No abstract

Records of plasma calcium (Ca ++ ), phosphorus (P i ), potassium (K + ), sodium (Na + ), chloride (Cl -), magnesium (Mg ++ ), iron (Fe ++ ), glucose, cholesterol, triglycerides and total protein levels were measured to determine the effects of exercise on occurrence of diurnal rhythms in Throughbred racehorses (n=7) under physical training. Physical activities consisted of gallop on the track and walking. Blood samples were collected from jugular vein every 4h over a 48h period. Plasma Ca ++ , K + , Mg ++ and Na + levels were obtained by flame photometry; and, P i , Cl -, Fe ++ , glucose, cholesterol, triglycerides and total protein levels were measured by colorimetric tests using visible UV spectrophotometry. The data were analyzed using a 24h period to each exercise performed. Diurnal rhythm of Pi was observed when walking was the physical activity performed, and its acrophase occurred at the light period. Plasma triclycerides showed significant diurnal rhythms, with their acrophases occurring at the dark period, even when walking or gallop were performed. High intensity exercise (gallop) decreased triglycerides amplitude. No significant diurnal rhythms of other variables were found. Gallop, as physical activity, masked phosphorus diurnal rhythm. However, physical training did not influence triglycerides diurnal rhythm occurrence. High intensity exercise (gallop) just declined triglycerides amplitude.

No abstract

The NIH Stroke Scale (NIHSS) is widely adopted in clinical practice. Despite being originally designed for research use, the NIHSS is a valued resource for communication and prognostication, and it is useful for the decision-making process regarding reperfusion therapies and prophylaxis. However, its assessment can be laborious and complex among even certified healthcare providers. In the context of increasing telemedicine use, an accurate assessment of the NIHSS may be crucial in acute stroke management We aimed to create and validate an automated tool for the NIHSS (SPOKES) in a national telemedicine service. A board of five certified vascular neurologists created an NIHSS algorithm based on a tree decision, including tips and hints in the main questions and auxiliary boxes. We randomized 22 spoke hospitals using an automated tool to invite emergency physicians not certified in the NIHSS to use or not the SPOKES. NIHSS-certified and blinded neurologists from a hub hospital performed a double-check of each item of the NIHSS. From June to August 2022, we included 144 cases from 10 spoke hospitals. Our algorithm was fully adopted in 27 cases (19%). The median of reported NIHSS was 3 [1, 5] and 3 [2, 7] points among users and non-users, p=0.38. The general difference between the reported and the double-checked score was 0 [0, 1] points – there was no difference between those who used or did not the SPOKES (p=0.12). A complete concordant score was achieved at 66.7% (n=18/27) and 45.3% (n=53/117), χ 2 =0.036, among users and non-users, respectively. In a bivariate regression analysis, the SPOKES increased the chance of complete agreement [OR 2.4, 95%CI 1-5.8, p=0.049]. There was no difference regarding discrepant scores (≥4 points), χ 2 =0.46. Among SPOKES cases, treatment with tPA was indicated in 11.1%, versus 12.7% among non-users (p=0.59). Despite the small number of included cases, our algorithm seems to be a promising tool for the NIHSS assessment in a national telemedicine service, increasing the chance of a complete agreement with certified neurologists. The tool is free and available at www.spokes-nihss.com