Effect of Gushen shetuo decoction in improving motor and non-motor symptoms and the expression of PERK, ATF4 and CHOP in patients with Parkinson's disease.

This study aims to observe the therapeutic effect of Gushen Shetuo decoction on Parkinson's disease (PD), so as to provide reference for clinical practice. In order to demonstrate the clinical value of Gushen Shetuo Decoction, we selected 80 patients with PD for the study. Among them, 38 patients received the Gushen Shetuo decoction (research group), and 42 patients received Levodopa and Benserazide Hydrochloride Tablets (control group). There was no difference in Non-Motor Symptoms Scale (NMSS) scores between the research group and the control group (P>0. 05). However, the scores of motor complications in Movement Disorder Society-sponsored revision of the Parkinson's Disease Rating Scale (MDS-UPDRS) and those of Drooling Severity and Frequency Scale (DSFS) in the research group were lower than those in the control group (P<0. 05). Subsequently, we established PD model rats, and after Gushen Shetuo Decoction gavage treatment, we found that rats in the intervention group had increased mobility (P<0. 05), as well as notably improved pathological damage of substantia nigra and striatum. Also, the expression of PERK, ATF4 and CHOP in the brain tissues of rats in the intervention group was lower than those in the control group (P<0. 05). These results confirm that Gushen Shetuo decoction effectively improved the drooling of patients with PD and showed high safety.

Characteristics and Outcomes of Ptyalism Gravidarum.

BACKGROUND: Ptyalism gravidarum (PG) is a condition of hypersalivation that affects pregnant women early in gestation. Symptoms include massive saliva volumes (up to 2 liters per day), swollen salivary glands, sleep deprivation, significant emotional distress, and social difficulties. OBJECTIVES: To examine maternal and fetal characteristics and pregnancy outcomes of patients with PG. METHODS: Patients diagnosed with PG in our clinic during the years 2001-2016 were identified and contacted. Demographic data were extracted from patient charts and clinical and outcome data was collected via telephone interviews. RESULTS: The incidence of PG was 1/963 (0.09%) in our sample. Eleven out of 22 women (40%) with PG were also diagnosed with hyperemesis gravidarum. Fetal gender did not increase the risk. Of the mothers presenting with PG, 37% had a positive family history for this condition. There was no associated increase in the rate of fetal or maternal complications. Two women reported a resolution of the symptoms immediately following hypnosis with acupuncture treatment. CONCLUSIONS: Although PG represents an unpleasant mental and physical condition, it does not pose any specific risk to the health of the mother or increase adverse perinatal outcomes for the fetus. Alternative medicine could play a role in the treatment of PG.

Un caso infrecuente de enfermedad de Crohn proximal / An uncommon case of proximal Crohn's disease

La enfermedad de Crohn (EC) es un trastorno inflamatorio crónico que puede afectar a cualquier parte del tracto digestivo, desde la boca hasta el ano. Aunque se manifiesta preferentemente en íleon terminal y colon, el tracto gastrointestinal alto puede afectarse en raras ocasiones. El diagnóstico se basa en los hallazgos clínicos, endoscópicos e histológicos. El tratamiento de la EC del tracto gastrointestinal proximal es similar al indicado en la EC distal. Se emplean habitualmente glucocorticoides, asociados a inhibidores de la bomba de protones. Se expone el caso clínico de una paciente de 42 años con EC localizada en esófago, estómago y duodeno. Entre las pruebas complementarias, la endoscopia alta con toma de biopsias fue esencial para llegar al diagnóstico de EC (AU)

Crohn's disease (CD) is a chronic, inflammatory disorder that can involve any part of the gastrointestinal tract, from the mouth to the anus. Although CD mainly affects the terminal ileum and colon, the involvement of the upper gastrointestinal tract rarely occurs. Diagnosis is based on clinical, endoscopic and histological features. Treatment for CD of the upper gastrointestinal tract is similar to distal CD therapy. Corticosteroids added to proton pump inhibitors are usually used. The case of a 42-year-old female patient with CD located in the oesophagus, stomach and duodenum is presented. Among the complementary tests, an endoscopic evaluation of the upper gastrointestinal tract with biopsies was essential to support CD diagnosis (AU)

