Monitoring the Outcome of Leprosy Using Leprosy Neuropathy Scale: A Preliminary Study

The disability and progress of leprosy patients is monitored by the WHO disability grading system which has limited sensitivity in leprous neuropathy. This study aims to report the spectrum of leprosy patients at a tertiary care neurology service and compare WHO grading, modified Rankin Scale (mRS) and Leprosy Neuropathy Scale (LNS) in monitoring the treatment outcome. The patients with leprosy diagnosed as per WHO criteria were subjected to medical history and clinical examination. Their disability was graded as per WHO grading scale, modified Rankin scale (mRS) and LNS. These parameters were repeated and compared after six months of multiple drug therapy (MDT). Thirty-eight patients with leprosy, aged 40 (`5-80) years, 33 of whom were males have been evaluated. The duration of symptoms was 24 (91-120) months. Mononeuropathy was present in 14, mononeuropathy multiplex in 24, trophic ulcer in two, claw hand in 11, wrist drop in two, foot drop in four, facial palsy in one, Charcot’s joint in one and lepra reaction in seven patients. Their disability as per WHO grade 1 and 2 was in 19 patients each. After 6 months of MDT, WHO grade improved in two patients, mRS revealed improvement in seven and LNS in nine patients. LNS- a clinical scale, seems more effective and easier to use for monitoring the progress/ outcome of neuropathy in leprosy patients and may complement the WHO grading scale

The safety and efficacy of hypothermia combining mechanical thrombectomy or thrombolysis in the treatment of ischemic stroke: A systematic meta-analysis

Abstract Background Stroke is a major global public health problem, affecting 13.7 million people worldwide. Previous studies have found a neuroprotective effect of hypothermia therapy and the efficacy and safety of combined hypothermia and mechanical thrombectomy or thrombolysis in the treatment of ischemic stroke have also attracted attention. Objective In the present research, the authors conducted a meta-analysis to comprehensively assess the safety and efficacy of hypothermia combining mechanical thrombectomy or thrombolysis in the treatment of ischemic stroke. Methods Articles published from January 2001 to May 2022 were searched from Google Scholar, Baidu Scholar and PubMed to evaluate the clinical significance of hypothermia treatment in ischemic stroke. Complications, short-term mortality, and the modified Rankin Scale (mRS) in the full text was extracted. Results 89 publications were selected and 9 among them were included in this study with sample size of 643. All selected studies are in accordance with the inclusion criteria. Forest plot of clinical characteristics was as follows: complications (RR = 1.132, 95% CI 0.942‒1.361, p = 0.186, I2= 37.2%), mortality within 3 months (RR = 1.076, 95% CI 0.694‒1.669, p = 0.744, I2= 0.00%), mRS ≤ 1 at 3 months (RR = 1.138, 95% CI 0.829‒1.563, p = 0.423, I2= 26.0%), mRS ≤ 2 at 3 months (RR = 1.672, 95% CI 1.236‒2.263, p = 0.001, I2=49.6%) and mRS ≤ 3 at 3 months (RR = 1.518, 95% CI 1.128‒2.043, p = 0.006, I2= 0.00%). The funnel plot suggested that there was no significant publication bias in the meta-analysis on complications, mortality within 3 months, mRS ≤ 1 at 3 months and mRS ≤ 2 at 3 months. Conclusion In summary, the results showed that hypothermia treatment was correlated with mRS ≤ 2 at 3 months, but not linked with complications and mortality within 3 months.

A Clinical Correlation of EEG Changes in Relation to Ischaemic Stroke on its Prognosis as per Location

Background : Stroke is a common, potentially devastating disease with potential high morbidity and mortality. EEG (Electro-encephalogram), functional representation of electrical activity of brain, changes are closely tied to CBF (Cerebral Blood Flow). Thus EEG is useful to establish the location of Ischaemic CVA (Cerebro-vascular accident). It can also prognosticate Ischaemic stroke. Aims & Objectives : (1) To assess the grade and severity of clinical manifestations in acute ischaemic stroke patients by clinical scoring following admission. (2) To obtain EEG findings of ischaemic stroke patients following admission and after 1 month. (3) To assess the morbidity of ischaemic stroke patients by Modified Rankin Scale after 1 month. (4) To correlate EEG changes according to the clinical outcome and according to the site of involvement of ischaemic stroke. Materials and Methods : 90 Patients were selected during the study period as per the inclusion and exclusion criteria. Clinical scoring was done by NIHSS (National Institute of Health Scoring System). CT (Computed Tomography) scan of brain and MRI (Magnetic Resonance Imaging) Brain with DWI (Diffusion Weighted Image) extension was done. EEG findings on admission of morbidity was done by Modified Rankin Score on follow up after 1 month was noted. EEG findings after 1 month was noted on follow up. Assessment Clinical correlation was compared with EEG changes. All the data were collected and analysed by statistical software SPSS version 20. Results : The mean MRS (Modified Rankin Score) after 1 month for abnormal EEG on admission was 4.50 in comparison to score of 3.36 in case of normal EEG. The p value of this association was 0.003 and was considered significant. Conclusions : Normal EEG and focal slowing of EEG was mostly noted in MCA (Middle Cerebral Artery) and PCA (Posterior Cerebral Artery) infarcts involving the cortical region. Those with normal EEG findings had good clinical outcome in comparison to those with abnormal findings in EEG

