Apathy and higher level of gait control in normal pressure hydrocephalus

Publication date: Available online 11 December 2016
Source:International Journal of Psychophysiology
Author(s): Gilles Allali, Magali Laidet, Stéphane Armand, Arnaud Saj, Paul Krack, Frédéric Assal
Apathy represents the most common behavioral disturbance in patients with suspicion of idiopathic normal pressure hydrocephalus (iNPH) and has a major impact on quality of life. However, its impact on gait –the hallmark motor disturbance of iNPH - has never been studied yet. This study aims to evaluate the impact of apathy on higher level of gait control in patients with suspicion of iNPH. Stride time variability (STV), a marker of higher level of gait control, was quantified during usual walking (single task) and during walking while performing simultaneously cognitive tasks (dual task) of counting and verbal fluency. Among 46 patients with suspicion of iNPH (77.6±6.7years; 34.8% women), 30 (65.2%) presented apathy (defined by a score≥14 on the Starkstein apathy scale). Backward counting induced more important worsening of STV (i.e. increasing STV) in apathetic compared to non-apathetic patients (14.8±25.1% versus 9.0±20.4%; p=0.005), while both groups presented similar executive functioning. These findings suggest that apathy contributes to gait disorders in iNPH. Apathy is easy to monitor and should be considered as a target symptom of treatment.



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Differences in Subjective Well-being Between Older Migrants and Natives in Europe

Abstract

This study examines disparities in subjective well-being (SWB) among older migrants and natives across several European countries using data from the Survey of Health, Aging and Retirement in Europe (SHARE). Our results show a significant SWB gap between migrants and non-migrants that diminishes with increasing age. While migrants from Northern and Central Europe have similar SWB levels as natives, Southern European, Eastern European, and Non-European migrants have significantly lower levels of SWB than the native population. The immigrant-native gap becomes smaller but remains significant after controlling for sociodemographic characteristics and health, the financial situation, citizenship, age at migration, and length of residence. Additionally, we find that the size of the SWB gap varies largely across countries. Current family reunion policies as measured by the Migrant Integration Policy Index (MIPEX) correlate with these country differences. The immigrant-native gap is bigger in countries with restrictive and smaller in countries with open policies.

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Referees 2016

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Effects of chin-down maneuver on the parameters of swallowing function following esophagectomy with three-field lymphadenectomy examined by videofluoroscopy

Publication date: Available online 10 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Yoshihiko Kumai, Naoya Yoshida, Yuta Kamenosono, Keigo Matsubara, Yasuhiro Samejima, Hideo Baba, Eiji Yumoto
ObjectivesThis study quantitatively determined the effect of the chin-down maneuver following esophagectomy with three-field lymphadenectomy (3FL) on pharyngeal residue, upper esophageal sphincter (UES) opening, and laryngeal closure.DesignProspective data were collected from a pharyngeal videofluoroscopic swallowing study.SettingDysphagia clinics at the ENT Department of Kumamoto University Hospital.ParticipantsA total 14 patients (mean age, 65.9 y) selected according to the inclusion criteria from a total of 43 patients who underwent esophagectomy with 3FL at the Department of Gastroenterological Surgery, Kumamoto University Hospital from May to December 2014 were enrolled.InterventionsVideoflurorscopy was conducted in head- neutral and chin-down positions to measure the pharyngeal constriction ratio (PCR), amount of residue in the vallecula and pyriform sinus after the first swallow, UES opening diameter, duration of UES opening, and duration of laryngeal vestibule closure.Main Outcome MeasuresThe above parameters were compared statistically, between the neutral and chin-down positions.ResultsIn comparison with the neutral group, the PCR and residue in the pyriform sinus were significantly smaller in the chin-down group (p < 0.01). However, the residue in the vallecula did not differ significantly from that of the neutral group (p = 0.44). The UES opening diameter, duration of UES opening, and duration of laryngeal vestibule closure were all significantly larger in the chin-down group than in the neutral group (p < 0.05).ConclusionThis study demonstrates that use of the chin-down maneuver after esophagectomy with 3FL can help expedite swallowing by strengthening pharyngeal constriction, widening the UES, and enhancing laryngeal closure.



