Roll Back Stroke: The Way Forward for Physicians and Patients

The 6-lettered word "Stroke" is an ancient disease, likened Biblicallyto "666" in Revelation 13 verse 18. Globally, it is the commonestcause of acquired long-term disability. While its incidence has beendeclining in high-, low/middle-income countries (LMICs) have witnessed an increase. This increase is driven byepidemiologic-transition/modernizatio n-complex, healthcaredisparities, and increasing prevalence of vascular risk-factors. Despitethe disproportionate burden of stroke in LMICs, these countrieshave the lowest rate of access to acute reperfusion-interventions leadingto greater stroke-related morbidity /mortality. Effective primordial,primary, secondary, and quaternary prevention-strategies coordinated at all levels of care are needed to reduce stroke incidenceand poor outcomes. The World Stroke Organization (WSO) hasproposed achieving global primary prevention through 1) Population-wide approach to limiting stroke risk-factors exposure, 2) App-basedmotivational population-wide approach to mitigating stroke risk-fa cto rs, 3 ) u se of lo w-co st co mbi n at io n /po ly- p il l to tre at hypertension/dyslipidemia and 4) addressing behavioural risk-factorsthrough interventions by community health-workers.The need to set-up stroke-units, post-hospitalisation rehabilitation-centres, stroke-registers/registries, stroke-clubs, and encouragecommunity health-education, must be emphasised for optimal care inLMIC.13 Community Health Empowerment (CHE) withthe AcronymBE FAST / STRoke as warning signs of stroke must be emphasised(B: Balance-loss; E: Eye vision-loss; F: Facial Asymmetry; A: Armweakness; S: Speech difficulties; T: Time is brain; Or first 3-lettersof STRoke ­ Can Patient Smile? Talk? Or Raise-arm?). Strokehemorheology/blood-flow and treatment involve 3Ps' of pathogenicprinciples/strategies (Passenger, Passage, Power). Its complicationsinclude the 10D's: Death, Disability, Depression, Dementia, Delirium,Dysphagia, Dehydration, Deep-Venous Thrombosis, Decubitus-ulcers, Dysphasia, Seizures.

Reflexiones en torno al lenguaje médico actual, los epónimos y abreviaciones: las razones de su existencia y los principales problemas que plantea su uso / Reflections on current medical language: the eponyms and abbreviations. the reasons of its existence and the main problems that raise its use

El lenguaje médico, como todo lenguaje científico, no persigue fines estéticos, creativos, lúdicos ni recreativos como sería el caso del lenguaje literario, sino fines informativos, didácticos y comunicativos. Los epónimos, así como los diferentes tipos de abreviaciones (abreviaturas, siglas y símbolos), han formado parte del lenguaje de la humanidad desde más de una veintena de siglos y son especialmente abundantes en los lenguajes de las especialidades, tanto de la medicina como de otras ciencias. Así como del lenguaje común y popular, estos han formado parte del lenguaje desde tiempos inmemoriales, y son especialmente abundantes en los lenguajes médico-científicos. Normalmente se utilizan como recurso para honrar, ganar tiempo y ahorrar espacio, cuando esté en su contenido se percibe bien, su uso revela notoriamente un ahorro en la comunicación médica; de no emplearlos, en cada caso habría que hacer una exposición o descripción relativamente amplia de la enfermedad o el signo de que se trata. Sin embargo, pueden producir problemas de comunicación entre los profesionales de los diferentes niveles asistenciales, debido a su imprecisión y a su carencia de equivalencia internacional, lo que puede llevar a confundir la realidad que tratan de describir, ya que un mismo término o abreviatura puede tener diferentes significados, lo que puede suscitar interpretaciones erróneas con posibles consecuencias graves. En este artículo se revisan las razones de su existencia que definen su construcción y uso, se describen los problemas de su utilización en la comunicación medico científica en la actualidad.

