There is increasing evidence of prodromal manifestation of neuropsychiatric symptoms in a variety of neurodegenerative diseases such as Parkinson's disease (PD) and Huntington's disease (HD). These ...affective symptoms may be observed many years before the core diagnostic symptoms of the neurological condition. It is becoming more apparent that depression is a significant modifying factor of the trajectory of disease progression and even treatment outcomes. It is therefore crucial that we understand the potential pathophysiologies related to the primary condition, which could contribute to the development of depression. The hypothalamic-pituitary-adrenal (HPA)-axis is a key neuroendocrine signaling system involved in physiological homeostasis and stress response. Disturbances of this system lead to severe hormonal imbalances, and the majority of such patients also present with behavioral deficits and/or mood disorders. Dysregulation of the HPA-axis is also strongly implicated in the pathology of major depressive disorder. Consistent with this, antidepressant drugs, such as the selective serotonin reuptake inhibitors have been shown to alter HPA-axis activity. In this review, we will summarize the current state of knowledge regarding HPA-axis pathology in Alzheimer's, PD and HD, differentiating between prodromal and later stages of disease progression when evidence is available. Both clinical and preclinical evidence will be examined, but we highlight animal model studies as being particularly useful for uncovering novel mechanisms of pathology related to co-morbid mood disorders. Finally, we purpose utilizing the preclinical evidence to better inform prospective, intervention studies.
To compare the effect of ultrasound (US)-guided dry needling (DN) with traditional DN in the treatment of pain and dysfunction for patients with knee osteoarthritis (KOA). A double-blind, randomized ...controlled trial. Eighty-four participants (61.26±5.57 years) completed the study. G1 achieved significant improvement in VAS at 8 weeks compared to G2 and G3 (G1 vs. G2: MD = -15.61, 95% CI -25.49, -5.51, p = 0.001; G1 vs. G3: MD = -19.90, 95% CI -29.71, -10.08, p< 0.001). G1 achieved significant improvement in KOOS-pain at 8 weeks compared to G2 and G3 (G1 vs. G2: MD = 9.76, 95% CI 2.38, 17.14, p = 0.006; G1 vs. G3: MD = 9.48, 95% CI 2.31, 16.66, p = 0.010). KOOS-symptoms and KOOS-QoL were not statistically significant between groups. G2 had no significant difference of the perceptions as G1 with p = 0.128. G2 were successfully blinded to placebo US-guided DN. US-guided DN with exercise therapy may be more effective than traditional DN with exercise therapy or exercise therapy alone in reduce pain of KOA.
Bedaquiline treatment significantly improves multidrug-resistant tuberculosis (MDR-TB) patient treatment outcomes. However, safety and efficacy data are lacking for bedaquiline used with background ...regimens to treat Chinese TB patients. Here, we describe our initial clinical experience for bedaquiline treatment of a large multicentre cohort of MDR-TB and extensively drug-resistant tuberculosis (XDR-TB) patients in China.
Patients (177) received 24-week bedaquiline treatment combined with personalized anti-TB drug background regimens. As primary efficacy endpoints, times to initial sputum culture conversion were measured.
Of 177 MDR-TB patients completing the 24-week treatment course, sputum culture conversion occurred for 151/177 (85.3%), while 26 had unfavourable outcomes, including 3/177 (1.7%) deaths and 23/177 (13.0%) non-responders at treatment completion. The median time to sputum culture conversion was 4 (interquartile range 2–8) weeks. Conversion rates were 33/39 (84.6%, 95% confidence interval (CI) 73.3–95.9) for MDR-TB patients, 47/56 (83.9%, 95% CI 74.3–93.6) for pre-XDR-TB patients and 71/82 (86.6%, 95% CI 79.2–94.0) for XDR-TB patients. Multivariate analysis demonstrated that patients with low body mass index (odds ratio 7.356; 95% CI 2.652–20.401) were at significantly high risk of unfavourable outcomes, with serious adverse events noted in 15 (8.5%) patients, including six with corrected QT interval (QTc) prolongation times (>500 ms).
Bedaquiline, when included in background regimens for treatment of MDR-TB and XDR-TB patients in China, was safe and associated with a high rate of culture conversion.
