2-STIR hyperintensities was positively associated with both BCVA and MD, and it was suspected to be a biomarker of visual disability in the pre-chronic phase of LHON.
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Affiliation(s)
- Juan Zhao
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China
| | - Houliang Sun
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China
| | - Hongyu Zhu
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China
| | - Qinglin Chang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China
| | - Jiawei Wang
- Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China.
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Maldonado TS, Dexter DJ, Kado H, Schor J, Annambhotla S, Mojibian H, Beasley RE. Outcomes from the ClotTriever Outcomes Registry show symptom duration may underestimate deep vein thrombus chronicity. J Vasc Surg Venous Lymphat Disord 2022; 10:1251-1259. [PMID: 35714903 DOI: 10.1016/j.jvsv.2022.04.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/04/2022] [Accepted: 04/19/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The all-comer ClotTriever Outcomes registry assessed indicators of thrombus chronicity in patients with acute, subacute, and chronic lower extremity deep vein thrombosis (DVT). The effectiveness of the ClotTriever System (Inari Medical, Irvine, CA) by chronicity subgroup was also assessed and reported here in this subanalysis. METHODS All-comer patients with lower extremity DVT were enrolled, with no limitation based on the patients' symptom duration. Chronicity was assessed three times and compared: before the procedure based on symptom duration, during the procedure based on available pre-thrombectomy imaging, and visual inspection of the extracted thrombus morphology after thrombectomy. Patients were grouped into acute, subacute, and chronic subgroups according to their post-thrombectomy thrombus chronicity based on thrombus morphology. Analyses on baseline and procedural characteristics along with thrombus removal were performed across subgroups. The effectiveness of thrombus removal was determined by Marder scores adjudicated by an independent core laboratory, with a prespecified primary effectiveness end point of complete or near-complete (≥75%) thrombus removal. RESULTS Of the 260 treated limbs from 250 patients, using symptom duration alone, 70.7% were considered acute, 20.9% subacute, and 8.4% chronic. Upon visual inspection, the extracted thrombus chronicity was approximately one-third in each subgroup: 32.7% had acute thrombus, 35.4% subacute thrombus, and 31.9% chronic thrombus. Chronicity assessed using symptom duration alone mismatched the post-thrombectomy chronicity in 55.1% of limbs (P < .0001) with 49.0% being more chronic than suggested by the patients' duration of symptoms. Chronicity assessed using pre-thrombectomy imaging mismatched the post-thrombectomy chronicity in 17.5% of limbs (P < .0001). No patients received thrombolytics and 99.6% were treated in a single session. Complete or near-complete thrombus removal was achieved in a high percentage of limbs regardless of thrombus chronicity: 90.8%, 81.9%, and 83.8% in limbs with acute, subacute, and chronic thrombus, respectively. CONCLUSIONS This subanalysis from the all-comer ClotTriever Outcomes registry demonstrates that extracted thrombus in DVT may be more chronic than suggested by the patients' duration of symptoms. The addition of imaging is helpful to determine the ability of thrombus to respond to therapy. Irrespective of thrombus chronicity, the ClotTriever system can be effective at removing acute, subacute, and chronic thrombus in a single-session procedure without the need for thrombolytics.
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Affiliation(s)
| | | | - Herman Kado
- Ascension Providence Hospital, Southfield, MI; William Beaumont Hospital, Royal Oak, MI
| | - Jonathan Schor
- Northwell Health, Staten Island University Hospital, Staten Island, NY
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Prideaux N, Barr C, Drummond C, van den Berg M. Towards a Clinical Decision-Making Algorithm Guiding Locomotor Therapy Modality in Subacute Stroke: An Exploratory Study. J Stroke Cerebrovasc Dis 2021; 30:106112. [PMID: 34601241 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/25/2021] [Accepted: 09/06/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To propose a clinical decision-making algorithm guiding modality choice and transition from the Lokomat® robotic to body-weight supported treadmill training in subacute stroke, due to current evidence being limited, making clinical decisions difficult. MATERIALS AND METHODS For 10 adult patients with subacute stroke completing Lokomat® therapy, physiotherapist clinical judgement regarding body-weight supported treadmill training readiness and the following objective measurements were collected; Functional Ambulation Category; sit to stand/standing ability; Lokomat® settings; maximal active hip and knee flexion in standing; and gait biomechanics during body-weight supported treadmill training. Based on observed patterns a proposed clinical decision-making algorithm was developed. RESULTS Clinical judgement deemed four of 10 participants ready to transition to body-weight supported treadmill training. Unlike participants judged not ready, these participants had: a) a Functional Ambulation Category of 1; b) independence with sit to stand and standing with even weight bearing; c) Lokomat®: Body-Weight Support <30%, Guidance Force <30-35%, speed >2.0kph; d) >45° standing active hip and knee flexion; e) no significant issues with physiological stepping in treadmill training or only requiring assistance from one therapist to achieve this. CONCLUSION Participants judged ready for transition from the Lokomat® to body-weight supported treadmill training presented with increased independent functional ability, more challenging Lokomat® settings, greater active volitional lower-limb control, and less issues with physiological stepping in treadmill training, than those participants judged not ready. Results were translated into a proposed clinical decision-making algorithm guiding transition from the Lokomat® to body-weight supported treadmill training, to be further tested in clinical trials.
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Affiliation(s)
- Nicole Prideaux
- Bachelor of Applied Science Physiotherapy (honours), Master Clinical Rehabilitation, Physiotherapist, Rehabilitation, Aged Care, and Palliative Division, Southern Adelaide Local Health Network: c/o Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia, 5042, Australia.
| | - Christopher Barr
- Bachelor Physiology, Sports Science and Nutrition (honours), Masters Research Bioengineering, PhD Bioengineering, College of Nursing and Health Sciences, Flinders University: GPO Box 2100, Adelaide 5001, South Australia, Australia.
| | - Claire Drummond
- Bachelor of Applied Science (Exercise and Sports Science), Human Movement (honours), PhD Health Sciences, College of Nursing and Health Sciences, Flinders University; GPO Box 2100, Adelaide 5001, South Australia, Australia.
| | - Maayken van den Berg
- Bachelor of Physiotherapy, Master of Movement Sciences, PhD Rehabilitation Sciences, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide 5001, South Australia, Australia.
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Christensen SWM, Rasmussen MB, Jespersen CL, Sterling M, Skou ST. Soft-collar use in rehabilitation of whiplash-associated disorders - A systematic review and meta-analysis. Musculoskelet Sci Pract 2021; 55:102426. [PMID: 34271416 DOI: 10.1016/j.msksp.2021.102426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 06/22/2021] [Accepted: 07/05/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Active rehabilitation of Whiplash Associated Disorders (WAD) is favoured over passive modalities such as soft-collars. However, the effectiveness of soft-collar use remains unclear. OBJECTIVE To investigate the effectiveness of soft-collar use on pain and disability in WAD. DESIGN Systematic review. METHOD Databases (AMED, CINAHL Complete, Cochrane Library, Embase, Medline, PEDro, PsycINFO, PubMed, SPORTDiscus) were searched for guidelines, reviews and RCTs on soft-collar use as part of WAD treatment. Reference lists of reviews and guidelines were screened for additional RCTs. Study quality was rated using the PEDro-scale and overall quality of evidence with GRADE. RESULTS Four RCTs (n = 409) of fair-good quality (PEDro-scores) were included with three using a soft collar in addition to other conservative treatment while one study compared soft-collar use to act-as-usual. All studies found that an active or act-as-usual approach was more effective in reducing pain intensity compared to soft-collar use, confirmed by meta-analysis (two RCTs with data: SMD of -0.80 (-1.20, -0.41)). No studies reported disability outcomes while contrasting results were found between groups regarding total cervical range of motion (two RCTs with data: SMD of 0.16 (-0.21, 0.54)) or rotation (two RCTs with data: SMD of 0.54 (-0.19, 1.27)). Overall quality of the evidence was low to very low. CONCLUSION All four RCTs favoured an active approach/act-as-usual over soft-collar treatment. However, due to methodological concerns and low certainty of evidence, future studies investigating soft collar use in combination with an active rehabilitation strategy for acute/subacute WAD are needed.
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Affiliation(s)
- Steffan Wittrup McPhee Christensen
- Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7D-3, 9220, Aalborg, Denmark; Department of Physiotherapy, University College of Northern Denmark (UCN), Selma Lagerløfs Vej 2, 9220, Aalborg, Denmark.
| | - Michael Bo Rasmussen
- Department of Physiotherapy, University College of Northern Denmark (UCN), Selma Lagerløfs Vej 2, 9220, Aalborg, Denmark
| | - Christoffer Lund Jespersen
- Department of Physiotherapy, University College of Northern Denmark (UCN), Selma Lagerløfs Vej 2, 9220, Aalborg, Denmark
| | - Michele Sterling
- RECOVER Injury Research Centre, Faculty of Health and Behavioural Sciences, University of Queensland, 288 Herston Road, Herston, QLD, 4006, Australia
| | - Søren Thorgaard Skou
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230, Odense, Denmark; Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, 4200, Slagelse, Denmark
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11
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Funayama K, Harada K, Koyama A, Katsuragi-Go R, Nishikawa-Harada N, Higuchi R, Aoyama T, Watanabe H, Takahashi N, Takatsuka H. The usefulness of postmortem computed tomography angiography for subdural hematoma caused by rupture of the cortical artery: A report of two autopsy cases and a literature review. Leg Med (Tokyo) 2021; 53:101941. [PMID: 34293697 DOI: 10.1016/j.legalmed.2021.101941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/02/2021] [Accepted: 07/08/2021] [Indexed: 11/23/2022]
Abstract
Acute subdural hematoma (SDH) occurs following severe head trauma with brain contusion or rupture of bridging veins. Conversely, SDH caused by rupture of a cortical artery without trauma or with minor trauma is also possible. Although over 150 cases of the latter SDH have been reported, they were predominantly diagnosed only during surgery, and therefore, no adequate histological evaluation has been performed. Therefore, essential etiology of this SDH type has remained unclear. In addition, the scarcity of autopsy cases may be attributed to arterial rupture being missed if the macroscopic findings are too minimal to detect during autopsy. Here, we describe two autopsy cases of SDH of cortical artery origin. Extravasation on postmortem computed tomography angiography and arterial leakage on macroscopic observation during autopsy facilitated detection of the ruptured artery and allowed detailed histological evaluation of the ruptured artery and adjacent dura mater. The etiology of arterial rupture is briefly described on the basis of histopathological findings in this study and the available literature.
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12
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Gath CF, Gianella MG, Bonamico L, Olmos L, Russo MJ. Prediction of Balance After Inpatient Rehabilitation in Stroke Subjects with Severe Balance Alterations at the Admission. J Stroke Cerebrovasc Dis 2021; 30:105627. [PMID: 33508725 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/12/2020] [Accepted: 01/16/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Patients with severe motor alterations would be those on who the prediction of the expected motor response after inpatient rehabilitation programs is most required. OBJECTIVES To analyze if the balance progress measured by the Berg Balance Scale and the time of hospitalization could be independent predictors of the Berg Balance at the end of a post stroke rehabilitation program in patients with severe balance alteration at the admission. Secondly, to compare a Berg Balance prediction model at the time of discharge based on the Berg Balance at the time of admission (model 1) to a Berg Balance prediction model at the time of discharge based on Berg Balance progress and the time of hospitalization (model 2). METHODS Subjects suffering a first subacute supratentorial stroke admitted for inpatient rehabilitation between 2010 through 2018 were included to develop two linear regression models of predicted Berg Balance at discharge (n=149). RESULTS According to model 1 (p < 0.0001, R2= 0.166), the Berg Balance at the admission would be a predictor of the Berg Balance at discharge from hospitalization. According to model 2 (p < 0.0001, R2= 0.993) the Berg Balance progress (β= 1.026; p < 0.0001) and the hospitalization time (β=-0.006; p < 0.0001) would be independent predictors of the Berg Balance at discharge. CONCLUSIONS The motor response to the rehabilitation programs in subacute patients with severe motor alterations could be explained on the basis of balance condition at the admission, but this explanation may be improved considering the progress on the balance the patients achieve during inpatient rehabilitation irrespective the time of hospitalization.
