فهرست مطالب

Archives of Neuroscience - Volume:6 Issue:2, 2019
  • Volume:6 Issue:2, 2019
  • تاریخ انتشار: 1398/02/01
  • تعداد عناوین: 13
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  • Nafise Mazboori, Abbas Norouzi Javidan, Parisa Bahmani* Page 1
    Context
    Studies revealed that remote patient monitoring can be effective in the prevention and control of complications in patients with spinal cord injury. However, there are a limited number of researches in this domain with contradictions in some cases. Thus, the current study aimed at investigating the impact of remote patient monitoring on patients with spinal cord injury (SCI).
    Methods
    The current descriptive retrospective study searched databases such as Elsevier, Google Scholar, and PubMed in English from 1977 to 2018. After going throw the required procedures, 40 articles were finally confirmed and enrolled in the current study.
    Conclusions
    The results of the current study revealed that the application of remote patient monitoring system was influential and promising in the prevention and control of complications in patients with SCI. Therefore, they can be considered in care planning for such patients.
    Keywords: SpinalCordInjury, RemotePatientMonitoring
  • Naghmeh Bahrami, Mohammad Bayat, Ali Farzin, Maryamossadat Sadredin Hajseyedjavadi, Arash Goodarzi, Majid Salehi, Roya Karimi, Abdolreza Mohamadnia, Akbar Ahmadi, Mehdi Khanmohammadi, Jafar Ai* Page 2
    Porous alginate/polyvinyl alcohol hybrid scaffolds have been extensively used in cartilage, bone, and dental tissue substitute applications. However, its mechanical and osteogenesis properties are not good enough to meet the requirement for use in hard tissues repair applications. In this study, to achieve the best mechanical and physical properties, we carried out the cross-linking of PVA physically and alginate chemically. Hydroxyapatite nanoparticles (nHA), the important component of hard tissues, was added to the hydrogel to improve its mechanical properties and osteoconductivity. The results showed that the fabricated alginate/polyvinyl alcohol-nHA scaffold has around 81% interconnected porosity, hydrophilic surface with the contact angle of water on the surface in the range of 38 ± 0.29°, 3.51 MPa compressive strength, and a degradation rate of 71%. The periodontal ligament stem cells (PDLSCs) culture results showed that both fabricated alginate/polyvinyl alcohol hybrid scaffolds with and without nHA had good cell attachment ability and could promote PDLSCs ingrowth. The real-time RT-PCR assay showed that the presence of nHA in the alginate/polyvinyl alcohol hybrid scaffold could significantly accelerate the expression of specific markers of pre- and mature osteoblast stages such as osteocalcin, alkaline phosphate, and osteopontin genes. These results showed that alginate/polyvinyl alcohol hybrid scaffolds with hydroxyapatite nanoparticles can be used in bone and dental substitute applications as osteoconductive and reinforcement components.
    Keywords: Modified Freeze-Drying Method, Nano Hydroxyapatite, Alginate
  • Leila Simani, Mahbobeh Oroei, Hasan Sadeghi, Mahdi Amirdosara, Arezoo Chouhdari, Omidvar Rezaei, Mohammadreza Hajiesmaeili* Page 3
    Background
    Platelet volume indices (PVIs) are inexpensive and readily available parameters in intensive care units (ICUs). However, their association with mortality has never been investigated in the post-neurosurgical meningitis (PNM).
    Objectives
    This study was designed to investigate the association of PVIs with mortality in PNM patients.
    Methods
    This retrospective study was conducted in the adult patients undergone various neurosurgical procedures in a neurosurgery department at a tertiary educational medical center in Tehran from 2016 to 2017. In this study, platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), and platelet count were measured on ICU admission.
    Results
    A total of 37 patients were included, 18 of whom survived (mortality rate: 50%). PDW and MPV values were significantly higher in non-survivors than in survivors. In non-survivor patients, platelet count was significantly lower and PDW was higher at diagnosis and discharge when compared to on admission. Also, there was no significant linear correlation between Charlson comorbidity index (CCI) and platelet indices. The means of these parameters showed no significant differences in CCI categories between the two patient subgroups.
