scholarly journals The Neurology of Cobalamin

1992 ◽  
Vol 19 (4) ◽  
pp. 472-486 ◽  
Author(s):  
Michael I. Shevell ◽  
David S. Rosenblatt
Keyword(s):  
Normal Development ◽  
Clinical Work ◽  
Cobalamin Deficiency ◽  
Neurologic Disease ◽  
Inherited Disorders ◽  
Wide Range ◽  
Normal Absorption ◽  
Intracellular Metabolism ◽  
Cobalamin Metabolism ◽  
The Impact

ABSTRACT:The following review indicates that the impact of cobalamin on neurologic disease extends far beyond the traditional myelopathy of classical pernicious anemia. The delineation of a broad spectrum of inherited disorders of cobalamin processing has served to illustrate and precisely define each step in the normal absorption, transport and intracellular metabolism of this essential vitamin. Recent clinical work has extended the boundaries of acquired cobalamin deficiency to encompass a variety of neuropsychiatric disturbances without identifiable concomitant hematologic derangements and emphasized the utility and sensitivity of new laboratory tests. These findings will demand increased vigilance from clinicians so that atypical and subtle cobalamin deficiency states will be readily diagnosed. The wide range of neurologic dysfunction observed in both inherited and acquired disorders of cobalamin metabolism challenges basic scientists to delineate cobalamin’s presumed important role in the normal development and homeostasis of the nervous system.

Contraception Options in Neurologic Disease

2018 ◽  
Author(s):  
Tessa L. Reisinger ◽  
Amy Robinson Harrington
Keyword(s):  
Chronic Disease ◽  
Contraceptive Use ◽  
Unplanned Pregnancy ◽  
Treatment Options ◽  
Hormonal Contraception ◽  
Neurologic Disease ◽  
Eligibility Criteria ◽  
Increased Risk ◽  
Wide Range ◽  
The Impact

Unplanned pregnancy has particular implications for women with chronic disease, including increased risk of adverse health events during pregnancy and potential impact on disease course or treatment options. While preventing unplanned pregnancy is especially important in this population, both medications and sequelae of chronic disease must be considered in choosing safe and effective contraceptive options. The US Medical Eligibility Criteria for Contraceptive Use were established to provide guidance on contraceptive use for women with various disease conditions; however, specific guidelines for many neurologic conditions are limited. This chapter reviews evidence and recommendations for contraception options in women with a wide range of neurologic conditions. Considerations include interactions with medications, the risk of venous thromboembolism in the setting of reduced mobility, and the impact of hormonal contraception on symptom frequency and disease progression. In many cases, long-acting reversible contraception (LARC) methods offer highly effective, well-tolerated contraception for women with neurologic disease.

Successful In Utero Hematopoietic Stem Cell Transplantation (IUHSCT) Likely Depends on Niche Maturity, Recipient/Donor MHC Compatibility and Donor Cell Origin

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 574-574 ◽  
Author(s):  
Christine Jeanblanc ◽  
Evan J Colletti ◽  
Christopher D Porada ◽  
Graca Almeida-Porada ◽  
Esmail Zanjani
Keyword(s):  
Conflicts Of Interest ◽  
Donor Cell ◽  
Cell Counting ◽  
Inherited Disorders ◽  
Fetal Sheep ◽  
Hematopoietic Stem ◽  
Wide Range ◽  
Significant Difference ◽  
Related Donor ◽  
The Impact

