Degree Of Paralysis Research Articles

O ATIVISMO JUDICIAL NA DÉBÂCLE DO SISTEMA POLÍTICO: SOBRE UMA HERMENÊUTICA DA CRISE

As presentes reflexões estudam as origens e as causas da expansão do Poder Judiciário, que cresceu na última década. O artigo tem como pano de fundo a crise política que se instalou no Brasil entre os anos de 2014 e 2015 e está baseado na seguinte hipótese de trabalho: quanto maior o grau de paralisação do sistema político maior o grau de provocação para que o judiciário decida sobre toda a sorte de tema controverso. A análise é organizada em três partes coordenadas: (a) a primeira representa a expansão do modelo, tipo “exportação”, dos Estados Unidos para o mundo; (b) essa migração cultural de instituições se faz por meio de uma acomodação desses instrumentos e mecanismos dos modelos políticos; (c) por fim, é apontado que a busca pelo judiciário aumenta quando o sistema político é levado ao limite e, é exatamente nesses casos, que o perigo de decisões ativistas se mostra mais evidenciado. Apresenta-se uma alerta para nortear aqueles que se preocupam com uma Constituição equilibrada: o agigantamento de atribuições em torno de um único poder pode levar há um governo autocrático, solapador da democracia.

Moderate hypothermia increased the incidence of delayed paralysis through activation of the spinal microglia in an aortic cross-clamping rat model

BackgroundHypothermia reduces immediate paralysis during surgical repair of aortic aneurysms. However, it is unknown what the impact of hypothermia is on delayed paralysis, a serious complication of this type of surgery. MethodsSprague-Dawley rats were subjected to occlusion of the descending aorta at different duration under normothermia (38.0±0.5) or hypothermia (33.0±0.5°). Neurologic function was assessed. Motor neuron number, glial activation, and cytokine expression in the spinal cord were examined. Minocycline was administered perioperatively by intraperitoneal injection in the rats subjected to the aorta occlusion. ResultsIn contrast to normothermia conditions at which immediate paralysis occurred when the duration of aorta occlusion exceeded 11.5min, hypothermia did not induce immediate paralysis if the duration of aorta occlusion was less than 41min. However, delayed paralysis was developed when the duration of aorta occlusion exceeded 18min, and reached peak level when the duration of aorta occlusion was 40min at hypothermia condition. The number of motoneurons was significantly decreased (P<0.05) at 30h postoperation. In addition, microglia was activated, and interleukin-1β and interleukin-6 levels were upregulated, both of which were co-localized in microglia at 24h postoperation in the hypothermia group. Minocycline treatment attenuated the incidence and degree of paralysis but did not decrease the mortality. ConclusionsHypothermia, a neuroprotective strategy in cardiothoracic surgery, increased the incidence of delayed paralysis through activation of spinal microglia and cytokines. Blocking the activated microglia may be a potential intervention to prevent the incidence of delayed paralysis.

Evaluation and Treatment Options of Post Traumatic Facial Nerve Palsy

Facial nerve paralysis by trauma is common cause after idiopathic. Facial palsy as a result of intra cranial, intra temporal and extra temporal blunt injury or fracture and both. Sudden and immediate facial nerve palsy needs early surgical intervention for better outcome. Facial nerve decompression and terminoterminal anastmosis surgical intervention had done in present study. It is a prospective study was done between 2004 to 2006 in Department of Otolaryngology and Head & Neck Surgery in Gandhi Medical College and Associate Hamidia Hospital, Bhopal, (M.P.). The complete clinic examination, otoscopic, audio logical, topodiagnostic, and radiological evaluation were done in all the patients. The outcome of these patients was done on the HouseBrackmann nerve grading system. All patients have infra nuclear type of facial nerve palsy. The maximum incidence of facial nerve paralysis found in the age group between 21 to 30 years. The most common mode of injury was motor vehicle accident in ten patients (60%) and thirteen (76%) patients show complete facial nerve palsy, three (18%) patients were temporal bone fracture and two patients were suffered head injury. Out of 17 patients, 13 patients were normal hearing. Suprachordal (47%) involvement is the most common site of lesion in traumatic facial nerve paralysis. Sudden and immediate onset facial nerve paralysis needs early surgical intervention for better outcome. Facial nerve decompression was better outcome comparing to termino terminal anastmosis. The facial nerve paralysis prognosis depends upon degree of paralysis, duration of paralysis, site of injury and patients’ factors.