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Affiliation(s)
- Christian Federico Gath
- Physical Therapy Unit, Fleni, Ruta 9 Km 52.5, Colectora Este (B1625), Escobar, Buenos Aires, Argentina.
| | - Matias Gabriel Gianella
- Physical Therapy Unit, Fleni, Ruta 9 Km 52.5, Colectora Este (B1625), Escobar, Buenos Aires, Argentina.
| | - Lucas Bonamico
- Department of Rehabilitation Medicine, Fleni, Escobar, Buenos Aires, Argentina.
| | - Lisandro Olmos
- Department of Rehabilitation Medicine, Fleni, Escobar, Buenos Aires, Argentina.
| | - Maria Julieta Russo
- Department of Rehabilitation Medicine, Fleni, Escobar, Buenos Aires, Argentina.
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Roberts M, Crasto D, Roy D. A Case of Subacute Necrotizing Fasciitis due to Serratia marcescens. J Clin Aesthet Dermatol 2021; 14:55-58. [PMID: 33584969 PMCID: PMC7869816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Necrotizing fasciitis (NF) is a progressive inflammatory infection of the fascia that is often aggressive and advances insidiously. NF can be preceded by traumatic injury or surgical intervention or may occur spontaneously. Here, we describe a patient who presented with monomicrobial subacute necrotizing fasciitis due to Serratia marcescens. Dermatology was consulted at the local hospital for suspected cellulitis with no resolution using appropriate antibiotics. Our patient failed to show improvement with antibiotic treatment and experienced an above-the-knee amputation. We have also included a review of the current literature on subacute necrotizing fasciitis and S. marcescens. A case review of 25 patients resulted in rates of 52.1% for overall mortality, 72% for mortality among patients treated with only antibiotics, and 40% for mortality among patients treated with surgical debridement. There needs to be a high suspicion for necrotizing fasciitis even in patients presenting with cellulitis without systemic symptoms. If S. marcescens is isolated, more aggressive treatment may be warranted. More cases of subacute necrotizing fasciitis and S. marcescens need to be reported in the literature to better understand early diagnosis and best management practices.
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Affiliation(s)
- Michael Roberts
- Dr. Roberts is with Merit Health Wesley in Hattiesburg, Mississippi
- Mr. Vo and Mr. Crasto are with the William Carey University College of Osteopathic Medicine in Hattiesburg, Mississippi
- Dr. Roy is with Pine Belt Dermatology and Skin Cancer Center in Petal, Mississippi
| | - David Crasto
- Dr. Roberts is with Merit Health Wesley in Hattiesburg, Mississippi
- Mr. Vo and Mr. Crasto are with the William Carey University College of Osteopathic Medicine in Hattiesburg, Mississippi
- Dr. Roy is with Pine Belt Dermatology and Skin Cancer Center in Petal, Mississippi
| | - David Roy
- Dr. Roberts is with Merit Health Wesley in Hattiesburg, Mississippi
- Mr. Vo and Mr. Crasto are with the William Carey University College of Osteopathic Medicine in Hattiesburg, Mississippi
- Dr. Roy is with Pine Belt Dermatology and Skin Cancer Center in Petal, Mississippi
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14
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Wang JJ, Qi P, Chen KP, Lu J, Hu S, Yang XM, Wang DM. [Endovascular recanalization of symptomatic non-acute intracranial arterial occlusion: a single center case series]. Zhonghua Wai Ke Za Zhi 2020; 58:897-903. [PMID: 33249806 DOI: 10.3760/cma.j.cn112139-20200429-00349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the feasibility and safety of endovascular recanalization for symptomatic non-acute intracranial arterial occlusion (NAICO). Methods: Twenty-five consecutive patients who underwent endovascular recanalization for NAICO between January 2017 and October 2019 at Department of Neurosurgery, Beijing Hospital were retrospectively reviewed.There were 20 males and 5 females, aged (60.5±11.0) years (range: 41 to 73 years).The preoperative modified Rankin score(M(Q(R))) was 2 (2.5)(range: 1 to 5).The occlusion time was 40 (54)days (range: 17 to 570 days).The demographic data were collected. The initial procedural results, including the rate of successful recanalization, periprocedural complications and data pertaining to angiographic and clinical follow-up were recorded. Results: Recanalization was successful in 20 of 27 occlusive lesions of 25 patients. Intraoperative complications occurred in 3 cases, including vascular perforation in 1 case, arterial dissection in 1 case, and perforator occlusion occurred in 1 case. The incidence of permanent complications was 3.7% (1/27). All 25 patients underwent clinical follow-up, with a median period of 8 months (range: 1 to 33 months), and 23 patients with improved or stable modified Rankin scale. One patient developed new ischemic symptoms 2 months after discharge, and 1 patient died of complications of bed rest.The results of the angiography follow-up (median 4 months, range: 2 days to 9 months) showed that reocclusion occurred in 5 of all 20 successfully recanalized patients. Conclusions: Endovascular recanalization for symptomatic NAICO is feasible, relatively safe, and efficacious in highly selected cases. However, further larger scale pilot studies are needed to determine the efficacy and long-term outcome associated with this treatment.
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15
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Maher Hulou M, McLouth CJ, Hayden CS, Sheldrake AK, Parekh M, Dillen WL, Wheeler GR, Fraser JF. Predictors of re-operation in the setting of non-acute subdural hematomas: A 12-year single center retrospective study. J Clin Neurosci 2020; 81:334-339. [PMID: 33222941 DOI: 10.1016/j.jocn.2020.09.052] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/08/2020] [Accepted: 09/28/2020] [Indexed: 11/30/2022]
Abstract
Non-acute subdural hematomas (naSDH) may recur after surgical treatment. A second operation affects the quality of life and functional outcome of the patients, and lengthens hospital stay. We aim to identify the predictors of reoperation as the healthcare system in the US is moving towards patient-centered care. This retrospective study included patients treated surgically with burr-holes or mini-craniotomy for non-acute subdural hematoma between February 2006-June 2018. Univariate and multiple logistic regression models were performed. 23 (12.0%) patients had reoperation. Controlling for all the factors, postoperative acute blood in the operative bed was the strongest predictor of recurrence of naSDH (OR = 37.93, 95% CI: 5.35-268.87, p < 0.001). Those undergoing a mini-craniotomy were over six times as likely to experience a recurrent SDH compared to those operated on via burr holes (OR = 6.34, 95% CI: 1.21-33.08, p = 0.029). Finally, patients with a past medical history of thrombocytopenia were nearly six times as likely to experience a recurrence of SDH (OR = 5.80, 95% CI: 1.20-28.10, p = 0.029). Postoperative hematoma thickness showed a trend toward significance such that thicker hematomas were associated with an increased likelihood of experiencing a recurrent SDH. In conclusion, we found that operative technique, thrombocytopenia and the presence of postoperative hemorrhage are significant predictors for reoperation. Given the current interest in endovascular embolization for SDH, understanding these risk factors may aid in determining indications for such adjunctive treatment.
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Affiliation(s)
- M Maher Hulou
- Department of Neurosurgery, University of Kentucky, Lexington, KY, USA
| | | | | | - Amy K Sheldrake
- Department of Neurosurgery, University of Kentucky, Lexington, KY, USA
| | - Mansi Parekh
- Department of Neurosurgery, University of Kentucky, Lexington, KY, USA
| | - William L Dillen
- Department of Neurosurgery, University of Kentucky, Lexington, KY, USA
| | - Greg R Wheeler
- Department of Neurosurgery, University of Kentucky, Lexington, KY, USA
| | - Justin F Fraser
- Department of Neurosurgery, University of Kentucky, Lexington, KY, USA; Department of Neurology, University of Kentucky, Lexington, KY, USA; Department of Radiology, University of Kentucky, Lexington, KY, USA; Department of Neuroscience, University of Kentucky, Lexington, KY, USA.
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16
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Sulaiman T, Medi S, Erdem H, Senbayrak S, Ozturk-Engin D, Inan A, Civljak R, Nechifor M, Akbulut A, Crisan A, Ozguler M, Namiduru M, Savic B, Dulovic O, Pehlivanoglu F, Sengoz G, Yasar K, Inal AS, Parlak E, Johansen IS, Kursun E, Parlak M, Yilmaz E, Yilmaz G, Gul HC, Oncul O, Siméon S, Tattevin P, Ulu-Kilic A, Alabay S, Beovic B, Catroux M, Hansmann Y, Harxhi A, Sener A, Ozkaya HD, Cağ Y, Agalar C, Vahaboglu H, Ugur BK, Hasbun R. The diagnostic utility of the "Thwaites' system" and "lancet consensus scoring system" in tuberculous vs. non-tuberculous subacute and chronic meningitis: multicenter analysis of 395 adult patients. BMC Infect Dis 2020; 20:788. [PMID: 33096990 PMCID: PMC7585215 DOI: 10.1186/s12879-020-05502-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 10/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tuberculous meningitis (TBM) represents a diagnostic and management challenge to clinicians. The "Thwaites' system" and "Lancet consensus scoring system" are utilized to differentiate TBM from bacterial meningitis but their utility in subacute and chronic meningitis where TBM is an important consideration is unknown. METHODS A multicenter retrospective study of adults with subacute and chronic meningitis, defined by symptoms greater than 5 days and less than 30 days for subacute meningitis (SAM) and greater than 30 days for chronic meningitis (CM). The "Thwaites' system" and "Lancet consensus scoring system" scores and the diagnostic accuracy by sensitivity, specificity, and area under the curve of receiver operating curve (AUC-ROC) were calculated. The "Thwaites' system" and "Lancet consensus scoring system" suggest a high probability of TBM with scores ≤4, and with scores of ≥12, respectively. RESULTS A total of 395 patients were identified; 313 (79.2%) had subacute and 82 (20.8%) with chronic meningitis. Patients with chronic meningitis were more likely caused by tuberculosis and had higher rates of HIV infection (P < 0.001). A total of 162 patients with TBM and 233 patients with non-TBM had unknown (140, 60.1%), fungal (41, 17.6%), viral (29, 12.4%), miscellaneous (16, 6.7%), and bacterial (7, 3.0%) etiologies. TMB patients were older and presented with lower Glasgow coma scores, lower CSF glucose and higher CSF protein (P < 0.001). Both criteria were able to distinguish TBM from bacterial meningitis; only the Lancet score was able to differentiate TBM from fungal, viral, and unknown etiologies even though significant overlap occurred between the etiologies (P < .001). Both criteria showed poor diagnostic accuracy to distinguish TBM from non-TBM etiologies (AUC-ROC was <. 5), but Lancet consensus scoring system was fair in diagnosing TBM (AUC-ROC was .738), sensitivity of 50%, and specificity of 89.3%. CONCLUSION Both criteria can be helpful in distinguishing TBM from bacterial meningitis, but only the Lancet consensus scoring system can help differentiate TBM from meningitis caused by fungal, viral and unknown etiologies even though significant overlap occurs and the overall diagnostic accuracy of both criteria were either poor or fair.
