Neurological and neurourological complications of electrical injuries

Electrical injury can affect any system and organ. Central nervous system (CNS) complications are especially well recognised, causing an increased risk of morbidity, while peripheral nervous system (PNS) complications, neurourological and cognitive and psychological abnormalities are less predictable after electrical injuries.PubMed was searched for English language clinical observational, retrospective, review and case studies published in the last 30 years using the key words: electrical injury, electrocution, complications, sequelae, neurological, cognitive, psychological, urological, neuropsychological, neurourological, neurogenic, and bladder.In this review, the broad spectrum of neurological, cognitive, psychological and neurourological consequences of electrical trauma are discussed, and clinical features characteristic of an underlying neurological, psychological or neurourological disorder are identified. The latest information about the most recently discovered forms of nervous system disorders secondary to electrical trauma, such as the presentation of neurological sequelae years after electrocution, in other words long-term sequelae, are presented. Unexpected central nervous system or muscular complications such as hydrocephalus, brain venous thrombosis, and amyotrophic lateral sclerosis are described. Common and uncommon neuropsychological syndromes after electrical trauma are defined. Neurourological sequelae secondary to spinal cord or brain trauma or as independent consequences of electrical shock are also highlighted

Development and reliability of questionnaires for the assessment of diet and physical activity behaviors in a multi-country sample in Europe the Feel4Diabetes Study

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In vitro & In vivo μελέτη αντιοξειδωτικής & αντιφλεγμονώδους δράσης εκχυλισμάτων φυτών του γένους Crepis L. (Asteraceae)

