Διερεύνηση της επίδρασης του βελονισμού στη μείωση της φλεγμονώδους αντίδρασης και της σπαστικότητας μετά από τραυματισμό του νωτιαίου μυελού

Η κάκωση του νωτιαίου μυελού (ΚΝΜ) είναι μια σοβαρή παθολογική κατάσταση, η οποία προκαλεί σημαντική νοσηρότητα και θνησιμότητα στους ασθενείς που πάσχουν από αυτήν. Ο βελονισμός αποτελεί σημαντικό και αναπόσπαστο μέρος της παραδοσιακής κινεζικής ιατρικής, η οποία εφαρμόζεται στις ασιατικές χώρες για περισσότερα από 5.200 χρόνια. Η παρούσα βιβλιογραφική ανασκόπηση αποσκοπεί στην παρουσίαση πρόσφατων ερευνητικών δεδομένων σε σχέση με τη θεραπευτική επίδραση του βελονισμού σε ασθενείς με ΚΝΜ, και πιο συγκεκριμένα στη μείωση της φλεγμονώδους αντίδρασης και της σπαστικότητας μετά από τραυματισμό του νωτιαίου μυελού. Φαίνεται ότι ο βελονισμός, μέσω της αντιφλεγμονώδους δράσης του, είναι αποτελεσματικός σε ασθενείς με ΚΝΜ. Αυτή η θεραπευτική επίδραση είναι πολυπαραγοντική, περιλαμβάνοντας τη ρύθμιση της δραστηριότητας διαφόρων ενδογενών βιολογικών μεσολαβητών, την αναγέννηση των νευρικών ινών και των βλαστικών κυττάρων και την αναστολή της φλεγμονής, της νευρικής απόπτωσης και του οξειδωτικού στρες στον τραυματισμένο νωτιαίο μυελό. Δεδομένου ότι υπάρχουν ενδείξεις ότι η φλεγμονή παίζει σημαντικό ρόλο στη σπαστικότητα που παρατηρείται σε ασθενείς με ΚΝΜ, οι μελλοντικές έρευνες, τόσο σε πειραματικό όσο και σε κλινικό επίπεδο, κρίνονται απαραίτητες ώστε να ελεγχθεί η υπόθεση της στενής συσχέτισης μεταξύ της αντιφλεγμονώδους δράσης του βελονισμού και της επιτυχούς αντιμετώπισης της σπαστικότητας σε ασθενείς με ΚΝΜ.Spinal cord injury (SCI) is a serious pathological condition, which causes significant morbidity and mortality in patients who are suffering from it. Acupuncture is an important and integral part of traditional Chinese Medicine, which has been practiced in Asian countries for more than 5,200 years. The present narrative literature review aims to present recent research data in relation to the therapeutic effect of acupuncture on patients with SCI, and more specifically on the reduction of the inflammatory response and the spasticity after an injury of the spinal cord. It seems that acupuncture, through its anti-inflammatory effect, is effective in patients with SCI. This therapeutic effect is multifactorial, including the regulation of the activity of various endogenic biological mediators, the regeneration of nerve fibers and stem cells and the inhibition of inflammation, neural apoptosis and oxidative stress in the injured spinal cord. Since there is evidence that inflammation plays an important role in the spasticity seen in patients with SCI, there is necessity for future research, both at the experimental and also at the clinical level, in order to test the hypothesis of a close correlation between the anti-inflammatory effect of acupuncture and the successful treatment of spasticity in patients with SCI

Oxcarbazepine as monotherapy of acute mania in insufficiently controlled type-1 diabetes mellitus: a case-report

