Investigating the Viability of Motor Imagery as a Physical Rehabilitation Treatment for Patients With Stroke-Induced Motor Cortical Damage

Although around 83% of individuals survive a stroke, they usually experience a significant loss in their motor execution (ME) capabilities due to their acquired cortical infarction. The loss of significant ME capabilities due to stroke damage was previously thought to be irreversible. Active movement therapies show considerable promise but depend on motor performance, excluding many otherwise eligible patients. Motor imagery (MI), a process that involves the use of mirror neurons to imagine motor activity, has emerged as a possible avenue to re-acquire some physical abilities lost to stroke damage. This paper examines previous studies to compare the strength of brain activation and connectivity in individuals who have brain lesions and those who do not as they all attempt ME and MI tasks. This paper reviews case studies investigating the direct effect of motor imagery in conjunction with physical therapy and the limitations of motor imagery based on the location of cortical damage and other variables, such as age. The findings analyzed in this review indicate that MI would serve as a beneficial addition to physical therapy and a viable option to stimulate motor evoked potentials (MEPs) in individuals not capable of pursuing physical therapy due to severe motor impairment. Regardless of the presence of brain lesions, motor imagery has consistently had a positive impact on motor rehabilitation either in boosting treatment or stimulating neuromuscular pathways. Therefore, we have concluded that MI is a viable supplemental treatment plan for motor recovery in most patients with motor cortical atrophy.

Have Our Attempts to Curb Obesity Done More Harm Than Good?

Dieting is a common method for weight loss, maintenance, and prevention of weight gain, but the harmful outcomes of dieting are understudied. Dieting is typically advised for obese patients for the sake of their health, though this does not account for the many complicated factors surrounding obesity. We conducted a search through the PubMed database on obesity, dieting, and eating disorders and did not limit the study by population or year. We found studies showing that although dieting may cause short-term weight loss, it is associated with weight gain in the long-term. We also found studies assessing the negative psychological and physical outcomes of dieting. Though there are many studies that emphasize the negative psychological impact of dieting, few studies have explored how dieting may contribute to the development of eating disorders in the obese. Studies on the physical impact of dieting were less conclusive but warrant further study. While it is difficult to draw any substantial conclusions from the data, our results showed that dieting may carry more risks than benefits as a means to lose weight.

Dialysis Patients With Restless Leg Syndrome: Can We Relieve Their Suffering?

Restless leg syndrome (RLS), also called Willis Ekbom disease, can be described as an unpleasant feeling that intensely urges the patients to move their lower limbs. RLS is classified into primary and secondary. It is one of the common complications in hemodialysis patients, and it impairs patients’ quality of life. Unfortunately, it is an underdiagnosed and undertreated disorder. In this review article, we performed a literature search using the PubMed database to compare different treatment modalities for RLS in patients with end-stage renal disease (ESRD) on regular hemodialysis. Many of the non-pharmacologic modalities of treatment are cost-effective and safer than pharmacologic therapy. Given the small sample size of the studies and short follow up duration, we should consider conducting studies on a larger number of patients and for longer periods of time to assess the efficacy and safety of different treatment patterns for RLS in hemodialysis patients. We hope to raise awareness about this neurologic condition in hemodialysis patients.

Romiplostim and Eltrombopag in Immune Thrombocytopenia as a Second-Line Treatment

Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by platelet count less than 100×10⁹/L and an increased risk of bleeding. The risk of bleeding increases in proportion with the degree of thrombocytopenia. Although several medications are used for primary thrombocytopenia treatment, refractoriness remains a concern. Romiplostim and eltrombopag, two relatively new drugs, have been shown to be successful in ITP treatment after standard treatment failure. The current guidelines recommend their use as a second-line treatment. In this article, we have tried to compare which of these two medications is the best option considering clinical effectiveness, cost-effectiveness, adverse effects, and the possibility of switching between them in case of ineffectiveness. The studies used in this article were found in the PubMed database. All the studies are limited to adults. Based on these studies, both medications seem to be a largely effective, safe option. Romiplostim appears to have slightly fewer adverse effects and higher costs. Switching between thrombopoietin receptor agonists (TRAs) is a successful way to overcome adverse effects and inadequacy according to the currently available literature. We believe that more detailed studies are needed to determine which of these drugs should be considered the first choice, to report long term efficacy and adverse effects, and to determine if treatment guidelines can change regarding the use of TRAs as first-line treatment.