Medical Specialties Commons^™

Not All Asymptomatic Carotid Plaques Are Equal: Some Require Intervention, Iram Naz

Pakistan Journal of Neurological Sciences (PJNS)

Ischemic stroke represents a major health hazard around the world, which has a severe impact on society and the health-care systems. Roughly, 15% of all strokes can be attributed to significant atherosclerotic disease of the carotid arteries. Some patients presenting with disabling strokes for the first time cannot benefit from carotid revascularization having lost the opportunity of prevention. We know that all symptomatic patients were once asymptomatic. Hence, after identifying high risk carotid plaques and patient’s characteristics suitable for interventions, they should be offered carotid revascularization at specialized centers (with low perioperative stroke and death rates) to prevent stroke and …

Combination Therapy For Inflammation And Neurodegeneration In Multiple Sclerosis Rodent Model, Nicole Neva Marie Trager

MUSC Theses and Dissertations

Multiple sclerosis (MS) is a complex demyelinating CNS disease that involves both immunologic and neurodegenerative mechanisms of pathophysiology. MS is characterized by lymphocyte infiltration in the CNS resulting in extensive axonal neurodegenerative processes. The current therapies for MS act through either immunomodulatory or immunosuppressive mechanisms; none address both the immune and degenerative arms of the disease. The immunomodulatory agents are generally broad spectrum and non-specific immunosuppression and are associated with significant toxicities. Thus, novel therapies or therapeutic strategies are needed to fully combat both inflammatory and neurodegenerative events that define MS. The animal model experimental autoimmune encephalomyelitis (EAE) is used …

Abstracts 4th Pediatric Neurology Conference Children Medical Center, Lahore February 2013, Tipu Sultan, Tahir Masood Ahmed Masood Ahmed

Pakistan Journal of Neurological Sciences (PJNS)

Clinical data of 100 patients being treated as TBM (group A) admitted in the Neurology department, and another 100 patients with diagnosis of meningitis, encephalitis or cerebral malaria (group B) were evaluated. History, clinical examination and relevant investigations were evaluated and Kenneth Jones criteria were applied to both groups. All children were followed and their outcome was also studied.

Mucor Mycosis: A Fulminant Case With Extensive Involvement And Remarkable Recovery, Asif Sa

Pakistan Journal of Neurological Sciences (PJNS)

Mucor mycosis is a rare but fatal illness. It is seen in diabetics and immune compromised individuals. A case is presented with fulminant course, rapid progression and extensive involvement. He was treated with Fungizone and Itraconazole alongwith surgical debridement of infected nasal mucosa. Recommendation is made to increase the awareness of this fatal illness among local practitioners.

Development Of Neurology In Pakistan., Sardar M. Alam

Pakistan Journal of Neurological Sciences (PJNS)

On the eve of the 20th Annual Neurology Conference we can look back over the last two decades to assess the development of Neurology in Pakistan. Neurology first functioned under the banner of Pakistan Academy of Neurological Sciences (PANS) and then as Pakistan Society of Neurology (PSN).

Test-Retest Reliability And Construct Validity Of The Tinetti Performance-Oriented Mobility Assessment In People With Stroke, Jennifer Canbek, George Fulk, John Echternach

Rehabilitation Sciences Faculty Publications

Background and Purpose: The Tinetti Performance-Oriented Mobility Assessment (POMA) is commonly used to measure balance ability in older adults. The purpose of this study was to determine the test-retest reliability and minimal detectable change (MDC) of the POMA and explore its cross-sectional and longitudinal construct validity for use in people early after stroke.

Methods: Participants were recruited if they had a first documented stroke and were receiving physical therapy during inpatient rehabilitation. The POMA, gait speed, and motor Functional Independence Measure (FIM) scores were collected at admission and at discharge from inpatient rehabilitation. A second trial of the POMA was …

Is Pramipexole Safe And Effective In Reducing Depressive Symptoms In Patients With Mild To Moderate Parkinson’S Disease And Depression?, Corinne J. Kern

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not pramipexole (Mirapex) is a safe and effective drug to treat depression in patients with mild to moderate Parkinson’s Disease (PD).

STUDY DESIGN: Review of three English language primary randomized controlled trials and one randomized prospective, observational study published between 2003-2010.

DATA SOURCES: Three randomized controlled trials and one randomized prospective, observational study comparing the efficacy of pramipexole to placebo, sertraline (an SSRI) and other dopamine agonists (pergolide) in the treatment of PD related depression symptoms were found using PubMed.