Medical language, like all scientific language, does not pursue aesthetic, creative, leisure and recreational purposes as would be the case in literary language, but informative, educational and communication purposes. Eponyms and the different types of abbreviations (abbreviations, acronyms, and symbols) have been part of the language of humanity for over twenty centuries and are especially abundant in the languages for both specialties in medicine, and other sciences. On the common and popular language, these elements have been part of the language since ancient times, and are especially abundant in the medical-scientific languages. Normally are used as a resource to honor, to save time and save space, when its content is perceived well, notoriously it reveals a saving in medical communication; not to use them, in each case would have to make a relatively large exposure or description of the disease or of the sign in question. However, they can cause communication problems between professionals of different levels of care, due to their imprecision and their lack of international equivalence, which may lead to confusing the reality they are trying to describe since the same term or abbreviation could have different meanings, which can lead to misinterpretations with potentially serious consequences. This article discusses the reasons for their existence which define their construction and uses, problems of its use in medical scientific communication at present are also described.

Prostate Cancer and Androgen Deprivation Therapy: Metabolic, Cardiovascular and Psychological Side Effects.

Exposure to androgen deprivation therapy (ADT) by prostate cancer (PCa) patients is increasing, either in early-stage and in metastatic disease. Frequently, ADT becomes a long-term treatment, lasting even more than 10 years, starting with gonadotropin releasing hormone (GnRH) agonists or antagonists, until the newest hormonal treatments as Abiraterone and Enzalutamide. As a consequence, ADT related adverse events occurred. We reviewed the medical literature using Pubmed search terms “prostate cancer”, “androgen deprivation”, “metabolic syndrome”, “cardiovascular diseases” and “psychological assessment”. The search was limited to manuscripts published in English language between 1999 and 2016, preferring more recent review articles. Metabolic syndrome, diabetes and cardiovascular diseases, rather than PCa itself, are the most common causes of mortality, particularly in early stage PCa patients. All these adverse eff ects synergistically increase morbidity in patients taking ADT. Psychological-cognitive implications emerging during ADT result in a signifi cant reduction of health-related quality of life of PCa patients. ADT is associated with several adverse events, which physicians andpatients should evaluate when recommending ADT. Multidisciplinary approach, with diff erent clinicians such as Urologist, Radiotherapist, Oncologist, Endocrinologist, Cardiologist, Psychologist, is mandatory for the suitable clinical management of patients with PCa submitted to ADT.

Abbreviations system: Preliminary results of a satisfaction study / Sistema das abreviaturas: Resultados preliminares de um estudo de satisfação

INTRODUÇÂO, com a finalidade de conheceras opiniões e percepções, este estudo avaliou o impacto que têm um sistema de auto expansão de abreviaturas na satisfação dos usuários em nosso Hospital. MÉTODO, o método foi mixto, com entrevistas semi estruturadas, entre dezembro 2015 e janeiro 2016, onde foram incorporados 7 médicos de diferentes especialidades. Enviou-se previamente o questionário por e-mail e finalmente se realizou um analise descritivo das perguntas. RESULTADOS, a maioria esteve "bastante satisfeita" com a utilidade do aplicativo, mais da metade respondeu que é "bastante fácil" ou "muito fácil" de usar. DISCUSSÃO-CONCLUSÃO, os profissionais consideraram que o uso do aplicativo melhorou a comunicação escrita, diminuiu os erros, favoreceu a compreensão e melhorou o seu trabalho. Vários encontraram significados errados, poucos observaram as mudanças solicitadas nas sugestões. Melhorar o suporte e a qualidade da informação, que limitam o grau de conformidade, aumentaria o nível de satisfação.