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Affiliation(s)
- Tarek Sulaiman
- Department of Internal Medicine, Section of Infectious Diseases, UT Health McGovern Medical School, University of Texas Health Sciences Center, 6431 Fannin St. 2.112 MSB, Houston, Texas, 77030m, USA
| | - Sai Medi
- Department of Internal Medicine, Section of Infectious Diseases, UT Health McGovern Medical School, University of Texas Health Sciences Center, 6431 Fannin St. 2.112 MSB, Houston, Texas, 77030m, USA
| | - Hakan Erdem
- Department of Infectious Diseases and Clinical Microbiology, Umut Hospital, Ordu, Turkey
| | - Seniha Senbayrak
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, HaydarpaşaTraining and Research Hospital, Istanbul, Turkey
| | - Derya Ozturk-Engin
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Asuman Inan
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, HaydarpaşaTraining and Research Hospital, Istanbul, Turkey
| | - Rok Civljak
- Department of Infectious Diseases, Dr. Fran Mihaljevic University Hospital for Infectious Diseases, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Mihai Nechifor
- Department of Pharmacology, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Ayhan Akbulut
- Department of Infectious Diseases and Clinical Microbiology, Firat University School of Medicine, Elazig, Turkey
| | - Alexandru Crisan
- Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Muge Ozguler
- Medical Sciences University Elazığ Education and Research Hospital Infectious Diseases and Clinical Microbiology Department, Elazığ, Turkey
| | - Mustafa Namiduru
- Department of Infectious Diseases and Clinical Microbiology, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Branislava Savic
- Institute of Microbiology and Immunology, National Reference Laboratory for Tuberculosis, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Olga Dulovic
- Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Filiz Pehlivanoglu
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Gonul Sengoz
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Kadriye Yasar
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Ayse Seza Inal
- Department of Infectious Diseases and Clinical Microbiology, Cukurova University School of Medicine, Adana, Turkey
| | - Emine Parlak
- Department of Infectious Diseases and Clinical Microbiology, Ataturk University School of Medicine, Erzurum, Turkey
| | | | - Ebru Kursun
- Department of Infectious Diseases and Clinical Microbiology, Baskent University School of Medicine, Adana, Turkey
| | - Mehmet Parlak
- Department of Infectious Diseases and Clinical Microbiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Emel Yilmaz
- Department of Infectious Diseases and Clinical Microbiology, Uludag University School of Medicine, Bursa, Turkey
| | - Gulden Yilmaz
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, GülhaneTraining and Research Hospital, Istanbul, Turkey
| | - Hanefi Cem Gul
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, Gülhane Medical Faculty, Istanbul, Turkey
| | - Oral Oncul
- Department of Infectious Diseases and Clinical Microbiology, Istanbul University School of Medicine, Istanbul, Turkey
| | - Soline Siméon
- Department of Infectious and Tropical Diseases, University Hospital of Pontchaillou, Rennes, France
| | - Pierre Tattevin
- Department of Infectious and Tropical Diseases, University Hospital of Pontchaillou, Rennes, France
| | - Aysegul Ulu-Kilic
- Department of Infectious Diseases and Clinical Microbiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Selma Alabay
- Department of Infectious Diseases and Clinical Microbiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Bojana Beovic
- Department of Infectious Diseases, University Medical Centre, Ljubljana, Slovenia
| | - Melanie Catroux
- Department of Infectious Diseases, Poitiers University Hospital, Poitiers, France
| | - Yves Hansmann
- Department of Infectious Diseases, University Hospital, Strasbourg, France
| | - Arjan Harxhi
- Service of Infectious Disease, University Hospital Center of Tirana, Tirana, Albania
| | - Alper Sener
- Department of Infectious Diseases and Clinical Microbiology, Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Hacer Deniz Ozkaya
- Department of Infectious Diseases and Clinical Microbiology, Cigli Regional Education Hospital, Izmir, Turkey
| | - Yasemin Cağ
- Department of Infectious Diseases and Clinical Microbiology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Canan Agalar
- Department of Clinical Microbiology and Infectiıus Diseases, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Haluk Vahaboglu
- Department of Infectious Diseases and Clinical Microbiology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Berna Kaya Ugur
- Department of Anesthesiology and Reanimation, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Rodrigo Hasbun
- Department of Internal Medicine, Section of Infectious Diseases, UT Health McGovern Medical School, University of Texas Health Sciences Center, 6431 Fannin St. 2.112 MSB, Houston, Texas, 77030m, USA.
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Owaraganise A, Tibaijuka L, Ngonzi J. Subacute uterine inversion following an induced abortion in a teenage girl: a case report. BMC Womens Health 2020; 20:220. [PMID: 33008375 PMCID: PMC7532615 DOI: 10.1186/s12905-020-01089-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 09/24/2020] [Indexed: 08/29/2023]
Abstract
Background Subacute uterine inversion is a very rare complication of mid-trimester termination of pregnancy that should be considered in a situation where unsafe abortion occurs. Case presentation We present a case of subacute uterine inversion complicated by hypovolemic shock following an unsafe abortion in a 17-year-old nulliparous unmarried girl. She presented with a history of collapse, mass protruding per vagina that followed Valsalva, and persistent lower abdominal pain but not vaginal bleeding. This followed her second attempt to secretly induce an abortion at 18 weeks amenorrhea. On examination, she was agitated, severely pale, cold on palpation, with an axillary temperature of 35.8 °C, a tachycardia of 143 beats per minute and unrecordable low blood pressure. The abdomen was soft and non-tender with no palpable masses; the uterine fundus was absent at its expected periumbilical position and cupping was felt instead. A fleshy mass with gangrenous patches protruding in the introitus was palpated with no cervical lip felt around it. We made a clinical diagnosis of subacute uterine inversion complicated with hypovolemic shock and initiated urgent resuscitation with crystalloid and blood transfusion. Non-operative reversal of the inversion failed. Surgery was done to correct the inversion followed by total abdominal hysterectomy due to uterine gangrene. Conclusion Our case highlights an unusual presentation of subacute uterine inversion following unsafe abortion. This case was managed successfully but resulted in significant and permanent morbidity.
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Affiliation(s)
- Asiphas Owaraganise
- Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Leevan Tibaijuka
- Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Joseph Ngonzi
- Department of Obstetrics and Gynecology, Mbarara University of Science and Technology, Mbarara, Uganda
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Ding SQ, Chen YQ, Chen J, Wang SN, Duan FX, Shi YJ, Hu JG, Lü HZ. Serum exosomal microRNA transcriptome profiling in subacute spinal cord injured rats. Genomics 2020; 112:5086-5100. [PMID: 32919018 DOI: 10.1016/j.ygeno.2019.09.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 08/27/2019] [Accepted: 09/23/2019] [Indexed: 12/11/2022]
Abstract
MicroRNAs (miRNAs) are involved in a series of pathology of spinal cord injury (SCI). Although, locally expressed miRNAs have advantages in studying the pathological mechanism, they cannot be used as biomarkers. The "free circulation" miRNAs can be used as biomarkers, but they have low concentration and poor stability in body fluids. Exosomal miRNAs in body fluids have many advantages comparing with free miRNAs. Therefore, we hypothesized that the specific miRNAs in the central nervous system might be transported to the peripheral circulation and concentrated in exosomes after injury. Using next-generation sequencing, miRNA profiles in serum exosomes of sham and subactue SCI rats were analyzed. The results showed that SCI can lead to changes of serum exosomal miRNAs. These changed miRNAs and their associated signaling pathways may explain the pathological mechanism of suacute SCI. More importantly, we found some valuable serum exosomal miRNAs for diagnosis and prognosis of SCI.
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Affiliation(s)
- Shu-Qin Ding
- Clinical Laboratory, The First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Anhui Key Laboratory of Tissue Transplantation, The First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China
| | - Yu-Qing Chen
- Clinical Laboratory, The First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Anhui Key Laboratory of Tissue Transplantation, The First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Department of Immunology, Bengbu Medical College, Anhui 233030, PR China
| | - Jing Chen
- Clinical Laboratory, The First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Anhui Key Laboratory of Tissue Transplantation, The First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Department of Immunology, Bengbu Medical College, Anhui 233030, PR China
| | - Sai-Nan Wang
- Clinical Laboratory, The First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Anhui Key Laboratory of Tissue Transplantation, The First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Department of Immunology, Bengbu Medical College, Anhui 233030, PR China
| | - Fei-Xiang Duan
- Clinical Laboratory, The First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Anhui Key Laboratory of Tissue Transplantation, The First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China
| | - Yu-Jiao Shi
- Clinical Laboratory, The First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Anhui Key Laboratory of Tissue Transplantation, The First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China
| | - Jian-Guo Hu
- Clinical Laboratory, The First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Anhui Key Laboratory of Tissue Transplantation, The First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China.
| | - He-Zuo Lü
- Clinical Laboratory, The First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Anhui Key Laboratory of Tissue Transplantation, The First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Department of Immunology, Bengbu Medical College, Anhui 233030, PR China.
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Gignoux P, Lanhers C, Dutheil F, Boutevillain L, Pereira B, Coudeyre E. Non-rigid lumbar supports for the management of non-specific low back pain: A literature review and meta-analysis. Ann Phys Rehabil Med 2020;:101406. [PMID: 32561503 DOI: 10.1016/j.rehab.2020.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 05/02/2020] [Accepted: 05/02/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND Clinical practice guidelines for non-specific low back pain do not recommend the use of non-rigid lumbar supports (NRLSs) despite the publication of several positive randomized controlled studies. OBJECTIVE We conducted a systematic review with meta-analysis to assess the efficacy of NRLSs in the treatment and prevention of non-specific low back pain. METHODS We searched for reports of randomized controlled trials in PubMed, Cochrane Library, EMBASE, Science Direct and Pedro databases. Data were analyzed by disease stage (acute, subacute, and chronic) and type of prevention (primary and secondary). The analysis of methodological quality involved the Physiotherapy Evidence Database (PEDro) scale. RESULTS Of the 1581 records retrieved, only 4 full-text articles were included, with 777 patients: 378 in the NRLS group, and 348 in the control group. NRLSs conferred greater amelioration of disability (effect size -0.54, 95% CI -0.90; -0.17) and pain (-0.29, -0.46; -0.12) than standard management. Insufficient data prevented a comparison of the efficiency for acute, subacute and recurrent low back pain as well as meta-regression of responder phenotypes (sociodemographic and other patient characteristics). CONCLUSION We demonstrated the overall efficacy of NRLSs for both disability and pain. However, further studies are needed to assess which patients can benefit the most from lumbar supports based on patient phenotype and the characteristics of low back pain. PROSPERO (CRD42018109855).
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Yang Y, Cao TT, Tian ZM, Gao H, Wen HQ, Pang M, He WJ, Wang NX, Chen YY, Wang Y, Li H, Lin JW, Kang Z, Li MM, Liu B, Rong LM. Subarachnoid transplantation of human umbilical cord mesenchymal stem cell in rodent model with subacute incomplete spinal cord injury: Preclinical safety and efficacy study. Exp Cell Res 2020; 395:112184. [PMID: 32707134 DOI: 10.1016/j.yexcr.2020.112184] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 12/22/2022]
Abstract
Functional multipotency renders human umbilical cord mesenchymal stem cell (hUC-MSC) a promising candidate for the treatment of spinal cord injury (SCI). However, its safety and efficacy have not been fully understood for clinical translation. In this study, we performed cellular, kinematic, physiological, and anatomical analyses, either in vitro or in vivo, to comprehensively evaluate the safety and efficacy associated with subarachnoid transplantation of hUC-MSCs in rats with subacute incomplete SCI. Concerning safety, hUC-MSCs were shown to have normal morphology, excellent viability, steady proliferation, typical biomarkers, stable karyotype in vitro, and no tumorigenicity both in vitro and in vivo. Following subarachnoid transplantation of hUC-MSCs in the subject rodents, the biodistribution of hUC-MSCs was restricted to the spinal cord, and no toxicity to immune system or organ function was observed. Body weight, organ weight, and the ratio of the latter upon the former between stem cell-transplanted rats and placebo-injected rats revealed no statistical differences. Regarding efficacy, hUC-MSCs could differentiate into osteoblasts, chondrocytes, adipocytes and neural progenitor cells in vitro. While in vivo studies revealed that subarachnoid transplantation of stem cells resulted in significant improvement in locomotion, earlier automatic micturition recovery and reduced lesion size, which correlated with increased regeneration of tracking fiber and reduced parenchymal inflammation. In vivo luminescence imaging showed that a few of the transplanted luciferase-labeled hUC-MSCs tended to migrate towards the lesion epicenter. Shortened latency and enhanced amplitude were also observed in both motor and sensory evoked potentials, indicating improved signal conduction in the damaged site. Immunofluorescent staining confirmed that a few of the administrated hUC-MSCs integrated into the spinal cord parenchyma and differentiated into astrocytes and oligodendrocytes, but not neurons. Moreover, decreased astrogliosis, increased remyelination, and neuron regeneration could be observed. To the best of our knowledge, this preclinical study provides detailed safety and efficacy evidence regarding intrathecal transplantation of hUC-MSCs in treating SCI for the first time and thus, supports its initiation in the following clinical trial.
