A prescription for exercise in systemic lupus erythematosus

Patients with systemic lupus erythematosus (SLE) have increased cardiovascular risk, and fatigue is a major subjective complaint. Sedentary lifestyle has been shown to have negative health impacts in cardiovascular and rheumatic disease, though exercise has not traditionally been incorporated into routine therapy recommendations. Regular exercise in SLE may improve difficult to treat Type 2 symptoms, such as fatigue, depression, stress, and quality of life. Insufficient counseling on exercise by physicians is a notable barrier for SLE patients to engage in physical activity. Aerobic exercise regimens are more commonly studied, and have been shown to improve cardiovascular health in SLE. Exercise may improve some inflammatory markers, though does not definitively affect SLE clinical disease activity. Physical activity should be recommended to improve quality of life and cardiovascular health in patients with SLE. Developing clearer guidelines for exercise regimens in a patient-centered manner is warranted, especially given diverse phenotypes of SLE patients and varying degrees of physical limitations.

Comprehensive Analysis of Brain Volume in REM Sleep Behavior Disorder with Mild Cognitive Impairment

Background: Rapid-eye-movement sleep behavior disorder (RBD) is a major risk factor for Parkinson’s disease and dementia with Lewy bodies. More than a third of RBD patients have mild cognitive impairment (MCI), but their specific structural brain alterations remain poorly understood. Objective: This study aimed to investigate the local deformation and volume of gray and white matter tissue underlying MCI in RBD. Methods: Fifty-two idiopathic RBD patients, including 17 with MCI (33%), underwent polysomnography, neuropsychological, neurological, and magnetic resonance imaging assessments. MCI diagnosis was based on a subjective complaint, cognitive impairment on the neuropsychological battery, and preserved daily functioning. Forty-one controls were also included. Deformation-based morphometry (DBM), voxel-based morphometry (VBM), and regional volume analyses of the corpus callosum and basal forebrain cholinergic were performed. Multiple regressions models were also computed using anatomical, cognitive (composite z score), and motor parameters. Results: Globally, patients with MCI displayed a widespread pattern of local deformation and volume atrophy in the cortical (bilateral insula, cingulate cortex, precuneus, frontal and temporal regions, right angular gyrus, and mid-posterior segment of the corpus callosum) and subcortical (brainstem, corona radiata, basal ganglia, thalamus, amygdala, and right hippocampus) regions compared to patients without MCI (DBM) or controls (DBM and VBM). Moreover, brain deformation (DBM) in patients were associated with lower performance in attention and executive functions, visuospatial abilities, and higher motor symptoms severity. Conclusion: The present study identified novel brain structural alterations in RBD patients with MCI which correlated with poorer cognitive performance. These results are consistent with those reported in patients with synucleinopathies-related cognitive impairment.

A Randomized, Double-Blind, Placebo-Controlled, Cross-Over Study to Evaluate the Efficacy of AqualiefTM Mucoadhesive Tablets in Head and Neck Cancer Patients Who Developed Radiation-Induced Xerostomia

Xerostomia, the subjective complaint of dry mouth, is caused by therapeutic interventions or diseases. Nowadays, radiotherapy (RT) in patients with head and neck cancer (HNC) stands out as one of the most important causes of xerostomia. Currently available therapies for the treatment of xerostomia are still less than optimal and xerostomia still represents an unmet clinical need. In this article, we present the results of a prospective clinical study with a new product, AqualiefTM, in patients treated with curative RT with or without chemotherapy for HNC. AqualiefTM is based on two main ingredients, carnosine and karkadé, which have acid buffering and antioxidant properties. The study was performed on 30 patients, with 4 of the patients being lost during the study period. Each patient received randomly one of the two treatments, AqualiefTM or placebo, for 8 days. After a 10-day wash-out period, each patient received the other treatment for a further 8 days. The results show that AqualiefTM stimulated salivation in these patients and reduced the pH drop that was observed in an equivalent placebo-treated population of patients. Moreover, no serious, treatment-related adverse events were observed. AqualiefTM has shown positive results, although with limitations due to unsuccessful trial accrual. Therefore, it may be further investigated as a tool for the treatment of RT-related xerostomia.