    Conclusions
    The obtained data revealed that the high levels of MPV and PDW in PNM are not associated with the increased risk of mortality, whereas the decrease in plateletcrit was not associated with increased risk of mortality.
    Keywords: PLT, MPV, PDW, Post-Neurological Meningitis
  • Zahra Salmani, Effat Sadat Merghati Khoei*, Noora Aghajani, Alireza Bayat Page 4
    Background
    Couples experiencing spinal cord injury (SCI) usually deal with altered sexual lives. Evaluation of the sexual satisfaction, intimacy, and partnership as well as sexual functioning of the couples with one SCI-affected partner is necessary.
    Methods
    The current cross sectional study was conducted on 28 couples (56 individuals) attending a sexual health clinic at the Brain and Spinal Cord Injury Research Center (BASIR) affiliated to Tehran University of Medical Sciences, Tehran, Iran. Descriptive statistics were employed and data were expressed as frequencies. The chi-square test, the Pearson and Spearman correlation coefficients, and the Student t-test were employed to determine the differences between male and female subjects with SCI as well as their partners. To investigate marital-related outcomes, ENRICH marital satisfaction scale, marital adjustment scale, and the Bagarozzi intimacy questionnaire were used. In addition, female sexual function index (FSFI) and international index erectile function (IIEF), as well as sexual knowledge and attitude, sexual expression (SE), and the Larson sexual satisfaction questionnaires were employed to evaluate sexual-performance-related outcomes.
    Results
    The mean age of male and female subjects with SCI (20 males and eight females) was 39.65 ± 9.483 and 34.88 ± 10.412 years, respectively. Mean age of the partners without SCI, male and female, was 37 ± 9.067 and 41.38 ± 10.155 years, respectively. Partners with and without SCI had low sexual satisfaction by 67.9% and 53.6%, respectively. There was also a poor intimacy and partnership in partners with SCI (46.4%). Gender-based differences in the couples' sexual functioning indicated that females without SCI showed lower scores in sexual functioning than their male counterparts. All female subjects got lower scores in FSFI. A significant mean difference was observed between the SCI and non-SCI groups in ENRICH marital satisfaction (P < 0.02), the Bagarozzi intimacy (P < 0.035), marital adjustment (P = 0.000), and IIEF (P < 0.001).
    Conclusions
    Based on the current study findings, sexuality of people with SCI was far more complex than those of their healthy counterparts, which caused the health providers face with clinical, social, and cultural challenges. Sexual rehabilitation should be effusively addressed in all spinal units and recovery centers, along with other aspects of treatment and rehabilitation.
    Keywords: Spinal Cord Injury, Sexuality, Sexual Health, Couple, Iran
  • Seyede Zahra Emami Razavi, Mohaddeseh Azadvari* Page 5
    Background
    Electrodiagnostic study is sometimes required for patients with stroke, which can develop various abnormalities.
    Objectives
    As there are little studies in this field, we designed a study to assess electro-diagnostic findings in cases with different post-stroke durations.
    Methods
    This cross-sectional study was conducted on 30 cases at Imam Hospital between March 2016 and March 2018. We conducted electrodiagnostic tests such as SNAPs and CMAPs of all four limbs and electromyography of at least three muscles per limb. The electrodiagnostic findings are reported for all cases and non-diabetic cases only.
    Results
    Among the patients, 28 (93.3%) were male and two (6.7%) were female. The mean age was 58 ± 8.3 years, and the mean duration of acute cerebrovascular (CVA) event was 5.9 ± 4.1 months. Ten patients (33.3%) had diabetes. Moreover, 42% of the patients suffered peripheral polyneuropathy with different severities. Entrapment neuropathy was seen in the median nerve in 47% and in the ulnar nerve in 3% of the patients at the wrist. Seven cases with diabetes had carpal tunnel syndrome (CTS) (70%) and the only patient with ulnar neuropathy had diabetes, too. In needle electromyography at rest, spontaneous activity was not detected in the examined muscles of the cases. Inactivity, upper motor neuron pattern was the prominent finding.