OUTCOME(S) MEASURED: Each of the …

Does Etravirine Decrease Central Nervous System (Cns)/Neuropsychiatric (Nps) Adverse Events Compared To Efavirenz, In Hiv Positive Patients?, Angelo D. T. Smith

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Etravirine (ETR) decreases adverse reactions on the central nervous system (CNS) compared to Efavirenz (EFV) in Human Immunodeficiency Virus (HIV) positive patients.

STUDY DESIGN: Review of three, English language, primary randomized controlled trial studies published in 2011.

DATA SOURCES: Three randomized controlled trials studying the possible decrease of ADR’s in HIV positive patients who are taking Efavirenz compared to study medication Etravirine.

OUTCOME(S) MEASURED: Outcomes measured were by surveys from patients that assess the development or cessation of CNS ADR’s. The self …

Inhibitory Effect Of Matrine On Blood-Brain Barrier Disruption For The Treatment Of Experimental Autoimmune Encephalomyelitis., Su Zhang, Quan-Cheng Kan, Yuming Xu, Guang-Xian Zhang, Lin Zhu

Department of Neurology Faculty Papers

Dysfunction of the blood-brain barrier (BBB) is a primary characteristic of experimental autoimmune encephalomyelitis (EAE), an experimental model of multiple sclerosis (MS). Matrine (MAT), a quinolizidine alkaloid derived from the herb Radix Sophorae Flave, has been recently found to suppress clinical EAE and CNS inflammation. However, whether this effect of MAT is through protecting the integrity and function of the BBB is not known. In the present study, we show that MAT treatment had a therapeutic effect comparable to dexamethasone (DEX) in EAE rats, with reduced Evans Blue extravasation, increased expression of collagen IV, the major component of the basement …

Delayed Amyloid Plaque Deposition And Behavioral Deficits In Outcrossed Aβpp/Ps1 Mice, Brian A. Couch, Meghan E. Kerrisk, Adam C. Kaufman, Haakon B. Nygaard, Stephen M. Strittmatter, Anthony J. Koleske

School of Biological Sciences: Faculty Publications

Alzheimer’s disease (AD) is a progressive neurodegenerative dementia characterized by amyloid plaque accumulation, synapse/dendrite loss, and cognitive impairment. Transgenic mice expressing mutant forms of amyloid-β precursor protein (AβPP) and presenilin-1 (PS1) recapitulate several aspects of this disease and provide a useful model system for studying elements of AD progression. AβPP/PS1 mice have been previously shown to exhibit behavioral deficits and amyloid plaque deposition between 4–9 months of age. We crossed AβPP/PS1 animals with mice of a mixed genetic background (C57BL/6 × 129/SvJ) and investigated the development of AD-like features in the resulting outcrossed mice. The onset of memory-based behavioral impairment …

Assistive Technology: Fixing Humans, Petros J. Katsioloudis, Millie Jones

STEMPS Faculty Publications

The need for assistive technology--technology that assists persons with disabilities--is great. At no time has there been a greater need to provide assistive technologies than to assist the thousands of military veterans returning home from the Middle East with a range of physical and mental disabilities. Mobility impairment is a significant concern for many returning veterans. Assistive technologies are playing a major role in assisting war veterans returning with physical limitations through the loss of a limb or, in many cases, several limbs. This article presents the history and background of assistive technology and how mobile- and computer-assistive technologies can …

Inhibitory Effect Of Il-17 On Neural Stem Cell Proliferation And Neural Cell Differentiation., Zichen Li, Ke Li, Lin Zhu, Quancheng Kan, Yaping Yan, Priyanka Kumar, Hui Xu, Abdolmohamad Rostami, Guang-Xian Zhang

Department of Neurology Faculty Papers

BACKGROUND: IL-17, a Th17 cell-derived proinflammatory molecule, has been found to play an important role in the pathogenesis of autoimmune diseases, including multiple sclerosis (MS) and its animal model, experimental autoimmune encephalomyelitis (EAE). While IL-17 receptor (IL-17R) is expressed in many immune-related cells, microglia, and astrocytes, it is not known whether IL-17 exerts a direct effect on neural stem cells (NSCs) and oligodendrocytes, thus inducing inflammatory demyelination in the central nervous system.

METHODS: We first detected IL-17 receptor expression in NSCs with immunostaining and real time PCR. We then cultured NSCs with IL-17 and determined NSC proliferation by neurosphere formation …

Neurocognitive Function Declines Following Migraine Headache In College Students, Marguerite Moore, T. Covassin, K.A. Pfeiffer, R.E. Norris, R.L. Jensen, C.F. Branta

Journal Articles

No abstract provided.

