Sandbergknowles3812
We explored themes in recent post-stroke dysphagia literature, focusing on the following questions (1) What does post-stroke dysphagia look like?; (2) Who gets post-stroke dysphagia?; (3) What are the consequences of post-stroke dysphagia?; and (4) How can we improve treatment of post-stroke dysphagia?
There have been several improvements in quantitative descriptions of swallowing physiology using standard and new evaluation techniques. These descriptions have been correlated with lesion locations, and several factors can predict development of post-stroke dysphagia and its sequelae. Novel treatment paradigms have leveraged post-stroke neuroplastic improvements using neurostimulation and biofeedback techniques. read more Despite recent findings, the field is limited by lack of standardization and unanswered questions on rehabilitation variables. Our improved understanding of post-stroke dysphagia will enhance our ability to prevent, identify, and treat it. Future work should be grounded in swallowing physiology and continue refining treatments, particularly in the acute stage.
There have been several improvements in quantitative descriptions of swallowing physiology using standard and new evaluation techniques. These descriptions have been correlated with lesion locations, and several factors can predict development of post-stroke dysphagia and its sequelae. Novel treatment paradigms have leveraged post-stroke neuroplastic improvements using neurostimulation and biofeedback techniques. Despite recent findings, the field is limited by lack of standardization and unanswered questions on rehabilitation variables. Our improved understanding of post-stroke dysphagia will enhance our ability to prevent, identify, and treat it. Future work should be grounded in swallowing physiology and continue refining treatments, particularly in the acute stage.The clinical spectrum of pericardial effusions varies from innocuous serous fluid to life-threatening hemopericardium. A misdiagnosis may be made by similar clinical presentation of acute chest pain/hypotension. Echocardiography is the first-line test for diagnosis of pericardial effusion and its etiology, but sometimes there are different drawbacks to the correct cardiovascular ultrasound diagnosis. Radiologists are reporting an increasing amount of thoracic Multidetector CT examinations at the emergency department. Multidetector CT has now become an established and complementary method for cardiac imaging, and diseases of the pericardium can now be quickly identified with increasing certainty. The aim of this review is to discuss the hemopericardium key Multidetector CT features in acute clinical setting which indicate the need to proceed with predominantly medical or surgical treatment, however, being able to identify forms of bleeding pericardial effusion for which only "a watch and wait strategy" and/or deferred treatment is indicated. In the emergency care setting, radiologists must be aware of different findings of hemopericardium in order to address a tailored and timely management approach.Family doctors can have an active role in identifying significant population needs and solutions. During the COVID-19 epidemic, patient home monitoring with pulse oximetry has been a key aspect of care of patients. However, pandemics bring shortage of medical equipment such as pulse oximeters. Through the local maker community, in a matter of days four "smart" pulse oximeters were built. Following Internet of Things principles, the prototypes were programmed to transmit real-time data through Wi-Fi directly to the doctors. Each pulse oximeter served a family doctor during the pandemic. In this article we describe the process that led to the production of the technology and provide detailed instructions, which have also been shared in maker-oriented websites. Dissemination can potentially lead to additional small-scale productions, limiting future shortages.
Ankle malleolar fractures are one of the most common surgical fractures. The literature about ankle fracture sport related is reduced. Severe fractures, fractures-dislocations, syndesmosis lesions, associated osteochondral lesions, postoperative complications, as well as age are associated in several studies with worse functional results and may, therefore, also be associated with a lower rate of sports return. This study aims to retrospectively assess the return to physical activity at the level prior to injury in individuals undergoing surgical treatment of unstable malleolar ankle injuries and to identify risk factors associated with a non-return.
We retrospectively evaluated between January 2008 and December 2017, patients with an unstable malleolar fracture of the ankle surgically treated, recreational or competitive sportsman with a minimum follow-up of one year. Demographic data, fracture classification according to AO classification, presence/absence of osteochondral lesion, presence/absence of unrse clinical outcome and lower return onset.
To sum all available evidence regarding mesh or mesh fixation material intestinal erosion following inguinal hernia repair and identify the parameters that lead to early (< 6months) versus late (> 6months) symptom presentation.
A systematic literature search of the MEDLINE, Scopus and Google Scholar databases was undertaken to identify relevant studies published up to June 2020.
A total of 54 case reports or cases series, incorporating 57 intestinal erosions were identified. Overall, 13 patients (23%) experienced early intestinal erosions occurring during the first 6 postoperative months while the remaining 44 events (67%) occurred after 6months. Patients presented most commonly with symptoms of acute obstruction (n = 18, 31.5%), followed by signs of a palpable inguinal mass in 15 patients (26.3%). The late presentation group exhibited significantly more cases of mesh erosion when compared to the early presentation group (100% versus 46.2%, respectively, p < 0.001). Conversely, early presenting cases were more often associated with mesh fixation material erosion (53.8% versus 6.8% in the late group, p < 0.001) and were more likely to develop symptoms of acute intestinal obstruction (61.5% versus 22.8%, p = 0.01). An open primary procedure was more common in late presenting cases (65.9% versus 7.7%, p < 0.001) while early presentation was linked to minimally invasive primary procedures (92.3% versus 34.2%, p < 0.001). Bowel resection was more frequently required in late presenting cases (84.1% versus 46.2%, p = 0.009).
