Objective
To report clinical and epidemiological data of Devic's disease in Mexico.
Design
Retrospective study of hospital case records.
Setting
The medical records were those of the National ...Institute for Neurology and Neurosurgery (INNN), a tertiary care referral center in Mexico City.
Patients
There were 424 medical histories available for review among 561 discharges with diagnoses of multiple sclerosis (MS), neuromyelitis optica (NMO), or equivalents. 390 met the diagnostic criteria of MS and 34 the NMO criteria.
Main outcome measures
We recorded clinical signs, visual acuities, and the Expanded Disability Status Scale (EDSS) at the initial diagnostic admission and during follow-up. All patients had examination of cerebrospinal fluid (CSF) at diagnosis; head and spine magnetic resonance imaging (MRI) were performed at diagnosis and at follow-up.
Results
All 34 patients were Mexican Mestizos, who comprise 79 % of the residents of Mexico City. There were 23 monophasic and 11 relapsing cases. Intervals between initial and defining events for the 8 ON and 12 myelitis onsets were 17 and 24 months (means) and 15 and 17 months (medians), respectively. Mean follow- up from onset was 70.2 months and 42.9 months from diagnostic examination. No patient showed improvement in EDSS scores. Visual loss was severe.
Conclusion
A provisional prevalence rate of about 1 per 100,000 population for NMO in Mexican Mestizos might be offered. The disease seems more severe in our population than in other recent series.
The lipid bilayer disrupting effect of antimicrobial peptides (AMPs) has been widely studied in model-lipid systems by applying biophysical techniques such as 2H NMR spectroscopy. Real bacteria cell ...envelopes contain non-lipid components, such as peptidoglycan, and thus it is important to assess the effects of such non-lipid components on the lipid-disrupting effects of AMPs. To this end, our group and other have developed methods that promote uptake of deuterium-labeled acyl chains in bacterial cells to produce 2H-membrane-enriched Bacillus subtilis. In this work, we studied changes in the static 2H NMR spectra of B. subtilis induced by the AMPs MSI-78 and BP100. Addition of both AMPs resulted in the increase of lipid acyl chain disorder consistent with disruption of the bacterial membrane. In addition, the peptide to lipid molar ratios (P:L) that give rise to observable effects fall between the P:L molar ratios necessary to generate membrane disruption in model-lipid-only systems and the P:L molar ratios needed to inhibit bacterial cell growth. This observation supports a role for the non-lipid components in modulating the AMP-lipid interactions.
•2H-labeled intact bacterial samples give reproducible NMR spectra.•Gram+ bacteria give similar 2H-NMR spectra to Gram−.•2H NMR spectra of bacteria indicate phospholipids in liquid crystalline phase.•AMPs cause a decrease in the orientational of membranes in bacteria.•AMP treatment results in greater changes to spectra of B. subtilis than E. coli (LA8).
Introduction Tobacco smoking is one of the most important risk factors for periodontitis as it alters the host response to plaque. Although the prevalence of tobacco smoking has declined in recent ...years, the use of electronic-cigarettes (vaping) has increased. The effect of vaping on the gingiva is unknown and an evidence-base needs to be established before providing dental advice about the use of these products.Objective To compare the gingival health of a group of established smokers before and after substituting vaping for smoking tobacco.Design Pilot.Setting Guy's Dental Hospital (England) from April-December 2015.Materials and methods Twenty established smokers (all staff members at Guy's Hospital) with mild periodontal disease replaced their regular smoking habits with the use of e-cigarettes for two weeks.Main outcome measure The primary outcome measure of gingival inflammation was bleeding on probing. Levels of selected pro-inflammatory cytokines in GCF, saliva and serum samples were also determined.Results and conclusions There was a statistically significant increase in gingival inflammation when tobacco smokers switched from smoking to vaping for two weeks. However, this result must be interpreted with extreme caution since this is only a pilot study. Nonetheless, this study should provide a stepping stone to encourage further investigation of the effects of vaping on periodontal health.
Approximately 20% of acquired brain injury (ABI) survivors experience reduced psychological wellbeing (PWB). Neuropsychological rehabilitation (NPR) is one approach supporting people with ABI to ...participate meaningfully in activities despite challenges. Although literature supports NPR effectiveness, little is known about change mechanisms. This systematic realist review identifies what NPR programmes have been designed, delivered, and evaluated for people with ABI to improve PWB and/or quality of life (QOL), as well as providing a context-relevant understanding of what NPR includes and how NPR might lead to positive outcomes. A rapid realist review was conducted in three phases: (1) structured retrieval and evidence extraction; (2) stakeholder consultation; (3) analysis and synthesis. Searches were completed, and findings from 35 publications and one stakeholder consultation were synthesized into a refined logic model. Six context-mechanism-outcome chains (CMOCs) were identified. Participants' relationships to internal experiences, and feelings of self-worth, mastery, and connection appeared to be mechanisms that led to improved PWB and QOL. Adaptation and individualized programmes were also key mechanisms to explain successful NPR. Embedding CMOCs into NPR could improve PWB and/or QOL for people with ABI. The logic model will inform ongoing development of a new online, group-based, NPR programme.