Abstract Abstract 574 Many of the most prevalent inherited disorders currently affecting the human population could potentially be treated with IUHSCT. IUHSCT does not require myeloablation, eliminating the risks inherent to this procedure. Moreover, performing IUHSCT during the period of preimmunity removes the recipient's immune response as a barrier to successful engraftment. Unfortunately, despite numerous clinical trials over the last 20 years for a variety of disorders, IUHSCT has only been successful in treating SCID, highlighting the need for a better understanding of the factors governing engraftment following IUHSCT. We hypothesized that the success of IUHSCT likely depends upon: 1) the maturity/receptivity of the bone marrow (BM) niches at the time of transplant; 2) the degree of donor/recipient MHC compatibility; and 3) the source of donor HSC. To test our hypothesis, we began by performing confocal analyses of fetal sheep bones at gestational days 30–145, using sheep as a model based on its immunologic, physiologic and developmental similarities with the human fetus. These analyses showed that the BM microenvironment commences development with the formation of the vascular niche, beginning by day 40 of gestation. In contrast, the osteoblastic niche, which is known to be critical for the engraftment and maintenance of primitive HCS, only starts developing at roughly day 51 of gestation, and does not reach maturity until day 65. These findings thus indicate that to achieve maximal levels of engraftment following IUHSCT, the transplant should likely be performed at gestational day 65 or later, to ensure that the crucial osteoblastic niche has fully developed. Unfortunately, partial immune-competence is also achieved by roughly day 65, suggesting that immune compatibility between the donor and the recipient will also need to be addressed to maximize engraftment. This issue was addressed by transplanting 65 day-old sheep fetuses (n=21) with eGFP-transduced CD34+ cells isolated from related and unrelated BM and cord blood (CB) donors and comparing the levels of engraftment. Cell counting, PCR, and flow cytometry at 63 days post-IUHSCT revealed that the engraftment levels of the related CB HSC were nearly double those of the unrelated CB HSC in BM (1.7% vs. 0.86%) and more than 4-fold higher in PB (2.77% vs. 0.66%). Interestingly, however, there was no significant difference between the engraftment levels of related and unrelated BM-derived HSC (1.77% vs. 1.88%). We presumed that a greater degree of MHC matching could explain the higher engraftment seen with related versus unrelated CB-derived HSC. This was experimentally confirmed by performing PCR-based MHC microsatellite typing at 12 selected MHC loci on the donor CB cells and on amniotic fluid-derived recipient cells. All related donor/recipient animals exhibited 5–7 perfect matches and 1–6 half matches at the 12 MHC loci. In contrast, non-related donor/recipient animals exhibited only 1–2 perfect matches and 4–6 half matches at these loci. To evaluate the impact of the source of HSC on IUHSCT outcome, we compared these same animals without consideration to donor/recipient relatedness. These analyses demonstrated that the CB-derived HSC engrafted in PB at nearly four-fold higher levels than their BM-derived counterparts (2.75% vs. 0.93%). Conversely, the BM-derived HSC engrafted within the recipient BM at three-fold higher levels than the CB-derived HSC (0.66% vs. 2.24%). Collectively, these results suggest that transplanted HSC show a predilection for engraftment in their site of origin. In conclusion, our data collectively indicate that: 1) delaying IUHSCT until a point in gestation when the osteoblastic and vascular niches of the BM are mature is likely to improve engraftment; 2) transplanted HSC exhibit a predilection for engraftment in their site of origin; and 3) higher degrees of CB donor/recipient MHC matching doubles the engraftment levels obtained following IUHSCT, but does not seem to impact upon engraftment levels of BM-derived HSC. By simultaneously addressing these issues, it is expected that curative levels of HSC engraftment can be obtained prior to birth, making it possible to establish clinically successful and reliable IUHSCT-based treatments for a wide range of inherited disorders. Disclosures: No relevant conflicts of interest to declare.

scholarly journals The Academic Half-Day in Canadian Neurology Residency Programs

2004 ◽  
Vol 31 (4) ◽  
pp. 511-513 ◽  
Author(s):  
Colin Chalk
Keyword(s):  
Professional Development ◽  
Clinical Work ◽  
Program Directors ◽  
Practice Management ◽  
Substantial Portion ◽  
Child Neurology ◽  
Residency Programs ◽  
Wide Range ◽  
Almost All ◽  
The Impact

Background:The academic half-day (AHD) appears to have become widespread in Canadian neurology residency programs, but there is little published information about the structure, content, or impact of the AHD.Methods:A written questionnaire was sent to the directors of all active Canadian adult and child neurology residency programs.Results:All 21 program directors responded. An AHD was operating in 15/15 adult and 5/6 child neurology programs. The AHD typically lasts three hours, and occurs weekly, 10 months per year. Most of the weekly sessions are lectures or seminars, usually led by clinicians, with about 90% resident attendance. Course-like features (required textbook, examinations) are present in many AHDs. There is a wide range of topics, from disease pathophysiology to practice management, with considerable variation between programs.Conclusion:Almost all Canadian neurology programs now have an AHD. Academic half-days are broadly similar in content and format across the country, and residents now spend a substantial portion of their training attending the AHD. The impact of the AHD on how residency programs are organized, and on the learning, clinical work, and professional development of residents merits further study.

