- Effects of Hochuekkito combined with pulmonary rehabilitation in patients with chronic obstructive pulmonary disease. [Journal Article]
- ETExp Ther Med 2018; 16(6):5236-5242
- Chronic obstructive pulmonary disease (COPD) has significant systemic effects, such as weight loss, which affects exercise capacity, health-related quality of life (HRQOL) and survival. The tradition...
Chronic obstructive pulmonary disease (COPD) has significant systemic effects, such as weight loss, which affects exercise capacity, health-related quality of life (HRQOL) and survival. The traditional herbal medicine, Hochuekkito (TJ-41), improves the nutritional status and decreases systemic inflammation in patients with COPD. However, to date, the additive effect of TJ-41 on pulmonary rehabilitation (PR) in patients with COPD has not been researched comprehensively. The purpose of the present study was to investigate the efficacy and safety of adding TJ-41 to PR for patients with COPD. Thirty-three malnourished patients with COPD were randomly assigned to receive low-intensity exercise with (TJ-41 group) or without (control group) TJ-41 treatment for 12 weeks. The primary outcome was the change in the 6-min walk distance (6MWD). Secondary outcomes included changes in the body composition, peripheral muscle strength, modified Medical Research Council dyspnea score, visual analog scale (VAS) score for dyspnea, VAS score for fatigue and COPD assessment test (CAT) score. After the 12-week treatment, body weight and percent ideal body weight were significantly increased in the TJ-41 group (P<0.05), but not in the control group. After the 12-week treatment, the modified Medical Research Council dyspnea score, VAS score for dyspnea, VAS score for fatigue and total CAT score decreased significantly in the TJ-41 group (all P<0.05), but not in the control group. There were no significant differences in the 6MWD and peripheral muscle strength between baseline and after 12 weeks of treatment in either group. No adverse effects were noted with the use of TJ-41. It was concluded that the addition of TJ-41 to PR may benefit malnourished patients with COPD with respect to dyspnea and HRQOL.
- Evaluation of pain, functional capacity and kinesiophobia in women in the chronic stage of chikungunya virus infection: a cross-sectional study in northeastern Brazil. [Journal Article]
- ATActa Trop 2018 Dec 07
- Arboviral diseases have been considered a global public health problem due to their growing territorial dispersion and impact on the population around the world. Individuals affected by the chikungun...
Arboviral diseases have been considered a global public health problem due to their growing territorial dispersion and impact on the population around the world. Individuals affected by the chikungunya virus go through an acute febrile illness associated with severe pain and long-lasting polyarthralgia. After the initial stage, infected individuals may progress to the chronic stage, which has an epidemic character and a high rate of disability and reduced mobility, impacting negatively on their quality of life. The aim of this study was to evaluate the relationship between pain, functional capacity, and kinesiophobia in individuals in the chronic stage of chikungunya virus infection. A cross-sectional study was conducted in the city of Natal, in Rio Grande do Norte, Brazil, between July and September 2018. The participants were 59 women in the chronic stage of chikungunya virus infection. Data were collected in at physical therapy outpatient clinic of the Federal University of Rio Grande do Norte (UFRN), using a socio-demographic questionnaire, the Visual Analogue Scale (VAS), the Nordic Musculoskeletal Questionnaire (NMQ), the Brief Pain Inventory (BPI), the Health Assessment Questionnaire (HAQ), and the Tampa Scale for Kinesiophobia (TSK). Descriptive statistics and bivariate analysis of the time data were conducted by simple regression. The participants' mean age was just over 50 years and average duration of virus infection was 21.54 months. Most participants had moderate to severe pain intensity that more frequent in the ankle and wrist joints. Functional capacity was low, and there was moderate fear of performing exercises and activities of daily living. Duration of infection was associated with increased pain intensity and loss of functional capacity. We can conclude that women in the chronic stage of chikungunya infection have significant pain, reduced functional capacity, and fear of performing common movements of daily living.
- False-positive technetium-99m methylene diphosphonate bone scan activity in the orbit in a patient with a history of breast carcinoma. [Journal Article]
- WJWorld J Nucl Med 2018 Oct-Dec; 17(4):299-301
- Metastasis of breast carcinoma to the orbit is an uncommon entity and carries a poor prognosis. This case report presents false-positive technetium-99m methylene diphosphonate activity in the right o...
Metastasis of breast carcinoma to the orbit is an uncommon entity and carries a poor prognosis. This case report presents false-positive technetium-99m methylene diphosphonate activity in the right orbit of a patient with a history of a primary breast neoplasm. Orbital computed tomography imaging was obtained to further characterize the radiotracer uptake identified on the bone scan and demonstrated diffuse right globe intraocular calcifications secondary to degenerative intraocular changes. A brief literature review of orbital metastasis from breast carcinoma and causes of intraocular calcification in the context of chronic vision loss are provided.
