Archives of Neuroscience
Year:2018 | Volume:5 | Issue:4|Papers Count:12

Because of our increasing technical capabilities in general and in intensive care medicine, in particular, patients may survive under ICU care even when there is no likelihood of any meaningful recovery and herein it props up issues related to end of life care. In the past, many patients would have died despite attempts to save them. . . .

We report a rare case of parieto-frontal subdural empyema after a cesarean section. A 23 years old woman with a history of cesarean section, two weeks prior to admission, presented to the emergency room with the chief complaints of a headache, fever (39. 5° C), nausea, vomiting, aphasia, tonic colonic movements, and a Glasgow coma scale score of 10/15 two weeks after a cesarean section. A subdural fluid collection in parieto-frontal on the left side was demonstrated in the brain MRI. She received rapidly an anticonvulsant drug (diazepam) and empirical board-spectrum antibiotics (vancomycin, metronidazole, and ceftriaxone) and subsequently underwent an urgent craniotomy. Antibiotic therapy continued for 4 weeks, the patient symptoms and signs improved, and she was discharged with a Glasgow coma scale score of 15/15 without neurological deficit and seizure.

Background: Emotional intelligence (EI) and depression are important issues that can affect the quality of nurse’ s work. Emotional intelligence is also an indicator of mental and physical health condition. Objectives: This study was designed to evaluate emotional intelligence and depression of hospital nurses working at Tehran University of Medical Sciences in Iran. Methods: In this cross sectional study, 113 hospital nurses of TUMS at different wards were enrolled. They filled the Persian version of the baron emotional quotient inventory (EQ-i) and beck depression inventory (BDI). Results: Mean age of participants was 25 years and 58% were male. Mean BDI and EI scores except independence and responsibility were not significantly different between male and female cases. Mean EI and its subscales were similar in different wards except emotional self-awareness. The correlation coefficient between BDI and total EI was r = 0. 2 and P = 0. 008, and the correlation coefficient between age and total EI was r =-0. 2, P = 0. 02. Conclusions: According to the results, depression evaluation and emotional intelligence improvement should be considered in Iranian nurses, who work at university associated hospitals.

Context: The retina is a part of the Central Nervous System that is easy to study. The visual disturbances are frequent in Alzheimer’ s disease (AD) patients and sometimes, the AD begins with visual symptoms. This paper aims to review the existing literature on the involvement of the eye in the AD. In this first part, the animal models and the pathology in humans were examined. Evidence Acquisition: The Medline literature until March 2018 was surveyed. Results: Both animal models and pathological studies in humans demonstrate the impairment of the visual system in the AD, often in the early stages. Conclusions: A frequent and sometimes early involvement of the visual system was demonstrated but new studies are needed in order to investigate the degree of the visual impairmentandin the animal models, the importance of the visual deficits in evaluating the cognitive deficits.

Background: Most studies show that picture-naming test is the best task to evaluate the underlined cognitive and language function in the patients with dementia. Naming performance is the most evident linguistic symptom, which starts in the initial phase of the mild cognitive impairment (MCI) and Alzheimer’ s disease (AD). Objectives: The current study aimed at determining the picture-naming performance level of Persian-speaking patients with MCI and AD compared with normal peers using naming subtests of Barnes language assessment (BLA). Methods: In total, 90 subjects were selected through self-report; some relevant tests including mini-mental status examination (MMSE) and functional assessment staging (FAST) scale, as well as experts comments were employed; subjects were divided into three groups of MCI, AD, and normal control (NC) (30 cases per group). Picture-naming performance of patients in the MCI and AD groups was assessed and compared with that of the NC group using the naming subtest of the BLA. Results: In the picture-naming test of BLA, the AD group performed worse than the NC and MCI groups (P < 0. 001). Moreover, a significant difference was observed between the NC and MCI groups. While the MCI group performed worse than the NC (P < 0. 001), it acted better than the AD group (P < 0. 001). Conclusions: According to the results of the current study, picture naming test was a useful cognitive-linguistic task, which can accurately differentiate the three study groups, especially MCI from normal subjects, despite its quick and simple application.

We present 3 patients who were taking oral direct factor Xa inhibitors (ODFXIs) within 24 hours prior to receiving intravenous recombinant tissue plasminogen activator (IV rtPA) for acute ischemic stroke (AIS). Two patients were on Rivaroxaban (20 mg once daily) and one on Apixaban (2. 5mgtwice daily). All 3 received IV rtPA within 3 hours of symptom onset. Their aPPT, PT and INR levels were within normal ranges. They all received the last dose of the ODFXI within the last 24 hours prior to IV rtPA administration. One patient underwent mechanical thrombectomy of a large vessel clot after IV rtPA. None had intracranial hemorrhage (ICH) on 24 hour head CT post IV rtPA. They all had acute infarcts on their brain MRI, diffusion weighted image. Although we had a very low number of patients in our case series, our findings suggest that neither IV rtPA nor the combination of IV rtPA and intra-arterial thrombolysis increases the risk of ICH in AIS patients who are taking ODFXIs and their coagulation parameters are within normal range.