Psychological Effects of Robot-Assisted Gait Rehabilitation According to Degree of Paralysis in SCI

Psychological Effects of Robot-Assisted Gait Rehabilitation According to Degree of Paralysis in SCI

Hearing loss in Peripheral Facial Palsy after decompression surgery

Facial paralysis can result from a variety of etiologies; the most common is the idiopathic type. Evaluation and treatment are particularly complex. The treatment of acute facial paralysis may require facial nerve decompression surgery. Any structure near the path of the facial nerve is at risk during transmastoid decompression surgery. AimThis is a retrospective study, carried out in order to evaluate hearing loss after transmastoid decompression and how idiopathic cases evolved in terms of their degree of paralysis in the last 15 years. Materials and MethodsWe selected the charts from 33 patients submitted to transmastoid facial nerve decompression in the past 15 years and we assessed their hearing loss and facial paralysis. ResultsThere was a high percentage (61%) of patients with some degree of hearing loss after the procedure and in all cases there was improvement in the paralysis. DiscussionThe values obtained are similar to those reported in the literature. One possible explanation for this hearing loss is the vibration transmission by drilling near the ossicular chain. ConclusionThe surgical procedure is not risk free; indications, risks and benefits should be explained to patients through an informed consent form.

English

Birth palsy, otherwise known as obstetric brachial plexus paralysis (OBPP), is a closed stretch injury to the brachial plexus of nerves during the birth process resulting in varying degree of paralysis and contractures of the upper limb. The study aimed to find out the susceptibility of humans and small-bodied primates to birth palsy. A comparative study on parturition in modern humans, hominoids, hominids, small-bodied primates and great apes was done to determine if the changes in female pelvis and neonatal head and shoulder during human evolution is the real cause for OBPP. During evolution, the morphology of the female pelvis and birth canal changed into a narrow and twisted one and also the size of the fetal head increased. Thus, the narrow and twisted pelvis of the mother, and the relatively large head and broad shoulders of the newborn has made the birthing process of modern human and small bodied primates a precarious fine-tuned act with a very narrow margin for error. This has necessitated proper obstetric care to reduce or even at times obviate the incidence of birth injuries like OBPP. Human evolution has made human babies susceptible to birth palsy and thus is the real cause of birth palsy.

New Predictive Parameters of Bell's Palsy: Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio.

Bell's palsy is the most frequent cause of unilateral facial paralysis. Inflammation is thought to play an important role in the pathogenesis of Bell's palsy. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are simple and inexpensive tests which are indicative of inflammation and can be calculated by all physicians. The aim of this study was to reveal correlations of Bell's palsy and degree of paralysis with NLR and PLR. Case-control study. The retrospective study was performed January 2010 and December 2013. Ninety-nine patients diagnosed as Bell's palsy were included in the Bell's palsy group and ninety-nine healthy individuals with the same demographic characteristics as the Bell's palsy group were included in the control group. As a result of analyses, NLR and PLR were calculated. The mean NLR was 4.37 in the Bell's palsy group and 1.89 in the control group with a statistically significant difference (p<0.001). The mean PLR was 137.5 in the Bell's palsy group and 113.75 in the control group with a statistically significant difference (p=0.008). No statistically significant relation was detected between the degree of facial paralysis and NLR and PLR. The NLR and the PLR were significantly higher in patients with Bell's palsy. This is the first study to reveal a relation between Bell's palsy and PLR. NLR and PLR can be used as auxiliary parameters in the diagnosis of Bell's palsy.

Comparison of Fat Mass Percentage and Body Mass Index in Koreans With Spinal Cord Injury According to the Severity and Duration of Motor Paralysis.

