Numbness Sensation Research Articles

Pungency of Chinese pepper: Its perception and preference

<h2>Abstract</h2> Pungency sensation is a Type III chemesthesis with tingling and numbing sensation. It is a somesthesis with complex sensory features, including sense of pain, temperature and touch, triggered by unsaturated fatty acid amide chemicals. As a basic component of China's characteristic flavor and spicy flavor, along with its unique healthy attributes, the research and application of pungency have attracted great attention. This report introduces the research centering on pungency carried out by the sensory analysis team at China National Institute of Standardization. The research includes the perception and preference of pungency, the psychophysical law of sensory response, qualitative and quantitative evaluation of sensory attributes, analysis of temporal characteristic, establishment of standard measurement, sensory interaction with other tastes, the mechanism of enhancing salty perception, and the preference of Chinese residents for pungency as well as its influencing factors. The established national standard for pungency evaluation, flavor label, pungency map of China and preference distribution exert important theoretical and application significance for the research, design and production of pungency flavor.

A 1-Year Survey of Zoster-Associated Pain after Amenamevir Treatment.

IntroductionAmenamevir is a new anti-varicella-zoster virus drug that inhibits the helicase–primase complex involved in viral replication. Amenamevir has the same effect as valaciclovir on acute pain and skin eruption, but no studies have examined the presence of long-term zoster-associated pain (ZAP) or postherpetic neuralgia (PHN) after amenamevir treatment.MethodsA total of 785 herpes zoster patients treated with amenamevir were followed up for 12 months. Patients recorded their pain status on a questionnaire once a month.ResultsThe proportion of patients with pain was 20.8% at 90 days, 8.0% at 180 days, 3.8% at 270 days, and 2.7% at 360 days after treatment. The median residual pain duration was 48 days. ZAP resolution rate slowed between 90 and 120 days, suggesting that the main feature of ZAP is a shift from nociceptive pain to neuropathic pain. Older age and more severe skin symptoms at the first visit were associated with a higher risk of developing PHN. Median ZAP duration was high for the head, face, and upper back and chest. Regarding the nature of pain, sudden pain attacks that felt like electric shocks, sensation of numbness, burning sensation, and cold/heat pain tended to remain as PHN.ConclusionsAlthough conclusions must remain tentative without further comparative studies, amenamevir seems to have a similar effect on PHN as conventional nucleoside analogs, despite having a different action mechanism.Clinical Trial RegistrationUMIN000035938.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13555-022-00727-9.

Application of thin free lateral femoral circumflex artery perforator flap in repair of scar contracture deformity in hand and foot

To explore the effectiveness of thin free lateral femoral circumflex artery perforator flaps that dissected under the superficial fascia in repair of scar contracture deformity in hand and foot. Between January 2017 and October 2020, 15 patients with scar contracture deformity in hand or foot were admitted. There were 9 males and 6 females; aged 6-42 years, with a median age of 23 years. Scar contracture lasted from 1 to 21 years, with a median of 13 years. There were 11 cases of scar contracture deformities in the hands and 4 cases in the feet, all of which showed different degrees of hand and foot joint dysfunction. After the scar contracture was released, the size of wounds ranged from 6 cm×4 cm to 9 cm×8 cm, including 12 cases with exposure of blood vessels, nerves, or tendons, and 4 cases with tendon defects. A thin free lateral circumflex femoral artery perforator flap that dissected under the superficial fascia was used to repair the wound. The size of flap ranged from 6.0 cm×5.0 cm to 10.0 cm×8.5 cm. Fascia strips were used to reconstruct tendons and the donor sites were sutured directly. The venous vascular crisis occurred in 1 flap, and the flap survived successfully after treatment. The rest flaps survived well, and the wounds healed by first intention. All incisions at donor sites healed by first intention. All patients were followed up 6-12 months after operation, with an average of 9 months. The flaps were in good shape and texture. The functions of the affected hand had been restored to a large extent. According to the upper limb function evaluation standard of the Society of Hand Surgery of the Chinese Medical Association, 7 cases were excellent and 4 cases were good. The deformity of the toe joint of the affected foot significantly improved. No muscular hernia, sensory numbness, or other complications occurred at the donor sites. The thin free lateral femoral circumflex artery perforator flap that dissected under the superficial fascia is an effective method to repair scar contracture deformity of hand and foot with well appearance, good function recovery, and less complication of the donor sites.