Epilepsia rolándica: características epidemiológicas, clínicas y evolutivas / Rolandic epilepsy: Epidemiological and clinical characteristics and outcome

Objetivo: Analizar las características epidemiológicas, clínicas y evolutivas de la epilepsia rolándica para facilitar su sospecha diagnóstica en la práctica clínica diaria. Pacientes y métodos: Se han revisado 56 historias clínicas de pacientes con epilepsia rolándica y se han registrado características epidemiológicas y clínicas, exploraciones complementarias y datos evolutivos. Los criterios diagnósticos aplicados fueron los de la International League Against Epilepsy. Resultados: La edad media al diagnóstico era de 7,7 años. El 62,5 % fueron diagnosticados en edad escolar, con mayor prevalencia del sexo masculino (58,9 %). El 80,4 % de los pacientes tuvieron crisis exclusivamente durante el sueño caracterizadas por contracciones hemifaciales con desviación ocular y/o cefálica (76,8 %), sialorrea (44,6 %), sonidos guturales (30,6 %), crisis motoras secundariamente generalizadas (35,7 %) y/o hemicorporales (26,8 %), disartria (17,9 %) y parestesias unilaterales (16,1 %). Se constataron paroxismos de localización centrotemporal, preferentemente unilaterales (78,6 %). El 50,7 % de las recurrencias se dieron en los primeros 12 meses tras el diagnóstico, el 24,6 % entre los 12 y 24 meses, y el 24,6 % restante entre los 2 y 4 años. Se objetivaron 2 casos de evolución atípica: uno de actividad continua de punta-onda en sueño lento, y otro de afasia adquirida (síndrome de Landau-Kleffner). Conclusiones: La epilepsia rolándica constituye un síndrome epiléptico específicamente pediátrico que afecta preferentemente a varones en edad escolar. Su secuencia semiológica es bastante característica, y es imprescindible documentar paroxismos centrotemporales para su diagnóstico. Su pronóstico es excelente; sin embargo, dado que algunos pacientes cursan una evolución atípica y/o una afectación cognitiva transitoria sería conveniente mantener un riguroso control evolutivo (AU)

Objective: To analyse the epidemiological, clinical and developmental characteristics of Rolandic epilepsy as an aid to its suspected diagnosis in daily clinical practice. Patients and methods: The medical records of 56 patients with Rolandic epilepsy were reviewed in order to collect epidemiological and clinical features, results of complementary examinations and developmental data. The criteria defined by the International League Against Epilepsy (ILAE) were used in the diagnosis. Results: Mean age at diagnosis was 7.7 years. In all, 62.5 % were diagnosed at school age, with a higher prevalence of males (58.9 %). Seizures occurred during sleep in 84.4 % of patients, and they were mainly characterised by hemifacial seizures with eye deviation and/or headaches (76.8 %), hypersalivation (44.6 %), guttural sounds (30.6 %), secondary generalised tonic-clonic (35.7 %) and/or unilateral clonic or tonic seizures (26.8 %), dysarthria (17.9 %) and unilateral paresthesias (16.1 %). Inter-ictal EEG showed paroxysms in the centrotemporal regions, frequently unilateral (78.6 %). Of all recurrences, 50.7 % occurred during the first 12 months after diagnosis, 24.6 % between 12 and 24 months after diagnosis, and 24.6 % between 2 and 4 years of follow up. Two patients with atypical progression were recorded: a case with epilepsy with continuous spikes and waves during slow-wave sleep, and another case with a Landau-Kleffner syndrome. Conclusions: Rolandic epilepsy is a common type of epilepsy in the pediatric age group and generally begins at school-aged children. Its semiological sequence is fairly characteristic, and finding centrotemporal spikes is considered as necessary for the syndromic diagnosis. The prognosis is excellent; however, as a few patients may progress to atypical outcomes and/or neuropsychological deficits, a rigorous developmental control of these patients should be of the highest priority (AU)