    Conclusions
    Electrodiagnostic evaluation should be considered for patients with stroke to distinguish upper and lower motor neuron patterns or peripheral neuropathy.
    Keywords: Electrodiagnosis Abnormalities, Stroke, Iran
  • Anita Sabzghabaei, Sohrab Aeinechian, Majid Shojaee, Parvin Kashani, Mohammad Manouchehrifar* Page 6
    Background
    Assessing the prevalence of brain stroke and its clinical patterns across countries and nations could be valuable. It is an important concern for Iran as one of the countries with a high rate of stroke.
    Objectives
    The present study was aimed to assess the epidemiological aspects of ischemic brain stroke.
    Methods
    This cross-sectional study was conducted in Loghman-e-Hakim Hospital, Tehran, Iran from January 2013 to December 2016. The data were gathered by retrospectively reviewing the hospital records.
    Results
    In this study, 2041 cases were admitted that 1145 (56%) cases were male. The mean age of the patients was 66.50 ± 13.49 years. The most common underlying risk factor was hypertension in 73.7% followed by diabetes mellitus in 44.3%. Left carotid stenosis was reported in 17.2% of the cases and right carotid stenosis in 9.5%. Left ventricular ejection fraction < 40% was found in 8.6% of the cases. The most common areas involved in the brain CT scanning were periventricular areas in 20.5%, left middle cerebral artery in 15.4%, and lacunar infarction 8.8% of the cases. In addition, 214 patients died indicating a crude mortality rate of 10.5%.
    Conclusions
    The prevalence of ischemic brain stroke in males is slightly higher than females and the mean age of the patients was estimated to be 66 years. The most common risk factors are comprised of hypertension, diabetes mellitus, and smoking. Carotid stenosis is evident in more than 25% of the patients, and the mortality rate was 10% in the studied population.
    Keywords: Epidemiology, Iran, Risk Factors, Stroke
  • Fariba Sadeghi Fazel, Ahad Mohammadnejad, Saeid Amanpour, Alireza Abdollahi, Asal Derakhshanrad, Nazi Derakhshanrad, Mir Saeed Yekaninejad, Hooshang Saberi* Page 7
    Background
    Infection is a common problem in chronically denuded skin, especially in pressure ulcers (PUs). It is one of the main reasons for delayed wound healing, in addition to morbidity and even mortality after spinal cord injury (SCI).
    Objectives
    The current study aimed at determining the pathogenic microorganisms, as well as their antimicrobial sensitivity, isolated from active PUs in post-rehabilitated cases with SCI.
    Methods
    The current cross sectional study was conducted from January 2015 to January 2016, on 55 outpatients with traumatic SCI and active stage II, III, and IV PUs in the Brain and Spinal Cord Injury Research Center (BASIR), Tehran, Iran. The largest PU in each case was rinsed with sterile saline and deeply sampled with sterile swabs. The cultures were bacteriologically identified and antibiogram was performed.
    Results
    The current study population included 55 cases with a mean age of 32.7 ± 11.5 years, of which 87.3% were male. The sacral region was the most common site (n = 31; 56.4%) for PU, followed by trochanteric area (n = 9; 16.4%). The wound swab culture was positive in 51 patients (92.7%). Majority of the bacteria isolated from smaller lesions of stage II and III PUs was Escherichia coli (E. coli) (P = 0.027), while larger lesions with advanced stage were more commonly colonized with Staphylococcus epidermidis (P = 0.0378). Antimicrobial assessment of the isolated microorganisms revealed multidrug resistant E. coli and staphylococci as the prevailing organisms.
    Conclusions
    Microorganisms invade PUs are multi-drug resistant, and their anti-microbial sensitivity patterns may be quite different from that of normal flora.
    Keywords: Pressure Ulcer, Bacteriology, Spinal Cord Injury, Infection, Anti-microbial Sensitivity
  • Abdolkarim Rahmanian, Alireza Mohsenian Sisakht, Nima Derakhshan*, Najme Karamzade Ziarati, Seyed Hossein Owji, Hadi Reisi Shahraki Page 8
    Background
    Seizures are quite common following subarachnoid hemorrhage (SAH) and due to increased mortality and morbidity in this setting, thus seizure prophylaxis is introduced as a common neurosurgical practice. Investigations are still ongoing to figure out the most efficient seizure prophylaxis guideline.