Human infection with Mycobacterium bovis is reported infrequently in the United Kingdom. Most cases involve previous consumption of unpasteurized milk. We report a rare occurrence of 2 incidents of ...cat-to-human transmission of M. bovis during a cluster of infection in cats.
Abstract
Background
Older people who are non-weight-bearing after a lower limb fracture are at risk of poor outcomes but there are no clinical guidelines for this group of patients. Given the paucity ...of the research evidence base, we conducted a consensus exercise to ascertain expert opinion about the management of this group.
Methods
A three-round e-Delphi technique was planned to use the online JISC survey tool with a multidisciplinary panel of health professionals. Panellists were invited by email via professional organisations and UK NHS Trusts. The initial statements for this study were prepared by the authors based upon the findings of their scoping review. Consensus required >/= 70% agreement with statements.
Results
Only 2 survey rounds were required. Ninety panellists, representing seven clinical disciplines, reached consensus for 24 statements about general issues (osteoporosis detection and management, falls risk reduction and nutrition) and specific non-weight bearing issues (such as the need for activity to be promoted during this period).
Conclusions
These findings can be used in the generation of a clinical guideline for this group of patients.
Only 24% of US youth meet physical activity recommendations set by the Centers for Disease Control and Prevention. Research demonstrates that community-based programs provide underresourced minority ...youth with opportunities for routine physical activity, although limited work draws from accelerometry data. This study objectively assessed youth physical activity attributable to participation (vs nonparticipation) days in a park-based afterschool program in Miami-Dade County, Miami, FL.
Participants' (n = 66; 60% male; 57% white Hispanic, 25% non-Hispanic black, 14% Black Hispanic, mean age = 10.2 y) physical activity was assessed April to May 2019 over 10 days across 7 park sites using Fitbit (Charge 2) devices. Separate repeated-measures multilevel models were developed to assess the relationship between program daily attendance and total (1) moderate to vigorous physical activity minutes and (2) step counts per day.
Models adjusted for individual-level age, sex, race/ethnicity, poverty, and clustering by park showed significantly higher moderate to vigorous physical activity minutes (β = 25.33 more minutes per day; 95% confidence interval, 7.0 to 43.7, P < .01) and step counts (β = 4067.8 more steps per day; 95% confidence interval, 3171.8 to 4963.8, P < .001) on days when youth did versus did not attend the program.
Study findings suggest that park-based programs may support underserved youth in achieving daily physical activity recommendations.
Introduction
The Promoting Activity, Independence and Stability in Early Dementia (PrAISED) is delivering an exercise programme for people with dementia. The Lincolnshire partnership NHS foundation ...Trust successfully delivered PrAISED through a video-calling platform during the COVID-19 pandemic.
Objectives
This qualitative case-study identified participants that video delivery worked for, and highlighted its benefits and challenges.
Methods
Interviews were conducted with participants with dementia, caregivers and therapists, and analysed through thematic analysis.
Results
Video delivery worked best when participants had a supporting carer, when therapists showed enthusiasm and had an established rapport with the client. Benefits included time-efficiency of sessions, enhancing participants’ motivation, caregivers’ dementia awareness and therapists’ creativity. Limitations included users’ poor IT skills and resources.
Conclusions
The COVID-19 pandemic required innovative ways of delivering rehabilitation. This study supports that people with dementia can use tele rehab, but success is reliant on having a caregiver and an enthusiastic and known therapist.
Many older adults are not physically active despite the well-documented health benefits of regular exercise. We examined cardiovascular, strength, and mobility outcomes among a sample of ...racially/ethnically diverse adults aged 55 or older participating in a community park-based physical activity program.
We assessed the following among adults aged 55 or older who attended a 1-hour park-based fitness class 2 or 3 times per week for 21 weeks: 1) 3 fitness outcomes, 2) systolic and diastolic blood pressure, 3) height and weight (to assess body mass index), and 4) pulse. We collected data at baseline (August-September 2016) and follow-up (January-February 2017). Linear regression analysis, adjusting for sex, age, and race/ethnicity, examined the association between program participation and changes in outcomes.
Adjusted models showed a mean decrease in systolic blood pressure (-3.80 mm Hg; 95% CI, -6.75 to -0.84 mm Hg) and diastolic blood pressure (-1.54 mm Hg; 95% CI, -3.01 to -0.06 mm Hg) and a mean increase in number of arm curls completed in 30 seconds (1.66; 95% CI, 0.71-2.61) from baseline to follow-up among all participants. Hispanic participants, compared with non-Hispanic white and non-Hispanic black participants, showed greater improvements in mean body mass index (-2.48; 95% CI, -4.60 to -0.34), systolic blood pressure (8.59 mm Hg; 95% CI, -16.82 to -0.36 mm Hg), diastolic blood pressure (-7.06 mm Hg; 95% CI, -11.16 to -2.97 mm Hg), and pulse (-6.53 beats per minute; 95% CI, -11.38 to -1.67 beats per minute).
Park-based fitness classes tailored to older, racially/ethnically diverse adults can improve cardiovascular health and strength.
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