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.

摘要： Background Globally, neurological, mental, and substance use disorders are the leading causes of disease burden, which has increased substantially from 1997 to 2017, accounting for 16·72% of total years of life with disability (YLDs). However, there are few studies investigating the effects of macro-environment on neuropsychiatric diseases. In this study, we aimed to estimate the effects of changes in society, the economy, and public health on neurological, mental, and substance use disorders at the country *** For this longitudinal analysis, we obtained social, economic, and public health indicators of all countries in 1990-2015 from the World Bank, including urbanisation, public health expenditure (% of gross domestic product [GDP]), sanitation access, number of physicians, calorie intake, and labour force (the number of people aged ≥15 years who supply labour for the production of goods and services). We calculated the disease burden (YLDs, deaths, and disability-adjusted life-years [DALYs]) using data from the Institute for Health Metrics and Evaluation which were calculated for every 5-year interval from 1990 to 2015. We use multivariable regression analysis, controlling for country-specific demographics and infrastructure, to investigate the relationship between socioeconomic changes and disease burden of neuropsychiatric *** Urbanisation has significantly increased the YLDs of mental disorders globally, but there was no effect on neurological disorders. As the number of labour force increased, it was associated with decreasing number of deaths from neurological disorders; however, its effect on disease burden was not statistically significant. From the public health perspective, with increased access to sanitation, the YLDs and DALYs of mental disorders and the deaths from neurological disorders were significantly decreased. Additionally, calorie intake was negatively correlated with all three aspects of disease burden in neurological

关键词： famous people   neurology   neurological diseases  

摘要： This retrospective review focuses on some illustrious personalities of history, who have suffered from neurological illnesses. Neurological diseases represent about 10% of all illnesses, and therefore do not spare anyone, much less, famous people. In this review, we discuss the neurological disorders that have struck some celebrities throughout history. We briefly examine the lives of emperors, writers, poets, and musicians that have suffered from neurological diseases such as epilepsy, stroke, tumors, and other illnesses, and which caused death or disability. From a historical point of view, recollection of the lives of famous people afflicted by neurological disorders holds important lessons for future generations.

关键词： metabolites   morphine   morphine-3-glucuronide   neuro-excitation   overdose   pain therapy  

摘要： While respiratory depression is a known complication of morphine overdose, the neuro-excitatory side effect of the morphine metabolite morphine-3-glucuronide is less widely known. Here, we report the case of an infant with neurological excitation after morphine overdose. The neuro-excitation in this infant was probably induced by an elevated morphine-3-glucuronide concentration.

关键词： Intracerebral hemorrhage   Caspase-1   Ac-YVAD-cmk   Microglia  

摘要： Objective: Intracerebral hemorrhage (ICH) is acknowledged as a serious clinical problem lacking effective treatments. And caspase-l-mediated inflammatory response happened during the progression of ICH. Therefore, we aimed to investigate the effects of caspase-1 inhibitor Ac-YVAD-cmk on ICH. Materials and methods: Microglia cells were isolated and activated by thrombin for 24 h. Then the transcript and protein expressions of NLRP3 and inflammatory factors were assessed by RT-PCR and western blotting. Moreover, Ac-YVAD-cmk was injected into the ICH model. The mNSS and brain water content were tested at 24 h post-ICH. Finally, the pathological changes of microglia activation following ICH were discovered by the immunohistochemical and HE staining ways. Results: Ac-YVAD-cmk inhibited the activation of pro-caspase-1 and decreased brain edema, in association with decreasing activated microglia and the expression of inflammation-related factors at 24 h post-ICH. Consequently, Ac-YVAD-cmk reduced the release of mature IL-1 beta/IL-18 in perihematoma, improved the behavioral performance, and alleviated microglia in perihematoma region in ICH rats. Conclusions: These results indicate that caspase-1 could amplify the plural inflammatory responses in the ICH. Administration of Ac-YVAD-cmk has the potential to be a novel therapeutic strategy for ICH.