Surgical site infections Young, Pang Y; Khadaroo, Rachel G
The Surgical clinics of North America,
12/2014, Letnik:
94, Številka:
6
Journal Article
Recenzirano
Surgical site infections are a major contributor to morbidity and mortality in postsurgical care. Risk for surgical site infection is multifactorial and includes a host of microbial, patient-related, ...and procedure-related factors. Prevention of surgical infection relies on optimization of patient factors and use of a variety of evidence-based pharmacologic and nonpharmacologic measures. At the forefront of these measures is antimicrobial prophylaxis, which has been shown to be effective at reducing risk of surgical site infection. As guidelines for prevention of surgical site infection become increasingly complex and nuanced, surgical infection outcomes are increasing tied to quality outcome and performances measures.
Abstract
We study the energy conversion in the turbulent region (TR) downstream of the reconnection front (RF) via 2.5D particle-in-cell simulations. Our study shows that most magnetic energy is ...transferred into plasma in the exhaust region (ER) and the TR downstream of the RF; the latter is formed due to the electron Kelvin–Helmholtz instability (KHI). Unlike the energy conversion in the ER, the energy conversion in the TR is mainly balanced by its in-plane component (
E
x
J
x
+
E
z
J
z
). We further find that the time evolution of the integrated energy conversion in the TR is strongly correlated with the time evolution of the electron KHI and secondary reconnection. The KHI feeds on the electron kinetic energy to grow, and electron vortices are formed, correspondently. The energy is transferred to ions through a nonideal electric field associated with those electron vortices after the KHI is well developed. Finally, the electron vortices are collapsed due to the secondary reconnection among those vortices. The power law of the magnetic energy spectra also shows a slope near −5/3 at wavenumbers larger than the ion scale when the KHI is fully developed.
Summary
This study was conducted to examine the association between the tibial bone strength index and leg muscle strength of different contraction types and speeds among people with chronic stroke. ...We found that concentric muscle power at moderate speed was more associated with tibial bone strength index than other types.
Introduction
To compare the influence of muscle strength of different contraction types and speeds on the bone strength index of tibial diaphysis in people with chronic stroke.
Methods
Eighty individuals with chronic stroke (age: 62.6 ± 8.0 years; men/women: 46/34; post-stroke duration: 9.0 ± 5.4 years) underwent scanning of the tibia at the 66% site on both sides using peripheral quantitative computed tomography. Each participant was also evaluated for isometric and dynamic (at 60°/s and 120°/s) strength of knee flexors/extensors and ankle dorsiflexors/plantarflexors using an isokinetic dynamometer. For a given contraction type and speed, the strength values of the four muscle groups were summed to yield a composite score. Multiple regression analysis was used to identify the association of the percent side-to-side difference (%SSD) in tibial polar-stress-strain index (p-SSI) with %SSD in muscle strength of different contraction types and speeds.
Results
The p-SSI and all muscle strength parameters on the paretic side had lower values than the non-paretic side (
p
≤ 0.001). The %SSD in concentric muscle power at angular speed of 60°/s (
R
2
= 0.317,
p
= 0.006) and 120°/s (
R
2
= 0.298,
p
= 0.020) remained independently associated with that in p-SSI, after controlling for age, sex, body mass index, post-stroke duration, motor impairment, spasticity, and physical activity level. The effect of isometric strength and eccentric muscle power was not significant in multivariate analysis.
Conclusions
Concentric muscle power was more predictive of %SSD in p-SSI at the tibial diaphysis than other contraction types and may be an important target for intervention to promote bone health in people with chronic stroke.
Abstract The high-speed solar wind decelerates as it travels through the Earth’s bow shock, during which a portion of the incident flow energy is converted into the plasma thermal energy. However, ...the energy partition of plasma heating among different species, as well as the energy dissipation mechanism, remains elusive. In this paper, we quantify the plasma heating and the energy dissipation by calculating the pressure–strain interactions in 33 quasi-perpendicular bow shocks observed by the Magnetospheric Multiscale spacecraft. Our results show that the Joule dissipation measured by J · E ′ and the quasi-viscous dissipation quantified by PiD are distinct in the examined shocks. We also reveal that ions gain more energy than electrons, and the compressive effect is more important than the incompressible channel in plasma heating. PiD contributed by the gyrotropic pressure tensor is consistently positive for electrons; however, there is no discernible distinction between the gyrotropic and nongyrotropic contribution to PiD for ions.
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