Is Alcohol Harmful for Patients with Multiple Sclerosis?

Multiple sclerosis (MS) is a chronic immune-mediated, inflammatory demyelinating disease of the central nervous system (CNS) that affects both thebrain and spinal cord. The cause of MS is not fully understood, but the disease is believed to relate to an abnormal immune response in individuals who are genetically predisposed.

Multiple Sclerosis

An association of personal predisposition and environmental conditions may result in immune-mediated inflammation of the CNS and culminate in neuronal loss. The disease usually manifests in bouts of neurological disabilities and later progresses to dysfunction of many areas of the CNS. It can affect motor and sensory functions, coordination, cognition, and vision and sphincter control. It is often associated with fatigue, pain, depression, and anxiety and sleep disorders, thus leading to considerable personal, social and economic losses. Lifestyle/environmental factors may have an important role in determining the risk of MS. These are harder to accurately study and quantify than are genetic factors. However, it is important to identify these potential determinants of risk and worse outcomes in MS, since they are potentially preventable. Depression, anxiety disorders, social withdrawal and cognitive deficits often affect the quality of life of patients with MS. Chronic diseases like MS may negatively affect friendships and family relations. Read more>>>>>>>>>

Supporting Elderly Patients at Risk in Hospital Environments

Consistently low birth rates and higher life expectancy lead towards an older population structure in Western countries. In Europe, the proportion of people 65 years and older increased from 16.6% in 2005 to 18.9% in 2015, with Germany, Italy and Greece having the highest share of people 65 years and olderin the total population.

The median age of the total population also increased by about 4 years from 2005 to 2015 so that the proportion of older people will increase strongly in the future. Especially the proportion of very old people 80 years and older is rising due to better living standards, lifestyles and education, as well as rapid progress in healthcare and medicine so that it is expected to more than double from 5.3% in 2015 to 10.9% in 2050. Consequently, hospitals are confronted with an increasing number of older patients, which have been shown to exhibit an increased risk of adverse outcomes during and after the hospital stay compared to younger patients. An important factor contributing to this increased risk of adverse outcomes is that many old patients suffer from multi morbidity, defined as the coexistence of 2 or more chronic disease conditions. To know more>>>>>>>>

Association of Brain-Derived Neurotrophic Factor (BDNF) Gene Snps G196A and C270T with Alzheimer’s Disease: A Meta-Analysis

Alzheimer's disease (AD) is a common age-associated neurodegenerative disorder, clinically characterized by progressive memory disorder and decline in cognitive function, which typically begins with dementia.

Alzheimers Disease 

The number of people with AD worldwide in 2006 was estimated at 26.6 million and is predicted to nearly quadruple by 2050. The key pathological changes associated with AD brain tissue are the accumulation of intracellular neurofibrillary tangles (NFTs) and abnormally aggregated ‘reactive’ proteins like β amyloid (Aβ) plaques and tau. Several elements, such as senile plaques, neurofibrillary tangles (NFTs), abnormally aggregated ‘reactive’ proteins like β amyloid (Aβ) and tau, brain inflammation and exposure to aluminum has already shown the development of AD. Brain derived neurotrophic factor (BDNF) gene is supposed to be one of the important genes, playing a significant role in AD progression. However, as a complex disorder, the neuropathological etiology of AD mentioned above are not due to the gene itself, but are also supposed to be associated with the combined interaction between genes and environmental factors. Read more>>>>>>>>

Technology to Take Care of Autism

The global prevalence of autism has increased twenty to thirty fold with in last 5 decades due to change of diagnostic criteria, increased awareness and biopsychosocial transformation. It is a global phenomenon that affects people of all strata from developed and developing countries.