Preliminary study on the potential of topical anaesthesia from betel leaf and clove leaf extract

Introduction: Betel leaf (Piper betle Linn.) and clove leaf (Syzygium aromaticum) are Indonesian herbs which are known to cause a numb sensation. The main ingredients of betel leaf, which act as an anesthetic, are caryophyllene, eugenol, methyl eugenol, eucalyptol (1.8-cineol), linalool, α-Pinene, estragole, while cloves have local anesthetic effects through their ingredients, namely eugenol, and β-Caryophyllene. Research on the benefits of these two ingredients as topical anesthetics in Indonesia is still rare. This study was aimed to describe the potential of betel leaf and clove leaf extract as a topical anesthetic in Wistar rats. Methods: This research was a laboratory experimental research with simple randomized controlled design. The sample consisted of 6 male Wistar rats, each of which was given four treatments, namely extract with a concentration of 50%, 75%, and 100%, and topical anaesthetic benzocaine 20% as a control. Each treatment was tested using an electric stimulator and observed onset, duration of action, and depth of topical anaesthesia. The data were processed using descriptive statistics with tables and graphs. Results: Betel leaf extract with a concentration of 100% had a better mean onset, duration of work, and depth of anesthesia than the 20% benzocaine control, whereas 75% clove leaf extract had the longest duration of action compared to 20% benzocaine and 100% concentration was the topical anesthetic agent with the highest anesthetic depth. Conclusion: Based on the onset, duration of action, and depth of anesthesia, betel leaf, and clove leaf have potential as topical anesthetic agents.

Understanding chronic feelings of emptiness in borderline personality disorder: a qualitative study

BackgroundChronic feelings of emptiness are significant in the lives of people with Borderline Personality Disorder (BPD). Feelings of emptiness have been linked to impulsivity, self-harm, suicidal behaviour and impaired psychosocial function. This study aimed to understand the experience of chronic emptiness, the cognitions, emotions and behaviours linked to emptiness, and clarify the differences between chronic emptiness and hopelessness, loneliness and depression.MethodsThis study interviewed people (n = 15) with BPD and used a template analysis qualitative approach to understand their experiences of chronic feelings of emptiness.ResultsChronic feelings of emptiness were experienced as a feeling of disconnection from both self and others, and a sense of numbness and nothingness which was frequent and reduced functional capacity. Feelings of purposelessness and unfulfillment were closely associated with emptiness, and most participants experienced emptiness as distressing. Responses to feelings of emptiness varied, with participants largely engaging in either impulsive strategies to tolerate feelings of emptiness or distracting by using adaptive behaviours. Most participants distinguished chronic feelings of emptiness from loneliness, hopelessness, dissociation, and depression.ConclusionsFeelings of chronic emptiness are an important and challenging symptom of BPD which require clinical intervention. Strengthening identity, sense of purpose and vocational and relationship functioning may reduce the intensity of emptiness.

Endoscopic spine surgery for cervicothoracic spine neurofibroma: a case report

Introduction: Spinal tumors are rare lesions. The incidence of spinal tumors is about 0.5-2.5 cases per 100,000 population per year.1 Thirty percent of spinal tumors are located intradural. Twenty to thirty percent of intradural tumors are schwannoma and spinal neurofibroma.2 Surgery is the leading choice for schwannomas and neurofibromas that grow progressively or cause neurological deficits.2,3,4 Currently, minimally invasive surgery is developing rapidly, including minimally invasive surgery on spine surgery.Better outcomes are expected in endoscopic spine surgery compared to conventional spine surgery techniques.This paper aims to provide an overview of endoscopic procedures for the surgical removal of spinal tumors.Case description: A 59-year-old man presented paraplegia of both lower limbs. The patient complained difficulty walking for nine months before admitted to the hospital. The patient also complained of difficulty moving both of his legs, burning pain sensation, pain and numbness sensation that radiates from chest region to both of his toes, he felt that his chest was tied, and he complained hard to breathe when he feels pain. Complaints are getting worse until the patient was unable to walk. We found intra-dural extramedullary lesion from the MRI that was suspicious of a nerve cell sheath tumor. The patient underwent surgical treatment for tumor removal with an endoscopic technique, the cancer was complete. From the histopathology, the tumor was a neurofibroma tumor.Conclusion: Neurofibroma is one of the most frequently intradural extramedullary spinal tumors. Good imaging can guide the diagnosis and a good plan for manage patients with spinal tumors. Complete tumor resection provides a better prognosis in patients with neurofibromas. With endoscopic techniques, total spinal tumor removal surgery can be performed. The surgical procedure for spinal tumors using an endoscopic approach may be an option for spinal neurofibromas patients.

