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Introduction: The reconstruction of bone defects of open lower leg fractures is challenging, and there is no established treatment strategy to date, especially in the acute phase. We report herein an 'acute Masquelet technique' for reconstructing bone defects of open lower limb fractures as the primary treatment in the acute phase. Patients and Methods: We retrospectively analyzed the outcomes of seven lower limbs of the seven Japanese patients (five males, two females, aged 24–76 years [mean 53 years]) who underwent the acute Masquelet technique for open fractures with bone defects. We evaluated postsurgical complications including deep infection, absorption of grafted bone, and the final result of the bone union. Results: Deep infection occurred in one of the seven limbs (14%). There was no case with absorption of grafted bone in our series. We have treated two patients who needed additional surgery for delayed bone union. Bone union was eventually obtained in all seven limbs. All of the patients became pain-free and could walk without a cane. Conclusion: The 'acute Masquelet technique' was quite useful for reconstructing bone defects of open lower limb fractures as the primary treatment in the acute phase. We believe that this is one of the options that might be successful in the treatment of open lower limb fractures. [ABSTRACT FROM AUTHOR]

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Highlights: • In the acute phase of electric burn injury, there was a significant change in platelet count. • Contrarily, no significant change in platelet count was observed during the subacute phase of electric burn injury. Abstract: Introduction: Electrical burns are one of the causes of important health burdens throughout the world with incidences varying between 4–18% of all burns. In electrical burns, blood vessels are the heavily damaged tissue characterized by endothelial erosion, followed by adhesion and aggregation of platelets to form a hemostatic plug. The screening test for assessing the formation of a hemostatic plug is platelet count. Platelet count monitoring is very important during the resuscitation phase and treatment periods in severe burns, namely in acute and subacute phases of burns. The purpose of this study is to determine and analyze the changes in the platelet count of rats after electrical exposure in the acute and subacute phases of burns. Methods: This is a quasi-experimental study in vivo with post-test-only group design. The control group in this study was not given electrical exposure and the rat's blood was taken directly after the adaptation process. In the other five groups, P1, P2, P3, P4, and P5 were exposed to 140 V for 17 seconds, then their blood was taken for platelet counts on days 0, 3, 7, 10, and 14 post-exposure. Results : The result of this study based on a Post Hoc LSD test showed that there was a change of platelet number after exposure in the acute phase of burn injury and there was no change of platelet number after exposure in the burning subacute phase. Conclusions: Platelet count difference in acute phase of electric burn injury and no difference in platelet count difference in subacute phase of electric burn injury.

Stroke is a ma jor challenge for medicine in the 21st century. Despite modern diagnostics and even revolutionary methods of treatment, stroke is still the main cause of permanent disability and the second cause of death worldwide. Recent clinical trials have led to a breakthrough in the treatment of stroke. On their basis, many scientific societies updated the guidelines for the management of stroke. We present the most important changes in prehospital care, emergency evaluation, in-hospital non-specific treatment and specific treatment with intravenous thrombolysis and endovascular therapies. The paper is based on the recent recommendations of American Heart Association/American Stroke Association; Canadian Stroke Consortium and the Canadian Association of Emergency Physicians; European Stroke Organisation and Polish Neurological Society. Problems related to the pre- and in-hospital management of patients with acute ischaemic stroke, with a particular emphasis on the dilemma on whether to bypass a primary stroke centre to transport the patient to a comprehensive stroke centre offering endovascular thrombectomy, and the problem of reducing door-to-needle time for intravenous thrombolysis are discussed. The recommendations for the treatment of arterial hypertension and hyperglycaemia in acute ischaemic stroke and the problem of extended time window for intravenous thrombolysis and endovascular thrombectomy are also discussed.

Background: Hand, foot, and mouth disease (HFMD) caused by enterovirus A71 (EV-A71) poses a serious threat to children's health. Kinetics of the neutralising antibody (NAb) response in EV-A71 infected HFMD patients remains unclear. The ideal sampling time of paired serum samples for serological diagnosis of EV-A71 infection is not well defined. Methods: HFMD inpatients admitted to Henan Children's Hospital between February 15, 2017 and February 15, 2018 were enrolled. Serial serum samples collected during hospitalisation and up to 1.5 years after discharge were tested for NAb against EV-A71. Random intercept modelling with B-spline was conducted to characterize the kinetics of the EV-A71 NAb response over time after illness onset. Findings: A total of 524 serum samples from 264 EV-A71 RNA positive HFMD inpatients were collected. NAb titres of EV-A71 infected patients were estimated to increase from 40 (95% CI: 9-180) at the day of onset to the peak of 2417 (95% CI: 1859-3143) at day 13, then remained above 1240 until 26 months. For serological diagnosis of EV-A71 infection, if at least a 4-fold rise in titre was used as the criteria, the acute phase serum should be collected at 0-4 days, the corresponding convalescent serum should be collected 14.9 days (95% CI: 9.1-23.8) after illness onset. Interpretation: EV-A71 infection induced a strong and persistent humoral immune response in HFMD patients. The findings provide a scientific support for determining the collection time of paired serum samples for serological diagnosis of EV-A71 infected HFMD patients. Funding: National Science Fund for Distinguished Young Scholars

This study was preformed to determine the effects of some diseases on acute phase protein and some hematobiochemical parameters in dogs. Our study was preformed on 91 dogs. These dogs aged from 4-24 months old and weighted from 12-15 kg. According to clinical signs and physical examinations, dogs were divided into 5 groups. Group 1 consists of 15 dogs served as apparently clinically healthy dogs, group 2 consists of 16 dogs and showing signs of diabetes mellitus, group3 (10 dogs) were diagnosed as suffering from paroviral infection, group 4(20) dogs were suffered from non parvoviral diarrhea diarrhea and group 5(20 dogs) were suffered from respiratory manifestations. After clinical examination, hematological and serum biochemical analysis were preformed. Our results showed that, levels of Hb, PCV and TEC showed a significant decrease in parvovirus infected dogs (group3) as compared with other diseased and healthy control dogs.Biochemical serum analysis showed that levels of serum glucose and BUN were significantly increased in diabetic dogs as compared with the healthy and other groups of diseased dogs. The level of serum albumin was significantly decreased in diabetic dogs and parvovirus infected dogs as compared with the healthy and other groups of diseased dogs. The serum creatinine level was significantly increased in parvovirus infected dogs as compared with the healthy and other groups of diseased dogs. Regarding the serum levels of AST and ALT, there was a significant increase in their levels in both diabetic dogs and those suffering from parvovirus infection as compared with the healthy and other groups of diseased dogs. The acute phase protein profile (SAA, HP, ceruloplasmin and CRP) showed a significant increase in all diseased dogs as compared with control healthy dogs. [ABSTRACT FROM AUTHOR]

Purpose: The current study aimed to investigate the effects of a trauma recovery program named the "My Special Program for Acute Burn Survivors (SPA)" program in Korean burn patients. Methods: This was a randomized pretest-posttest control group study that included patients with an acute burn injury. Participants in the intervention group (n = 42) completed the "SPA" program, whereas those in the control group (n = 43) received standard care. Participants completed baseline and follow-up measures that assessed perceived stress, psychological distress, and post-traumatic stress disorder (PTSD). Results: The results for perceived stress revealed a statistically significant change regardless of assigned group. For psychological distress, there was an interaction effect of time and condition in terms of the anxiety subscale only. The findings for PTSD revealed a statistically significant decrease in the total PTSD score for the intervention group only. Conclusion: The current study suggests that SPA interventions may help alleviate and prevent negative outcomes among burn patients. [ABSTRACT FROM AUTHOR]

