COVID-19 is a severe infectious disease that has claimed >150,000 lives and infected millions in the United States thus far, especially the elderly population. Emerging evidence has shown the virus ...to cause hemorrhagic and immunologic responses, which impact all organs, including lungs, kidneys, and the brain, as well as extremities. SARS-CoV-2 also affects patients', families', and society's mental health at large. There is growing evidence of re-infection in some patients. The goal of this paper is to provide a comprehensive review of SARS-CoV-2-induced disease, its mechanism of infection, diagnostics, therapeutics, and treatment strategies, while also focusing on less attended aspects by previous studies, including nutritional support, psychological, and rehabilitation of the pandemic and its management. We performed a systematic review of >1,000 articles and included 425 references from online databases, including, PubMed, Google Scholar, and California Baptist University's library. COVID-19 patients go through acute respiratory distress syndrome, cytokine storm, acute hypercoagulable state, and autonomic dysfunction, which must be managed by a multidisciplinary team including nursing, nutrition, and rehabilitation. The elderly population and those who are suffering from Alzheimer's disease and dementia related illnesses seem to be at the higher risk. There are 28 vaccines under development, and new treatment strategies/protocols are being investigated. The future management for COVID-19 should include B-cell and T-cell immunotherapy in combination with emerging prophylaxis. The mental health and illness aspect of COVID-19 are among the most important side effects of this pandemic which requires a national plan for prevention, diagnosis and treatment.
: Seizures, neurological deficits, bradycardia, and, in the worst cases, cardiac arrest may occur following incidental durotomy during routine lumbar endoscopy. Therefore, we set out to measure the ...intraoperative epidural pressure during lumbar endoscopic decompression surgery.
: We conducted a retrospective observational cohort study to obtain intraoperative epidural measurements with an epidural catheter-pressure transducer assembly through the spinal endoscope on 15 patients who underwent lumbar endoscopic decompression of symptomatic lumbar herniated discs and spinal stenosis. The endoscopic interlaminar technique was employed.
: There were six (40.0%) female and nine (60.0%) male patients aged 49.0667 ± 11.31034, ranging from 36 to 72 years, with an average follow-up of 35.15 ± 12.48 months. Three of the fifteen patients had seizures with durotomy and one of these three had intracranial air on their postoperative brain CT. Another patient developed spinal headaches and diplopia on postoperative day one when her deteriorating neurological function was investigated with a brain computed tomography (CT) scan, showing an intraventricular hemorrhage consistent with a Fisher Grade IV subarachnoid hemorrhage. A CT angiogram did not show any abnormalities. Pressure recordings in the epidural space in nine patients ranged from 20 to 29 mm Hg with a mean of 24.33 mm Hg.
: Most incidental durotomies encountered during lumbar interlaminar endoscopy can be managed without formal repair and supportive care measures. The intradural spread of irrigation fluid and intraoperatively used drugs and air entrapment through an unrecognized durotomy should be suspected if patients deteriorate in the recovery room. Ascending paralysis may cause nausea, vomiting, upper and lower motor neuron symptoms, cranial nerve palsies, hypotension, bradycardia, and respiratory and cardiac arrest. The recovery team should be prepared to manage these complications.
The COVID-19 pandemic has accelerated neurological, mental health disorders, and neurocognitive issues. However, there is a lack of inexpensive and efficient brain evaluation and screening systems. ...As a result, a considerable fraction of patients with neurocognitive or psychobehavioral predicaments either do not get timely diagnosed or fail to receive personalized treatment plans. This is especially true in the elderly populations, wherein only 16% of seniors say they receive regular cognitive evaluations. Therefore, there is a great need for development of an optimized clinical brain screening workflow methodology like what is already in existence for prostate and breast exams. Such a methodology should be designed to facilitate objective early detection and cost-effective treatment of such disorders. In this paper we have reviewed the existing clinical protocols, recent technological advances and suggested reliable clinical workflows for brain screening. Such protocols range from questionnaires and smartphone apps to multi-modality brain mapping and advanced imaging where applicable. To that end, the Society for Brain Mapping and Therapeutics (SBMT) proposes the Brain, Spine and Mental Health Screening (NEUROSCREEN) as a multi-faceted approach. Beside other assessment tools, NEUROSCREEN employs smartphone guided cognitive assessments and quantitative electroencephalography (qEEG) as well as potential genetic testing for cognitive decline risk as inexpensive and effective screening tools to facilitate objective diagnosis, monitor disease progression, and guide personalized treatment interventions. Operationalizing NEUROSCREEN is expected to result in reduced healthcare costs and improving quality of life at national and later, global scales.