COMPARISON OF SERUM NEURON SPECIFIC ENOLASE AND RADIOLOGICAL IMAGING IN ASSESSING THE SEVERITY OF STROKE

Neuron Speci?c Enolase (NSE) is a glycolytic enzyme. It is exclusively present in neurons and neuroendocrine cells. It is an important marker to assess functional damage to neurons. Studies have shown that NSE is more than 90% sensitive to decide the severity of stroke. This study was conducted to compare the Serum levels of NSE and radiological imaging in assessing the severity of stroke. A hospital based descriptive study was conducted on 60 stroke patients (<72hrs from onset) and 60 controls. Glasgow Coma Scale (GCS) was assessed, and serum NSE was measured. Non contrast CT brain was taken. mRS scale was assessed after 30 days of onset of stroke. ROC curve analysis was done which showed a Sensitivity of 82.5% and Speci?city of 82.5% for serum levels of NSE at a cut off value 12ng/mL. NSE showed a positive correlation with mRS; negative correlation with GCS. Hence it is advisable to measure serum NSE levels at the existing health care facilities, where CT brain is not available.

Attention-deficit/hyperactivity disorder and brain metabolites from proton magnetic resonance spectroscopy: a systematic review and meta-analysis protocol

Abstract Despite major advances in the study of the brain, investigations on neurochemistry in vivo still lack the solid ground of more established methods, such as structural and functional magnetic resonance imaging. Proton magnetic resonance spectroscopy (MRS) is a technique that might potentially fill in this gap. Nevertheless, studies using this approach feature great methodological heterogeneity, such as varying voxel of choice, differences on emphasized metabolites, and absence of a standardized unit. In this study, we present a methodology for creating a systematic review and meta-analysis for this kind of scientific evidence using the prototypical case of attention-deficit/hyperactivity disorder. Systematic review registration: International Prospective Register of Systematic Reviews (PROSPERO), CRD42018112418.

Detection of the main multiresistant microorganisms in the environment of a teaching veterinary hospital in Brazil / Detecção dos principais microrganismos multirresistentes no ambiente de um hospital veterinário de ensino no Brasil

Contamination of the veterinary hospital environment with multiresistant pathogens endangers not only hospitalized animals, but also the workplace safety of veterinarians and nurses, animal guardians and, when in case of a teaching hospital, veterinary students. The objective of this study was to map the main points of bacterial contamination of a veterinary teaching hospital in Brazil to identify multiresistant microorganisms and their antimicrobial resistance genes. Samples were collected from 39 different locations of a veterinary school hospital which comprised a pool according to each hospital environment. In certain environments, more than one pool has been collected. All samples were collected in quadruplicates for the selective isolation of the main multiresistant microorganisms: methicillin-resistant Staphylococcus (MRS), vancomycin resistant Enterococcus (VRE), cephalosporinases and/or extended-spectrum beta-lactamase-producing Gram-negative bacteria (ESBL) and Carbapenemase-producing (CP). After isolation and identification of isolates, multiplex-PCR reactions were performed to detect the main genes for each microorganism and antimicrobial susceptibility tests with the main antibiotics used for each bacterial group according to CLSI. Of the 39 veterinary teaching hospital sites collected, all (100%) had at least one of the microorganisms surveyed, and 17.95% (n=7) of the sites were able to isolate the four pathogens. From the 94 pools collected, it was possible to isolate MRS in 81.91% (n=77), VRE in 12.77% (n=12), cephalosporinases and/or ESBL in 62.77% (n=59) and CP in 24.47%. (n=23). Regarding MRS, the mecA gene was detected in all isolates. All isolated VREs were identified as Enterococcus faecalis and presented the vanA gene. Regarding cephalosporinases and/or ESBL, 89.83% (n=53) of the isolates presented the blaTEM gene, 57.63% (n=34) the blaOXA-1 gene, 37.29% (n=22) blaCTX-M gene from some group (1, 2, 9 ou 8/25) and 20.34% (n=12) the blaSHV gene. It was possible to identify the main microorganisms responsible for causing nosocomial infections in humans (VRE, MRS, ESBL and CP) in the veterinary hospital environment, suggesting a source of infection for professionals and students of veterinary medicine, placing a high risk for public health.(AU)