Aim: Although numerous studies have demonstrated promising results for the cognitive rehabilitation in subjects with schizophrenia, the efficacy of cognitive rehabilitation for everyday and social functioning is not yet sufficient. Although consideration of the contents and methods are vital, the timing for implementing cognitive rehabilitation also seems to be crucial. The aim of this study was to examine the feasibility and acceptability of cognitive rehabilitation during the acute phase of schizophrenia. Methods: Patients were recruited from consecutive acute admissions to the inpatient unit during a 15‐month period and were evaluated to determine whether they could be enrolled in an 8‐week cognitive rehabilitation program within 14 days of their hospital admission. Cognitive rehabilitation programs with a workbook style were adopted, taking the patients' conditions and burdens into consideration. Results: Eighty‐three patients were newly admitted during the entry period, and 49 patients (59.0%) were eligible for inclusion. Of them, 22 patients (44.9%) agreed to participate and started the program. Sixteen patients completed the program and underwent a second assessment. Thus, 32.7% (16/49) of all the eligible patients actually completed the study. The participants were quite satisfied with the program. Conclusions: This preliminary study yielded encouraging data demonstrating the feasibility and acceptability of cognitive remediation for patients with schizophrenia during the acute phase. The provision of cognitive rehabilitation during the acute phase of the first episode can reasonably be expected to lead to better functional outcomes. [ABSTRACT FROM AUTHOR]

• ICH results in metabolic alterations in the rat brains in the acute and recovery phases. • Bilirubin, uric acid, 6-methylnicotinamide et al. are upregulated in the acute phase. • Bilirubin, uric acid et al. and are upregulated in the recovery phase while histamine decreased. • Arginine associated metabolism and PPAR signaling pathway may be therapeutic target of ICH. Intracerebral hemorrhage (ICH) is the top lethal and disabling form of stroke. The pathophysiology of ICH is not fully understood yet. Metabolites are indicators and regulators of cellular processes. However, the overall brain metabolic pattern and the temporal alterations after ICH remain unknown. A total of 40 male rats were randomly assigned to sham group and ICH group. ICH was induced by collagenase Ⅶ. Body weight was assessed. Neurological deficits were evaluated by modified neurological severity score. Then, the perihematomal brain tissues were collected for metabolites detection using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS). The metabolic profiles were displayed by principal component analysis (PCA), partial least-squares-discriminant analysis (PLS-DA) and cluster analysis. The significant differential metabolites were screened by fold change > 2.0, the false discovery rate (FDR) < 0.05 and Variable Importance of Projection (VIP) > 1. Next, the relevant metabolic pathways were discerned by MetaboAnalyst website. A metabolite-protein interaction network was subsequentially constructed to further annotate the function of differential metabolites. Rats suffered from compromised body weight increasement and impaired neurological function. The metabolomics profiles of brain tissues in the post-ICH rats were markedly different from those in the sham group on days 3 and 14. Thirty-four metabolites (bilirubin, uric acid, 6-Methylnicotinamide et al.) were abnormally upregulated in the acute stage, while 27 metabolites were disturbed in the recovery stage, including bilirubin, uric acid, and histamine et al. Seven and three metabolic pathways altered in the acute and recovery stage, respectively. Metabolite-protein interaction analysis revealed that the disturbed metabolites may participate in ICH pathophysiology by altering amino acid metabolism, peroxisome proliferators-activated receptor signaling pathway, fatty acid metabolism and urea cycle in the acute stage, while influencing amino acid metabolism, urea cycle and peroxisome in the recovery stage. Our study mapped the pathological metabolomics profiles of the post-ICH rat brains in the acute and recovery phases. This work will assist in discovering novel therapeutic targets and treatments for ICH. [ABSTRACT FROM AUTHOR]

The clinical advantage staging and underlying mechanisms of Wangbi Tablets against knee osteoarthritis(KOA) were studied based on the &quot;disease-formula&quot; interaction network. Firstly, the clinical symptoms and related genes corresponding to Wangbi Tablets and KOA in the acute, remission, and recovery phases were collected from clinical guidelines/consensus and SoFDA database, and the putative targets of Wangbi Tablets were obtained from ETCM 2.0. Then, Jaccard similarity and cosine similarity were employed to assess the similarities of clinical symptoms, genes, and enriched pathways between Wangbi Tablets and KOA in different phases. The &quot;disease-formula&quot; interaction network of the drug targets and disease genes was constructed, and the key targets were screened by topological feature calculation. KEGG and Reactome database were used for the functional enrichment of the key targets, on the basis of which the functional characteristics of Wangbi Tablets against KOA in the acute, remission, and recovery phases were predicted. Finally, the SW1353 cells exposed to lipopolysaccharide were used to decipher the mechanism of Wangbi Tablets against KOA. The results showed that 92/3 921, 138/3 708, 139/3 800, and 196/3 946 clinical symptoms and the related genes corresponded to KOA in the acute, remission, and recovery phases and Wangbi Tablets were collected from SoFDA, and 260 putative targets of Wangbi Tablets were obtained from ETCM 2.0. Wangbi Tablets had highest similarity of clinical symptoms, genes, and enriched pathways with KOA in the remission phase and the secondary highest similarity with KOA in the recovery phase. The key targets of Wangbi Tablets mainly participated in the regulation of immunity-inflammation imbalance and exerted pain-relieving and bone-protecting effects to alleviate symptoms such as knee joint pain, joint swelling, soreness, fatigue, and dysfunction. Intriguingly, the key targets of Wangbi Tablets possessed antioxidant effects during KOA in the acute and remission phases, while they maintained material and energy metabolism homeostasis and protected vessels during KOA in the recovery phase. The cell experiment indicated that Wangbi Tablets down-regulated the expression of interleukin(IL)-6, IL-1β, tumor necrosis factor-α(TNF-α), and Bcl-2-associated X protein(Bax)/B-cell lymphoma 2(Bcl-2) via regulating the phosphatidylinositol 3-kinase(PI3K)-protein kinase B(Akt) signaling pathway. The findings lay a theoretical foundation for further clarifying the clinical advantage stage and precise clinical application of Wangbi Tablets in treating KOA.

Antimicrobial usage (AMU) could be reduced by differentiating the causative bacteria in cases of clinical mastitis (CM) as either Gram-positive or Gram-negative bacteria or identifying whether the case is culture-negative (no growth, NG) mastitis. Immunoassays for biomarker analysis and a Tandem Mass Tag (TMT) proteomic investigation were employed to identify differences between samples of milk from cows with CM caused by different bacteria. A total of 94 milk samples were collected from cows diagnosed with CM across seven farms in Scotland, categorized by severity as mild (score 1), moderate (score 2), or severe (score 3). Bovine haptoglobin (Hp), milk amyloid A (MAA), C-reactive protein (CRP), lactoferrin (LF), α-lactalbumin (LA) and cathelicidin (CATHL) were significantly higher in milk from cows with CM, regardless of culture results, than in milk from healthy cows (all P-values <0.001). Milk cathelicidin (CATHL) was evaluated using a novel ELISA technique that utilises an antibody to a peptide sequence of SSEANLYRLLELD (aa49-61) common to CATHL 1-7 isoforms. A classification tree was fitted on the six biomarkers to predict Gram-positive bacteria within mastitis severity scores 1 or 2, revealing that compared to the rest of the samples, Gram-positive samples were associated with CRP < 9.5 μg/ml and LF ≥ 325 μg/ml and MAA < 16 μg/ml. Sensitivity of the tree model was 64%, the specificity was 91%, and the overall misclassification rate was 18%. The area under the ROC curve for this tree model was 0.836 (95% bootstrap confidence interval: 0.742; 0.917). TMT proteomic analysis revealed little difference between the groups in protein abundance when the three groups (Gram-positive, Gram-negative and no growth) were compared, however when each group was compared against the entirety of the remaining samples, 28 differentially abundant protein were identified including β-lactoglobulin and ribonuclease. Whilst further research is required to draw together and refine a suitable biomarker panel and diagnostic algorithm for differentiating Gram- positive/negative and NG CM, these results have highlighted a potential panel and diagnostic decision tree. Host-derived milk biomarkers offer significant potential to refine and reduce AMU and circumvent the many challenges associated with microbiological culture, both within the lab and on the farm, while providing the added benefit of reducing turnaround time from 14 to 16 h of microbiological culture to just 15 min with a lateral flow device (LFD)., Competing Interests: Declaration of competing interest All authors declare no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