Adverse health manifestations in the hands of vibration exposed carpenters - a cross sectional study

BackgroundDespite EU regulatory standards, many workers suffer injury as a result of working with hand-held vibrating tools. Our aim of this study was to confirm whether carpenters, a highly exposed group, suffer more injuries to their hands than painters, a group assumed to be less exposed to vibration.Methods193 carpenters (participation rate 100%) and 72 painters (participation rate 67%), all men, answered a questionnaire and underwent a clinical examination to identify manifestations of neural and vascular origin in the hands. Neurosensory affection was defined as having at least one symptom in the fingers/hands (impaired perception of touch, warmth, or cold, impaired dexterity, increased sensation of cold, numbness or tingling, or pain in the fingers/hands when cold) and at least one clinical finding (impaired perception of touch, warmth, cold, vibration, or two-point discrimination). Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI).ResultsNeurosensory affection was fulfilled for 31% of the carpenters and 17% of the painters, age-adjusted OR 3.3 (CI 1.6–7.0). Among carpenters with neurosensory affection 18% reported interference with daily life activities, the most common symptoms being increased sensation of cold, numbness and pain in the fingers/hands when cold, the most common clinical findings were impaired perception of touch and vibration. Neurosensory affection was found in 12% of young carpenters (≤ 30 years old). No difference was found in the prevalence of white fingers between carpenters and painters.ConclusionsCarpenters showed more symptoms and clinical findings of neurosensory affection than painters, probably due to vibration exposure. Also young carpenters showed signs of neurosensory affection, which indicates that under current conditions workers at these companies are not protected against injury. This underlines the importance of reducing exposure to vibration and conducting regular medical check-ups to detect early signs of neural and vascular manifestations indicating hand-arm vibration injuries. Special attention should be given to symptoms of increased sensation of cold, pain in the fingers when cold, and numbness, as these were the most common initiating ones, and should be addressed as early as possible in the preventive sentinel process. It is also important to test clinically for small- and large-fibre neuropathy, as the individual may be unaware of any pathology.

An evaluation of a ScarWork service for cancer survivors experiencing adverse effects of surgery and/or radiotherapy

IntroductionIn the UK, 68% of early stage cancer patients undergo surgical resection, which may result in troublesome physiological and psychosocial symptoms from scars associated with this curative- intent surgery. We evaluated a 12-month service offering ScarWork, a light-touch manual therapy, to improve our understanding of this novel intervention. MethodsA National Health Service (NHS) cancer centre offered eight ScarWork treatments to survivors who had undergone surgery (and/or radiotherapy) for breast, colorectal, gynaecological, head and neck cancers or melanoma. Outcome measures administered at beginning and end-of-treatment included the Patient Scar Assessment Questionnaire (PSAQ) and Measure Yourself Medical Outcome Profile (MYMOP). Patients could specify one or more scars. A semi-structured questionnaire administered at end-of-treatment collected patients’ impressions of ScarWork. ResultsNineteen patients, reporting 25 scars with a mean scar age of 4.2 years (range: 0.5-17 years) received a median of six ScarWork treatments (range: 0-12). PSAQ showed significant improvements for subscales Appearance, Consciousness, Satisfaction with Appearance, and Satisfaction with Symptoms; symptom improvements included itching, frequency of discomfort, sensations of numbness and overall troublesomeness. Mean MYMOP profile score showed 1.8 (SE=0.3) points improvement on a 7-point scale, where change of ≥0.5-1.0 points is clinically significant. In written feedback, patients reported benefits including improved appearance, texture, mobility, wellbeing and acceptance of scars. No serious adverse events were reported. ConclusionsFeedback from this service assured funding for continued clinical activity. Valuable experience in administering outcome measures, especially PSAQ, was gained. This will facilitate improved data collection and analysis for future service development.

