EFFECT OF EXERCISE ON EARLY REHABILITATION OF PATIENTS WITH NEUROLOGICAL DISORDERS

ABSTRACT Introduction: Acute cerebral infarction refers to the deficiency of the blood supply to the brain and the damage of tissue function. Objective: To study the effect of exercise training in early rehabilitation of patients with hemiplegia treated in the neurology department. Methods: Ninety-six patients with acute cerebral infarction hemiplegia were studied. According to the order of admission, 96 patients were divided into a control group and an early recovery group, with 48 patients in each group. Results: Before early rehabilitation, there was no statistical significance in NIHSS and FUGL-Meyer scores between the two groups (P > 0.05). After early rehabilitation,the NIHSS score of early rehabilitation group was lower than both its pre-early-rehab score and the control group score, while the FUGL-Meyer score was higher than both its pre-early-rehab and the control group score (P<0.05). Before early rehabilitation, there was no significant difference in the GQOLI-74 score between the two groups (P > 0.05). After early rehabilitation, the GQOLI-74 score was higher in the early rehabilitation group than both its pre-early-rehab score and the control group score (P<0.05). Conclusions: The clinical effect of early rehabilitation training in acute cerebral infarction patients with hemiplegia is significant and can further improve the clinical treatment of patients and their quality of life. Level of evidence II; Therapeutic studies - investigation of treatment results.

Utilizing Pulmonary Function Parameters to Predict Dysphagia in Individuals With Cervical Spinal Cord Injuries

Objective To utilize pulmonary function parameters as predictive factors for dysphagia in individuals with cervical spinal cord injuries (CSCIs).Methods Medical records of 78 individuals with CSCIs were retrospectively reviewed. The pulmonary function was evaluated using spirometry and peak flow meter, whereas the swallowing function was assessed using a videofluoroscopic swallowing study. Participants were divided into the non-penetration-aspiration group (score 1 on the Penetration-Aspiration Scale [PAS]) and penetration-aspiration group (scores 2–8 on the PAS). Individuals with pharyngeal residue grade scores >1 were included in the pharyngeal residue group.Results The mean age was significantly higher in the penetration-aspiration and pharyngeal residue groups. In this study, individuals with clinical features, such as advanced age, history of tracheostomy, anterior surgical approach, and higher neurological level of injury, had significantly more penetration-aspiration or pharyngeal residue. Individuals in the penetration-aspiration group had significantly lower peak cough flow (PCF) levels. Individuals in the pharyngeal residue group had a significantly lower forced expiratory volume in 1 second (FEV1). According to the receiver operating characteristic curve analysis of PCF and FEV1 on the PAS, the cutoff value was 140 L/min and 37.5% of the predicted value, respectively.Conclusion Low PCF and FEV1 values may predict the risk of dysphagia in individuals with CSCIs. In these individuals, active evaluation of swallowing is recommended to confirm dysphagia.

The influence of Mediterranean diet in acne pathogenesis and the correlation with insulin-like growth factor-1 serum levels: implications and results

Acne is a chronic inflammatory disease of the pilosebaceous unit and its etiology is complex and multifactorial. The role of the diet in its pathogenesis is still debated. The purpose of this study was to assess the association between MD and IGF-1 in acne patients and, as secondary objective, the role of systemic treatment on IGF-1 serum levels, in accordance to the patients’ diet. This study included 35 patients aged 14-30 years affected by acne and treated in line with the EDF guidelines. Patients were divided into 2 groups based on a questionnaire score assessing the adherence to the Mediterranean diet: the Mediterranean Group (score ≥ 6) and the Western Group (score < 5). IGF-1 serum levels were measured in all patients before and after treatment and then compared to healthy population. IGF-1 levels were higher in patients than in controls and in the Western group than in the Mediterranean group. We speculate that the Mediterranean diet can have a protective role in the pathogenesis of acne by acting on the systemic route of IGF-1.