INTRODUCTION, in order to know the opinions and perceptions, this study evaluates the user satisfaction and impact of a Synchronous Self-expanding Abbreviation (SSA) system in our Hospital. METHODS, mixed methods research with semi-structured interviews from December 2015 to January 2016, were included for convenience 7 doctors ofdifferent specialties. The survey was previously sent by email and finally a descriptive analysis of the questions was performed. RESULTS, most were "quite satisfied" with the usefulness of the application, more than half said it is " fairly easy" or "very easy" to use. DISCUSSION-CONCLUSION, professionals considered that the use of application improves the written communication, reduces errors, promotes understanding and improves their work. Many users found wrong meanings, few observed the changes requested in the suggestions. Improve support and quality of information, which limit the degree of conformity, would increase the level of satisfaction.

In Vitro Propagation of Chamomilla Recutita From Capitulum Inflorescence: A Medicinal Plant With Multiple Therapeutic Applications

A protocol has been developed for induction of somatic embryogenesis from whole inflorescence explants of Chamomilla recutita L. (chamomile). Chamomile is a well-known medicinal plant from the Asteraceae family often referred to as the “star among medicinal species.” Nowadays, it is a highly favoured medicinal plant in folk and traditional medicine. Its multitherapeutic, cosmetic and nutritional values have been established through the years of traditional and scientific use and research. Chamomile has an established domestic (Indian) and international market, which is increasing day by day. Among the various major constituents, α-bisabolol and chamazulene have been reported to be more useful than others. Chamazulene occurs in the capitula of the flowers in minute quantities and has been demonstrated to exert antiinflammatory activity in-vivo. Moreover, chamomile is a seasonal 4-5 months winter crop in India but is extensively required in various medicinal applications. Therefore, to increase the overall yield of this plant, its in-vitro propagation is needed. In the present study, somatic embryos were developed from capitulum explants after 2-4 weeks of culture on MS medium supplemented with 26.8 µM NAA and 11.5 µM Kin. The somatic embryos were further subcultured in-vitro, where new plantlets regenerated from embryos. It is concluded that in-vitro propagation is possible in case of chamomile and can be used to increase the overall yield of chamazulene present in the capitula of flowers as well as augment the overall yield of this important plant, which is conventionally propagated by seeds.

Hypertension Prevalence in the US Population Varies with Difference in Alpha-1 Antitrypsin Genotype: A Cross Sectional Study.

Background: The prevalence of hypertension (HTN) associated with alpha-1 antitrypsin deficiency (AATD) has been studied with indeterminate results. The aim of the study was to prospectively compare the prevalence of HTN before testing in 3 groups of individuals with subsequently normal, moderately deficient, and severely deficient genotypes of AATD with adjustment for differences in demographics and clinical variables. Methods: We performed a cross sectional study using data from the Alpha-1 Coded Testing (ACT) study. The univariate demographic and clinical factors associated with HTN were further analyzed by logistic regression analysis. Results: The prevalence of HTN was 27.2%, 20.6%, and 27.9% for individuals with normal, moderate and severe AATD, respectively (p<0.02). The prevalence of HTN increased with age and an interaction between age, alpha-1 antitrypsin deficiency genotype and HTN was identified. The relative risk of HTN among young moderately deficient individuals was 0.53 (95% CI 0.37-0.76) the risk of young PiMM and PiMS (normal genotype) individuals. There was no significant difference in the risk in older moderately deficient individuals 1.02 (95% CI 0.76-1.37) and individuals with severe AATD 1.10 (95% CI 0.71-1.68) when compared to normal genotypes. Conclusion: Moderate deficiency genotypes (PiMZ, PiSS, PiMNull) have less HTN than normal or severe deficiency genotypes, particularly in young individuals. We speculate that protease inhibitor deficiency over a lifetime allows unopposed proteolysis of vascular connective tissue.Measured comorbidities do not explain these findings. Validation of this data should occur in other AATD cohorts.