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Wearable sensor-based biofeedback training for balance and gait in Parkinson’s disease: a pilot randomized controlled trial

Publication date: Available online 10 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Ilaria Carpinella, Davide Cattaneo, Gianluca Bonora, Thomas Bowman, Laura Martina, Angelo Montesano, Maurizio Ferrarin
ObjectivesTo analyze the feasibility and efficacy of a novel system (Gamepad) for biofeedback rehabilitation in Parkinson's Disease (PD). It is hypothesized that Gamepad-based training is feasible and provides larger improvements of balance and gait, compared to physiotherapy without biofeedback.DesignRandomized controlled trial.SettingsClinical rehabilitation gym.ParticipantsForty-two PD subjects randomized into Experimental (EG) and Control Group (CG).InterventionsBoth groups underwent a 20-session training for balance and gait. EG performed tailored functional tasks using Gamepad. The system, based on wearable inertial sensors, provided users with real-time visual and acoustic feedback about their movement during the exercises. CG underwent individually structured physiotherapy without feedback.Main Outcome MeasuresAssessments were performed by a blinded examiner pre-, post-intervention and at 1-month follow-up. Primary outcomes were Berg Balance Scale (BBS) and 10-meter Walk Test (10MWT). Secondary outcomes included instrumental stabilometric indexes and the Tele-healthcare Satisfaction Questionnaire.ResultsGamepad was well-accepted by participants. Statistically significant between-group differences in BBS suggested better balance performances of EG compared to CG both post-training [EG-CG mean (SD): 2.3 (3.4) points, p=0.047] and at follow-up [EG-CG: 2.7 (3.3) points, p=0.018]. Post-training stabilometric indexes showed that medio-lateral body sway during upright stance was significantly reduced in EG compared to CG [EG-CG: -1.6 (1.5) mm, p=0.003). No significant between-group differences were found in the other outcomes.ConclusionsGamepad-based training was feasible and superior to physiotherapy without feedback in improving BBS performance and retaining it for one month. Following training, 10MWT data were comparable between groups. Further development of the system is warranted to allow the autonomous use of Gamepad outside clinical settings, enhance gait improvements, and increase transfer of training effects to real-life contexts.



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Association between seven days per week rehabilitation and functional recovery of acute stroke patients: A retrospective cohort study based on Japan Rehabilitation Database

Publication date: Available online 10 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Shoji Kinoshita, Ryo Momosaki, Wataru Kakuda, Takatsugu Okamoto, Masahiro Abo
ObjectiveTo test the hypothesis that functional outcome of stroke patients who receive seven days per week rehabilitation (7DWR) is generally better than that of similar patients who undergo five to six days per week rehabilitation.DesignA retrospective cohort study.Setting14 acute hospitals across Japan.ParticipantsFrom the Japan Rehabilitation Database, which includes data on 8,033 acute stroke patients collected between January 2005 and December 2013, we included 3,072 stroke patients who were admitted to the above hospitals and received 7DWR.Intervention7DWR was defined as rehabilitation therapy administrated by physical or occupational therapist, on every weekday, Saturday and Sunday.Main Outcome MeasuresFavorable functional independence in daily living defined as modified Rankin scale 0-2 at the time of discharge.ResultsA total of 1,075 (35.0%) patients received 7DWR. Univariate analysis demonstrated significant difference in favorable functional recovery between the 7DWR group and control group (43.3% vs 37.6%, p=0.002). Multivariate logistic regression analysis using generalized estimating equations method showed that 7DWR was independently associated with favorable functional recovery.ConclusionsOur cohort analysis demonstrated that 7DWR in early rehabilitation for acute stroke patients can lead to functional recovery.



