Factors affecting the health-promoting behavior of thyroid cancer survivors: comparison by stage of cancer survivorship

Purpose The purpose of this study was to identify differences in factors affecting health-promoting behaviors according to the survival stage of thyroid cancer survivors. Methods This descriptive cross-sectional study analyzed data from 354 thyroid cancer survivors after diagnosis. The survivors were divided into three stages: (1) the acute stage (< 2 years after diagnosis), (2) extended stage (2–5 years after diagnosis), and (3) permanent stage (≥ 5 years after diagnosis). To measure health-promoting behavior, the revised Korean version of the Health Promoting Lifestyle Profile questionnaires was used. The factors affecting the health-promoting behavior included social support, self-efficacy, fear of recurrence, and symptoms. Multiple regression analysis was used to analyze factors affecting the health-promoting behavior according to survival stage. Result The factors affecting the health-promoting behavior of thyroid cancer survivors differed by survival stage. In the acute stage, the factors of health-promoting behavior were self-efficacy (t = 4.76, p < .001) and social support (t = 3.54, p < .001). In the extended stage, symptoms (t = − 3.65, p < .001), social support (t = 2.61, p = .011), fear of recurrence (t = 2.18, p = .032), and receipt of radioiodine treatment (t = − 2.18, p = .032) were found to be significant variables that affected health-promoting behaviors. In the permanent stage, social support (t = 2.79, p = .007), receipt of radioiodine treatment (t = − 3.21, p = .002), and age (t = − 2.77, p = .007) were significant variables that affected health-promoting behaviors. Conclusion The experience of thyroid cancer survivors varies as they progress through the survival stages; thus, health-promotion interventions should be tailored to each survival stage.

Efficacy of arterial spin labeling for detection of the ruptured micro-arteriovenous malformation: illustrative cases

BACKGROUND Diagnosis of a microarteriovenous malformation (micro-AVM) is difficult, especially in the acute stage of rupture because of the small size of the nidus and the existence of hematoma. We report two cases of ruptured micro-AVMs detected by arterial spin labeling (ASL). OBSERVATIONS In one case, a 45-year-old male was transported with a complaint of right hemiparesis. Computed tomography (CT) revealed a right parietal lobar hemorrhage. Standard magnetic resonance imaging (MRI) showed no abnormal findings as the cause of the hemorrhage. ASL 23 days after the onset demonstrated high signals on the medial wall of the hematoma. Digital subtraction angiography (DSA) showed a micro-AVM in accordance with the site of high signals on ASL. In another case, a 38-year-old female was transported with a complaint of left hemianopsia. CT on admission revealed a right parietal lobar hemorrhage. Standard MRI showed no abnormal findings as the cause of the hemorrhage. ASL 15 days after the onset demonstrated high signals on the internal wall of the hematoma. DSA showed micro-AVM in accordance with the site of high signaling on ASL. Both cases were successfully treated with open surgery. LESSONS ASL can manifest micro-AVMs as high signals within the hematoma. ASL is a useful less-invasive screening tool for the detection of ruptured micro-AVMs.

Case Report : Mr. I 56 years old with Stroke Non Hemoragic

Stroke is one of the most common diseases that cause functional impairment and disability. Stroke is the second leading cause of death and the leading cause of disability worldwide. Its incidence is increasing as the population ages. In addition, more young people have strokes in low- and middle-income countries. Data in Indonesia shows that stroke is the third most common cause of death, followed by diabetes mellitus and hypertension with a mortality rate of 138,268 people or 9.7% of the total deaths. Indonesia has a double burden in dealing with health problems. Lacunar strokes, a type of ischemic stroke, are small and located in non-cortical areas. Lacunar infarctions are caused by occlusion of small branches penetrating within the cerebral vessels of the circle of Willis, including branches of the middle cerebral artery, anterior cerebral artery, posterior cerebral artery, or spinal cord. basilar artery. The principle of treatment for acute lacunar stroke is very similar to that of acute ischemic stroke. The initial goals of acute stage treatment are to ensure medical stability and determine candidacy for thrombolysis. Tissue plasminogen activator (TPA) improves outcomes for patients with ischemic stroke. Once intracerebral hemorrhage has been ruled out, intravenous thrombolysis is an important step in treatment. Acute lacunar infarction is efficiently treated with TPA. This case report discusses a 56 year old Mr I diagnosed with a non-hemorrhagic stroke.