THE IMPACT OF LEADERSHIP PRACTICES TO TEAM MEMBERS’ SATISFACTION

2009 ◽  
Vol 8 (1) ◽  
Author(s):  
Chalimah .
Keyword(s):  
Conflict Resolution ◽  
Leadership Practices ◽  
Hotel Industry ◽  
Leader Behavior ◽  
Team Leader ◽  
Shop Floor ◽  
Team Members ◽  
Top Executives ◽  
Wide Range ◽  
The Impact

eamwork is becoming increasingly important to wide range of operations. It applies to all levels of the company. It is just as important for top executives as it is to middle management, supervisors and shop floor workers. Poor teamwork at any level or between levels can seriously damage organizational effectiveness. The focus of this paper was therefore to examine whether leadership practices consist of team leader behavior, conflict resolution style and openness in communication significantly influenced the team member’s satisfaction in hotel industry. Result indicates that team leader behavior and the conflict resolution style significantly influenced team member satisfaction. It was surprising that openness in communication did not affect significantly to the team members’ satisfaction.

Stress, anxiety, depression and burnout in frontline health care workers during COVID-19 pandemic: a brief systematic review and new data from Russia

2021 ◽  
Author(s):  
Ekaterina Mosolova ◽  
Dmitry Sosin ◽  
Sergey Mosolov
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Female Gender ◽  
Assessment Tools ◽  
Care Workers ◽  
Younger Age ◽  
Wide Range ◽  
Associated Risk Factors ◽  
Anxiety Depression ◽  
The Impact

During the COVID-19 pandemic, healthcare workers (HCWs) have been subject to increased workload while also exposed to many psychosocial stressors. In a systematic review we analyze the impact that the pandemic has had on HCWs mental state and associated risk factors. Most studies reported high levels of depression and anxiety among HCWs worldwide, however, due to a wide range of assessment tools, cut-off scores, and number of frontline participants in the studies, results were difficult to compare. Our study is based on two online surveys of 2195 HCWs from different regions of Russia during spring and autumn epidemic outbreaks revealed the rates of anxiety, stress, depression, emotional exhaustion and depersonalization and perceived stress as 32.3%, 31.1%, 45.5%, 74.2%, 37.7% ,67.8%, respectively. Moreover, 2.4% of HCWs reported suicidal thoughts. The most common risk factors include: female gender, nurse as an occupation, younger age, working for over 6 months, chronic diseases, smoking, high working demands, lack of personal protective equipment, low salary, lack of social support, isolation from families, the fear of relatives getting infected. These results demonstrate the need for urgent supportive programs for HCWs fighting COVID-19 that fall into higher risk factors groups.

A MODELING SYSTEM FOR CLIMATE CHANGE RISK ASSESSMENT, MANAGEMENT AND HEDGING IN COASTAL AREAS

2017 ◽  
Author(s):  
Sergei Soldatenko ◽  
Sergei Soldatenko ◽  
Genrikh Alekseev ◽  
Genrikh Alekseev ◽  
Alexander Danilov ◽  
...  
Keyword(s):  
Climate Change ◽  
Risk Assessment ◽  
Coastal Areas ◽  
Mitigation Strategies ◽  
System Structure ◽  
The Arctic ◽  
Risk Modeling ◽  
Wide Range ◽  
Adverse Weather ◽  
The Impact

