Problemas neurológicos

Background: Neurological emergencies are a frequent presentations and often times with devastating short and long term consequences. Neurological disorders are increasingly prevalent in Sub-Saharan Africa with the paucity of data on adult neurological emergencies in the region.

Objective: The objective of the study was to determine the pattern of neurologic emergencies in TASH, Addis Ababa, Ethiopia.

Method: This was a Retrospective cross sectional study of adult patients with neurologic emergencies evaluated in emergency department of Tikur Anbessa Specialized and teaching Hospital from February 1, 2013 to January 31, 2014.

Results: Neurological emergencies accounted for 5.27% of the total medical emergencies. The mean age of the patients was 44.68 ± 1.1 years and males outnumbered Females giving a sex ratio (M: F) of 1.22:1. The most common neurologic emergencies were cerebrovascular disorder (54%), neurologic complications of HIV/AIDS (9%), meningitis (8.7%) and seizure disorder (7.7%). Hemiparesis, altered mental status and convulsion were the common presenting features accounting 44%, 19.3% and 13.1%, respectively. The overall mortality rate of neurologic emergencies was 27.3%.

Conclusion: Cerebrovascular disorders, neurologic complications of HIV/AIDS, meningitis and seizure disorder are the most common diseases, and the causes of neurological morbidity are preventable and had high case fatality rates.

Objective: The ubiquitin/proteosome system is one of the main axes of the pathogenesis of Parkinson’s disease (PD). Small ubiquitin-related modifier (SUMO) proteins are involved in many biochemical events including regulation of transcriptional activity, modulation of signal transduction pathways, and response to cellular stress indicating a role for SUMO in the ubiquitin/proteosome system. In this study, our aim was to examine the prevalence of SUMO gene variants and their clinical associations in PD.

Methods: Fifty-four consecutively recruited PD patients and 74 age-gender matched healthy controls were included. SUMO1, 2, 3 and 4 genes were screened by a next generation sequencing method using blood samples of participants. Single nucleotide polymorphisms (SNPs) with a significantly altered prevalence were determined by Bonferroni correction.

Results: Two SNPs in the SUMO4 gene rs237025 and rs237024 and two SNPs in the SUMO3 gene rs180313 and rs235293 were found to have altered prevalence in PD. Although there was no association among these SNPs and clinical features of the patients, an increased family history of cancer was found in patients with SUMO3 gene variants.

Conclusion: Several SUMO SNPs were identified for the first time in PD patients suggesting that SUMO is involved in the pathophysiology of the disease. rs237025 has also been associated with diabetes mellitus indicating a pathogenic mechanism for SUMO that is shared with other degenerative disorders.

Alzheimer’s Disease (AD) has become a major worldwide health crisis with increasing prevalence among the aging population. People with early stage Alzheimer’s will continue to experience symptoms that progressively worsen as time goes on. Pharmacotherapy has shown its limited effectiveness in slowing down the development of symptoms, but non-pharma therapies such as music therapy have shown promise in assisting Alzheimer’s patients to improve their quality of life. The goal of this study is to assess the effects of two genres of music interventions on an Alzheimer’s patient’s selective cognitive measures such as relational communication, the verbal and nonverbal aspects of how messages from the patient are conveyed. This paper presents the case of a 73-year-old patient with moderate Alzheimer’s living at Memory Care Center at Fox Trail, Princeton, NJ. Music interventions were applied to slow the development of additional symptoms. His successful response to certain types of music inspired the author to continue Alzheimer’s treatment using music interventions, and as a systematic controlled treatment for this condition. The different response after the periods of treatment using different types of music genres in a five-year period (2014-2019) may suggest the modality of certain genres of music interventions on this patient. The Individualized Music Therapy Assessment Profile (IMTAP) will be used to measure the patient’s cognitive response. This study may lay the groundwork for future research on selective genres of music intervention in non-drug therapy for Alzheimer’s patients, specifically music therapy.

Background: Parkinson’s disease is a long term degenerative disorder of the central nervous system. Bradykinesia and muscle weakness are motor symptoms of parkinson’s disease which progressively affect balance in the disease. Progressive resisted exercises increase the torque and power generating capacity of muscle thus directly affecting both weakness and bradykinesia. These exercises can significantly improve muscle strength which may have an effect on balance.

Objective: The aim of this study was to evaluate the added effect of lower limb progressive resisted exercises on balance in parkinson’s patients using MINI-BES test scale and functional reach test.

Subjects and methods: 10 patients with Parkinson’s with Hoehn and Yahr stage 2.5-3 and Berg Balance Score 34- 44 were selected. The subjects were randomly assigned to an experimental group (n=5), which received treatment of conventional balance exercises and lower limb progressive resisted exercises while that of control group (n=5) received only conventional balance exercises. Balance was measured using MINI-BES test scale and functional reach test both pre and post intervention.

Results: The experimental group showed significant improvement in outcome measures when compared to the control group (p Value: 0.0003 at 95% confidence interval)

Conclusion: The above study conducted concluded that combination of progressive resisted exercises and conventional balance exercises is effective in improving balance in parkinson’s patients.