ObjectiveTo analyze the relationship of the change in fat mass percentage (FMP) and body mass index (BMI) with the change in obesity rate according to gender, extent of spinal cord injury (SCI) and the duration.MethodsThe retrospective study was conducted with medical records of 915 patients. FMP was calculated with BMI and bioelectrical impedance analysis (BIA). Statistical analysis of the relationship between FMP and gender, extent of SCI and the duration after SCI was done.ResultsFMP increased in relation to the duration. The mean FMP was higher in the motor complete tetraplegia group, as compared to the motor incomplete group. The rate of obesity was 69.8% with cutoff FMP values of over 22% and 35% for male and female patients, respectively. Rate of obesity was correlated with the duration after SCI and degree of paralysis. The rate of obesity was 17.1% with a cutoff value of BMI 25 kg/m2 and 51.3% with a cutoff value of 22 kg/m2. For evaluation of the diagnostic value of BMI to predict obesity according to FMP standards, a cutoff value of 25 kg/m2 showed a sensitivity level of 22.3% and specificity level of 94.9%. When the cutoff level for BMI was set at 22 kg/m2, the sensitivity and specificity were 59.3% and 67.0%, respectively.ConclusionIn Korean SCI patients, FMP showed good correlation with the duration of SCI and the extent of SCI, while BMI did not. Especially in the motor complete tetraplegia group, the diagnostic value of BMI decreased as the duration after SCI increased. This study suggested that FMP could be used complementarily when evaluating the obesity of SCI patients.

EVALUATION OF DELTAMETHRIN 7.5 % POUR ON FOR THECONTROL OF SOME ECTOPARASITES OF CATTLE AND BUFFALOES

The results of in vivo evaluation of deltamethrin 7.5 % pour on revealed that single application caused 100% elimination of Boophilus annulatus hard ticks from naturally infested cows under treatment within 2-3 weeks. There was neither any reinfestation nor undesirable side effect up to 45 days post treatment. Deltamethrin 7.5% pour on seems to be very effective against tick infested cows, safe for use and easy for application. In vitro evaluation, B. annulatus tick species exposed to hair (10 minutes) collected from cows previously treated with deltamethrin 7.5% pour on show some degree of paralysis and mortality varies according to time of collected hair post treatment. The most effective result was observed on hair collected 14 days post treatment, while hair collected 35 days post treatment was the least, since the speed of killing activity slows down gradually with time pass. The predilection site of lice, Haematopinus tuberculatus among buffaloes were the wither region (47.6%) followed by the neck and dewlap (45%), while the cheek was (0.16%) the lowest predilection site for buffaloe lice. In vivo evaluation, of deltamethrin 7.5% pour on against buffaloe's lice was 100% on day 7 post treatment compared to control group. Animal showed relief from symptoms of itching which continued for 35 days post treatment. In vitro evaluation, the mortality of lice was started 15 minutes after exposure and completed after 30 minutes from exposure to insecticide.

A New Invention to Transfer the Patients from Ordinary Hospital Beds to Surgical Beds and Vice Versa in Two States of Railing and Transferring, a Pictorial Review

The process of transferring the patients from ordinary hospital beds to surgical beds and vice versa is really a long lasting challenge in medicine and surgery. Every health care center which deals with transferring the patients from one bed to another may be encountering with this major problem. This problem will be most pronounced when we would like to talk about the surgical and neurosurgical patients specifically with various degrees of cord injuries and multiple trauma, burned patients, orthopedic patients with disability and inability in movement, patients suffering from cancer and with various degrees of weakness and disabilities and older patients with various degrees of paralysis and movement disorders. Many patients with various degrees of Spinal cord injury need close care because a very small change in the alignment of the fixed spinal cord can cause a very dangerous consequence for them. Also the patients with various degrees of disabilities by any congenital or acquired movement disorders or the patients who are suffering from any fractures specifically in their big bones and joints, during the process of transferring may encounter other problems which can have so many dangerous consequences for them. So finding a way to give an answer to this important question that “How can we transfer the patients from one bed to another without causing any problem for them?” was the foundation of designing and manufacturing a device that can facilitate this difficult process.

