Rehabilitation of Motor Impairments Following a Traumatic Head Injury

Traumatic head injury belongs to the group of neurological conditions, following the occurrence of which we may detect difficulties in motor behaviour and cognitive functioning of the persons. The impact of a traumatic head injury on majority of patients is substantial. Rehabilitation of motor impairments encompasses a series of interventions performed on persons after a traumatic head injury and is of crucial significance for such persons to return to their customary activities of everyday life. This study gives a brief display of the rehabilitation approach and its importance to recovery of motor functioning in persons who suffered a traumatic head injury. It is considered that motor impairment rehabilitation programme following a traumatic head injury should focus on specific approaches, leading to improvement of certain motoric tasks and outcome measures.Черепно-мозговая травма относится к группе неврологических со- стояний, при возникновении которых могут определяться проблемы двигательного поведения и когнитивной деятельности. Влияние череп- но-мозговой травмы на большинство пациентов велико. Реабилитация 101 двигательных нарушений включает в себя ряд вмешательств, которые предоставляются людям после черепно-мозговой травмы и необходимы для того, чтобы люди могли вернуться к нормальной повседневной дея- тельности. В статье дано краткое описание реабилитационного подхода и его значения для восстановления двигательных функций у лиц, пере- несших черепно-мозговую травму. Считается, что основное внимание в программах реабилитации при двигательных нарушениях после череп- но-мозговой травмы должно быть сосредоточено на конкретных подхо- дах, которые приводят к улучшению определенных двигательных задач и показателей результатов

Rehabilitation of Motor Impairments Following a Traumatic Head Injury

Traumatic head injury belongs to the group of neurological conditions, following the occurrence of which we may detect difficulties in motor behaviour and cognitive functioning of the persons. The impact of a traumatic head injury on majority of patients is substantial. Rehabilitation of motor impairments encompasses a series of interventions performed on persons after a traumatic head injury and is of crucial significance for such persons to return to their customary activities of everyday life. This study gives a brief display of the rehabilitation approach and its importance to recovery of motor functioning in persons who suffered a traumatic head injury. It is considered that motor impairment rehabilitation programme following a traumatic head injury should focus on specific approaches, leading to improvement of certain motoric tasks and outcome measures.Черепно-мозговая травма относится к группе неврологических со- стояний, при возникновении которых могут определяться проблемы двигательного поведения и когнитивной деятельности. Влияние череп- но-мозговой травмы на большинство пациентов велико. Реабилитация 101 двигательных нарушений включает в себя ряд вмешательств, которые предоставляются людям после черепно-мозговой травмы и необходимы для того, чтобы люди могли вернуться к нормальной повседневной дея- тельности. В статье дано краткое описание реабилитационного подхода и его значения для восстановления двигательных функций у лиц, пере- несших черепно-мозговую травму. Считается, что основное внимание в программах реабилитации при двигательных нарушениях после череп- но-мозговой травмы должно быть сосредоточено на конкретных подхо- дах, которые приводят к улучшению определенных двигательных задач и показателей результатов

Harmonizing ophthalmic residency surgical training across Europe: A proposed surgical curriculum.

BACKGROUND: One of the core aims of the European Union of Medical Specialists is to harmonize training across Europe by creating European Training Requirements for all medical specialties including Ophthalmology. The theoretical part is already defined by the EBO, however as ophthalmology also includes surgical skills, we herein propose a surgical minimum curriculum for ophthalmology residents in Europe. METHODS: National and international ophthalmic training curricula which are publicly available in English were reviewed and compared. The final proposal was created from 5 criteria: 1. Disease prevalence; 2. Patient safety; 3. Case-trainee ratio; 4. Skill transfer; and 5. Technical difficulty. RESULTS: In total 7 different training curricula from across the world were compared. Among the surgical procedures, cataract surgery has the highest median number of procedures required to be completed during residency: 86 procedures (50-350). Followed by oculoplastics: 28 procedures (10-40) and panretinal photocoagulation: 27.5 procedures (10-49) Full procedural competence is proposed in 9 surgical skills, including YAG laser posterior capsulotomy, retinal argon laser, intravitreal injection, corneal foreign body removal, removal of corneal sutures, facial and periocular laceration repair, eyelid laceration repair, minor eyelid procedures, and punctal occlusion. These procedures are deemed essential and feasible for all ophthalmology residents in Europe to perform independently upon completion of their training. CONCLUSION: This proposal should be regarded as a recommendation based on comparable surgical curricula in use worldwide to establish standards across European countries and may serve as valuable insight to those responsible for compiling ETRs for ophthalmology, or their national curriculums