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Affiliation(s)
- Yang Yang
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, People's Republic of China
| | - Ting-Ting Cao
- Department of Cell Biology, School of Basic Medical Sciences, Southern Medical University, 1023 Shatai South Road, Baiyun District, Guangzhou, Guangdong Province, People's Republic of China
| | - Zhen-Ming Tian
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, People's Republic of China
| | - Han Gao
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, People's Republic of China
| | - Hui-Quan Wen
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, People's Republic of China
| | - Mao Pang
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, People's Republic of China
| | - Wei-Jie He
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, People's Republic of China
| | - Nan-Xiang Wang
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, People's Republic of China
| | - Yu-Yong Chen
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, People's Republic of China
| | - Yang Wang
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, People's Republic of China
| | - He Li
- Department of Physiology, School of Basic Medical Sciences, Southern Medical University, 1023 Shatai South Road, Baiyun District, Guangzhou, Guangdong Province, People's Republic of China
| | - Jun-Wei Lin
- Department of Obstetrics, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, People's Republic of China
| | - Zhuang Kang
- Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, People's Republic of China
| | - Mang-Mang Li
- Department of Cell Biology, School of Basic Medical Sciences, Southern Medical University, 1023 Shatai South Road, Baiyun District, Guangzhou, Guangdong Province, People's Republic of China.
| | - Bin Liu
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, People's Republic of China.
| | - Li-Min Rong
- Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Tianhe District, Guangzhou, Guangdong Province, People's Republic of China.
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Abstract
BACKGROUND Clinical observation suggests that total remission of tinnitus may exist, but a systematic analysis of these cases is missing. We aimed to identify subjects with long lasting total remission of tinnitus. METHODS By publishing announcements, we included volunteers of any gender and age who have had daily perception of tinnitus for over 3 months and have been in total remission (lack of tinnitus perception, even in silence and with deliberate attention to it) for over 6 months. We excluded individuals in a state of habituation or masking. We applied a structured interview to standardize information about tinnitus and its remission. Follow-up interviews took place after 6, 12, and 18 months. RESULTS Eighty individuals (56 females; age=54.2±16.8 years) were included. History of bilateral tinnitus accounted for 51.4% of cases. Total remission occurred in subjects whose tinnitus lasted for 49.0±73.5 months. Remission occurred gradually in 78.6% of cases and suddenly in 22%. During the further 18-month follow-up, 7.9% reported recurrence of tinnitus and 92.1% remained symptom free. CONCLUSION Different than the knowledge obtained from clinical trials, this study showed that long-lasting total remission of tinnitus may occur. This status was reached by individuals of any gender and age range, with any location and duration of tinnitus, mostly as a gradual process. Future studies should better clarify how each treatment modality may achieve the best results.
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Affiliation(s)
- Tanit Ganz Sanchez
- Department of Otolaryngology, University of São Paulo School of Medicine, São Paulo, Brazil; Instituto Ganz Sanchez, São Paulo, Brazil.
| | | | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, Bezirksklinikum, University of Regensburg, Regensburg, Germany
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Ebohon O, Irabor F, Omoregie ES. Sub-acute toxicity study of methanol extract of Tetrorchidium didymostemon leaves using biochemical analyses and gene expression in Wistar rats. Heliyon 2020; 6:e04313. [PMID: 32637701 PMCID: PMC7327260 DOI: 10.1016/j.heliyon.2020.e04313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/08/2020] [Accepted: 06/22/2020] [Indexed: 10/31/2022] Open
Abstract
Tetrorchidium didymostemon is widely used by traditional medicine practitioners to manage and treat several diseases. Despite its known ethnomedicinal uses, there are no scientific studies on the toxic effects of this plant. This study was performed to evaluate the potential toxicity of methanol extracts Tetrorchidium didymostemon leaves through sub-acute oral administration in rats. Twenty four (24) male albino rats (Wistar strain) of average weight 150 ± 20 g were randomly divided into 4 groups of 6 rats each. Group 1 was the control while groups 2, 3 and 4 were administered 100, 300 and 600 mg/kg body weight of the plant extracts respectively for 14 consecutively days. The extract did not induce any treatment related changes in body weight, organ/body weight ratio, biochemical parameters (aspartate transaminase, alanine transaminase, total protein, albumin, creatinine and urea), oxidative stress indices (malondialdehyde, superoxide dismutase and reduced glutathione) and histopathology (liver and kidney) of the treated groups when compared to the control. However, at 600 mg/kg body weight dose, the extract caused a significant (p < 0.05) decrease in hemoglobin level, packed cell volume and the expression of albumin gene of rats. Similarly, at 300 and 600 mg/kg body weight, the extract also caused a non-significant (p > 0.05) decrease in red blood cell count. Furthermore, the extract at 100 and 300 mg/kg body weight induced a significant (p < 0.05) increase in the expression of tumor necrosis factor - alpha and kidney injury molecule - 1 (KIM-1) genes. Catalase gene expression especially in the kidney was up-regulated in the groups administered the extract. Our study suggests that oral administration of T. didymostemon leaves extract is relatively safe. However, there is need for caution due to the observed changes in hematological profile, up-regulation of KIM-1 genes as well as down regulation of albumin gene.
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Affiliation(s)
- Osamudiamen Ebohon
- Department of Biochemistry, Faculty of Natural and Applied Sciences, Michael and Cecilia Ibru University, Agbarha-Otor, Delta, Nigeria
| | - Francis Irabor
- Department of Biochemistry, Faculty of Natural and Applied Sciences, Michael and Cecilia Ibru University, Agbarha-Otor, Delta, Nigeria
| | - Ehimwenma Sheena Omoregie
- Malaria Research, Molecular Biology and Toxicology Unit, Department of Biochemistry, Faculty of Life Sciences, University of Benin, PMB 1154, Benin City, Nigeria
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Hadrup N, Sharma AK, Loeschner K, Jacobsen NR. Pulmonary toxicity of silver vapours, nanoparticles and fine dusts: A review. Regul Toxicol Pharmacol 2020; 115:104690. [PMID: 32474071 DOI: 10.1016/j.yrtph.2020.104690] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/12/2020] [Accepted: 05/26/2020] [Indexed: 12/17/2022]
Abstract
Silver is used in a wide range of products, and during their production and use, humans may be exposed through inhalation. Therefore, it is critical to know the concentration levels at which adverse effects may occur. In rodents, inhalation of silver nanoparticles has resulted in increased silver in the lungs, lymph nodes, liver, kidney, spleen, ovaries, and testes. Reported excretion pathways of pulmonary silver are urinary and faecal excretion. Acute effects in humans of the inhalation of silver include lung failure that involved increased heart rate and decreased arterial blood oxygen pressure. Argyria-a blue-grey discoloration of skin due to deposited silver-was observed after pulmonary exposure in 3 individuals; however, the presence of silver in the discolorations was not tested. Argyria after inhalation seems to be less likely than after oral or dermal exposure. Repeated inhalation findings in rodents have shown effects on lung function, pulmonary inflammation, bile duct hyperplasia, and genotoxicity. In our evaluation, the range of NOAEC values was 0.11-0.75 mg/m3. Silver in the ionic form is likely more toxic than in the nanoparticle form but that difference could reflect their different biokinetics. However, silver nanoparticles and ions have a similar pattern of toxicity, probably reflecting that the effect of silver nanoparticles is primarily mediated by released ions. Concerning genotoxicity studies, we evaluated silver to be positive based on studies in mammalian cells in vitro and in vivo when considering various exposure routes. Carcinogenicity data are absent; therefore, no conclusion can be provided on this endpoint.
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Affiliation(s)
- Niels Hadrup
- National Research Centre for the Working Environment, DK, 2100, Copenhagen, Denmark.
| | - Anoop K Sharma
- Division for Risk Assessment and Nutrition, Group for Chemical Risk Assessment and GMO, National Food Institute, Technical University of Denmark, Denmark
| | - Katrin Loeschner
- Division for Food Technology, Research Group for Nano-Bio Science, National Food Institute, Technical University of Denmark, Denmark
| | - Nicklas R Jacobsen
- National Research Centre for the Working Environment, DK, 2100, Copenhagen, Denmark.
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Xu YD, Zhong BY, Yang C, Cai XS, Hu B, Wang XY, Fan BR, Jin YH, Ni CF, Duan PF. Comparison of catheter-directed thrombolysis with and without percutaneous mechanical thrombectomy for subacute iliofemoral deep vein thrombosis. Phlebology 2020; 35:589-596. [PMID: 32316832 DOI: 10.1177/0268355520919201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To evaluate and compare the treatment efficacy and safety between catheter-directed thrombolysis monotherapy and catheter-directed thrombolysis combined with percutaneous mechanical thrombectomy for patients with subacute iliofemoral deep vein thrombosis. METHODS We conducted a retrospective analysis of a total of 74 subacute iliofemoral deep vein thrombosis patients who underwent catheter-directed thrombolysis with and without percutaneous mechanical thrombectomy. Patients treated with catheter-directed thrombolysis combined with percutaneous mechanical thrombectomy (percutaneous mechanical thrombectomy group, n = 30) or catheter-directed thrombolysis monotherapy (catheter-directed thrombolysis group, n = 44) were included. The primary endpoints were the clinical efficacy rate of thrombolysis, primary patency, and the incidence of post-thrombotic syndrome (at 12 months diagnosed according to the original Villalta score criteria. Secondary endpoints were the total urokinase dose, the thrombolysis time, the detumescence rate and complications. RESULTS The percentage of successful thrombolysis for percutaneous mechanical thrombectomy group was higher than that for catheter-directed thrombolysis group (P = 0.045). At the 12-month follow-up, there was no difference in the primary patency (P > 0.05) or the incidence of post-thrombotic syndrome (P = 0.36). Percutaneous mechanical thrombectomy group had significant advantages in reducing urokinase doses and thrombolysis times compared with catheter-directed thrombolysis group for patients with thrombus clearance levels II and III (P < 0.05). CONCLUSION Catheter-directed thrombolysis combined with percutaneous mechanical thrombectomy performs better in removing vein thrombi, reducing urokinase doses, and shortening thrombolysis times.
