Učinak atorvastatina na debljinu arterijske intime medije u bolesnika s ishemijskim moždanim udarom

Occlusion of the initial segment of internal carotid artery is the most common reason for vascular events in the brain. The purpose of this study was to investigate the effect of oneyear treatment with atorvastatin on intima-media thickness (IMT) of carotid arteries as a measure of atherosclerosis in stroke patients. In this prospective interventional study, 44 patients with ischemic stroke were investigated. Patients were treated with atorvastatin 40 mg once a day for one year. IMT of carotid arteries was measured by extracranial Doppler ultrasonography in the distal part of the common carotid artery at the beginning of the study, at 6 months and one year of treatment with atorvastatin. The IMT of both right and left carotid arteries decreased after 6- and 12-month atorvastatin treatment. Based on the results of this study, long-term administration of atorvastatin was associated with reduction in carotid artery IMT in patients with ischemic stroke. Such a decrease in IMT may prevent subsequent stroke or cardiovascular events in these patients.Blokada početnog dijela interne karotidne arterije najčešći je razlog vaskularnih ispada u mozgu. Namjera ovoga istraživanja bila je ispitati učinak jednogodišnje terapije atorvastatinom na debljinu intime medije (intima-media thickness, IMT) karotidnih arterija kao mjere ateroskleroze kod bolesnika s moždanim udarom. U ovoj prospektivnoj intervencijskoj studiji ispitana su 44 bolesnika s ishemijskim moždanim udarom. Bolesnici su liječeni atorvastatinom, 40 mg jedanput na dan kroz jednu godinu. IMT karotidnih arterija mjeren je ekstrakranijskom Doppler ultrasonografijom u distalnom dijelu zajedničke karotidne arterije na početku istraživanja te nakon 6 mjeseci i 12 mjeseci liječenja atorvastatinom. Zabilježeno je sniženje IMT i u desnoj i u lijevoj karotidnoj arteriji nakon 6 mjeseci i 12 mjeseci liječenja atorvastatinom. Rezultati ovoga istraživanja pokazuju da je dugotrajno uzimanje atorvastatina bilo udruženo sa smanjenjem IMT karotidnih arterija u bolesnika s ishemijskim moždanim udarom. Takvo sniženje IMT moglo bi spriječiti naknadni moždani udar ili kardiovaskularne ispade kod ovih bolesnika

Effectiveness of Mindfulness Intervention on Cognitive Functions: A Meta-analysis of Mindfulness Studies

Background: The experience of cognitive deficits is common among patients with degenerative and psychiatric disorders. Objective: The present study aimed to evaluate the effect of the empirical literature of mindfulness intervention on cognitive functions. Methods: This study was conducted in June 2020 by using the scientific records were retrieved by a systematic search of several bibliographic databases on the Medline, Scopus, ISI Web of Sciences, Google scholar database from 2000 to 2020 for testing the effect of mindfulness intervention on cognitive functions. For data analysis CMA2 software were used. Heterogeneity assessed by Cochran’s Q statistics test. Publication Bias assessed by Orwin fail safe N, Begg’s method kendall’s Tau, Egger’s method intercept and funnel plot. Results: from 17 initial studies, 28 effect sizes were calculated. Among the 28 effect sizes, 6 indicators were negative and 22 indicators were positive. key results from the meta-analysis, Compared to healthy controls showed that people were receive mindfulness intervention significantly improved in working memory and attention function, with this enhance medium magnitude (Hedges’ g = 0.32, 0.35 respectively, see Figure 2). There was no significant improve by use mindfulness intervention on executive function. Conclusions: The results prove the initial evidence that mindfulness intervention can improve some neurocognitive processing such as attention function and working memor

Parkinson’s Disease Is Associated With Dysregulation of Circulatory Levels of lncRNAs