<p>Abstract</p> <p>Background</p> <p>Type-1 diabetes mellitus (DM) is a lifelong serious condition which often renders the application of standard treatment options for patients' comorbid conditions, such as bipolar disorder I, risky – especially for acute manic episodes. We present such a case whereby the application of standard anti-manic treatments would have jeopardized a patient whose physical condition was already compromised by DM.</p> <p>Methods</p> <p>We report the case of a 55-year-old female with a history of type-1 DM since the age of 11, and severe ocular and renal vascular complications thereof. While on the waiting list for pancreatic islet cell transplantation, she developed a manic episode that proved recalcitrant to a treatment with gabapentin, lorazepam and quetiapine. Moreover, her mental state affected adversely her already compromised glycemic control, requiring her psychiatric hospitalization. Her psychotropic medication was almost discontinued and replaced by oxcarbazepine (OXC) up to 1800 mg/day for 10 days.</p> <p>Results</p> <p>The patient's mental state improved steadily and on discharge, 3 weeks later, she showed an impressive improvement rate of over 70% on the YMRS. Moreover, she remains normothymic 6 months after discharge, with OXC at 1200 mg/day.</p> <p>Conclusion</p> <p>Standard prescribing guidelines for acute mania recommend a combination of an antipsychotic with lithium or, alternatively, a combination of an antipsychotic with valproate or carbamazepine. However, in our case, administration of lithium was at least relatively contra-indicated because of patient's already compromised renal function. Furthermore, antipsychotics increase glucose levels and thus were also relatively contra-indicated. Moreover, the imminent post-transpantation immunosupressant treatment with immuno-modulating medicines also contra-indicated both valproate and carbamazepine. Despite the severe methodological limitations of case reports in general, the present one suggests that OXC as monotherapy might be both safe and efficacious in the treatment of acute mania in patients with early-onset type-1 DM, whose already compromised physical condition constitutes an absolute or relative contra-indication for the administration of standard treatments, though there are no, as yet, randomized clinical trials attesting to its efficacy unambiguously.</p

High performance shared state schedulers

Large organizations and research institutes store a huge volume of data nowadays.In order to gain any valuable insights distributed processing frameworks over acluster of computers are needed. Apache Hadoop is the prominent framework fordistributed storage and data processing. At SICS Swedish ICT we are building Hops, a new distribution of Apache Hadoop relying on a distributed, highly available MySQL Cluster NDB to improve performance. Hops-YARN is the resource management framework of Hops which introduces distributed resource management, load balancing the tracking of resources in a cluster. In Hops-YARN we make heavy usage of the back-end database storing all the resource manager metadata and incoming RPCs to provide high fault tolerance and very short recovery time. This project aims in optimizing the mechanisms used for persisting metadata in NDB both in terms of transactional commit time but also in terms of pre-processing them. Under no condition should the in-memory RM state diverge from the state stored in NDB. With these goals in mind several solutions were examined that improved the performance of the system, making Hops-YARN comparable to Apache YARN with the extra benefits of high-fault tolerance and short recovery time. The solutions proposed in this thesis project enhance the pure commit time of a transaction to the MySQL Cluster and the pre-processing and parallelism of our Transaction Manager. The results indicate that the performance of Hops increased dramatically, utilizing more resources on a cluster with thousands of machines. Increasing the cluster utilization by a few percentages can save organizations a big amount of money.Nu för tiden lagrar stora organisationer och forskningsinstitutioner enorma mängder data.För att kunna utvinna någon värdefull information från dessa data behöver den bearbetasav ett kluster av datorer. När flera datorer gemensamt ska bearbeta data behöver de utgåfrån ett så kallat "distributed processing framework''. I dagsläget är Apache Hadoop detmest använda ramverket för distribuerad lagring och behandling av data. Detta examensarbeteär har genomförts vid SICS Swedish ICT där vi byggt Hops, en ny distribution avApache Hadoop som drivs av ett distribuerat MySQL Cluster NDB som erbjuder en hög tillgänglighet.Hops-YARN är Hops ramverk för resurshantering med distribuerade ResourceManagers som lastbalanserarderas ResourceTrackerService. I detta examensarbete använder vi Hops-Yarn på ett sätt där ``back-end''databasen flitigt används för att hantera ResourceManagerns metadata och inkommande RPC-anrop. Vårkonfiguration erbjuder en hög feltolerans och återställer sig mycket snabbt vidfelberäkningar. Vidare används NDB-klustrets Event API för att ResourceManager ska kunnakommunicera med den distribuerade ResourceTrackers. Detta projekt syftar till att optimera de mekanismer som används för ihållande metadatai NDB både i termer av transaktions begå tid men också i termer av pre-bearbeta dem medan samtidigt garantera enhetlighet i RM: s tillstånd. ResourceManagerns tillståndi RAM-minnet får under inga omständigheteravvika från det tillstånd som finns lagrat i NDB:n. Med dessa mål i åtanke undersöktes fleralösningar som förbättrar prestandan och därmed gör Hops-Yarn jämförbart med Apache YARN.De lösningar som föreslås i denna uppsats förbättrar “pure commit time” när en transaktiongörs i ett MySQL Cluster samt förbehandlingen och parallelismen i vår Transaction Manager.Resultaten tyder på att Hops prestanda ökade dramatiskt vilket ledde till ett effektivarenyttjande av tillgängliga resurser i ett kluster bestående av ett tusental datorer. Närnyttjandet av tillgänliga resurser i ett kluster förbättras med några få procent kanorganisationer spara mycket pengar