Functional and cognitive outcomes in patients with covert cognition during acute intensive rehabilitation

Background: Disorders of consciousness (DOC) result from focal or extensive brain lesions. Patients suffering from DOC go through neurobehavioral assessments and are classified in different categories: coma, unresponsive wakefulness syndrome (UWS) (also known as vegetative state) and minimally conscious state (MCS). Recently, the broader use of technologies, such as functional neuroimaging and electroencephalography, has allowed the highlighting of preserved cognitive capacities in patients behaviourally categorized as UWS or MCS. Such condition is called cognitive motor dissociation (CMD). Objectives: 1) To investigate the consciousness/functional recovery in patients with disorders of consciousness (DOC) as well as those presenting with cognitive motor dissociation (CMD), 2) to compare the different functional outcomes to see whether those with preserved cognitive capacities differ and 3) to evaluate the patients’ clinical evolution between admission and discharge. Method: We retrospectively included 141 patients admitted to the Acute Neurorehabilitation Unit (NRA) of the University Hospital of Lausanne (CHUV, Lausanne, Switzerland) from November 2011 to August 2018 and investigated their functional outcomes at admission and discharge using 6 different outcome scales. Univariate analyses were then performed to compare the different functional outcomes. Results: Patients presenting with CMD were significantly associated with better functional outcomes and potential of improvement than the patients suffering from DOC. Conclusion: Our findings support the fact that CMD patients constitute a separate category of patients with different potential of improvement and functional outcomes than patients suffering from DOC. This reinforces the need for them to be recognized as soon as possible, as it could have a direct impact on patient care and influence life and death decisions

Predicting effects of corrosion erosion of high strength steel pipelines elbow on CO2-Acetic Acid (HAc) solution

Simultaneously effect of erosion combined with corrosion becomes the most concern in oil and gas industries. It is due to the fast deterioration of metal as effects of solid particles mixed with corrosive environment. There are many corrosion software to investigate possible degradation mechanisms developed by researchers. They are using many combination factors of chemical reactions and physical process. However effects of CO2 and acid on pipelines orientations are still remain uncovered in their simulation. This research will investigate combination effects of CO2 and HAc on corrosion and erosion artificial environmental containing sands particles in 45o , 90o and 180o elbow pipelines. The research used theoretical calculations combined with experiments for verification. The main concerns are to investigate the maximum erosion corrosion rate and maximum shear stress at the surface. Methodology used to calculate corrosion rate are Linear Polarization Resistance (LPR) and weight loss. The results showed that at 45ᵒ, erosion rate is the more significant effects in contributing degradation of the metal. The effects of CO2 and HAc gave significant effects when flow rate of the solution are high which reflect synergism effects of solid particles and those chemical compositions

Recovery in cognitive motor dissociation after severe brain injury: A cohort study.

To investigate the functional and cognitive outcomes during early intensive neurorehabilitation and to compare the recovery patterns of patients presenting with cognitive motor dissociation (CMD), disorders of consciousness (DOC) and non-DOC. We conducted a single center observational cohort study of 141 patients with severe acquired brain injury, consecutively admitted to an acute neurorehabilitation unit. We divided patients into three groups according to initial neurobehavioral diagnosis at admission using the Coma Recovery Scale-Revised (CRS-R) and the Motor Behavior Tool (MBT): potential clinical CMD, [N = 105]; DOC [N = 19]; non-DOC [N = 17]). Functional and cognitive outcomes were assessed at admission and discharge using the Glasgow Outcome Scale, the Early Rehabilitation Barthel Index, the Disability Rating Scale, the Rancho Los Amigos Levels of Cognitive Functioning, the Functional Ambulation Classification Scale and the modified Rankin Scale. Confirmed recovery of conscious awareness was based on CRS-R criteria. CMD patients were significantly associated with better functional outcomes and potential for improvement than DOC. Furthermore, outcomes of CMD patients did not differ significantly from those of non-DOC. Using the CRS-R scale only; approximatively 30% of CMD patients did not recover consciousness at discharge. Our findings support the fact that patients presenting with CMD condition constitute a separate category, with different potential for improvement and functional outcomes than patients suffering from DOC. This reinforces the need for CMD to be urgently recognized, as it may directly affect patient care, influencing life-or-death decisions

Phenotypic and genotypic evaluation of fluoroquinolone resistance in clinical isolates of Staphylococcus aureus in Tehran

Background: Fluoroquinolones are broad-spectrum antibiotics widely used in the treatment of bacterial infections such as Staphylococcus aureus isolates. Resistance to these antibiotics is increasing. Material/Methods: The occurrence of mutations in the grlA and gyrA loci were evaluated in 69 fluoroquinolone-resistant S. aureus isolates from 2 teaching hospitals of Tehran University of Medical Sciences. Results: Out of the 165 S. aureus isolates, 87 (52.7) were resistant to methicillin and 69 (41.8) were resistant to fluoroquinolone. Fluoroquinolone-resistant S. atoms isolates had a mutation at codon 80 in the grlA gene and different mutational combinations in the gyrA gene. These mutational combinations included 45 isolates at codons 84 and 86,23 isolates at codons 84,86 and 106 and 1 isolate at codons 84, 86 and 90. Fluoroquinolone-resistant S. aureus isolates were clustered into 33 PFGE types. Conclusions: The findings of this study show that the fluoroquinolone-resistant S. aureus strains isolated in the teaching hospitals in Tehran had multiple mutations in the QRDRs region of both grlA and gyrA genes

A novel chromogenic medium for isolation of Pseudomonas aeruginosa from the sputa of cystic fibrosis patients

AbstractBackgroundA novel chromogenic medium for isolation and identification of Pseudomonas aeruginosa from sputa of cystic fibrosis (CF) patients was evaluated and compared with standard laboratory methods.MethodsOne hundred sputum samples from distinct CF patients were cultured onto blood agar (BA), Pseudomonas CN selective agar (CN) and a Pseudomonas chromogenic medium (PS-ID). All Gram-negative morphological variants from each medium were subjected to antimicrobial susceptibility testing, and identification using a combination of biochemical and molecular methods.ResultsP. aeruginosa was isolated from 62 samples after 72 h incubation. Blood agar recovered P. aeruginosa from 56 samples (90.3%) compared with 59 samples (95.2%) using either CN or PS-ID. The positive predictive value of PS-ID (98.3%) was significantly higher than growth on CN (88.5%) for identification of P. aeruginosa (P<0.05).ConclusionsPS-ID is a promising medium allowing for the isolation and simultaneous identification of P. aeruginosa from sputa of CF patients