Une approche de collaboration en centre d’hébergement. Retour sur l’unité de vie La clé des champs

GoalThis paper is discussing an intervention program that has been developed in the housing unit called La clé des champs, in a residential centre of Montreal. This unit is trying to create an adaptive environment for persons who live with severe or moderate neurological disorders due to an accident or a disease.MethodThe research project relied on Chen's theory-driven evaluation model (2012, 2015) and combined a document analysis with research interviews conducted with several persons living in the unit and with members of the staff.ResultsOn this basis, the intervention model distinctive features, its levers for action and some of its outcomes, for the persons who live in the residential centre, are drawn.ConclusionFinally, we discuss the issues at stake concerning the conditions of implementation of the program, its sustainability and its transfer in other residential centres.     

电针治疗对脑缺血患者的临床分析

目的探讨电针治疗对脑缺血患者的临床效果。方法选取本院2015年6月~2016年11月收治的脑缺血患者148例,采用随机数字表法分为两组,对照组患者74例实施常规治疗,观察组患者74例联用电针治疗。于治疗前后行日常生活能力、运动功能、神经功能评定,并行临床指标检测,比较两组患者的治疗效果。结果治疗后,两组患者血清Bcl-2、超氧化物歧化酶、日常生活能力评分、Fugl Meyer评分增加(P0.05)。两组患者胶质纤维酸性蛋白、丙二醛、髓鞘碱性蛋白、S100β、神经元特异性烯醇化酶、神经功能缺损评分降低(P0.05)。观察组患者血清Bcl-2、超氧化物歧化酶、日常生活能力评分、Fugl Meyer评分、治疗总有效率高于对照组(P0.05)。观察组患者胶质纤维酸性蛋白、丙二醛、髓鞘碱性蛋白、S100β、神经元特异性烯醇化酶、神经功能缺损评分低于对照组(P0.05)。结论电针治疗可提高脑缺血患者的日常生活能力、运动功能、神经功能,并改善机体氧化应激水平,具有较高的临床价值。     

Determinants of neurological disease: Synthesis of systematic reviews

Systematic reviews were conducted to identify risk factors associated with the onset and progression of 14 neurological conditions, prioritized as a component of the National Population Health Study of Neurological Conditions. These systematic reviews provided a basis for evaluating the weight of evidence of evidence for risk factors for the onset and progression of the 14 individual neurological conditions considered. A number of risk factors associated with an increased risk of onset for more than one condition, including exposure to pesticides (associated with an increased risk of AD, amyotrophic lateral sclerosis, brain tumours, and PD; smoking (AD, MS); and infection (MS, Tourette syndrome). Coffee and tea intake was associated with a decreased risk of onset of both dystonia and PD. Further understanding of the etiology of priority neurological conditions will be helpful in focusing future research initiatives and in the development of interventions to reduce the burden associated with neurological conditions in Canada and internationally.     

Congenital cytomegalovirus infection: the impact of cerebral cortical malformations

Aim: Cytomegalovirus has been suggested to have a teratogenous influence during the migration of neural cells from the ventricular zones to the cortex during the gestational period. The aim of this study was to investigate the prevalence of congenital cytomegalovirus infections in a cohort of children with neurological disability and cerebral cortical malformations recognized by neuroimaging. Methods: Twenty‐six children with neurological disability and cerebral cortical malformations were investigated retrospectively for congenital cytomegalovirus infection by analysing the dried blood spot samples for cytomegalovirus deoxynucleic acid using qualitative polymerase chain reaction. Results: CMV DNA in the dried blood spot samples was found in four out of 26 children. Two of these four had severe disabilities with mental retardation, autism, spastic cerebral palsy, epilepsy and deafness. A third child had epilepsy and unilateral cerebral palsy, while the fourth had a mild motor coordination dysfunction and hearing deficit. Conclusion: In our study, the number of congenital cytomegalovirus infections in children with cerebral cortical malformations was higher (4/26) than expected with reference to the birth prevalence (0.2–0.5%) of congenital cytomegalovirus infection in Sweden. We thus conclude that congenital cytomegalovirus infection should be considered in children with cortical malformations of unknown origin.     

An examination of the synergistic interaction of ethanol and thiamine deficiency in the development of neurological signs and long-term cognitive and memory impairments

BACKGROUND: The prolonged and heavy consumption of ethanol has been associated with thiamine deficiency and a wide range of cognitive and memory impairments. The present study was undertaken to test the hypothesis that ethanol and thiamine deficiency act synergistically, producing more severe clinical neurological disturbances and cognitive and memory impairments than either thiamine deficiency or chronic ethanol alone. METHODS: The acute neurological and long-term behavioral consequences of combined chronic (32 weeks) ethanol consumption (20% v/v in drinking water) and three separate 4-week long episodes of dietary thiamine deficiency (ET/TD) versus ethanol (ET) or thiamine deficiency (TD) treatments alone were examined in male Sprague Dawley rats aged 12 weeks at the start of treatment. RESULTS: The ET/TD group lost less weight than the TD group during each episode of thiamine deficiency. Contrary to expectations, the progression and severity of ataxia, impaired righting reflexes, and opisthotonic posturing were similar in the ET/TD and TD groups. None of the ET animals displayed any neurological or behavioral symptoms during treatment. After withdrawal from ethanol and a 7-week recovery period, none of the groups differed in spontaneous activity. On subsequent testing, the ET group displayed a significant increase in perseverative responding in a spontaneous alternation task. A small but significant proportion of ET/TD (23%), ET (17%), and TD (8%) animals were unable to reach criterion on an initial nonmatching-to-position task (NMTP) or in two subsequent reversals of the matching and NMTP tasks, which indicated persistent learning impairments. A large proportion of animals in each of the three groups demonstrated significantly reduced accuracy compared with controls at longer delays of matching-to-position tasks (MTP), but only the ET group was consistently impaired at the shorter delays. There were no significant correlations between blood ethanol concentration and any of the learning and memory measures. CONCLUSIONS: These results indicate that the interaction of chronic ethanol consumption and bouts of TD is both domain specific and not always synergistic. Learning and reference memory appear to be sensitive to a synergistic interaction of ET and TD, whereas short-term working memory disturbances are most affected by ET and neurological symptoms are most associated with TD. Furthermore, neither the presence of neurological symptoms nor blood ethanol concentrations appear to be good predictors of learning and memory deficits.     

益气醒脑饮对大鼠局灶性脑缺血的影响

益气醒脑饮可改善因脑中动脉阻断而形成局灶性脑缺血后大鼠的神经症状，并可缩小脑梗塞范围。提示该药对缺血性脑损伤有保护作用。     

Pregnancy and otosclerosis

A retrospective study has been made of a sample of 479 women with deafness from otosclerosis, classified according to the number of pregnancies they have had and whether there had been a subjective impression of deterioration of hearing during or immediately after at least 1 pregnancy. The study confirms previous reports that pregnancy does involve a risk of aggravating deafness in clinical otosclerosis. The chance of female patients with bilateral otosclerosis reporting a subjective deterioration of hearing in pregnancy can be accurately described by a simple mathematical model and varies from about 33% after 1 pregnancy to about 63% after 6 pregnancies. In women with unilateral otosclerosis pregnancy-related deterioration of hearing is much less commonly perceived. There is no strong evidence that pregnancies cause any alteration to the actual footplate pathology of female patients.