关键词： Neuroprotective   Polyphenols   Naringin antiapoptotic   Antioxidant   Antineuroinflammation  

摘要： Neurological illnesses are multifactorial incurable debilitating disorders that may cause neurodegeneration. These diseases influence approximately 30 million people around the world. Despite several therapies, effective management of such disorders remains a global challenge. Thus, natural products might offer an alternative therapy for the treatment of various neurological disorders. Polyphenols, such as curcumin, resveratrol, myricetin, mangiferin and naringin (NRG) have been shown to possess promising potential in the treatment of neurogenerative illness. In this review, we have targeted the therapeutic potential of naringin as a neuroprotective agent. The overall neuroprotective effects and different possible underlying mechanisms related to NRG are discussed. In light of the strong evidence for the neuropharmacological efficacy of NRG in various experimental paradigms, it is concluded that this molecule should be further considered and studied as a potential candidate for neurotherapeutics, focusing on mechanistic and clinical trials to ascertain its efficacy.

关键词： HaNDL   Pseudomigraine with pleocytosis   Acute confusional syndrome   Cerebral vasomotor changes   Transcranial Doppler   Cannabis and cocaine use  

摘要： Introduction: HaNDL syndrome (transient headache and neurological deficits with cerebrospinal fluid lymphocytosis) is characterised by one or more episodes of headache and transient neurological deficits associated with cerebrospinal fluid lymphocytosis. To date, few cases of HaNDL manifesting with confusional symptoms have been described. Likewise, very few patients with HaNDL and confusional symptoms have been evaluated with transcranial Doppler ultrasound (TCD). TCD data from patients with focal involvement reveal changes consistent with vasomotor alterations. Development: We present the case of a 42-year-old man who experienced headache and confusional symptoms and displayed pleocytosis, diffuse slow activity on EEG, increased blood flow velocity in both middle cerebral arteries on TCD, and single-photon emission computed tomography (SPECT) findings suggestive of diffuse involvement, especially in the left hemisphere. Conclusions: To our knowledge, this is the first description of a patient with HaNDL, confusional symptoms, diffuse slow activity on EEG, and increased blood flow velocity in TCD. Our findings suggest a relationship between cerebral vasomotor changes and the pathophysiology of HaNDL. TCD may be a useful tool for early diagnosis of HaNDL. (C) 2017 Sociedad Espanola de Neurologia. Published by Elsevier Espana, S.L.U.

关键词： Enteral feeding   Early rehabilitation   Nutritional status   Rehabilitation nutrition  

关键词： Brain   Estrogen receptors   G1   GPER   Signaling pathways  

摘要： G protein-coupled estrogen receptor 1 (GPER) is a membrane-associated estrogen receptor (ER) associated with rapid estrogen-mediated effects. Over recent years GPER emerged has a potential therapeutic target to induce neuroprotection, avoiding the side effects elicited by the activation of classical ERs. The putative neuroprotection triggered by GPER selective activation was demonstrated in mood disorders, Alzheimer's disease or Parkinson's disease of male and female in vivo rodent models. In others, like ischemic stroke, the results are contradictory and currently there is no consensus on the role played by this receptor. However, it seems clear that sex is a biological variable that may impact the results. The major objective of this review is to provide an overview about the physiological effects of GPER in the brain and its putative contribution in neurodegenerative disorders, discussing the data about the signaling pathways involved, as well as, the diverse effects observed.

关键词： acute ischemic stroke   early neurological deterioration   intravenous thrombolysis   neutrophil-lymphocyte ratio   risk factor  

摘要： Background and purpose Intravenous thrombolysis (IVT) has become the standard treatment for acute ischemic stroke within 4.5 hr after symptoms onset. However, a fraction of patients would develop early neurological deterioration (END) after IVT. The aim of our study was to explore the utility of neutrophil-lymphocyte ratio (NLR) in predicting END. Methods From October 2016 to March 2018, 342 consecutive patients with thrombolytic therapy were prospectively enrolled in this study. Blood cell counts were sampled in stroke emergency room before IVT. END was defined as a National Institutes of Health Stroke Scale score increase of >= 4 points within 24 hr after IVT. Multiple regression analysis was used to investigate the potential risk factors of END. We also performed receiver operating characteristic curve analysis and nomogram analysis to assess the overall discriminative ability of the NLR in predicting END. Results Of the 342 patients, 86 (25.1%) participants were identified with END. Univariate logistic regression analysis demonstrated that patients with NLR in the third tertile, compared with the first tertile, were more likely to have END (odds ratio, 9.783;95% confidence interval [CI], 4.847-19.764;p = .001). The association remained significant even after controlled for potential confounders. Also, a cutoff value of 4.43 for NLR was detected in predicting post-thrombolysis END with a sensitivity of 70.9% and a specificity of 79.3% (area under curve, 0.779;95% CI, 0.731-0.822). Furthermore, our established nomogram indicated that higher NLR was an indicator of post-thrombolysis END (c-index was 0.789, p < .001). Conclusions This study showed that elevated level of NLR may predict post-thrombolysis END in ischemic stroke patients.