Prevalence and Risk Factors of Sensory Symptoms in Diabetes Patients in Taiwan.

BackgroundDiabetic sensory neuropathy has rarely been studied in the Asian populations. This study investigated the prevalence and risk factors of sensory symptoms (SS) in the Taiwanese diabetes patients.MethodsA total of 1,400 diabetes patients received a health examination together with a structured questionnaire interview for three categories of abnormal sensation of numbness or tingling pain, electric shock, and skin thickness sensation on seven anatomical sites on upper limbs and six sites on lower limbs. Prevalence of SS was defined using nine different criteria, with the least stringent criterion of “any positive symptom on at least 1 site” and the most stringent criterion of “any positive symptom on at least bilateral and symmetrical 2 sites involving the lower limb.” Logistic regression was used to estimate the odds ratios and their 95% confidence interval for SS by the different definitions. Fasting plasma glucose and hemoglobin A1c were entered in separate models to avoid hypercollinearity.ResultsThe prevalence of SS was 14.4 and 54.0% when using the most stringent and least stringent criterion, respectively. Women consistently had a significantly higher prevalence than men did. Among the three categories of symptoms, numbness or tingling pain was the most common, and fingers and toes were the most commonly involved anatomical sites. For any symptoms, 37.1% of the patients had any symptoms on the upper limbs and 41.7% had any symptoms on the lower limbs. Female sex, diabetes duration, hemoglobin A1c, and hypertension were associated with SS in all models.ConclusionsTaiwanese diabetes patients may have a high prevalence of SS if a structured questionnaire is used for screening. Female sex, diabetes duration, hemoglobin A1c, and hypertension are associated with SS.

Comparison of physical electrical conductivity and acupuncture de-qi sensation between stainless steel needling and supercritical fluid-treated needling

BackgroundWhile acupuncture has been used for thousands of years, modern technology to develop new needle materials has rarely been discussed. We aim to explore a new acupuncture needle material and compare the differences in the needling sensations between the acupuncture needle surface treated with nitrogen applied supercritical fluid (SCF–N) and conventional stainless steel needles. MethodsThis was a double-blind cohort study. The acupuncture needles were randomly used in this experiment, including the SCF-N-treated needles and the control stainless steel needles. LI 4 (Hegu) and LI 11 (Quchi) acupuncture points in the Yangming Large Intestine Meridian of Hand were treated. Physical electrical resistance, scanning electron microscopy, energy dispersive spectrometry, and visual analog scale (VAS) score including the sensations of soreness, numbness, distention, and heaviness were assessed. ResultsThe proportion of nitrogen (N) was significantly higher in the SCF-N-treated needles than in the stainless steel needles group (2.3 ± 0.2% vs 0.0 ± 0.0%, P < 0.01). The cumulative de-qi sensation score at the LI 4 Hegu acupoint (1.87 ± 1.88 vs 1.54 ± 1.62, P = 0.014), especially the sensation of soreness score (2.76 ± 2.06 vs 2.13 ± 1.85, P = 0.045), revealed statistically significant differences between both groups. SCF-N surface treatment of acupuncture needles may lower the electrical resistance more than the control stainless steel needles (24.67 ± 0.88 kW vs 26.45 ± 0.75 kW, p < 0.01). ConclusionAcupuncture needles modified with SCF-N surface treatment can enhance de-qi sensations to improve electrical conductivity of the meridian and therapeutic effects on the Yangming Large Intestine Meridian of Hand. SCF-N surface treated needles can be as a new acupuncture needle material in the future.