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Affiliation(s)
- Yi-Ding Xu
- Department of Vascular and Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Bin-Yan Zhong
- Department of Vascular and Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Chao Yang
- Department of Vascular and Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xu-Sheng Cai
- Department of Vascular and Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Bo Hu
- Department of Vascular and Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiao-Yun Wang
- Department of Vascular and Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Bao-Rui Fan
- Department of Vascular and Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yong-Hai Jin
- Department of Vascular and Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Cai-Fang Ni
- Department of Vascular and Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Peng-Fei Duan
- Department of Vascular and Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Prideaux N, van den Berg M, Drummond C, Barr C. Augmented Performance Feedback during Robotic Gait Therapy Results in Moderate Intensity Cardiovascular Exercise in Subacute Stroke. J Stroke Cerebrovasc Dis 2020; 29:104758. [PMID: 32245693 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104758] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 02/06/2020] [Accepted: 02/12/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Low cardiovascular fitness is common poststroke. Conventional subacute stroke rehabilitation does not meet Australian National Stroke Guidelines for cardiovascular exercise, particularly in mobility-dependent patients. Walking robotics can potentially achieve recommended cardiovascular exercise with these patients. AIM The primary aim was to determine whether sustained moderate intensity cardiovascular exercise can be achieved using 3 Lokomat Augmented Performance Feedback activities in mobility-dependent adults with subacute stroke. Secondary aims were to assess if cardiovascular workload was influenced by the activity completed, participants motivation or enjoyment, or changes in Lokomat settings. METHODS Ten patients with subacute stroke (mean (SD) age: 63.4 (13) years) participated in 6x20-minute Lokomat study sessions. Each study session involved a warm-up and 3x5-minute APF activities presented in a random order. Metabolic data were collected using the COSMED-K5. Participants rated their perceived exertion on the BORG CR10 scale and Lokomat settings of body-weight support, guidance force, and speed were recorded. RESULTS Moderate intensity cardiovascular exercise was achieved and maintained over the 15 minutes of exercise, objectively demonstrated by a mean (SD) Metabolic Equivalent Task of 3.1 (1.3), and mean (SD) oxygen consumption of 8.0 (3.8) ml/kg/min, estimated as 52% VO2max. This was subjectively confirmed by exertion scores between 3 and 5. The cardiovascular workload was not affected by which activity was completed, participant motivation or enjoyment, or significant progression of Lokomat settings between study sessions. CONCLUSIONS Mobility-dependent patients with subacute stroke can achieve sustained moderate intensity cardiovascular exercise on the Lokomat when using APF activities.
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Affiliation(s)
- Nicole Prideaux
- Physiotherapist, Rehabilitation, Aged Care, and Palliative Division, Southern Adelaide Local Health Network: c/o Flinders Medical Centre, Bedford Park, South Australia, Australia.
| | - Maayken van den Berg
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Claire Drummond
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Christopher Barr
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Ding SQ, Chen YQ, Chen J, Wang SN, Duan FX, Shi YJ, Hu JG, Lü HZ. Serum exosomal microRNA transcriptome profiling in subacute spinal cord injured rats. Genomics 2019; 112:2092-2105. [PMID: 31830526 DOI: 10.1016/j.ygeno.2019.12.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
MicroRNAs (miRNAs) are involved in a series of pathology of spinal cord injury (SCI). Although, locally expressed miRNAs have advantages in studying the pathological mechanism, they cannot be used as biomarkers. The "free circulation" miRNAs can be used as biomarkers, but they have low concentration and poor stability in body fluids. Exosomal miRNAs in body fluids have many advantages comparing with free miRNAs. Therefore, we hypothesized that the specific miRNAs in the central nervous system might be transported to the peripheral circulation and concentrated in exosomes after injury. Using next-generation sequencing, miRNA profiles in serum exosomes of sham and subactue SCI rats were analyzed. The results showed that SCI can lead to changes of serum exosomal miRNAs. These changed miRNAs and their associated signaling pathways may explain the pathological mechanism of suacute SCI. More importantly, we found some valuable serum exosomal miRNAs for diagnosis and prognosis of SCI.
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Affiliation(s)
- Shu-Qin Ding
- Clinical Laboratory, the First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Anhui Key Laboratory of Tissue Transplantation, the First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China
| | - Yu-Qing Chen
- Clinical Laboratory, the First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Anhui Key Laboratory of Tissue Transplantation, the First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Department of Immunology, Bengbu Medical College, Anhui 233030, PR China
| | - Jing Chen
- Clinical Laboratory, the First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Anhui Key Laboratory of Tissue Transplantation, the First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Department of Immunology, Bengbu Medical College, Anhui 233030, PR China
| | - Sai-Nan Wang
- Clinical Laboratory, the First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Anhui Key Laboratory of Tissue Transplantation, the First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Department of Immunology, Bengbu Medical College, Anhui 233030, PR China
| | - Fei-Xiang Duan
- Clinical Laboratory, the First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Anhui Key Laboratory of Tissue Transplantation, the First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China
| | - Yu-Jiao Shi
- Clinical Laboratory, the First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Anhui Key Laboratory of Tissue Transplantation, the First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China
| | - Jian-Guo Hu
- Clinical Laboratory, the First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Anhui Key Laboratory of Tissue Transplantation, the First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China.
| | - He-Zuo Lü
- Clinical Laboratory, the First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Anhui Key Laboratory of Tissue Transplantation, the First Affiliated Hospital of Bengbu Medical College, Anhui 233004, PR China; Department of Immunology, Bengbu Medical College, Anhui 233030, PR China.
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Park JG, Lee KW, Kim SB, Lee JH, Kim YH. Effect of Decreased Skeletal Muscle Index and Hand Grip Strength on Functional Recovery in Subacute Ambulatory Stroke Patients. Ann Rehabil Med 2019; 43:535-543. [PMID: 31693843 PMCID: PMC6835132 DOI: 10.5535/arm.2019.43.5.535] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/24/2019] [Indexed: 12/16/2022] Open
Abstract
Objective To investigate the effect of decreased Skeletal Muscle Index (SMI) and hand grip strength on functional recovery in subacute ambulatory stroke patients. Methods Subacute stroke patients who were referred to the rehabilitation center were recruited. Decreased SMI and hand grip strength were diagnosed according to the Asian Working Group on Sarcopenia. Diagnostic criteria were decreased SMI and decreased unaffected hand grip strength. SMI was measured by bioelectrical impedance analysis. Unaffected hand grip strength was measured with a hand dynamometer. Patients were divided into two groups, decreased group (DG) and not-decreased group (NDG), according to the presence of decreased SMI and hand grip strength. Both groups received conventional stroke rehabilitation for 3 weeks. All patients were evaluated at the baseline and at 3 weeks after treatment. Functional status was evaluated with 4-meter walk test (4MWT), 6-minute walk test (6MWT), Timed Up and Go test (TUG), and Modified Barthel Index (MBI). Results Both groups showed improvement in 4MWT, TUG, and MBI. NDG showed improvement in 6MWT. Comparing improvements between the two groups, NDG showed more improvement in 6MWT and TUG than DG. Conclusion The presence of decreased SMI and hand grip strength had negative effects on functional recovery in subacute ambulatory stroke patients.
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Affiliation(s)
- Jin Gee Park
- Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Busan, Korea.,Regional Cardiocerebrovascular Center, Dong-A Medical Center, Busan, Korea
| | - Kyeong Woo Lee
- Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Busan, Korea.,Regional Cardiocerebrovascular Center, Dong-A Medical Center, Busan, Korea
| | - Sang Beom Kim
- Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Busan, Korea.,Regional Cardiocerebrovascular Center, Dong-A Medical Center, Busan, Korea
| | - Jong Hwa Lee
- Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Busan, Korea.,Regional Cardiocerebrovascular Center, Dong-A Medical Center, Busan, Korea
| | - Young Hwan Kim
- Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine, Busan, Korea.,Regional Cardiocerebrovascular Center, Dong-A Medical Center, Busan, Korea
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Mirza AC, Panchal SS. Safety evaluation of syringic acid: subacute oral toxicity studies in Wistar rats. Heliyon 2019; 5:e02129. [PMID: 31463381 DOI: 10.1016/j.heliyon.2019.e02129] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 05/20/2019] [Accepted: 07/18/2019] [Indexed: 02/05/2023] Open
Abstract
Syringic acid (SA) is a phenolic acid and have been investigated for diverse pharmacological activities, but the safety and/or mechanism of toxicity is still lacking in the literature. Subacute toxicity studies will add value to its pharmacological profile and support its exploration as a future medicine. According to OECD TG 407 (OECD, 2008), rats were divided into 3 groups (n = 12). The dose of SA was decided by limit test. Treatment and satellite groups received SA (1000 mg/kg/day, p.o for 14 days), whereas an equal volume of vehicle was given to control groups. In order to access reversibility, satellite groups were kept for another 14 days post-treatment. The toxic signs, mortality and body weight changes were recorded. On day 15 and 29 the rats were anesthetized to collect blood for estimation of hematological and biochemical parameters and then sacrificed to collect internal body organ for weighing and histopathological studies. SA has no major adverse effect on the body weight, food intake, erythropoiesis, leucopoiesis and on internal body organs which was confirmed by evaluating various biochemical and hematological parameters, relative body organ weight and histopathological studies. Therefore, SA could be considered safe over limited period of time and this study may help researchers in establishing the doses for the longer-term subchronic studies. Further, subchronic and chronic toxicity studies are required to evaluate safety on long term use.
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Nees F, Löffler M, Usai K, Flor H. Hypothalamic-pituitary-adrenal axis feedback sensitivity in different states of back pain. Psychoneuroendocrinology 2019; 101:60-66. [PMID: 30414593 DOI: 10.1016/j.psyneuen.2018.10.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/23/2018] [Accepted: 10/25/2018] [Indexed: 12/14/2022]
Abstract
Pain normally signals a threat to bodily integrity and causes emotional distress. Acute pain serves a protective function, yet, when pain turns chronic, the protective function is lost. A chain of psychophysiological alterations including changes in the stress regulation system, apparent in dysfunctional activity and responsivity of the hypothalamic-pituitary-adrenal (HPA) axis, might be an important factor in this context. Moreover, maladaptive responses may be complicated by affective comorbid symptoms such as anxiety and depression, and alter nociceptive processing. However, the relationship among pain chronicity, stress regulation, and contributing components of comorbid symptomatology as well as somatosensory profiles has rarely been examined. In the present study, we obtained diurnal cortisol profiles at baseline and feedback regulation (following a dexamethasone suppression test (DST)) in subacute (SABP) and chronic (CBP) back pain patients and healthy control individuals (HC). We also assessed anxiety, depression and chronic stress levels and used quantitative sensory testing (QST) to detect sensory abnormalities. We found a hyper-suppression of cortisol following DST and thus enhanced negative stress feedback sensitivity in SABP compared to both CBP and HC. In SABP, DST-related cortisol levels were negatively associated with pain intensity, mediated by cold pain thresholds and anxiety. These data support a stress model of pain chronicity and suggest that stress responses might be indicators of individual vulnerability in the transition period of subacute pain.
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Affiliation(s)
- Frauke Nees
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| | - Martin Löffler
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katrin Usai
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Herta Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Lou ZC, Dong Y, Lou ZH. Comparative study of epidermal growth factor and observation only on human subacute tympanic membrane perforation. Am J Otolaryngol 2019; 40:209-12. [PMID: 30554883 DOI: 10.1016/j.amjoto.2018.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 11/21/2018] [Accepted: 11/27/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare the effects of epidermal growth factor (EGF) and observation only on human subacute tympanic membrane perforation (TMP). METHODS A total of 44 patients with traumatic TMPs >2 months after trauma were divided into an observation group (n = 18) and EGF group (n = 26). Patients in the EGF group underwent direct application of EGF without stripping of the perforation edge. All patients were followed up for at least 6 months. The TMP closure rate, closure time, and hearing gain were evaluated. RESULTS At 6 months, 25 of 26 (96.2%) perforations achieved complete closure with a mean closure time of 9.1 ± 3.9 days (range, 3-14 days) in the EGF group. However, only 11 of 18 (61.1%) perforations achieved complete closure in the observation group, with a mean closure time of 20.6 ± 10.7 days (range = 9-71 days). The patients in the EGF-treated group had significantly improved closure rates (P = 0.026) and a reduced closure time (P < 0.01) compared to those in the observation group. The difference in mean hearing improvement between the two groups was not statistically significant (P = 0.86). CONCLUSIONS Topical application of EGF improved the closure rate and shortened the closure time of human subacute TMPs compared with spontaneous healing, the stripping of the perforation edge was unnecessary. This treatment is simple and convenient and should be recommended pre-myringoplasty.
