scholarly journals Quantitative Assessment of Motor Neglect

Stroke ◽  
2021 ◽  
Author(s):  
Monica N. Toba ◽  
Chiara Pagliari ◽  
Marco Rabuffetti ◽  
Norbert Nighoghossian ◽  
Gilles Rode ◽  
...  
Keyword(s):  
Clinical Observation ◽  
Motor Behavior ◽  
Clinical Signs ◽  
Cost Effective ◽  
Additional Patient ◽  
Sensorimotor Deficits ◽  
Neurological Patients ◽  
Quantitative Manner ◽  
Motor Neglect ◽  
Cutoff Scores

Background and Purpose: We used differential actigraphy as a novel, objective method to quantify motor neglect (a clinical condition whereby patients mimic hemiplegia even in the absence of sensorimotor deficits), whose diagnosis is at present highly subjective, based on the clinical observation of patients’ spontaneous motor behavior. Methods: Patients wear wristwatch-like accelerometers, which record spontaneous motor activity of their upper limbs during 24 hours. Asymmetries of motor behavior are then automatically computed offline. On the basis of normal participants’ performance, we calculated cutoff scores of left/right motor asymmetry. Results: Differential actigraphy showed contralesional motor neglect in 9 of 35 patients with unilateral strokes, consistent with clinical assessment. An additional patient with clinical signs of motor neglect obtained a borderline asymmetry score. Lesion location in a subgroup of 25 patients was highly variable, suggesting that motor neglect is a heterogenous condition. Conclusions: Differential actigraphy provides an ecological measure of spontaneous motor behavior, and can assess upper limb motricity in an objective and quantitative manner. It thus offers a convenient, cost-effective, and relatively automatized procedure for following-up motor behavior in neurological patients and to assess the effects of rehabilitation.

scholarly journals Quantitative assessment of motor neglect

2020 ◽  
Author(s):  
Monica N. Toba ◽  
Chiara Pagliari ◽  
Marco Rabuffetti ◽  
Norbert Nighoghossian ◽  
Gilles Rode ◽  
...  
Keyword(s):  
Clinical Signs ◽  
Cost Effective ◽  
Additional Patient ◽  
Motor Behaviour ◽  
Unilateral Brain Damage ◽  
Neurological Patients ◽  
Clinical Consequences ◽  
Quantitative Manner ◽  
Motor Neglect ◽  
Normal Strength

Objectives. Patients with unilateral brain damage may avoid moving the limbs contralateral to their lesion, even in the absence of sensorimotor deficits. However, when asked to move their limbs these patients typically show normal strength and dexterity. In their seminal 1983 article on the Journal of Neurology, Neurosurgery and Psychiatry, Laplane and Degos dubbed this condition Motor Neglect (MN). MN can mimic hemiplegia, with severe clinical consequences. Its assessment has thus important clinical implications. However, MN diagnosis is at present highly subjective, because it is based on the clinical observation of patients' spontaneous motor behaviour. Here we introduce differential actigraphy as a novel, objective method to quantify MN. Methods. Patients wear wristwatch-like accelerometers, which record spontaneous motor activity of their upper limbs during 24 hours. Asymmetries of motor behaviour are then automatically computed offline. On the basis of normal participants' performance, we calculated cut-off scores of left/right motor asymmetry. Results. Differential actigraphy showed contralesional MN in nine of 35 patients with unilateral strokes, consistent with clinical assessment. An additional patient with clinical signs of MN obtained a borderline asymmetry score. Lesion location in a subgroup of 25 patients was highly variable, suggesting that MN is a heterogenous condition. Conclusions. Differential actigraphy provides an ecological measure of spontaneous motor behaviour, and can assess upper limb motricity in an objective and quantitative manner. It thus offers a convenient, cost-effective, and relatively automatized procedure for following-up motor behaviour in neurological patients, and to assess the effects of rehabilitation.

Sonographically guided, transcatheter foam sclerotherapy of the great saphenous vein

Phlebologie ◽  
2007 ◽  
Vol 36 (06) ◽  
pp. 309-312 ◽  
Author(s):  
T. Schulz ◽  
M. Jünger ◽  
M. Hahn
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Clinical Stage ◽  
Clinical Signs ◽  
Cost Effective ◽  
Duplex Sonography ◽  
Foam Sclerotherapy ◽  
Average Loss ◽  
One Year ◽  
The Cost