A contaminação do ambiente hospitalar veterinário com patógenos multirresistentes coloca em perigo não apenas os animais hospitalizados, mas também a segurança no local de trabalho de veterinários e enfermeiros, responsáveis por animais e, quando se tratar de um hospital de ensino, estudantes de veterinária. O objetivo deste estudo foi mapear os principais pontos de contaminação bacteriana de um hospital veterinário de ensino no Brasil, identificando microorganismos multirresistentes e seus genes de resistência antimicrobiana. As amostras foram coletadas em 39 locais diferentes de um hospital de escola veterinária, que compreendia um pool de acordo com o ambiente de cada hospital. Em certos ambientes, mais de um pool foi coletado. Todas as amostras foram coletadas em quadruplicados para o isolamento seletivo dos principais microorganismos multirresistentes: Staphylococcus resistente à meticilina (MRS), Enterococcus resistente à vancomicina (VRE), bactérias Gram-negativas produtoras de cefalosporinases e/ou beta-lactamase de espectro estendido (ESBL) e produtoras de carbapenemase (PC). Após o isolamento e identificação dos isolados, foram realizadas reações de PCR multiplex para detectar os principais genes de cada microorganismo e testes de susceptibilidade a antimicrobianos com os principais antibióticos utilizados para cada grupo bacteriano de acordo com o CLSI. Dos 39 locais do VCH coletados, todos (100%) possuíam pelo menos um dos microrganismos pesquisados e 17,95% (n=7) dos locais foram capazes de isolar os quatro patógenos. Dos 94 pools coletados, foi possível isolar MRS em 81,91% (n=77), VRE em 12,77% (n=12), ESBL em 62,77% (n=59) e carbapenemases em 24,47% (n=23). Em relação ao MRS, o gene mecA foi detectado em todos os isolados. Todos os VREs isolados foram identificados como Enterococcus faecalis e apresentaram o gene vanA. Em relação às cefalosporinases e/ou ESBL, 89,83% (n=53) dos isolados apresentaram o gene blaTEM, 57,63% (n=34) o gene blaOXA-1, 37,29% (n=22) o gene blaCTX-M de algum grupo e 20,34% (n=12) o gene blaSHV. Foi possível identificar os principais microrganismos responsáveis por causar infecções nosocomiais em humanos (VRE, MRS, ESBL e CP) no ambiente hospitalar veterinário, sugerindo uma fonte de infecção para profissionais e estudantes de medicina veterinária, colocando alto risco para a saúde pública.(AU)

Detection of the main multiresistant microorganisms in the environment of a teaching veterinary hospital in Brazil

ABSTRACT: Contamination of the veterinary hospital environment with multiresistant pathogens endangers not only hospitalized animals, but also the workplace safety of veterinarians and nurses, animal guardians and, when in case of a teaching hospital, veterinary students. The objective of this study was to map the main points of bacterial contamination of a veterinary teaching hospital in Brazil to identify multiresistant microorganisms and their antimicrobial resistance genes. Samples were collected from 39 different locations of a veterinary school hospital which comprised a pool according to each hospital environment. In certain environments, more than one pool has been collected. All samples were collected in quadruplicates for the selective isolation of the main multiresistant microorganisms: methicillin-resistant Staphylococcus (MRS), vancomycin resistant Enterococcus (VRE), cephalosporinases and/or extended-spectrum beta-lactamase-producing Gram-negative bacteria (ESBL) and Carbapenemase-producing (CP). After isolation and identification of isolates, multiplex-PCR reactions were performed to detect the main genes for each microorganism and antimicrobial susceptibility tests with the main antibiotics used for each bacterial group according to CLSI. Of the 39 veterinary teaching hospital sites collected, all (100%) had at least one of the microorganisms surveyed, and 17.95% (n=7) of the sites were able to isolate the four pathogens. From the 94 pools collected, it was possible to isolate MRS in 81.91% (n=77), VRE in 12.77% (n=12), cephalosporinases and/or ESBL in 62.77% (n=59) and CP in 24.47%. (n=23). Regarding MRS, the mecA gene was detected in all isolates. All isolated VREs were identified as Enterococcus faecalis and presented the vanA gene. Regarding cephalosporinases and/or ESBL, 89.83% (n=53) of the isolates presented the blaTEM gene, 57.63% (n=34) the blaOXA-1 gene, 37.29% (n=22) blaCTX-M gene from some group (1, 2, 9 ou 8/25) and 20.34% (n=12) the blaSHV gene. It was possible to identify the main microorganisms responsible for causing nosocomial infections in humans (VRE, MRS, ESBL and CP) in the veterinary hospital environment, suggesting a source of infection for professionals and students of veterinary medicine, placing a high risk for public health.

RESUMO: A contaminação do ambiente hospitalar veterinário com patógenos multirresistentes coloca em perigo não apenas os animais hospitalizados, mas também a segurança no local de trabalho de veterinários e enfermeiros, responsáveis por animais e, quando se tratar de um hospital de ensino, estudantes de veterinária. O objetivo deste estudo foi mapear os principais pontos de contaminação bacteriana de um hospital veterinário de ensino no Brasil, identificando microorganismos multirresistentes e seus genes de resistência antimicrobiana. As amostras foram coletadas em 39 locais diferentes de um hospital de escola veterinária, que compreendia um pool de acordo com o ambiente de cada hospital. Em certos ambientes, mais de um pool foi coletado. Todas as amostras foram coletadas em quadruplicados para o isolamento seletivo dos principais microorganismos multirresistentes: Staphylococcus resistente à meticilina (MRS), Enterococcus resistente à vancomicina (VRE), bactérias Gram-negativas produtoras de cefalosporinases e/ou beta-lactamase de espectro estendido (ESBL) e produtoras de carbapenemase (PC). Após o isolamento e identificação dos isolados, foram realizadas reações de PCR multiplex para detectar os principais genes de cada microorganismo e testes de susceptibilidade a antimicrobianos com os principais antibióticos utilizados para cada grupo bacteriano de acordo com o CLSI. Dos 39 locais do VCH coletados, todos (100%) possuíam pelo menos um dos microrganismos pesquisados e 17,95% (n=7) dos locais foram capazes de isolar os quatro patógenos. Dos 94 pools coletados, foi possível isolar MRS em 81,91% (n=77), VRE em 12,77% (n=12), ESBL em 62,77% (n=59) e carbapenemases em 24,47% (n=23). Em relação ao MRS, o gene mecA foi detectado em todos os isolados. Todos os VREs isolados foram identificados como Enterococcus faecalis e apresentaram o gene vanA. Em relação às cefalosporinases e/ou ESBL, 89,83% (n=53) dos isolados apresentaram o gene blaTEM, 57,63% (n=34) o gene blaOXA-1, 37,29% (n=22) o gene blaCTX-M de algum grupo e 20,34% (n=12) o gene blaSHV. Foi possível identificar os principais microrganismos responsáveis por causar infecções nosocomiais em humanos (VRE, MRS, ESBL e CP) no ambiente hospitalar veterinário, sugerindo uma fonte de infecção para profissionais e estudantes de medicina veterinária, colocando alto risco para a saúde pública.

