ABSTRACT
Background & objectives: As CD4+ and CD8+ T lymphocyte numbers decline, the conventional, localized forms of tuberculosis shift to the atypical, disseminated forms. Variations in lymphocyte and immune cell expression levels affect how tuberculosis manifests in disseminated forms. Understanding the relationship between lymphocyte counts (CD4+ and CD8+) and pro-inflammatory cytokines such as tumour necrosis factor-alpha, interleukin-12 and interferon, we may therefore be able to shed light on how infections spread and suggest potential biomarkers for these immune factors. Methods: In this study, 15 guinea pigs were infected with Mycobacterium tuberculosis (M.tb) H37Rv strain and grouped into three groups of five each for further investigation. Serum samples and bronchoalveolar lavage (BAL) fluid were examined for the expression of pro-inflammatory cytokines and T-cell subsets in guinea pigs infected with pulmonary tuberculosis and disseminated tuberculosis. Results: We found that M.tb escapes macrophages due to pro-inflammatory cytokine dysregulation. Despite the protective immunity created by T-cells and cytokines, M.tb bacilli may spread to other organs due to inflammation induced by these immune components. A high number of T-cells and stimulated cytokine production are involved in triggering inflammation after necrotic tissue develops and tuberculosis spreads. Interpretation & conclusions: Our findings imply that increased bacilli in the spleen at the 8th wk of infection may be caused by the overexpression of CD4+ T-cell lymphocyte subsets and cytokines that generated inflammation during the 4th wk of infection. This is a pilot study with a small sample size and less assertive inference. Larger studies would be helpful to validate the results of the present investigation.
ABSTRACT
Few reports have yet investigated adequate cognitive rehabilitation for patients with chronic cognitive disorder. In this report, we describe a case of cognitive rehabilitation 10 months after onset of cerebral infarction in the right middle cerebral artery region, resulting in a good outcome. The patient was a 44-year-old right-handed male, with primary symptoms of inattention and left hemispatial neglect. The patient had not undergone any neuropsychological evaluations or cognitive rehabilitation until 10 months after disease onset. After 30 days of both direct attention training and metacognitive strategy training, including time pressure management, improvement of his cognitive disorder was achieved. The teaching of internal methods to improve metacognition with a high level of evidence was effective even 10 months after onset. Furthermore, it is important for therapists who provide cognitive rehabilitation using metacognitive strategy training to understand patients' remaining functions based on neuropsychological assessment, and to consider and teach compensatory methods so that they can be effectively used by patients in situations of daily life.
ABSTRACT
Few reports have yet investigated adequate cognitive rehabilitation for patients with chronic cognitive disorder. In this report, we describe a case of cognitive rehabilitation 10 months after onset of cerebral infarction in the right middle cerebral artery region, resulting in a good outcome. The patient was a 44-year-old right-handed male, with primary symptoms of inattention and left hemispatial neglect. The patient had not undergone any neuropsychological evaluations or cognitive rehabilitation until 10 months after disease onset. After 30 days of both direct attention training and metacognitive strategy training, including time pressure management, improvement of his cognitive disorder was achieved. The teaching of internal methods to improve metacognition with a high level of evidence was effective even 10 months after onset. Furthermore, it is important for therapists who provide cognitive rehabilitation using metacognitive strategy training to understand patients' remaining functions based on neuropsychological assessment, and to consider and teach compensatory methods so that they can be effectively used by patients in situations of daily life.
ABSTRACT
@# Objective To explore the effects of transcutaneous electrical acupoint stimulation (TEAS) on upper limbs function in chronic stroke patients. Methods From March, 2016 to May, 2018, 53 patients were randomly divided into control group (n = 27) and research group (n = 26). All the patients received conventional rehabilitation, and the research group received additional intervention of TEAS, for six weeks. They were assessed with Manual Muscle Test (MMT) on upper limbs, modified Ashworth Scale (MAS), Fugl-Meyer Assessment-upper extremities (FMA-UE), Hand Motor Status Scale and modified Barthel Index (MBI) before, at the end of 6-week treatment and twelve weeks after treatment. Results There was no significant difference in all the scores between two groups at the end of 6-week treatment (t < 1.511, P > 0.05). The scores of MMT of wrist dorsal extension, FMA-UE and MBI were better in the research group than in the control group twelve weeks after end of treatment (t > 2.312, P < 0.05). Conclusion TEAS may promote the recovery of hands and upper limbs function in chronic stroke patients.
ABSTRACT
Subacute and chronic cerebrovascular occlusion is an uncommon but an important cause for ischemic stroke.The main pathogenic mechanism is local hemodynamic disorder.Theoretically,the improvement of hemodynamic disorder can reduce the incidence of stroke as well as improve the prognosis.At present,there is still controversy over the optimal therapeutic plan.With the rapid development of interventional techniques,considerable progresses have been made in the endovascular treatment for subacute and chronic cerebrovascular occlusion,although some shortcomings still exist.This article aims to make a comprehensive review about the subacute and chronic cerebrovascular occlusion,focusing on its definition,damage,clinical status of its treatment,imaging evaluation,technical points of endovascular therapy,and procedure-related complications.
ABSTRACT
Background : Constraint-induced movement therapy (CI therapy) is a rehabilitation treatment that effectively improves upper extremity function in patients with chronic hemiparesis after stroke. In Japan, no previous studies have shown the effects of CI therapy in a large size sample, and the Simple Test for Evaluating Hand Function (STEF), a standard assessment tool for upper extremity function, is rarely used to evaluate the effects of CI therapy. Little is known regarding the factors capable of predicting the outcome of CI therapy. The present study aimed to examine potential predictors of outcomes after CI therapy and the effects of CI therapy using STEF. Methods : This study included patients with hemiparesis in the chronic stage of stroke (≥180 days from onset). We compared upper extremity function before and after CI therapy intervention, which involved 5 hours per day for 10 consecutive weekdays of training. We assessed upper extremity function using the STEF, Wolf Motor Function Test-functional ability scale (WMFT-FAS) before and after intervention, and investigated potential predictors (age, gender, time since stroke, type of stroke, side of stroke, hand dominance, spasticity). Results : There were 107 subjects. Our comparison revealed that both STEF and WMFT-FAS scores improved significantly following intervention, from means of 31.3 to 42.7 points and 51.8 to 57.0 points, respectively. No significant predictors that influenced the functional outcome were identified. Conclusion : CI therapy is effective for improving upper extremity function. It is important not to exclude people from CI therapy based on any supposed predictors.