Effects of walking endurance reduction on gait stability in patients with stroke.

Control of gait is usually altered following stroke, and it may be further compromised by overexertion and fatigue. This study aims to quantitatively assess patients' gait stability during six-minute walking, measuring upper body accelerations of twenty patients with stroke (64 ± 13 years old) and ten age-matched healthy subjects (63 ± 10 years old). Healthy subjects showed a steady gait in terms of speed and accelerations over the six minutes. Conversely, the patients unable to complete the test (n = 8) progressively reduced their walking speed (-22 ± 11%, confidence interval CI(95%): -13, -29%, P = 0.046). Patients able to complete the test (n = 12) did not vary their walking speed over time (P = 0.493). However, this ability was not supported by an adequate capacity to maintain their gait stability, as shown by a progressive increase of their upper body accelerations (+5 ± 11%, CI(95%): -1; +12%, P = 0.010). Walking endurance and gait stability should be both quantitatively assessed and carefully improved during the rehabilitation of patients with stroke.

Seven capital devices for the future of stroke rehabilitation.

Stroke is the leading cause of long-term disability for adults in industrialized societies. Rehabilitation's efforts are tended to avoid long-term impairments, but, actually, the rehabilitative outcomes are still poor. Novel tools based on new technologies have been developed to improve the motor recovery. In this paper, we have taken into account seven promising technologies that can improve rehabilitation of patients with stroke in the early future: (1) robotic devices for lower and upper limb recovery, (2) brain computer interfaces, (3) noninvasive brain stimulators, (4) neuroprostheses, (5) wearable devices for quantitative human movement analysis, (6) virtual reality, and (7) tablet-pc used for neurorehabilitation.

Is antioxidant and n-3 supplementation able to improve functional status in poststroke patients? Results from the Nutristroke Trial.

BACKGROUND: To test whether supplementary antioxidants and n-3 fatty acids, alone or in combination, could improve functional status in stroke survivors. METHODS: We performed a randomized, double-blind, placebo-controlled clinical trial in 72 stroke patients (47 males; age 65.3 +/- 12.9 years) admitted to a rehabilitation hospital for sequelae of first-ever ischemic stroke, and divided them into 4 subgroups. Group 1 patients received daily oral antioxidants, group 2 received n-3 polyunsaturated fatty acids, group 3 both supplements, and group 4 placebo, all for 12 months. No difference at baseline was observed among groups in neurological severity or in disability. All measures were repeated after 6 and 12 months of treatment. All major clinical events were recorded. RESULTS: At baseline, 25% of the patients had a low plasma vitamin status, and 48.5% was at risk of undernutrition. At the 1-year follow-up, we observed a trend for lower mortality (p = 0.060) in subgroups treated with n-3 fatty acids, but without significant differences in rehabilitation result status among groups. CONCLUSIONS: Malnutrition is widely observed in patients admitted to a rehabilitative hospital for stroke rehabilitation, and dietary supplementation, even if not able to improve rehabilitation results, is likely to reduce mortality at the 1-year follow-up.

Determination of some sulfonamides and trimethoprim in chicken, fish muscle and eggs by liquid chromatography-tandem mass spectrometry.

Sulfonamides represent a wide range of synthetic compounds commonly used in veterinary therapy for the treatment of several bacterial and protozoan infections in cattle, swine and poultry. Trimethoprim is another antibacterial agent mainly used in fish culture and often combined with sulfonamides in commercial preparations. Residues of these drugs in foodstuffs are of concern because of their potential carcinogenic character. Consequently, the European Union (EU) and United States Food and Drug Administration set maximum residue limits for both sulfonamides (100 microg/kg either as a single molecule or as a sum of all detected compounds within the class) and trimethoprim (TMP) (50 microg and 100 microg/kg, according to the matrix) in chicken, fish muscle and eggs.On the other hand, these limits have made of concern the development of confirmatory methods for the analysis of these molecules. LC-MS/MS technique, in particular, resulted fit for the detection of these medium polarity compounds. An effective multi-residue method is presented for the simultaneous determination of certain sulfonamides (sulfadiazine, sulfathiazole, sulfamerazine, sulfamethazine, sulfamethoxypyridazine, sulfamethoxazole, sulfadimethoxine and sulfaquinoxaline) and TMP in products of animal origin (chicken muscle, fish muscle and eggs) by liquid chromatographymass spectrometry/mass spectrometry (LC-MS/MS) at levels in compliance with the legislation in force. The drugs were extracted with a mixture of dichloromethane/acetone (1:1, v/v) and clean-up was carried out by solid phase extraction (SPE) on a sulfonic acid column after addition of acetic acid to the extract, so as to allow for ionexchange. Sulfonamides and TMP were then eluted from the SPE column using a solution of ammonia in methanol. The chromatographic separation was performed on a C18 column by using a mobile phase of methanol/5 mM aqueous ammonium acetate and 0.1% formic acid in gradient, and the LC-MS/MS analysis was performed in a triplequadrupole mass spectrometer equipped with a TurboIonSpray source and operated in positive ion mode. The multiple reaction monitoring (MRM) approach was adopted for the identification and quantification of the molecules of concern and was applied by selecting three specific diagnostic ions (one precursor ion and two product ions) for each analyte, so as to meet the criteria set by the EU both for the minimum required number of identification points and for the ion intensity ratio tolerances. Calculated detection limits for sulfonamides (signal/noise ratio 3:1) ranged from 0.1 microg to 1.7 microg/kg, whereas the recovery rates varied between 69.5% and 94.2% throughout the different compounds and matrices. The corresponding values for TMP ranged from 0.2 microg to 0.4 microg/kg and between 51.9% and 52.8%, according to the matrix. The easy sample preparation procedure and the specific and selective mass spectrometric detection make the present method reliable and suitable for the unambiguous identification and quantitation of the analytes taken into account in chicken, fish muscle and eggs. Moreover, method application has successfully extended to other sulfonamides, such as sulfaguanidine, sulfapyridine, sulfamoxole and sulfamethizole.