STUDY OF CORRELATION OF INFLAMMATORY CELL INFILTERATION SCORE WITH TUMOR GRADE, NODAL STATUS, ER, PR, HER-2 NEU STATUS IN PATIENTS OF STAGE 2 AND 3 BREAST CANCER IN A TERTIARY CENTER, KOLKATA

Breast Cancer is the most common cancer in women in India and constitute one–third of women’s cancers and is second reason of mortality after lung carcinoma.[1] It is the most commonly diagnosed malignancy in most cities in India, and 2nd most common cancer in females in the rural areas. As the disease burden and mortality rate is very high, evaluation of several parameters that influence survival rates among women with breast cancer may help design early detection, predict the prognosis and frame a suitable line of treatment.[2] The link between inflammation and cancer was first suggested in 1863.[3] Chronic inflammation is known to increase the risk of cancer development, such as colon cancer in inflammatory bowel diseases.[4] There is good evidence that the development of cancer and its progression are dependent on a complex interaction of the tumour and the host inflammatory response.[5] Aim: This study aims to correlate the relation of inflammatory cell infilteration with tumour staging, nodal status, ER, PR, HER-2 NEU status of breast cancer. Material and Method: The proposed study was a cross sectional study with mostly prospective observation and with some retrospective observation, included 74 patients of stage II and stage III breast carcinoma who underwent MRM in Cancer Institute from 2017-2018. The various clinical and histopathological prognostic parameters along with inflammatory cell infilterate score in invasive breast carcinoma patients were studied and correlated. The inflammatory cell infilterates was assessed according to Klintrup-Makinen (K-M) criteria. It is scored on 4 point scale where score 0 defined no increase in inflammatory cell infilterate, score 1 defined as mild or patchy increase ,score 2 denoted as prominent inflammatory response with some cancer cell destruction and score 3 as florid cup like response. Further it is classified as low group score (score 0-1)and high group score (score 2-3) .[6] Result: There was significant association between inflammatory cell infiltrate score and grade of tumor (p=0.0005) (TABLE 1) .58.1% ,54.1% and 37.8% of the cases were ER, PR and Her-2/neu positive respectively. ER negative tumors (74.19%) were showing statistically significant (p= 0.01) association with high inflammatory cell infilterate score (ie. Score 2 and 3). Similarly PR negative tumors (64.7%) were showing statistically significant association (p= 0.04) with high inflammatory cell infilterate score. No such correlation was found between between HER-2 /NEU status and nodal involvement with inflammatory cell infilterate score (TABLE 3). Keywords: Breast cancer, Invasive ductal carcinoma, ER , PR , HER-2/Neu ,grade of tumor, Nodal status, inflammatory cell infilterate score.

23. Development and Validation of a Risk Score for Post-transplant Lymphoproliferative Disorders among Solid Organ Transplant Recipients

Background Post-transplant lymphoproliferative disease (PTLD) is a well-recognized complication after transplant. This study aimed to develop and independently validate a risk score to predict PTLD among solid organ transplant (SOT) recipients (kidney, liver, lung and heart). Methods Poisson regression identified predictors of PTLD with the best fitting model selected for the risk score, where each predictor contributed with a risk coefficient to the risk score, dividing patients in high vs low risk of having a PTLD. Results For both cohorts, most of the patients were male, aged more than 16 years old, kidney recipients and with a low-risk pre-transplant Epstein-Barr Virus (EBV) IgG donor/recipient serostatus. The derivation cohort consisted of 2546 SOT transplanted at Rigshospitalet, Copenhagen between 2004-2019; 57 developed PTLD. Predictors of PTLD were high-risk pre-transplant Epstein-Barr Virus (EBV) IgG donor/recipient serostatus, and current plasma EBV DNA positive, abnormal hemoglobin and C-reactive protein levels. A positive EBV DNA was the strongest parameter for the PTLD risk score (figure 1), although the model was able to predict the risk of PTLD cases in both EBV positive and EBV negative individuals. Individuals in the high-risk group had almost 7 times higher incidence of PTLD compared to the low risk group (table 1). In the validation cohort of 1611 SOT recipients between 2008-2018 from University Hospital of Zürich, 24 developed PTLD. A similar seven times higher risk of PTLD was observed in the high-risk group compared to the low risk group (table 1). The discriminatory ability was also similar in derivation (Harrell’s C-statistic of 0.82 95%CI (0.76-0.88) and validation (0.82, 95% CI:0.72-0.92) cohorts. An explanation about how the risk for PTLD is calculated for the SOT recipients; in this example the risk of developing PTLD is calculated in the next 180 days Performance of the PTLD score in the derivation and validation cohorts (low-risk group: score&lt;=17 points; high-risk group: score&gt;17 points) Conclusion The risk score had a good discriminatory ability in both cohorts and helped to identify patients with higher risk of developing PTLD, so they can be monitored more often. This is the first risk-score developed and externally validated to predict risk of PTLD among SOT recipients. Disclosures All Authors: No reported disclosures

