COVID-19 and Dementia: A Review and Synthesis of Material on a Deadly Combination

Within modern history, the majority of the worldwide population has not experienced pandemic conditions, and not in recent history has a global pandemic occurred. Arguably therefore we were not prepared for, and did not anticipate, some of its effects, with emerging evidence indicating that this was particularly the case with respect to dementia care. The aim of this paper is to highlight some of the issues raised by COVID-19 surrounding dementia care, focusing on issues experienced both by individuals living with dementia and by those who provide their care. This is in response to the need to raise awareness of this issue and we do so by bringing this information together in order that it might inform policy for ongoing care post-virus and future outbreaks and lockdown situations. While there is a marked need to change the current tactics being used in the treatment and care of preexisting and longstanding illnesses, like dementia, there is also a need to take into account the safety procedures necessary to prevent potential exposure to COVID-19. Through the targeted exploration of these considerations, there is a hope that documentation of these actions can both facilitate current treatment and care efforts and approaches and provide a framework for future efforts, should another pandemic situation arise in the near future.

Incidence of Burns Caused by Epileptic Crisis in Paraguay

Objectives: The present study was initiated in order to evaluate the epileptic crisis as causes of serious burns that merit an admission to hospital. Methodology: This is a retrospective descriptive study based on information on admission reports and medical records of patients who met the inclusion criteria to be enrolled in the present investigation. The Institution studied was the Public Hospital Specialized in Burns, in Asuncion City, Republic of Paraguay, South America. Results: From 937 adult patients admitted in the National Centre of Burns in Paraguay during the study period, in only 35 of them their burns were due to epileptic seizures, which represent 3.73% of all admissions. The average age of those affected was 40 ± 16.5 years. 62.86% of the patients were female and 65.71% of those affected came from rural areas where to heat homes and to cook food braziers are used. Education and prevention campaigns to reduce burn injuries in people with seizure disorders may help to minimize the incidence of these cases.

Developing Person-Centered, Interactive, Systematic, Effective Rehabilitation (PISER) for Persons with Parkinson’s - The Outcomes of a Pilot Intervention

Aim: To describe the development and outcomes of a rehabilitation intervention for persons with Parkinson’s and their near-ones. Material and methods: Customer-understanding-based intervention development; and a pilot study: a random sample of persons with PD (n=18) and their near-ones (n=7) were divided into subgroups: Persons with PD, Gym rehabilitation; Persons with PD, Home rehabilitation; Near-ones, Gym rehabilitation; Near-ones, Home rehabilitation. Data included clinical measurements, scores from a PDQ-39 questionnaire and a simple diary, analyzed with descriptive statistics. Results: The PISER intervention was established to be feasible in relation to study and data collection procedures, outcome measures and to recruitment of persons with PD. After the eight-week intervention, both Persons with PD subgroups and Near-ones in Gym group had better clinical outcomes and better emotional, social and communicative health-related quality of life. Near-ones, Home rehabilitation had marginally poorer clinical outcomes, but still reported better cognitive well-being. Conclusions: The PISER intervention was shown to be feasible. By engaging in systematic physical activity, persons with PD and near-ones maintained or developed their functional capacity, psychosocial well-being and certain aspects of health-related quality of life. An eight-week rehabilitation intervention had a positive impact on self-management, especially in gym-groups, in which the participants enjoyed the social aspects of group rehabilitation and received individual instruction and feedback during physical activity. This kind of person-centered, systematic physical activity intervention may prevent inactivity and fall risks, and delay onset of activity limitations. It is vital that healthcare professionals and clients with PD together analyze and discuss the meaning of physical activity and self-rehabilitation.

