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Maltreatment-related ED visits decreased from 15.7/week in the matched pre-COVID period (n=380 total) to 12.3/week (n=296 total) in the COVID period (P<.01). However, ED visits (P<.05) and CPS reports (P<.001) for child neglect increased during this period. Provider notes identified 62.4% of child maltreatment ED visits, while ICD-10 codes identified only-CM captured 46.8%.
ED visits for physical and sexual abuse declined, but neglect cases increased during the COVID-19 pandemic in X state.
ED visits for physical and sexual abuse declined, but neglect cases increased during the COVID-19 pandemic in X state.
Surface electromyography (sEMG) is a common electrophysiological assessment used in clinical trials in individuals with spinal cord injury (SCI). This scoping review summarizes the most common sEMG techniques used to address clinically relevant neurorehabilitation questions. We focused on the role of sEMG assessments in the clinical practice and research studies on neurorehabilitation after SCI, and how sEMG reflects the changes observed with rehabilitation. Additionally, this review emphasizes the limitations and pitfalls of the sEMG assessments in the field of neurorehabilitation after SCI.
A comprehensive search of Medline (Ovid), Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, Emcare, Cumulative Index to Nursing & Allied Health Literature, and PubMed was conducted to find peer-reviewed journal articles that included individuals post-SCI that participated in neurorehabilitation interventions using sEMG assessments. This is a scoping review using a syand discusses the barriers limiting its widespread use in the clinic.
This scoping review reveals the potential of sEMG in exploring promising neurorehabilitation strategies following SCI and discusses the barriers limiting its widespread use in the clinic.
Although adolescent idiopathic scoliosis is thought to be an orthopedic disorder, sensorimotor deficits resulting in asymmetric neural drive to the axial musculature have been proposed as contributing factors. Asymmetry in the vestibular control of spinal motoneurons can cause spine deformation reminiscent of idiopathic scoliosis in animal models.
To examine the neural control of axial muscles, we compared common oscillatory drive to bilateral lumbar muscles between 19 participants with adolescent idiopathic scoliosis and 19 healthy adolescents. We measured right and left paraspinal muscle activity during steady isometric back extensions at 15% or 30% of their maximum voluntary contraction.
The variance in exerted force and symmetry in bilateral muscle activation were similar between groups. We estimated the strength of common oscillations between muscle motoneuron pools using intermuscular coherence. Compared to controls, participants with adolescent idiopathic scoliosis exhibited smaller intermuscular coherence between paraspinal muscles in the alpha and beta bands. To identify the cause of the observed decreased in intermuscular coherence, we quantified variability of electromyography power ratio and relative activation timing between the paraspinal muscle. Intermuscular phase between muscle oscillations across the alpha band demonstrated larger variability in adolescent with idiopathic scoliosis. The variability of the ratio of lumbar muscles power was similar between groups in the alpha and beta bands.
Our results suggest that altered bilateral control of axial muscles characterized by increased variability in the timing of alpha oscillations may be linked to spine deformation in adolescents.
Our findings provide a new perspective on neural factors associated with a common spine deformation, adolescent idiopathic scoliosis.
Our findings provide a new perspective on neural factors associated with a common spine deformation, adolescent idiopathic scoliosis.
We aimed to determine whether the proportion of putative seizure onset zone (SOZ) contacts resected associates with seizure outcome in a cohort of children undergoing stereoelectroencephalography (SEEG)-guided resective epilepsy surgery.
Patients who underwent SEEG-guided resective surgery over a six-year period were included. The proportion of SOZ contacts resected was determined by co-registration of pre- and post-operative imaging. PDD00017273 clinical trial Outcome was classified as seizure free (SF, Engel class I) or not seizure-free (NSF, Engel class II-IV) at last clinical follow-up.
Twenty-nine patients underwent resection of whom 22 had sufficient imaging data for analysis (median age at surgery of 10years, range 5-18). Fifteen (68.2%) were SF at median follow-up of 19.5months (range 12-46). On univariate analysis, histopathology, was the only significant factor associated with SF (p<0.05). The percentage of defined SOZ contacts resected ranged from 25-100% and was not associated with SF (p=0.89). In a binary logistic regression model, it was highly likely that histology was the only independent predictor of outcome.
The percentage of SOZ contacts resected was not associated with SF in children undergoing SEEG-guided resective epilepsy surgery.
Factors such as spatial organisation of the epileptogenic zone, neurophysiological biomarkers and the prospective identification of pathological tissue may therefore play an important role.
Factors such as spatial organisation of the epileptogenic zone, neurophysiological biomarkers and the prospective identification of pathological tissue may therefore play an important role.
Despite decades of research, outcomes in pediatric traumatic brain injury (pTBI) remain highly variable. Brain biofluid-specific biomarkers from pTBI patients may allow us to diagnose and prognosticate earlier and with a greater degree of accuracy than conventional methods. This manuscript reviews the evidence surrounding current brain-specific biomarkers in pTBI and assesses the temporal relationship between the natural history of the traumatic brain injury (TBI) and measured biomarker levels.
