Suchergebnisse

Cumulative toxicity from weekly paclitaxel (myalgia, peripheral neuropathy, fatigue) compromises long-term administration. Preclinical data suggest that the burden of critically short telomeres ( 21.9% CSTs) had 2-fold higher number of neuropathy (P = 0.04) or fatigue (P = 0.019) episodes and >3-fold higher number of myalgia episodes (P = 0.005). The average telomere length was unrelated to the incidence of side effects.The percentage of CSTs, but not the average telomere size, is associated with weekly paclitaxel-derived toxicity. ; This work was supported by the Fondo de Investigación Sanitaria [FIS PI10/00288 and FIS PI13/00430]; AECC Scientific Foundation [Beca de Retorno-2010, to MQF]; Spanish Ministry of Economy and Competitiveness Projects [SAF2013-45111-R]; Madrid Regional Government Projects [S2010/BMD- 2303]; AXA ...

Carpal tunnel syndrome is currently the most common peripheral nerve compression neuropathy that affects approximately 1% of the population [7,8,9]. The incidence of CTS seems to be increasing. The diagnosis is based on clinical symptoms and electrodiagnostic studies.

Intro -- Advances in Human Factors and Ergonomics 2019 -- Preface -- Contents -- Patient Safety -- Towards a Deeper Understanding of Conceptual Models that Incorporate Patient Safety -- Abstract -- 1 Background -- 2 Approach -- 2.1 Walk Through the Literature -- 2.2 Interpretation -- 3 Discussion -- 3.1 Learning -- 3.2 Biological Models -- 3.3 Linguistics and Computational Linguistics -- 3.4 Philosophy -- Acknowledgments -- References -- An Interactive Device for Reducing Risk of Infusion Therapy and Blood Transfusions -- Abstract -- 1 Introduction -- 2 Related Work -- 3 System Design and Architecture -- 4 System and Human Factors Evaluation -- 5 Conclusion -- References -- Medical Error Disclosure - A Canadian Perspective in Improving Quality of Health Care -- Abstract -- 1 Introduction -- 1.1 Medical Error -- 1.2 Barriers for Disclosure -- 1.3 Benefits of Disclosure -- 1.4 International Disclosure Policies -- 1.5 Canadian Disclosure Policies -- 2 Methodology -- 3 Results -- 4 Discussion -- 5 Conclusion -- References -- Pattern of Postural Sway of Diabetic Peripheral Neuropathy People -- Abstract -- 1 Introduction -- 2 Methods -- 2.1 Participants -- 2.2 Peripheral Neuropathy Testing -- 2.3 Instruments and Protocol -- 2.4 Data Analysis -- 3 Results -- 3.1 Physical Characteristics and Peripheral Neuropathy -- 3.2 Placement of Center of Pressure -- 4 Conclusions -- References -- Quality Assessment and Management: An Overview of Concordance and Discordance Rates Between Clinical and Autopsy Diagnoses -- Abstract -- 1 Introduction -- 2 Methods -- 3 Results -- 4 Discussion -- 5 Conclusion -- References -- Comparative Assessment of the Risk of Manual Patient Handling Between Standard Methods and Job Analysis -- Abstract -- 1 Introduction -- 2 Materials and Methods -- 3 Results -- 4 Discussion -- 5 Conclusions -- References.

Purpose.To elucidate factors that impact intention (INT) to be active as well as actual physical activity (PA) behavior in colorectal cancer survivors (CRC-S) using the theory of planned behavior (TpB). Planning for PA was explored as a mediator of the INT-behavior relationship. Chemotherapy-induced neuropathy and fatigue were also explored.Design.A cross-sectional quantitative mailed survey was used.Setting.The study was conducted among community-dwelling adults living in Pennsylvania when diagnosed with colorectal cancer (CRC).Subjects.Subjects comprised 843 CRC-S diagnosed with CRC in Pennsylvania in 2009.Measures.The survey included questions about planning for PA, TpB constructs, medical and social variables, and PA as measured by a modified Godin Leisure Time Questionnaire.Analysis.Descriptive statistics were used to characterize the sample. A mediation analysis was used to determine if planning mediated the relationship between INT and actual PA behavior. A stepwise regression was used to determine predictors of INT and PA.Results.Ninety-six CRC-S responded, with 25% meeting PA recommendations for health promotion, suggesting that CRC-S are insufficiently active. Perceived behavioral control (PBC) and social norm (SN) accounted for 43% of the variance in INT, whereas 30% of the variance in PA was explained by PBC and age. Neuropathy negatively impacted PA behavior (p = .008). Both action and coping planning partially mediated the INT-behavior relationship (β = 20.08, p = .007; β = 22.85, p = .001, respectively).Conclusion.Survivors at risk for inactivity are those with low PBC, low SN, and neuropathy, and those who are older.