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Ha JH, Park JH, Jeong JH, Im SB, Hwang SC. Expanding Subdural Hematomas in the Subacute Stage and Treatment via Catheter Drainage. Korean J Neurotrauma 2018; 14:76-79. [PMID: 30402422 PMCID: PMC6218348 DOI: 10.13004/kjnt.2018.14.2.76] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/27/2018] [Accepted: 09/27/2018] [Indexed: 11/15/2022] Open
Abstract
Objective Rapid expansion of subacute subdural hematomas (saSDHs) is an uncommon complication in the course of acute subdural hematomas (SDHs). The current study evaluated relevant factors and treatment methods for saSDHs with neurologic deterioration and mass effect. Methods A saSDHs was chronologically defined as an SDH occurring 4 to 21 days after head trauma. All cases of surgically treated SDHs were retrieved from the head trauma bank at our institution. Twenty-three patients with expanding saSDHs who met the following criteria were enrolled in the study: defined age of the hematoma, clinical deterioration, and radiological expansion of the hematoma. Cases were analyzed according to demographic factors, trauma mechanism, medical co-morbidity, and surgical method. Results Expanding saSDHs occurred more often in older (≥60 years old) than in younger patients (69.6% vs. 30.4%, respectively); they also occurred more often in men than in women (64% vs. 36%, respectively). Antiplatelet or anticoagulant therapy was used in 52% of patients. The Glasgow Coma Scale score was 13 at the time of the trauma and deteriorated to 11 at the time of surgery. The mean time from the trauma to development of the expanding saSDH from an SDH was 13.3 days. Regarding surgical methods, closed-system drainage was performed in 22 patients, and only one patient underwent craniotomy with hematoma removal. All patients exhibited neurological improvements after surgery. Conclusion An expanding saSDH usually occurs around 13 days after trauma in older adults. Minimal trephination with closed-system drainage can be used to manage an expanding saSDHs.
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Affiliation(s)
- Jong-Ho Ha
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jong-Hyun Park
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Je Hoon Jeong
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Soo Bin Im
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Sun-Chul Hwang
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
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Abstract
BACKGROUND Diffuse unilateral subacute neuroretinitis (DUSN) is a rare cause of posterior uveitis in the United Kingdom. It typically presents unilaterally in children and young adults but rarely bilateral cases have been reported. It is also rare to have multiple worms in the same eye causing the clinical picture. In this article, we present a challenging case of DUSN in a young girl unresponsive to conventional treatments suggesting the possibility of multiple worms being present in the same eye. CASE PRESENTATION An 8-year-old girl presented with a 2-month history of headaches. On occasions the headaches were associated with redness and watering of her left eye. She denied any visual loss or visual symptoms. Her visual acuity was reduced to 6/30 in her left eye. Fundal examination revealed a unilateral chorioretinitis. Investigation did not reveal a specific cause for the chorioretinitis. Over 15 months her visual acuity improved to 6/9 but the fundal appearance changed and a diagnosis of DUSN was made. She was treated with focal laser, systemic anti-helminthic and immunosuppressive treatments but continued to develop new, active areas of chorioretinitis, raising the possibility of multiple worms in the sub-retinal space. There is also a concern as to other central nervous system (CNS) involvement given her significant and ongoing headaches. CONCLUSION We present a challenging case of DUSN in a young girl; a condition that remains rare in the UK. She was unresponsive to both focal laser and systemic anti-helminthic and immunosuppressive treatments suggesting the possibility of multiple worms being present in the sub-retinal space. This case highlights the difficulties often encountered in the treatment of DUSN, even when a worm can be identified. Her visual prognosis is poor as there was ongoing recurrence of active chorioretinitis.
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Affiliation(s)
- David S Curragh
- Department of Ophthalmology, Royal Victoria Hospital, 274 Grosvenor Road, Belfast, BT12 6BA, Northern Ireland.
| | - Anne Ramsey
- Department of Ophthalmology, Royal Victoria Hospital, 274 Grosvenor Road, Belfast, BT12 6BA, Northern Ireland
| | - Sharon Christie
- Royal Hospital for Sick Children, Royal Victoria Hospital, Belfast, Northern Ireland
| | - Eibhlin McLoone
- Department of Ophthalmology, Royal Victoria Hospital, 274 Grosvenor Road, Belfast, BT12 6BA, Northern Ireland
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Guex CG, Reginato FZ, Figueredo KC, da Silva ARHD, Pires FB, Jesus RDS, Lhamas CL, Lopes GHH, Bauermann LF. Safety assessment of ethanolic extract of Olea europaea L. leaves after acute and subacute administration to Wistar rats. Regul Toxicol Pharmacol 2018; 95:395-9. [PMID: 29678768 DOI: 10.1016/j.yrtph.2018.04.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 03/28/2018] [Accepted: 04/16/2018] [Indexed: 12/13/2022]
Abstract
Olea europaea L., popularly known as olive, is a plant widely used worldwide. Its leaves, fruit and oil are extensively consumed and present important pharmacological properties. However, studies regarding the toxicity of olive leaves are still limited in the literature. Therefore, the aim of the study was to investigate acute and subacute oral toxicities of the ethanolic extract of olive leaves (EEO) in Wistar rats through histopathology and biochemical and hematological parameters. Acute toxicity was assessed using a single dose of 2000 mg/kg of EEO administered by oral gavage to male and female rats. To assess subacute toxicity, EEO was administered during 28 days at different doses (100, 200 and 400 mg/kg) to male and female rats. At the end of the experiments, the liver and kidney were removed and examined microscopically, and blood was collected for hematological and biochemical parameters. A single dose of 2000 mg/kg did not induce mortality or any signs of toxicity among the animals treated. Animals exposed to EEO during 28 days did not present sign of abnormalities. Results demonstrated that EEO did not induce toxicity after exposure to single and repeated doses. However, more studies are needed to fully understand implications for human safety.
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Wang L, Zhou Q, Li L, Zeng S. Unique fluid-fluid level ultrasonic appearance in subacute placenta abruption with massive subchorionic hematoma. Int J Gynaecol Obstet 2018; 141:391-392. [PMID: 29485691 DOI: 10.1002/ijgo.12474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 01/26/2018] [Accepted: 02/23/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Ling Wang
- Department of Ultrasound Diagnosis, Maternal and Child Health Center of Zhuzhou, Hunan, China
| | - Qichang Zhou
- Department of Ultrasound Diagnosis, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lingling Li
- Department of Ultrasound Diagnosis, Maternal and Child Health Center of Zhuzhou, Hunan, China
| | - Shi Zeng
- Department of Ultrasound Diagnosis, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Sabzevari S, Chao T, Kalawadia J, Lin A. The use of Achilles tendon allograft for latissimus dorsi tendon reconstruction: a minimally invasive technique. Knee Surg Sports Traumatol Arthrosc 2018; 26:63-6. [PMID: 28028567 DOI: 10.1007/s00167-016-4401-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 12/05/2016] [Indexed: 10/20/2022]
Abstract
Treatment of subacute, retracted latissimus dorsi and teres major tendon ruptures in young overhead athletes is challenging. This case report describes management of a subacute retracted latissimus dorsi and teres major rupture with Achilles tendon allograft reconstruction using a two-incision minimally invasive technique. Level of evidence V.
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Leconte S, Valentin S, Dromelet E, De Jonghe M. Prolonged Cough in Pediatric Population First Line Care, Belgian Guidelines. Open Respir Med J 2017; 11:54-66. [PMID: 29081858 PMCID: PMC5633727 DOI: 10.2174/1874306401711010054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 07/31/2017] [Accepted: 07/31/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The clinical approach to a prolonged cough, i.e. a cough lasting more than three weeks, is challenging for general practitioners as well for primary care pediatricians. What the recommended clinical approach in primary care is, how cough duration or cough characteristics impact the diagnosis, and what the efficiency and safety of antibiotics or symptomatic treatments are remain in question for primary care physicians. OBJECTIVE The last Belgian guidelines were published in 2006 and needed to be reviewed. Those background questions were used to conduct our guideline updating procedure. METHODS We systematically performed a pyramidal literature search between the periods 2006-2014 in order to write evidence based guidelines. The data of the literature was summarized, discussed by the authors, experts and the Belgian primary care guidelines committee. Recommendations were formulated and scored following the GRADE classification. RESULTS The consultation history as well as the physical examination should be directed towards searching for warning signs (GRADE 1B) and towards the common etiologies depending on cough duration (GRADE 2C). If the cough lasts for more than eight weeks, chest radiography and spirometry should be considered (GRADE 2C). An antibiotic is recommended for a prolonged wet cough (over eight weeks) if prolonged bacterial bronchitis is suspected (GRADE 1B). In the absence of clinical signs of a specific etiology of a cough, no drug can be recommended (GRADE 1B). For all cases, it is initially suggested to avoid irritants (GRADE 1C) as well as to take into account the concerns of parents and inform them about the natural development of a cough. CONCLUSIONS More research is needed to provide evidence on the clinical pathway on prolonged cough for primary care. Cough duration of more than eight weeks and prolonged wet cough are the most useful cough characteristics. Regarding a specific cough treatment, no medication has proved any effect greater than placebo. Attention to environmental triggers and patient-centered care remain the keystones of interventions.
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Affiliation(s)
- Sophie Leconte
- Centre académique de médecine générale, Université catholique de Louvain, Bruxelles, Belgium
- Institut de Recherche santé et société, Université catholique de Louvain, Bruxelles, Belgium
| | - Stéphanie Valentin
- Centre académique de médecine générale, Université catholique de Louvain, Bruxelles, Belgium
| | - Estelle Dromelet
- Centre académique de médecine générale, Université catholique de Louvain, Bruxelles, Belgium
| | - Michel De Jonghe
- Centre académique de médecine générale, Université catholique de Louvain, Bruxelles, Belgium
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Moshiri M, Moallem SA, Attaranzadeh A, Saberi Z, Etemad L. Injury to skeletal muscle of mice following acute and sub-acute pregabalin exposure. Iran J Basic Med Sci 2017; 20:256-259. [PMID: 28392896 PMCID: PMC5378961 DOI: 10.22038/ijbms.2017.8352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Objective(s): Pregabalin (PGB) is a new antiepileptic drug that has received FDA approval for patient who suffers from central neuropathic pain, partial seizures, generalized anxiety disorder, fibromyalgia and sleep disorders. This study was undertaken to evaluate the possible adverse effects of PGB on the muscular system of mice. Materials and Methods: To evaluate the effect of PGB on skeletal muscle, the animals were exposed to a single dose of 1, 2 or 5 g /kg or daily doses of 20, 40 or 80 mg/kg for 21 days, intraperitoneally (IP). Twaenty-four hr after the last drug administration, all animals were sacrificed. The level of fast-twitch skeletal muscle troponin I and CK-MM activity were evaluated in blood as an indicator of muscle injury. Skeletal muscle pathological findings were also reported as scores ranging from 1 to 3 based on the observed lesion. Results: In the acute and sub-acute toxicity assay IP injection of PGB significantly increased the activity and levels of CK-MM and fsTnI compared to the control group. Sub-acute exposure to PGB caused damages that include muscle atrophy, infiltration of inflammatory cells and cell degeneration. Conclusion: PGB administration especially in long term care causes muscle atrophy with infiltration of inflammatory cells and cell degeneration. The fsTnI and CK-MM are reliable markers in PGB-related muscle injury. The exact mechanisms behind the muscular damage are unclear and necessitate further investigations.