Long non-coding RNAs (lncRNAs) have been recently reported to be involved in the pathoetiology of Parkinson’s disease (PD). Circulatory levels of lncRNAs might be used as markers for PD. In the present work, we measured expression levels of HULC , PVT1 , MEG3 , SPRY4-IT1 , LINC-ROR and DSCAM-AS1 lncRNAs in the circulation of patients with PD versus healthy controls. Expression of HULC was lower in total patients compared with total controls (Expression ratio (ER)=0.19, adjusted P value<0.0001) as well as in female patients compared with female controls (ER=0.071, adjusted P value=0.0004). Expression of PVT1 was lower in total patients compared with total controls (ER=0.55, adjusted P value=0.0124). Expression of DSCAM-AS1 was higher in total patients compared with total controls (ER=5.67, P value=0.0029) and in male patients compared with male controls (ER=9.526, adjusted P value=0.0024). Expression of SPRY4-IT was higher in total patients compared with total controls (ER=2.64, adjusted P value<0.02) and in male patients compared with male controls (ER=3.43, P value<0.03). Expression of LINC-ROR was higher in total patients compared with total controls (ER=10.36, adjusted P value<0.0001) and in both male and female patients compared with sex-matched controls (ER=4.57, adjusted P value=0.03 and ER=23.47, adjusted P value=0.0019, respectively). Finally, expression of MEG3 was higher in total patients compared with total controls (ER=13.94, adjusted P value<0.0001) and in both male and female patients compared with sex-matched controls (ER=8.60, adjusted P value<0.004 and ER=22.58, adjusted P value<0.0085, respectively). ROC curve analysis revealed that MEG3 and LINC-ROR have diagnostic power of 0.77 and 0.73, respectively. Other lncRNAs had AUC values less than 0.7. Expression of none of lncRNAs was correlated with age of patients, disease duration, disease stage, MMSE or UPDRS. The current study provides further evidence for dysregulation of lncRNAs in the circulation of PD patients

Evaluation of Distributive Frequency of Oral Contraceptive Pills Consumption in Women with Cerebrovascular Events Admitted in Farshchian Hospital of Hamadan between 1997-2007

Background & Objectives: Although there is no prolonged time elapsed from propagation of oral contraceptive pills (OCP), case reports demonstrated occurrence of pulmonary embolism and cerebral infarction in women using these pills. Present study was done to specify distributive frequency of oral contraceptive pills consumption in women with cerebrovascular events admitted in Farshchian hospital of Hamadan between 1997 to 2007. Materials & Methods: Every woman with cerebrovascular events during years 1997-2007 who was admitted in Farshchian hospital of Hamadan and her dossier was present in archive of hospital, were carefully checked and those who hadn’t exclusion criteria, were include in this study, a total of 1587 of them with respect to their Characteristics such as type of cerebrovascular event, age, type of oral contraceptive pill and duration of pill use were extracted from patient dossier and registered in respective checklist. Results: 24.1% of patient used oral contraceptive pill and 76.9% of patients were non users. Mean age of OCP users and non users were 45 years. Mean duration of pill use among these patients was 33 months. In assessing type of vascular events, in the group OCP users 73.1% and non users 66.4% had ischemic stroke.Which was statistically significant. In the group OCP users 24.6% and non users 29.1% were hemorrhagic stroke.. Also in the group OCP users 2.3% and non users 4.5% were affected sagital sinuses thrombosis that showed no significant difference. Among OCP users 85% of the patients used OCP, LD and 15% of the patients OCP, HD. Conclusion: The present study showed, the ischemic stroke rate of the patients with OCP consumption were significantly more than those of non users

Comparison of Serum Levels of Magnesium and Potassium in Stroke Patient and Healthy Controls

Background & Objectives: CVA (cerebrovascular accident) is the most common debilitating disease. Studies show that magnesium and potassium have significant neuroprotective effects. The aim of this study is evaluation of serum levels of potassium and magnesium in stroke patients. Materials & Methods: In this case study, 70 stroke patients were entered in following manner. For a patient, a questionnaire include: age, sex, and kind of stroke was provided and then, in which the serum levels of magnesium and potassium were entered. These levels were compared with those of control group (70 people) whose individuals were sexual and age wise identical and results from these were analyzed with statistical test, t-test. Results: From 70 patients who were entered in this study, 39 (55.7%) individuals were male and 31 (44.3%) female. The mean age of case group was 72.11±10.76. The mean serum level of magnesium and potassium in case group was 1.89±0.25meq/L and 3.81±0.26 meq/L respectively and in control group was 1.95±0.46 meq/L and 3.9±0.41 meq/L that showed the mean serum level of magnesium and potassium in CVA patients was lower than control group, and only about serum level K is significant (P=0.004) Conclusion: The serum level of magnesium and potassium in stroke patients is lower than control group