Такие аутоиммунные заболевания периферической нервной системы, как синдром Гийена Барре, хроническая воспалительная демиелинизирующая полинейропатия и мультифокальная моторная невропатия, являются высокочувствительными к препаратам нормального в/в иммуноглобулина человека, а обоснованность назначения иммунотерапии в таких случаях соответствует наивысшему уровню доказательности А благодаря результатам специально спланированных рандомизированных клинических исследований. В данной статье приведены доказательства эффективности и безопасности в/в иммуноглобулина при аутоиммунных поражениях периферической нервной системы как на основании рекомендаций экспертов EFNS, регламентирующих применение иммуноглобулинотерапии в неврологии в странах Европейского cоюза, так и результатов новых клинических исследований, проведенных после 2008 года, когда были опубликованы указанные рекомендации. ; The autoimmune peripheral nervous system diseases, such as Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy, are highly sensitive to the normal human intravenous immunoglobulins, and the validity of the administration of immunotherapy in these cases is of the highest level of evidence А thanks to the results of a specially-designed randomized clinical trials. This article presents evidence on the efficacy and safety of intravenous immunoglobulin in autoimmune lesions of the peripheral nervous system, both on the basis of EFNS expert recommendations regulating the use of immunoglobulin therapy in neurology in the European Union, and the results of new clinical studies conducted after 2008, when these recommendations were published.

Такі автоімунні захворювання периферичної нервової системи, як синдром Гійєна — Барре, хронічна запальна демієлінізуюча полінейропатія і мультифокальна моторна нейропатія, є високочутливими до препаратів нормального в/в імуноглобуліну людини, а обґрунтованість призначення імунотерапії в цих випадках відповідає найвищому рівню доказовості А завдяки результатам спеціально спланованих рандомізованих клінічних досліджень. У даній статті наведені докази ефективності й безпечності в/в імуноглобуліну при автоімунних ураженнях периферичної нервової системи як на підставі рекомендацій експертів EFNS, що регламентують застосування імуноглобулінотерапії в неврології в країнах Європейського Союзу, так і результатів нових клінічних досліджень, проведених після 2008 року, коли були опубліковані зазначені рекомендації. ; Такие аутоиммунные заболевания периферической нервной системы, как синдром Гийена — Барре, хроническая воспалительная демиелинизирующая полинейропатия и мультифокальная моторная невропатия, являются высокочувствительными к препаратам нормального в/в иммуноглобулина человека, а обоснованность назначения иммунотерапии в таких случаях соответствует наивысшему уровню доказательности А благодаря результатам специально спланированных рандомизированных клинических исследований. В данной статье приведены доказательства эффективности и безопасности в/в иммуноглобулина при аутоиммунных поражениях периферической нервной системы как на основании рекомендаций экспертов EFNS, регламентирующих применение иммуноглобулинотерапии в неврологии в странах Европейского cоюза, так и результатов новых клинических исследований, проведенных после 2008 года, когда были опубликованы указанные рекомендации. ; The autoimmune peripheral nervous system diseases, such as Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy, are highly sensitive to the normal human intravenous immunoglobulins, and the validity of the administration of immunotherapy in these cases is of the highest level of evidence А thanks to the results of a specially-designed randomized clinical trials. This article presents evidence on the efficacy and safety of intravenous immunoglobulin in autoimmune lesions of the peripheral nervous system, both on the basis of EFNS expert recommendations regulating the use of immunoglobulin therapy in neurology in the European Union, and the results of new clinical studies conducted after 2008, when these recommendations were published.

Acute flaccid paralysis (AFP) is a clinical syndrome determined by a prompt onset of weakness, often involving bulbar and respiratory weakness. Early and accurate diagnosis of the cause has a significant impact on the prognosis and management. Guillian Barre syndrome (GBS) is post-infectious polyradiculoneuropathy, which mostly affects the motor, but sometimes affects autonomic and sensory nervous system. Objective: To determine the acute flaccid paralysis clinical presentations, electrophysiologic subtypes of GBS, their outcome and seasonal variations in our setup. Study Design: A Retrospective Study. Place And Duration: In the Department of Neurology, Combined Military Hospital (CMH), Lahore for one year duration from September 2017 to September 2018. Methods: Retrospective and hospital studies were performed in the department of Neurology to determine the clinical characteristics of GBS including current treatment methods and outcomes, and prognosis of disease severity. Diagnostic features include paresis, flaccid paralysis or weakness of limb with or without autonomic symptoms or sensory symptoms, albino-cytological dissociation, nerve conduction rate (NCV), laboratory properties such as ECG, serum electrolytes and MRI. Results: In this study; 55 patients were included for 1 year duration. Of these, 29 (53%) had GBS, hypokalemic periodic paralysis in 21 (38%) and idiopathic neuropathy in 5 (9%). NCV test was applied to all and categorized as 18 patients ha AIDP (acute inflammatory demyelinating polyneuropathy, 8 patients had AMAN (acute motor axonal neuropathy) and 3 patients had AMASAN (acute motor and sensory axonal neuropathy. Most of the patients presented symmetrically elevated paralysis, gradually progressing in all extremities. In our study, the rate of males was affected by more females: 1.63: 1 and in spring and winter season; 23 patients presented. During the 2nd and 3rd decade there was mild increase age range and in the 5th decade, the second peak was seen. Ten percent of the patients has ...