Autism

However, the developing countries are affected more severely by this rapid escalation of this disease due to their lack of preparedness, resources and various other sociocultural problems. Among the developing countries Bangladesh is making a remarkable contribution in autism awareness and the country has already established herself as the role model for the low and middle income countries. Existing literatures reported about 2 to 8.4 children per thousand are suffering from Autism Spectrum Disorder in this country. However, none of these data was extracted from a nationwide sample and few other studies have major methodological concern and inconsistency that prevent them from citing in this article. Read more>>>>>>> 

Outcome of Palliative Single Posterior Reconstruction Surgery for Metastatic Spinal Tumor

Metastatic spinal tumor has been reported to occur in approximately 30% of cancer patients. The distribution of lesions is 10% in cervical spine, 20% in lumbar spine and 70% in thoracic spine. Five percent of metastatic spinal tumor is reportedto cause epidural compression, giving rise to clinical symptoms such asparalysis and pain. These symptoms can lead to deterioration of patients’ daily activities. The therapeutic choice for these patients should be based on clinical information such as the extent of metastasis, degree of malignancy, general condition of the patient, and estimated life expectancy.

Tokuhashi et al. reported a scoring system for pre-operative evaluation of prognosis of metastatic spine tumor. In their paper, prognosis evaluation was based on the opinion of oncologist and the pre-operative prognostic score. They suggested that excisional procedures are indicated in patients with a total score from their scoring system of 12 or more (predicted survival period, 1 year or longer), while conservative or palliative procedures are indicated on patients with a total score of 8 or less (predicted survival period, less than 6 months). Tomita et al. also described a scoring system, with corresponding treatment proposals, for patients with spinal metastasis. It was based on three prognostic factors: (1) grade of malignancy, (2) presence of visceral metastasis, and (3) presence of bone metastases. Their strategy for each patient was decided along with treatment goal: a wide or marginal excision for long-term local control, marginal or intralesional excision for medium-term local control, palliative surgery for short-term palliation, and non-operative supportive care.(Read More)

Can Enforced Behavioral Activity in Spinal Cord Injured Rats be considered as Rehabilitation Process to Accentuate Tacrolimus Treated Recovery? A nursing Care Perspective

Experimental studies using suitable animal models for spinal cord injury (SCI) help to simulate clinical conditions as observed in humans and play an important role to understand the pathophysiology of the disease and to develop effective treatment modalities. To date no satisfactory drug treatment or other methodsof interventions like physiotherapeutically related rehabilitation process havebeen designed to repair the traumatically injured spinal cord in humans. The aim of the present study is to understand the behavioral recovery that often occurs following the initial primary injury, and to develop suitable rehabilitative intervention including pharmacological agent to enhance improved sensory and motor function. Furthermore, this research intends to bring awareness among the nurses working in general wards, specialized wards, and occupational health set-ups, to understand the need to show their passion for SCI patient’s care by exploring and learning standardized and improvised rehabilitation methods to manage and practice effective nursing caring skills for SCI patients.

Tacrolimus (also known as FK506), a macrolide lactane antibiotic, was introduced as an immunosuppressive agent with virtually no side effects. Tacrolimus, a potent calcineurin inhibitor exhibits neuroprotection actions in several experimental models of central nervous system trauma, including stroke and improved neurological recovery following peripheral and spinal cord injuries. However, some side effects from oral and intravenous administration of Tacrolimus in clinical case studies have been reported which include nephrotoxicity, lung damage, various neuropsychiatric problems, neurotoxic effects such as akinetic mutism and catatonic mutism. On the contrary, in experimental studies, Tacrolimus improves the functional outcome of spinal cord injury and has an in vivo neurotrophic action whereby it enhances the rate of axon regeneration leading to more rapid neurological recovery.(Read more)

Capillaries, Old Age and Alzheimer’s Disease

Diminished blood flow to the brain and other organ systems may result from an impaired microcirculation due to pathological changes in the capillaries or reduced numbers of capillaries. The former are reflected in twisting, kinking, andlooping of capillaries in the cerebral cortex. Whether these changes progress to reduced capillary numbers by cellular atrophy has not been demonstrated and is not considered further here. However, the widespread reduced capillary density (CD) found in aged animals and people has been correlated with diminished levels of angiogenic growth factors (AGFs).