Η παρούσα διπλωματική εργασία πραγματοποιήθηκε με σκοπό την αξιολόγηση της αντιοξειδωτικής και αντιφλεγμονώδους δράσης εκχυλισμάτων και κλασμάτων φυτών του γένους Crepis L., της οικογένειας Asteraceae. Η αξιολόγηση έλαβε χώρα μέσω in vitro αλλά και in vivo δοκιμασιών. Τα στάδια αυτής της πειραματικής μελέτης είναι τρία και διακρίνονται στα παρακάτω. Στο πρώτο πειραματικό στάδιο, έγινε εκχύλιση υπέργειων και υπόγειων τμημάτων των φυτών με κατάλληλους διαλύτες. Αρχικά, το εκάστοτε τμήμα του φυτού (δρόγη) εκχυλίστηκε με μίγμα διαλυτών: κυκλοεξάνιο, μεθανόλη και αιθέρα σε αναλογίες 1:1:1 (από όπου προέκυψε το άπολο εκχύλισμα της δρόγης) και στη συνέχεια η ίδια η δρόγη εκχυλίστηκε με μεθανόλη και νερό σε αναλογία 5:1 (από όπου προέκυψε το πολικό εκχύλισμα της δρόγης). Στο δεύτερο πειραματικό στάδιο, πραγματοποιήθηκαν in vitro δοκιμασίες στα εκχυλίσματα που ελήφθησαν, αλλά και σε κλάσματα του πολικού εκχυλίσματος του φυτού Crepis incana (RIN). Αρχικά, έγινε διερεύνηση της αντιοξειδωτικής τους δράσης χρήσει του αντιδραστηρίου DPPH. Σε αυτή τη δοκιμασία, ιδιαίτερα δραστικό φάνηκε το εκχύλισμα Crepis incana 5:1 με IC50 ίση με 0.07 mg/mL, τα εκχυλίσματα Crepis heldreichiana 5:1, Crepis dioscoridis 5:1 και τα κλάσματα RINI, RINJ, RINH με IC50 ίση με 0.10, 0.12 και 0.06, 0.11, 0.12 mg/mL αντίστοιχα. Εν συνεχεία προσδιορίστηκε το ολικό φαινολικό περιεχόμενό τους με τη μέθοδο Folin Ciocalteu. Από αυτήν προέκυψε ότι το πλουσιότερο φαινολικό περιεχόμενο εμφάνισαν το εκχύλισμα Crepis incana 5:1 (0.08 Gallic Acid Equivalents - GAE) και τα κλάσματα RINB (0.13 GAE), RINC (0.17 GAE) και RINI (0.12 GAE). Ακολούθησε αξιολόγηση της αντιφλεγμονώδους δράσης βάσει της in vitro αναστολής του ενζύμου λιποξυγονάσης και προέκυψε ότι τα πιο άπολα εκχυλίσματα εμφάνισαν μεν δράση αλλά όχι αξιόλογη, ενώ τα πιο πολικά εκχυλίσματα δεν εμφάνισαν δράση. Αυτό πιθανώς αιτιολογείται με το ότι τα εκχυλίσματα / κλάσματα εμφάνισαν τα ίδια κάποια απορρόφηση στα 234nm (μήκος κύματος στο οποίο ελέγχθηκε η δράση του ενζύμου βάση του πρωτοκόλλου της δοκιμασίας), γεγονός που πιθανά παρεμβαίνει στη σωστή εκτίμηση της ανασταλτικής δράσης του υπό εξέταση εκχυλίσματος / κλάσματος. Στο τρίτο και τελευταίο πειραματικό στάδιο διεξήχθησαν τρία διαφορετικά in vivo πειράματα για τη μελέτη της αντιοξειδωτικής, αντιυπερλιπιδαιμικής και αντιφλεγμονώδους δράσης των εκχυλισμάτων και κλασμάτων που επέδειξαν καλή αντιοξειδωτική και αντιφλεγμονώδη δράση στις in vitro δοκιμασίες. Αρχικά, διερευνήθηκε η αντιφλεγμονώδης δράση των εκχυλισμάτων Crepis incana 5:1, Crepis heldreichiana 5:1 και Crepis dioscoridis 5:1 και των κλασμάτων RINH και RINI, κατόπιν πρόκλησης οιδήματος άκρου ποδός μυός με καραγενίνη. Ιδιαίτερα καλή δράση εμφάνισαν τα εκχυλίσματα Crepis incana 5:1, Crepis dioscoridis 5:1 και το κλάσμα RINH. Στη συνέχεια μελετήθηκε η αντιυπερλιπιδαιμική και αντιοξειδωτική δράση των Crepis incana 5:1, Crepis dioscoridis 5:1, RINH και RINI κατόπιν πρόκλησης οξείας υπερλιπιδαιμίας / οξειδωτικού στρες. Σημαντική δράση επέδειξε το εκχύλισμα Crepis incana 5:1, αυξάνοντας το αντιοξειδωτικό δυναμικό και μειώνοντας τα επίπεδα χοληστερόλης και τριγλυκεριδίων του πλάσματος. Το εκχύλισμα Crepis dioscoridis 5:1 μείωσε σημαντικά τη χοληστερόλη του πλάσματος, ενώ το κλάσμα RINI έδειξε την τάση να μειώνει τη χοληστερόλη και τα τριγλυκερίδια του πλάσματος. Τέλος, μελετήθηκε η προστατευτική και θεραπευτική δράση υδατικής γέλης που περιείχε το εκχύλισμα Crepis incana 5:1 σε in vivo πείραμα, όπου προκλήθηκε φλεγμονή στο δέρμα με UV ακτινοβόληση. Σε αυτή τη δοκιμασία, σημειώθηκε αξιόλογη αύξηση της ενυδάτωσης και μείωση της άδηλης απώλειας νερού, της ερυθρότητας και του πάχους της επιδερμίδας σε σχέση με την ομάδα Control, αλλά μόνο οριακά μεγαλύτερη ενυδάτωση και μικρότερη άδηλη απώλεια νερού, ερυθρότητα και πάχος επιδερμίδας σε σχέση με την ομάδα που λάμβανε μόνο το έκδοχο - γέλη. Από τις μετρήσεις στα διάφορα στάδια του πειράματος, η προστατευτική - θεραπευτική δράση του εκχυλίσματος φαίνεται ότι δε μπόρεσε να αναδειχθεί πέραν της όποιας ευεργετικής δράσης του εκδόχου.The scope of the present dissertation is the evaluation of the antioxidant and anti-inflammatory activity of extracts and fractions of several plants of the genus Crepis L., of the Asteraceae family. This evaluation was performed through both in vitro and in vivo assays. The stages of this experimental study are three as described below: In the first experimental stage, aboveground and underground parts of the plants were extracted with appropriate solvents. Initially, the plant parts were extracted with the following mixture of solvents: cyclohexane, methanol and ethyl ether in a 1:1:1 ratio (non - polar extracts) followed by an extraction with methanol and water in a 5:1 ratio (polar extracts). In the second experimental stage, in vitro assays were performed on the obtained extracts, as well as on fractions of the polar extract of the plant Crepis incana (RIN). Initially, their antioxidant activity was investigated using the DPPH reagent. According to this assay, the Crepis incana 5:1 extract was particularly active with an IC50 equal to 0.07 mg/mL, while the extracts Crepis heldreichiana 5:1, Crepis dioscoridis 5:1 and fractions RINI, RINJ, RINH exhibited an IC50 equal to 0.10, 0.12 and 0.06, 0.11, 0.12 mg/mL, respectively. Their total phenolic content was then determined by the Folin Ciocalteu method. It was shown that the richest phenolic content was exhibited by the Crepis incana 5:1 extract (0.08 Gallic Acid Equivalents - GAE) followed by the fractions RINB (0.13 GAE), RINC (0.17 GAE) and RINI (0.12 GAE). Subsequently, the in vitro anti-inflammatory activity, based on the inhibition offered against the enzyme lipoxygenase, was evaluated. The results indicated that the non - polar extracts showed activity but not significant, while the polar extracts did not show activity. This may be due to the absorption of the extracts / fractions themselves, at 234nm (detection wavelength for this assay). In the third and last experimental stage, three different in vivo protocols were performed to study the antioxidant, anti-hyperlipidemic and anti-inflammatory effects of extracts and fractions that showed good antioxidant and anti-inflammatory activity in the in vitro assays. Initially, the anti-inflammatory activity of Crepis incana 5:1, Crepis heldreichiana 5:1 and Crepis dioscoridis 5:1 extracts and RINH, RINI fractions was investigated following carrageenin-induced paw edema in mice. The extracts Crepis incana 5:1, Crepis dioscoridis 5:1 and the fraction RINH showed particularly good activity. The anti-hyperlipidemic and antioxidant activities of Crepis incana 5:1, Crepis dioscoridis 5:1, RINH and RINI were then studied in an experimentally induced acute hyperlipidemia / oxidative stress mouse model. The Crepis incana 5:1 extract showed the best antioxidant and anti-hyperlipidemic activity, while the Crepis dioscoridis 5:1 extract significantly reduced plasma cholesterol, and the RINI fraction showed a tendency to reduce plasma cholesterol and triglycerides. Finally, the protective and therapeutic effect of the Crepis incana 5:1-containing aqueous gel was studied in an in vivo experiment where inflammation of the skin was induced by UV irradiation. In this experiment, a significant increase in hydration and a significant decrease in the transepidermal water loss, redness and thickness of the skin were observed compared to the Control group. However, compared to the group receiving the Excipient (aqueous gel), only a borderline improvement was observed. From the measurements at various stages of the experiment, the protective - therapeutic effect of the Crepis incana 5:1 gel could not be fully appreciated since they did not add to the observed activity of the Excipient itself