A literature search was conducted in the Ovid, PubMed, MEDLINE, and Cochrane databases seeking relevant publications. The study selection and screening process were documented in a Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram. Extraction forms included developmental stages of patients, type and biofluid source of biomarkers, brain injury type, and other relevant data.
The search strategy identified 443 articles, of which 150 examining the biomarkers of our interest were included. The references retrieved were examined thoroughly and discussed at length with a pediatric neurocritical care intensivist specializing in pTBI and a Ph.D. scientist with a high degree of involvement in TBI biomarker research, authoring a vast amount of literature in this field.
TBI biomarkers might serve as valuable tools in the diagnosis and prognosis of pTBI. However, while each biomarker has its advantages, they are not without limitations, and therefore, further research is critical in pTBI biomarkers.
TBI biomarkers might serve as valuable tools in the diagnosis and prognosis of pTBI. However, while each biomarker has its advantages, they are not without limitations, and therefore, further research is critical in pTBI biomarkers.
Fanconi syndrome (FS) can be of primary or secondary origin. Some cases of FS secondary to the use of sodium valproate (VPA) have been described, mostly in children with severe psychomotor retardation who are fed by feeding device. The objetive of this study was to describe patients treated for this entity in our center, comparing them against the published literature.
Descriptive study of our patients and those found in the literature. Epidemiologic and clinical data were collected.
We describe seven patients (three to 17years old) with severe psychomotor retardation and undergoing treatment with VPA. Four presented pathologic fractures before the diagnosis of FS, and in three patients the diagnosis was reached due to abnormal laboratory findings. A review of the published cases was carried out and, including our sample, a total of 42 patients were studied 51.3% were male, and the median age at diagnosis of FS was 6years. Severe psychomotor retardation was found in 92.8% of patients, 78% carried a feeding device, and 77.5% received treatment with several antiepileptic drugs. The mean duration of VPA treatment was 5.7years (range 2 to 7.5years). Fifteen patients (37.5%) had bone complications. The resolution time of FS after discontinuation of drug therapy ranged from two to 19months (median 4months).
FS related to VPA is a rare complication, but it should be considered in patients with epilepsy, especially if they have severe psychomotor retardation, are users of feeding devices, and receive other antiepileptic treatments in addition to VPA.
FS related to VPA is a rare complication, but it should be considered in patients with epilepsy, especially if they have severe psychomotor retardation, are users of feeding devices, and receive other antiepileptic treatments in addition to VPA.
To systematically review the available data and scientific literature and to compile all evidence-related studies of the effectiveness of pain management for traumatic patients in the emergency department.
The present study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
A total of 777 articles were retrieved, and eighteen were selected according to the inclusion criteria in this systemic review. These studies were published from 2004 to 2020 and reported from all around the world. Seventeen studies were based on pharmacological intervention, and one study was based on nonpharmacological intervention. Analgesics and methoxyflurane administration were the most adapted interventions for pain management in traumatic patients among the selected studies. Other reported interventions were fixed nitrous oxide/oxygen mixture, sufentanil, and professional practice assessment.
This systemic review provides an overview of the effectiveness of phaerventions may also contribute to pain relief.
Atherosclerosis (AS) is a chronic cardiovascular disease that seriously endangers human health. Our previous studies have shown that the expression of miR-205-5p is significantly reduced in the AS model of ApoE
mice, which has attracted our attention. This study aimed to explore the role and molecular mechanism of miR-205-5p in the progression of human aortic vascular smooth muscle cells (HAVSMCs) METHODS Use ox-LDL to induce HAVSMCs to construct an in vitro cell model of AS, and silence/overexpress miR-205-5p. Use MTT, cell flow cytometry, wound healing experiments, RT-qPCR and Western blot to explore the role and mechanism of miR-205-5p.
miR-205-5p can reduce the cell viability of HAVSMCs induced by ox-LDL; inhibit the expression of cyclin D1 to inhibit the cell cycle; increase the expression of Bax/Bcl-2 and Cleaved-caspase3 to promote cell apoptosis; inhibit proliferation and migration. RT-qPCR and Western blot results showed that miR-205-5p can inhibit the phosphorylation of ERBB4 and AKT in HAVSMCs induced by ox-LDL CONCLUSION miR-205-5p can inhibit the proliferation and migration of HAVSMCs induced by ox-LDL, revealing its possibility of becoming a new target for alleviating AS.
miR-205-5p can reduce the cell viability of HAVSMCs induced by ox-LDL; inhibit the expression of cyclin D1 to inhibit the cell cycle; increase the expression of Bax/Bcl-2 and Cleaved-caspase3 to promote cell apoptosis; inhibit proliferation and migration. RT-qPCR and Western blot results showed that miR-205-5p can inhibit the phosphorylation of ERBB4 and AKT in HAVSMCs induced by ox-LDL CONCLUSION miR-205-5p can inhibit the proliferation and migration of HAVSMCs induced by ox-LDL, revealing its possibility of becoming a new target for alleviating AS.
