Paralysis of the deep branch of the radial nerve due of an entrapment neuropathy

The clinical and neurophysiological findings in two cases of spontaneous paralysis of the deep branch of the radial nerve are reported. The patients are sisters and the dominant hand was affected in both. One patient was submitted to surgical exploration, and 'entrapment neuropathy' was found to be the cause. After neurolysis the patient gained complete recovery. The usefulness of the EMG illustrated and stressed.     

A reinvestigation of the analgesic effects induced by stimulation of the periaqueductal gray matter in the rat. I. The production of behavioral side effects together with analgesia

It has been shown that stimulation-produced-analgesia (SPA) in the cat elicited from the periaqueductal gray matter (PAG) is obtained from sites located in the ventral part, particularly the dorsal raphé nucleus (DRN). These data contrast with the numerous studies performed in the rat in which efficient sites seem widely distributed throughout the PAG. These discrepancies led us to reinvestigate SPA from PAG and adjacent structures in the rat. Central stimulation was delivered through bipolar concentric electrodes (one for each animal). Analgesia was evaluated (before and during central stimulation) by measuring the modification in the vocalization threshold induced by electrical tail shocks or by considering the reaction of the animal to pinch. In contrast with the majority of previous studies, these experiments were performed on the totally freely-moving rat. The most striking result was that, in order to obtain analgesia from all regions of the PAG, it was necessary to apply intensities of central stimulation which also triggered other strong behavioral reactions. With intensities of PAG stimulation which did not induce such side effects, very few effective analgesic sites were found (21/129 sites of which 14/83 were strictly located in the PAG). However, it was possible to define two 'pure analgesic regions', both located in the ventral PAG: one centered on the dorsomedial part of the DRN and the other one situated in the ventrolateral PAG. No modification of nociceptive thresholds was observed when stimulating the dorsal and dorsolateral parts of the PAG as well as structures adjacent to these regions; in some rats, an increase in pain reactivity was even noted. When the intensity of central stimulation (applied to the various parts of the PAG) was increased, some stereotyped 'behavioral responses' occurred depending on the location of the stimulation site: motor effects (gnawing, rotation or tremor) in the ventral PAG and aversive effects (flight, jumping and on occasions, distress vocalizations) in the dorsal, dorsolateral PAG and in the ventral region just surrounding the cerebral aqueduct. Under these conditions, analgesia was obtained from practically the entire PAG, the vocalization threshold being increased dramatically on occasions. It must be emphasized that antinociceptive effects associated with other obvious behavioral manifestations (aversive ones) were also obtained from sites located outside the PAG (colliculi and tectum adjacent to the dorsal and dorsolateral PAG).(ABSTRACT TRUNCATED AT 400 WORDS)     

Overview of biological effects of Quercetin on ovary

Over the last few decades, using natural products has been increased to treat different diseases. Today, great attention has been pointed toward the usage of natural products such as flavonoids, especially Quercetin (QUR), in the treatment of diseases. QUR as a natural antioxidant has been traditionally used to prevent or treat a variety of diseases such as cancer, cardiovascular disease, polycystic ovary syndrome (PCOS), obesity, chronic inflammation, and reproductive system dysfunction. Several studies demonstrated that QUR acts as an anti‐inflammatory, anti‐apoptotic, antioxidant, and anticancer agent. With this in view, in this study, we intended to describe an overview of the biological effects of QUR on the ovary. QUR improves the quality of oocytes and embryos. It affects the proliferation and apoptosis and decreases the oxidative stress in granulosa cells (GCs). Furthermore, QUR can be used as a complementary and alternative therapy in ovarian cancer and it has beneficial effects in the treatment of PCOS patients. It seems that QUR as a supplementary factor has different activities for the treatment of different disorders and it also has bidirectional activities. However, further investigations are needed for understanding the efficacy of QUR in the treatment and improvement of gynecological patients.     

Does statin use affect amyloid beta deposition and brain metabolism?

Background

There are contradictory findings regarding the effect of statin drugs on amyloid β (Aβ) deposition as one of the main hallmarks of Alzheimer's disease (AD), along with tau pathology. We aimed to longitudinally investigate the therapeutic and preventive role of statin drugs by examining the brain Aβ deposition and metabolism rate in AD, mild cognitive impairment (MCI), and healthy controls (HC).

Methods

The data of 828 subjects including 178 HC, 492 MCI, and 158 AD individuals were obtained from ADNI. The baseline and longitudinal [¹⁸F] AV45 and 18-fluorodeoxyglucose (FDG) PET standard uptake value ratio (SUVR) measures were investigated among statin users and non-users.

Results

Our results showed that there is no significant difference in baseline Aβ deposition and metabolism rate between statin users and non-users among HC, MCI, and AD subjects. While there was no significant effect of statin on metabolism rate, there was a significant difference in Aβ deposition change after 4 years (from baseline) between statin users and non-users within HC subjects (p = 0.011). The change of Aβ deposition at 4 years from baseline was −2.0 ± 6.3% for statin users and 1.4 ± 4.7% for non-users. There was no significant association between statin duration use with baseline and longitudinal Aβ deposition and metabolism rate. However, statin dosage was significantly associated with Aβ deposition in 2 years (r = −0.412, p = 0.021) in the HC group. Moreover, our analysis showed a significant correlation between total statin exposure (duration×dosage) and Aβ deposition in 2 years visit (r = −0.198, p = 0.037) in HC subjects. Furthermore, we investigated the longitudinal changes within each group of statin users and non-users separately in linear mixed models. Our findings showed that there are no significant changes in AV45 and FDG SUVR among both groups.