Democratic Administration and Commitment of Members of Agricultural Cooperatives: A Case Study from a Prefecture in Greece

Cooperatives are democratic organizations, governed and controlled by their members, who are actively involved in their policy-making and decision-making process. The aim of this paper is to investigate the correlation between cooperative culture and the way that cooperatives are governed. To this end, a probability sampling method is used in the agricultural cooperatives of the Greek prefecture of Larissa, which is one of the most powerful and dynamic in the agricultural economy. The data collection was carried out to 100 members of agricultural cooperatives through the use of a closed-ended questionnaire. The findings highlighted that agricultural cooperatives are distinguished for their increased level of cooperative culture and commitment, provided that the conditions for the democratic governance of cooperatives are met. The role played by the level of education of the members of the agricultural cooperatives was also important, thus confirming the main purpose of the research, which was none other than to prove this correlation. Finally, this correlation can lead to the improvement of certain elements which contribute to the optimization of agricultural governance

Reasons for Failed Trials of Disease-Modifying Treatments for Alzheimer Disease and Their Contribution in Recent Research

Despite all scientific efforts and many protracted and expensive clinical trials, no new drug has been approved by FDA for treatment of Alzheimer disease (AD) since 2003. Indeed, more than 200 investigational programs have failed or have been abandoned in the last decade. The most probable explanations for failures of disease-modifying treatments (DMTs) for AD may include late initiation of treatments during the course of AD development, inappropriate drug dosages, erroneous selection of treatment targets, and mainly an inadequate understanding of the complex pathophysiology of AD, which may necessitate combination treatments rather than monotherapy. Clinical trials’ methodological issues have also been criticized. Drug-development research for AD is aimed to overcome these drawbacks. Preclinical and prodromal AD populations, as well as traditionally investigated populations representing all the clinical stages of AD, are included in recent trials. Systematic use of biomarkers in staging preclinical and prodromal AD and of a single primary outcome in trials of prodromal AD are regularly integrated. The application of amyloid, tau, and neurodegeneration biomarkers, including new biomarkers—such as Tau positron emission tomography, neurofilament light chain (blood and Cerebrospinal fluid (CSF) biomarker of axonal degeneration) and neurogranin (CSF biomarker of synaptic functioning)—to clinical trials allows more precise staging of AD. Additionally, use of Bayesian statistics, modifiable clinical trial designs, and clinical trial simulators enrich the trial methodology. Besides, combination therapy regimens are assessed in clinical trials. The above-mentioned diagnostic and statistical advances, which have been recently integrated in clinical trials, are relevant to the recent failures of studies of disease-modifying treatments. Their experiential rather than theoretical origins may better equip potentially successful drug-development strategies