Summary Objective: The goal of the study was to assess the effectiveness and patient tolerability of single-session, sonographically guided, transcatheter foam sclerotherapy and to evaluate its economic impact. Patients, methods: We treated 20 patients with a total of 22 varicoses of the great saphenous vein (GSV) in Hach stage III-IV, clinical stage C2-C5 and a mean GSV diameter of 9 mm (range: 7 to 13 mm). We used 10 ml 3% Aethoxysklerol®. Additional varicoses of the auxiliary veins of the GSV were sclerosed immediately afterwards. Results: The occlusion rate in the treated GSVs was 100% one week after therapy as demonstrated with duplex sonography. The cost of the procedure was 207.91 E including follow-up visit, with an average loss of working time of 0.6 days. After one year one patient showed clinical signs of recurrent varicosis in the GSV; duplex sonography showed reflux in the region of the saphenofemoral junction in a total of seven patients (32% of the treated GSVs). Conclusion: Transcatheter foam sclerotherapy of the GSV is a cost-effective, safe method of treating varicoses of GSV and broadens the spectrum of therapeutic options. Relapses can be re-treated inexpensively with sclerotherapy.

scholarly journals Cost-effectiveness and feasibility of conditional economic incentives and motivational interviewing to improve HIV health outcomes of adolescents living with HIV in Anambra State, Nigeria

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Obinna Ikechukwu Ekwunife ◽  
Chinelo Janefrances Ofomata ◽  
Charles Ebuka Okafor ◽  
Maureen Ugonwa Anetoh ◽  
Stephen Okorafor Kalu ◽  
...  
Keyword(s):  
Viral Load ◽  
Cost Effectiveness ◽  
Service Delivery ◽  
Motivational Interviewing ◽  
Cost Effective ◽  
Economic Incentives ◽  
Additional Patient ◽  
Incentive Scheme ◽  
The Cost ◽  
The Impact

Abstract Background In sub-Saharan Africa, there is increasing mortality and morbidity of adolescents due to poor linkage, retention in HIV care and adherence to antiretroviral therapy (ART). This is a result of limited adolescent-centred service delivery interventions. This cost-effectiveness and feasibility study were piggybacked on a cluster-randomized trial that assessed the impact of an adolescent-centred service delivery intervention. The service delivery intervention examined the impact of an incentive scheme consisting of conditional economic incentives and motivational interviewing on the health outcomes of adolescents living with HIV in Nigeria. Method A cost-effectiveness analysis from the healthcare provider’s perspective was performed to assess the cost per additional patient achieving undetected viral load through the proposed intervention. The cost-effectiveness of the incentive scheme over routine care was estimated using the incremental cost-effectiveness ratio (ICER), expressed as cost/patient who achieved an undetectable viral load. We performed a univariate sensitivity analysis to examine the effect of key parameters on the ICER. An in-depth interview was conducted on the healthcare personnel in the intervention arm to explore the feasibility of implementing the service delivery intervention in HIV treatment hospitals in Nigeria. Result The ICER of the Incentive Scheme intervention compared to routine care was US$1419 per additional patient with undetectable viral load. Going by the cost-effectiveness threshold of US$1137 per quality-adjusted life-years suggested by Woods et al., 2016, the intervention was not cost-effective. The sensitivity test showed that the intervention will be cost-effective if the frequency of CD4 count and viral load tests are reduced from quarterly to triannually. Healthcare professionals reported that patients’ acceptance of the intervention was very high. Conclusion The conditional economic incentives and motivational interviewing was not cost-effective, but can become cost-effective if the frequency of HIV quality of life indicator tests are performed 1–3 times per annum. Patients’ acceptance of the intervention was very high. However, healthcare professionals believed that sustaining the intervention may be difficult unless factors such as government commitment and healthcare provider diligence are duly addressed. Trial registration This trial is registered in the WHO International Clinical Trials Registry through the WHO International Registry Network (PACTR201806003040425).

scholarly journals Cost-Effectiveness of Investigations for Invasive Bladder Cancer

1987 ◽  
Vol 80 (3) ◽  
pp. 143-144 ◽  
Author(s):  
M T Hunt ◽  
C R J Woodhouse
Keyword(s):  
Transitional Cell ◽  
Clinical Signs ◽  
Cost Effective ◽  
Intravenous Urography ◽  
Liver Scan ◽  
Chest X Ray ◽  
Carcinoma Of The Bladder ◽  
Disseminated Disease ◽  
Positive Results ◽  
Diagnostic Investigations

The results of diagnostic and staging investigations in consecutive cases of invasive transitional cell carcinoma of the bladder are reviewed. Urine culture, urine cytology and intravenous urography had positive results in a high percentage of cases. As diagnostic investigations they are cost-effective but certainly do not remove the obligation to perform cystoscopy and examination under anaesthetic. Isotopic bone scan and liver scan showed metastases in 4 and one cases respectively and only when there were clinical signs of disseminated disease. Chest X-ray showed metastases in one case. These investigations are not cost-effective. Lymphangiography was positive in 12 of the 94 cases and, although expensive (£70), is still a staging investigation of value in planning treatment.