A study on the use of abbreviations among doctors and nurses in the medical department of a tertiary hospital in Malaysia

Introduction: Misinterpretation of abbreviations by healthcare professionals has been reported to compromise patient safety. This study was done to determine the prevalence of abbreviations usage among medical doctors and nurses and their ability to interpret commonly used abbreviations in medical practice. Methods: Seventy-seven medical doctors and eighty nurses answered a self-administered questionnaire designed to capture demographic data and information regarding abbreviation use in medical practice. Comparisons were made between doctors and nurses with regards to frequency and reasons for using abbreviations; from where abbreviations were learned; frequency of encountering abbreviations in medical practice; prevalence of medical errors due to misinterpretation of abbreviations; and their ability to correctly interpret commonly used abbreviations. Results: The use of abbreviations was highly prevalent among doctors and nurses. Time saving, avoidance of writing sentences in full and convenience, were the main reasons for using abbreviations. Doctors learned abbreviations from fellow doctors while nurses learned from fellow nurses and doctors. More doctors than nurses reported encountering abbreviations. Both groups reported no difficulties in interpreting abbreviations although nurses reported often resorting to guesswork. Both groups felt abbreviations were necessary and an acceptable part of work. Doctors outperformed nurses in correctly interpreting commonly used standard and non-standard abbreviations. Conclusion: The use of standard and non-standard abbreviation in clinical practice by doctors and nurses was highly prevalent. Significant variability in interpretation of abbreviations exists between doctors and nurses.

A comparative study on how medical students learn about the use of abbreviations in medical practice

Background: Misinterpretation of abbreviations by healthcare workers has been reported to compromise patient safety. Medical students are future doctors. We explored how early medical students acquired the practice of using abbreviations, and their ability to interpret commonly used abbreviations in medical practice. Method: Eighty junior and 74 senior medical students were surveyed using a self-administered questionnaire designed to capture demographic data; frequency and reasons for using abbreviations; from where abbreviations were learned; frequency of encountering abbreviations in medical practice; prevalence of mishaps due to misinterpretation; and the ability of students to correctly interpret commonly used abbreviations. Comparisons were made between senior and junior medical students. Results: Abbreviation use was highly prevalent among junior and senior medical students. They acquired the habit mainly from the clinical notes of doctors in the hospital. They used abbreviations mainly to save time, space and avoid writing in full sentences. The students experienced difficulties, frustrations and often resorted to guesswork when interpreting abbreviations; with junior students experiencing these more than senior students. The latter were better at interpreting standard and nonstandard abbreviations. Nevertheless, the students felt the use of abbreviations was necessary and acceptable. Only a few students reported encountering mishaps in patient management as a result of misinterpretation of abbreviations. Conclusion: Medical students acquired the habit of using abbreviations early in their training. Senior students knew more and correctly interpreted more standard and non-standard abbreviations compared to junior students. Medical students should be taught to use standard abbreviations only.

Challenges and Practical Approaches with Word Sense Disambiguation of Acronyms and Abbreviations in the Clinical Domain / 대한의료정보학회지

OBJECTIVES: Although acronyms and abbreviations in clinical text are used widely on a daily basis, relatively little research has focused upon word sense disambiguation (WSD) of acronyms and abbreviations in the healthcare domain. Since clinical notes have distinctive characteristics, it is unclear whether techniques effective for acronym and abbreviation WSD from biomedical literature are sufficient. METHODS: The authors discuss feature selection for automated techniques and challenges with WSD of acronyms and abbreviations in the clinical domain. RESULTS: There are significant challenges associated with the informal nature of clinical text, such as typographical errors and incomplete sentences; difficulty with insufficient clinical resources, such as clinical sense inventories; and obstacles with privacy and security for conducting research with clinical text. Although we anticipated that using sophisticated techniques, such as biomedical terminologies, semantic types, part-of-speech, and language modeling, would be needed for feature selection with automated machine learning approaches, we found instead that simple techniques, such as bag-of-words, were quite effective in many cases. Factors, such as majority sense prevalence and the degree of separateness between sense meanings, were also important considerations. CONCLUSIONS: The first lesson is that a comprehensive understanding of the unique characteristics of clinical text is important for automatic acronym and abbreviation WSD. The second lesson learned is that investigators may find that using simple approaches is an effective starting point for these tasks. Finally, similar to other WSD tasks, an understanding of baseline majority sense rates and separateness between senses is important. Further studies and practical solutions are needed to better address these issues.