An extended milking interval of 24 h (24-h milking interval (24h-MI)) constitutes the acute phase of cow adaptation to once-daily milking (ODM). A recent trial including 724 24h-MI challenges demonstrated that milk yield responses to this acute phase of ODM are highly variable (from+22% to −52% of milk yield when switching to the 24h-MI, mean=−25.3%) and that factors such as stage of lactation parity and milk yield level influenced cows’ responses but did not account for all individual variability. Additional traits related to physiological, immune and behavioural adaptation were measured on a subset (96 observations) of this data set. This study aimed to determine (1) the relationship of these traits with cows’ milk yield responses, (2) their ability – combined with previously identified traits – to help predict milk yield responses to 24h-MI (adaptive profiles). The 24h-MI challenge consisted of three successive periods: one control week of twice-daily milking (cTDM), one single day of 24h-MI and then 13 days of TDM (pTDM). Milk yield responses to the 24h-MI (corrected for effects of stage of lactation, parity, milk yield level and milk yield) were related to physiological traits measured during cTDM (milk flow rate, presence or absence of interleukin-8) and to their changes during the 24h-MI (absolute increase in milk flow rate and relative udder distension). Analysis of associations between milk yield responses, stage of lactation, parity, milk yield level, proteolysis, udder expansion and immune traits found three adaptive cow profile clusters. Cows in cluster 1 had a less compliant udder than cows in cluster 2, and they lost more milk during the 24h-MI than cluster-2 and cluster-3 cows. After resuming twice daily-milking (TDM), cluster-2 cows fully recovered the milk they had lost during the 24h-MI. On the opposite, cluster-3 cows did not recover the milk they lost, likely due to udder inflammation during cTDM, as suggested by elevated concentrations of interleukin-8 in their milk. These results combining new traits with stage of lactation, parity and milk yield level constitute a first step towards predicting individual cow responses to a 24h-MI.

Many clinical studies have addressed the treatment of acute cerebral hemorrhage using acupuncture. However, few studies have examined the relationship between time of acupuncture and curative effect on cerebral hemorrhage. By observing the effect of acupuncture on changes in histopathology, ultrastructure, and neuroethology in a cerebral hemorrhage model of rats, we have directly examined the time-effect relationship of acupuncture. The rat model of cerebral hemorrhage was produced by slowly injecting autologous blood to the right caudate nucleus. The experimental groups were: 3-, 9-, 24-, and 48-hour model groups; and 3-, 9-, 24-, and 48-hour acupuncture groups. The sham-operation group was used for comparison. Acupuncture was performed at the Neiguan (PC6) and Renzhong (DU26) acupoints, twice a day, 6 hours apart, for 5 consecutive days. Brain tissue changes were observed by light microscopy and transmission electron microscopy. Neuroethology was assessed using Bederson and Longa scores. Our results show that compared with the sham-operation and model groups, Bederson and Longa scores were lower in each acupuncture group, with visibly improved histopathology and brain tissue ultrastructure. Further, the results were better in the 3- and 9-hour acupuncture groups than the 24- and 48-hour acupuncture groups. Our findings show that acupuncture treatment can relieve pathological and ultrastructural deterioration and neurological impairment caused by the acute phase of cerebral hemorrhage, and may protect brain tissue during this period. In addition, earlier acupuncture intervention following cerebral hemorrhage (by 3 or 9 hours) is associated with a better treatment outcome.

Chikungunya disease (CHIKD) is a viral infection caused by an alphavirus, chikungunya virus (CHIKV), and triggers large outbreaks leading to epidemics. Despite the low mortality rate, it is a major public health concern owing to high morbidity in affected individuals. The complete spectrum of this disease can be divided into four phases based on its clinical presentation and immunopathology. When a susceptible individual is bitten by an infected mosquito, the bite triggers inflammatory responses attracting neutrophils and initiating a cascade of events, resulting in the entry of the virus into permissive cells. This phase is termed the pre-acute or the intrinsic incubation phase. The virus utilizes the cellular components of the innate immune system to enter into circulation and reach primary sites of infection such as the lymph nodes, spleen, and liver. Also, at this point, antigen-presenting cells (APCs) present the viral antigens to the T cells thereby activating and initiating adaptive immune responses. This phase is marked by the exhibition of clinical symptoms such as fever, rashes, arthralgia, and myalgia and is termed the acute phase of the disease. Viremia reaches its peak during this phase, thereby enhancing the antigen-specific host immune response. Simultaneously, T cell-mediated activation of B cells leads to the formation of CHIKV specific antibodies. Increase in titres of neutralizing IgG/IgM antibodies results in the clearance of virus from the bloodstream and marks the initiation of the post-acute phase. Immune responses mounted during this phase of the infection determine the degree of disease progression or its resolution. Some patients may progress to a chronic arthritic phase of the disease that may last from a few months to several years, owing to a compromised disease resolution. The present review discusses the immunopathology of CHIKD and the factors that dictate disease progression and its resolution.

Abstract Background There are numerous barriers to early mobilization (EM) in a resource-limited intensive care unit (ICU) without a specialized team or an EM culture, regarding patient stability while critically ill or in the presence of medical devices. We hypothesized that ICU physicians can overcome these barriers. The aim of this study was to investigate the safety of EM according to the Maebashi EM protocol conducted by ICU physicians. Methods This was a single-center prospective observational study. All consecutive patients with an unplanned emergency admission were included in this study, according to the exclusion criteria. The observation period was from June 2015 to June 2016. Data regarding adverse events, medical devices in place during rehabilitation, protocol adherence, and rehabilitation outcomes were collected. The primary outcome was safety. Results A total of 232 consecutively enrolled patients underwent 587 rehabilitation sessions. Thirteen adverse events occurred (2.2%; 95% confidence interval, 1.2–3.8%) and no specific treatment was needed. There were no instances of dislodgement or obstruction of medical devices, tubes, or lines. The incidence of adverse events associated with mechanical ventilation or extracorporeal membrane oxygenation (ECMO) was 2.4 and 3.6%, respectively. Of 587 sessions, 387 (66%) sessions were performed at the active rehabilitation level, including sitting out of the bed, active transfer to a chair, standing, marching, and ambulating. ICU physicians attended over 95% of these active rehabilitation sessions. Of all patients, 143 (62%) got out of bed within 2 days (median 1.2 days; interquartile range 0.1–2.0). Conclusions EM according to the Maebashi EM protocol conducted by ICU physicians, without a specialized team or EM culture, was performed at a level of safety similar to previous studies performed by specialized teams, even with medical devices in place, including mechanical ventilation or ECMO. Protocolized EM led by ICU physicians can be initiated in the acute phase of critical illness without serious adverse events requiring additional treatment.