关键词： Multiple sclerosis   disability   ambulation   mobility   upper extremity function   activities of daily living  

摘要： Background: Accurate clinical assessment in multiple sclerosis (MS) is challenging. The Assess MS system is being developed to automatically quantify motor dysfunction in MS, including upper extremity function (UEF) and mobility. Objective: To determine to what extent combinations of standardized movements included in the Assess MS system explain accepted measures of UEF and mobility. Methods: MS patients were recruited at four European MS centres. Eight movements were selected, including tasks of activities of daily living (ADL) and classical neurological tests. Movements were recorded on video and rated by experienced neurologists (n = 5). Subsequently, multivariate linear regression models were performed to explain the variance of the Nine-Hole Peg Test (9HPT), Arm Function in Multiple Sclerosis Questionnaire (AMSQ) and Timed-25 Foot Walk test (T25WT). Results: In total, 257 patients were included. The movements explained 62.9% to 80.1% of the variance of the 9HPT models, 43.3% and 44.3% of the AMSQ models and 70.8% of the T25WT. In all models, tasks of ADL contributed most to the variance. Conclusion: Combinations of movements are valuable to assess UEF and mobility. Incorporating ADL tasks into daily clinical practice and clinical trials may be more valuable than the classical neurological examination of UEF and mobility.

关键词： burden of care   caregiver   caregiver stress   caregiver wellbeing level   neurological disease  

摘要： Purpose The present study was conducted to determine the effects of the caregiver burden perceived by caregivers of patients with neurological disorders on caregiver wellbeing and stress. Design and Methods The study was designed as a descriptive, cross-sectional, and correlational study. Findings In the study, it was determined that the care burden is related to a caregiver's wellbeing and stress level and that the caregivers' levels of performing activities of living decreased and their stress levels increased as their perceived burden of care increased. Implications for Practice Determining caregivers' difficulties in providing care and providing them with professional support will contribute to reducing the burden of care.

关键词： Hirschsprung disease   Enteric nervous system   Smooth muscle   Development   ACTG2 gene   Mutation   Intestinal motility  

摘要： Background: Hirschsprung disease is a functional obstruction of the gastrointestinal tract due to the congenital absence of ganglion cells in the intermyenteric plexuses of the distal bowel. Gastrointestinal motility requires intact muscular layers as well as neural network connection to function properly. The Actin G2 gene is the main gene encoding actin gamma 2;a smooth muscle actin found in enteric tissues. Aim: This study of the Actin G2 gene in patients with Hirschsprung disease explores a possible molecular basis abnormal muscle function and post-surgical pseudo-obstruction in a group of patients. As far as the authors are aware, this is the first report confirming structural muscle deficits in Hirschsprung disease. Patients and methods: Ethical permission and informed consent were obtained. DNA was extracted from whole blood samples in 10 patients with histologically proven HSCR patients. PCR amplification of the ACTG2 gene, were subjected to semi-automated bi-directional sequencing analysis. Sequencing results were analyzed using FinchTV Sequence Alignment Software (http:/*** ) to read chromatogram files. Further predicting bioinformatic investigation was obtained by PolyPhen 2 software to evaluate the significance of the observed amino add changes. Results: Ten new patients with similar HSCR phenotypes were prospectively investigated for variation in the Actin G2 gamma gene (ACTG2) variations. The results of ACTG2 gene analysis showing variation in exons 5, 8 and 10 of the ACTG2 gene in 7 of them (64%). The c.109C> G S345 L was the most frequent occurring in 6 of the 10 patients (54%), the c.171 A > A K119E in 2 and the significant c.108 T > G W357G variation in exon 10 (1 patient) Four patients had a combination of different variants in different exons which were less significant. Allele frequency on a control sample of the South African population showed no comparable pathology link scores (http:***/). Bioinformatic in s

摘要： [8] The neurological complications in dengue infection can be categorized into three groups based on the pathogenic mechanisms: (1) neurotropism leading to encephalitis, meningitis, myositis, and myelitis; (2) systemic complications resulting in encephalopathy, stroke, and hypokalemic paralysis; and (3) postinfectious immune-mediated acute disseminated encephalomyelitis, Guillain–Barre syndrome, and peripheral neuritis. [...]dengue fever should be suspected in the endemic area during an outbreak in a patient with any undiagnosed neurologic syndrome. [...]dengue fever is a significant public health problem, especially in a tropical country like India.

关键词： Disability   disability law   guidelines  

摘要： New disability law called "Rights of Persons with Disabilities Act 2016" has been acted in 2016. The United Nations' Convention for Rights of Persons with Disabilities is the sole of this new act. Of the total 21 categories, three new neurological legal disability categories such as chronic neurological conditions, Parkinson disease (PD), and multiple sclerosis have been notified first time in the new act. The new guidelines have been notified in the year 2018 for evaluation and certification of specified disabilities. As a new addition in these guidelines, modified Rankin scale score has been added to measure locomotor disability of stroke. Certainly, newer guidelines have many lacunae also. There are no recommendations of any method of disability measurement associated with movement disorders such as PD, chronic neurological conditions such as migraine, epilepsy, and ataxia. The tables of older guidelines for disability calculation in conditions such as unconsciousness and epileptic fits have been removed in newer guidelines. Professional bodies should come into action immediately and doeffort for rectifying these shortcomings and/or fallacies in new guidelines.