In Vitro Regeneration from Shoot Tip and Nodal Explants of Simarouba Glauca DC, a Promising Biodiesel Tree.

An efficient regeneration protocol was developed from shoot tip and nodal explants of Simarouba glauca DC, a promising biodiesel plant. Nodal explants appeared to have better regeneration capacity than shoot tip explants (40%) in the tested media. The highest regeneration frequency (90%) and shoot number (7.00 ± 1.00 shoots per explants) were obtained in nodal explants in Murashige and Skoog’s (MS) medium supplemented with 6-benzylaminopurine (BAP) 4.43 μM and α-naphthalene acetic acid (NAA) 5.36 μM.Induced shoot buds were multiplied and elongated on the MS medium supplemented with BAP (4.44 μM), NAA (5.36 μM) and TDZ (Thidiazuron) 2.27 μM with 9.66±0.33 (mean length 5.35±0.32 cm) and 9.00±0.57 (mean length 4.51±0.15cm) shoots using nodal segments and shoot tip explants, respectively. Halfstrength woody plant medium (WPM) containing 2.46μM indole-3-butyric acid (IBA) produced the maximum number of roots (6.00±1.15). The rooted plantlets were hardened on MS basal liquid medium and subsequently in polycups containing sterile soil and vermiculite (1:1) and successfully established in pots.

High-throughput virtual screening for novel dhfr inhibitors of P. Jiroveci from the zinc database.

Many of the opportunistic infections that occur at this late stage can be fatal and since that Pneumocystis carinii pneumonia (PCP) is a leading opportunistic infection found among immunocompromised (CD4 cell < 200) patients worldwide. DHFR is responsible for the growth and maturation of sporozoites stage (life cycle) in Pneumocystis as reported. Currently, 13 million chemical compounds are available for virtual screening in ZINC database. The biological information of four known drug molecules like TMP/SMX, Dapsone, Atovaquone and Pentamidine were collected from the PubChem compound database. Q-Site Finder online tool was used to determine the active site of DHFR in P. jiroveci. LogP values of chemical compounds were identified with the Atom-additive method. Since, existing drugs are synthetic chemicals that give more side effects in Pneumocystis affected patients. Polar surface area value of oxamide (86.18) was predicted to be in the ranges of existing drug values. Pentamidine was proved to be a more efficient ligand based on the dock score of -26.3398 still could not be considered as the natural compound oxamide also was highly comparable with the value of -20.3173. The binding affinity of the selected molecule was analyzed through Pose View and LigPlot.

Influence of fenvalerate and quercetin on hepatic antioxidant enzymes.

Pyrethroids are a class of neurotoxic pesticides with high selectivity for insects. Fenvalerate is a synthetic pyrethroid pesticide used to protect a variety of crops. Fenvalerate has been reported to exert deleterious effects on non target organisms including mammals. Recently, Fenvalerate was reported to cause liver damage in rats probably by generating oxidative stress while Quercetin, a potential antioxidant, has been reported to posses hepatoprotective activity. Therefore, the aim of the present investigation was to assess the ability of Quercetin to protect liver from Fenvalerate induced toxicity. In the present investigation an effort was made to evaluate the effect of Quercetin and Fenvalerate on hepatic G 6PD, GST and GR. Fenvalerate administration demonstrated significant reduction in the activities of hepatic G-6-PD, GST and GR while rats co treated with Quercetin showed significant recovery in the activities of these antioxidant enzymes.

Ethanol production from spent substrate of pleurotus eous.