Intestinal erosion from prosthetic material is a rare complication of hernia repair leading to considerable morbidity. Prompt operative repair is key in avoiding catastrophic consequences.
Intestinal erosion from prosthetic material is a rare complication of hernia repair leading to considerable morbidity. Prompt operative repair is key in avoiding catastrophic consequences.Tetracyclines have been used to treat many bacterial infections. The use of these antibiotics for the treatment of viral diseases dates to the 1960s to 1970s. Over the decades, the effect of tetracyclines on the pathogenesis of viral infections has been demonstrated both clinically and experimentally. Tetracyclines can act on viral infections either through their antibacterial properties or through direct antiviral action. This review focuses on clinical and experimental data that support the use of tetracycline in treating viral infections and highlights an important approach to slowing disease progression during viral infections. Tetracycline treatment might represent a strategy for eliminating the infection or inhibiting the progression of COVID-19.Deformed wing virus (DWV) is an emerging honeybee pathogen that has appeared across the globe in the past 40 years. When transmitted by the parasitic varroa mite, it has been associated with the collapse of millions of colonies throughout the Northern Hemisphere. However, despite the presence of the mite in the Southern Hemisphere, infested colonies survive. This study investigated the prevalence of DWV genotypes A, B and C along with their viral loads in South Africa and compared the findings with recent data from Brazil, the UK and the USA. We found that DWV-B was the most prevalent genotype throughout South Africa, although the total DWV viral load was significantly lower (2.8E+07) than found in the Northern Hemisphere (2.8E+07 vs. 2.7E+10, p > 0.00001) and not significantly different to that found in Brazil (5E+06, p = 0.13). The differences in viral load can be explained by the mite resistance in Brazil and South Africa, since mite-infested cells containing high viral loads are removed by the bees, thus lowering the colony's viral burden. This behaviour is much less developed in the vast majority of honeybees in the Northern Hemisphere.In this study, a novel parvovirus (gyb-MR02/2015/HUN, MT580795) was detected in barn owls (Tyto alba) and genetically characterized using viral metagenomics and PCR methods. The NS1 and VP1 proteins of gyb-MR02/2015/HUN share only 45.4% and 50.1% amino acid sequence identity, respectively, to the corresponding proteins of peafowl parvovirus 2 (MK988620), the closest relative. Out of 11 faecal specimens from owls (six from little owls, three from barn owls, and two from long-eared owls), two barn owl samples were positive for the novel parvovirus, which is distantly related to members of the recently established genus Chaphamaparvovirus in the subfamily Hamaparvovirinae. Systematic investigation is necessary to explore the diversity of parvoviruses.
Cutting actions are associated with non-contact ACL injuries in multidirectional sports due to the propensity to generate large multiplanar knee joint loads (KJLs) that have the capacity to increase ACL loading and strain. Numerous studies have investigated the biomechanical determinants of KJLs in cutting tasks. The aim of this systematic review was to comprehensively review the literature regarding biomechanical determinants of KJLs during cutting, in order to develop a cutting technical framework alongside training recommendations for practitioners regarding KJL mitigation.
Databases (SPORTDiscus, Web of Science and PubMed) were systematically searched using a combination of the following terms "Biomechanical determinants", or "Knee abduction moment", or "Technical determinants", or "Knee loading", or "Knee loads", or "Mechanical determinants", or "ACL strain", or "Knee adduction moment", or "Anterior tibial shear", or "Knee internal rotation moment", or "Knee valgus moment" AND "Change of direction", ally by attenuation through increased knee flexion and emphasising a greater proportion of braking during the penultimate foot contact (PFC).
Meningioma is a common intracranial neoplasm currently classified in 15 histologic subtypes across 3 grades of malignancy. First-choice therapy for meningioma is maximum safe resection for grade I tumors, and surgery plus optional and mandatory adjuvant radiotherapy for grade II and III, respectively, given the increased rate of recurrence even in the event of complete resection. The WHO 2016 histopathologic grading of meningioma has been questioned due to subjectivity and its controversial predictive power for recurrence.
Novel DNA methylation profiling has simplified classification into six classes that seem to improve prognostic accuracy. We review five main topics of molecular biology research regarding tumorigenesis and natural history of meningioma from the clinician's perspective the histopathologic diagnostic features and pitfalls of the current tumor classification; the molecular integrated diagnosis supported by identification of genetic alterations and DNA methylation profiling; the general landscape of the various signaling pathways involved in meningioma formation; the pathogenic theories of the peri-tumoral edema present in meningioma and its therapy implications; and a summarized review on the current treatments and plausible targeted therapies directed to meningioma.