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Affiliation(s)
- Mohammad Moshiri
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran
| | - Seyed Adel Moallem
- Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Armin Attaranzadeh
- Milad Infertility Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Saberi
- Nanotechnology Research Center School of Pharmacy, Mashhad University Medical Sciences, Mashhad, Iran
| | - Leila Etemad
- Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Orihuela-Espina F, Roldán GF, Sánchez-Villavicencio I, Palafox L, Leder R, Sucar LE, Hernández-Franco J. Robot training for hand motor recovery in subacute stroke patients: A randomized controlled trial. J Hand Ther 2016; 29:51-7; quiz 57. [PMID: 26847320 DOI: 10.1016/j.jht.2015.11.006] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 10/17/2015] [Accepted: 11/15/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND Evidence of superiority of robot training for the hand over classical therapies in stroke patients remains controversial. During the subacute stage, hand training is likely to be the most useful. AIM To establish whether robot active assisted therapies provides any additional motor recovery for the hand when administered during the subacute stage (<4 months from event) in a Mexican adult population diagnosed with stroke. HYPOTHESIS Compared to classical occupational therapy, robot based therapies for hand recovery will show significant differences at subacute stages. TRIAL DESIGN A randomized clinical trial. METHODS A between subjects randomized controlled trial was carried out on subacute stroke patients (n = 17) comparing robot active assisted therapy (RT) with a classical occupational therapy (OT). Both groups received 40 sessions ensuring at least 300 repetitions per session. Treatment duration was (mean ± std) 2.18 ± 1.25 months for the control group and 2.44 ± 0.88 months for the study group. The primary outcome was motor dexterity changes assessed with the Fugl-Meyer (FMA) and the Motricity Index (MI). RESULTS Both groups (OT: n = 8; RT: n = 9) exhibited significant improvements over time (Non-parametric Cliff's delta-within effect sizes: dwOT-FMA = 0.5, dwOT-MI = 0.5, dwRT-FMA = 1, dwRT-MI = 1). Regarding differences between the therapies; the Fugl-Meyer score indicated a significant advantage for the hand training with the robot (FMA hand: WRS: W = 8, p <0.01), whilst the Motricity index suggested a greater improvement (size effect) in hand prehension for RT with respect to OT but failed to reach significance (MI prehension: W = 17.5, p = 0.080). No harm occurred. CONCLUSIONS Robotic therapies may be useful during the subacute stages of stroke - both endpoints (FM hand and MI prehension) showed the expected trend with bigger effect size for the robotic intervention. Additional benefit of the robotic therapy over the control therapy was only significant when the difference was measured with FM, demanding further investigation with larger samples. Implications of this study are important for decision making during therapy administration and resource allocation.
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Affiliation(s)
| | | | | | - Lorena Palafox
- National Institute of Neurology and Neurosurgery (INNN), Mexico City, Mexico
| | - Ronald Leder
- National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Luis Enrique Sucar
- National Institute for Astrophysics, Optics and Electronics (INAOE), Puebla, Mexico
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Inoue A, Kohno K, Fukumoto S, Ozaki S, Ninomiya S, Tomita H, Kamogawa K, Okamoto K, Ichikawa H, Onoue S, Miyazaki H, Okuda B, Iwata S. Importance of perioperative management for emergency carotid artery stenting within 24h after intravenous thrombolysis for acute ischemic stroke: Case report. Int J Surg Case Rep 2016; 26:108-12. [PMID: 27478968 PMCID: PMC5013329 DOI: 10.1016/j.ijscr.2016.07.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 07/23/2016] [Accepted: 07/23/2016] [Indexed: 12/25/2022] Open
Abstract
We report a patient treated successfully via endovascular surgery within 24 h after intravenous thrombolysis using recombinant tissue plasminogen activator for acute cervical internal carotid artery occlusion. Emergency carotid artery stenting for the acute internal carotid artery occlusion may be considered a safe procedure in preventing early stroke recurrence in selected patients. When trying to perform emergency carotid artery stenting within 24 h after intravenous recombinant tissue plasminogen activator administration, several issues require attention, such as the decisions regarding the type of stent and embolic protection device, the selection of antiplatelet therapy and the methods of preventing hyper perfusion syndrome. We administered aspirin and clopidogrel for the prevention of subacute thrombosis, and we used dexmedetomidine for preventing hyperperfusion syndrome, so that we also obtained a good result.
Introduction We report a patient treated successfully via endovascular surgery within 24 h after intravenous thrombolysis using recombinant tissue plasminogen activator for acute cervical internal carotid artery occlusion. Presentation of case A 68-year-old man was admitted to our hospital. Neurological examination revealed severe left-sided motor weakness. Magnetic resonance imaging showed no cerebral infarction, but magnetic resonance angiography revealed complete occlusion of the right internal carotid artery. Systemic intravenous injection of recombinant tissue plasminogen activator was performed within 4 h after the onset. But, magnetic resonance angiography still revealed complete occlusion. Revascularization of the right cervical internal carotid artery was performed via endovascular surgery. The occluded artery was successfully recanalized using the Penumbra System® and stent placement at the origin of the internal carotid artery. Immediately after surgery, dual antiplatelet therapy (aspirin and clopidogrel) was initiated, and then cilostazol was added on the following day. Carotid ultrasonography and three-dimensional computed tomographic angiography at 14 days revealed no further obstruction to flow. Discussion When trying to perform emergency carotid artery stenting within 24 h after intravenous recombinant tissue plasminogen activator administration, several issues require attention, such as the decisions regarding the type of stent and embolic protection device, the selection of antiplatelet therapy and the methods of preventing hyperperfusion syndrome. Conclusion Emergency carotid artery stenting for the acute internal carotid artery occlusion may be considered a safe procedure in preventing early stroke recurrence in selected patients.
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Affiliation(s)
- Akihiro Inoue
- Departments of Neurosurgery, Ehime Prefectural Central Hospital, Japan.
| | - Kanehisa Kohno
- Departments of Neurosurgery, Ehime Prefectural Central Hospital, Japan
| | - Shinya Fukumoto
- Departments of Neurosurgery, Ehime Prefectural Central Hospital, Japan
| | - Saya Ozaki
- Departments of Neurosurgery, Ehime Prefectural Central Hospital, Japan
| | - Satoko Ninomiya
- Departments of Neurology, Ehime Prefectural Central Hospital, Japan
| | - Hitomi Tomita
- Departments of Neurology, Ehime Prefectural Central Hospital, Japan
| | - Kenji Kamogawa
- Departments of Neurology, Ehime Prefectural Central Hospital, Japan
| | - Kensho Okamoto
- Departments of Neurology, Ehime Prefectural Central Hospital, Japan
| | - Haruhisa Ichikawa
- Departments of Neurosurgery, Ehime Prefectural Central Hospital, Japan
| | - Shinji Onoue
- Departments of Neurosurgery, Ehime Prefectural Central Hospital, Japan
| | - Hajime Miyazaki
- Departments of Neurosurgery, Ehime Prefectural Central Hospital, Japan
| | - Bungo Okuda
- Departments of Neurology, Ehime Prefectural Central Hospital, Japan
| | - Shinji Iwata
- Departments of Neurosurgery, Ehime Prefectural Central Hospital, Japan
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Spyropoulou V, Dhouib Chargui A, Merlini L, Samara E, Valaikaite R, Kampouroglou G, Ceroni D. Primary subacute hematogenous osteomyelitis in children: a clearer bacteriological etiology. J Child Orthop 2016; 10:241-6. [PMID: 27174185 PMCID: PMC4909654 DOI: 10.1007/s11832-016-0739-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 04/29/2016] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND This study aimed to describe the spectrum of pediatric primary subacute hematogenous osteomyelitis (PSAHO) and to investigate its bacterial etiology. METHODS Sixty-five consecutive cases of PSAHO admitted to our institution over a 16-year period (2000-2015) were retrospectively reviewed to assess their laboratory and radiographic imaging features, as well as their bacteriological etiology. RESULTS On evaluation, white blood cell count and C-reactive protein were normal in 53 (81.5 %) and 34 cases (52.3 %), respectively, whereas the erythrocyte sedimentation rate was superior to 20 mm/h in 44 cases (72.1 %). Blood cultures failed to identify the pathogen in all but one patient, and classic bone sample cultures only managed to isolate the pathogen in five cases (11.6 %). Use of polymerase chain reaction (PCR) assays on bone aspirates or blood allowed the causative microorganism to be isolated in a further 22 cases. Using classic cultures and PCR assays together resulted in pathogen detection in 27 cases (62.8 % of the children bacteriologically investigated), with Kingella kingae being the most frequently reported microorganism. CONCLUSIONS Two distinct forms of PSAHO should be distinguished on the basis of age of patients and bacteriological etiology. The infantile form affects children aged between 6 months and 4 years and is predominantly due to K. kingae. The juvenile form involves children aged >4 years and Staphylococcus aureus appears to be the main bacteriological etiology. Appropriate nucleic amplification assays drastically improve the detection rate of the microorganisms responsible for PSAHO. LEVEL OF EVIDENCE Case series, level IV.
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Affiliation(s)
- Vasiliki Spyropoulou
- Service of Pediatric Orthopedics, Department of Child and Adolescent Medicine, University Hospitals of Geneva, 6, rue Willy Donzé, Geneva 14, 1211, Switzerland
| | - Amira Dhouib Chargui
- Pediatric Radiologic Unit, University Hospitals of Geneva, Geneva 14, 1211, Switzerland
| | - Laura Merlini
- Pediatric Radiologic Unit, University Hospitals of Geneva, Geneva 14, 1211, Switzerland
| | - Eleftheria Samara
- Service of Pediatric Orthopedics, Department of Child and Adolescent Medicine, University Hospitals of Geneva, 6, rue Willy Donzé, Geneva 14, 1211, Switzerland
| | - Raimonda Valaikaite
- Service of Pediatric Orthopedics, Department of Child and Adolescent Medicine, University Hospitals of Geneva, 6, rue Willy Donzé, Geneva 14, 1211, Switzerland
| | - Georgios Kampouroglou
- Service of Pediatric Orthopedics, Department of Child and Adolescent Medicine, University Hospitals of Geneva, 6, rue Willy Donzé, Geneva 14, 1211, Switzerland
| | - Dimitri Ceroni
- Service of Pediatric Orthopedics, Department of Child and Adolescent Medicine, University Hospitals of Geneva, 6, rue Willy Donzé, Geneva 14, 1211, Switzerland.
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Jiang X, Guan X, Yao L, Zhang H, Jin X, Han Y. Effects of Single and Joint Subacute Exposure of Copper and Cadmium on Heat Shock Proteins in Common Carp (Cyprinus carpio). Biol Trace Elem Res 2016; 169:374-81. [PMID: 26105544 DOI: 10.1007/s12011-015-0402-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 06/08/2015] [Indexed: 10/23/2022]
Abstract
Copper (Cu) and cadmium (Cd) are the most common heavy metals that are easily detected in aquatic environments on a global scale. In this paper, we investigated the messenger RNA (mRNA) and protein levels of HSPs (HSP60, HSP70, and HSP90) in the liver of the common carp exposed to Cu, Cd, and a combination of both metals by real-time quantitative PCR and Western blot. The results indicated that in each exposure group, the mRNA levels of HSP60, HSP70, and HSP90 were increased significantly compared to the corresponding controls after 96 h of exposure (P < 0.05). A significant increase was observed in the HSP70 protein level in the high-dose Cu group and all of the Cd groups. Significant increases were also observed in the protein levels of HSP60 and HSP90 in the high combination group and the low combination group, respectively. These results indicated that the dynamics of HSP expression observed in the common carp support the role of HSPs as biochemical markers in response to environmental pollution and provided valuable insights into the adaptive mechanisms used by the common carp to adapt to the challenges of stressful environments.