Objectives. The aim of the present study was to clarify clinical neurological characteristics and different ischemic stroke subtypes unfavorable course predictors in acute phase. Material and Methods. 482 patients with different ischemic stroke subtypes were observed. Among them there were 125 (25.9 %) with cardioembolic infarct (CEI), 119 (24.7 %) with large artery atherosclerosis (LAAS) infarct, 122 (25.3 %) with lacunar stroke (LAC), 116 (24.1 %) with stroke of undetermined etiology (UDE). The comparative analysis of clinical picture was performed. The predictors of unfavorable course of acute phase were established. Results. We have found out that severe neurological deficit, high mortality and the worst functional outcome during the first 14 days were observed in patients with CEI and LAAS. The highest frequency of early neurological deterioration (END) was detected at LAC (in 22.7 % of patients). There was a relationship between END and presence of transient ischemic attack (TIA) in past medical history, the level of systolic blood pressure (SBP) at the beginning of the disease and the degree of carotid arteries stenosis on the side of lesion. The patients with LAC had mild neurological deficit and better prognosis compared with other ischemic stroke subtypes. Among the clinical factors that have impact on the CEI, LAAS and UDE acute phase course were: the size of lesion, the level of consciousness on the 1st day, the baseline SBP, patient’s age. At LAAS, the presence of transient ischemic attack (TIA) in past medical history and low SBP in the onset of the disease (less than140 mm Hg) has an additional prognostic value for an unfavorable functional outcome. The severity of LAC in acute period depended on its localization and size. Localization of LAC in the internal capsule, thalamus and pons were characterized by the highest severity. Conclusions. Clinical neurological features of ischemic stroke depend on its subtype and have some prognostic value for the course of different ischemic stroke subtypes in acute phase.

Coronavirus disease 2019 (COVID-19), driven by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a global pandemic in March 2020. Pathogenic T cells and inflammatory monocytes are regarded as the central drivers of the cytokine storm associated with the severity of COVID-19. In this study, we explored the characteristic peripheral cellular profiles of patients with COVID-19 in both acute and convalescent phases by single-cell mass cytometry (CyTOF). Using a combination of algorithm-guided data analyses, we identified peripheral immune cell subsets in COVID-19 and revealed CD4+ T-cell depletion, T-cell differentiation, plasma cell expansion, and the reduced antigen presentation capacity of innate immunity. Notably, COVID-19 induces a dysregulation in the balance of monocyte populations by the expansion of the monocyte subsets. Collectively, our results represent a high-dimensional, single-cell profile of the peripheral immune response to SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

Objective: In this retrospective study, we aimed to group the albumin concentrations at the time of hospitalization among elderly patients who were admitted for internal medical care. These concentrations were then used to clarify the relationship between physical function and activities of daily living. Method: We included 1328 patients aged ≥ 65 years old who were hospitalized between December 2015 and April 2018. Datawere collected on prehospital mobility, hand grip strength, balance, activities of daily living, and blood test results. Patients were assigned to low (< 2.5 mg/dL; 270 patients), mild (< 3.5 mg/dL; 796 patients), and normal (≥ 3.5 mg/dL; 262 patients) albumin groups. Results: The low albumin group had worse outcomes in all evaluations. The risk of having poorer walking ability at discharge was significantly higher in the low albumin group than in the normal albumin group. Compared with the normal group, the OR for the low albumin group that was associated with a change in the level of assistance from independent to assisted walking was 1.7 (95% CI, 1.1-2.4; p < 0.01), whereas that for the mildly low albumin group was 1.3 (95% CI, 0.7-2.7; p = 0.33). The respective ORs for declining from independent walking to difficulty with walking were 2.4 (95% CI, 1.2-4.8; p < 0.01) and 2.1 (95% CI, 0.8-2.8; p = 0.25). Conclusion: We conclude that a relationship exists between low admission albumin levels and poorer physical function at discharge. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to clarify factors associated with post-stroke depression in patients with acute stroke within 2 weeks of onset. Method: Eighty-eight patients with stroke were divided into post-stroke depression (n = 49) and non-post-stroke depression (n = 39) groups based on their Hamilton Depression Rating Scale scores. We evaluated stroke severity, upper limb function, activities of daily living, frontal lobe/cognitive function, and level of apathy. Activity levels were measured using an ActiGraph GT9X Link system. Mann–Whitney U -tests were used to determine differences between the two groups. Spearman's rank correlation and logistic regression analyses were also performed. Results: The post-stroke depression and non-post-stroke depression groups exhibited significant differences in National Institutes of Health Stroke Scale scores at admission and discharge; Functional Independence Measure exercise items, cognitive items, and total items at admission; Fugl-Meyer Assessment scores; and Apathy Rating Scale scores. Logistic regression indicated that Fugl-Meyer Assessment scores were associated with post-stroke depression. Conclusion: Stroke severity, paralysis, and physical function/activities of daily living ability are associated with post-stroke depression in the acute phase. Our findings suggest that increases in physical impairment severity are associated with increased post-stroke depression risks. Rehabilitation professionals should focus on identifying post-stroke depression in early post-stroke stages. [ABSTRACT FROM AUTHOR]

Objects: To analyze changes in consciousness level and blood pressure of acute stoke patients administering mannitol therapy. Methods: The study was a descriptive cohort. Thirty-four respondents were applied to selecting by purposive sampling. Data were analyzed by descriptive. Results: The results showed that there was an improvement in consciousness level (GCS). The improvement in the patient’s level of consciousness occurred after more than twenty-four hours of getting mannitol therapy. While the blood pressure until the third day, there were still suffering from hypertension. Conclusion: Improvements in consciousness level after administering mannitol therapy indicate loss of cerebral edema, improvement in cerebral blood flow (CBF) and brain perfusion pressure (CPP), and repair of damaged nerve cells. [ABSTRACT FROM AUTHOR]

Background: Animal models of trauma have shown that females have better posttraumatic survival; however, results of previous studies on the influence of gender on major trauma patients have been controversial. This study aimed to evaluate the association between gender and survival in major trauma patients. Methods: We retrospectively analyzed patients registered in Taiwan's National Health Insurance Research Database between 2008 and 2012 with the diagnosis codes 800-939 and 950-957 (International Classification of Diseases, ninth revision, clinical modification). Data on gender, age, catastrophic illness, and new injury severity score (NISS) â¥16 were collected for comparing patients' mortality after trauma. Propensity score matching (PSM) was performed to eliminate dissimilarities in age, comorbidities, NISS, and primary traumatic regions between the genders. Results: Among 10 012 major trauma patients included in the study cohort, 28.8% (n = 2880) were women. The PSM patient group consisted of 50% (2876 of 5752) women. Women had a higher 30-day (15.4% of women vs 13.8% of men; p < 0.05) and hospital (16.1% of women vs 14.5% of men; p < 0.05) mortality and lower incidence rates of acute respiratory dysfunction (62.5% of women vs 65.9% of men; p < 0.005) and acute hepatic dysfunction (0.8% of women vs 2.1% of men; p < 0.001). However, the analysis of PSM patient groups showed lower mortality rates in women with moderate trauma (NISS 16-24) in the acute phase within three days (1.4% of women vs 2.7% of men, p = 0.03). Analysis of patients with an NISS of 16-24 who died within three days showed a higher NISS in women than in men (19.7 ± 2.3 vs 18.0 ±1.9, respectively, p <0.05). Conclusion: There is no gender difference in 30-day or hospital mortality among major trauma patients. However, women admitted for moderate major trauma had higher survival within three days of major trauma. [ABSTRACT FROM AUTHOR]