The association between CD and AGFs during old age is the focus of this essay, which advances two ideas. 1) The reduced CD of old age may be the main, primary cause of many symptoms and signs of the elderly, i.e., the ‘lesser ailments of aging’. 2) A reduced CD may also be an underlying, secondary condition for other diseases associated with aging and may facilitate the action of factors postulated to cause them -- e.g. amyloid plaques, neurofibrillary tangles, etc. of Alzheimer’s disease (AD) or Lewy bodies, proposed malfunctioning mitochondria, etc. of Parkinson’s disease (PD).

Is Autism Monocausal?

A monocausal explanation of Kanner’s syndrome is in the literature for 42 years but got ignored for most of the time. According to it, a single functional termsuffices to characterize the syndrome: “smile blindness.” Smile blindness means that the caretaker’s smile seen by the child has no directly rewarding effect. As a consequence, a certain interactional positive feedback – called reward cycle – cannot build up in the interaction between the children with the caretaker. For an ordinary child, by contrast, the displayed momentary happiness of the parent acts as a strong reward. This “interactional interpretation” of deep autism is not incompatible with the findings of a recent study showing that in a fraction of autistic children, several genes are mutated, one of which is MYO9B which plays a key role in dendritic arborization. 

And a related study focuses instead on MIB1 which encodes an E3 ubiquitin ligase critical for neurogenesis which in turn is regulated by miR-137, a microRNA that regulates neuronal maturation. Such low-level neuro-biochemical observations are hoped to date to be helpful in better understanding the causal mechanism as to why autistic children do lack the faculty of “associating the smile with the reward cycle”. Baron-Cohen et al’s famous diagnosis – “absence of a theory of mind”– is currently attempted to be explained in terms of such an underlying biochemical failure, which approach is no doubt far from misleading.

Conceptualizing Trauma for Children of Drug Addicted Mothers: A Developmental Mapping.

Children of drug addicted parents experience ongoing and multiple levels and forms of trauma and these damaging experiences lead to several psychological problems and psychiatric nosology along with comorbid symptomologies. Regular and ongoingexposure to trauma is likely to have a significantly negative impact on thedevelopment of children (i.e. social, emotional, cognitive physical) at all levels of their lifespan. This paper extends the findings of Lombard, et al. to capture the implication of prolonged traumatic experiences among children of addicted mothers using lifespan domains. 

Very few studies have accounted for prolonged trauma and its implications in the manner of this current study.Trauma can be the result of several negative experiences such as sexual abuse or exposure to domestic violence but the experiences of children of addicted parents are likely to be far more traumatic, as these harmful experiences are likely to be ongoing leading to a complex array of problems and behaviours.(Read More)

High Prevalence of ADHD: How Best can we Identify Cases of ADHD from the General Population?

Major advances have been made over the past decades in understanding the difficulties of children and adults with ADHD (attention deficit/hyperactivity disorder (ADHD). In spite of it,numerous research studies have documented the increase of people diagnosed withADHD in the last few decades. Thus, the aim of this paper has been to provide the cornerstones for a basic understanding of such high prevalence of ADHD.

Recent population-based studies indicate that ADHD is a condition affecting approximately 5% of the child population. It this is the case, yet significant evidence exists that far fewer children receive ADHD services. As result of it, in many countries concerted serious efforts directed at earlier detection and diagnosis of ADHD are well justified. In fact, the diagnosis in practice is made with remarkable differences in frequency between nations. At the same time, taking into consideration individual differences, the data over the past 10 years have shown that there is great heterogeneity in the diagnostic methods for children and adults with ADHD.(Read More)

A Basic Introduction to Diffusion Tensor Imaging Mathematics and Image Processing Steps.