Can We Enhance Statistical Learning? Exploring Statistical Learning Improvement in Children with Vocabulary Delay

Objectives: If statistical learning ability is critical for language acquisition and language development, it is necessary to confirm whether enhancing statistical learning ability can improve the children’s language skills. The present study investigated whether children with and without vocabulary delay (VD) show a difference in improving statistical learning (SL) tasks manipulated with implicit, implicit*2 and explicit conditions, and with visual and auditory domains; and also explores the relationship among SL, vocabulary, and quick incidental learning (QUIL).Methods: A total of 132 children between 3 to 8 years participated in this study, including vocabulary delayed children (N= 34) and typically developing children (N = 98). Participants completed SL tasks which were composed of three exposure conditions, and Quick incidental learning (QUIL) tasks to tap the novel word learning ability.Results: The VD group score was significantly lower than the TD group in the explicit condition of the auditory statistical learning task, and there was a significant correlation between QUIL and SL_auditory (implicit*2) only in the TD group.Conclusion: These results may explain that the TD group was ready to accept the explicit cues for learning as a domain-specific (auditory) benefit, and their auditory SL ability can be closely linked to vocabulary abilities. The current study suggests one possibility; that the VD group can increase the statistical learning ability through double auditory exposures. The novel quick incidental learning in the TD group was supported by the statistical learning, but this was not seen in the VD group.

Does the choice of response time threshold procedure substantially affect inferences concerning the identification and exclusion of rapid guessing responses? A meta-analysis

Background In testing contexts that are predominately concerned with power, rapid guessing (RG) has the potential to undermine the validity of inferences made from educational assessments, as such responses are unreflective of the knowledge, skills, and abilities assessed. Given this concern, practitioners/researchers have utilized a multitude of response time threshold procedures that classify RG responses in these contexts based on either the use of no empirical data (e.g., an arbitrary time limit), response time distributions, and the combination of response time and accuracy information. As there is little understanding of how these procedures compare to each other, this meta-analysis sought to investigate whether threshold typology is related to differences in descriptive, measurement property, and performance outcomes in these contexts. Methods Studies were sampled that: (a) employed two or more response time (RT) threshold procedures to identify and exclude RG responses on the same computer-administered low-stakes power test; and (b) evaluated differences between procedures on the proportion of RG responses and responders, measurement properties, and test performance. Results Based on as many as 86 effect sizes, our findings indicated non-negligible differences between RT threshold procedures in the proportion of RG responses and responders. The largest differences for these outcomes were observed between procedures using no empirical data and those relying on response time and accuracy information. However, these differences were not related to variability in aggregate-level measurement properties and test performance. Conclusions When filtering RG responses to improve inferences concerning item properties and group score outcomes, the actual threshold procedure chosen may be of less importance than the act of identifying such deleterious responses. However, given the conservative nature of RT thresholds that use no empirical data, practitioners may look to avoid the use of these procedures when making inferences at the individual-level, given their potential for underclassifying RG.