    Objectives
    To compare the efficacy of two seizures prophylaxis protocols that have been practiced in a tertiary neurovascular center in Southern Iran through a retrospective cohort analysis
    Methods
    A total of 426 patients who were operated due to aneurysmal SAH between September 2007 and March 2016 were included in this retrospective cohort study. From September 2007 to March 2011 the common practice was prophylaxis with phenytoin for 3 - 6 months, which was switched to a shorter 1-month course since March 2011. Seizure control was evaluated in telephoned patients and outpatient records.
    Results
    Out of 426 subjects eligible for this study, 165 (38.7%) took the 1-month (short-term) regimen and 261 (61.3%) took the 3 - 6 months (long-term) regimen. Results revealed that achievement of seizure control was similar for both groups in those without perioperative seizures (P = 0.4); however, with perioperative seizures, the short-term protocol had inferior results for seizure control and higher odds (almost 109-fold) for developing post-operative seizures.
    Conclusions
    Although short-term 1-month seizure prophylaxis with phenytoin provides adequate seizure control for most individuals after SAH, perioperative seizures necessitates a longer course of 3 - 6 month seizure prophylaxis.
    Keywords: Cerebral Aneurysm, Seizure Prophylaxis, Clipping, SAH, Phenytoin
  • Fatemeh Mirzaei, Mozafar Khazaei, Alireza Komaki, Iraj Amiri, Cyrus Jalili * Page 9
    Background
    Almost 5% of people over 65 and 35% of those over 80 years of age have Alzheimer's disease (AD).
    Objectives
    The current study evaluated the neuroprotective effects of virgin coconut oil (VCO) on amyloid beta (Aβ)-induced cell injury.
    Methods
    The total phenolic content (TPC) and total flavonoid content (TFC), 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging and total antioxidant activity were measured. Rats were randomly divided into six groups: control; sham; sham receiving normal saline; Alzheimer’s rats (received Aβ 1 - 40); Alzheimer’s rats + 8% VCO and Alzheimer’s rats + 10% VCO. After 8 weeks, the levels of TNF-α protein, TNF-α and iNOS gene expression in the hippocampus, the nitric oxide level, thiol group, catalase, superoxide dismutase (SOD) and glutathione peroxidase (GPx) activity were measured. The morphological changes in the regions of the hippocampus and Aβ plaque formation were determined. Phosphorylated tau proteins were also determined by immunohistochemistry.
    Results
    VCO showed potential antiradical and antioxidant activity after in vitro treatment. VCO also significantly increased the thiol content, catalase, SOD and GPx activity and decreased the cholinesterase and nitric oxide levels. TNF-α and iNOS gene expression and protein levels decreased significantly after administration of VCO. Different areas of the hippocampus showed a significant change in the number of neurons in hippocampus, amount of phosphorylated tau and count of amyloid beta plaque in the Alzheimer’s rats that had been markedly restored by VCO.
    Conclusions
    VCO showed neuroprotective effects in conjunction with various anti-Alzheimer’s medications (antioxidant, anti-inflammatory, cholinesterase inhibitors and reduced phosphorylated tau).
    Keywords: Coconut Oil, Antioxidant, Tumor Necrosis Factor, Nitric Oxide, Superoxide Dismutase
  • Arash Goodarzi, Mehdi Khanmohammadi, Somayeh Ebrahimi, Barough, Mahmoud Azami, Amir Amani, Alireza Baradaran Rafii, Nasrin Lotfi bakhshaiesh, Armin Ai, Ali Farzin, Jafar Ai * Page 10
    The hydrogel efficacy of taurine-loaded chitosan nanoparticle/alginate hydrogel was investigated for controlled release of the taurine substrate, which is known as an antioxidative drug. The composition of the fabricated hydrogels was explored by Fourier-transform infrared spectroscopy. The swelling ability and degradation rate of hydrogels were also analyzed in phosphate-buffered saline at the physiological condition and alginate lyase for a period of 21 days. Moreover, morphologies and structure of hydrogels and cells were determined using a scanning electron microscope. The possible cytotoxicity of the fabricated hydrogel was carried out by seeding endometrial stem cells on hydrogels. The results demonstrated that hydrogel of chitosan nanoparticle/alginate hydrogel successfully controlled the release of taurine. We observed that the chitosan nanoparticle/alginate hydrogel possessed adjust swelling ability and degradation rate as compared to neat alginate hydrogel. The results proved that the chitosan nanoparticle/alginate hydrogel is non-cytotoxic and could be utilized as a promising composition in tissue engineering and drug delivery systems.