Quantification of Muscle Metabolites Using Proton Magnetic Resonance Spectroscopy (1 H-MRS) for Incomplete Spinal Cord Injury Patients: Preliminary Study

@#Introduction: This preliminary study aimed to non-invasively evaluate choline (CHO), creatine (Cr) and intramyocellular lipid (IMCL) metabolites in skeletal muscles at pre- and post-functional electrical stimulation (FES) exercise among incomplete spinal cord injury (SCI) of American Spinal Injury Association Impairment Scale (ASIA-AIS) D patients using proton magnetic resonance spectroscopy or 1 H-MRS. Methods: These metabolites were measured from the vastus lateralis and semitendinosus muscles of three incomplete SCI ASIA-AIS D patients who completed the FES exercise and later underwent 3 Tesla (T) MRI (repetition time/echo time; TR/TE of 3500ms/100ms, field-ofview; FOV of 20cm, slice thickness of 6mm) and 1 H-MRS (TR/TE of 2000ms/31ms, voxel size of 20mm x 20mm x 35mm). Results: Out of those selected metabolites, only CHO value of vastus lateralis showed a statistically significant difference between pre- and post FES exercise 1 H-MRS scanning (p = 0.01). Conclusion: Therefore, this preliminary finding has postulated that the quantification of muscle metabolites using 1 H-MRS imaging could be used as a potential indicator in evaluating the muscle strength for incomplete SCI ASIA-AIS D patients after the completion of FES cycling exercise.

Effect of timing of acupuncture on limb dysfunction in patients with cerebral infarction: a multicenter prospective cohort pilot study / 中国针灸

OBJECTIVE@#To evaluate the clinical efficacy of acupuncture at different timings in acute stage for limb dysfunction in patients with cerebral infarction.@*METHODS@#A total of 101 patients with cerebral infarction limb dysfunction were divided into an early exposure group (@*RESULTS@#Compared before treatment, the mRS grade at 30 and 60 days after onset in the early exposure group was improved (@*CONCLUSION@#The timing of acupuncture is an independent factor affecting the disability status and limb motor dysfunction in patients with cerebral infarction, and the effect of early intervention may be better than late intervention.

O Tempo vivido em Mrs. Dalloway à Luz da fenomenologia de Merleau-Ponty / Experienced Time in Mrs. Dalloway in Light of Merleau-Ponty's phenomenology / El Tiempo Vivido en La Señora Dalloway a la Luz de la fenomenología de Merleau-Ponty

O romance Mrs. Dalloway, escrito pela inglesa Virginia Woolf (1882-1941), é um marco na literatura universal por apresentar um novo formato na arte da escrita intitulado fluxo de consciência. Esta forma estilística visa descrever as falas e os pensamentos dos personagens por meio do discurso indireto livre, integrado à preleção do narrador. O enredo se passa em um único dia da vida da protagonista Clarissa Dalloway, no qual são captados os ínfimos detalhes do que ela experiencia. Dentre os fenômenos vivenciados encontramos a noção de tempo, por meio da qual o narrador mistura homogeneamente o fluxo passado, presente e futuro. O objetivo deste artigo é discutir a vivência do tempo na referida obra literária pautada numa discussão fenomenológica. Para isto, utilizamos como método a revisão narrativa da literatura de autores que contribuíram para o desenvolvimento da noção de tempo vivido na fenomenologia. É no fluxo do tempo que se dão os significados das experiências na história dos personagens no seu contato ambíguo com o mundo. Concluímos que as descrições elaboradas por Virginia Woolf possibilitam uma aproximação à vivência do tempo, que atravessa a totalidade da dimensão do ser...(AU)

The novel Mrs. Dalloway, written by English writer Virginia Woolf (1882-1941), is a landmark in universal literature for presenting a new format in the art of writing named Stream of Consciousness. This stylistic form aims to describe the speeches and thoughts of the characters through free indirect speech, integrated to the narrator's lecture. The novel takes place in a single day of the life of the protagonist Clarissa Dalloway, capturing the minute details of what she experiences. Among the phenomena experienced we find the notion of time, whereby the narrator mixes the past, present, and future flux into one envelope. This article thus discusses the experience of time in this literary work based on a phenomenological discussion. We conducted a review of the literature including authors that contributed to the development of the notion of experienced time in phenomenology. In the flow of time lie meanings of the experiences of characters in their ambiguous contact with the world. We conclude that the descriptions elaborated by Virginia Woolf allow for an approximation to the experience of time that crosses the totality of the dimension of being...(AU)