Objective: The objective of the present study was to evaluate the effect of low-dose of ketamine, in short-term, on behavioral impairment and acute neuronal death in the cerebral cortex during the acute phase in a model of epileptic mouse induced by pilocarpine. Methods:Ketamine was administrated (10 mg/kg) intraperitoneally, 30 min before pilocarpine injection (100 mg/kg) in the first group. The second group received the same dose of ketamine 30 min after pilocarpine injection. The effect of ketamine on behavioral disorders and cerebral neuronal integrity in epileptic mice was evaluated. Results:Clinical observations and behavioural tests relate a reduction in behavioural dysfunctions in mice treated with ketamine. Interestingly, treatment of mice with low dose of ketamine decreased the clinical symptoms (movements of the vibrios, nods of the head, and movements of the whiskers), especially when administered before epilepsy induction. Furthermore, the administration of ketamine limits oedema in the hippocampus, neuronal degeneration and gliosis in the different cortical layers. These results could be explained by NMDA receptors inhibition by ketamine. Conclusion:Therefore, it appears that ketamine is endowed with a potential neuroprotective effect and can reduce the severity of neurodegeneration, especially when administrated before Status Epilepticus (SE) installation. [ABSTRACT FROM AUTHOR]

Background: Although previous studies have shown that intra-network abnormalities in brain functional networks are correlated with clinical/cognitive impairment in multiple sclerosis (MS), there is little information regarding the pattern of causal interactions among cognition-related resting-state networks (RSNs) in different disease stages of relapsing-remitting MS (RRMS) patients. We hypothesized that abnormalities of causal interactions among RSNs occurred in RRMS patients in the acute and remitting phases.Methods: Seventeen patients in the acute phases of RRMS, 24 patients in the remitting phases of RRMS, and 23 appropriately matched healthy controls participated in this study. First, we used group independent component analysis to extract the time courses of the spatially independent components from all the subjects. Then, the Granger causality analysis was used to investigate the causal relationships among RSNs in the spectral domain and to identify correlations with clinical indices.Results: Compared with the patients in the acute phase of RRMS, patients in the remitting phase of RRMS showed a significantly lower expanded disability status scale, modified fatigue impact scale scores, and significantly higher paced auditory serial addition test (PASAT) scores. Compared with healthy subjects, during the acute phase, RRMS patients had significantly increased driving connectivity from the right executive control network (rECN) to the anterior salience network (aSN), and the causal coefficient was negatively correlated with the PASAT score. During the remitting phase, RRMS patients had significantly increased driving connectivity from the rECN to the aSN and from the rECN to the visuospatial network.Conclusions: Together with the disease duration (mean disease duration < 5 years) and relatively better clinical scores than those in the acute phase, abnormal connections, such as the information flow from the rECN to the aSN and the rECN to the visuospatial network, might provide adaptive compensation in the remitting phase of RRMS. [ABSTRACT FROM AUTHOR]

Recent clinical studies have shown that HIV disease pathogenesis can depend strongly on many factors at the time of transmission, including the strength of the initial viral load and the local availability of CD4+ T-cells. In this article, a new within-host model of HIV infection that incorporates the homeostatic proliferation of T-cells is formulated and analyzed. Due to the effects of this biological process, the influence of initial conditions on the proliferation of HIV infection is further elucidated. The identifiability of parameters within the model is investigated and a local stability analysis, which displays additional complexity in comparison to previous models, is conducted. The current study extends previous theoretical and computational work on the early stages of the disease and leads to interesting nonlinear dynamics, including a parameter region featuring bistability of infectious and viral clearance equilibria and the appearance of a Hopf bifurcation within biologically relevant parameter regimes. [ABSTRACT FROM AUTHOR]

Chronic fatty liver disease is common worldwide. This disease is a spectrum of disease states, ranging from simple steatosis (fat accumulation) to inflammation, and eventually to fibrosis and cirrhosis if untreated. The fibrotic stage of chronic liver disease is primarily characterized by robust accumulation of extracellular matrix (ECM) proteins (collagens) that ultimately impairs the function of the organ. The role of the ECM in early stages of chronic liver disease is less well-understood, but recent research has demonstrated that several changes in the hepatic ECM in prefibrotic liver disease are not only present but may also contribute to disease progression. The purpose of this review is to summarize the established and proposed changes to the hepatic ECM that may contribute to inflammation during earlier stages of disease development, and to discuss potential mechanisms by which these changes may mediate the progression of the disease. [ABSTRACT FROM AUTHOR]

Chikungunya disease (CHIKD) is a viral infection caused by an alphavirus, chikungunya virus (CHIKV), and triggers large outbreaks leading to epidemics. Despite the low mortality rate, it is a major public health concern owing to high morbidity in affected individuals. The complete spectrum of this disease can be divided into four phases based on its clinical presentation and immunopathology. When a susceptible individual is bitten by an infected mosquito, the bite triggers inflammatory responses attracting neutrophils and initiating a cascade of events, resulting in the entry of the virus into permissive cells. This phase is termed the pre-acute or the intrinsic incubation phase. The virus utilizes the cellular components of the innate immune system to enter into circulation and reach primary sites of infection such as the lymph nodes, spleen, and liver. Also, at this point, antigen-presenting cells (APCs) present the viral antigens to the T cells thereby activating and initiating adaptive immune responses. This phase is marked by the exhibition of clinical symptoms such as fever, rashes, arthralgia, and myalgia and is termed the acute phase of the disease. Viremia reaches its peak during this phase, thereby enhancing the antigen-specific host immune response. Simultaneously, T cell-mediated activation of B cells leads to the formation of CHIKV specific antibodies. Increase in titres of neutralizing IgG/IgM antibodies results in the clearance of virus from the bloodstream and marks the initiation of the post-acute phase. Immune responses mounted during this phase of the infection determine the degree of disease progression or its resolution. Some patients may progress to a chronic arthritic phase of the disease that may last from a few months to several years, owing to a compromised disease resolution. The present review discusses the immunopathology of CHIKD and the factors that dictate disease progression and its resolution. [ABSTRACT FROM AUTHOR]

Introduction: Peyronie's disease (PD) can affect men of all ages and is associated with penile pain as well as curvature and erectile dysfunction. Treatment modalities for PD include conservative, less invasive and surgical treatments. Choice of treatment depends on the disease's phase. Injection of collagenase Clostridium histolyticum (CCH) is only the Food and Drug Administration approved treatment for the management of the chronic phase of the disease. Only a few limited studies have evaluated its potential benefits during the acute phase. Aim: To evaluate the current evidence on the use of injectable CCH during the acute or active phase of PD. Methods: We performed a PubMed database search for articles published between 2015 and 2018 that investigated the use of CCH for the management of the acute phase of PD. Search keywords included "Peyronie's disease", "collagenase Clostridium histolyticum", and "acute phase". Main outcome measures: Changes in penile curvature after treatment with injectable CCH. Results: Mean curvature decrease ranged between 15.8° and 22.6° corresponding to 27.4–37.4% decrease from baseline after 2.5–4 cycles, corresponding to 5–8 injections, of CCH treatment in patients during the acute phase of PD. Conclusions: Intralesional CCH injection therapy during the acute phase of PD can be both safe and effective and clinically significant improvements in penile curvature may be achieved. Larger multi-institutional studies are, however, still needed to confirm these results and validate this additional indication for CCH. [ABSTRACT FROM AUTHOR]

