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The Gait Restorative Effects of Robotic-Assisted Gait Training for Individuals with Neurodegenerative Disease: A Review
No full textBackground: Neurodegenerative diseases and disorders present with a wide range of clinical and neuropathological symptoms caused by progressive neuronal dysfunction and eventual neuronal death. As individuals with neurodegenerative diseases experience gradual sensory, motor, and cognitive debilitation, the maintenance and recovery of a functional gait holds physiological, psychological, and financial importance. Developments in robotically-aided therapies are becoming more commonly used as a therapeutic tool for the improvement of gait characteristics and overall motor function for individuals with various gait impairments. To date, studies examining the effects of robotic-assisted gait training (RAGT) as treatment for neurodegenerative diseases, have only been performed in individuals with multiple sclerosis (MS), Parkinson’s disease (PD), and progressive supranuclear palsy (PSP).Purpose: The purpose of this review is to summarize and show trends to the efficacy of RAGT as a gait restorative and preservative modality for individuals with these neurodegenerative diseases including MS, PD, and PSP.Results: The overall trends reported by these reviewed studies show that RAGT may be an effective therapy for producing significant improvements in multiple gait characteristics including balance, walking speed, endurance, leg strength, gait safety, and motor function for individuals with neurodegenerative disease.Conclusion: The studies in this review suggest that RAGT therapies may be an effective substitute for, or addition to, present conventional therapies for individuals with neurodegenerative disease, however the long-term effects of this therapy are still not known for these individuals
Paradoxical Vocal Fold Motion Disorder: Etiology, Clinical Presentation and Diagnosis
No full textParadoxical vocal fold motion disorder (PVFMD) is a disease characterized by intermittent adduction of the vocal folds during inspiration and/or expiration, causing dyspnea and sensation of throat tightness. Usually there are intermittent symptoms of shortness of breath and inspiratory stridor that may lead patient to emergency units. The disease is frequently misdiagnosed and many patients are treated wrongly. Some neurologic alterations are accused but the etiology is still unclear. The diagnostic work-up should include a detailed history and physical examination, pulmonary function testing, measures of oxygenation and flexible laryngoscopy. Asthma, laryngopharyngeal reflux, some air irritants and some psychologic conditions should be ruled out in differential diagnosis
Risk of Malignancy in Juvenile-Onset Arthritis (Brief Report)
No full textObjective: An increased risk for certain types of malignancies has been reported in rheumatoid arthritis (RA) patients. Comparable risks may exist in juvenile-onset arthritis due to its pathophysiological similarities with adult rheumatoid arthritis. Our objective was to investigate the relationship between juvenile-onset arthritis and risk of malignancy.Methods: A systematic review of the published literature was performed. Articles reporting data concerning the observed cancer rates in patients with juvenile-onset arthritis versus the general population rates were further assessed. The standardized incidence ratios (SIR) of observed to expected cases were retrieved from the studies and pooled in order to determine the overall risk of malignancy in patients with juvenile-onset arthritis.Results: The pooled SIR for overall cancer was 1.4 (95% Confidence Interval, CI 1.2-1.7). However, study data were not homogenous: certain studies showed a significantly increased risk of malignancy overall in juvenile-onset arthritis, but others showed that there was no significant increase in cancer risk overall. The pooled SIR for hematological malignancies was 1.7 (95% CI 1.2-2.4) across all studies.Conclusions: Existing data on malignancy risk in juvenile-onset arthritis are conflicting. Additional data are needed in order to definitively establish the presence or absence of an association between juvenile-onset arthritis and cancer risk
Vitamin D Receptor Gene Polymorphism in Egyptian Patients with Knee Osteoarthritis
No full textIntroduction: Several polymorphisms have been implicated and associated with osteoarthritis (OA), including vitamin D receptor (VDR). VDR is present in many tissues, including chondrocytes. Vitamin D has been found to increase synthesis of proteoglycan in vitro, suggesting that it may affect the cartilage metabolism.Objective: to investigate the frequency of the VDR gene polymorphism in Egyptian patients with knee OA, and compared them with controls.Subjects and Methods: 200 patients with primary knee OA according to the American College of Rheumatology criteria and 200 matched controls who had no OA.Clinical impact of OA were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. VDR gene polymorphism BsmI, ApaI, FokI and TaqI restriction fragment length polymorphisms (RFLPs) were determined by the polymerase chain reaction (PCR).Results: The frequency of ApaI genotype and alleles did not differ significantly between the knee OA patients and the controls. However, three genotypes where significantly higher in knee OA patients than in controls: the bb genotype of BsmI, TT genotype of TaqI and FF genotype of FokI. Knee OA patients with osteophytes had significantly more frequent bb genotype of BsmI, TT genotype of TaqI and FF genotype of FokI. BsmI, TaqI and FokI genotypes or alleles did not show any association with the presence of joint space narrowing (JSN). Knee OA patients who had bb genotype of BsmI, TT genotype of TaqI and FF genotype of FokI are associated with significantly higher WOMAC scores.Conclusion: The current study suggests that VDR gene polymorphism may be associated knee OA in the studied group of Egyptian patients. Association was mostly with severe clinical manifestation and osteophyte formation but not with JSN
Urodynamic Evaluation of Female Patients with Metabolic Syndrome
No full textObjective: In this study, our main objective is to show the connection between metabolic syndrome (MetS) and bladder functions by using urodynamic evaluation in female MetS patients.Materials and Methods: 131 female patients referred to our clinic for urodynamic evaluation from April 2014 to December 2014 were included in our study. 85 of these patients were diagnosed with MetS (study group) meanwhile 46 patients did not meet MetS criteria (control group). MetS definitions were taken from National Cholesterol Education Program’s Third Adult Treatment Panel criteria. SPSS 17.0 was used for statistical analysis of data and p<0.05 values were deemed as statistically significant.Results: Urodynamic results of 131 patients were analyzed and patients were divided into study and control groups in accordance with their MetS profile. 85 patients were included in the study group and rest 46 were used as the controls. A statistically significant difference was detected when IPSS results were separated into low, intermediate and severe between study and controls (p=0.007). Moreover, urge-type incontinence was more frequent in MetS patients when compared with control group (p<0.001). However, there was no significant difference between groups in terms of SEAPI scores and IPSS. Patients with MetS had significantly higher detrusor, vesical and abdominal pressure in comparison with control group (p<0.001). No significant difference was found in uninhibited contractions, first urinary sense, strong desire to urinate, Valsalva leak-point pressure (VLPP) and abdominal leak-point pressure (ALPP) parameters between the groupsConclusion: Our results showed that MetS and its components can be associated with neurogenic bladder symptoms due to peripheral neuropathy and urge incontinence. Female patients with MetS have significantly higher post-voiding residue and intravesical pressure in comparison with control group. Further clinical studies with longer and controlled series are necessary for clarification of the metabolic syndrome’s effect on bladder dysfunction on a molecular level
Clinical Evaluation to Determine Dry Weight in Hemodialysis is as Good as Bioelectrical Impedance Analysis
No full textObjective: The aim of this study was to compare the efficacy of bioelectrical impedance analysis against clinical evaluation for the adequacy of DW in hemodialysis (HD) patients.Material and Methods: A randomized crossover study with patients randomized into two groups: A - DW determined by clinical evaluation (CA), and B - DW evaluated by bioimpedance analysis (BIA), for 4 weeks. After this period, the crossover to the alternate treatment was performed for a further 4 weeks.Results: The study included 57 CKD patients on HD. No statistical difference was found when comparing the two treatments for data related to blood pressure, hydration parameters and DW, regardless of group.Conclusions: The results suggest equivalence between the treatments of BIA and CA for determining DW and guiding HD ultrafiltration
Response to Pegylated Interferon in Chronic Hepatitis B, Effect of with and without Precore Mutant Stain: A Multicenter Tunisian Study
No full textBackground and Study Aims: To evaluate the effectiveness of pegylated interferon in patients with chronic hepatitis B infection in a real life setting.Patients and Methods: Fifteen hospitals in Tunisia were included in this study. Data from consecutively treated chronic hepatitis B (CHB) patients, who received pegylated interferon, were collected retrospectively. Baseline demographic and clinical data, on-treatment virological and serological responses and adverse events (AE) were recorded. Sustained virologic response (SVR) is defined as an hepatitis B virus (HBV) DNA concentration of less than 2,000 IU/mL six months after the completion of therapy.Results: A total of 351 CHBÂ patients under peg interferon alfa-2a treatment were included in this multicenter, open label, non-interventional study.Thirty five HBeAg positive patients were identified (62% male, 23% advanced fibrosis). Six months after therapy, 24% had viral loads < 2000 IU/mL, 20% achieved HBeAg seroconversion and 5, 7% achieved HBs Ag loss.Three hundreds sixteen HBeAg negative patients were treated (72, 5% male, 24% advanced fibrosis). Six months post-treatment, 14 % had viral loads < 2000 IU/mL and 1, 2% achieved HBs Ag loss.Treatment was well tolerated in 92% of cases and was stopped in 5.2% of patients.In multivariate analysis, predictors of response to pegylated interferon were: age less than 50 years (P=0,04 IC [0,169-0,737]), precore mutant stain infection (p=0,04 IC [0,60-0,69]), a body mass index < 30kg/m2 (P=0,05 IC [0,225-0,320]), and a pre-treatment serum HBV DNA level <20000IU/ml (P=0,03 IC [1,316-2,225]).Conclusion: PEG-IFN therapy in chronic hepatitis B (CHB) is well tolerated and can achieve a good response especially if we select good responders