122 Bioactive Peptides for Enhancing Intestine Health

2021 ◽  
Vol 99 (Supplement_3) ◽  
pp. 65-65
Author(s):  
Julang Li ◽  
Nadeem Akhtar ◽  
Celina Osakowicz ◽  
Lauren Fletcher ◽  
Karmin O ◽  
...  
Keyword(s):  
Animal Health ◽  
Clinical Signs ◽  
Body Weight Loss ◽  
Cost Effective ◽  
Significant Rise ◽  
Feed Ratio ◽  
Resistant Bacteria ◽  
Intestinal Development ◽  
Antibiotic Resistant ◽  
Animal Trials

Abstract Intestinal disorders and colitis affect both animals and humans. The pathogenesis behind the inflammation is complex and not entirely understood. Furthermore, the significant rise in antibiotic-resistant bacteria has emphasized an urgent need for alternative anti-infective therapies. Antimicrobial peptides (AMPs) is one of the appealing alternative to antibiotics due to their antimicrobial activity, mode of actions, and potential role in tissue repair. Epidermal growth factor (EGF) plays an important role in intestinal proliferation and differentiation and thus promotes intestinal development. Using food grade microorganisms such as Lactococcus lactis and yeast as hosts, our laboratory has produced recombinant porcine protegrin-1 (PG-1), a pig originated antimicrobial peptide and EGF via fermentation. Oral administration of PG-1 reduced Citrobacter rodentium induced intestinal infection in mice. This was evidenced by reduced histopathological changes in the colon, prevention of body weight loss, milder clinical signs of disease, and ultimately more effective clearance of bacterial infection. On the other hand, animal trials using the recombinant EGF demonstrated that it enhances intestinal development and growth of early weaned pig fed with antibiotic-free diet. Moreover, piglets challenged with enterotoxigenic Escherchia coli (E. coli) K88 showed similar beneficial responses to EGF as those fed diets with antibiotic in terms of improving gain to feed ratio and lowering oxidative stress. Taken together, our findings suggest the potential for cost-effective production and application of recombinant bioactive proteins as alternatives to antibiotics in animal health and production.

scholarly journals Clinical case of hemolytic disease of the newborn with incompatibility of the blood of the mother and fetus in the “minor” erythrocyte antigen

2019 ◽  
Vol 6 (3) ◽  
pp. 77-82
Author(s):  
E. L. Krivosheina ◽  
T. S. Mikhailova
Keyword(s):  
Blood Cells ◽  
Clinical Observation ◽  
Clinical Signs ◽  
Low Frequency ◽  
Early Diagnostics ◽  
Hemolytic Disease ◽  
Adequate Treatment ◽  
Special Aspect ◽  
Nucleated Red Blood Cells ◽  
Erythrocyte Antigen

Presented a clinical observation of hemolytic disease of the newborn as a result of fetus immunization with low-frequency erythrocyte antigen (Lutheran). The special aspect of the case is the presence of hyperleukocytosis with evident regenerative shift of neutrophils to the left to singular blastic variants, thrombocytopenia, high reticulocytosis (more than 1000 ‰) and a great number of nucleated red blood cells (normoblasts) in the newborn’s hemogram. In myelogram a sharp expansion of erythroid sprout (90 %) and signs of dizerythropoiesis were determinded. Typical clinical signs and isoserological incompatibility of mother and fetus in erythrocyte antigen provided basis for early diagnostics and adequate treatment of hemolytic disease of the newborn.

scholarly journals Delayed splenic rupture and conservative management: case series

2021 ◽  
Vol 8 (11) ◽  
pp. 3407
Author(s):  
Marta A. Silva ◽  
Nídia Moreira ◽  
José Baião ◽  
Carlos E. Costa Almeida
Keyword(s):  
Conservative Management ◽  
Splenic Injury ◽  
Clinical Observation ◽  
Splenic Rupture ◽  
Clinical Signs ◽  
Case Series ◽  
Emergency Rooms ◽  
Abdominal Injuries ◽  
Hemodynamic Stability ◽  
Delayed Splenic Rupture

Splenic injury is frequent in patients with abdominal trauma and delayed splenic rupture yields a poorer prognosis. Patients with hemodynamic stability, despite the grade of splenic anatomical injury, can be safely treated by conservative management (observation or angiography/angioembolization), if no other intra-abdominal injuries are found and a multidisciplinary team (surgeons, interventional radiologists) is available. The conservative approach is an alternative to surgery and its possible complications. In this case series, the authors present three trauma cases very commonly seen in emergency rooms, in whom delayed splenic rupture was diagnosed. All three patients were submitted to conservative management, with no need for surgery or complications.  This case series presents some common clinical signs and diagnostic steps, also showing the safety and efficacy of clinical observation in this setting.