Event-related potentials in insomnia reflect altered perception of sleep

Study Objectives Insomnia is defined by the subjective complaint of poor sleep as well as daytime impairments. Since polysomnography (PSG) typically shows only modest sleep impairment, some still unidentified property of sleep, not mirrored in PSG, may be modified in insomnia.One possible mechanistic hypothesis is that insomnia patients may be more sensitive to inevitably occurring internal or external stimuli during the night, causing brief sleep disruptions then perceived as wake time. Methods Auditory event-related potentials (ERP) to low intensity (50 dB SPL) synthesized guitar tones played continuously throughout two nights of polysomnographically registered sleep were obtained in fifty patients with insomnia disorder (ID, without comorbidities) and 50 age- and sex- matched good sleeper controls (GSC) for each sleep stage and NREM/REM cycle. Phasic and tonic REM were treated as separate stages. Latencies and amplitudes of components P1, N1 and P2 were measured and analyzed by multivariate repeated-measures ANCOVA including effects of group, night, cycle and age. Results ID showed reduced P2 amplitudes relative to GSC specifically in phasic REM sleep. The same reduction also correlated with the amount of sleep misperception across groups. Independent component analysis showed a frontal negativity to contribute most to this group difference. Conclusions The present finding can be interpreted as increased mismatch negativity (MMN) in ID, reflecting automated detection of change in the auditory system and a concomitant orienting response. Specifically phasic REM sleep appears to be vulnerable to sensory afferences in ID patients, possibly contributing to the perception of being awake.

Pola Dermatom pada Herpes Zoster di Poliklinik Kulit dan Kelamin RSUP Dr. M. Djamil Padang

Background. Herpes zoster is a skin disease caused by reactivation of varicella zoster virus after its primary infection and characterized by the onset of a skin rash with a dermatomal distribution and accompanied by severe pain. The cases of herpes zoster have tended with increasing age. Objectives. This study was aimed to obtain the dermatome pattern of herpes zoster in the Dermatovenerology Polyclinic of Dr. M. Djamil Hospital Padang period 2015-2017. Method. This study was a descriptive study that was conducted in May 2018-August 2018. Simple size was 18 patients suited by inclusion criteria. Data were obtained from medical records of herpes zoster patients and presented in the frequency distribution tables. Results. The results showed that thoracic dermatome and trigeminal nerve area were most commonly involved (44.4%), within the age range of 45-64 years old (33.3%). There is no differences in events between men and women (50%). Pain is the most common major subjective complaint (88.2%) and classical grouped vesicles is the most major objective complaint (92.9%). Most patients have complications (72.2%), common complication is the neurological (38%). Conclusion. The location of dermatomes for herpes zoster patients in the the Dermatovenerology Polyclinic of Dr. M. Djamil Hospital Padang was a thoracic region of 8 patients (44.4%) and a trigeminal nerve area of ​​8 patients (44.4%). Keywords: : dermatome, herpes zoster

Malaria related myalgia-arthralgia: an imported case report treated with anti-malarial drug

Malaria is still a major health problem in Indonesia, especially in endemic areas. We present an imported case of malaria with prominent subjective complaint of the patient is in the form of persistent muscles and joints pain. A 21 years old female with complaint of intermittent fever and persistent muscle joints paint since one week before seeing a doctor. She had history of repetitive attack of malaria tropica. Physical examination in general showed no clear derangements, but on thick and thin blood smear stained with Giemsa revealed malaria falciparum (+). Combo therapy of antimalarial drug soon be given and the patient healed with the disappearance of all previous complaint. Myalgia and arthralgia in case of malaria falciparum (+) might be the earliest subjective sign of rhabdomyolisis, a potentially fatal and lethal complication of malaria.

Faktor Fisik dan Biologi dengan Keluhan Sick Building Syndrome

Physical And Biology Factor with Sick Building Syndrome Subjective Complaint. One of disturbance health phenomenalism that linked to air quality is Sick Building Syndrome (SBS). SBS is symptom collections whom felt by employeer in a work room that linked to duration of work and air quality. This research used explanatory research by cross sectional approachment. Total population used to sample collection that count of 44 respondents. Research variable for unimpeded variables were temperature, humidity, illumination, amount of air bacteria, age, work duration per day and year of work whereas impeded variable was Sick Building Syndrome subjective complaint. Technical of data collection were measuring, observation and quiz. Data analyze method used univariat analyze with descriptive, and bivariat analyze with spearman’s rho correlation. Outcome of research showed that there were no relation between temperature with p value 0,716 > 0,05, humidity with p value 0,818 > 0,05, illumination with p value 0,529 > 0,05 and amount of air bacteria with p value 0,759 > 0,05 to SBS subjective complaint in office work room of RRI Banjarmasin.