- Antibodies to myelin oligodendrocyte glycoprotein in chronic relapsing inflammatory optic neuropathy. [Journal Article]
- BJBr J Ophthalmol 2018 Dec 04
- CONCLUSIONS: CRION was predominantly found in adults with unilateral ON and exhibited a higher rate of seropositive MOG-IgG. MOG-CRION, which may be a disparate subtype of MOG-IgG-induced demyelinating disease that needs further investigation, was found in younger patients at onset, with more bilateral involvement and more relapse tendency.
- Secondary hyperhomocysteinemia-related occlusive retinal vasculopathy: A case report. [Journal Article]
- AJAm J Ophthalmol Case Rep 2019; 13:41-45
- CONCLUSIONS: Hyperhomocysteinemia is a rare but well-known disease, capable of accelerating atherosclerotic disease and generating a prothrombotic state that can lead to multiple systemic complications. Despite its low incidence, the disease should be part of the differential diagnosis in patients with bilateral proliferative retinopathy, in the absence of diabetes mellitus and systemic hypertension.
- [Corneal degenerations]. [Journal Article]
- VOVestn Oftalmol 2018; 134(5. Vyp. 2):282-288
- Degeneration is the process of change occurring in cells, their parts or intracellular matter that happens due to external factors affecting the life of an organism and results in gradual disruption ...
Degeneration is the process of change occurring in cells, their parts or intracellular matter that happens due to external factors affecting the life of an organism and results in gradual disruption of normal condition of the tissue or the organ, and possibly complete loss of its functionality. Corneal degenerations may be caused by age-related physiological changes, associated with a certain systemic disease or local inflammations, or be the consequence of chronic toxic action of unhealthy environmental factors on the eye. Unlike dystrophies, corneal degenerations cannot be inherited and do not onset early. When corneal degenerations significantly affect visual acuity, the treatment should aim at alleviating the primary disease before inducing changes in the cornea. The existence of such pathology is important to remember and timely differentiate from acute inflammatory processes of various etiology that require immediate treatment. The right diagnosis is the key factor in choosing effective treatment strategy and thus achieving positive clinical results.
- Disorders of the inner-ear balance organs and their pathways. [Journal Article]
- HCHandb Clin Neurol 2018; 159:385-401
- Disorders of the inner-ear balance organs can be grouped by their manner of presentation into acute, episodic, or chronic vestibular syndromes. A sudden unilateral vestibular injury produces severe v...
Disorders of the inner-ear balance organs can be grouped by their manner of presentation into acute, episodic, or chronic vestibular syndromes. A sudden unilateral vestibular injury produces severe vertigo, nausea, and imbalance lasting days, known as the acute vestibular syndrome (AVS). A bedside head impulse and oculomotor examination helps separate vestibular neuritis, the more common and innocuous cause of AVS, from stroke. Benign positional vertigo, a common cause of episodic positional vertigo, occurs when otoconia overlying the otolith membrane falls into the semicircular canals, producing brief spells of spinning vertigo triggered by head movement. Benign positional vertigo is diagnosed by a positional test, which triggers paroxysmal positional nystagmus in the plane of the affected semicircular canal. Episodic spontaneous vertigo caused by vestibular migraine and Ménière's disease can sometimes prove hard to separate. Typically, Ménière's disease is associated with spinning vertigo lasting hours, aural fullness, tinnitus, and fluctuating hearing loss while VM can produce spinning, rocking, or tilting sensations and light-headedness lasting minutes to days, sometimes but not always associated with migraine headaches or photophobia. Injury to both vestibular end-organs results in ataxia and oscillopsia rather than vertigo. Head impulse testing, dynamic visual acuity, and matted Romberg tests are abnormal while conventional neurologic assessments are normal. A defect in the bony roof overlying the superior semicircular canal produces vertigo and oscillopsia provoked by loud sound and pressure (when coughing or sneezing). Three-dimensional temporal bone computed tomography scan and vestibular evoked myogenic potential testing help confirm the diagnosis of superior canal dehiscence. Collectively, these clinical syndromes account for a large proportion of dizzy and unbalanced patients.
- Dry Eye After LASIK. [Journal Article]
- IOInvest Ophthalmol Vis Sci 2018 Nov 01; 59(14):DES109-DES115
- Post-LASIK dry eye is the most common postoperative dry eye after ophthalmic surgeries. The clinical signs of post-LASIK dry eye include positive vital staining of the ocular surface, decreased tear ...