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Affiliation(s)
- Xuyang Jiang
- College of Animal Science and Technology, Northeast Agricultural University, 59 Mucai Street, Harbin, 150030, People's Republic of China
- National and Local Joint Freshwater Fish Breeding Engineering Laboratory of China, 43 Songfa Street, Harbin, 150030, People's Republic of China
| | - Xueting Guan
- College of Animal Science and Technology, Northeast Agricultural University, 59 Mucai Street, Harbin, 150030, People's Republic of China
| | - Linlin Yao
- College of Veterinary Medicine, Northeast Agricultural University, 59 Mucai Street, Harbin, 150030, People's Republic of China
| | - Hong Zhang
- College of Animal Science and Technology, Northeast Agricultural University, 59 Mucai Street, Harbin, 150030, People's Republic of China
| | - Xian Jin
- Harbin Academy of Agricultural Sciences, 5399 Wanbao Street, Harbin, 150030, People's Republic of China.
| | - Ying Han
- College of Animal Science and Technology, Northeast Agricultural University, 59 Mucai Street, Harbin, 150030, People's Republic of China.
- National and Local Joint Freshwater Fish Breeding Engineering Laboratory of China, 43 Songfa Street, Harbin, 150030, People's Republic of China.
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Reddy UA, Prabhakar PV, Mahboob M. Biomarkers of oxidative stress for in vivo assessment of toxicological effects of iron oxide nanoparticles. Saudi J Biol Sci 2015; 24:1172-1180. [PMID: 28855809 PMCID: PMC5562456 DOI: 10.1016/j.sjbs.2015.09.029] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 09/21/2015] [Accepted: 09/22/2015] [Indexed: 11/18/2022] Open
Abstract
Iron oxide nanoparticles (Fe2O3-IONPs) have revolutionized the industry by significant economic and scientific impacts. Enormous increase in the usage of IONPs has raised concerns about their unseen adverse effects. In the current study, we investigated the effects of IONPs and its bulk on oxidative stress biomarkers, histopathology and biodistribution in rats after 28 days repeated oral treatment at 30, 300 and 1000 mg/kg body weight (b.w.). IONPs size in dry, wet forms and crystallinity was determined using TEM, DLS and XRD. The investigation of oxidative stress biomarkers demonstrated significant increase in lipid peroxidation and decrease in reduced glutathione content in the liver, kidney and the brain of the treated groups in a dose dependant manner. Further, antioxidant enzymes catalase, glutathione S transferase, glutathione peroxidase and glutathione reductase activities were significantly elevated along with significant decrease in superoxide dismutase activity in treated rat organs. ICP-OES analysis revealed dose and size dependant accumulation of IONPs in the liver followed by kidney and the brain than bulk. Moreover, accumulation of IONPs at high dose brought pathological changes only in liver. A large fraction of IONPs was eliminated in urine. Bulk material was substantially excreted in faeces than IONPs suggesting increased absorption of IONPs. In conclusion accumulated IONPs and bulk in organs trigger free radical generation, leading to the induction of oxidative stress condition in rats. The results obtained highlight the importance of toxicity assessments in evaluating the efficiency of IONPs for the safe implementation for diversified applications.
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Affiliation(s)
- Utkarsh A Reddy
- Toxicology Unit, Biology Division, Indian Institute of Chemical Technology, Hyderabad 500007, Telangana, India
| | - P V Prabhakar
- Toxicology Unit, Biology Division, Indian Institute of Chemical Technology, Hyderabad 500007, Telangana, India
| | - M Mahboob
- Toxicology Unit, Biology Division, Indian Institute of Chemical Technology, Hyderabad 500007, Telangana, India
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Ochi M, Wada F, Saeki S, Hachisuka K. Gait training in subacute non-ambulatory stroke patients using a full weight-bearing gait-assistance robot: A prospective, randomized, open, blinded-endpoint trial. J Neurol Sci 2015; 353:130-6. [PMID: 25956233 DOI: 10.1016/j.jns.2015.04.033] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 04/05/2015] [Accepted: 04/23/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND This study was a prospective, randomized, open, blinded-endpoint trial with the aim of examining whether gait training with a gait-assistance robot (GAR) improves gait disturbances in subacute non-ambulatory hemiplegic stroke patients more than overground conventional gait training. The GAR adopts a robot arm control system with full weight bearing and foot pressure visual biofeedback. METHODS Twenty-six hemiplegic patients were randomly assigned to either the GAR-assisted gait training (GAGT) group or the overground conventional gait training (OCGT) group. Both groups underwent 60 min of standard physical therapy and 20 min of GAGT or OCGT 5 days a week for 4 weeks. The primary outcome measure was the Functional Ambulation Classification (FAC). The secondary outcome measures were the peak torque of the extensor muscles in the lower extremities and a 10-m walking test. The lower extremity function was evaluated using the Fugl-Meyer Assessment, and activities of daily living were assessed using the Functional Independence Measure. RESULTS The GAGT group demonstrated significantly greater improvements in FAC and peak torque on the unaffected side (p=0.02) than the OCGT group. Additionally, gait speed tended to be faster (p=0.07) in the GAGT group. CONCLUSIONS GAGT combined with standard physical therapy in subacute non-ambulatory hemiplegic patients led to significant improvements in gait and peak torque on the unaffected side compared to OCGT.
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Affiliation(s)
- Mitsuhiro Ochi
- University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, 8078555 Kitakyushu, Japan.
| | - Futoshi Wada
- University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, 8078555 Kitakyushu, Japan.
| | - Satoru Saeki
- University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, 8078555 Kitakyushu, Japan.
| | - Kenji Hachisuka
- University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, 8078555 Kitakyushu, Japan.
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Earl BJ, Lazzarini PA, Kinnear EM, Cornwell PL. Prevalence of active foot disease and foot disease risk factors in a subacute inpatient rehabilitation facility: a cross-sectional prevalence study. J Foot Ankle Res 2014; 7:41. [PMID: 25328541 PMCID: PMC4200129 DOI: 10.1186/s13047-014-0041-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 10/02/2014] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Australian subacute inpatient rehabilitation facilities face significant challenges from the ageing population and the increasing burden of chronic disease. Foot disease complications are a negative consequence of many chronic diseases. With the rapid expansion of subacute rehabilitation inpatient services, it seems imperative to investigate the prevalence of foot disease and foot disease risk factors in this population. The primary aim of this cross-sectional study was to determine the prevalence of active foot disease and foot disease risk factors in a subacute inpatient rehabilitation facility. METHODS Eligible participants were all adults admitted at least overnight into a large Australian subacute inpatient rehabilitation facility over two different four week periods. Consenting participants underwent a short non-invasive foot examination by a podiatrist utilising the validated Queensland Health High Risk Foot Form to collect data on age, sex, medical co-morbidity history, foot disease risk factor history and clinically diagnosed foot disease complications and foot disease risk factors. Descriptive statistics were used to determine the prevalence of clinically diagnosed foot disease complications, foot disease risk factors and groups of foot disease risk factors. Logistic regression analyses were used to investigate any associations between defined explanatory variables and appropriate foot disease outcome variables. RESULTS Overall, 85 (88%) of 97 people admitted to the facility during the study periods consented; mean age 80 (±9) years and 71% were female. The prevalence (95% confidence interval) of participants with active foot disease was 11.8% (6.3 - 20.5), 32.9% (23.9 - 43.5) had multiple foot disease risk factors, and overall, 56.5% (45.9 - 66.5) had at least one foot disease risk factor. A self-reported history of peripheral neuropathy diagnosis was independently associated with having multiple foot disease risk factors (OR 13.504, p = 0.001). CONCLUSION This study highlights the potential significance of the burden of foot disease in subacute inpatient rehabilitation facilities. One in eight subacute inpatients were admitted with active foot disease and one in two with at least one foot disease risk factor in this study. It is recommended that further multi-site studies and management guidelines are required to address the foot disease burden in subacute inpatient rehabilitation facilities.
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Affiliation(s)
- Brenton J Earl
- />Department of Podiatry, Metro North Hospital and Health Service, Queensland Health, Brisbane, Queensland 4032 Australia
- />School of Medicine, Flinders University, Adelaide, South Australia 5001 Australia
| | - Peter A Lazzarini
- />Department of Podiatry, Metro North Hospital and Health Service, Queensland Health, Brisbane, Queensland 4032 Australia
- />Allied Health Research Collaborative, Metro North Hospital and Health Service, Queensland Health, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, Queensland 4032 Australia
- />School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland 4059 Australia
| | - Ewan M Kinnear
- />Department of Podiatry, Metro North Hospital and Health Service, Queensland Health, Brisbane, Queensland 4032 Australia
| | - Petrea L Cornwell
- />Allied Health Research Collaborative, Metro North Hospital and Health Service, Queensland Health, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, Queensland 4032 Australia
- />Griffith Health Institute, Behavioural Basis of Health, Griffith University, Brisbane, Queensland 4122 Australia
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Mohan B, Chhabra ST, Aslam N, Wander GS, Sood NK, Verma S, Mehra AK, Sharma S. Mechanical breakdown and thrombolysis in subacute massive pulmonary embolism: A prospective trial. World J Cardiol 2013; 5:141-147. [PMID: 23710301 PMCID: PMC3663128 DOI: 10.4330/wjc.v5.i5.141] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 04/24/2013] [Accepted: 05/10/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess role of combined modality of mechanical fragmentation and intralesional thrombolysis in patients with massive pulmonary embolism presenting subacutely.
METHODS: Eight of 70 patients presenting in tertiary care centre of North India with massive pulmonary embolism within 4 years had subacute presentation (symptom onset more than 2 wk). These patients were subjected to pulmonary angiography with intention to treat basis via mechanical breakdown and intra lesional thrombolysis. Mechanical breakdown of embolus was accomplished with 5-F multipurpose catheter to re-establish flow, followed by intralesional infusion of urokinase (4400 IU/kg over 10 min followed by 4400 IU/kg per hour over 24 h).
RESULTS: Eight patients, mean age 47.77 ± 12.20 years presented with subacute pulmonary embolism (mean duration of symptoms 2.4 wk). At presentation, mean heart rate, shock index, miller score and mean pulmonary pressures were 101.5 ± 15.2/min, 0.995 ± 0.156, 23.87 ± 3.76 and 37.62 ± 6.67 mmHg which reduced to 91.5 ± 12.2/min (P = 0.0325), 0.789 ± 0.139 (P = 0.0019), 5.87 ± 1.73 (P = 0.0000004) and 27.75 ± 8.66 mmHg (P = 0.0003) post procedurally. Mean BP improved from 80.00 ± 3.09 mmHg to 90.58 ± 9.13 mmHg (P = 0.0100) post procedurally. Minor complications in the form of local hematoma-minor hematoma in 1 (12.5%), and pseudoaneurysm (due to femoral artery puncture) in 1 (12.5 %) patient were seen. At 30 d and 6 mo follow up survival rate was 100% and all the patients were asymptomatic and in New York Heart Association class 1.
CONCLUSION: Combined modality of mechanical fragmentation and intralesional thrombolysis appears to be a promising alternative to high risk surgical procedures in patients with subacute massive pulmonary embolism.
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Abstract
This case report describes a rare complication of a left ventricular assist device (LVAD). A patient with ischemic cardiomyopathy had an LVAD placed due to intractable congestive heart failure following a large anterior myocardial infarction. The patient developed chronic bacteremia and multiple septic episodes. A gastric endoscopy revealed perforation of the anterior wall of the stomach by the LVAD. Gastric acid related erosions were present on the metallic surface suggesting prolonged exposure. This is the second case report of this rare complication and the first case report of a subacute course.
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Affiliation(s)
- Demetris Yannopoulos
- Division of Cardiology, University of Minnesota, MN, Mail Code 508, 420 Delaware St, SE Minneapolis, MN 55455, United States.
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