Utilizing diabetes mellitus risk assessment tool in screening of hemodialysis patients at risk of diabetes mellitus

Background: Hamad General Hospital is the main provider of hemodialysis (HD) in Qatar, for approximately 650 patients per year. Over 60% of these patients have Diabetes Mellitus (DM) and 55% of them suffer from end stage renal disease (ESRD). 2% of ESRD patients develop DM after their first year of dialysis. The aims of this quality improvement study were early DM detection, risk factors modifications, and reduction of diabetes complications in our patients. Methods: A risk assessment tool was adapted to identify the risk level of HD patients to develop DM. They were screened to determine their risk score across 8 categories. Six categories (gender, history of gestational diabetes, family history of high blood pressure, diabetes, physical activity and smoking) were scored 0 to 1, age was scored 0 to 3, and relationship between weight and height scored 1 to 3. (Overall score range: 1-12). Patients were classified into two groups: a low-risk group (score < 5) and a high-risk group (score ≥ 5). Patients were referred to different medical specialties for further management according to the risk factor and a lifestyle modification management plan was set individually. Results: 189 non-diabetic dialysis patients were screened in the first quarter of 2020, their mean age was 51 years-old, and 69% were male. Forty-three percent of patients were found to be at high risk of developing DM. The most important risk factors were family history (55%), obesity (40%), age >60 years (32%), low physical activity (14%), and smoking (11%). Thirty-seven percent of patients were referred to the obesity clinic, 10% to the smoking cessation clinic, 5% to physiotherapy, and 100% of patients were referred to the multidisciplinary care. Conclusion: Screening for diabetes is pivotal for early detection and risk factor modification in dialysis patients. We recommend quarterly data assessment and evaluation so patients can be managed according to the findings.

Robotic enucleation of a biliary adenofibroma

A 69-year-old man was referred to the hepatobiliary surgeons for mild enlargement of an asymptomatic cystic liver lesion found on routine screening in 2017 that measured 3.7×3.6×4.3 cm. Work-up with MRI revealed a complex multilocular cyst that had enlarged to 6.6×5.5×4.6 cm. Other work-up was unremarkable. He had a Eastern Cooperative Oncology Group score of 1; therefore, a surgical excision was planned due to the possibility for malignancy. A robotic approach with enucleation of the lesion was undertaken, with plans for return for a wider resection if pathological examination revealed malignancy. The lesion was noted to be a biliary adenofibroma, an exceptionally rare lesion that is thought to be benign, but requires excision due to potential malignant degeneration. The patient was discharged home the following day and has had minimal pain in his postoperative course.

Relevansi dan Efektivitas Metode Resitasi Dalam Meningkatkan Prestasi Belajar Siswa

This study aims to determine the relevance and effectiveness of implementing the recitation method in improving student achievement. This research is directed to answer two problems: the relevance and effectiveness of the recitation method in learning Akidah Akhlaq subjects. Classroom Action Research with a quantitative research approach is used in the research method where data collection uses research measuring instruments (instruments). Data analysis is quantitative/statistical, aiming to test and prove the hypotheses that have been made/set. The data analysis technique used in this study was carried out in several stages, namely: a) data reduction, b) data presentation and c) conclusion drawing, data analysis in research using SPSS (Product Moment). The recitation method was applied to the subjects of Aqidah Akhlak grade 5. The conclusions followed the study results with the acquisition of scores and percentages: Cognitive score acquisition in cycle-1: 85.88 in cycle-2: 87.06, which means up: 1.18. the acquisition of affective values ​​in cycle-1: 89.41 in cycle-2:89,26. It means down: 0.15. The group score in the first cycle: 86.47 in the second cycle 89.41. It means up: 0.99. The acquisition of psychomotor scores in cycle-1: 90.69 in cycle-2 90.69. It means fixed. The average score (average) in cycle-1: 88.11 in cycle-2: 89.11 means that the value increases by: 0.99. The research analysis results can be concluded that the recitation method in Akidah Akhlaq subjects is relevant and effective in improving student achievement.