Identification Of Phosphorylation Sites In The Cooh-Terminal Tail Of The Μ-Opioid Receptor., Ying-Ju Chen, Sue Oldfield, Adrian J. Butcher, Andrew B. Tobin, Kunal Saxena, Vsevolod V. Gurevich, Jeffrey L. Benovic, Graeme Henderson, Eamonn Kelly

Department of Biochemistry and Molecular Biology Faculty Papers

Phosphorylation is considered a key event in the signalling and regulation of the μ opioid receptor (MOPr). Here, we used mass spectroscopy to determine the phosphorylation status of the C-terminal tail of the rat MOPr expressed in human embryonic kidney 293 (HEK-293) cells. Under basal conditions, MOPr is phosphorylated on Ser(363) and Thr(370), while in the presence of morphine or [D-Ala2, NMe-Phe4, Gly-ol5]-enkephalin (DAMGO), the COOH terminus is phosphorylated at three additional residues, Ser(356) , Thr(357) and Ser(375). Using N-terminal glutathione S transferase (GST) fusion proteins of the cytoplasmic, C-terminal tail of MOPr and point mutations of the same, we …

Key Neurological And Neurochemical Features In A Model Of Repetitive Concussions: Implications For Post-Concussion Headache, C. Macolino, B. Daiutolo, A. Tyburski, Melanie B. Elliott

Department of Neurosurgery Faculty Papers

Introduction

Incidence rates for concussion will continue to grow along with the increasing awareness and improvements in diagnosis. Headache is a hallmark feature of post-concussion syndrome. Post-concussion headache (PCH) is highly prevalent in the military with as high as 97.8% reporting having headaches¹. occurring in up to 85% of athletes following ^2-4. In the Military and sports, return to duty or play guidelines state that a soldier/player should be asymptomatic before returning to physical activity. However, headache following concussion is commonly dismissed. PCH can be a new headache resulting from head trauma or worsening of pre-existing headache …

Hyperosmolar Therapy For Raised Intracranial Pressure., Ethan A Benardete

Department of Neurosurgery Faculty Papers

No abstract provided.

Global Profiling Of Alternative Splicing Events And Gene Expression Regulated By Hnrnph/F, Erming Wang, Vahid Aslanzadeh, Filomena Papa, Haiyan Zhu, Pierre De La Grange, Franca Cambi

Neurology Faculty Publications

In this study, we have investigated the global impact of heterogeneous nuclear Ribonuclear Protein (hnRNP) H/F-mediated regulation of splicing events and gene expression in oligodendrocytes. We have performed a genome-wide transcriptomic analysis at the gene and exon levels in Oli-neu cells treated with siRNA that targets hnRNPH/F compared to untreated cells using Affymetrix Exon Array. Gene expression levels and regulated exons were identified with the GenoSplice EASANA algorithm. Bioinformatics analyses were performed to determine the structural properties of G tracts that correlate with the function of hnRNPH/F as enhancers vs. repressors of exon inclusion. Different types of alternatively spliced events …

Radiation Therapy Quality In Ccg/Pog Intergroup 9961: Implications For Craniospinal Irradiation And The Posterior Fossa Boost In Future Medulloblastoma Trials, Bernadine Donahue, Mary A.H. Marymont, Sandra Kessel, Matthew K. Iandoli, Thomas Fitzgerald, Emiko Holmes, Mehmet Kocak, James M. Boyett, Amar Gajjar, Roger J. Packer

Neurology Faculty Publications

Purpose: Associations of radiation therapy (RT) deviations and outcomes in medulloblastoma have not been defined well, particularly in the era of reduced-dose craniospinal irradiation and chemotherapy. The aim of this study is to evaluate the quality of RT on Children’s Cancer Group/Pediatric Oncology Group 9961 and analyze associations of RT deviations with outcome.

Materials and Methods: Major volume deviations were assessed based on the distance from specified anatomical region to field edge. We investigated associations of RT deviations with progression-free survival (PFS), overall survival (OS), and explored associations with demographics and clinical variables.

Results: Of the 308 patients who were …

Asymtomatic Arachnoid Cyst Presenting With Subdural Hygroma After Cyst Rupture: A Rare Complication, Pari Gul, Bushra Rehan, Saleha Anwar, Ayub Mansoor

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Prevelacne Of Pressure Ulcers In Patients With Spinal Cord Injury; A Retrospective Study, Aatik Arsh, Haider Darain, Syed Muhammad Ilyas, Amir Zeb

Pakistan Journal of Neurological Sciences (PJNS)

Pressure ulcers in patients with spinal cord injury (SCI) are associated with incredible financial cost and human sufferings. The aim of this retrospective study was to determine prevalence of pressure ulcers amongst patients with different levels of SCI.