Post-LASIK dry eye is the most common postoperative dry eye after ophthalmic surgeries. The clinical signs of post-LASIK dry eye include positive vital staining of the ocular surface, decreased tear breakup time and Schirmer test values, reduced corneal sensitivity, and decreased functional visual acuity. The symptoms and signs usually last for about 1 month after LASIK. A small number of patients continue to experience symptoms more than 1 year postoperatively. It has been suggested that the loss of corneal innervation caused by flap-making is the major cause, affecting the corneal-lacrimal gland, corneal-blinking, and blinking-meibomian gland reflexes, resulting in decreased aqueous and lipid tear secretion and mucin expression. A new type of corneal refractive surgery, SMILE, which has less impact on corneal nerves, induces less postoperative dry eye, supporting the association between corneal denervation and postoperative dry eye. As LASIK enhancement by flap-lifting induces fewer dry eye symptoms and signs than initial surgery, factors other than neurotrophic effects may be involved in the mechanisms of post-LASIK dry eye. Post-LASIK ocular surface pain is a type of postoperative chronic pain and discomfort, and is thought to be a different clinical entity from dry eye, possibly induced by abnormal reinnervation or neural sensitization of peripheral nerves and the central nervous system after LASIK. Treatments include tear supplements, anti-inflammatory agents, meibomian gland dysfunction management, ointment and eye patches, punctal plugs, and autologous serum eye drops. For patients with preoperative dry eye, careful patient selection, and preoperative ocular surface management are mandatory.
- Severe Dry Eye With Combined Mechanisms is Involved in the Ocular Sequelae of SJS/TEN at the Chronic Stage. [Journal Article]
- IOInvest Ophthalmol Vis Sci 2018 Nov 01; 59(14):DES80-DES86
- Stevens-Johnson syndrome (SJS), and its more severe variant, toxic epidermal necrolysis (TEN), are life-threatening diseases of the skin and mucous membranes. After the acute-stage damage subsides, s...
Stevens-Johnson syndrome (SJS), and its more severe variant, toxic epidermal necrolysis (TEN), are life-threatening diseases of the skin and mucous membranes. After the acute-stage damage subsides, serious visual impairment and severe dry eye remains as ocular sequelae. At the acute stage, ocular complications occur in 77% of SJS/TEN patients. In cases with pseudomembranous formation and/or epithelial defects, the risk of ocular sequelae increases. Among 13 slit-lamp microscopy images that we obtained of SJS/TEN patients at the chronic stage, the loss of corneal epithelial stem cells and severe meibomian gland involvement were found to be the most common disorders. Severe dry eye in SJS includes three important mechanisms: (1) aqueous tear deficiency, (2) decreased wettability of corneal surface, and (3) increased evaporation. Dry eye severity in SJS patients is often underestimated when the meniscus is first observed, as the punctum is closed due to scarring or surgery. In SJS patients with severe dry eye, the dryness results in immense eye pain, and unstable tear film related to dry eye result in a change/loss of vision. For the treatment of dry eye in SJS, it is important to suppress chronic inflammation on the ocular surface, and 2% rebamipide ophthalmic solution reportedly helps to obtain ocular surface stabilization. Scleral contact lenses, as well as the newly developed limbal-rigid contact lenses, improve the patients' visual acuity and reduce symptoms related to severe dry eye. Further studies and new therapeutic methods are needed to more effectively treat dry eye in patients afflicted with SJS/TEN.
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- Sequential nonarteritic anterior ischemic optic neuropathy in patient on chronic hemodialysis. [Journal Article]
- CCCEN Case Rep 2018 Nov 21
- Nonarteritic anterior ischemic optic neuropathy (NAION) is a well acknowledged rare complication of chronic hemodialysis in patients with end-stage renal disease (ESRD). We present a unique case of a...
Nonarteritic anterior ischemic optic neuropathy (NAION) is a well acknowledged rare complication of chronic hemodialysis in patients with end-stage renal disease (ESRD). We present a unique case of a patient on chronic hemodialysis who presented with an NAION in the right eye, then 3 months later developed an NAION in the left eye followed in 1 month by second NAION episode in the left eye. Every episode of NAION was accompanied by intradialytic hypotension (drop in systolic blood pressure of over 20 mmHg) where visual loss was noticed at the end of the dialysis session. Clinicians should be aware of association between NAION and hemodialysis and that patients with dialysis-induced hypotension are at particularly increased risk of having NAION. Patients who had dialysis-associated NAION should be closely monitored to prevent occurrence of intra-dialytic hypotension as they are at the highest risk of sequential NAION and thus severe visual loss.