Spinal Dural Arteriovenous Fistula (SDAVF) in a Patient with Progressive Paraparesia: A Case Report

Background: Spinal dural arteriovenous fistula (SDAVF) is a known cause of nontraumatic slow progressive araparesia and is frequently overlooked because its clinical features overlap with more common causes of myelopathy and also neuroimaging may be normal. Case Report: A 53 year-old man with developed weakness of both lower limbs had symptoms begun spontaneously 3.5 month before admission and progressed from 1 month ago with bowel and bladder incontinence. The patient's physical examination was normal and neurologic testing revealed lower extremity motor strength of 3/5. Deep tendon reflexes were decreased and superficial abdominal reflexes were absent. Sensation of pinprick and temperature was absent distal to the T4-T5 level. Vibration and proprioception were decreased to the ankle and saddle anesthesia and the patient was non ambulatory. Laboratory routine and specific tests for vitamin B12 level, hepatitis, HIV, HTLV1, 2 were negative. MRI of spine with and without contrast raised the possibility of dural arteriovenous malformation extended from T3 level to conus medullaris which was confirmed by angiography. The patient referred to neurosurgeon for deciding route of treatment. Conclusion: SDAVF can be a significant non traumatic slowly progressive cause of myelopathy. The majority of the affected patients are males older than 50 years of age. Rapid diagnosis in these patients leads to significant improvement

Relationship of Retinal Nerve Fibers Layer Thickness with Mild Cognitive Impairment and Alzheimer\'s Dementia

Background and Objective: In this study, the thickness of the retinal nerve fibers layer(RNFL) was compared among patients with mild cognitive impairment, Alzheimer's dementia, and healthy individuals (controls) using Optical Coherence Tomography (OCT) device. Materials and Methods: This case-control study was conducted on 30 patients diagnosed with mild cognitive impairment and 31 healthy subjects undergoing neurological examination. The examinations included minimal mental state examination a comprehensive assessment of ophthalmology and performance of OCT using a Spectralis device. Both eyes were selected for analysis, and the differences in the thickness of retinal nerve fibers layer between patients with mild cognitive impairment and healthy subjects were investigated. Results: In this study, the mean age scores of the patients and healthy individuals were 66.00±8.56 and 60.25±7.50 years, respectively. According to the results of the ordinal logistic regression model, after controlling the effects of other variables, the severity of cognitive impairment increased by 1.26 times in the right eye and by 1.30 times in the left eye (P<0.001). Similarly, for each micrometer increase in the thickness of the retinal nerve layer in the superior quadrant of the right and left eyes, the severity of the cognitive impairment decreased by 4% and 5%, respectively. Conclusion: These results indicated that superior and inferior retinal nerve fiberslayer thickness was reduced in patients with mild cognitive impairment and Alzheimer's dementia, compared to the healthy subjects, and it can be an element to detect and track this pathology

Calculation of stroke risk in persons above 55 years old without history of stroke who referred to health centers in Hamadan on 2012