Background: The use of Image Guided Surgery (IGS) systems at lateral skull base surgery is controversial due to the limitation of the accuracy of the systems. The intraoperative accuracy of the IGS is dependent on deferent parameters, mainly the precision of the system, resolution of utilized imaging, rigidity of the reference frame/adaptor, registration method, calibration of the utilized instruments, and intraoperative movement of the reference markers. Objectives: In this study the researchers examined the target registration error of an electromagnetic IGS system on different important structures of lateral skull base through different approaches. This study compared two registration methods and two scanning systems. Methods: In 10 formaldehyde-fixed human cadaver heads, 69 target points were marked with titanium screws for determining target registration errors. The target points were facial nerve, lateral semi-circular canal, geniculate ganglion, superior semi-circular canal, internal auditory canal, and the foramen rotundum. Seven heads were scanned using a Cone Beam CT Scanner (CBCT) and three heads were scanned using a CT scanner. Three screws were implanted around the mastoidectomy cavity as Fiducial Markers (FM). Two different registration methods were applied, including point based registration using the FM versus surface registration. All samples were dissected via the middle cranial fossa approach, retrosigmoid approach, and transmastoid approaches. Results: The overall accuracy of the IGS-system was 1. 2mmand plusmn; 0. 15 mm. Optimum accuracy was reached with CBCT-scan and the FM registration marker. Navigation using CT scans with the surface registration method, using CT scans with FM registration method, and using CBCT-scans with surface registration method had lower accuracy, respectively, yet their difference was not statistically significant (P > 0. 5). The best accuracy was noted on the facial nerve in the mastoid approach (mean 0. 8 mm). Conclusions: The feasibility of the use of an electromagnetic IGS system in lateral skull base, surgery using Cone Beam CT as well as conventional CT scanner with fiducial marker registration as well as surface registration were evaluated. The accuracywasbest at the lateral region of the temporal bone and decreased on further medial targets, such as lower cranial nerve and trigeminal ganglion.

A case of Churg-Strauss syndrome with schwannoma of T12 in a middle-aged female with large hepatic hemangioma was presented with special emphasisonits anestheticmanagementandtherapeutic protocol. Tothe authors’ best knowledge, itwasthe first report of a case with a myriad of symptomatology.

Background: Anomia is a common symptom that can be detrimental to the everyday communication of patients with primary progressive aphasia (PPA). Studies on the anomia treatment in PPA demonstrate that re-learning is possible, but the maintenance and generalization of improvements are limited. The treatment of word retrieval in PPA has typically centered on the retrieval of single lexical items. Little is known about the effects of word-finding treatments in discourse tasks on lexical retrieval. Objectives: The purpose of this study was to introduce a combined semantic/phonological cueing treatment in the context of narrative discourse as a novel method for the treatment of word retrieval difficulty in a PPA patient and compare its effects with the effect of cueing treatment in the context of single words. Methods: One individual with PPA (FK) participated in this single-subject interventional study. FK was a 56-year-old woman with a one-year history of word finding difficulties following Frontotemporal dementia. She received 16 sessions of naming treatment over an eight-week period. The participant completed three baselines prior to treatment. The treatment used a semantic and phonological cueing hierarchy (four weeks, two times a week), followed by a cueing in a story-retelling context (four weeks, two times a week). The main outcome was the naming ability assessment score administered 10 times in order to examine the effectiveness of the therapy through statistical analysis. Results: The participant showed a significant improvement in the word retrieval ability in all stimuli and each set separately related to the therapies phases (P < 0. 001). Nevertheless, no significant differences were observed between the therapies (P = 0. 26). Following the integrated therapy, FK showed a slightly significant improvement in untreated words. Conclusions: Generally, without considering the type of therapy during this study, in spite of the progressive nature of the disease, wordretrieval ability of the patient improved via both treatment programs. Furthermore, the generalization of untreated itemsand maintenance of treated items also were occurred to some extents. However, there was no evidence of integrated discourse context in cueing hierarchy protocol to make it elaborated and cause a greater effect in people with PPA. As the first known study to trial this issue in the context of PPA, its findings may warrant further investigations.