Mortality, complication risk, and total charges after the treatment of epidural abscess

Background contextThe treatment of epidural abscess is known to have a high rate of morbidity. Little is known regarding the risk factors for postoperative complications, mortality, and costs of care. PurposeTo identify predictors of postsurgical morbidity and mortality, and total charges, associated with epidural abscess. Study designNationwide Inpatient Sample (NIS) from the year 2006 to 2011. Patient sampleAll patients who had epidural abscess and underwent surgery in the NIS were included. Weighting was used to derive a representative sample. Outcome measuresThey included in-hospital mortality, the development of complications, and total charges. A utility for failure to rescue (FTR) was also developed. Failure to rescue was defined as occurring when patients died after sustaining a complication. MethodsAll patients identified as having epidural abscess and receiving surgical intervention were included. Risk factors were assessed in a bivariate fashion with those maintaining p values less than .2 included in the final multivariable models. Independent predictors of outcome were those that maintained significance after inclusion in multivariable regression. Predictors for total charges were evaluated using generalized linear modeling. ResultsThe population consisted of 30, 274 individuals. The mean age was 57.4 years (±14.7 years). Sixty-three percent of the population was white and 27% was underinsured. Diabetes was present in 30% and 19% had some degree of paralysis. Three percent of patients died during hospitalization and 26% sustained one or more complications. Mean total charges were $159,782 (range: $4,008–$3,373,410). Significant independent predictors for mortality included age, insurance status, liver disease, paralysis, and renal failure, with age (80 years or more) having the greatest effect (odds ratio 4.0 [95% confidence interval 2.0, 7.9]). Many of these same variables were found to be influential in the development of postoperative complications, major morbidity, and FTR. The number of medical comorbidities, underinsured status, paralysis, and renal failure were factors that influenced charges to an extent greater than 20% of the population mean. ConclusionsAge, insurance status, paralysis, and medical comorbidities appear to be the predictors of morbidity, mortality, and expense of care. The results of this work highlight the characteristics that may be targeted to reduce charges and improve care for epidural abscess.

Parinaud's syndrome due to a /INS;unilateral vascular ischemic lesion

Background: Parinaud'/INS;s syndrome includes as core feature /INS;paralysis of conjugate vertical eye movements (especially upgaze) with convergence–/INS;retraction nystagmus on attempted upgaze. Since the lesions accounting for the paralysis of voluntary vertical eye movements are located adjacent to the pupillomotor pathways, there can be varying degrees of paralysis of convergence, pupillary constriction, and accommodation. Parinaud's syndrome may be caused by extrinsic or intrinsic lesions, with pineal tumors and hydrocephalus being common etiologies.

Heat Shock and Caloric Restriction Have a Synergistic Effect on the Heat Shock Response in a sir2.1-dependent Manner in Caenorhabditis elegans

The heat shock response (HSR) is responsible for maintaining cellular and organismal health through the regulation of proteostasis. Recent data demonstrating that the mammalian HSR is regulated by SIRT1 suggest that this response may be under metabolic control. To test this hypothesis, we have determined the effect of caloric restriction in Caenorhabditis elegans on activation of the HSR and have found a synergistic effect on the induction of hsp70 gene expression. The homolog of mammalian SIRT1 in C. elegans is Sir2.1. Using a mutated C. elegans strain with a sir2.1 deletion, we show that heat shock and caloric restriction cooperate to promote increased survivability and fitness in a sir2.1-dependent manner. Finally, we show that caloric restriction increases the ability of heat shock to preserve movement in a polyglutamine toxicity neurodegenerative disease model and that this effect is dependent on sir2.1.