La novela La Señora Dalloway, de la escritora inglesa Virginia Woolf (1882-1941), es un hito en la literatura universal por presentar un nuevo formato en el arte de la escritura titulado "flujo de conciencia". Esta forma estilística pretende describir las palabras y los pensamientos de los personajes por medio del discurso indirecto libre, integrado a la prelección del narrador. La historia de la novela se pasa en un único día de la vida de la protagonista Clarissa Dalloway, en el que se captan los ínfimos detalles de lo que ella experimenta. Entre los fenómenos vivenciados encontramos la noción de tiempo, por medio de la cual el narrador mezcla el flujo pasado, presente y futuro en un envoltorio único. El objetivo de este artículo es discutir la vivencia del tiempo en la referida obra literaria pautada en una discusión fenomenológica. Para ello, utilizamos como método la revisión de la literatura de autores que contribuyeron al desarrollo de la noción de tiempo vivido en la fenomenología. Es en el flujo del tiempo que se dan los significados de las experiencias en la historia de los personajes en su contacto ambiguo con el mundo. Concluimos que las descripciones elaboradas por Virginia Woolf posibilitan una aproximación a la vivencia del tiempo, que atraviesa la totalidad de la dimensión del ser...(AU)

Exploring Changes in Thalamus Metabolites as Diagnostic Biomarkers in Idiopathic Generalised Epilepsy Patients Using Magnetic Resonance Spectroscopy

@#Introduction: Idiopathic generalised epilepsy (IGE) refers to a group of epilepsies resulting from the activation of neurons in the whole brain. This study aimed to evaluate the metabolite changes in thalamus as diagnostic biomarkers in IGE patients compared to healthy individuals using magnetic resonance spectroscopy (MRS) technique. Methods: The MRS was performed on 35 IGE patients (26 women and 11 men) with average age of 32 (ranged from 18 to 43) and 35 healthy individuals (13 women and 22 men) with average age of 31 (ranged from 21 to 50) as the control group. The levels of N-acetylaspartate (NAA), creatine (Cr) and choline (Cho) were measured using MRS. The NAA/Cr and NAA/Cho ratios were calculated for all participants. These values were statistically compared using t-test between the groups. Results: The NAA had significant lower values in IGE patients, 9.6 (SD = 0.8) and 9.9 (SD = 0.7) for right and left thalamus, respectively, compared to 10.9 (SD = 0.9) and 10.7 (SD = 0.9) in control group. The Cr values in the left side of thalamus were significantly higher in IGE patients (6.7 [SD = 0.8] versus 5.8 [SD = 0.5]); however, there was no difference in right thalamus. Measurements showed no difference for amounts of Cho between the groups in both sides of thalamus. The NAA/Cr ratio was 1.48 (SD = 0.14) and 1.48 (SD = 0.16) for right and left thalamus, respectively, in IGE patients in comparison with 1.83 (SD = 0.2) and 1.86 (SD = 0.26) in controls. There was no meaningful variation between the NAA/Cho ratio of the right and left thalamus among the groups. Conclusion: Thalamic NAA, Cr and NAA/Cr ratio values in IGE patients showed statistical differences compared to healthy individuals. Evaluating metabolites variations in thalamus using MRS is suggested for differentiating IGE patients from healthy individuals.

Antibacterial activity of Eriobotrya japonica leaf extracts against methicillin-resistant Staphylococcus aureus

Aim: To investigate antimethicillin-resistant Staphylococcus aureus (MRSA) activity of E. japonica leaf and to elucidate its anti-MRSA mechanism. Methodology: Methanolic extract of dried E. japonica leaf was partitioned in n-hexane, dichloromethane, ethyl acetate (EtOAc) and n-butyl alcohol. Antibacterial activity of extracts was determined by disk diffusion assay and minimum inhibitory concentration.Total RNA isolation was performed by treating MRSA culture with EtOAc sub-fractions. All MRSA isolates were tested for the presence of genes by reverse transcription polymerase chain reaction, followed by Western Blot. Results: The highest MRSA activity was observed from EtOAc sub-fraction 03 of methanolic extract. The minimum inhibitory concentration values of EF03 ranged from 32 to 64 µg ml-1 against methicillin-susceptible and -resistant S. aureus. EF03 fractions inhibited the expression of resistant genes in a dose-dependent manner. Moreover, the results of Western Blot assay indicated that the EF03 fractions inhibited the expression levels of resistant protein, PBP2a in a dose-dependent manner. Interpretation: EtOAc soluble fraction of E. japonica leaf evidenced profound antimicrobial activity, and inhibited expression of resistant genes against MRSA.