Conclusion

The present longitudinal analysis revealed that using statins might be beneficial in slowing down or stabilizing the Aβ deposition due to aging in subjects without cognitive impairment. However, once the clinical symptoms of cognitive impairment appear, statins fail to slow down Aβ deposition. Overall, our findings revealed that statin users might have slower Aβ aggregation than non-users.     

Social support and posttraumatic growth in Iranian burn survivors: The mediating role of spirituality

BackgroundSocial support and spirituality are important issues among burn survivors that appear to affect their posttraumatic growth (PTG).AimTo investigate the relationship between social support and PTG in Iranian burn survivors, as mediated by their perceptions of spiritual well-being.MethodThis is a correlation study with a cross-sectional design, and it uses anonymous questionnaires as study instruments (i.e. Posttraumatic Growth Inventory, Spiritual Well-Being Scale and the Multidimensional Scale of Perceived Social Support). A total of 118 questionnaires were sent to participants by post. Nine envelopes were not returned, and seven questionnaires were incompletely filled. Data were collected from 102 burn survivors who had a history of hospitalisation at Imam Khomeini Teaching Hospitals of Urmia, the capital of Western Azerbaijan Province, northwest of Iran. Structural equation modelling and bootstrapping procedures were employed to identify the mediating role of their perceptions of spiritual well-being.ResultsThe mean scores of social support (ranging from 12 to 84), PTG (ranging from 0 to 105) and the spirituality (ranging from 20 to120) among the participants were 56.96, 78.13 and 92.15, respectively. The results confirmed our hypothesised model. All the latent variables (variables that are not directly observed but are rather inferred from other variables that are observed (directly measured by items of an instrument)) of study were significantly correlated in the predicted directions. Social support and spirituality were significant predictors of PTG. Spirituality partially mediated the relationship between social support and PTG. The mediating role of the spirituality suggests that social support increases PTG, both directly and indirectly.ConclusionThe mediating role of spirituality should provide new visions for the augmentation of PTG in burn survivors.     

Pleuroperitoneal shunting for recalcitrant pleural effusions

From March 1, 1984, to Nov. 1, 1985, six patients underwent pleuroperitoneal shunting for either malignant (n = 5) or benign (n = 1) effusions intractable to the usual therapy. A modified double-valve Denver peritoneovenous shunt was inserted under local anesthesia in each case, and fluid from the right or left pleural space was shunted to the subhepatic space or pelvic area. No early complication was recognized in the perioperative period. Each shunt is working in the patients who are alive, and both functioned up to the time of death in the two who have died. Intraoperative pressures simultaneously recorded from both the chest and abdomen indicated that spontaneous flow would not occur without active pumping. All pleural effusions, including the solitary bilateral one, were alleviated by pumping the shunt 20 times four times a day. Two of the patients with cancer died after 1 and 2 months of unrelated events, with their symptomatic pleural effusions relieved. Two are alive at 20 and 10 months, respectively. The long-term follow-up revealed no erosions, shunt failures, infections, or symptomatic pleural effusions.     

EMG prognosis of facial palsy associated with herpes zoster oticus (Ramsay-Hunt's syndrome). A longitudinal study of 11 cases (author's transl

Eleven patients with peripheral facial palsy associated with geniculate herpes zoster (Ramsay-Hunt's syndrome) have been followed-up clinically and electromyographically. Each patient was examined three times: within the first week, at the end of the third week and 3-4 months after the onset of symptoms. Only in three cases the facial palsy evolved satisfactorily, with an almost total recovery within three weeks. In eight cases the recovery was delayed and incomplete, with residual, and often severe, hemifacial spasm. This study confirms the rather poor prognosis of peripheral facial palsy in Ramsay-Hunt's syndrome. The importance of detecting even slight signs of herpetic eruption in any case of apparently "idiopathic" peripheral facial palsy is emphasized.     

Effectiveness of a multidisciplinary team approach to hip fracture management

The purpose of the current study was to evaluate the effectiveness of a multidisciplinary Hip Fracture Service in the treatment of hip fractures in elderly patients. Baseline information and hospital outcomes were compared for 510 patients over the age of 65 with hip fracture treated before and after the institution of the Hip Fracture Service. Data included basic demographic data, admission laboratory results, surgical information, number of comorbidities, mortality, medical complications, discharge information, time to surgery, and length of stay in hospital. The demographics of the two groups of patients were similar. Patients treated as part of the Hip Fracture Service had fewer medical complications (36% vs. 51%), more often had surgery within 24 hours (63% vs. 35%), and had shorter hospital stays (mean, 5.7 days vs. 8.1 days) than patients treated before the Hip Fracture Service. These findings provide the rationale for a prospective, randomized trial of the service.