Spent substrate, the residual material of mushroom cultivation, causes disposal problems for cultivators. Currently the spent substrate of different mushrooms is used mainly for composting. Edible mushrooms of Pleurotus sp. can grow on a wide range of lignocellulosic substrates. In the present study, Pleurotus eous was grown on paddy straw and the spent substrate was used for the production of ethanol. Lignocellulosic biomass cannot be saccharified by enzymes to high yield of ethanol without pretreatment. The root cause for the recalcitrance of lignocellulosic biomass such as paddy straw is the presence of lignin and hemicelluloses on the surface of cellulose. They form a barrier and prevent cellulase from accessing the cellulose in the substrate. In the untreated paddy straw, the amount of hemicelluloses and lignin (in % dry weight) were 20.30 and 20.34 respectively and the total reducing sugar was estimated to be 5.40 mg/g. Extracellular xylanase and ligninases of P. eous could reduce the amount of hemicelluloses and lignin to 16 and 11(% dry weight) respectively, by 21st day of cultivation. Growth of mushroom brought a seven fold increase in the total reducing sugar yield (39.20 mg/g) and six fold increase in the production of ethanol (6.48 g/L) after 48hrs of fermentation, when compared to untreated paddy straw.

The use of shortening in english for specific purposes: A practical review for nurses

Shortening as a word building process has become very productive in present day English. Abbreviations in nursing have also found a way for professional and quick communication. The main goals of this article, based on actual teaching-learning problems, is to provide some practical activities to give the learners opportunities to get acquainted with and practice abbreviations in an effective and communicative way, and to provide a glossary of the most frequently used abbreviations by nurses.

El uso de abreviaturas como proceso de construcción de palabras se ha vuelto muy productivo en el Inglés actual. Las abreviaciones también han encontrado un camino para la comunicación profesional y rápida. Los principales objetivos de este artículo, son proporcionar algunas oportunidades prácticas para brindar a los que aprenden oportunidades de familiarizarse y practicar abreviaturas de una forma eficaz y comunicativa, y proporcionar un glosario de las abreviaturas utilizadas más frecuentemente por las enfermeras.

Continence Self-Efficacy to Increase PFM Exercise Adherence in SUI / 간호학회지

Stress urinary incontinence is most common type in urinary incontinence. Most women had been suffering with stress urinary incontinence for more than a year in the community without seeking medical help. Under the assumption that stress urinary incontinence will be treated or improved by keeping PFM exercise with his/her continence confidence, this study was conducted. This study examined Continence self-efficacy effect on PFM exercise adherence. Subject were in 48 women aged 20 to 75 years with stress urinary incontinence and were recommended by their doctor to attempt PFM exercise as one treatment method.. Data were collected by self-administered report using Continence Self-Efficacy Scale, PFM exercise adherence check sheet. Telephone support was used as a method of CEIP to increase Continence self-efficacy. Continence self-efficacy score was higher in the intervention group than in control group (T=-3.23, P<.01), PFM exercise adherence was better in the intervention group than in control group (T=-4.03, P<.001). Through this research, it was also found that there were three types in attitude toward treatment; those who want to be treated completely, those who want to be relieved, and those who think urine loss is no problem. It can be concluded that to increase Continence self-efficacy was useful to the PFM exercise adherence of women with stress urinary incontinence.

Instructions to Contributors and References of Articles Published in the Journal of Korean Neurosurgical Society(Vol. 1-20)

The author reviewed references of the articles published in the Journal of Korean Neurosurgical Society(J Kor Neurosurg Soc), which is the only official journal of the Korean Neurosurgical Society. The number and descriptive methods of the references, and the instructions to contributors were studied. Some faults in the articles and the instructions were pointed out to improve the journal. Overall, 555 articles(30.0%) referenced articles published in the J Kor Neurosurg Soc. The number of referenced articles publishted in the journal was 1,223. The ratio of referenced articles published in the J Kor Neurosurg Soc to the total number of references was 3.0%. The number of the articles referencing articles published in the J Kor Neurosurg Soc was one in Volume 2, but it became 64 in Volume 17. Such tendency to increase seems to be continued. However, descriptive methods of references and the abbreviations of the journals were extremely variable. For the consistant reference, some correction of the instructions were proposed.