Can Telemedicine Improve Stroke Outcomes?, Quratulain Shaikh, Ayeesha Kamran Kamal

Department of Medicine

No abstract provided.

3t Or Not To 3t? Making Sense Of Magnetic Field Strengths In Mr Scanners, Zafar Sajjad

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Frequency Of Carpal Tunnel Syndrome In Patients Of Diabetic Peripheral Neuropathy, Ahmad Furqan Dr., Naeem Kasuri, Athar Javed, Javed Iqbal, Haroon Khan, Mohsin Zaheer

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Leukemia With Ptosis, Saira Saad, Mazhar Badshah, Muhammad Tariq, Muhammad Irshad Awan, Sohail Rao, Mansoor Iqbal, Haris Majid Rajput, Zakir Jan

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Survey Of Knowledge, Attitude And Practice Of Epilepsy Among 221 School Teachers In Karachi, Syed Wasim Akhtar, Zarin Mogal, Shaukat Ali, Munawar Ali, Abdul Latif Sonija, Husainuddin Afridi, Hasan Aziz

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

A Clinical Approach To Myopathy, Sara Khan

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Spectrum Of Acute Clinical Characteristics Of Diagnosed Concussions In College Athletes Wearing Instrumented Helmets, Ann-Christine Duhaime,, Jonathan G. Beckwith, Arthur C. Maerlender, Thomas W. Mcallister, Joseph J. Crisco, Stefan M. Duma, P. Gunnar Brolinson, Steven Rowson, Laura A. Flashman, Jeffrey J. Chu, Richard M. Greenwald

Department of Psychology: Faculty Publications

Object. Concussive head injuries have received much attention in the medical and public arenas, as concerns have been raised about the potential shortand long-term consequences of injuries sustained in sports and other activities. While many student athletes have required evaluation after concussion, the exact definition of concussion has varied among disciplines and over time. The authors used data gathered as part of a multiinstitutional longitudinal study of the biomechanics of head impacts in helmeted collegiate athletes to characterize what signs, symptoms, and clinical histories were used to designate players as having sustained concussions.

Methods. Players on 3 college …

Metabolic Syndrome And Migraine., Amit Sachdev, Michael J Marmura

Department of Jefferson Headache Center Papers and Presentations

Migraine and metabolic syndrome are highly prevalent and costly conditions. The two conditions coexist, but it is unclear what relationship may exist between the two processes. Metabolic syndrome involves a number of findings, including insulin resistance, systemic hypertension, obesity, a proinflammatory state, and a prothrombotic state. Only one study addresses migraine in metabolic syndrome, finding significant differences in the presentation of metabolic syndrome in migraineurs. However, controversy exists regarding the contribution of each individual risk factor to migraine pathogenesis and prevalence. It is unclear what treatment implications, if any, exist as a result of the concomitant diagnosis of migraine and …

Risk Factors Associated With Death In In-Hospital Pediatric Convulsive Status Epilepticus, Tobias Loddenkemper, Tanvir U. Syed, Sriram Ramgopal, Deepak Gulati, Sikawat Thanaviratananich, Sanjeev V. Kothare, Amer Alshekhlee, Mohamad Z. Koubeissi

Neurology Faculty Publications

Objective

To evaluate in-patient mortality and predictors of death associated with convulsive status epilepticus (SE) in a large, multi-center, pediatric cohort.

Patients and Methods

We identified our cohort from the KID Inpatient Database for the years 1997, 2000, 2003 and 2006. We queried the database for convulsive SE, associated diagnoses, and for inpatient death. Univariate logistic testing was used to screen for potential risk factors. These risk factors were then entered into a stepwise backwards conditional multivariable logistic regression procedure. P-values less than 0.05 were taken as significant.

Results

We identified 12,365 (5,541 female) patients with convulsive SE aged …

Validation Of A Novel, Non-Invasive System For Autonomic Profiling In Healthy Volunteers, Agostino Ingraldi, Behzad B. Pavri, Himanshu Patel, Sammy Zakaria, Reginald T. Ho, Arnold J. Greenspon

The Medicine Forum

Noninvasive profiling of the autonomic nervous system has been shown to have prognostic value in patients with myocardial infarction, CHF and diabetes. The ANSAR system (ANX 3.0, Philadelphia, PA) is a new commercially available system that utilizes respiratory rate, HR and BP to assess on-going sympathovagal modulation during various maneuvers known to evoke autonomic perturbations. Instead of using conventional Fast Fourier Transform for frequency domain analysis, a Continuous Wavelet Transform (CWT) is used to generate numerical and graphical data. The system calculates Low Frequency Area (LFA, analogous to LF Power) and Respiratory Frequency Area (RFA, analogous to High Frequency Power.) …