The role of the Wnt/β-catenin signaling pathway in epilepsy and the effects of its modulators as efficacious treatment options, though postulated, has not been sufficiently investigated. We evaluated the involvement of β-catenin and GSK-3β, the significant proteins in this pathway, in the lithium chloride-pilocarpine-induced status epilepticus model in rodents to study acute phase of temporal lobe epilepsy (TLE). The modulators studied were 6-BIO, a GSK-3β inhibitor and Sulindac, a Dvl protein inhibitor. The disease group exhibited increased seizure score and seizure frequency, and the assessment of neurobehavioral parameters indicated notable alterations. Furthermore, histopathological examination of hippocampal brain tissues revealed significant neurodegeneration. Immunohistochemical study of hippocampus revealed neurogenesis in 6-BIO and sulindac groups. The gene and protein expression by RT-qPCR and western blotting studies indicated Wnt/β-catenin pathway downregulation and increased apoptosis in the acute phase of TLE. 6-BIO was very efficient in upregulating the Wnt pathway, decreasing neuronal damage, increasing neurogenesis in hippocampus and decreasing seizure score and frequency in comparison to sulindac. This suggests that both GSK-3β and β-catenin are potential and novel drug targets for acute phase of TLE, and treatment options targeting these proteins could be beneficial in successfully managing acute epilepsy. Further evaluation of 6-BIO to explore its therapeutic potential in other models of epilepsy should be conducted. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) can result in poor functional outcomes and death, and overall outcomes are varied. Growth factors, such as angiopoietin-1 (Ang-1), vascular endothelial growth factor (VEGF), and granulocyte-colony stimulating factor (G-CSF), play important roles in the neurological functions. This study investigated the relationship between serum growth factor levels and long-term outcomes after TBI. Blood samples from 55 patients were collected at 1, 3 and 7 days after TBI. Blood samples from 39 healthy controls were collected as a control group. Serum Ang-1, G-CSF, and VEGF levels were measured using ELISA. Patients were monitored for 3 months using the Glasgow Outcome Scale-Extended (GOSE). Patients having a GOSE score of > 5 at 3 months were categorized as a good outcome, and patients with a GOSE score of 1–5 were categorized as a bad outcome. Our data demonstrated that TBI patients showed significantly increased growth factor levels within 7 days compared with healthy controls. Serum levels of Ang-1 at 1 and 7 days and G-CSF levels at 7 days were significantly higher in patients with good outcomes than in patients with poor outcomes. VEGF levels at 7 days were remarkably higher in patients with poor outcomes than in patients with good outcomes. Receiver operating characteristic analysis showed that the best cut-off points of serum growth factor levels at 7 days to predict functional outcome were 1,333 pg/mL for VEGF, 447.2 pg/mL for G-CSF, and 90.6 ng/mL for Ang-1. These data suggest that patients with elevated levels of serum Ang-1, G-CSF, and decreased VEGF levels had a better prognosis in the acute phase of TBI (within 7 days). This study was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR1800018251) on September 7, 2018.

Abstract In heartworm disease, several biomarkers of cardiopulmonary injury and inflammatory activity have been studied during the recent years. D-dimer is a fibrin degradation product present after a clot is degraded, which has been reported to provide support for the diagnosis of pulmonary thromboembolism in heartworm disease. Furthermore, concentrations increment with increased disease severity and during the adulticide treatment. This increase in concentration has proved to be valuable. Cardiac biomarkers troponin I, myoglobin and NT-proBNP demonstrated presence of myocardial injury and heart failure, especially in chronic infections, which in some cases, slightly improve after the adulticide treatment. An acute phase response in dogs with Dirofilaria immitis, characterized by variations of acute phase proteins (APP), has been reported, indicating inflammatory processes that could contribute to disease progression. Among them, C-reactive protein (CRP) increases according to the severity of the disease; and a strong correlation between pulmonary hypertension and CRP has been observed. In cats, little work has been done to ascertain the utility of these biomarkers in feline heartworm; the only published study in D. immitis–seropositive cats reported significantly higher concentrations in positive APP serum amyloid A, haptoglobin and ceruloplasmin.

Nausea and vomiting may occur in patients receiving chemotherapy, a condition referred to as chemotherapy-induced nausea and vomiting. The provision of combined dexamethasone and ondansetron or granisetron is the therapeutic management of acute phase nausea and vomiting in cytostatics with a high risk of nausea and vomiting. Granisetron has been known to have better pharmacokinetics and pharmacodynamics compared to ondansetron, so it is possible to have nausea and vomiting suppressing effect higher than that of ondansetron. This study aimed to compare antiemetic effectiveness of granisetron and dexamethasone with ondansetron and dexamethasone in acute-phase chemotherapy patients. This study was conducted in patients who received the combination of cisplatin-paclitaxel and cisplatin-fluorouracil, double-blind, with samples comprised new head and neck surgical oncology patients. Measurement of nausea and vomiting during the acute phase of chemotherapy was conducted using Index of Nausea, Vomiting, and Retching (INVR). Observation of nausea and vomiting in the patients was done during the first 12 hours after administration of cisplatin and interviews were conducted on h 12. Results showed that there was no difference in the effectiveness of nausea and vomiting suppression in the administration of granisetron and dexamethasone compared to ondanstron and dexamethasone in acute phase chemotherapy patients (p = 0.076).

Proinflammatory cytokines, including TNF-α and IL-6, can contribute to insulin resistance. Conversely, insulin has some actions that can be considered anti-inflammatory. Hemopexin is a Class 2 acute phase reactant and control of its transcription is predominantly regulated by IL-6, with TNF-α and IL-1β also inducing hemopexin gene expression. Thus, we asked whether insulin could inhibit the ability of TNF-α to stimulate hemopexin mRNA expression. In cultured rat hepatoma (H4IIE) cells, TNF-α significantly increased hemopexin mRNA accumulation. The TNF-α-induced increase of hemopexin mRNA was dramatically attenuated by insulin, even though TNF-α reduced peak insulin activation of ERK. Thus, even though TNF-α can contribute to insulin resistance, the residual insulin response was still able to counteract TNF-α actions.

We evaluated endothelial dysfunction and hemorheological indicatorsin acute ischemic stroke. The hemorheological indicators(blood viscosity, plasma viscosity, hematocrit, erythrocyte aggregationand deformability, fibrinogen concentration) were assessedthree times: within the first 12 hours of the onset of symptomsand on day 35 and day 1820 after hospitalization; theendothelial dysfunction indicators were examined on day 1517 using a cuff test. Patients in the acute phase of ischemic strokehad pronounced changes in the hemorheological indicators thatcould be characterized as high blood viscosity syndrome. Forexample, we observed increased platelet aggregation that playsa key role in the blood viscosity value in blood vessels with lowshear rates. We also observed reduced erythrocyte deformabilityat high shear rates. After treatment, patients had positive clinicaldynamics according to neurological scales. Dynamics of thehemorheological indicators was as follows: erythrocyte aggregationdecreased; blood viscosity tended to reduce; however, erythrocytedeformability tended to worsen. Therefore, the pathologicalchanges in elastic properties of the erythrocyte membranes instroke are not corrected by ongoing standard therapy. Assessmentof the endothelial functional activity revealed that stroke patientshad a decreased brachial artery response associated with reactivehyperemia and an increased response to the nitroglycerin test. The study demonstrated that treated patients with ischemicstroke had endothelial functional activity changes that manifestedas a statistically significant increase in the endothelial dysfunctionindex. We concluded that the approach to stroke treatmentrequires complex pharmacological correction, in particularby means with the proven hemorheological activity.