Introduction: Cerebrovascular accidents are the third leading cause of mortality and the most important cause of morbidity in adults in the most of the world. Multiple factors such as Socioeconomic, lifestyle, environmental and genetic factors may be the cause of stroke risk differences in our community. This study was designed to evaluate the Stroke Risk Factor in persons above 55 years old without history of Stroke who referred to Health Centers in Hamadan on 2012.Material and Methods: In a Descriptive- Analytical study, 300 person above 55 years without history of stroke who referred to Health centers of Hamadan were selected (randomly),with regarded of inclusion and exclusion criteria and after explaining the research and its purposes, their permission was obtained. Their demographic data (such as age, gender), history of heart disease, hypertension and drug reception for it, diabetes, hyperlipidemia, smoking were filled in questionnaire. One EKG was performed (about the atrial fibrillation and signs of left ventricular hypertrophy).then data were analyzed and average tenth year stroke risk with use the Prof. Donald Smith software (stroke risk calculator) calculated.Results: The mean age, risk factors and systolic blood pressure in men and women were: 68.62±10006y, 2.16±1.33 and 129.05±18.71mmHg. History of diabetes mellitus, hyperlipidemia, smoking, hypertension(HTN), drug reception for HTN, drug reception in persons with history of HTN, SBP≥140mmHg, drug reception in persons with SBP≥140mmHg,Cardiovascular disease, atrial fibrillation(AF ¬¬rhythm) and signs of left ventricular hypertrophy(LVH)in EKG have frequency: 19066%, 28%, 19%, 42023%, 34%, 29%, 59077%, 20033%, 3033%, 8033% respectively. The mean calculated stroke risk was for tenth year 10071%.This risk was 11074% in men and 9052% in women population.Conclusion: It’s can be concluded that with regard to transition of socioeconomic and community especially aging and international experience of epidemiologic transition, stroke risk factors and consecutive stroke risk in Hamadan as a small sample of a developing country are rapidly increasing . Its hope that experiences obtained in developed countries applied in preventive programs and healthy planning

Effects of Normobaric Hyperoxia in Severe Acute Stroke: a Randomized Controlled Clinical Trial Study

Oxygen therapy might increase damaged tissue oxygenation, turn on the aerobic pathway, and save neurons from death and could improve clinical outcome of the patients with stroke and head trauma. Hyperbaric oxygen therapy is accompanied by some unfavorable effects. Results of normobaric oxygen therapy on clinical outcomes of patients with stroke were controversial up till now.  This study was therefore designed to evaluate effects of normobaric hyperoxia on clinical outcomes of patients with severe acute stroke. A total of 52 consecutive patients with stroke who meet the inclusion criteria of the study were entered into this randomized controlled clinical trial. The patients in the case group underwent oxygen therapy with Venturi mask for first 12 hours of admission. The patients were examined for neurologic defects at the time of discharge and after six months using both Barthel and modified Rankin Scale (mRS) neurologic disability scoring systems. There was no significant sex difference between the two groups (P=0.5). There was no statistically significant difference between ischemic-hemorrhagic stroke constitutions of two groups (P=0.2). There were no significant difference in Barthel index scores of both groups at the time of discharge as well as the follow-up examination (P=0.7) According to the mRS scoring system, there was no difference between the patients of both groups at the time of admission (P= 0.8), however after treatment there was a significant difference between mRS scores of the treated group compared to the controls (P=0.04). According to the results of this study, normobaric oxygen therapy in the first 12 hours of accident could improve long time outcome of the patients with either ischemic or hemorrhagic stroke

The effect of natalizumab on disability score and relapse rate of multiple sclerosis patients: a prospective cohort study

Abstract Multiple sclerosis (MS) is a progressive immune-related disorder of the central nervous system leading to destruction of myelin sheaths. Natalizumab is a humanized monoclonal antibody against the cell adhesion molecule α4-integrin which has been approved for treatment of relapsing forms of MS. This study aims at determining the effect of natalizumab on expanded disability status scale (EDSS) score and relapse rate of MS patients. Fifty MS patients participated in the present prospective cohort study. Twenty patients (Mean age ± SD: 33 ± 6.03) received natalizumab and 30 patients (Mean age ± SD: 36.83 ± 7.24) were under treatment with IFN-β (control group). Patients were followed-up during a 12-month period. EDSS score and clinical signs were assessed monthly. Significant decreases were detected in EDSS score in natalizumab treated patients compared with the controls in months 10, 11 and 12. EDSS score showed a significant decrease in 80% of natalizumab treated patients. Number of relapses was significantly lower in natalizumab treated patients compared with control group. Natalizumab is effective in improvement of disability and reduction of relapse rate in MS patients