Diffusion tensor imaging (DTI) is one of the most powerful magnetic resonance imaging (MRI) techniques developed in the twentieth century. In spite of the fact that DTI has been in use for more than twodecades, it is still hard to find publications that simplify mathematics behind DTI for DTI users without extensive mathematical background. We believe that this may prevent some researchers from using DTI technique to its fullest extent.

To the best of our knowledge, there are no published reviews which have tried to clarify the methods of DTI measurement and analysis. In this article, we attempted to explain the mathematics of DTI in simple terms with the goal of providing DTI users, with a better understanding of this technique and its usage. In addition, we have also described the DTI processing steps and explained the reasons behind each step.(Read more)

Individual Case Study: Improved Memory Functioning following Neurocognitive Training in a Diagnosed TBI patient

Patients have been receiving neurocognitive training as part of their treatment at an outpatient mental health facility for the past ten years and findings are the result of an ongoing study completed over the past five years. The program consists of neuropsychologicalassessment, which is patient specific and related to the reason for evaluation. Based upon the individual neuropsychological evaluation, a specific treatment plan is created. The plan is patient specific. Evaluation is completed, using the same testing at the same time of day, following a general range of three to six months of treatment to ascertain changes and efficacy of the program.

Neurocognitive intervention has been gaining credence in recent research, along with the modifiable risk factors and exercise as an intervention to address dementia decline. There are commercial programs that have shown to have efficacy and large scale studies have been conducted revealing the benefit of cognitive training and stimulation. Cognitive training intervention and cognitive enhancement have been found to have positive effects, as well as impacting cognitive decline in the aged population.(Read More) 

Prion Proteins and Sleep Disturbances.

Prions normally exist as cellular membrane proteins. In humans, 209 amino acids with one disulfide bond form a primarily alpha-helical prion protein structure with a molecular mass of 35 to 36 kDa. The native prion protein exists in this stateand appears likely to play a role in cell-cell adhesion and intracellular signaling leading to cell-cell communication within the brain. 

The specific role and function of the prion protein elude research efforts and remains a controversial topic. In addition, early and definitive diagnosis of the infection remains difficult. According to the protein only theory, variations in the protein structure and resistance to proteases may cause infectious diseases leading to encephalopathy. Misfolding of the native prion protein leads to a protein’s structure that increases the proportion of alpha-helices to beta-sheets.(Read More)

Nipah Virus Infection in Thailand: Status.

Dear Editor, the Nipah virus is an important emerging infectious disease that is still included in the list of disease to be surveillance by WHO. The neurological involvement in Nipah virus infection is an important clinical manifestation. This pathogenic virus of this disease was firstly detected and reported by professor Bing from Malaysia,a Southeast Asian country. Here, the authors would like to discuss thepresent situation of Nipah virus infection in Thailand, a Southeast Asiancountry next to Malaysia. At present, Nipah virus infection is still under the closed surveillance from Thailand public health ministry. According to a recent report on pathogen causing neurological infection, the Nipah virus is still not observed as a cause of neurological infection in Thai patients with neuro infections Nevertheless, there are some reports on the survey of prevalence of Nipah virus in several animals, especially for bats, in Thailand. 

According to the survey in bats, the prevalence of Nipah virus contamination was seen in 6.29% of bats collected from several regions in Thailand. Of interest, although bat is proved to be the carrier of several pathogenic virus such rabies, the bat has never been the problem of zoonosis in Thailand. This might be due to the fact that there is no blood sucking bat in Thailand and the local people usually live far from bats. At present, the Nipah virus is observable in animal but not human in Thailand. The risk of human Nipah virus infection in Thailand and nearby countries still needed the closed surveillance. (Read more)

A Short Note on Minimally Invasive Lumbar Spine Surgery.