Examination of 102 patients with acute ischemic stroke and diabetes mellitus of type II was carried out. Cerebral ischemia developed on the background of concomitant risk factors: hypertension, coronary disease, and dislipidemia. Ischemic stroke in diabetes mellitus type II has several characteristic features in the acute phase: it occurs frequently in the period of patients daily activity, clinical presentations are more severe and include severe disturbances of consciousness and marked focal neurological symptoms. Repeated strokes occur in 33% of cases. According to pathogenetic subtype, atherothrombotic stroke is prevalent in diabetes mellitus of type II. Computed tomography in the majority of patients showed multiple small cysts, leucoaraosis and atrophic changes, that suggests the presence of long-term chronic insufficiency of cerebral blood flow.

Acute phase reactants (APRs) have not been investigated in white rhinoceros (Ceratotherium simum). This study aimed to identify clinically useful APRs in this species. Reference intervals (RIs) were generated for albumin, fibrinogen, haptoglobin, iron and serum amyloid A (SAA) from 48 free-ranging animals, except for SAA (n = 23). APR concentrations between healthy animals and those with tissue injury (inflammation) (n = 30) were compared. Diagnostic performance was evaluated using receiver-operator characteristic (ROC) curve and logistic regression analyses. RIs were: albumin 18–31 g/L, fibrinogen 1.7–2.9 g/L, haptoglobin 1.0–4.3 g/L, iron 9.7–35.0 μmol/L, SAA 4.7 g/L were significant predictors of inflammatory status and together correctly predicted the clinical status of 91% of cases. SAA > 20 mg/L had a specificity of 100%. In conclusion, albumin and iron are negative and fibrinogen, haptoglobin and SAA positive APRs in the white rhinoceros. The combination of iron and haptoglobin had an excellent diagnostic accuracy for detecting inflammation.

Research into the identification and use of protein biomarkers for use in veterinary clinical pathology has produced numerous potential analytes that could become common tests in the future. One problem that has to be overcome in the general acceptance of a novel biomarker is that differing standards for calibration may be developed by individual laboratories or the diagnostic companies that will provide kits for widespread use. This has been apparent in the development of acute phase protein biomarkers such as canine C-reactive protein. In order to overcome this problem an international initiative is required to ensure that assays developed in separate laboratories would have a consistent calibration protocol so that results produced are equivalent. International reference preparations for serum protein analysis for each relevant species should be established for use as primary standard in the calibration of biomarkers for veterinary diagnosis.

Abstract INTRODUCTION Uric acid is one of the compounds associated with the inflammatory process in malaria. It acts as an indicator of cellular damage by activating the immune response and inflammatory process. METHODS: We measured serum concentrations of uric acid in 60 symptomatic patients before and after treatment for malarial infections caused by Plasmodium vivax. RESULTS: Lower serum concentrations of uric acid were found during the acute phase of P. vivax malaria compared to those in its convalescent phase (p < 0.0001). CONCLUSIONS: Patients in the acute phase of malaria had lower uric acid levels than those in its convalescent phase.

Recent studies have indicated that functional abnormalities in the K Na 1.2 channel are linked to epileptic encephalopathies. However, the role of K Na 1.2 channel in traumatic brain injury (TBI) remains limited. We collected brain tissue from the TBI mice and patients with post-traumatic epilepsy (PTE) to determine changes in K Na 1.2 channel following TBI. We also investigated whether the MAPK pathway, which was activated by the released cytokines after injury, regulated K Na 1.2 channel in in vitro. Finally, to elucidate the physiological significance of K Na 1.2 channel in neuronal excitability, we utilized the null mutant-Kcnt2 -/- mice and compared their behavior patterns, seizure susceptibility, and neuronal firing properties to wild type (WT) mice. TBI was induced in both Kcnt2 -/- and WT mice to investigate any differences between the two groups under pathological condition. Our findings revealed that the expression of K Na 1.2 channel was notably increased only during the acute phase following TBI, while no significant elevation was observed during the late phase. Furthermore, we identified the released cytokines and activated MAPK pathway in the neurons after TBI and confirmed that K Na 1.2 channel was enhanced by the MAPK pathway via stimulation of TNF-α. Subsequently, compared to WT mice, neurons from Kcnt2 -/- mice showed increased neuronal excitability and Kcnt2 -/- mice displayed motor deficits and enhanced seizure susceptibility, which suggested that K Na 1.2 channel may be neuroprotective. Therefore, this study suggests that enhanced K Na 1.2 channel, facilitated by the inflammatory response, may exert a protective role in an acute phase of the TBI model., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The present study was aimed to observe the antiinflammatory and nursing effect of atorvastatin on acute cerebral infarction. About 180 patients with acute cerebral infarction who were treated in Chengdu Fifth People's Hospital were selected as research subjects. They were divided into the control group (90 cases) and the research group (90 cases). The control group received conventional treatment while the research group received atorvastatin treatment. In addition, the research group received a comprehensive nursing intervention program, while the control group received only a routine nursing mode. The therapeutic effects and nursing effects of the 2 groups were compared. By comparing the serum lipid-related indices of the two groups, the patients in the research group were found to have a significant advantage over the control group. Through observing and comparing the levels of markers of immune inflammation, the improvement in serum TNF level, IL-6 and ICAM-1 concentrations in the research group was more significant, p<0.05. In addition, the comprehensive life quality evaluation score and FMA exercise ability score of the research group showed significant advantages, p<0.05. For patients with acute cerebral infarction, atorvastatin treatment can produce good antiinflammatory effect and the treatment effect can be significantly improved after adopting scientific nursing measures. [ABSTRACT FROM AUTHOR]

Purpose of Review: The goal of this article is to review the current management options for Peyronie's disease (PD), focusing on the acute phase of the disease. Additionally, we aim to highlight the most recent literature on the subject. Recent Findings: Contemporary studies suggest that there are promising novel therapies on the horizon for acute phase PD, such as topical H-100 gel and intralesional interferon-α2b and mycophenolate mofetil. Recent findings also suggest that intralesional collagenase Clostridium histolyticum (CCH) may be effective for the acute phase of PD, in addition to its conventional use in the chronic phase. Summary: A variety of treatments have been proposed for PD, with more recent literature focusing on the acute phase. Novel topical therapies are on the horizon and may show promise. External mechanical therapies have shown clinically meaningful changes. CCH may have efficacy during the acute phase of PD. Other intralesional therapies are promising but still require additional large studies to confirm efficacy. Future research on the acute phase of PD may expand treatment options and impact disease management. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to develop a toileting performance assessment test to measure the toileting performance ability of patients in the early phase after stroke. Methods: In this study, 214 stroke patients were enrolled. Cronbach's α, Spearman's rank correlations (ρ values) with the toileting-related items of the functional independence measure and Barthel Index, interrater reliability (weighted κ), and responsiveness (standardized response mean) were evaluated. Receiver operating characteristic and the area under the curves were utilized to determine the cutoff scores for the significance of the independence of toilet ability with the functional independence measure and Barthel Index. Results: Cronbach's α was ≥0.90. The p values between toileting performance assessment test and Barthel Index and between toileting performance assessment test and functional independence measure were 0.88 and 0.86, respectively. The weighted κ for each item was ≥0.61. The standardized response means were 0.81 for the functional independence measure, 0.70 for the Barthel Index, and 0.93 for the toileting performance assessment test. Cutoff scores of the toileting performance assessment test were 18 points. Conclusions: The toileting performance assessment test has acceptable psychometric properties and proved useful in assessing toileting performance ability of patients in the early phase after stroke. Toileting performance assessment test demonstrated acceptable psychometric properties, and it can be useful for assessing the toileting ability of patients in the early phase after stroke. Toileting performance assessment test should provide information that leads to lowered risk of falls while toileting, and the information gathered can assist patients in achieving early toileting independence after stroke. As the development of toileting performance assessment test excluded patients with cognitive disabilities, the item for cognitive function should be developed as well. [ABSTRACT FROM AUTHOR]