Every aspect of human operations faces a wide range of risks, some of which can cause serious consequences. By the start of 21st century, mankind has recognized a new class of risks posed by climate change. It is obvious, that the global climate is changing, and will continue to change, in ways that affect the planning and day to day operations of businesses, government agencies and other organizations and institutions. The manifestations of climate change include but not limited to rising sea levels, increasing temperature, flooding, melting polar sea ice, adverse weather events (e.g. heatwaves, drought, and storms) and a rise in related problems (e.g. health and environmental). Assessing and managing climate risks represent one of the most challenging issues of today and for the future. The purpose of the risk modeling system discussed in this paper is to provide a framework and methodology to quantify risks caused by climate change, to facilitate estimates of the impact of climate change on various spheres of human activities and to compare eventual adaptation and risk mitigation strategies. The system integrates both physical climate system and economic models together with knowledge-based subsystem, which can help support proactive risk management. System structure and its main components are considered. Special attention is paid to climate risk assessment, management and hedging in the Arctic coastal areas.

The Management of Post-Tonsillectomy Morbidity in Patients With Sleep Apnoea

2019 ◽  
Vol 70 (10) ◽  
pp. 3738-3740
Keyword(s):  
Day Surgery ◽  
Sleep Apnoea ◽  
Integrative Approach ◽  
Multicenter Studies ◽  
Therapeutic Modalities ◽  
Advantages And Disadvantages ◽  
Obstructive Sleep ◽  
Wide Range ◽  
The Impact ◽  
Surgery Center

The Tonsillectomy in children or adults is an intervention commonly encountered in the ENT (Ear Nose and Throat) and Head and Neck surgeon practice. The current tendency is to perform this type of surgery in major ambulatory surgery centers. Two objectives are thus pursued: first of all, the increase of the patient quality of life through the reintegration into the family as quickly as possible and secondly, the expenses associated with continuous hospitalization are reduced. Any tertiary (multidisciplinary) sleep center must ensure the complete diagnosis and treatment (including surgery) of sleep respiratory disorders. Under these conditions the selection of patients and especially the implementation of the specific protocols in order to control the postoperative complications it becomes essential. The present paper describes our experience of tonsillectomy as treatment for selected patients with chronic rhonchopathy (snoring) and mild to moderate obstructive sleep apnoea. It was presented the impact of antibiotics protocols in reducing the main morbid outcomes following tonsillectomy, in our day surgery center. The obtained results can also be a prerequisite for the integrative approach of the patients with sleep apnoea who were recommended surgical treatment. Considering the wide range of therapeutic modalities used in sleep apnoea, each with its specific advantages and disadvantages, more extensive and multicenter studies are needed. Keywords: post-tonsillectomy morbidity, day surgery center, sleep disorders

Cognitive Impact of Cerebellar Damage: Is There a Future for Cognitive Rehabilitation?

2018 ◽  
Vol 17 (3) ◽  
pp. 199-206 ◽  
Author(s):  
Kim van Dun ◽  
Frank V. Overwalle ◽  
Mario Manto ◽  
Peter Marien
Keyword(s):  
Affective Disorders ◽  
Cognitive Rehabilitation ◽  
Therapeutic Interventions ◽  
Posterior Fossa Surgery ◽  
Daily Life Activities ◽  
Wide Range ◽  
Affective Deficits ◽  
Cerebellar Injury ◽  
Cognitive Therapies ◽  
The Impact

Background & Objective: During the past 3 decades, numerous neurophysiological, neuroimaging, experimental and clinical studies have evidenced a crucial role for the cerebellum in cognitive, affective and behavioral functions. As a result of the acknowledged modulatory role of the cerebellum upon remote structures such as the cerebral cortex, cerebellar injury may give rise to a constellation of behavioral, affective and cognitive symptoms (Schmahmann's Syndrome). In sharp contrast to the wide range of therapeutic interventions to treat cognitive and affective disorders following cerebral cortical lesions and despite the consequences of Schmahmann’s syndrome upon daily life activities, the literature is surprisingly only scantly documented with studies investigating the impact of cognitive therapies on cerebellar induced cognitive and affective disorders. This survey aims to present an overview of the therapeutic interventions available in the literature as a possible treatment for Schmahmann’s Syndrome after cerebellar injury, after posterior fossa surgery in children, and in children with neurodevelopmental disorders. Although systematical studies are clearly warranted, available evidence suggests that cerebellar-induced cognitive and affective disorders should be treated in a specific way. Approaches where the patients are explicitly made aware of their deficits and are considered to act as an “external cerebellum” are the most promising. Conclusion: The study of the anatomical connectivity of the cerebellar microcomplexes involved in cognitive/affective deficits is likely to play a major-role in the future.