CANOMAD, characterized by chronic ataxic neuropathy, ophthalmoplegia, immunoglobulin M (IgM) paraprotein, cold agglutinins, and disialosyl antibodies, encompasses a clinical, radiological, and ...laboratory diagnosis. CANOMAD is a rare condition, with fewer than 100 cases reported in the literature. The understanding and diagnosis of the disease have improved in the last few years, but the treatment of CANOMAD is mainly unknown, and there is not a clear consensus about it. We conducted a systematic review regarding the efficacy of rituximab in CANOMAD's treatment to investigate the clinical and biological response of CANOMAD in patients treated with rituximab. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-Analyses of Observational Studies in Epidemiology (MOOSE) reporting guidelines for this systematic review. To analyze the bias of the study, we used the Joanna Briggs Institute's (JBI) Critical Appraisal Checklist to analyze the bias of the case reports, and we used the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool for the observational studies. We only included case reports, case series, and observational studies written in English with patients formally diagnosed with CANOMAD and treated with rituximab. We excluded systematic reviews, literature reviews, and meta-analyses. We investigated the clinical and biological responses of the patients to rituximab. The clinical response was classified as complete recovery (CR), partial response (PR), stable disease (SD), and non-response (NR). We gathered 34 patients. The literature uses a modified Rankin score to define complete improvement (CR), partial response (PR), stable disease (SD), and progression. Clinically, there were three patients with CR, five with PR, 15 with SD, and 11 with progression. The biological response was assessed by measuring the decrease in antibody titers in 27 patients. Among those, six patients had CR, 12 had PR, eight had SD, and one had progression. Among 15 patients with neurological evaluation, 10 had ocular symptoms, and two presented with bulbar symptoms. Seven of the ten patients with ocular symptoms had SD, two had PR, and one had progression. Only 14 patients had a report of demyelinating features. Three had an axonal pattern, six had a demyelinating pattern, and five had a mixed pattern. Among patients with an axonal pattern, three had an SD. Among patients with a demyelinating pattern, three had a PR, two had an SD, and one had progression. Among patients with a mixed pattern, four had SD, and one had progression. We concluded that patients with CR have a shorter disease duration than patients with PR, SD, or progression. In addition, patients with CR had longer follow-ups than the other groups, suggesting that being treated early with rituximab improves the clinical outcome and has a sustained effect. There were no differences in the frequency of ocular and bulbar symptoms among patients with CANOMAD. The axonal pattern is more common in patients with SD, suggesting that axonal and mixed patterns could be markers of a bad prognosis.
La educación física sostenible contribuye al enriquecimiento motriz y desarrollo armónico del estudiante, pues busca la modificación de hábitos de vida, por ello, el objetivo del presente trabajo es ...conocer el nivel de las capacidades orgánico motrices de los estudiantes universitarios para desarrollar conciencia de un comportamiento motriz sostenible que posibilite modos de vida equilibrados y saludables. El diseño metodológico fue transversal no experimental, se aplicó el método analítico, científico y descriptivo bajo un enfoque cuantitativo. Se trabajó con un grupo de 165 estudiantes del Centro de Formación Complementaria de la Universidad Nacional de Chimborazo a quienes se les aplicó la batería de test de capacidades orgánico motrices que evalúa velocidad, fuerza, flexibilidad y resistencia. Los resultados ubicaron a los participantes en el nivel bueno con el 49,1% seguido por el 38,8% en el nivel bajo. A partir de estos resultados se aplicó un programa piloto denominado “movimiento y armonía” que busca motivar una conducta motriz que influya de manera positiva en el estado emocional de los estudiantes universitarios, quienes están sometidos permanentemente a situaciones académicas de presión, propias de sus carreras.
The present investigation deals with the case of a patient with a picture of acute abdominal pain and a large abdominal tumor, arrives at the Clínica Sur Hospital and based on clinical and imaging ...studies, the diagnosis of acute abdomen was postulated due to possible tumor twisting. ovary giant. The exploratory laparotomy showed a plastron cecal appendix and a giant tumor of the right ovary which, due to histopathological studies, turned out to be acute appendicitis and a benign mucinous ovarian cystadenoma.. Key Word: Acute appendicitis; giant ovarian tumor; benign mucinous cystadenoma.