Management of hemiplegic shoulder pain following stroke

Shoulder pain is a common problem following stroke. Patients may present with varying degrees of paralysis (hemiplegia), which commonly affects the arm. As a consequence, the stability of the shoulder may be compromised with subsequent risk of damage to soft tissue structures. Patients with more severe paralysis of the arm are increasingly likely to develop shoulder pain. The underlying causes of shoulder pain, and the sources of this pain, have been the subject of debate and research for many years. There is recent evidence to suggest that damage to soft tissues can occur during post-stroke care in hospital. An evidence-based, multidisciplinary approach should be used to prevent damage to the shoulder and enable management of any complications that arise.

Value of clinical manifestations in predication of prognosis of patients with diffuse axonal injury

Objective To investigate the relationship of clinical manifestations with prognosis of patients with diffuse axonal injury (DAI) and select the indices that can accurately evaluate the prognosis so as to create a predictive model of outcome of DAI patients. Methods Clinical data of 98 DAI patients were retrospectively analyzed to identify the relationship between the indices and outcomes through Cochran-Mantel-Haenszel x2 test or Student-Newman-Keuls one way variance test via SAS 8.1.Then,the indices was analyzed through multivariant cumulative stepwise way so as to establish the Logistic regression model. Results (1)The indices including Glasgow Coma Score (GCS) on admission,combined with other type of cerebral injuries,unstable vital signs,abnormal pupil size and reactivity,decerebrate rigidity,imaging with characteristic DAI signs,paralysis of the limbs and length of coma were correlated with the outcome,while the indices including gender,age,injury mechanism,pathologic signs and decorticate rigidity were insignificantly associated with the outcome.(2) The logistic regression model showed that GCS on admission,paralysis degree of the limbs,abnormal pupil size and reactivity,and combined with cerebral injuries were the optimum predictors of outcome of the DAI patients. Conclusions The logistic regression model in the study is a reliable tool in predicting the prognosis of DAI patients.The patients wit higher GCS on admission may have better outcome.The patients with light degree of paralysis,normal pupil size and reaction,and combined with none cerebral injuries may have sound prognosis. Key words: Diffuse axonal injury; Prognosis; Regression analysis

Acute barium intoxication following ingestion of soap water solution

We present a rare case in which a young girl ingested a solution of a hair-removing soap. The ingestion resulted in profound hypokalemia and severe acidosis leading to flaccid paralysis, respiratory arrest and ventricular arrhythmias. Ultimately the patient made complete recovery. The soapwas found to contain barium sulfide. The degree of paralysis and acidosis appeared to be directly related to serum potassium levels.

Neurological, Functional, and Biomechanical Characteristics After High-Velocity Behind Armor Blunt Trauma of the Spine

Behind armor blunt trauma (BABT) describes a nonpenetrating injury to the organs of an individual wearing body armor. The aim of this study was to investigate the neurologic and functional changes that occur in the central nervous system after high-velocity BABT of the spine as well as its biomechanical characteristics. This study evaluated 28 healthy adult white pigs. Animals were randomly divided into three experimental groups: (1) 15 animals (9 in the exposed group and 6 in the control group) were tested for neurologic changes; (2) 10 animals (5 in the exposed group and 5 in the control group) were used for studies of cognitive function; (3) and 3 animals were used for examination of biomechanics. In the group tested for neurologic changes, 9 anesthetized pigs wearing body armor (including a ceramic plate and polyethylene body armor) on the back were shot on the eighth thoracic vertebrae (T8) with a 5.56-mm rifle bullet (velocity appropriately 910 m/s). As a control, six pigs were shot with blank ammunition. Ultrastructural changes of the spinal cord and brain tissue were observed with light and electron microscopy. Expression levels of myelin basic protein, neuron-specific enolase (NSE), and glial cytoplasmic protein (S-100B) were investigated in the serum and cerebrospinal fluid using enzyme-linked immunosorbent assays. Electroencephalograms (EEGs) were monitored before and 10 minutes after the shot. Pressures in the spine, common carotid artery, and brain were detected. Acceleration of the 10th vertebrae (T10) was tested. Finally, cognitive outcomes between exposed and control groups were compared. Neuronal degeneration and nerve fiber demyelination were seen in the spinal cord. The concentrations of neuron-specific enolase, myelin basic protein, and S-100B were significantly increased in the serum and cerebrospinal fluid 3 hours after trauma (p < 0.05). The electroencephalogram was suppressed within 3 to 6 minutes after trauma. The pressure detected in the brain was higher than that detected in the common carotid artery (p < 0.01). The trauma resulted in paralysis of two hind limbs and in cognitive dysfunction. The results from our animal model indicate that high-velocity BABT of the spine generates high pressure and acceleration in the spine, induces varying degrees of paralysis of hind limbs, and disturbs cerebral function. The neuronal degeneration caused by the pressure wave may be one of the important pathologic events involved in the development of trauma-related complications.