Role of Dynein and Dynactin (DCTN-1) in Neurodegenerative Diseases

The pathophysiology and concept of degeneration in central nervous system is very complex and overwhelming at times. There is a complex mechanism which exists among different molecules in the cytoplasm of cell bodies of neurons, antegrade and retrograde axonal transport of cargoes and accumulation of certain substances and proteins which can influence the excitatory neurotransmitter like glutamate initiating the process of neurodegeneration. Neurons have extensive processes and communication between those processes and the cell body is crucial to neuronal function, viability and survival over time with progression of age. Researchers believe neurons are uniquely dependent on microtubule-based cargo transport. There is enough evidence to support that deficits in retrograde axonal transport contribute to pathogenesis in multiple neurodegenerative diseases. Cytoplasmic dynein and its regulation by Dynactin (DCTN1) is the major molecular motor cargo involved in autophagy, mitosis and neuronal cell survival. Mutation in dynactin gene located in 2p13.1,is indeed studied very extensively and is considered to be involved directly or indirectly to various conditions like Perry syndrome, familial and sporadic Amyotrophic lateral sclerosis, Hereditary spastic paraplegia, Spinocerebellar Ataxia (SCA-5), Huntingtons disease, Alzheimers disease, Charcot marie tooth disease, Hereditary motor neuropathy 7B, prion disease, parkinsons disease, malformation of cortical development, polymicrogyria to name a few with exception of Multiple Sclerosis (MS).

Experiences of Foundation Year Students at Oman College of Health Sciences

Joining college for the first time might be a difficult experience for most students as the transitional stage from being a student of secondary school to one in a college can lead to problems in terms of adjusting to college life. There are multiple aspects that students need to adjust to in college life such as social, academic, lifestyle, institutional attachment, and personal-emotional aspects. The aim of this project was to identify the common adjustment issues among first-year students enrolled in the foundation program at the Oman College of Health Sciences (OCHS). To achieve the purpose of the project, a survey comprising 26 points and subdivided into four parts was designed using a Likert-type scale. A sample of 200 first-year students (mean age=19yrs.) at OCHS were randomly selected to be surveyed from total of 374 students. However, only 188 students participated in the survey: 48 males (25.5%), and 140 females (74.5%). The gathered data were entered and analyzed through the google forms service. The results showed lack of entertainment to be the main issue with first-year students followed by concerning economic problems, social and wellbeing issues. The findings indicated that Extracurricular Activities (ECAs) within and outside the college play an important role in the students’ academic performances and have positive effects on their lives. Such students will also be able to alter their behavior, improve their learning, develop their personality, and increase their teamwork and leadership skills.

Spinal Mobility with Concept of the Combination of Motion Spheres in the Body

In recent years, the importance of physical rehabilitation has been more emphasized. The authors and colleagues have continued practice and research for long. Furthermore, we have given workshops for various subjects. The content included how to perform walking, jogging, and running associated with stretching, pole exercising, standing straight, leaning forward and others. How can person keep a good standing attitude at all times? Firstly, make the body relax without muscle tension. Secondly, make your back bone stretch straight. It is important to conduct the following three operations slowly in this order.

New Case Reports with Phage Therapy-What is Needed for More?

A recent article had the provocative title: A wake-up call: we need phage therapy now. Indeed, there are very few sources for phages available if someone needs them urgently. Thus phages are needed and should be produced, characterized and banked and provided upon need, possibly on a European basis.

Dissociation of Measures of Topographical and Non-topographical Cognitive Ability in Older Adults

The relationship between topographical and non-topographical cognitive measures was studied for 25 elderly participants. The topographical measures were the Camden Topographical Recognition Memory Test (CTRMT), a Topographical Mental Rotation Test (TMRT), and a Virtual Pond Maze (VPM). The non-topographical tests were the Montreal Cognitive Assessment (MoCA), the Trail-Making Test-B (TMT-B), and a matching-to-sample Visual Short-Term Memory Test (VSMT). Only the correlation (0.48) between the TMT-B and the TMRT attained significance; the bivariate correlations among the three topographical measures were modest, ranging from 29 to 33, although they did correlate highly with a topographic composite score (0.69-0.78). A factor analysis yielded a further distinction between the topographical and non-topographical measures. Loadings for the three topographical measures on a presumed “topographical” factor ranged from 0.62 to 0.71 but only from 0.17 to 0.23 for the second factor. The MoCA and TMT-B loaded on both factors, while the VSMT measure loaded poorly (-0.03) on the topographical factor but highly (0.89) on the second factor. The results suggest that standard measures of cognitive function may not be optimal for specific assessment of topographical abilities, the best predictor of impending Alzheimer’s dementia.