Health-related quality of life in elderly patients hospitalized with chronic heart failure

Background: Chronic heart failure is a very common condition in the elderly, characterized not only by high mortality rates, but also by a strong impact on health-related quality of life (HRQOL). Previous studies of HRQOL in elderly heart failure subjects have included mostly outpatients, and little is known about determinants of HRQOL in hospitalized elderly population, especially in Serbia. In this study, we tried to identify factors that influence HRQOL in elderly patients hospitalized with chronic heart failure in Serbia. Methods: The study population consisted of 136 patients aged 65 years or older hospitalized for chronic heart failure. HRQOL was assessed using the Minnesota Living with Heart Failure questionnaire. Predictors of HRQOL were identified by multiple linear regression analysis. Results: Univariate analysis showed that patients with lower income, a longer history of chronic heart failure, and longer length of hospital stay, as well as those receiving aldosterone antagonists and digoxin, taking multiple medications, in a higher NYHA class, and showing signs of depression and cognitive impairment had significantly worse HRQOL. Presence of depressive symptoms (P<0.001), higher NYHA class (P=0.021), lower income (P=0.029), and longer duration of heart failure (P=0.049) were independent predictors of poor HRQOL. Conclusion: Depressive symptoms, higher NYHA class, lower income, and longer duration of chronic heart failure are independent predictors of poor HRQOL in elderly patients hospitalized with chronic heart failure in Serbia. Further, there is an association between multiple medication usage and poor HRQOL, as well as a negative impact of cognitive impairment on HRQOL. Hence, measures should be implemented to identify such patients, especially those with depressive symptoms, and appropriate interventions undertaken in order to improve their HRQOL.publishedVersio

Structure of human RNA polymerase III

In eukaryotes, RNA Polymerase (Pol) III is specialized for the transcription of tRNAs and other short, untranslated RNAs. Pol III is a determinant of cellular growth and lifespan across eukaryotes. Upregulation of Pol III transcription is observed in cancer and causative Pol III mutations have been described in neurodevelopmental disorders and hypersensitivity to viral infection. Here, we report a cryo-EM reconstruction at 4.0 Å of human Pol III, allowing mapping and rationalization of reported genetic mutations. Mutations causing neurodevelopmental defects cluster in hotspots affecting Pol III stability and/or biogenesis, whereas mutations affecting viral sensing are located in proximity to DNA binding regions, suggesting an impairment of Pol III cytosolic viral DNA-sensing. Integrating x-ray crystallography and SAXS, we also describe the structure of the higher eukaryote specific RPC5 C-terminal extension. Surprisingly, experiments in living cells highlight a role for this module in the assembly and stability of human Pol III

Endocrine and Growth Abnormalities in 4H Leukodystrophy Caused by Variants in POLR3A, POLR3B, and POLR1C.

CONTEXT: 4H or POLR3-related leukodystrophy is an autosomal recessive disorder typically characterized by hypomyelination, hypodontia, and hypogonadotropic hypogonadism, caused by biallelic pathogenic variants in POLR3A, POLR3B, POLR1C, and POLR3K. The endocrine and growth abnormalities associated with this disorder have not been thoroughly investigated to date. OBJECTIVE: To systematically characterize endocrine abnormalities of patients with 4H leukodystrophy. DESIGN: An international cross-sectional study was performed on 150 patients with genetically confirmed 4H leukodystrophy between 2015 and 2016. Endocrine and growth abnormalities were evaluated, and neurological and other non-neurological features were reviewed. Potential genotype/phenotype associations were also investigated. SETTING: This was a multicenter retrospective study using information collected from 3 predominant centers. PATIENTS: A total of 150 patients with 4H leukodystrophy and pathogenic variants in POLR3A, POLR3B, or POLR1C were included. MAIN OUTCOME MEASURES: Variables used to evaluate endocrine and growth abnormalities included pubertal history, hormone levels (estradiol, testosterone, stimulated LH and FSH, stimulated GH, IGF-I, prolactin, ACTH, cortisol, TSH, and T4), and height and head circumference charts. RESULTS: The most common endocrine abnormalities were delayed puberty (57/74; 77% overall, 64% in males, 89% in females) and short stature (57/93; 61%), when evaluated according to physician assessment. Abnormal thyroid function was reported in 22% (13/59) of patients. CONCLUSIONS: Our results confirm pubertal abnormalities and short stature are the most common endocrine features seen in 4H leukodystrophy. However, we noted that endocrine abnormalities are typically underinvestigated in this patient population. A prospective study is required to formulate evidence-based recommendations for management of the endocrine manifestations of this disorder