Robotic-Assisted Gait Training Therapies for Pediatric Cerebral Palsy: A Review
No full textBackground: Children and adolescents with CP experience many types of disability and functional impairment that effect the gait cycle. New robotic gait therapies adapted to pediatric patients provide a safe, highly repetitive, and task-specific therapeutic venue for the rehabilitation and elicitation of a more natural walking gait. While the use of robotic-assisted gait training (RAGT) is a relatively novel therapeutic approach to gait therapy, several studies have examined the efficacy of this therapeutic modality in pediatric patients with CP.Purpose: The purpose of this review is to examine the trends in the therapeutic efficacy of utilizing RAGT therapy as a gait restorative modality for children with CP.Results: The present studies show that RAGT therapy may provide multiple therapeutic benefits to children with CP, including statistically significant improvements in gross motor function and multiple gait characteristics. Also, RAGT therapy may be a safe and favorable complement to current physiotherapy regimens.Conclusion: As various degrees of functional improvement are a noticeable trend among all presented studies, further study in this therapeutic technique is warranted, and implementation of similar therapeutic protocol may be valuable to a rehabilitation care plan. The highly repetitive and task-specific nature of RAGT may provide a valuable paradigm for children with CP whom have never learned a normal gait pattern
Right Hemisphere Language Battery in Hindi
No full textCommunicative deficits are identified by the Speech-Language Pathologists (SLPs) which are otherwise attributed to a loss of memory, attention, or visual-perceptual skills. Tools to measure right hemisphere functions have been developed in only two Indian languages (Kannada and Malayalam), but no test has been developed in Hindi. Hundred participants were considered for the study. They were divided into three groups- eighty normal participants (Group-I) and ten Hindi speaking diagnosed right hemisphere vascular damaged participants (Group- II) and ten Hindi speaking diagnosed left hemisphere vascular damaged participants (Group-III). There is no significant difference existed between the performance of the participants between Right Hemisphere Language Battery (RHLB) and Right Hemisphere Language Battery in Hindi (RHLB-H) across all the subtests at α = 0.05 level of significance. A significant difference exists between the obtained mean scores among the normal control participants and Right Hemisphere Disorder (RHD) participants at α = 0.05 level significance. ANOVA test results showed that RHD participants had a significantly higher discourse error rating than either Left Hemisphere Disorder (LHD) or controls. Furthermore, the Tukey’s Honest Significant Difference (HSD) Post-Hoc test reveals that there is a decrease in the obtained mean scores from Normal Control participants to the LHD and RHD groups in order. It can thus be concluded that there is a significant difference in the mean scores across all the three groups
Ribonucleases and their Applications
No full textRibonuclease (RNase) is a type of nuclease that catalyzes degradation of RNA into smaller components. RNase can be classified into two broader categories namely endoribonucleases and exoribonucleases on the basis of their site of action. RNases play key roles in the maturation of all RNA molecules; endoribonucleases cleave the RNA molecules from the interior at 5′ end while exoribonucleases degrade RNA molecules in a 3′–5′ direction. With the advent of new frontiers in biotechnology, the applications of ribonucleases besides molecular biology have expended into many other fields like medicinal, clinical, and analytical chemistry. RNase A that belongs to pancreatic ribonucleases super family plays an important key role in structural, biochemical and evolutionary studies. Discovery of eukaryotic orthologues of the bacterial double stranded (ds) RNA-specific ribonuclease III (RNase III) suggests a central role for these enzymes in the regulation of ds-RNA and eukaryotic RNA metabolism. The more recent studies have shown that the mammalian and some fungal RNases are also bestowed with antiproliferative, antiangiogenic and/ or antitumor/ anticancer activities. Some of the members of RNase A superfamily such as RNase 6 and RNase 7 appears to be evolutionary conserved peptides with potent antimicrobial activities for upkeep of sterility in the urinary tract