Religion and Medicine

2020 ◽  
Author(s):  
Jeff Levin ◽  
Stephen G. Post
Keyword(s):  
Clinical Decision Making ◽  
Well Being ◽  
Clinical Decision ◽  
Religion And Medicine ◽  
Physical And Mental Health ◽  
Faith Based ◽  
Baylor University ◽  
Wide Range ◽  
History Of ◽  
The Impact

In Religion and Medicine, Dr. Jeff Levin, distinguished Baylor University epidemiologist, outlines the longstanding history of multifaceted interconnections between the institutions of religion and medicine. He traces the history of the encounter between these two institutions from antiquity through to the present day, highlighting a myriad of contemporary alliances between the faith-based and medical sectors. Religion and Medicine tells the story of: religious healers and religiously branded hospitals and healthcare institutions; pastoral professionals involved in medical missions, healthcare chaplaincy, and psychological counseling; congregational health promotion and disease prevention programs and global health initiatives; research studies on the impact of religious and spiritual beliefs and practices on physical and mental health, well-being, and healing; programs and centers for medical research and education within major universities and academic institutions; religiously informed bioethics and clinical decision-making; and faith-based health policy initiatives and advocacy for healthcare reform. Religion and Medicine is the first book to cover the full breadth of this subject. It documents religion-medicine alliances across religious traditions, throughout the world, and over the course of history. It summarizes a wide range of material of relevance to historians, medical professionals, pastors and theologians, bioethicists, scientists, public health educators, and policymakers. The product of decades of rigorous and focused research, Dr. Levin has produced the most comprehensive history of these developments and the finest introduction to this emerging field of scholarship.

Textual Transformations

2019 ◽  
Keyword(s):  
Early Modern ◽  
Financial Incentives ◽  
Book History ◽  
John Dryden ◽  
Book Production ◽  
Original Essays ◽  
Wide Range ◽  
Lucy Hutchinson ◽  
The Many ◽  
The Impact

This collection of twelve original essays by an international team of eminent scholars in the field of book history explores the many ways in which early modern books were subject to reworking, re-presentation, revision and reinterpretation. Their history is often the history of multiple, sometimes competing, agencies as their texts were re-packaged, redirected and transformed in ways that their original authors might hardly recognize. The essays discuss the processes of editing, revision, redaction, selection, abridgement, glossing, disputation, translation and posthumous publication that resulted in a textual elasticity and mobility that could dissolve distinctions between text and paratexts, textuality and intertextuality, manuscript and print, author and reader or editor, such that title and author’s name are no longer sufficient pointers to a book’s identity or contents. The essays are alive to the impact of commercial and technological aspects of book production and distribution (discussing, for example, the career of the pre-eminent bookseller John Nourse, the market appeal of abridgements, and the financial incentives to posthumous publication), but their interest is also in the many additional forms of agency that shaped texts and their meanings as books were repurposed to articulate, and respond to, a variety of cultural and individual needs. They engage with early modern religious, political, philosophical and scholarly trends and debates as they discuss a wide range of genres and kinds of publication (including fictional and non-fictional prose, verse miscellanies, abridgements, sermons, religious controversy) and of authors and booksellers (including Lucy Hutchinson, Richard Baxter, Thomas Burnet, Elizabeth Rowe, John Dryden, and Samuel Taylor Coleridge, Lucy Hutchinson, Henry Maundrell, John Nourse; Jonathan Swift, Samuel Richardson, John Tillotson, Isaac Watts and John Wesley).

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