Incidencia, circunstancias y consecuencias de caídas en sujetos con accidente cerebrovascular: un año de seguimiento / Incidence, circumstances and consequences of falls in subjects with stroke: One year of follow-up

Introducción: Luego del accidente cerebrovascular (ACV), una de las complicaciones más frecuentes son las caídas, impactando negativamente en la rehabilitación. Objetivos: Estudiar la incidencia, las circunstancias y las consecuencias de las caídas en sujetos con ACV hasta 12meses de iniciado el tratamiento kinésico ambulatorio. Materiales y métodos: Diseño prospectivo, serie de casos. Muestreo consecutivo. Pacientes ingresados en el Hospital de Día entre junio de 2019 y mayo de 2020. Se incluyeron: adultos con diagnóstico de primer ACV supratentorial y puntuación ≥3 en la Functional Ambulatory Category. Criterios excluyentes: otra afección que afecte la locomoción. Variables principales: número de caídas, circunstancias y consecuencias. Se midieron las características clínico-demográficas y funcionales. Resultados: Un total de 21 sujetos incluidos; 13 sufrieron al menos una caída. Reportaron 41 caídas: 15 fueron hacia el lado más afectado, 35 en el interior del hogar, 28 sin el equipamiento indicado, en 29 ocasiones estaban solos durante el evento y en 2 situaciones se requirió asistencia médica. Hubo diferencias estadísticamente significativas (p<0,05) en el desempeño funcional (equilibrio, velocidad de marcha) entre los que se cayeron con respecto a los que no. No se hallaron diferencias significativas entre la resistencia de la marcha y las caídas. Conclusión: Más de la mitad sufrieron caídas, estando solos, hacia el lado más débil y sin el equipamiento indicado. Con esta información se podría disminuir la incidencia desarrollando medidas preventivas.(AU)

Introduction: Falls are among the most frequent complications following stroke (CVA), and have a negative impact on rehabilitation. Objectives: To study the incidence, circumstances, and consequences of falls in stroke patients up to 12months after starting outpatient kinetic treatment. Materials and methods: Prospective design, case series. Consecutive sampling. Patients admitted to the day hospital between June 2019 and May 2020. Included: adults with a diagnosis of first supratentorial stroke and functional ambulatory category score ≥3. Exclusion criteria: other condition affecting locomotion. Main variables: number of falls, circumstances, and consequences. Clinical, demographic, and functional characteristics were measured. Results: Twenty-one subjects were included, 13 suffered at least one fall. The subjects reported 41 falls: 15 were to the most affected side, 35 inside the home, 28 without the indicated equipment, they were alone when the event occurred on 29 occasions, and in two situations medical assistance was required. There were statistically significant differences (P<.05) in functional performance (balance, gait velocity) between those who fell and those who did not. No significant differences were found between gait endurance and falls. Conclusion: More than half suffered a fall, alone, to the weaker side, and without the appropriate equipment. With this information the incidence could be reduced by preventive measures.(AU)

[Incidence, circumstances and consequences of falls in subjects with stroke: One year of follow-up]. / Incidencia, circunstancias y consecuencias de caídas en sujetos con accidente cerebrovascular: un año de seguimiento.

INTRODUCTION: Falls are among the most frequent complications following stroke (CVA), and have a negative impact on rehabilitation. OBJECTIVES: To study the incidence, circumstances, and consequences of falls in stroke patients up to 12months after starting outpatient kinetic treatment. MATERIALS AND METHODS: Prospective design, case series. Consecutive sampling. Patients admitted to the day hospital between June 2019 and May 2020. Included: adults with a diagnosis of first supratentorial stroke and functional ambulatory category score ≥3. EXCLUSION CRITERIA: other condition affecting locomotion. MAIN VARIABLES: number of falls, circumstances, and consequences. Clinical, demographic, and functional characteristics were measured. RESULTS: Twenty-one subjects were included, 13 suffered at least one fall. The subjects reported 41 falls: 15 were to the most affected side, 35 inside the home, 28 without the indicated equipment, they were alone when the event occurred on 29 occasions, and in two situations medical assistance was required. There were statistically significant differences (P<.05) in functional performance (balance, gait velocity) between those who fell and those who did not. No significant differences were found between gait endurance and falls. CONCLUSION: More than half suffered a fall, alone, to the weaker side, and without the appropriate equipment. With this information the incidence could be reduced by preventive measures.

Comparative seed longevity under genebank storage and artificial ageing: a case study in heteromorphic wheat wild relatives.