Background: During hypoxia, the increased production of reactive oxygen species occurs during the re-oxygenation phase of periodic continuous hypobaric hypoxia. Objectives: In this study, we surveyed the effect of supplementary flaxseed (Fx) on oxidative damage to the hippocampus of the hypoxic rat model. Methods: In this study, 24 adult Wistar rats were randomly divided and studied in four groups: (1) The control group with normal oxygen and food (Co. ), (2) The sham group placed in a hypoxia chamber with normal oxygen and food (Sh. ), (3) Hypoxia induction group with normal food (Hx), and (4) Hypoxia induction group with 10% Fx food (Hx + Fx). Both the Hx and Hx + Fx groups were kept in a hypoxic chamber for 30 days while the atmospheric pressure was reduced (oxygen 8%, nitrogen 92%) for four hours daily. Malondialdehyde (MDA) and total antioxidant capacity (TAC) levels were evaluated in the hippocampus region of the brain tissue. Neuronal damage was examined using histological studies. Blood samples were collected to measure interleukin-18 (IL-18). Results: A significant increase was recorded in the IL-18 level and hippocampal dark neurons of the CA1, CA2, CA3, and dentate gyrus (DG) areas in the Hx group as compared to Co. and Sh. groups (P < 0. 05). Moreover, a significant decrease was noted in the dark neurons in the Hx + Fx group as compared to the Hx group (P < 0. 05). A significant increase was observed in the TAC concentration in the Hx + Fx group in comparison with the Co., Sh., and Hx groups (P < 0. 05), while a significant increase was observed in the MDA concentration in the Hx group as compared to the Co. and Sh. groups and a significant decrease in the Hx + Fx group as compared to the Hx group (P < 0. 05). Conclusions: This study suggested that the consumption of flaxseed could be a useful strategy for preventing the harmful effect of hypoxia on the hippocampus of the rat brain.

The efficacy of Alginate/ Polyvinyl alcohol/ Hydroxyapatite nanopowders (Alg/PVA/HANPs) mats was investigated for increasing periodontal ligament stem cells (PDLSCs) differentiation into the osteoblast cells. The Alg/PVA/HANPs nanofibers were fabricated through electospinning process and following ionic crosslinking of Ca+2 and glutaraldehyde crosslinkers. The physical features of mats and expression of osteoblast cell markers were evaluated. Results showed the diameter of nanofiber increases with decreasing the incorporation of HANPs in Alg/PVA nanofiber. According to MTT assay the viability of cells on scaffolds are better in the all of groups, so the scaffolds were not toxic for the cultured cells. The osteogenic culture media appropriately enhanced osteopontin and osteocalcin markers. Furthermore, in vitro study indicated that the Alg/PVA/HANPs nanofiber provided a suitable three-dimensional structure for osteoblast cells differentiation. Thus, the Alg/PVA/HANPs scaffold can be recommended for in bone repair.

Background: Nowadays, stroke is one of the most important and commonly diagnosed neurological diseases throughout the world. This disease annually causes numerous moralities and disabilities; its high prevalence is reported among the elderly. Objectives: The current study aimed at determining the lifestyle of the elderly with stroke in Ilam, Western Iran. Methods: The current descriptive, cross sectional study was conducted on 200 elderly people with stroke in Ilam, Western Iran by convenience sampling method. The study was conducted by the application of healthy lifestyle questionnaire with confirmed validity and reliability. After data collection, the data were analyzed with SPSS version 16 using descriptive statistics (mean and standard deviation) and inferential statistics (independent t test and ANOVA). Results: Findings of the current study showed that the majority of the studied elderly were male (n = 106, 53%) aged 65-70 years (n = 93, 46. 5%), educated up to middle school level (n = 112, 56%), with annual income range of $US72, 000 to $US144, 000 (n = 117, 58. 5%), had no spouse (n = 111, 5. 55%) and lived in the city (n = 115, 57. 5%). Mean ( standard deviation; SD) of age was 75. 56 9. 87 years, mean lifestyle score was 37. 54  3. 91, 9. 55  1. 79, 24. 30  3. 36, 18. 76  1. 79, and 28. 04  2. 41 in the dimensions of prevention, physical activity and recreational activities and sport, healthy nutrition, stress management, and inter-personal relationships, respectively. Total score of the questionnaire was 118. 20 6. 00, which indicated a medium score of healthy lifestyle in the elderly. Conclusions: Findings of the current study revealed that the lifestyle condition of the elderly with stroke was in medium level. It was suggested that the therapeutic and health teams, in particular nurses, intervene properly and use nursing care models to enhance the lifestyle of the elderly.