Evaluación del Tratamiento Homeopático de Mujeres en Climaterio entre los 45 y 60 años con la Menopause Rating Scale (MRS) / Treatment Evaluation Homeopathic Women in Climacteric between 45 and 60 years old with Menopause Rating Scale (MRS)

La terapia hormonal es el tratamiento convencional para contrarrestar síntomas propios del climaterio; sin embargo, algunas mujeres tienen contraindicada esta terapia debido a los efectos adversos que provoca. El objetivo de este estudio fue evaluar la utilidad del tratamiento homeopático durante el climaterio con el uso de la Menopause Rating Scale (MRS) o Escala de Calificación Menopáusica. El estudio incluyó a 31 mujeres, sin problemas cardiacos, sin terapia de reemplazo hormonal y sin antecedentes de cáncer, a quienes se les aplicó el cuestionario de la MRS para obtener un puntuaje antes del tratamiento. Para determinar el tratamiento se utilizó el repertorio electrónico Radar 10.0 para Windows, con el objetivo de repertorizar los síntomas característicos de cada paciente y determinar el medicamento similar. El medicamento fue prescrito en dinamizaciones 30CH, indicando 5 gotas sublinguales cada 8 horas. La evaluación de los pacientes se llevó a cabo cada mes durante tres meses. Se realizó una evaluación final a los tres meses por comparación de puntajes de la escala inicial y final, a través de un análisis estadístico y utilizando la prueba de Wilcoxon. Lachesis trigonocephalus y Pulsatilla nigricans fueron los medicamentos indicados con mayor frecuencia, de acuerdo con los síntomas de cada paciente. La comparación del puntaje, antes y después del tratamiento, evidenció una reducción de síntomas con diferencia estadística, lo cual reflejó una mejoría global del 35%. Esta evidencia sugiere que el tratamiento homeopático beneficia a las mujeres en el climaterio. (AU)

Hormonal therapy is the conventional treatment for counteracting climacteric symptoms; however, this treatment is contraindicated in some women due to the adverse effects that this therapy may cause. The purpose of this study was to evaluate the usefulness of homeopathic therapy during the climacteric using the Menopause Rating Scale (MRS). The study included 31 women, without cardiac problems, history of no cancer or hormone replacement therapy; a MRS scale questionnaire was applied to these women to evaluate each symptom before to treatment. The Radar 10.0 for Windows electronic repertoire was used to repertorize the characteristic symptoms of each patient and determine the similarly. Homeopathic medication was prescribed in 30CH dynamization as 5 sublingual drops every 8 hrs. Patient evaluation took place monthly for 3 months. The evaluation of the results was performed by the comparison of scale scores through a statistical analysis using the Wilcoxon test. Lachesis trigonocephalus and Pulsatilla nigricans were the most frequent treatment indications, according to the symptoms of each patient. At the end of the homeopathic treatment, symptoms reduction was observed with statistical significance in the score, which reflects an overall improvement of 35%. This evidence suggested that homeopathic treatment benefits women in climacteric. (AU)

Therapeutic effect of early directional catheterization on malignant middle cerebral artery infarction / 中华急诊医学杂志

Objective@#To investigate the efficacy and safety of cuboid stereotactic aspiration of necrotic brain tissue for treating malignant middle cerebral artery infarction in the elderly patients.@*Methods@#Sixteen elderly patients with malignant middle cerebral artery infarction were selected from June 2017 to January 2019 in our hospital. Patients were followed up for 6 months to evaluate the efficacy of stereotactic aspiration of necrotic brain tissue using the modified Rankin Scale (mRS).@*Results@#The 30-day mortality was 18.75%. Among the 16 elderly patients, 6 (37.5%) had an mRS score of 3 (defined as moderate disability), 6 (37.5%) had an mRS score of 4 (defined as moderate to severe disability), 1 (6.25%) had an mRS score of 5 (defined as severe disability), and 3 (18.75%) had an mRS score of 6. The probability of 6-month favorable outcome, defined as an mRS score of ≤3, was 37.5%, and the 6-month mortality was 18.75%.@*Conclusions@#It is a simple, minimally invasive, effective and safe method to treat malignant middle cerebral artery infarction in the elderly patients with cuboid stereotactic aspiration of necrotic brain tissue, which needs to be confirmed by further randomized controlled studies.

Therapeutic effect of early directional catheterization on malignant middle cerebral artery infarction / 中华急诊医学杂志

Objective To investigate the efficacy and safety of cuboid stereotactic aspiration of necrotic brain tissue for treating malignant middle cerebral artery infarction in the elderly patients.Methods Sixteen elderly patients with malignant middle cerebral artery infarction were selected from June 2017 to January 2019 in our hospital.Patients were followed up for 6 months to evaluate the efficacy of stereotactic aspiration of necrotic brain tissue using the modified Rankin Scale (mRS).Results The 30-day mortality was 18.75％.Among the 16 elderly patients,6 (37.5％) had an mRS score of 3 (defined as moderate disability),6 (37.5％) had an mRS score of 4 (defined as moderate to severe disability),1 (6.25％) had an mRS score of 5 (defined as severe disability),and 3 (18.75％) had an mRS score of 6.The probability of 6-month favorable outcome,defined as an mRS score of ≤ 3,was 37.5％,and the 6-month mortality was 18.75％.Conclusions It is a simple,minimally invasive,effective and safe method to treat malignant middle cerebral artery infarction in the elderly patients with cuboid stereotactic aspiration of necrotic brain tissue,which needs to be confirmed by further randomized controlled studies.

