关键词： Myelopathy   motor neurons   spinal cord   panniculus reflex   cutaneous trunci  

摘要： Objectives The aim of this study was to perform the cutaneous trunci reflex (CTR) in neurologically normal cats using two different instruments and determine how body condition score (BCS), body circumference, age, sex and instrument type may affect this reflex. Methods Sixty-five cats without evidence of neurologic disease were prospectively enrolled. Cats were randomly assigned to have the reflex tested first using a pair of hemostatic forceps or the integrated Babinski tip of an MDF Babinski Buck Reflex Hammer. After 30 mins, the reflex was retested using the other instrument. Data collected included the reflex presence, reflex caudal border, reflex intensity (weak, moderate, strong) and reflex symmetry (unilateral or bilateral). The influence of BCS, body circumference, age and sex on these variables was statistically evaluated along with effect of the instrument used. Results The CTR was elicited bilaterally in 52 (80%) cats and unilaterally in 64 (98%) cats. In two cats, the CTR was only able to be elicited using the Buck Reflex Hammer, while in four cats, the CTR was only able to be elicited using hemostatic forceps. Body circumference, BCS, age and sex had no effect on the presence, caudal border, intensity or symmetry of the CTR, regardless of the instrument used. No difference in the bilateral presence of the CTR was noted based on the instrument used first (P = 0.53). When assessing the influence of the instrument on reflex presence, caudal border, intensity and symmetry, the hemostatic forceps elicited the reflex further caudally (P = 0.02) and usually bilaterally (P = 0.02). Conclusions and relevance The CTR could be elicited in the majority of cats with both instruments. However, hemostatic forceps elicited a reflex more caudally and bilaterally symmetrical than the Buck Reflex Hammer.

关键词： Functional Motor Disorders   Psychogenic non-epileptic seizures   Functional Neurological Disorder   Psychogenic Disorder  

摘要： IntroductionLiterature on childhood Functional Neurological Disorders (FNDs) is spare. Clinical presentations are vaguely characterized and often misdiagnosed in younger ages. Their main neurological features enrol: Psychogenic non-epileptic seizures (PNES), Functional movement disorders (FMDs), sensory alterations, cephalgia and feeding *** study was aimed to better characterize the childhood population of FND, because of they represent an emerging challenge for clinicians, giving its higher presentation in the younger age and the difficulties of an early and differential diagnosis as well as an effective management.MethodsOur study retrospectively examined the characteristics of 82 FNDs children and adolescents (8 to 16 y.o.; 13 males; 29 females) referred as neurological inpatients of an urban academic neuropsychiatric department, from 2014 to 2019. Three main clinical aspects were analysed: type and pattern of symptoms manifestations (DSM-5 criteria); Life Events; family functioning.ResultsFND accounted for 2% of 5-years consultations of neurological inpatients (M: F=1:2). The clinical presentation was characterized in 70% by pattern of co-expressed neurological symptoms: FMDs (9.5%); PNES (12%); dizziness/lipothymia (12%); paraesthesia/anaesthesia (16%). Generalized pain was associated in 38% of the reported patterns while cephalgia in 44%. Sleep disorders were reported in 40%. Previous psychiatric diagnoses were uncommon (2 out 82). Antecedent stressors were identified in 97% of patients for personal illness history and in the 93% for chronic illness in the family anamnesis. Family problems were in 25% of cases.ConclusionsOur data contributes to better characterize the childhood population of FND, describing clinical patterns of presentation, highlighting putative antecedent stressors and risk

关键词： Neurology   Science   Gross domestic product   Scientific production  

摘要： Objective Scientific productivity is relevant to support clinical activity, improve therapeutic strategies, and understand the pathophysiological mechanisms of neurological disorders. We performed an updated bibliometric research to assess the country-specific relationship between neurological scientific production and socio-economic variables of dedicated resources. Methods Neurological scientific productivity of 168 countries, from 1996 to 2019, was obtained using the SCImago online website. Data on gross domestic product (GDP), percentage of GDP spent in research and development, and number of researchers per million people were obtained using the World Bank Group website. Results The USA was the first country in terms of documents produced (260,030), followed by Germany (69,841), Japan (65,200), the UK (60,914), and Italy (50,017). Except for Japan, all the most productive countries had an increase in scientific productivity in the last 12 years. In 2019, the USA still ranked first in the number of neurological papers published, followed by Germany, the UK, Italy, and Japan. Among the most productive countries, Canada and Japan did not increase the percentage of GDP spent in research over time. Except for Canada and Japan, all the most productive countries increased the number of researchers in the last years. Conclusions Our analysis provided novel evidence of the adequacy of the scientific return on country-specific investment of local dedicated resources.

