Varicella zoster encephalitis mimicking stroke.

Physicians need to consider a broad differential diagnosis when evaluating a patient presenting with a suspected stroke. The rates of overdiagnosis of stroke in studies of consecutive patients vary from 19% to 31%. The two most common stroke mimics are hypoglycemia and seizure, but several etiologies have been reported.We reported the case of a 41-year-old patient presenting to the emergency department with aphasia and right-side hemiparesis, initially suspected to have stroke and finally diagnosed of varicella-zoster encephalitis.

Ergonomic Factors That Impact Job Satisfaction and Occupational Health during the SARS-CoV-2 Pandemic Based on a Structural Equation Model: A Cross-Sectional Exploratory Analysis of University Workers.

This paper presents a structural equation model to determine the job satisfaction and occupational health impacts concerning organizational and physical ergonomics, using (as a study) objective unionized workers from the University of Sonora, South Campus, as an educational enterprise, during the SARS-CoV-2 pandemic. The above is a key element of an organizational sustainability framework. In fact, there exists a knowledge gap about the relationship between diverse ergonomic factors, job satisfaction, and occupational health, in the educational institution's context. The method used was a stratified sample of workers to which a job satisfaction-occupational health questionnaire was applied, consisting of 31 items with three-dimensional variables. As a result, the overall Cronbach's Alpha coefficient was determined, 0.9028, which is considered adequate to guarantee reliability (i.e., very high magnitude). Therefore, after the structural equation model, only 12 items presented a strong correlation, with a good model fit of 0.036 based on the root mean square error of approximation, 1.09 degrees of freedom for the chi-square, 0.9 for the goodness of fit index, and a confidence level of 95%. Organizational and physical factors have positive impacts on job satisfaction with factor loads of 0.37 and 0.53, respectively, and p-values of 0.016 and 0.000, respectively. The constructs related to occupational health that are considered less important by the workers were also determined, which would imply a mitigation strategy. The results contribute to the body of knowledge concerning the ergonomic dimensions mentioned and support organizational sustainability improvements in educational institutions and other sectors.

Clinical Predictors of Hyperperfusion Syndrome Following Carotid Stenting: Results From a National Prospective Multicenter Study.

OBJECTIVES: The aim of the HISPANIAS (HyperperfusIon Syndrome Post-carotid ANgIoplasty And Stenting) study was to define CHS rates and develop a clinical predictive model for cerebral hyperperfusion syndrome (CHS) after carotid artery stenting (CAS). BACKGROUND: CHS is a severe complication following CAS. The presence of clinical manifestations is estimated on the basis of retrospective reviews and is still uncertain. METHODS: The HISPANIAS study was a national prospective multicenter study with 14 recruiting hospitals. CHS was classified as mild (headache only) and moderate-severe (seizure, impaired level of consciousness, or development of focal neurological signs). RESULTS: A total of 757 CAS procedures were performed. CHS occurred in 22 (2.9%) patients, in which 16 (2.1%) had moderate-severe CHS and 6 (0.8%) had mild CHS (only headache). The rate of hemorrhages was 0.7% and was associated with high mortality (20%). Pre-operative predictors of moderate-severe CHS in multivariate analysis were female sex (odds ratio [OR]: 3.24; 95% confidence interval [CI]: 1.11 to 9.47; p = 0.03), older patients (OR: 1.09; 95% CI: 1.01 to 1.17; p = 0.02), left carotid artery treated (OR: 4.13; 95% CI: 1.11 to 15.40; p = 0.03), and chronic renal failure (OR: 6.29; 95% CI: 1.75 to 22.57; p = 0.005). The area under the curve of this clinical and radiological model was 0.86 (95% CI: 0.81 to 0.92; p = 0.001). CONCLUSIONS: The rate of CHS in the HISPANIAS study was 2.9%, with moderate-severe CHS of 2.1%. CHS was independently associated with female sex, older age, history of chronic kidney disease, and a treated left carotid artery. Although further investigations are needed, the authors propose a model to identify high-risk patients and develop strategies to decrease CHS morbidity and mortality in the future.

Dopa-responsive infantile hypokinetic rigid syndrome due to dominant guanosine triphosphate cyclohydrolase 1 deficiency.