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Edible Camphor-induced Histopathological Changes in Hippocampus and Cerebral Cortex Following Oral Administration into Rats

2016-12-10T15-20-04Z
Source: Journal of Interdisciplinary Histopathology
Oluwatobi T Somade, Damilola M. Ogunberu, Toyin T. Fakayode, Adeola O. Animashaun.
Introduction: Raw edible camphor (EC), and as component of herbal infusions are widely used to treat pile, back pain, erectile dysfunction, and as an aphrodisiac especially in preparation for sexual intercourse by men. It has been traced in umbilical cord, blood, fetal, adipose, and other tissues including brain, where it bioaccumulates. Methods: The study, therefore, investigated the possible histopathological changes in brain, heart, and spleen that may result following EC administration in rats. Thirty animals were used for the study and were divided into six groups of five rats each. Group I animals served as normal control, Group II animals served as vehicle control and were orally administered 6 mL/kg corn oil daily for 7 days, while Groups III-VI animals were orally administered 1, 2, 4, and 6 g/kg EC for 7 days daily. Results and Conclusions: Following the administrations of various doses of EC, the histopathological changes seen in the cerebral cortex of the brain include mild submeningeal spongiosis, mild diffuse spongiosis of the parenchyma, a very mild diffuse gliosis, and presences of gitter cells, while in hippocampus, there were mild diffuse gliosis and disruption of the progression of the hippocampal horns, as well as foci of spongiosis around the hippocampal horns, and neuronal cells have open faced nuclei. No effect was seen in heart and spleen except 4 g/kg of EC that revealed moderate diffuse congestion in spleen only. In conclusion, EC may not have any toxic effects on the cardiac and splenic cells, but had toxic effects on the brain hippocampus and cerebral cortex, and may lead to brain cell damage.


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Massive ascites caused by intra-pancreatic arterioportal fistula: a rare complication of chronic pancreatitis

Abstract

An 86-year-old man with a long-term habit of ethanol consumption was admitted due to massive transudate ascites and leg edema. Abdominal computed tomography revealed a dilated main pancreatic duct and atrophied pancreatic parenchyma, leading to the diagnosis of chronic pancreatitis. Moreover, the portal vein was enhanced in the early arterial phase, which indicated the presence of an arterioportal fistula. The fistula was located between the posterior superior pancreaticoduodenal artery and the portal vein near a pancreatic retention cyst. Transarterial coil embolization dramatically improved the ascites. Arterioportal fistula and ensuing ascites should be recognized as a complication of chronic pancreatitis.

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Evidence-based clinical practice guidelines for cholelithiasis 2016

Abstract

Cholelithiasis is one of the commonest diseases in gastroenterology. Remarkable improvements in therapeutic modalities for cholelithiasis and its complications are evident. The Japanese Society of Gastroenterology has revised the evidence-based clinical practice guidelines for cholelithiasis. Forty-three clinical questions, for four categories—epidemiology and pathogenesis, diagnosis, treatments, and prognosis and complications—were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012. The guidelines were developed with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. This article preferentially describes the clinical management of cholelithiasis and its complications. Following description of the diagnosis performed stepwise through imaging modalities, treatments of cholecystolithiasis, choledocholithiasis, and hepatolithiasis are introduced along with a flowchart. Since there have been remarkable improvements in endoscopic treatments and surgical techniques, the guidelines ensure flexibility in choices according to the actual clinical environment. The revised clinical practice guidelines are appropriate for use by clinicians in their daily practice.

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The complete mitochondrial genome sequence of the little grebe ( Tachybaptus ruficollis )

Abstract

Podicipediformes comprises one family (Podicipedidae) including 6 genera, 22 species, and the phylogenetic placement of this order was still in debate. In this study, we sequenced the complete mitochondrial genome (mitogenome) of little grebe (Tachybaptus ruficollis) in Podicipediformes, and explored the phylogenetic position of this order with mitogenome sequences of 21 species from ten families in seven orders. The genome was 16,688 bp in length, and contained 37 genes typical to avian mitogenomes and one control region. The gene organization and characters were similar with other two mitogenomes available in Podicipediformes to date. Phylogenetic tree was constructed with Bayesian method based on mitogenome sequences excluding the control regions. The results supported the closest relationship between Podicipediformes and Phoenicopteriformes, and the topology of our tree was generally similar with the conclusions of previous molecular systematic investigations. Our results furtherly proved the validity of mitogenome data in taxonomic and phylogenetic studies.

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Sedentary Time and Physical Activity Surveillance Through Accelerometer Pooling in Four European Countries

Abstract

Objective

The objective of this study was to pool, harmonise and re-analyse national accelerometer data from adults in four European countries in order to describe population levels of sedentary time and physical inactivity.