    Keywords: Alginate-Based Hydrogel, Chitosan Nanoparticle, Taurine, Controlled Drug Release, Cytocompatibility
  • Mansour Arab, Seyed Hamid Seyed Bagheri *, Ahmadreza Sayadi, Nabiollah Heydarpour Page 11
    Background
    Death anxiety and obsession are human tensions that routinely present in nursing. The sense of humor is also associated with obsession and anxiety.
    Objectives
    Therefore, the present study aimed to determine the level of death anxiety, death obsession, and sense of humor among nurses working in medical-surgical wards and intensive care units in Iran. This is a descriptive-analytical study.
    Methods
    The research population comprised 240 nurses working in intensive care units and medical-surgical departments in Kerman. The research instrument was composed of a demographic questionnaire, death obsession scale (DOS), Templer death anxiety scale (TDAS), and humor styles questionnaire (HSQ).
    Results
    The mean scores of nurse’s death anxiety in intensive care units and medical-surgical wards were 7.46 ± 3.43 and 5.46 ± 2.84, respectively. The mean scores of death obsession in intensive care units and medical-surgical wards were 30.47 ± 11.17 and 26.38 ± 11.67, respectively. The mean scores of the sense of humor in the two groups were 117.37 ± 21.31 and 109.56 ± 23.47, respectively. The mean scores of death anxiety, death obsession, and sense of humor among nurses were significantly higher in intensive care units than in medical-surgical wards (P < 0.05).
    Conclusions
    It is necessary to determine the sources of death anxiety and obsession and strengthen the sense of humor in nurses to provide better healthcare.
    Keywords: Death Anxiety, Death Obsession, Humor, Nurse
  • Arezoo Chouhdari, Mohammadreza Hajiesmaeili, Omidvar Rezaee, Mohammad Samadian, Guive Sharifi, Hossein Pakdaman, Kaveh Ebrahimzadeh * Page 12
    Background
    Post-operative meningitis(POM) is the important challenge with high mortality in the neurosurgery
    Objectives
    To identify related factors to predict mortality rate of post-operative meningitis.
    Methods
    This descriptive longitudinal study, conducted on patients affected by postoperative meningitis within 30 days after neurosurgery from 2017 to 2018, in one subspecialty hospital, Tehran, Iran. Total basic characteristics of patients diagnosed with POM collected and they followed for 30 days. The mortality rate was estimated. For data analysis Chi2 and Fisher exact, so, independent t and Mann-Whitney U, the test used. As well as multivariable logistic regression analysis showed predictor factors of patient's outcome. Finally, Survival curve was executed by SPSS 19. A significant level was considered P < 0.05 for all tests.
    Results
    In this study, the mortality rate was 5.6 times incidence rate. In multivariable logistic regression analysis, having mechanical ventilation (P = 0.03, OR = 1.1, 95%CI= 1.05 - 5.1), length of ICU stays more than 7 days (P = 0.04, OR = 1.2, 95%CI = 0.04 - 6.2), positive cerebrospinal fluid leakage (CSF) culture (P = 0.01, OR = 2.4, 95%CI = 1.9 - 4.08) were forecasting factors to poor outcome. Finally, an inverse relationship between survival function and length of ICU stay in patients affected by postoperative meningitis reported.
    Conclusions
    According to the high rate of mortality and predictor factors in POM, further studies are recommended to find preventive strategies to decrease this dreaded cause of morbidity and mortality in neurosurgical patients.
    Keywords: Mortality, Prediction, Post-Operative Meningitis, Neurosurgery