Cervical myelopathy due to neurovascular compression syndrome caused by persistent first intersegmental artery: a case report

BackgroundPersistent first intersegmental artery (PFIA) is a rare anatomical variation of vertebral arteries and is an asymptomatic finding in most cases. Here we report a rare case of cervical myelopathy caused by spinal cord compression by the PFIA.Case presentationThe patient was a 52-year-old man who complained of numbness and burning sensation around the neck and left shoulder area, partial weakness in the left deltoid muscle, right side thermal hypoalgesia, and disturbance of deep sensation since the past 1 year, and the symptoms had gradually worsened. Magnetic resonance imaging (MRI) and computed tomography (CT) showed spinal cord compression by the left PFIA at the C1/C2 level. Because conservative treatment was ineffective, microvascular decompression (MVD) of the PFIA was performed. The left PFIA was laterally transposed using polytetrafluoroethylene (PTFE) bands and anchored to the dura mater using three PTFE bands. To achieve adequate transposition, the small blood vessels bridging the spinal cord and PFIA and the dorsal root nerve had to be sacrificed. Postoperative T2-weighted MRI showed a small hyperintense region in the lateral funiculus of the spinal cord, but no new neurological deficits were identified. In the early postoperative stage, the patient’s deep sensory impairment and motor dysfunction were improved. His numbness and burning sensation almost disappeared, but slight thermal hypoalgesia remained in the lower limb.ConclusionMVD is an effective treatment for spinal cord compression caused by the PFIA, but further studies are necessary to help address technical difficulties and avoid complications.

Evaluation of the efficacy of treatment modalities in burning mouth syndrome-A systematic review.

Burning mouth syndrome (BMS) is a medical entity characterised by a spontaneous sensation of burning, numbness or pain of the oral mucosa in the absence of clinical symptoms. The goal of this systematic review was to assess the efficacy of various current treatments for BMS. The literature search used the following inclusion criteria: randomised controlled trials (RCTs) which compared one or more treatment strategies for patients with primary/idiopathic BMS with a placebo group describing all types of interventions. The primary and secondary outcome measures included: relief of pain/burning sensations, changes in psychosocial factors and feeling of sensation of dryness. A computer and manual search was performed in Pubmed, Web of Science and Cochrane Library up to 5 November 2019 and updated on 28 June 2020. The risk of bias was measured with the Cochrane Collaboration tool. Thirty RCTs which included 727 study participants and 589 controls were identified. The following interventions were introduced: dietary supplements, anticonvulsants, benzodiazepines, antidepressants, analgesics, topical agents, electromagnetic radiation or induction, physical barriers and psychological therapies. The most successful therapeutic outcomes were observed for clonazepam tested in 3 RCTs, where significant pain reduction appeared after both topical and systemic application. Evident pain reduction was also reported for tongue protectors and capsaicin in 2 separate studies. Short follow-up periods, low numbers of participants, variability of the metrics used in the evaluation of the results and heterogeneous study design were the main limitations of the reviewed studies. Based on our analysis, clonazepam appears to be the most effective treatment option for BMS.

Effectiveness of a far-infrared low-temperature sauna program on geriatric syndrome and frailty in community-dwelling older people.

AimAlthough it is known that geriatric syndrome is associated with the development of frailty, it is not known whether an amelioration of geriatric syndrome also improves shared risk factors and frailty.MethodsIn total, 67 community‐dwelling older people (79.6 ± 6.5 years, 49 women) participated in this study (41 were classified as pre‐frail and 26 as frail). We analyzed indices of physical frailty and cognitive depression, exercise tolerance and health‐related quality of life as frailty related indices, and the participants completed a questionnaire regarding common geriatric symptoms (cold extremities, leg edema, breathlessness, urinary incontinence, chronic headache, chronic pain, a sense of numbness, anorexia, constipation, insomnia and skin trouble) using numeric ratings. Frailty was evaluated using the Japanese version of the Cardiovascular Health Study (J‐CHS) criteria. The participants then underwent a far‐infrared low‐temperature sauna (FILTS) program twice a week for 3 months and the above parameters were reassessed.ResultsAfter the FILTS program, there were significant differences in usual walking speed, peak oxygen uptake, Geriatric Depression Scale‐15, health‐related quality of life and the severity of several geriatric symptoms. Of the 67 participants, 18 showed improvements in their J‐CHS frailty score, 47 showed no change and two showed reductions. Linear regression analysis showed that the change in the numeric rating of the coldness of extremities (B = −0.105, P = 0.013) and the cumulative numeric rating for geriatric syndromes (B = 0.044, P < 0.001) were independent determinants of the change in the J‐CHS score.ConclusionsA 3‐month FILTS program ameliorates geriatric syndrome, the severity of frailty and frailty related indices in older Japanese people. Geriatr Gerontol Int 2020; 20: 892–898.