Seed longevity is a complex trait that depends on numerous factors. It varies among species and populations, and within different seed morphs produced by the same plant. Little is known about variation in longevity in different seed morphs or the physiological and molecular basis of these differences. We evaluated the longevity and oxidative stress status in heteromorphic seeds aged in two different storage conditions. We compared controlled ageing tests (seed storage at 45°C and 60% relative humidity; a method of accelerated ageing used to estimate longevity in genebank conditions) with storage in a genebank for up to 40 years (-18°C and 8% seed moisture content). We employed as study species two wild wheats characterized by seed heteromorphism: Aegilops tauschii and Triticum monococcum subsp. aegilopoides. We estimated the ROS content and the expression of genes coding for enzymes related to the H2 O2 scavenging pathway. Results confirmed that seed longevity varies between different seed morphs. Different storage environments resulted in different longevity and survival curves. ROS levels, even if with variable patterns, were higher in several aged seed lots. We observed consistency in the expression of two genes (GSR and CAT) related to ROS scavenging in the late phase of pre-germinative metabolism. Differences in seed longevity between morphs were observed for the first time under genebank conditions. Our results suggest also that controlled ageing tests should be used with caution to infer ranks of longevity under cold storage.

Absolute frequency referencing in the long wave infrared using a quantum cascade laser frequency comb.

Optical frequency combs (OFCs) based on quantum cascade lasers (QCLs) have transformed mid-infrared spectroscopy. However, QCL-OFCs have not yet been exploited to provide a broadband absolute frequency reference. We demonstrate this possibility by performing comb-calibrated spectroscopy at 7.7 µm (1305 cm-1) using a QCL-OFC referenced to a molecular transition. We obtain 1.5·10-10 relative frequency stability (100-s integration time) and 3·10-9 relative frequency accuracy, comparable with state-of-the-art solutions relying on nonlinear frequency conversion. We show that QCL-OFCs can be locked with sub-Hz-level stability to a reference for hours, thus promising their use as metrological tools for the mid-infrared.

Coherently-averaged dual comb spectrometer at 7.7†µm with master and follower quantum cascade lasers.

We demonstrate coherent averaging of the multi-heterodyne beat signal between two quantum cascade laser frequency combs in a master-follower configuration. The two combs are mutually locked by acting on the drive current to control their relative offset frequency and by radio-frequency extraction and injection locking of their intermode beat signal to stabilize their mode spacing difference. By implementing an analog common-noise subtraction scheme, a reduction of the linewidth of all heterodyne beat notes by five orders of magnitude is achieved compared to the free-running lasers. We compare stabilization and post-processing corrections in terms of amplitude noise. While they give similar performances in terms of signal-to-noise ratio, real-time processing of the stabilized signal is less demanding in terms of computational power. Lastly, a proof-of-principle spectroscopic measurement was performed, showing the possibility to reduce the amount of data to be processed by three orders of magnitude, compared to the free-running system.

Heteromorphic seeds of wheat wild relatives show germination niche differentiation.

Crop wild relatives are fundamental genetic resources for crop improvement. Wheat wild relatives often produce heteromorphic seeds that differ in morphological and physiological traits. Several Aegilops and Triticum species possess, within the same spikelet, a dimorphic seed pair, with one seed being larger than the other. A comprehensive analysis is needed to understand which traits are involved in seed dimorphism and if these aspects of variation in dimorphic pairs are functionally related. To this end, dispersal units of Triticum urartu and five Aegilops species were X-rayed and the different seed morphs weighed. Germination tests were carried out on seeds, both dehulled and left in their dispersal units. Controlled ageing tests were performed to detect differences in seed longevity among seed morphs, and the antioxidant profile was assessed in terms of antioxidant compounds equipment and expression of selected antioxidant genes. We used PCA to group seed morphs sharing similar patterns of germination traits, longevity estimates and antioxidant profile. Different seed morphs differed significantly in terms of mass, final germination, germination timing, longevity estimates and antioxidant profile in most of the tested species. Small seeds germinated slower, had lower germination when left in their dispersal units, a higher antioxidant potential and were longer-lived than large seeds. The antioxidant gene expression varied between morphs, with different patterns across species but not clearly reflecting the phenotypic observations. The results highlight different trait trade-offs in dimorphic seeds of Aegilops and T. urartu, affecting their germination phenology and longevity, thereby resulting in recruitment niche differentiation.

Prediction of Gait without Physical Assistance after Inpatient Rehabilitation in Severe Subacute Stroke Subjects.