Double Hit Theory for the Development of Vascular Parkinsonism

Introduction: Identify the non-decoded network in Vascular Parkinsonism (VasP). Objective: To determine what pattern of stroke lesions is responsible for VasP, as compared to those patients who had stroke, gait and balance problems, but absence of a hypokinetic rigid syndrome also called Vascular Pseudo Parkinsonism-V PSeuP. Materials and Methods: Design: prospective cohort study. Participants were consecutively screened for parkinsonian symptoms during a year as according to our previous study. Validated questionnaire (Tanner Questionnaire-TQ) was used, and a new scale operationalizing the criteria for VasP (FMAS score). All participants in the original study had a clinical exam to identify if presence of a hypokinetic rigid syndrome. Lesion patterns were analyzed. Setting: tertiary care stroke prevention clinic at the University of Alberta Hospital. Participants: Eligible participants attained a score of ≥ 4 on the TQ, high risk for parkinsonism. Four groups were considered: V PseuP, VasP (onset of parkinsonism within a year of the stroke -FMAS score of 4), Pseudo Vascular Parkinsonism-PseuVP (hypokinetic rigid syndrome not related to stroke), and Pseudo Vascular Pseudo Parkinsonism-PseuV PseuP (no stroke and no extrapyramidal syndrome), but with gait and balance problems. Baseline demographic information and clinical characteristics were recorded including vascular risk factors, and stroke subtype. All participants had a Holter, CT head and/or brain MRI, and CTA. Medications that produce drug-induced-parkinsonism were recorded for every participant. The primary outcome was to find the pattern of anatomical lesions particularly involved in the VasP subgroup considering the Basal Ganglia Motor Output Circuit-BGMO, the Thalamo Cortical Drive Loop-TCD and connections to frontal cortex. Results: 240 consecutive participants were screened during 12 months. We found 46 patients with potential Parkinsonism (TQ>4). VPseuP was found in 25/46 (54%), VasP in 8/46 (17%), PseuVP in 7/46 (15%), and PseuV PseuP in 6/46 (14%). VasP were older (p<0.0007) and had a higher risk for cardio embolism due to atrial fibrillation (p=0.02, odd ratio 6.6 CI 95% (1.2 – 35.2)). Neuro images showed that only the pattern involving the BGMO and frontal cortex was significantly associated to the group of VasP (X2 Fisher exact test p<0.0005 Odds ratio 32 CI 95% (9.6-108)); whereas the pattern TCD was not significantly different between the groups (X2 Fisher exact test p=0.828 Odds ratio 1.2 CI 95% (0.5-2.8)). Discussion and Conclusion: A two strategic location hit within the BGMO circuit and frontal cortex is required, so a phenotype of VasP may occur.

Correcting the Anteroposterior Discrepancy of Class Ⅱ Patient with Overject by the Vertical Control of Miniscrew

Background: While various orthodontic appliances were designed to manage the anteroposterior and vertical discrepancy, miniscrew was one of the powerful appliances and was widely utilized as anchorage to treatment the anteroposterior relationship. Method and Result: In the study we treated the severe Class Ⅱ skeletal discrepancy subject with protrude upper incisors and mandibular hypoplasia by the vertical control with the miniscrew. After two years treatment, all the objectives were achieved. The skeletal Class Ⅱ discrepancy was improved (ANB 6.3), the protrude upper incisors were treated (U1 angulation 92.8, U1-L1 120.7) and the occlusive plan was leveled (Occ Plane 8.2). Class Ⅰ molars and canines relationship were obtained. Conclusion: The vertical control was vital for the correction of anteroposterior discrepancy. The anteroposterior, vertical and transverse dimension and the time, especially the long term of post-treatment stability, interacts with each other.