Efficacy of platelet-rich plasma injection in mild and moderate carpal tunnel syndrome: randomized control study

BackgroundCarpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy. Typical symptoms and signs include numbness, tingling, pain, or burning sensation in the digits supplied by the median nerve and/or nocturnal paresthesia. Treatments of CTS range from conservative measures to surgical decompression of the median nerve.ResultsThe PRP group showed a statistically significant reduction in the visual analog scale, Boston Carpal Tunnel Syndrome Questionnaire, for the severity and the functional capacity scores, and cross-sectional area of the median nerve compared to those of control group 3 months post-treatment (p < 0.05).ConclusionsPlatelet-rich plasma injection in CTS relieves pain and symptom severity and improves functional status but not significantly improve the electrophysiological parameters.

Globalization of Sichuan hot pot in the “new era”

This paper explores the transformation of the Sichuan hot pot from a regional Chinese food to a global cuisine. It first analyzes how Sichuan food businesses had been “gentrified” by rigorous state regulation and control. With a series state-led food standardization and industrialization programs, hot pot restaurants quickly developed a franchising business model. In the late 2010s, several famous hot pot brands have established in different locations in the bustling cities in the United States. Challenging the taste buds of world food consumers, the hot and numbing sensation of the Sichuan hot pot is part of the national trajectory that aims to enhance China’s soft power. The paper argues that unlike the previous waves of Chinese food globalization brought by the earlier migrants from China, the globalizing hot pot is a different kind of Chinese food globalization developed within a political and economic context that witnesses China’s rise to global power.

The Effect of Data Theft on a Firm’s Short-Term and Long-Term Market Value

The prevalence of the internet as firm’s primary channel of operations and marketing in recent decades has made information security management a critical issue for firms. Yet, previous research on the information security issue have mostly focused on the impact of information security events on firms’ short-term value. Their impact on firms’ long-term value is rarely analyzed. Corporate managers have also largely dismissed the negative long-term impact of information security breaches by considering them as accidental and arguing that their frequency in recent years has instigated a sense of numbness in customers to their regards. Consequently, managers have paid little attention to information security investments. To assess the importance of information security investment, this study examines short-term and long-term stock market assessment of data breaches events at publicly traded companies. The findings of this study offer new insights for firms in assessing information security investment.

LO90: Predictors of post-concussion syndrome in adults with acute mild traumatic brain injury presenting to the emergency department: a secondary analysis of a randomized controlled trial

Introduction: The emergency department (ED) is the first point of health care contact for most head injured patients. Although early and spontaneous resolution occurs in most patients with mild traumatic brain injury (MTBI), between 15-30% develop post-concussion syndrome (PCS). To date, clinical prediction tools do not yet exist to accurately identify adult MTBI patients at risk of PCS. The objective of this study was to identify predictors of PCS within 30 days in adults with acute MTBI presenting to the ED. Methods: This was a secondary analysis of a randomized controlled trial conducted in three Canadian EDs evaluating prescribed light exercise compared to standard care. Adult (18-64 years) patients with a MTBI sustained within the preceding 48 hours were eligible for enrollment. Participants completed follow-up questionnaires at 7, 14, and 30 days. The primary outcome was the presence of PCS at 30 days, defined as the presence of ≥ 3 symptoms on the Rivermead Post-concussion Symptoms Questionnaire (RPQ) at 30 days. Backward, stepwise, multivariable logistic regression with a removal criterion probability of 0.05 was conducted to determine predictor variables independently associated with PCS at 30 days. Likelihood ratio tests were used to determine appropriate inclusion of variables in the multivariable model. Results are reported as odds ratios (OR) with 95% confidence intervals (CIs). Results: A total of 367 patients were enrolled, 18 (4.9%) withdrew, and 108 (29.4%) were lost to follow-up. Median (IQR) age was 32 (25 to 48) years, and 201 (57.6%) were female. Of the 241 patients who completed follow-up, 49 (20.3%) had PCS at 30 days. Headache at ED presentation (OR = 6.59; 95% CI: 1.31 to 33.11), being under the influence of drugs or alcohol at the time of injury (OR = 4.42; 95% CI: 1.31 to 14.88), the injury occurring via bike or motor vehicle collision (OR = 2.98; 95% CI: 1.39 to 6.40), history of anxiety or depression (OR = 2.49; 95% CI: 1.23 to 5.03), and the sensation of numbness or tingling at ED presentation (OR = 2.25; 95% CI: 1.04 to 4.88), were independently associated with PCS at 30 days. Conclusion: Five variables were found to be significant predictors of PCS. Although MTBI is a self-limited condition in the majority of patients, patients with these risk factors should be considered high risk and flagged for early follow-up. There continues to be an urgent need for a clinical prognostic tool that accurately identifies adult patients at risk for PCS early in their injury.