Zhenxing Li,* Kaiwei Han,* Danfeng Zhang,* Jigang Chen, Zheng Xu, Lijun HouDepartment of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China*These authors contributed equally to this workAbstract: Traumatic brain injury (TBI), a mainly lethal and highly debilitating condition, is increasing worldwide. However, the underlying mechanism has not been fully elucidated and effective therapy is needed. Long noncoding RNAs (lncRNAs), which form a major class of noncoding RNAs, have emerged as novel targets for regulating physiological functions and mediating numerous neurological diseases. Notably, gene expression profile analyses have demonstrated aberrant changes in lncRNA expression in the cerebral cortex and hippocampus of rats, mice and human after TBI. lncRNAs may be associated with multiple pathophysiological processes following TBI and might play a crucial role in complications of TBI, such as traumatic optic neuropathy due to the regulation of specific signaling pathways. Some lncRNAs have also been found to be therapeutic targets for motor and cognitive recovery after TBI. lncRNAs may be promising biomarkers for TBI diagnosis, treatment, and prognosis prediction. However, further research isneeded to clarify the underlying mechanisms and therapeutic effects of lncRNAs on TBI. We review the current progress of studies on lncRNAs in TBI to draw more attention to their roles in this debilitating condition.Keywords: long non-coding RNA, traumatic brain injury, neuropathy

Abstract
Autoantibodies most commonly found in association with neuropathies are those against the ganglioside family antigens - GM1, GQ1b, asialo-GM1, GM2, GD1a, and GD1b. The major diagnostic role is set for two of antibodies - anti-GM1 and anti-GQ1b. This retrospective study was designed to evaluate the status of antiganglioside antibodies in patients with possible autoimmune neuropathy. The study included 85 patients tested for antiganglioside antibodies during their hospitalization. Clinical information such as demographic data and antecedent illness was collected for all patients, and paraclinical studies including results from cerebrospinal fluid and neuroelectrophysiological examination were analyzed. In our study, a total of 27 patients (32%) were found positive for at least one antiganglioside antibody. The most commonly found antibodies were against asialoGM1 (n=13) and GM1 (n=10) gangliosides. Eight patients were diagnosed with a disease where antiganglioside antibodies are used as a diagnostic marker: five patients - Guillain-Barré syndrome (GBS), 1 patient - Miller-Fisher syndrome (MFS), two patients - multifocal motor neuropathy (MMN). Three out of five patients diagnosed with GBS and one of two patients diagnosed with MMN were seronegative. The acute course of disease, positive antiganglioside antibodies and cytoalbuminologic dissociation in cerebrospinal fluid-induced patients is preference for a specific immune therapy. The results of our study support the previously described immunological association between antiganglioside antibodies and GBS, MFS, and MMN.

Neuromidin Attenuates Neuropathic Pain in the Streptozocin-Induced Diabetes Model in RatsDiabetic neuropathy, which affects all peripheral nerves and may cause dramatic pain, is one of the most severe pathologies associated with hyperglycaemia, damage in the blood vessels, and inflammation in nerves. Anticonvulsants and antidepressants are still the most commonly used options to manage diabetic neuropathy. However, to improve clinical benefit in the treatment of diabetic neuropathies, as well as to minimize side effects, search for a new type of drugs to protect/treat neuropathic pain is still important. The aim of this study was to investigate neuromidin (ipidacrine, amiridin, NIK-247), an anticholinesterase drug of tetrahydroaminoacridine series, in the streptozocin (STZ)-induced diabetic neuropathic pain model in rats. Neuromidin was administered per os at daily doses 0.3, 1.0 and 3.0 mg/kg for ten days. The dynamics in the development of hyperalgesia (pain threshold) was measured by algesimeter for five weeks. The data obtained show that neuromidin considerably protects the development of peripheral neuropathic pain caused by STZ. The most active dose was the lowest—0.3 mg/kg. Neuromidin did not affect STZ-hyperglycemia, nor the weight gain in animal groups. Neuromidin per se at the doses 0.3 and 1.0 mg/kg showed a short-term analgesic activity. The cholinergic mechanism of neuromidin may be considered as essential in attenuating of diabetic neuropathic pain; other mechanisms remain to be elucidated.