关键词： COVID19 pandemic   Lockdown   Health care   Child neurology   Telemedicine  

摘要： Background: The costs and benefits of full lockdown measures are debated. Neurologically impaired children are a vulnerable population with specific needs in terms of protection against infection and access to health services. Objectives: We investigated the effects of lockdown on the health of children with neurological disorders and on their access to care during lockdown. Methods: Data from 514 children (282 males e 232 females) were collected through physician administered interviews to investigate: the occurrence of viral-like physical symptoms, the correlation between the risk of developing such symptoms and several demographic and clinical variables, the occurrence of any worsening of the children's neurological conditions during lockdown, and their access to care services during this period. Results: 49.1% experienced at least one symptom during the study period, but no child developed severe complications. The prevalence of symptoms was significantly lower during lockdown than during the previous two months. The underlying neurological condition worsened in 11.5% of the patients. Children who regularly left the home during lockdown were greater risk of exhibiting symptoms. During lock down, 67.7% had a specialist appointment cancelled, 52.6% contacted their paediatrician, and 30.9% contacted their child neuropsychiatrist. Among patients who usually receive rehabilitation, 49.5% continued remotely. Conclusion: Lockdown protected children from infections. Telemedicine and telerehabilitation constituted a valid alternative for the care and treatment of these children, but they should not become a widespread and definitive model of care. COVID-19 and other emergency response plans must take into account the specific needs of children with disabilities. (c) 2020 Elsevier Inc. All rights reserved.

摘要： Background Distemper is a viral multisystem disease that affects dogs of all ages. So far, there are only palliative treatments and the consequence of the disease is decreasing the quality of life of the animals and in more severe cases is euthanasia. Mesenchymal stem cells (MSCs) are potential candidates for the treatment of distemper due mainly to their immunomodulatory and anti-inflammatory characteristics. Although the most explored source for the isolation of MSC in dogs is the adipose tissue, the collection results in invasive procedures, and the cells may be influenced by the age and physical conditions of the donor, so there is great interest in seeking alternative sources of MSC. Our objectives are to validate and define an optimized isolation protocol for canine umbilical cord MSCs for application in dogs diagnosed with neurological sequels of distemper. Methods The umbilical cords obtained in elective cesarean sections were processed according to the following protocols: Group 1 - 1 hour in collagenase 1 mg/ml, group 2 - 1 hour in trypsin 0.125% + 1 hour in collagenase 1 mg/ml, and group 3 - tissue explants. Following isolation, the cells were cultured in the same way, in DMEM culture medium, and a CO2 incubator at 37°C. After cultivation, the groups were subjected to evaluation of specific membrane markers by flow cytometry (CD90, CD44, CD29, CD45, CD34, CD14, and HLA-DR). Later in this project, we will carry out cell differentiation tests and the therapeutic evaluation will be carried out through the transplantation of umbilical cord MSCs in dogs diagnosed with neurological sequels of distemper. Results Using the same amount of starting material, groups 1 and 2 showed more adhered cells (at least ten times greater) than group 3, in addition to having greater expansion capacity along the passages. Groups 1 and 2 were similar in the number of cells obtained, with group 2 showing more homogeneous morphology from passage 2. In a preliminary study of me

关键词： COVID-19   dizziness   Guillain-Barr-syndrome   seizures   stroke   syncope  

摘要： SARS-CoV2 infection is a systemic disease that may involve multiple organs, including the central nervous system (CNS). Aims of our study are to describe prevalence and clinical features of neurological manifestations, mortality and hospital discharge in subjects hospitalized with COVID-19. All individuals admitted for to our hospital COVID-19 were retrospectively included. Patients were classified according to the symptoms at hospital entry in (1) isolated respiratory, (2) combined respiratory and neurologic, (3) isolated neurologic and (4) stroke manifestations. Descriptive statistics and nonparametric tests to compare the groups were calculated. Kaplan Meier probability curves and multivariable Cox regression models for survival and hospital discharge were applied. The analysis included 901 patients: 42.6% showed a severe or critical disease with an overall mortality of 21.2%. At least one neurological symptom or disease was observed in 30.2% of subjects ranging from dysgeusia/anosmia (9.1%) to postinfective diseases (0.8%). Patients with respiratory symptoms experienced a more severe disease and a higher in-hospital mortality compared to those who showed only neurologic symptoms. Kaplan Meier estimates displayed a statistically significant different survival among groups (p = 0.003): subjects with stroke had the worst. After adjusting for risk factors such as age, sex and comorbidity, individuals with isolated neurologic manifestations exhibited a better survival (aHR 0.398, 95% CI [0.206, 0.769], p = 0.006). Neurologic manifestations in COVID-19 are common but heterogeneous and mortality in subjects with isolated neurologic manifestations seems lower than in those with respiratory symptoms.