La presente investigación trata sobre el caso de una paciente con un cuadro de dolor abdominal agudo y una gran tumoración abdominal, llega a la Clínica Sur Hospital y en base a los estudios clínicos y de imágenes se postuló el diagnóstico abdomen agudo por posible torsión de tumor gigante de ovario. La laparotomía exploratoria demostró apéndice cecal plastronada y tumor gigante de ovario derecho que por estudios histopatológicos resulto ser apendicitis aguda y un cistoadenoma mucinoso benigno de ovario.
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Determina el efecto en la aplicación del programa de actividad física “PAFCOM” para el desarrollo de las capacidades orgánicas motrices y en el Rendimiento ...Académico de los estudiantes de Turismo de la facultad de Ingeniería de la Universidad Nacional de Chimborazo. Es una investigación de diseño cuasi experimental. La población está conformada por 61 personas, la mayoría de ellas de sexo femenino, de talla y peso bajo. A esta población se la divide en dos grupos: grupo de control y grupo experimental. El test aplicado evalúa la capacidad orgánica motriz velocidad, fuerza, flexibilidad y resistencia. Para ello se diseña una test orgánico motriz. Este instrumento cumple con la validez a través de la prueba binomial, la confiabilidad a través de la prueba de medición Alfha de Cronbach.
Tesis
Hepatocellular carcinoma (HCC), the fourth leading cause of cancer mortality worldwide, develops almost exclusively in patients with chronic liver disease and advanced fibrosis
. Here we interrogated ...functions of hepatic stellate cells (HSCs), the main source of liver fibroblasts
, during hepatocarcinogenesis. Genetic depletion, activation or inhibition of HSCs in mouse models of HCC revealed their overall tumour-promoting role. HSCs were enriched in the preneoplastic environment, where they closely interacted with hepatocytes and modulated hepatocarcinogenesis by regulating hepatocyte proliferation and death. Analyses of mouse and human HSC subpopulations by single-cell RNA sequencing together with genetic ablation of subpopulation-enriched mediators revealed dual functions of HSCs in hepatocarcinogenesis. Hepatocyte growth factor, enriched in quiescent and cytokine-producing HSCs, protected against hepatocyte death and HCC development. By contrast, type I collagen, enriched in activated myofibroblastic HSCs, promoted proliferation and tumour development through increased stiffness and TAZ activation in pretumoural hepatocytes and through activation of discoidin domain receptor 1 in established tumours. An increased HSC imbalance between cytokine-producing HSCs and myofibroblastic HSCs during liver disease progression was associated with increased HCC risk in patients. In summary, the dynamic shift in HSC subpopulations and their mediators during chronic liver disease is associated with a switch from HCC protection to HCC promotion.
Prepulse inhibition (PPI) represents an attenuation of the startle reflex following the presentation of a weak prepulse at brief intervals prior to the startle eliciting pulse. It has been shown that ...increases in striatal dopamine levels decrease PPI; because dopamine release is sensitive to estrogen, it is likely that PPI varies across the menstrual cycle. Cross‐sectional studies looking at estrogen effects suggest that this may be true. In this study, we compare effects of menstrual phase on PPI in a between‐group design (men, follicular phase women, and luteal phase women) as well as a within‐subjects design (women across the two phases). The study found a between‐group as well as a within‐subjects effect of phase on PPI. PPI in follicular phase women did not differ significantly from PPI in men. However, PPI was reduced in luteal women compared to follicular women. These data provide evidence that ovarian hormones affect sensorimotor gating.
If greenhouse gas emissions are not sharply reduced, air pollution, extreme weather events, and desertification in southern Spain will occur, along with many deaths, and collapses of the health ...system and the country’s main economic sectors, agriculture, and tourism. The European Union adopted a strategy in 2019 with a series of environmental policy initiatives to protect the population from climate change hazards as ‘the Green Deal’.This strategy provides funding opportunities for Granada, one of Spain's most polluted and climate change-vulnerable cities, to reduce its high emissions of harmful greenhouse gases from transport.A spacious, well-connected, and safe cycling infrastructure is needed. New on-road cycle lanes and cycle paths with planted barriers to the car lane should be constructed. An e-bike sharing system can also enable people with special needs to cycle in the hilly city and drive tourism. Extensive participation opportunities and assessments of disparate impacts on access and health outcomes of different population groups need to be used to ensure that existing inequalities are not exacerbated.
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