Almost all spine surgeons tout minimally Invasiveness in spine surgery as a beneficial focus. The meaning of minimally invasiveness, however, is actually a concept with different meanings for each surgeon. To some, it is the use of smaller incisions using standard surgical approaches, the use of tubular retractors, and/or the use of surgicalmagnification with a microscope, or an endoscope. Minimally invasiveness often advertises the use of lasers as a sexy and high tech surgical tool to tout their state- of- the- art surgical technique in minimally invasiveness, but it is not used as a needed part of the surgery unless visually used with endoscopes under irrigation.

Studies published in peer reviewed journals promote microscopic surgery, different types of MIS fusion, robotics guided fusion, and minimally invasive lumbar decompression as beneficial and cost effective. All tout less surgical morbidity using the measured parameters of less intra-operative blood loss, less surgical time after a short learning curve, faster recovery, decreased pain, and faster ambulation.(Read more)

Translation of the Multiple Sclerosis Quality of Life-54: Brazilian Version.

MS is a neurological disease that primarily affects young adults. Its prevalence varies by ethnicity and location decreasing in the lower latitude. According to recent data from the World Health Organization (WHO), the estimated number of people with MS worldwide increased from 2.1 million in 2008 to 2.3 million in 2013. Although its etiology remains uncertain, evidence suggests that MS is an immune-mediated attack on myelin with secondary destruction of axons causing progressive disability. The disease’s symptoms include weakness, fatigue, sensory loss, dizziness, lack of coordination, sexual dysfunction, urinary incontinence, optic atrophy, dysarthria, and mental problems. 

The longevity of patients with MS is about eight years less than that of a healthy person. Longevity is bimodally distributed with many patients having normal longevity and some dying at a significantly younger age depending on disease aggressiveness, disability severity, infection, or suicide. One third of patients with MS will need to use a wheelchair. About two-thirds will have disabilities that prevent them from working. It is important to incorporate a quality of life (QoL) evaluation from the beginning, during patient monitoring, and when evaluating the effects of the treatment used.(Read more)

Capillaries, Old Age and Alzheimer’s Disease

Diminished blood flow to the brain and other organ systems may result from an impaired microcirculation due to pathological changes in the capillaries or reduced numbers of capillaries. The former are reflected in twisting, kinking, and looping of capillaries in the cerebral cortex. Whether these changes progress to reduced capillary numbers by cellularatrophy has not been demonstrated and is not considered further here. However, the widespread reduced capillary density (CD) found in aged animals and people has been correlated with diminished levels of angiogenic growth factors (AGFs).

The association between CD and AGFs during old age is the focus of this essay, which advances two ideas. 1) The reduced CD of old age may be the main, primary cause of many symptoms and signs of the elderly, i.e., the ‘lesser ailments of aging’. 2) A reduced CD may also be an underlying, secondary condition for other diseases associated with aging and may facilitate the action of factors postulated to cause them -- e.g. amyloid plaques, neurofibrillary tangles, etc. of Alzheimer’s disease (AD) or Lewy bodies, proposed malfunctioning mitochondria, etc. of Parkinson’s disease (PD).(Read more)

Technology to Take Care of Autism

The global prevalence of autism has increased twenty to thirty fold with in last 5 decades due to change of diagnostic criteria, increased awareness and biopsychosocial transformation. It is a global phenomenon that affects people of all strata from developed and developing countries. However, the developing countries are affected more severely by this rapid escalation of this disease due to their lack of preparedness, resources and various other sociocultural problems. Among the developing countries Bangladesh is making a remarkable contribution in autism awareness and the country has already established herself as the role model for the low and middle income countries. 

Existing literatures reported about 2 to 8.4 children per thousand are suffering from Autism Spectrum Disorder in this country. However, none of these data was extracted from a nationwide sample and few other studies have major methodological concern and inconsistency that prevent them from citing in this article. Moreover, the researchers suspect the actual rate of Autism in Bangladesh will vary widely from the existing data when a real time nationwide data will be collected using a valid instruments with the expert guidance.(Read more)