Spinal cord injury (SCI) involves both primary and secondary damages. After the phase of primary injury, a series of inflammatory responses initiate, which belong to the secondary injury. There has been little investigation into the cellular inflammatory response of the spleen to SCI. To disclose the impact of SCI on the spleen, we examined the inflammatory reactions of the spleen during the acute phase of SCI in rat. Adult rats were used as experimental animals and divided into un-injured, sham, and SCI groups (n = 36). Contusion injuries were produced at the T3 vertebral level. Spinal cords were harvested 6 h, 24 h, 48 h, 72 h, 120 h, and 168 h after surgery and were prepared for immunohistochemistry. Spleen wet weight was measured. Blood and spleens were prepared for quantitative analyses. The spleen index was significantly decreased in the SCI groups. Immunohistochemical results showed an increase of the infiltrating cells in the spinal cord tissues from SCI rats at all time points, peaking in 72 h post injury. In the blood, T and B lymphocytes significantly decreased in the SCI group as compared with the sham group, while monocyte increased. Surprisingly, in the SCI group, neutrophil initially decreased and subsequently tended to return toward baseline levels, then remained elevated until the end of the study. Spleen analyses revealed a significant increase in monocyte and neutrophil but a minor (not statistically significant) reduction in T and B lymphocytes. Our data show that the four most prevalent inflammatory cells infiltrate the spinal cord after injury. Increased levels of inflammatory cells (monocyte and neutrophil) in the blood and spleen appear to be very sensitive to SCI. The spleen plays a critical role in the acute phase of SCI. [ABSTRACT FROM AUTHOR]

Clinical presentation and neurological outcome in subarachnoid hemorrhage (SAH) is highly variable. Aneurysmal SAH (aSAH) is hallmarked by sudden increase of intracranial pressure (ICP) and acute hypoperfusion contributing to early brain injury (EBI) and worse outcome, while milder or non-aneurysmal SAH with comparable amount of blood are associated with better neurological outcome, possibly due to less dramatic changes in ICP. Acute pressure dynamics may therefore be an important pathophysiological aspect determining neurological complications and outcome. We investigated the influence of ICP variability on acute changes after SAH by modulating injection velocity and composition in an experimental model of SAH. Five hundred microliters of arterial blood (AB) or normal saline (NS) were injected intracisternally over 1 (AB1, NS1), 10 (AB10, NS10), or 30 min (AB30) with monitoring for 6 h (n = 68). Rapid blood injection resulted in highest ICP peaks (AB1 median 142.7 mmHg [1.Q 116.7–3.Q 230.6], AB30 33.42 mmHg [18.8–38.3], p < 0.001) and most severe hypoperfusion (AB1 16.6% [11.3–30.6], AB30 44.2% [34.8–59.8]; p < 0.05). However, after 30 min, all blood groups showed comparable ICP elevation and prolonged hypoperfusion. Cerebral autoregulation was disrupted initially due to the immediate ICP increase in all groups except NS10; only AB1, however, resulted in sustained impairment of autoregulation, as well as early neuronal cell loss. Rapidity and composition of hemorrhage resulted in characteristic hyperacute hemodynamic changes, with comparable hypoperfusion despite different ICP ranges. Only rapid ICP increase was associated with pronounced and early, but sustained disruption of cerebral autoregulation, possibly contributing to EBI. [ABSTRACT FROM AUTHOR]

To observe the clinical efficacy of aerosol inhalation of ipratropium bromide and terbutaline on the patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). A total of 136 COPD patients with acute exacerbation were divided into the ipratropium bromide group (n=69) and the terbutaline group (n=67). Patients in the ipratropium bromide group were required to take ipratropium bromide, while those in the terbutaline group took terbutaline for 3 days. Then, changes in symptoms, vital signs, blood-gas indicators and pulmonary functions were compared and analyzed between two groups. In ipratropium bromide group, patients with amelioration in vital signs and symptoms, especially for the symptom of coughing (P<0.01), were more than those in the terbutaline group, with statistically significant difference (P<0.05). In addition, following medication, analysis showed that the improvement in the blood-gas indicators and pulmonary functions in the ipratropium bromide was excellent in comparison with the terbutaline group, especially the improvement in the pulmonary ventilation function (P<0.01). Comparison over the incidence rates of adverse events in the ipratropium bromide group and terbutaline group showed an evident difference (P<0.05). For treatment of patients with acute exacerbation of COPD, aerosol inhalation of ipratropium bromide is a safe but effective method. [ABSTRACT FROM AUTHOR]

BACKGROUND: Anterior cruciate ligament injury combined with medial collateral ligament injury is common in the clinic.OBJECTIVE: To summarize the treatment of anterior cruciate ligament combined with medial collateral ligament injury of knee joint by consulting relevant papers.METHODS: The first author retrieved the relevant literatures from CNKI(January 1982 to June 2018) and PubMed(January 1970 to June 2018)databases on August 1, 2018. The keywords were "knee, anterior cruciate ligament injury, injury of medial collateral ligament, treatment" in Chinese and English, respectively. The types of articles included research articles, review, perspective, empirical exchange and case report.RESULTS AND CONCLUSION: At present, the treatment concept of anterior cruciate ligament combined with medial collateral ligament injury is maturing. The surgical reconstruction methods of anterior cruciate ligament and medial collateral ligament are various, and the therapeutic effect has been improved. But there are some problems, such as the selection of the length of the force arm of the ligament and the anatomical weight of the anterior cruciate ligament. With the development of science and technology, accurate localization of anterior cruciate ligament combined with medial collateral ligament injury by computer technology will come true. At the same time, with the development of three-dimensional printing technology, the appearance of three-dimensional ligament will improve the efficiency of surgery,thereby improving the curative effect and further increasing the postoperative patient satisfaction. [ABSTRACT FROM AUTHOR]

Aim: Malnutrition during hospitalization affects the functional recovery and postdischarge destinations of elderly stroke patients. However, insufficient studies exist about nutritional status during hospitalization in the acute stroke phase in this population. This study determined factors of nutritional status changes during hospitalization in elderly patients in the acute phase of stroke, and investigated the relationship between nutritional status changes and improved activities of daily living and postdischarge destination.Methods: This retrospective observational study included 205 acute-phase stroke patients admitted to Shinshu University Hospital from 2010-2016. Multiple regression analysis was conducted to determine relationships between nutritional status changes, patient characteristics, and improved activities of daily living. Binomial logistic regression analysis was used to determine the relationship between the postdischarge destination and nutritional status changes.Results: Prevalence of malnutrition was 42% at admission and 76% at discharge. Factors affecting nutritional status changes at admission included Geriatric Nutritional Risk Index (β = -0.35, P < .001) and Barthel Index/feeding (β = 0.22, P = .002), and factors during hospitalization included age (β = -0.21, P < .001), ischemic stroke (β = 0.16, P = .008), and National Institute of Health Stroke Scale score (β = -0.29, P < .001). Significant associations of changes in geriatric nutritional risk index occurred with improved activities of daily living during hospitalization (β = 0.26, P < .001) and discharge to home (odds ratio = 1.11, 95% confidence interval: 1.03-1.19, P = .008).Conclusion: Many elderly patients in the acute phase of stroke with malnutrition exhibited worsening conditions during hospitalization, which was negatively associated with their activities of daily living abilities and postdischarge destinations. Nutritional status changes and associated factors must be evaluated during hospitalization in this patient population. [ABSTRACT FROM AUTHOR]