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Poststroke depression (PSD) negatively affects the functional outcome of stroke patients. Patient Health Questionnaire-9 (PHQ-9) is a validated screening tool for detecting PSD. This study investigated the relationship between PHQ-9 score and functional outcomes in stroke patients in a convalescent rehabilitation ward by evaluating functional independence measure (FIM) gain scores and the proportion of patients discharged.

In this retrospective study conducted from January 2017 to September 2019, consecutive stroke patients who were admitted to the convalescent rehabilitation ward and could answer PHQ-9 were assessed. The association between PHQ-9 scores at the time of admission to the convalescent rehabilitation ward and outcomes (FIM gain score and the proportion of patients discharged) was statistically analyzed.

Among the 215 patients enrolled in the study, 62 (28.8%) were assessed as having depression, in whom PHQ-9 scores were 5 or above. Multivariate analysis revealed that the PHQ-9 score on admission to the convalescent rehabilitation ward was a significant independent factor influencing the FIM gain score (p=.009). In addition, a multivariate analysis revealed that the PHQ-9 score at the time of admission to the convalescent rehabilitation ward was a significant independent factor influencing the inability to discharge a patient (odds ratio 1.24, 95% confidence interval 1.12-1.39, p<.001).

The PHQ-9 score is a useful tool for predicting patient functional outcome, admission to the facility, and screening for poststroke depression.

The PHQ-9 score is a useful tool for predicting patient functional outcome, admission to the facility, and screening for poststroke depression.Findings from randomized trials addressing the effect of vitamin D supplementation and blood pressure are inconsistent and have been the subject of recent debate. This study aimed to assess the effect of vitamin D supplementation on primary hypertension. This double-blind randomized clinical trial was conducted on patients aged 26-84 years with essential hypertension from March 2017 to April 2019. Patients with vitamin D insufficiency (serum vitamin D levels 20-30 ng/ml) or vitamin D deficiency (serum vitamin D levels less then 20 ng/ml) were enrolled in the study. Patients were randomly assigned to receive vitamin D supplementation or placebo. Systolic and diastolic blood pressure was measured before the intervention and one and two months thereafter. Of 208 patients enrolled, 171 patients remained for analysis. The effect of vitamin D supplementation on systolic blood pressure was statistically significant in the first and second months after the intervention (P=0.004 and P=0.024, respectively). The effect of vitamin D supplementation on diastolic blood pressure was statistically significant in the first month after the intervention (P=0.046), but not in the second month (P=0.885). No evidence of drug side effects was reported in the two groups. The results of this trial are suggestive of the potential benefits of vitamin D supplementation on blood pressure end points. Therefore, the use of vitamin D may be recommended as an adjuvant drug in the treatment of essential hypertension in patients with vitamin D deficiency because it is safe and well-tolerated by the patients and can significantly reduce the systolic and diastolic blood pressure. Trial registration Iranian Registry of Clinical Trials registration number IRCT201703129014N151.Clinical outcomes of COVID-19 vary considerably between patients. Little was known about the clinical course and optimal management of immunosuppressed patients infected with SARS-CoV-2. We report a kidney transplant recipient with COVID-19 who presented with pneumonitis and acute kidney injury (AKI). She improved after reduction of immunosuppressive treatment and had two consecutive negative reverse transcription polymerase chain reaction (RT-PCR) tests. Her respiratory tract samples turned positive again afterwards, and she was treated with lopinavir-ritonavir. She had satisfactory virological and clinical response after a prolonged disease course. This case illustrates the risk of relapse or persisting shedding of SARS-CoV-2 in immunosuppressed patients, the important role of viral load monitoring in management, the challenges in balancing the risks of COVID-19 progression and transplant rejection, and the pharmacokinetic interaction between immunosuppressive and antiviral medications.

Oral antifungal agents are the mainstay of the therapy of pediatric tinea capitis. No approved topical medications for tinea capitis are found. We evaluated the therapeutic efficacy, safety, and tolerability of topical 1% encapsulated terbinafine hydrochloride gel for the treatment of pediatric tinea capitis.

An open-label clinical trial was performed on 10 children with clinical and mycologically confirmed diagnosis of tinea capitis. selleck inhibitor Each child was prescribed topical 1% encapsulated terbinafine hydrochloride gel to be applied twice daily to the full scalp for 4weeks. Clinical and mycological examinations were assessed 2weeks after completion of treatment. Monitoring was performed for associated side effects during the treatment and follow-up periods.

Ten male patients were enrolled with a mean age of 10.3years. A cure rate of 80% (n=8) was noted 2weeks after treatment completion. An additional 20% (n=2) had mycological cure with incomplete, but significant clinical improvement. No significant side effects were reported.

This preliminary study demonstrated that topical 1% encapsulated terbinafine hydrochloride gel was an effective treatment for tinea capitis in children.

This preliminary study demonstrated that topical 1% encapsulated terbinafine hydrochloride gel was an effective treatment for tinea capitis in children.

Tissue engineering is a promising strategy for repair of large bone defect. However, the immune system reactions to biological scaffold are increasingly being recognized as a crucial factor influencing regeneration efficacy. In this study, a bone-bioactive hydrogel bead loaded with interleukin-4 (IL-4) was used to regulate macrophages polarization and accelerate bone regeneration.

IL-4-loaded calcium-enriched gellan gum (Ca-GG+IL-4) hydrogel beads were synthesised. And the effect on cell behaviour was detected. Furthermore, the effect of the Ca-GG+IL-4 hydrogel bead on macrophage polarization and the effect of macrophage polarization on bone mesenchymal stem cells (BMSCs) apoptosis and osteogenic differentiation were evaluated in vitro and in vivo.

BMSCs were able to survive in the hydrogel regardless of whether IL-4 was incorporated. Immunofluorescence staining and qPCR results revealed that Ca-GG+IL-4 hydrogel bead could promote M2 macrophage polarization and increase transforming growth factor (TGF)-β1 expression level, which activates the TGF-β1/Smad signalling pathway in BMSCs and promotes osteogenic differentiation.