Aim: To assess the awareness of diabetic foot among Saudi population with type 2 diabetes. Methods: This cross-sectional study was conducted among the participants who attended the outpatient diabetes clinic at Diabetes Treatment Center in Prince Sultan Military Medical City, Saudi Arabia between July 2015 to September 2015. Data were collected using a structured questionnaire. Results: Compared to females (53.3%) males (72.4%) were found to be more aware of diabetic foot problem related knowledge. Also participants with family history and long duration of DM were more aware of diabetic foot problem and the related knowledge. Compared to females (48%), males (67.2%) have more pins and needles sensation in the feet. Similarly those with the family history, higher duration of DM, have shown more pins and needles sensation. More than 15% of highly educated participants reported that pain alters their sleep pattern and also affects the daily life (12.1%) compared to lower educated participants. Compared to the females (68.2%), male participants (55.2%) were reported to be more ignorant in doing self-examination of feet. Similarly, the participants of more than 40 years (72.9%) reported that they ignore the self-examination of feet than the participants of less than 40 years (53.9%). Majority of the male participants have good compliance to medication. Conclusion: There is a disparity in diabetic foot awareness among the Saudi diabetic population. It is necessary to educate people about foot care, lack of which will lead to a health burden due to preventable complications of diabetes.

The Sixth Edition of ""A Practical Guide to Diabetes Mellitus"" offers a unique combination of rigorous pathophysiology with very practical approaches to diabetes prevention and control. This outstanding textbook will equip a cadre of doctors and other health care professionals to deliver high quality care to vulnerable populations around India and far beyond. Based on research as well as clinical practice, the text describes diabetes in relation to physiology, ocular, cardiovascular, neuropathy, pregnancy, emergencies, childhood diabetes, etc. Each chapter beings with a brief outline of the d

Background:Microvascular complications in type 2 diabetes have significant impact on morbidity, mortality and patients' quality of life. There are few clinical studies in this direction but most of them lack sufficient power and are focused only towards one specific complication. The aim of this study to determine the association of microvascular complications with duration of diabetes and glycemic indices (Fpg, 2hpg & HbA1c) among type 2 diabetes mellitus patients.Materials & Methods: This is a hospital based prospective study done on 100 cases of type 2 diabetes mellitus in upgraded department of medicine, Government Medical College & attached group of Hospitals, Barmer, Rajasthan. Each subject underwent detailed history and complete clinical examination. Diabetes was diagnosed according to American Diabetes Association (ADA) revised criteria. The selected patients were evaluated for presence of micro complications i.e. diabetic retinopathy, diabetic nephropathy and diabetic neuropathy by relevant investigations.Results: Our study showed that The fasting blood glucose level, 2 hr. postprandial glucose level & HbA1c was not significant correlate but >10 years duration of diabetes was higher mean value as compared to less than 5 year duration of diabetes. The spearmen correlation analysis showing association of various risk factors with diabetic neuropathy, diabetic retinopathy & diabetic nephropathy. The fasting blood glucose level, 2 hr. postprandial glucose level & HbA1c was significant correlate (P<0.0001, p<0.0001 & p<0.0001 respectively).Conclusion: We concluded that on applying spearman correlation for microvascular complications, a positive association was observed for age of patients, duration of diabetes, fasting blood sugar, 2 hr. postprandial glucose and HbA1C.

Diabetes contributes to sensory peripheral neuropathy, which has been linked to lower limb abnormalities that raise the risk for foot ulcers and amputations. Because amputations are a reason for pain and hospitalization in those with diabetes, it is of critical importance to gain insight about prevention of ulcer development in this population. Although the American Diabetes Association (ADA) now recommends that individuals with neuropathy can engage in moderate-intensity weight-bearing activity (WBA), they must wear appropriate footwear and inspect their feet daily. The physical forces and inflammatory processes from WBA may contribute to plantar characteristics that lead to ulcers. The purpose of this study was to compare neuropathic status and foot characteristics in Native Americans according to WBA classification. The t tests for unequal sample sizes found that exercisers had more difficulty sensing baseline temperature than nonexercisers, except at the right foot (all p values < .05). By dividing groups into no/low risk and high risk for ulcer, a majority showed no/low risk according to touch and vibration sense. Exercisers demonstrated higher surface skin temperature gradients at the first metatarsal head, a plantar site where wounds tend to form. The more consistently exercisers performed, the higher the plantar pressures were at the right second (r = .24, p = .02) and third metatarsal heads (r = .26, p = .01). Findings from this investigation do not refute current ADA recommendations and further intervention studies are needed that are longitudinal and measures WBA more accurately.