Understanding the relationships among aging, cognitive function, and olfaction may be useful for diagnosing olfactory decline in older adults. Olfactory function declines in the early stage of neurodegenerative diseases, including Alzheimer's and Parkinson's diseases. Aging and cognitive impairment are associated with olfactory decline. Moreover, the assessment of hyposmia and anosmia is paramount to the diagnosis of neurodegenerative diseases. We aimed to assess the relationships among aging, cognitive function, and olfaction in patients with olfactory impairment.
This observational study included 141 patients with olfactory deterioration who presented with dementia, mild cognitive impairment (MCI), age-related hyposmia, or postviral olfactory dysfunction (PVOD). The patients underwent T&T olfactometry, a self-administered odor questionnaire (SAOQ), a visual analog scale (VAS), and a Mini-Mental State Examination.
T&T odor recognition thresholds decreased with aging (p < 0.01) and cognitive hresholds, a large difference between the T&T detection and recognition thresholds, and high SAOQ and VAS scores.
Although >10% bands on a CBC has been a part of the definition for sepsis, scant data exists regarding the clinical significance of lower percentages of bands. Our aim was to determine whether any associations exist between percentage of bands on an initial CBC and likelihood of a bloodstream infection and in-hospital mortality.
We performed a retrospective study of emergency department adults from January 1, 2016 to September 1, 2019 who had a CBC with manual differential and blood cultures obtained during their initial evaluation. Band percentages were grouped into zero (0% bands), minimal (1-2% bands), mild (3-4% bands), moderate (5-10% bands) and high (>10% bands). The primary outcomes were bloodstream infections and in-hospital mortality.
Increasing rates of bloodstream infections were observed as bands went from zero (95% CI 9.3%-10.5%) to minimal (17.5%-19.1%, p<0.0001), minimal to mild (19.2%-22.0%, p=0.0039), mild to moderate (23.5%-26.7%, p<0.0001), and moderate to high (33.0%-37.4%, p<0.0001). Similar observations were seen when comparing mortality. The most common bloodstream infections were due to Gram-negative bacilli.
Elevated bands on an initial CBC were correlated with the likelihood of a concurrent bloodstream infection and in-hospital mortality, even at levels below 10%. Our results suggest that clinical suspicion for a bloodstream infection due to Gram-negative bacilli should rise if bands are elevated on an initial CBC. Therefore, clinicians should consider obtaining blood cultures if bands are elevated on an initial CBC.
Elevated bands on an initial CBC were correlated with the likelihood of a concurrent bloodstream infection and in-hospital mortality, even at levels below 10%. Our results suggest that clinical suspicion for a bloodstream infection due to Gram-negative bacilli should rise if bands are elevated on an initial CBC. Therefore, clinicians should consider obtaining blood cultures if bands are elevated on an initial CBC.
The efficacy of ginger for migraine remains controversial. We conduct a systematic review and meta-analysis to explore the influence of ginger versus placebo on treatment in migraine patients.
We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through September 2020 for randomized controlled trials (RCTs) assessing the effect of ginger versus placebo on treatment efficacy in migraine patients. This meta-analysis is performed using the random-effect model.
Three RCTs are included in the meta-analysis. https://www.selleckchem.com/products/Trichostatin-A.html Overall, compared with control group in migraine patients, ginger treatment is associated with substantially improved pain free at 2h (RR=1.79; 95% CI=1.04-3.09; P=0.04) and reduced pain scores at 2h (MD=-1.27; 95% CI=-1.46 to -1.07; P<0.00001), but reveals no obvious impact on treatment response (RR=2.04; 95% CI=0.35-11.94; P=0.43) or total adverse events (RR=0.80; 95% CI=0.46-1.41; P=0.44). The incidence of nausea and vomiting is obviously lower in ginger group than that in control group.
Ginger is safe and effective in treating migraine patients with pain outcomes assessed at 2h.
Ginger is safe and effective in treating migraine patients with pain outcomes assessed at 2 h.Crotalidae envenomation has been managed successfully in emergency departments across the world with antivenom. Over the years, antivenom has evolved and newer agents have been studied with the possibility of eliminating maintenance antivenom therapy. Here we report a patient who had worsening platelet and fibrinogen concentrations, as well as complaints of swelling and pain at the site of a rattlesnake envenomation following an initial dose of F(ab')2AV (Crotalidae immune F(ab')2 (equine) [ANAVIP®]) Crotalidae antivenom. The patient was subsequently transferred to a tertiary children's hospital for a higher level of care and received FabAV (Crotalidae polyvalent immune Fab (ovine) [CroFab®]) Crotalidae antivenom. The details of this patient's treatment course highlight the possibility that patients who receive F(ab')2AV, may require additional antivenom treatment. Furthermore, it appears that based on our single patient experience, giving FabAV after F(ab')2AV is safe and effective.
The impact of sagittal imbalance in patients has been reported in LBP and LBP-related disabilities due to spinopelvic imbalance. However, no reports investigating the spine-pelvis-lower extremity axis using lateral images have been reported thus far. This study introduced a novel parameter of the spine-pelvis-lower extremity axis and evaluated whether this parameter was related to symptoms.
A total of 343 subjects were included in this cross-sectional study. Standing spine-pelvis and pelvis-lower extremity radiographs were obtained to assess the sagittal vertical axis (SVA), pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS), lumbar lordosis, and thoracic kyphosis. The sacral-knee distance (SKD) (i.e., distance from the anterior femoral condyle to the vertical axis at the upper posterior edge of S1 body) was measured. Furthermore, the SVA/SKD ratio was calculated for global balance. Subjects were divided into leg compensated (LC; SVA/SKD ratio <0.8) and decompensated (LD; SVA/SKD ratio ≥0.8) groups.