Low Vitamin B12 Levels: An Underestimated Cause Of Minimal Cognitive Impairment And Dementia.

BackgroundVitamin B12 deficiency is linked to impaired cognition and memory along with a sensation of tingling and numbness, an outcome of poor myelination. Elevated methylmalonic acid and serum homocysteine levels are markers of Vitamin B12 deficiency. Elevated homocysteine levels are also often associated with Alzheimer’s disease and stroke. We conducted this study to determine the effect of vitamin B12 replacement therapy on vitamin B12-deficient patients with noted cognitive impairment.MethodsWe conducted a cross-sectional, multicenter study of patients with minimal cognitive impairment (MCI) to assess for Vitamin B12 and homocysteine levels. All patients found to be deficient in vitamin B12 underwent replacement therapy and were assessed again after three months via the Mini-Mental State Examination (MMSE) and a review of symptoms.ResultsA total of 202 patients were included in the study. Of those, 171 (84%) patients reported marked symptomatic improvement after vitamin B12 replacement while MMSE scores improved in 158 (78%) patients. Of the remaining 44 patients who reported no symptomatic improvement, MMSE scores improved in 26 while 18 patients showed no MMSE score improvements.ConclusionsVitamin B12 deficiency is linked to cognition, and replacement therapy may be an option to improve patient cognition outcomes. Further studies are needed to confirm and refine the observed associations over a larger scale and to determine whether these findings will translate to a reduction in cognitive decline.

麻痺肢接触時の能動性がしびれ感の軽減に影響した中心前後回・島皮質・前頭頭頂弁蓋部損傷の1例

麻痺肢接触時の能動性がしびれ感の軽減に影響した中心前後回・島皮質・前頭頭頂弁蓋部損傷の1例

Effect of Self-treatment During Rehabilitation Maintenance Phase on Affected Limb Lymphedema in Patients After Breast Cancer Surgery

Objective: This article aims to discuss the effect of self-treatment during rehabilitation maintenance phase on affected limb lymphedema after surgery for breast cancer. Methods: Therapists for lymphedema gave one course of complex decongestion therapy (CDT) to affected limb lymphedema of 42 patients after operation for breast cancer. After CDT, patients took self-treatment during rehabilitation maintenance phase. At the 1st, 3rd, 6th, and 12th month after self-treatment, follow-up was conducted for the patients to measure the circumference of the limb, and condition of some lymphedema-related symptoms (such as limitation of shoulder movement, sense of tension, heaviness, needling and numbness). Results: After self-treatment, the circumference of the limb reduced and the lymphedema-induced symptoms improved significantly at the 1st, 3rd, 6th, and 12th month (P<0.05). Besides, 12 months after self-treatment, the lymphedema was maintained at stable phase and lymphedema-related symptoms were improved. The incidence of limitation of shoulder movement, sense of numbness, needling, tension, and heaviness reduced significantly compared with that before self-treatment (P<0.05). Conclusions: Adherence to self-treatment for lymphedema-related symptoms during rehabilitation maintenance phase can reduce the recurrence rate of lymphedema and thus is an effective method for consolidation treatment.