Methionyl-tRNA Synthetase is a Useful Diagnostic Marker for Lymph Node Metastasis in Non-Small Cell Lung Cancer

PURPOSE: Identification of lymph node (LN) metastasis in non-small cell lung cancer (NSCLC) is critical for disease staging and selection of therapeutic modalities. Sometimes it is not possible to obtain LN core tissue by endobronchial ultrasound-guided transbronchial needle aspirate (EBUS-TBNA), resulting in low diagnostic yield. MATERIALS AND METHODS: In this study, 138 specimens were collected from 108 patients who underwent EBUS-TBNA under the suspicion of LN metastasis of NSCLC. Diagnostic yields of anti-CD45 and anti-methionyl-tRNA synthetase (MRS), immunofluorescent (IF) staining on cytology specimens were compared with those of conventional cytology and positron emission tomography-computed tomography (PET-CT). RESULTS: MRS was strongly expressed in NSCLC cells metastasized to LNs, but weakly expressed in cells at the periphery of the LN germinal center. The majority of cells were CD20 positive, although a few cells were either CD3 or CD14 positive, indicating that CD45 staining is required for discrimination of non-malignant LN constituent cells from NSCLC cells. When the diagnostic efficacy of MRS/CD45 IF staining was evaluated using 138 LN cellular aspirates from 108 patients through EBUS-TBNA, the sensitivity was 76.7% and specificity was 90.8%, whereas those of conventional cytology test were 71.8% and 100.0%, respectively. Combining the results of conventional cytology testing and those of PET-CT showed a sensitivity and specificity of 71.6% and 100%, and the addition of MRS/CD45 dual IF data to this combination increased sensitivity and specificity to 85.1% and 97.8%, respectively. CONCLUSION: MRS/CD45 dual IF staining showed good diagnostic performance and may be a good tool complementing conventional cytology test for determining LN metastasis of NSCLC.

Therapeutic effects of heated humidified high flow nasal cannula oxygen therapy in patients with post-stroke systemic inflammatory response syndrome / 实用医学杂志

Objective To observe the effect of heated humidified high flow nasal cannula oxygen therapy (HFNC) on patients with post-stroke systemic inflammatory response syndrome (SIRS). Methods Totally 78 patients with post-stroke SIRS were selected in the department of neurology of Wuxi People's Hospital and were randomly divided into HFNC group (n=40) and conventional therapy group (n = 38). The neurological impairment score (NIHSS) , APACHE-Ⅱ, clinical pulmonary infection score (CPIS) , C-reactive protein (CRP) of the 2 groups were recorded before and after the treatment. At the same time, modified Rankin score (mRS) of the two groups were also recorded. Results There was no significant difference in terms of morality and the number of patients with mechanical ventilation in the 2 groups. The 7-day APACHE Ⅱ, 7-day CPIS, 7-day SIRS cure rate, 14-day NIHSS and mRS of 3 months in HFNC group were higher than those in the conventional therapy group (P < 0.05).There was no significant difference in 7-day CRP, 14-day CRP and 14-day CPIS between HFNC group and conventional oxygen therapy group (P> 0.05). Conclusions HFNC can improve lung infection of patients with SIRS thus improve the recovery rate of SIRS. At the same time, it can improve the recovery of the neurological deficit and prognosis in acute stroke.

Changes and clinical significance of serum sLOX-1 and omentin-1 in patients with H-type hypertension complicated with acute ischemic stroke / 实用医学杂志

Objective To investigate the changes of soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) and omentin-1 in patients with H-type hypertension complicated with acute ischemic stroke, and to analyze the correlation of sLOX-1 and omentin-1 levels with the severity and prognosis of the disease.Methods Totally 136 patients with H-type hypertension complicated with acute ischemic stroke from February2017 to May 2018 were selected as observation group, and 136 non-acute ischemic stroke patients with H-type hypertension in the same period as the control group. The patients of observation group were divided into mild, moderate and severe sub-groups according to NIHSS score, and they were also divided into good prognosis group and poor prognosis group based on modified RANKIN scale (mRS) score. The serum sLOX-1 and omentin-1 levels were detected, and the correlation of sLOX-1 and omentin-1 levels with severity and prognosis of disease was analyzed. Results The serum sLOX-1 level of the observation group was higher, but the serum omentin-1 level lower than that of control group (P < 0.05). With the severity of the disease, the serum sLOX-1 level increased, but the serum omentin-1 level decreased (P < 0.05). The serum sLOX-1 level of good prognosis group was significantly lower, whereas the serum omentin-1 level significantly higher than that of poor prognosis group (P < 0.05). sLOX-1 was positively correlated with NIHSS score and mRS score, while omentin-1 was negatively correlated with NIHSS score and mRS score (P < 0.05). Conclusions The levels of serum sLOX-1 and omentin-1 are closely related to the severity and prognosis of patients with H-type hypertension complicated with acute ischemic stroke, which could be used as markers for evaluating the severity and prognosis of the patients.