Methods

Five cross-sectional studies were included from England, Portugal, Norway and Sweden. ActiGraph accelerometer count data were centrally processed using the same algorithms. Multivariable logistic regression analyses were conducted to study the associations of sedentary time and physical inactivity with sex, age, weight status and educational level, in both the pooled sample and the separate study samples.

Results

Data from 9509 participants were used. On average, participants were sedentary for 530 min/day, and accumulated 36 min/day of moderate to vigorous intensity physical activity. Twenty-three percent accumulated more than 10 h of sedentary time/day, and 72% did not meet the physical activity recommendations. Nine percent of all participants were classified as high sedentary and low active. Participants from Norway showed the highest levels of sedentary time, while participants from England were the least physically active. Age and weight status were positively associated with sedentary time and not meeting the physical activity recommendations. Men and higher-educated people were more likely to be highly sedentary, while women and lower-educated people were more likely to be inactive.

Conclusions

We found high levels of sedentary time and physical inactivity in four European countries. Older people and obese people were most likely to display these behaviours and thus deserve special attention in interventions and policy planning. In order to monitor these behaviours, accelerometer-based cross-European surveillance is recommended.

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Association Between Exercise-Induced Hyperthermia and Intestinal Permeability: A Systematic Review

Abstract

Background

Prolonged and strenuous physical exercise increases intestinal permeability, allowing luminal endotoxins to translocate through the intestinal barrier and reach the bloodstream. When recognized by the immune system, these endotoxins trigger a systemic inflammatory response that may affect physical performance and, in severe cases, induce heat stroke. However, it remains to be elucidated whether there is a relationship between the magnitude of exercise-induced hyperthermia and changes in intestinal permeability.

Objective

In this systematic review, we evaluated whether an exercise-induced increase in core body temperature (T _Core) is associated with an exercise-induced increase in intestinal permeability.

Methods

The present systematic review screened the MEDLINE/PubMed and Web of Science databases in September 2016, without any date restrictions. Sixteen studies that were performed in healthy participants, presented original data, and measured both the exercise-induced changes in T _Core and intestinal permeability were selected. These studies assessed intestinal permeability through the measurement of sugar levels in the urine and measurement of intestinal fatty acid binding protein or lipopolysaccharide levels in the blood.

Results

Exercise increased both T _Core and intestinal permeability in most of the 16 studies. In addition, a positive and strong correlation was observed between the two parameters (r = 0.793; p < 0.001), and a T _Core exceeding 39 °C was always associated with augmented permeability.

Conclusion

The magnitude of exercise-induced hyperthermia is directly associated with the increase in intestinal permeability.

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COMPARISON OF A SINGLE SYRINGE MIXTURE OF KETAMINE AND PROPOFOL (KETOFOL) AND PROPOFOL AS AN ANESTHETIC AGENT IN DIRECT LARYNGEAL BIOPSY PROCEDURE

2016-12-10T00-22-31Z
Source: Indo American Journal of Pharmaceutical Research
Dr. Kinna Shah, Dr. B.M Patel.
Aim: To evaluate the effect of ketofol on haemodynamic response and recovery parameters and to compare it with Propofol in direct laryngoscopic examination /biopsy (DLBX). Method: Three hundred fifteen patients posted for DLB were allocated in this prospective double blind study. Patients were randomly assigned to either Group KP (Ketamine 50 mg +Propofol 100mg in 10 cc) or Group P (100 mg in 10 cc).Inj. Succinylcholine 1mg/kg given in all patients. Pulse, BP and Spo2 were noted at 0, 1, 3, 5, 7 minutes and after every 15 minutes interval up to discharge. Total volume of drug used and Ramsay sedation scale in each procedure was noted. Results: Time to eye opening was earlier in Group KP (10.56+/-4.22v/s 15.82+/-5.66 P value

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ANTIHYPERTENSIVE AND ANTIOXIDANT ACTIVITY OF CAESALPINIA DIGYNA ROTTLER IN L-NAME INDUCED HYPERTENSIVE RATS