We report on a GTP cyclohydrolase 1 mutation-confirmed heterozygous case presenting with an infantile hypokinetic rigid syndrome and delay in attainment of motor milestones starting from the first year of life. He had a family history of dopa-responsive dystonia-parkinsonism. CSF neopterin, biopterin and HVA values were decreased. Molecular study of GCH-1 gene showed the Q89X mutation in exon 1. Treatment with l-dopa resulted in a complete remission of symptoms.

Current use of wild plants with edible underground storage organs in a rural population of Patagonia: between tradition and change.

BACKGROUND: Edible plants with underground storage organs (USOs) are neglected resources. We studied the local ecological knowledge edible plants with (USOs) in rural populations of North-Patagonia in order to establish how people are utilizing these plants. Some aspect of corpus-praxis-cosmos complex associated to the local ecological knowledge was documented and discussed. In addition, variation in this ecological knowledge due to age, gender, family structure, ethnic self-determination was also evaluated. METHODS: Semi-structured interviews were conducted with 51 inhabitants in order to study the relationship between the current use of plants with USOs and the age, sex, family group composition and ethnic self-identification of interviewees. In addition, the Cultural Importance Index for each species was calculated. RESULTS: The current richness of known species in these populations is a total of 9 plants. Plants with USOs tend to be used more frequently as the age of the interviewee increases. Women and men showed no differences in the average richness of species cited. The interviewees who share their homes with other generations use these plants more frequently than those who live alone. Our results indicate that the interviewees who identified themselves as belonging to the Mapuche people use these plants more frequently. CONCLUSION: For the Mapuche people, wild plants have constituted material and symbolic resources of great importance in their historical subsistence. In addition, they are currently being redefined as elements which present a connection with ancestral practices, produce a strong relationship with the 'land', and become markers which identify the 'natural' (historical) ways of their people; these are key elements in the current political processes of identity revaluation. This research is valuable to stimulate cultural revival and health promotion programs in the communities with their own local, cultural food.

Ethnoecology of Oxalis adenophylla Gillies ex Hook. & Arn.

ETHNOPHARMACOLOGICAL RELEVANCE: We studied the ethnoecological knowledge of medicinal Oxalis adenophylla in 3 rural villages of north Patagonia, Argentina. To evaluate links between use frequency, ethnoecological knowledge, sociocultural variables and the conservation status of this plant. MATERIALS AND METHOD: Forty informants were interviewed in relation to their knowledge, use, perception and the ecology of Oxalis adenophylla. Sociocultural variables were also documented, such as age, gender, size of family group living in the house, economic activities and ethnic self-determination. The abundance and availability of these plants were estimated in two villages, by measuring the number of plants per area, their weight and the relation between time invested and biomass collected. We tested frequency of use and age with Spearman׳s rank correlation coefficient. The relation between use frequency and gender, family group, economic activities, and ethnic self-determination of the informants was tested with the Mann Whitney non parametric test. An index of ethnoecological knowledge was constructed and correlated with use frequency through Spearman׳s rank correlation. To estimate conservation status we established a local risk index, taking both intrinsic and extrinsic parameters for this species into account. RESULTS: Regionally, Oxalis adenophylla is a plant known for its medicinal, alimentary and ornamental properties, but it has been poorly studied from a pharmacological point of view. Locally, the leaves of the plant are harvested for the preparation of "tortillas", which are stored and consumed in the cold months of the year for the treatment of flu fevers (95% of informants). Informants know the value of its root as a nutrient source and 35.8% reported its consumption. Use is sporadic and involves the harvesting of a mean of one root per year, which is eaten raw in-situ. Only 12% of informants mentioned the plant׳s ornamental feature. The ethnoecological knowledge of Oxalis adenophylla included references to specific environments where the plant grows, its phenology and morphological and organoleptic characteristics, appropriate times for harvesting, and animals that forage for this species. The informants with the greatest ethnoecological knowledge harvested leaves and roots most frequently. The frequency of use did not differ in relation to age or gender. In contrast, frequency of use was the highest when the informant lived with several generations at home, maintained traditional animal husbandry practices and when they considered themselves as belonging to the Mapuche people. Informants perceived low abundance and availability of the plant in the environment, restricted by the great distances involved in obtaining them, seasonality, and in particular, difficulty in finding the roots. Informants believe that the plant is sensitive and it should be harvested in such a way as to ensure no damage to the whole plant, allowing resprouting. Our ecological measurements agreed with this perception. The local risk index for the plant was medium. CONCLUSION: In Patagonian Argentina, Oxalis adenophylla is a multipurpose species widely used for its medicinal properties but less for its edible roots and ornamental features. In the rural communities where we worked, frequency of use seems to depend on individual ethnoecological knowledge, the practice of indigenous worldview, living in households interacting with other generations and maintaining the activity of cattle raising. Locally, the main risk for the plant is the particular environment where it grows, characterized by slopes vulnerable to erosion. The human practice of local use could promote the conservation of this species through the understanding of its sensitivity to harvesting, and its insipient cultivation. This research shows the importance of obtaining a general overview of useful wild species used by local people.