STUDY OF ABSOLUTE, IMMATURE NEUTROPHIL COUNT AND CRP AS DIAGNOSTIC MARKERS FOR EARLY ONSET NEONATAL SEPSIS.

2021 ◽  
pp. 25-26
Author(s):  
Pooja Poswal ◽  
Manisha Rohilla ◽  
Sunil Arora ◽  
Irbinder Kour Bali
Keyword(s):  
Blood Culture ◽  
Neutrophil Count ◽  
Neonatal Sepsis ◽  
Hematological Parameters ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms

Introduction: Neonatal Sepsis is difcult to differentiate from other conditions due to non- specic clinical signs and symptoms. Inammation in neonates shows variations in hematological parameters. Our study is to evaluate the hematological parameters and C-reactive protein estimation in neonatal sepsis for early diagnosis. Material And Methods: It was a cross-sectional study including 80 neonates admitted in the neonatal care unit, 40 (proven sepsis) and 40 probable cases); blood culture being the gold standard. Hematological parameters, immature to total neutrophil ratio (I/T ratio), Absolute neutrophil count (ANC), CRP and Blood culture were done as per standard protocols. Results: ANC had highest sensitivity of 90% followed by I/T ratio (87.5%) and CRP (77.5%). The sensitivity and specicity for the combination of ANC and I/T ratio was 78.3% and 83.6% respectively. Conclusion: ANC, I/T Ratio and CRP are quick, simple and cost-effective routine laboratory tests which help in neonatal sepsis prediction and to start proper and timely antibiotic therapy.

scholarly journals Global lateral preference inventory

2011 ◽  
Vol 6 (3) ◽  
pp. 14-23 ◽  
Author(s):  
Everton de A. Marim ◽  
Regina Lafasse ◽  
Victor H. A. Okazaki
Keyword(s):  
Motor Behavior ◽  
Hand Preference ◽  
Self Assessment ◽  
Lateral Preference ◽  
Eye Preference ◽  
Quantitative Manner ◽  
Different Dimensions ◽  
Preference Inventory ◽  
Diagnostic Applications

This study developed and validated the contents of an inventory of global lateral preference (IPLAG) that can be applied as self-assessment which included representing everyday tasks and different dimensions of laterality, such as (a) hand preference, (b) foot preference, (c) trunk preference, (d) eye preference, and (e) ear preference. To validate the IPLAG, it was referred for evaluation of content by professional doctors in the area of Motor Behavior in Brazil. It was analyzed the coherence of the task with the lateral dimension proposed, the understanding of the statement in the proposed task, suggestions for modification in the description of the proposed tasks, also allowing the reviewers to suggest other tasks for the inventory, and other suggestions for the inventory improvement. The analysis of the suggestions from the reviewers was held in a quantitative manner, using absolute and relative frequency of the notes supplied by the evaluators, and qualitatively by a Likert scale established in the instrument provided to reviewers. Evaluators’ analyses pointed to the quality of IPLAG as a feature for assessing global lateral preference. Therefore, the IPLAG may be an interesting feature for research and practical diagnostic applications related to the different manifestations of human laterality.

scholarly journals Mycophenolate Mofetil and Clostridium difficile-associated Colitis

2021 ◽  
Vol 31 (4) ◽  
pp. 64-69
Author(s):  
A. I. Dolgushina ◽  
A. A. Selyanina ◽  
E. A. Mezenceva ◽  
A. G. Vasilenko ◽  
L. I. Pozdeeva ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Clostridium Difficile ◽  
Clinical Observation ◽  
Clinical Signs ◽  
Diagnostic Algorithm ◽  
Graft Versus Host ◽  
Key Points ◽  
History Of ◽  
Related Donor

Aim. A clinical observation of colitis conditioned by mycophenolate mofetil intake and concomitant Clostridium difficile-associated disease.Key points. Mycophenolate mofetil (MMF) is an active immunosuppressant with side effects affecting gastrointestinal tract (GIT). A 37-yo male patient with type 1 diabetes mellitus was admitted at a gastroenterology unit with clinical signs of diarrhoea with haematochezia. A history of diabetic nephropathy and related-donor pre-dialysis kidney transplantation in 2012, since when MMF intake was 2000 mg daily. Catarrhal ulcerative colitis in colonoscopy, C. difficile toxins in pathogen stool panel. Ulcerative, ischaemic colitises and the graft-versus-host disease were ruled out in examination. A positive clinical and endoscopic trend was observed upon MMF withdrawn and start of vancomycin.Conclusion. The case presented illustrates the clinical picture and diagnostic algorithm in MMF-associated colitis. The case-distinctive is association with C. difficile infection.

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