BACKGROUND: Gait recovery is one of the main therapeutic goals of the rehabilitation for patients after a stroke. OBJECTIVE: This study is aimed at describing the frequency of achievement of gait without physical assistance in poststroke subacute patients by the time of discharge from a rehabilitation hospitalized program. Secondarily, our goal is to identify gait without physical assistance predictors in this same population based on the admission's clinical and demographic conditions. METHODS: Data from 185 first unilateral hemispheric stroke patients that need physical assistance to walk at admission were analyzed. The sample was dichotomized into gait with physical assistance and gait without physical assistance to calculate the frequency of achievement of gait without assistance at discharge. Multivariate logistic modeling was applied to identify prognostic factors for regaining gait without physical assistance. RESULTS: Gait without assistance was achieved in 50.27% of the subjects. Five variables were identified for the prediction model: age (Odds ratio [OR] = .87, 95% confidence interval [CI] = .83-.92), gender (OR = .37, 95% CI = .14-.94), time between stroke and hospitalization (OR = .96, 95% CI = .94-.99), initial Berg Balance (OR = 1.52, 95% CI = 1.23-1.88), and initial lower limb Fugl Meyer (OR = 1.17, 95% CI = 1.07-1.27). CONCLUSIONS: Although discharge planning is complex, achievement of gait without physical assistance is undoubtedly a landmark to decide on hospitalization discharge. Half of this sample was able to walk without physical assistance at hospitalization discharge. Five clinical and demographic conditions at admission were found predictors of gait without physical assistance at inpatient discharge.

Endogenous α-calcitonin-gene-related peptide promotes exercise-induced, physiological heart hypertrophy in mice.

AIM: It is unknown how the heart distinguishes various overloads, such as exercise or hypertension, causing either physiological or pathological hypertrophy. We hypothesize that alpha-calcitonin-gene-related peptide (αCGRP), known to be released from contracting skeletal muscles, is key at this remodelling. METHODS: The hypertrophic effect of αCGRP was measured in vitro (cultured cardiac myocytes) and in vivo (magnetic resonance imaging) in mice. Exercise performance was assessed by determination of maximum oxygen consumption and time to exhaustion. Cardiac phenotype was defined by transcriptional analysis, cardiac histology and morphometry. Finally, we measured spontaneous activity, body fat content, blood volume, haemoglobin mass and skeletal muscle capillarization and fibre composition. RESULTS: While αCGRP exposure yielded larger cultured cardiac myocytes, exercise-induced heart hypertrophy was completely abrogated by treatment with the peptide antagonist CGRP(8-37). Exercise performance was attenuated in αCGRP(-/-) mice or CGRP(8-37) treated wild-type mice but improved in animals with higher density of cardiac CGRP receptors (CLR-tg). Spontaneous activity, body fat content, blood volume, haemoglobin mass, muscle capillarization and fibre composition were unaffected, whereas heart index and ventricular myocyte volume were reduced in αCGRP(-/-) mice and elevated in CLR-tg. Transcriptional changes seen in αCGRP(-/-) (but not CLR-tg) hearts resembled maladaptive cardiac phenotype. CONCLUSIONS: Alpha-calcitonin-gene-related peptide released by skeletal muscles during exercise is a hitherto unrecognized effector directing the strained heart into physiological instead of pathological adaptation. Thus, αCGRP agonists might be beneficial in heart failure patients.

Cholinergic compounds. II - Synthesis and biological activity of epi- and allo-desethermuscarines.

To obtain further clarification of structure-activity relationships of cholinergic substances, which would give better understanding of cholinergic receptors, the carbocyclic analogs of epi-muscarine (I) and allo-muscarine (II) were prepared starting from 6-methyl-3-oxo-2-oxabicyclo[2.2.1]heptane (IV). Pharmacological tests show that these two compounds possess lower muscarinic activity than the carbocyclic analog of muscarine (desethermuscarine), the allo isomer being from 5 to 500 times more active than the epi isomer. Therefore, the activity in the carbocyclic series follows, for these receptors, the same pattern as the oxygenated one. As far as nicotinic activity is concerned. (I) is 2.5 times more active than (II), the effective doses being from 40 to 100 times higher than that of Ach. These results suggest a steric rather than an electronic influence for the ether oxygen, whose principal role seems to be that of contributing to the rigidity of the molecule. For most receptors assayed, an inverse relationship between the potency ratio of the isomers and the sensitivity towards Ach has been observed.