A Comprehensive Overview of Broca’s Aphasia after Ischemic Stroke

Aphasia denotes an acquired central disorder of language, which alters patient’s ability of understanding and/or producing spoken and written language. The main cause of aphasia is represented by ischemic stroke. The language disturbances are frequently combined into aphasic syndromes, contained in different vascular syndromes, which may suffer evolution/involution in the acute stage of ischemic stroke. The main determining factor of the vascular aphasia’s form is the infarct location. Broca’s aphasia is a non-fluent aphasia, comprising a wide range of symptoms (articulatory disturbances, paraphasias, agrammatism, anomia, and discrete comprehension disorders of spoken and written language) and is considered the third most common form of acute vascular aphasia, after global and Wernicke’s aphasia. It is caused by a lesion situated in the dominant cerebral hemisphere (the left one in right-handed persons), in those cortical regions vascularized by the superior division of the left middle cerebral artery (Broca’s area, the rolandic operculum, the insular cortex, subjacent white matter, centrum semiovale, the caudate nucleus head, the putamen, and the periventricular areas). The role of this chapter is to present the most important acquirements in the field of language and neurologic examination, diagnosis, and therapy of the patient with Broca’s aphasia secondary to ischemic stroke.

Dynamics of morphological manifestations of the experimental acute aspiration bronchopneumonia development.

Background. Currently, there is a need to create an experimental model for reproducing the main pathogenetic mechanisms of COVID-associated lungs damage. The first stage of such a model may be reproducing acute aspiration bronchopneumonia in rats. Objective. Examine the dynamics of morphological changes in the lungs in the development of experimental acute aspiration bronchopneumonia. Methods. The group of laboratory Wistar rats (n=25) in compliance with bioethical norms under typoental anesthesia was carried out operational intervention with the introduction of a sterile capron thread 2.5 cm long and a thickness of 0.2 mm to a depth of 2.5 cm. In the control group included 5 false-controlled animals. At 7, 14, 21, 28 and 56 days, the animals were derived from the experiment, morphological studies were carried out with the painting serial sections with hematoxylin-eosin. Results. On the 7 day, the morphological picture testified to the development of the acute stage of exudative inflammation with the full-blood of vessels, microtrombosis, dyslectasis, hyperplasia of alveolocytes II type. After 14 days, the proliferative stage was formed with alveolocytes hyperplasia, the epithelium of bronchi, as well as fibroblasts with the formation of sharp peribronchial and alveolar abscesses. After 21 days, the development of the lungs fibrosis with the organization of acute peribronchial and alveolar abscesses was noted, peribronchial and intraalveoli pronounced interstitial edema and the reactive hyperplasia of lymphoid follicles of a mixed nature. After 28 days, bronchopneumonia was organized in the form of fibrosis parenchyma, sections of chronic productive inflammation with the formation of resorbative granuloms; sections of the blood vessels hyalinose. For 56 days, these phenomena were progressed before the development of dense fibrosis (carnification) with sections of chronic abscesses with a formed by a connective tissue capsule, the development of vascular hyalinose. Conclusion. Thus, the model of acute aspiration bronchopneumonia reproduces the dynamics of morphological manifestations of acute lung damage, which is the basis for the development of pathogenetic therapy fields.

Toxoplasma gondii GRA15 DNA Vaccine with a Liposomal Nanocarrier Composed of an SS-Cleavable and pH-Activated Lipid-like Material Induces Protective Immunity against Toxoplasmosis in Mice

Toxoplasma gondii affects the health of humans and livestock and causes severe illness in the fetus and immunocompromised individuals. Because of the high incidence and severe consequences of T. gondii infection, a safe and suitable vaccine is needed. We found that lipid nanoparticles (LNPs) consisting of a series of functional materials prepared with vitamin E, such as SS-cleavable and pH-activated lipid-like materials (ssPalmE), were a safe and efficient way to develop next-generation DNA vaccines. In this study, we prepared ssPalmE-LNP to encapsulate pCpG-free-T. gondii dense granule protein 15 DNA (ssPalmE-LNPTgGRA15). Following a challenge infection with avirulent PLK strain of T. gondii, the mice immunized with ssPalmE-LNPTgGRA15 had a significantly higher survival rate and lower clinical scores compared with unimmunized and ssPalmE-LNPnon-coding-immunized mice. Immunization of mice with the ssPalmE-LNPTgGRA15 led to a significantly higher production of specific IgG1 and IG2c antibodies compared with unimmunized and ssPalmE-LNPnon-coding-immunized mice, while there was no statistically significant difference in the concentration of serum interferon-gamma at the acute stage of the infection. These findings indicate that ssPalmE-LNP is an effective cargo for the transportation of DNA vaccines for protozoan infections. To explore the mechanism of protective immunity induced by ssPalmE-LNPTgGRA15, further immunological study is needed in the future.

Promising Applications of Nanotechnology in Cancer Diagnostics and Therapeutics

: Cancer is characterized by the accumulation of genetic mutations in cells by different types of mutagens such as physical, chemical, and biological. Consequently, normal cell cycles get interrupted. Conventional techniques used for diagnosis include. Various conventional techniques used for cancer diagnosis include immunological assays, histopathogical tests, polymerase chain reaction, computed tomography, magnetic resonance, radiation therapy, and many more. These techniques are expensive, time consuming, tedious, adverse effects to healthy cells and requirement of skilled personnel for their operation. Therefore nanomaterials based biosensors have been used for the sensitive, selective, economic and quick detection of cancer biomarkers. Electrochemical biosensors have shown profound impact in efficient diagnosis of cancers that facilitate the effective treatment of patient in acute stage. Nanomaterials including inorganic, organic and polymeric nanomaterials have been used in the treatment of different types of cancers. Nanoapproaches have offered several merits including site-specific, require traces amount of therapeutic molecules, limited toxicity, avoid drug resistance, more efficient, sensitive and reliable than conventional chemotherapeutics and radiation therapies. Therefore, future research should be focussed on development of highly inventive nanotools for the diagnosis and therapeutics of cancers.