Alteration of protein expression profile following voluntary exercise in the perilesional cortex of rats with focal cerebral infarction

Identification of functional molecules in the brain related to improvement of the degree of paralysis or increase of activities will contribute to establishing a new treatment strategy for stroke rehabilitation. Hence, protein expression changes in the cerebral cortex of rat groups with/without voluntary exercise using a running wheel after cerebral infarction were examined in this study. Motor performance measured by the accelerated rotarod test and alteration of protein expression using antibody microarray analysis comprised 725 different antibodies in the cerebral cortex adjacent to infarction area were examined. In behavioral evaluation, the mean latency until falling from the rotating rod in the group with voluntary exercise for five days was significantly longer than that in the group without voluntary exercise. In protein expression profile, fifteen proteins showed significant quantitative changes after voluntary exercise for five days compared to rats without exercise. Up-regulated proteins were involved in protein phosphorylation, stress response, cell structure and motility, DNA replication and neurogenesis (11 proteins). In contrast, down-regulated proteins were related to apoptosis, cell adhesion and proteolysis (4 proteins). Additional protein expression analysis showed that both growth-associated protein 43 (GAP43) and phosphorylated serine41 GAP43 (pSer41-GAP43) were significantly increased. These protein expression changes may be related to the underlying mechanisms of exercise-induced paralysis recovery, that is, neurite formation, and remodeling of synaptic connections may be through the interaction of NGF, calmodulin, PKC and GAP43. In the present study at least some of the participation of modulators associated with the improvement of paralysis might be detected.

Evaluation of intubating conditions after rocuronium bromide in adults induced with propofol or thiopentone sodium

Aim:The aims of present study were to compare the propofol and rocuronium with thiopentone and rocuronium in terms of clinically satisfactory intubating conditions and to co-relate intubating conditions with degree of paralysis in adductor pollicis muscle using train of four ratio (TOFR). The intubating conditions were evaluated after rocuronium bromide 0.6 mg kg-1 at 60 s.Materials and Methods:60 patients of ASA grades I-II of either sex, age 18-50 years, undergoing various elective surgical procedures were randomly divided into two groups, propofol rocuronium (PR group) and thiopentone rocuronium (TR group) of 30 patients in each. In the PR group, patients received propofol 2.5 mg kg-1 and rocuronium 0.6 mg kg-1; in TR group, patients received thiopentone 5 mg kg-1 and rocuronium 0.6 mg kg-1. In all patients the intubating conditions were evaluated by the observer at 60 s. TOFR was measured at the time of intubation by an assistant.Results:In the PR group the number of the patients placed in intubating conditions grades I, II, III and IV were 40%, 36.67%, 13.33% and 10% and their mean TOFR were 31.8±17.9%, 61.8±;14.6%, 61.7±27.9%, and 78.3±5.7% respectively. While in theTR group the number of patients placed in intubating condition grade I, II, and III were 60%, 26.67%, and 13.33% and their mean TOFR , 41.2±28.3%, 68.0±10.9% and 78.7±6.8%, respectively. There was no patient in grade lV in theTR group.Conclusion:The clinical intubating conditions and degree of paralysis of adductor pollicis muscle after rocuronium 0.6 mg kg-1 at 60 s in adults induced with propofol or thiopentone sodium are comparable.

Experts' agreement on therapy for bone metastases

Experts' agreement on therapy for bone metastases