Plantas silvestres con órganos subterráneos comestibles: transmisión cultural sobre recursos subutilizados en la Patagonia (Argentina) / Wild plants with edible underground storage organs: cultural transmission about neglected resourcesin Patagonia (Argentina)

En este trabajo documentamos el conocimiento y uso de plantas con órganos de almacenamiento subterráneos comestibles (POAS). Evaluamos los mecanismos de transmisión cultural por los que se difunde dicho conocimiento en 2 poblaciones rurales del Noroeste de la Patagonia argentina. Realizamos entrevistas (N = 34), observación participante y recolección de plantas. Los datos fueron analizados de forma cualitativa y cuantitativa. Un total de 6 especies son conocidas y actualmente 3 son utilizadas. La recolección ocurre mientras se realizan otras actividades como la cría del ganado o la búsqueda de plantas combustibles o medicinales. Los órganos subterráneos, en general, se consumen crudos in situ. El aprendizaje sobre las POAS ocurrió en la infancia por observación e instrucción por parte de adultos, principalmente las madres y las abuelas. La transmisión horizontal en contextos lúdicos también posee un papel importante. La singularidad de los contextos de uso y de aprendizaje confiere fragilidad a la continuidad de estos saberes y el mantenimiento de las prácticas de uso de las POAS.

In this study we documented the knowledge and use of wild plants with edible underground organs (PEUO). We have also evaluated the cultural transmission mechanisms in two rural populations of NW Argentinean Patagonia. Thirty-four informants were interviewed about this topic and they became part of participant observation and gathering join actions. Data were analyzed by quali and quantitative approaches. In total, 6 species are known by people, but only 3 species are used at present. Gathering occurs meanwhile other rural activities, such as cattle raising, medicinal plant collection or fuelwood gathering. Edible underground organs are generally consumed raw in situ. Cultural learning about plants with edible underground organs occurs in the childhood including observation and instruction activities from adults, mainly mothers and grandmothers. Horizontal transmission in ludic contexts has also an important role. The singularity about the learning and use contexts, give a certain fragility in the continuity in the practice of use of PEUO.

Uso de recursos herbolarios entre mapuches y criollos de la comunidad campesina de Arroyo Las Minas (Río Negro, Patagonia Argentina) / Use of medicinal plant resources in Mapuche and Criollo inhabitants of the rural community of Arroyo Las Minas (Río Negro, Argentina)

This work investigates wild medicinal plant use in a rural population of Northwest Patagonia. Arroyo Las Minas population is composed by families with different cultural identitites. Biogeographical origin and differential use between Mapuches and Criollos were focused in this work.. Open and semi-structured interviews were conducted with 17 inhabitants. Among the medicinal plants used in this population, native flora was best represented than the exotic one. The Mapuche inhabitants utilized more total richness (particularly native species) of medicinal plants than the Criollos. Cultural identity (i.e. self-recognition as Mapuche) and time of interaction with the local flora seems to influence the present use of the medicinal plants in this population.

Este trabajo indaga acerca del uso de plantas silvestres medicinales usadas en una pequeña población campesina del noroeste patagónico. La población Arroyo Las Minas está compuesta por familias con diferente auto-reconocimiento cultural. En este estudio se enfoca en aspectos relacionados con el origen biogeográfico de los recursos utilizados y se analiza si el uso de plantas varía entre mapuches y criollos. Se realizaron entrevistas abiertas y semi-estructuradas a 17 personas del paraje. La flora nativa se encuentra mejor representada que los elementos exóticos en la herbolaria de esta población. Los pobladores mapuches utilizan una mayor riqueza de plantas medicinales, y de nativas en particular en comparación con los pobladores criollos. El auto-reconocimiento cultural y el tiempo de interacción con la flora son aspectos que parecen influir en el uso actual de plantas medicinales en esta población.