Influencia de la etnia mapuche sobre la indicación de terapia hormonal de la menopausia según aplicación escala de calidad de vida (mrs), en población rural de la araucanía / Influence of the Mapuche ethnic group on the indication of hormonal therapy for menopause according to the application of the quality of life scale (mrs), in a rural population of Araucanía

RESUMEN Objetivo: Relacionar la pertenencia a la etnia Mapuche y los síntomas climatéricos de indicación de Terapia Hormonal de la Menopausia (THM), en una población del sector rural de Boyeco, región de La Araucanía. Materiales y métodos: Estudio observacional realizado en mujeres rurales en control de salud en CESFAM Boyeco entre octubre de 2016 y enero de 2017. Ninguna de las participantes evaluadas recibía THM. Para el estudio, se consideró el número de apellidos mapuches. Se utilizó el instrumento validado para población chilena, "Escala MRS" (Menopause Rating Scale), el cual permite discriminar los diferentes dominios sintomáticos del climaterio. Resultados: El grupo en estudio lo componen 36 mujeres de 41 a 78 años de edad, promedio (DE) 52,8(8,6) años, un 52,8% tiene dos apellidos mapuches y 25% uno. Un 92,8% de las mujeres mapuche tiene indicación de terapia, versus todas las no mapuche. En las menores de 50 años, todas tiene indicación de terapia, frente a un 71,4% en las mayores de 50 años. Conclusiones: Las pacientes mapuches tienen mayor sintomatología en los dominios somáticos y psicológicos, especialmente aquellas bajo 50 años. Todas las mujeres estudiadas bajo 50 años requieren terapia, sin variación estadísticamente significativa x etnicidad.

SUMMARY Objective: To stablish the relationship between belonging to Mapuche ethnic group on the climacteric symptoms for indication of menopause hormone therapy (HTM), in the rural population of Boyeco, inside of Araucania's region, Chile. Materials and methods: An observational and descriptive study, in a sample in time of 36 women belonging to the sector who attended CESFAM Boyeco, between October 2016 and January 2017. None of the evaluated participants received THM. As exposure variable, it was considered the number the mapuche surnames. We used the Menopause Rating Scale (MRS), an international instrument validated for Chilean population, to discriminate the different symptomatic domains of the climacteric period. Results: 94.7% of mapuche women and all non-mapuche population had prescribed hormonal therapy. Independent of ethnicity, those under 50 years of age, 100% have an indication for therapy compared to 71.4% in those over 50 years of age. Conclusions: Mapuche patients have greater symptomatology in the somatic-psychological domains, especially in those under 50 years of age. The totality of women under 50 requires therapy, however, variation according to ethnicity.

Síntomas psicológicos en la transición menopáusica / Psychological symptoms in the menopausal transition

RESUMEN OBJETIVO: Conocer los síntomas en la Transición Menopáusica, mediante el autoinforme de la mujer, clasificado en tres grupos: 1er. Temprana de la Transición Menopáusica (etapa −2), 2°. Tardía de la Transición Menopáusica y Temprana de Postmenopausia (etapas −1 y +1a) y 3er. grupo Temprana de Postmenopausia con Tardía de Postmenopausia (etapas +1b, +1c y +2), analizando síntomas psicológicos. MATERIAL Y MÉTODO: Estudio no experimental transversal muestreo no probabilístico. Participantes 116 mujeres en un rango de edad entre 40 y 60 años con alto nivel de escolaridad, mediante la Escala de Clasificación en la Menopausia MRS, el Inventario de Ansiedad y Depresión de Beck. RESULTADOS: La muestra quedó conformada por un total de 100 mujeres con al menos un síntoma, con alto nivel de escolaridad y en el rango de edad de 40 a 60 años, agrupadas por etapa de Transición Menopáusica: 1er. grupo 36 mujeres, 2°. grupo 16 y 3er. grupo con 48 personas. Los síntomas psicológicos medidos con MRS son los más frecuentes en 41.60%; reportan queja subjetiva de pérdida de memoria 57% de las mujeres. Alfa Cronbach de .74 en MRS. CONCLUSIONES: Los síntomas psicológicos están presentes como un continuo a lo largo de la Transición Menopáusica, posiblemente debidos a la disminución de concentración de estrógenos, lo que conlleva en algunos casos al diagnóstico de Trastorno Neurocognitivo Leve.

ABSTRACT OBJECTIVE: To know the symptoms in the Menopausal Transition, through the self-report of the women, classified into three groups: 1st. Early Menopausal Transition (stage −2), 2nd. Late Menopausal Transition and Early Postmenopause (stages −1 and +1a) and 3rd. group Early Postmenopause with Late Postmenopause (stages +1b, +1 c and +2), analyzing psycological symptoms. MATERIAL & METHOD: Non-experimental transversal study, non-probabilistic sampling. The participants were 116 women between 40 and 60 years old with high schooling level, through The Menopause Rating Scale MRS, Beck Anxiety Inventory and Depression Inventory. RESULTS: The final sample consisted of 100 women with at least one symptom, with a high schooling level in the range of 40 to 60 years, grouped by Menopausal Transition stage: 1st. 36 women, 2nd. Group 16 and 3rd. group with 48. The psycological symptoms measured with MRS were the most frequently in 41.60%; report subjective complaint of memory loss 57% of women. Alfa Cronbach of .74 in MRS. CONCLUSION: Psychological symptoms are present as a continuum throughout the Menopausal Transition, possibly due to the decreased concentration of estrogen, which in some cases leads the diagnosis of Mild Neurocognitive Disorder.