Neurological and neurourological complications of electrical injuries

Electrical injury can affect any system and organ. Central nervous system (CNS) complications are especially well recognised, causing an increased risk of morbidity, while peripheral nervous system (PNS) complications, neurourological and cognitive and psychological abnormalities are less predictable after electrical injuries. PubMed was searched for English language clinical observational, retrospective, review and case studies published in the last 30 years using the key words: electrical injury, electrocution, complications, sequelae, neurological, cognitive, psychological, urological, neuropsychological, neurourological, neurogenic, and bladder. In this review, the broad spectrum of neurological, cognitive, psychological and neurourological consequences of electrical trauma are discussed, and clinical features characteristic of an underlying neurological, psychological or neurourological disorder are identified. The latest information about the most recently discovered forms of nervous system disorders secondary to electrical trauma, such as the presentation of neurological sequelae years after electrocution, in other words long-term sequelae, are presented. Unexpected central nervous system or muscular complications such as hydrocephalus, brain venous thrombosis, and amyotrophic lateral sclerosis are described. Common and uncommon neuropsychological syndromes after electrical trauma are defined. Neurourological sequelae secondary to spinal cord or brain trauma or as independent consequences of electrical shock are also highlighted

Prevalence of dementia in elderly patients with hip fracture

Hip fractures occur commonly and are a cause of disability for older adults and lead to increased dependence and requirements for social support. Dementia is one of the possible risk factors for falling and hip fracture, a potential source for complications during surgery and during the postoperative period, difficulties in rehabilitation and a risk factor for hip fracture reccurence. However, in previous studies of hip fracture patients, cognitive status has not been formally assessed during the inpatient stay and diagnosis was based only on previous history. Additionally, no previous studies have compared prevalence of dementia between elderly patients with hip fracture and patients with other surgical pathology. Our aim was to define whether dementia was more prevalent in older subjects with hip fracture than in other elderly patients undergoing surgery. In this study, we prospectively assessed all patients aged 68 and older admitted to our hospital for hip fracture surgery during a one year period and compared them with age and gender matched patients attending other surgical departments. 80 hip fracture patients and 80 controls were assessed for dementia. Dementia was common in both groups, presumably reflecting the advanced mean age of both groups and cognitive deterioration due to hospitalization-status. Dementia was significantly higher in the hip fracture group (85%) compared to the control group (61.5%; p=0.002). Dementia is very common in older patients admitted for surgery to a general hospital and extremely common in those with hip fracture. It seems that dementia is under diagnosed in elderly hospitalised patients. Our data confirm that dementia is a major risk factor for hip fracture in the elderly

Prevalence of Parkinsonism in older patients with hip fracture

Parkinsonism in hip fracture (HF) patients is a potential source for complications during surgery, postoperative period and rehabilitation and a risk factor of second HF. We investigated whether parkinsonism was more prevalent in older subjects with HF than in other older patient groups undergoing surgery. We prospectively assessed patients who had suffered HF and controls. We assigned all patients aged 68 and older admitted in our hospital for HF surgery during last year and compared them with age- and gender matched patients attending other surgical departments. 80 HF patients and 80 controls were assessed for parkinsonism. Parkinsonism was common in both groups, presumably reflecting the mean ages of approximately 80 years, plus hospitalization-status. However, parkinsonism was much higher in the hip fracture group (76.25%) compared to the control hospitalised subjects (37.5%; p < 0.001). The majority of HF patients with parkinsonism were undiagnosed for their parkinsonism symptoms prior to HF and the same was observed in the control group (91.8% and 86.7% respectively, p = 0.471). Among those with parkinsonism, pre-hospitalization drug therapy may have been contributory in 24.5% of HF patients and 30% of controls (p = 0.589). Parkinsonism is very common in older patients admitted for surgery to a general hospital and extremely common in those with HF. It seems that parkinsonism, is heavily under recognised in the elderly. Our data seem to confirm that Parkinsonism is a major risk factor of HF in the elderly

Symptoms of Acute Posttraumatic Stress Disorder in Prostate Cancer Patients Following Radical Prostatectomy

Psychological morbidity is increasingly reported in cancer survivors. The authors’ objective was to determine the presence of acute posttraumatic stress disorder (PTSD) symptoms in prostate cancer (PC) patients following radical prostatectomy. Fifteen patients who underwent radical prostatectomy for localized prostate cancer were assessed for the presence of PTSD-related symptoms by completing the Davidson Trauma Scale (DTS), a month following the procedure. A group of 20 patients who underwent surgery for benign prostate hyperplasia (BPH) served as the control group. PTSD total scores were significantly higher in PC patients when compared with BPH patients, whose PTSD scores did not differ from those reported in the general population (32.6 +/- 18.5 vs. 11.3 +/- 9.7, p = .001). PTSD did not vary among PC patients when adjusted for educational status. PTSD symptoms are common among patients undergoing radical prostatectomy and independent of their educational level. Research investigating these aspects of posttreatment psychological adjustment is needed for developing well-targeted psychological interventions