关键词： Epilepsy   ADK   Vicine   Bitter gourd   Stroke   AutoDock  

摘要： Epilepsy disease is characterized by the neuronal dysfunction or abnormal neuronal activity of the brain which is regulated by astrocytes. These are glial cells and found to be the major regulators of the brain which are guided by the occurrence of adenosine kinase (ADK) enzyme in the central nervous system (CNS). During the normal physiological environment, ADK maintains the level of adenosine in the CNS. Dysfunction of ADK levels results in accumulation of adenosine levels in the CNS that leads to the pathophysiology of the brain such as astrogliosis which is a pathological hallmark of epileptic seizures. Vicine, an alkaloid glycoside in bitter gourd juice (Momordica charantia) is found to be toxic to the human system if the bitter gourd juice is consumed more. This compound inhibits ADK enzyme activity to lead epilepsy and seizure. Here, the toxic effect of vicine targeting ADK using computational predictions was investigated. The 3-dimensional structure of ADK has been constructed using I-Tasser, which has been refined by ModRefiner, GalaxyRefine, and 3D refine and it was endorsed using PROCHECK, ERRAT, and VADAR. 3D structure of the ligand molecule has been obtained from PubChem. Molecular docking has been achieved using AutoDock 4.2 software, from which the outcome showed the effective interaction between vicine and ADK, which attains binding free energy (Delta G) of - 4.13 kcal/mol. Vicine molecule interacts with the active region ARG 149 of ADK and inhibits the functions of ADK that may cause imbalance in energy homeostasis. Also, pre-ADMET results robustly propose in which vicine possesses toxicity, and meanwhile, from the Ames test, it was shown as mutagenic. Hence, the results from our study suggest that vicine was shown to be toxic that suppresses the ADK activity to undergo pathological conditions in the neuronal junctions to lead epilepsy.

摘要： Purpose Neurological complications are considered as most frequent complications following left ventricular device device (VAD) implantation. The aim of this multicenter study is to investigate neurological complications in patients requiring durable VADs following extra-corporeal life support (ECLS) implantation. Endpoints The primary endpoint will be freedom from stroke at 30, 180, and 360 days post implant. Association of stroke events with operative strategies (using heart lung machine vs. ECLS for VAD implantation) will be evaluated. Further, factors predicting stroke events in this patient population are analyzed. We hypothesize that postoperative (after VAD Implantation) stroke complications may be higher in this sick patient population on ECLS compared to traditional VAD candidates.

关键词： Middle cerebral artery   Stroke   Transient ischemic attack   Atherosclerosis   Hemodynamics  

摘要： Objectives We aimed to investigate differential characteristics of plaque in the middle cerebral artery (MCA) and hemodynamics in patients with ischemic stroke and transient ischemic attack (TIA), and to develop a predictive model for the presence of ischemic stroke and neurological impairment. Methods Sixty-seven patients with acute ischemic events in MCA territory who underwent high-resolution vessel wall imaging between September 2016 and August 2018 were reviewed retrospectively. Patients were assigned to either the stroke group or TIA group, according to diffusion-weighted imaging and neurological examination. Plaque characteristics and anterograde score (AnS) were *** > 6.0-s volume was acquired by RApid Processing of perfusIon and Diffusion software. Multivariate logistic regression analysis and multiple linear regression analysis were performed to establish a predictive model for irreversible infarction occurrence and clinical severity. Results Forty-five patients were assigned to the stroke group, and 22 were assigned to the TIA group. Plaque length, intraplaque hemorrhage (IPH), enhancement, AnS, andTmax > 6.0-s volumes were significantly different between the two groups (p< 0.05). IPH and AnS were independent predictors for patients with stroke (p= 0.020 and 0.034, respectively).Tmax > 6.0-s volume, IPH, hypertension, and AnS were associated with high National Institutes of Health Stroke Scale (NIHSS) scores (allp< 0.05,R= 0.725, and adjustedR(2)= 0.494). Conclusions IPH and AnS are useful in predicting stroke *** > 6.0-s volume, IPH, hypertension, and AnS are associated with neurological impairment of the patients.