The results indicate that unilateral stroke of either cerebral hemisphere can produce dysphagia. Effective recovery is associated with cerebral activation related to cortical swallowing representation in the compensating or recruited areas of the intact hemisphere. Functional MRI is a useful method for exploring the spatial localisation of changes in neuronal activity during tasks that may be related to recovery. Therefore, the subsequent information gleaned from changes in neural plasticity could be useful for assessing the prognosis of dysphagic stroke.
Background Multiple sclerosis (MS) and stroke are two common causes of death and disability worldwide. The relationship between these two diseases remains unclear. Effective early preventative measures and treatments are available to reduce the morbidity and mortality of acute stroke. The objectives of our systematic review are to estimate the risk of stroke in patients with MS and to collate related studies to draw preliminary conclusions that may improve clinical practice. Method Relevant studies were systematically searched in MEDLINE, Embase, the Chinese Biomedical Literature Database (CBM), the China National Knowledge Infrastructure and the VIP database of Chinese periodicals from January 1983 to May 2017, with no restrictions on language. Patients included in this review were adults who suffered from MS. Review Manager 5.3 software program was used to pool data and calculate the risk ratio (RR) and its 95% confidence interval (CI). We also performed heterogeneity and sensitivity analyses and evaluated bias in the meta-analysis. Results Nine studies including more than 380,000 participants that met our inclusion criteria were incorporated into the meta-analysis. During different follow-up periods, patients with MS had an increased risk of any type of stroke [RR = 3.48, 95% CI (1.59, 7.64), P = 0.002 for 1 year; RR = 2.45, 95% CI (1.90, 3.16), P < 0.00001 for 10–13 years]. The total prevalence of stroke (any type) in patients with MS exceeded expectations compared to different groups [Comparing with general veteran: RR = 2, 95% CI (1.19, 3.38), P = 0.009. Comparing with general population: RR = 2.93, 95% CI (1.13, 7.62), P = 0.03]. Furthermore, ischemic stroke was particularly more common in the MS population than in people without MS [RR = 6.09, 95% CI (3.44, 10.77), P < 0.00001]. Conclusion Compared with the general population, people with MS have an increased risk of developing any type of stroke and ischemic stroke in particular. Consistent results were obtained from patients of different sexes and age groups. Preventative measures and treatments should be administered at earlier time points to improve patient outcomes. Electronic supplementary material The online version of this article (10.1186/s12883-019-1366-7) contains supplementary material, which is available to authorized users.
PurposeTo quantitatively determine the size and contractility of the superior oblique (SO) muscle in primary SO overaction (PSOOA).Patients and methodsA prospective, observational study was conducted on 12 patients with PSOOA, and 10 healthy, orthotropic subjects. Sets of contiguous, 2 mm slice thickness, quasi-coronal magnetic resonance imaging were obtained during different gazes, giving pixel resolution of 0.391 mm. Cross-sectional areas of the SO muscles were determined in primary position, supraduction, and infraduction to evaluate size and contractility. The cross-sectional areas of SO muscle were compared with those of controls in the primary position to detect hypertrophy or atrophy and changes in contractility could be detected during the vertical gaze. All statistical calculations were performed using PROC MIXED (SAS 9.4).ResultsThere was no difference between the ipsilesional (affected eye), contralesional (unaffected eye), and normal SO muscle cross-sections: 0.176±0.018 cm2, 0.175±0.005 cm2, and 0.173±0.015 cm2, respectively (P=0.82). The maximum contractility of SO muscle on the ipsilesional (affected) side was 0.097±0.024 cm2, and was different than on the contralesional (unaffected) side: 0.067±0.015 cm2 and in control subjects: 0.063±0.018 cm2 (P=0.0002).ConclusionsIn PSOOA, the ipsilesional SO is more contractile than the contralesional SO muscle and different than in controls, with no difference in SO muscle size in primary position, which suggests that excessive innervation rather than muscle hypertrophy underlies PSOOA.
The regulating gene of femA was studied in methicillin-resistant Staphylococcus aureus (MRSA). High-level MRSA, low-level MRSA and methicillin-sensitive S. aureus (MSSA) were identified by agar diffusion. Beta-lactamases were detected by nitrocephin and the presence of the mecA gene was determined by polymerase chain reaction (PCR). Only isolates that were both beta-lactamase-negative and mecA-positive were used. The femA gene and its 250 base pair (bp) upstream sequence were amplified by PCR and expression was determined by real-time fluorescent quantitative PCR. The 250 bp upstream sequence was labelled by BrightStar Psoralen-Biotin and detected by electrophoretic mobility shift assay (EMSA). Expression levels of femA in MSSA, low-level MRSA and high-level MRSA were 3.53 x 10(-3)% - 29.91%, 5.54 x 10(-3)% - 3.1 x 10(2)% and 13.88 - 5.50 x 10(4)%, respectively. EMSA detected a signal shift in 57 high-level MRSA isolates but not in four low-level MRSA and four MSSA strains. Expression of femA in high-level MRSA (non-beta-lactamase-producing) was higher than in low-level MRSA and MSSA. The femA regulating gene probably lies in the 250 bp upstream sequence in MRSA and high-level expression is essential for high-level methicillin resistance.
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