Transient Global Cerebral Hypoperfusion as a Characteristic Cerebral Hemodynamic Pattern in the Acute Stage after Combined Revascularization Surgery for Pediatric Moyamoya Disease: N-Isopropyl-P-[123I] Iodoamphetamine Single-Photon Emission Computed Tomography Study

<b><i>Introduction:</i></b> Surgical revascularization prevents cerebral ischemic attack by improving cerebral blood flow (CBF) in both adult and pediatric patients with moyamoya disease (MMD). Uneven hemodynamic changes, including local cerebral hyperperfusion and remote ischemia, can cause delayed intracerebral hemorrhage and perioperative infarctions in adult MMD patients, but the characteristic hemodynamic pattern among pediatric MMD patients after revascularization surgery is poorly understood. <b><i>Methods:</i></b> This study included 16 consecutive pediatric MMD patients (age, 6–16 years; mean age, 11.3) undergoing superficial temporal artery-middle cerebral artery anastomosis combined with encephalo-duro-myo-synangiosis on 21 affected hemispheres. Perioperative management was conducted by aspirin administration and strict blood pressure control (110–130 mm Hg). We prospectively performed N-isopropyl-p-[¹²³I] iodoamphetamine single-photon emission computed tomography on postoperative days (POD) 1 and 7 and analyzed the temporal changes in perioperative hemodynamics. <b><i>Results:</i></b> Four patients (19.0%, 4/21) exhibited immediate CBF improvement from POD 1, which was classified as “immediate redistribution pattern.” In contrast, 9 (42.9%, 9/21) demonstrated transient hemispheric global hypoperfusion at POD 1 and subsequent CBF improvement at POD 7, which was defined as “transient hypoperfusion pattern.” Although 8 patients, including 4 with “transient hypoperfusion pattern” (44.4, 4/9), developed mild transient neurological deterioration in the acute stage, it resolved in all 21 patients, and there were no permanent neurological deficits. <b><i>Discussion/Conclusions:</i></b> This study revealed that the “transient hypoperfusion pattern” after revascularization surgery is relatively common among pediatric MMD patients, and its outcome is favorable under strict perioperative management.

Change in hippocampal volume in children with febrile seizure at different periods

Background This study aimed to investigate the change of hippocampal volume in children at different periods after febrile seizure. Methods MRI of the brain was performed in 60 children with febrile seizure (30 patients with simple febrile seizure and 30 patients with prolonged febrile seizure) and in 30 healthy children. The volume of the hippocampus was tested and compared at different periods after febrile seizure. Results The volumes of hippocampus in the two febrile seizure groups increased compared with that of the control group in acute period after seizure. There was no obvious difference in hippocampal volume between the simple febrile seizure group and the prolonged febrile seizure group in the acute or chronic period after seizure. The average annual growth of hippocampal volume in the simple febrile seizure group was greater than that in the prolonged febrile seizure group. Conclusions Febrile seizure can affect hippocampus volume in the acute stage of convulsion. Prolonged febrile seizure affects hippocampus development with aging.

Assessing lexical-semantic naming deficits using an automated machine learning approach

After left hemisphere stroke, 20-50% of people experience language deficits, including difficulties in naming. Naming errors that are semantically related to the intended target (e.g., producing “violin” for picture HARP) indicate a potential impairment in accessing knowledge of word forms and their meanings. Understanding the cause of naming impairments is crucial to better modeling of language production as well as for tailoring individualized rehabilitation. However, evaluation of naming errors is typically by subjective and laborious dichotomous classification. As a result, these evaluations do not capture the degree of semantic similarity and are susceptible to lower inter-rater reliability because of subjectivity. We investigated whether a computational linguistic measure, word2vec (Mikolov, Chen, Corrado, &amp; Dean, 2013) addressed these limitations by evaluating errors during object naming in a group of patients during the acute stage of a left-hemisphere stroke (N=105). Pearson correlations demonstrated excellent convergent validity of word2vec’s semantically related estimates of naming errors and independent tests of access to lexical-semantic knowledge (p’s &lt; .0001). Further, multiple regression analysis showed word2vec’s semantically related estimates were significantly better than human error classification at predicting performance on tests of lexical-semantic knowledge (p &lt; .001). Useful to both theorists and clinicians, word2vec provides an automated, continuous, and objective psychometric measure of access to lexical-semantic knowledge during naming.