2016-12-10T00-22-31Z
Source: Indo American Journal of Pharmaceutical Research
Karuna M*, Ravindra Babu S.
Caesalpinia digyna rottler is used in the treatment of hypertension, inflammation, diabetes, hepatotoxicity. In the present study methanolic extract of Caesalpinia digyna Rottler root (MECD) at doses of 200 and 400 mg/kg was evaluated on N-nitro-L-arginine methyl ester (L-NAME) induced hypertensive rats by observing blood pressure and heart rate. The anti hypertensive activity of the MECD were studied using a non-invasive rat tail-cuff blood pressure system.The MECD produced significant decrease (p


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FORMULATION AND EVALUATION OF pH TRIGGERED IN SITU OPHTHALMIC GEL OF MOXIFLOXACIN HYDROCHLORIDE

2016-12-10T00-22-31Z
Source: Indo American Journal of Pharmaceutical Research
Hemalata Dol*, Ashok Hajare, Vikram Shinde, Sanket Gandhi, Omprakash Gaja.
Antibiotics are the second most widely prescribed drugs in todays scenario due to the increasing rate of infections. Irrational prescriptions of antibiotics can lead to the emergence of antimicrobial resistance and the present study was carried in our hospital surgery department with the objective to estimate the antibiotic prescribing pattern in surgery department.A prospective and observational study was carried out in 207 patients from October 2014 to March 2015. Relevant information was obtained from the interview as well the treatment chart of patients, by using case report form. Results from the study suggest that majority of the patients enrolled in study were females (72.94%).Among the study population majority were belonging 59-68 years age group (23.1%) in which majority was farmers (59.4%).Most of the subjects were diagnosed with Hernia(21.7%), Appendicitis (14.5%) in which surgery was done for 70.7%. After the treatment (96.1%) of the study population showed improvement and 26% patients had drug-drug interactions in which 20.7% the drug interaction was mild .3.8% of underwent with culture sensitivity test with blood and peritoneal fliud.Cephalosporins (63.8%) and Nitroimidazole (53.1%) were the most commonly prescribed antibiotics. It can be concluded from the study that prescribing pattern of drugs antibiotics needs to be continuously evaluated in surgery department in order to promote the more rational prescribing to decrease morbidity and cost of therapy to the patient.


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BIOPROCESSING OF Α-AMYLASE PRODUCED BY BACILLUS SPAVMB1-EFFECT OF INDUCERS AND ENHANCERS

2016-12-10T00-22-31Z
Source: Indo American Journal of Pharmaceutical Research
MounijaDidla, Amrutha V Audipudi*.
The objective of this study was to demonstrate the significant difference in the rate of amylase production when different carbon, nitrogen and oil cakes were used for the amylase production. To this end, bacterial strain (AVMB1) isolated from Chilli rhizosphere was screened for Amylase production and identified as genus Bacillus by morphological, physical, physiological, biochemical and molecular characterization by partial 16S r RNA gene sequencing. α-amylase enzyme production was quantitatively characterized from the Bacillus strain and optimized the culture conditions for bioprocessing under submerged fermentation with different organic sources. The production of amylase was increased by 35-60% under optimized conditions of 35°C, pH7.0 with maltose as carbon sources and yeast extract as nitrogen sources respectively after 48 hrs of incubation. Soya bean oil seed cake induced maximum amylase production.


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SYNTHESIS OF CARBAMATE AND SULFONAMIDE ANALOGUES OF 2-(PHENYLTHIO) ANILINE AND THEIR ANTIMICROBIAL EVALUATION

2016-12-10T00-22-31Z
Source: Indo American Journal of Pharmaceutical Research
K. Gowri, D. Srinivasulu*, M. Srinivasa Rao, VVPC. Narayana.
A series of new 2-(phenylthio) phenyl substituted carbamate (3a-d) and N-(2-(phenylthio) phenyl substituted sulfonamide derivatives (5a-d) were synthesized from 2-(phenylthio) aniline (1) using various pharmacologically active carbonochloridates (2a-d) and sulfonyl chlorides (4a-d) in the presence of a mild base. The structures of all the newly synthesized compounds were characterized by the IR, NMR (1H & 13C) and mass analysis. Further, all the synthesized compounds were screened for the antimicrobial activity. Among all the tested compounds, 3c and 5b showed potent antibacterial and antifungal activities and these compounds might be used as antibiotic drugs.


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