One of the most complex and challenging developments at the beginning of the third millennium is the alarming increase in demographic aging, mainly—but not exclusively—affecting developed countries. This reality results in one of the harsh medical, social, and economic consequences: the continuously increasing number of people with dementia, including Alzheimer’s disease (AD), which accounts for up to 80% of all such types of pathology. Its large and progressive disabling potential, which eventually leads to death, therefore represents an important public health matter, especially because there is no known cure for this disease. Consequently, periodic reappraisals of different therapeutic possibilities are necessary. For this purpose, we conducted this systematic literature review investigating nonpharmacological interventions for AD, including their currently known cellular and molecular action bases. This endeavor was based on the PRISMA method, by which we selected 116 eligible articles published during the last year. Because of the unfortunate lack of effective treatments for AD, it is necessary to enhance efforts toward identifying and improving various therapeutic and rehabilitative approaches, as well as related prophylactic measures.

Background: We aimed to assess the effects of modulated neuroprotection with intermittent administration in patients with unresponsive wakefulness syndrome (UWS) after severe traumatic brain injury (TBI). Methods: Retrospective analysis of 60 patients divided into two groups, with and without neuroprotective treatment with Actovegin, Cerebrolysin, pyritinol, L-phosphothreonine, L-glutamine, hydroxocobalamin, alpha-lipoic acid, carotene, DL-α-tocopherol, ascorbic acid, thiamine, pyridoxine, cyanocobalamin, Q 10 coenzyme, and L-carnitine alongside standard treatment. Main outcome measures: Glasgow Coma Scale (GCS) after TBI, Extended Glasgow Coma Scale (GOS E), Disability Rankin Scale (DRS), Functional Independence Measurement (FIM), and Montreal Cognitive Assessment (MOCA), all assessed at 1, 3, 6, 12, and 24 months after TBI. Results: Patients receiving neuroprotective treatment recovered more rapidly from UWS than controls (p = 0.007) passing through a state of minimal consciousness and gradually progressing until the final evaluation (p = 0.000), towards a high cognitive level MOCA = 22 ± 6 points, upper moderate disability GOS-E = 6 ± 1, DRS = 6 ± 4, and an assisted gait, FIM =101 ± 25. The improvement in cognitive and physical functioning was strongly correlated with lower UWS duration (−0.8532) and higher GCS score (0.9803). Conclusion: Modulated long-term neuroprotection may be the therapeutic key for patients to overcome UWS after severe TBI.

Background: This study aimed to compare the effectiveness of radial extracorporeal shockwave and ultrasound therapies in adult patients with idiopathic scoliosis in terms of pain, disability, and quality of life. Methods: Forty-eight patients with idiopathic scoliosis were randomly divided into three groups of 16: shockwave, ultrasound, and control. The patients were evaluated at admission (day one) and at discharge (day 14) for pain, by using the visual analogue scale; for disability, by using the Oswestry disability index; and for the quality of life, with short form-36. Results: Radial extracorporeal shockwave therapy was more effective than ultrasound in reducing pain (p = 0.004) and increasing quality of life, bringing extra vitality (p = 0.003) and emotional comfort (p = 0.007) to the patient. Both shockwave therapy (p = 0.001) and ultrasound therapy (p = 0.003) were effective in reducing pain. In terms of disability, both treatments had similar effects (p = 0.439). Conclusion: Radial shockwave was significantly more effective than ultrasound in reducing pain and increasing the quality of life, bringing additional vitality and emotional comfort to the patient with idiopathic scoliosis. In terms of disability, both treatments had similar effects when associated with kinesitherapy.

Introduction: Neurofibromatosis - type 1 (NF1) and type 2 (NF2) - are genetic disorders of the nervous system that can affect the growth and development of nerve cell tissue and so can determine severe or rather permanent sequels. NF2 implies usually multiple tumors on the cranial and spinal nerves and it is less common than NF1. The most frequent symptom of NF2 is hearing progressive loss, as a consequence of auditory nerves affection and appears at early ages or at twenties. The evolution of a patient with NF2 depends on the number and location of tumors and some of them might develop a life-threatening or disabling condition. With a prompt diagnosis and an appropriate therapy it can be improved the patient prognosis and QOL. Materials and Methods: This paper presents the case of a 43-year-old patient, with personal antecedents of hearing dysfunction, diagnosed in 2013 with neurofibromatosis that was hospitalized at the IV Neurosurgery Clinic of TEHBA in January 2019 and suffered a re-intervention for removal of the spinal cord tumor (psammomatous meningioma) and with spinal cord decompression. In our clinic, the patient was admitted for incomplete AIS/Frankel C paraplegia, he had initially followed a complex nursing program and subsequently a rehabilitation adequate program. The patient was assessed functionally using the following scales: AIS / Frankel, modified Ashworth, Functional Independence Measure (FIM), Life Quality Assessment (QOL), FAC International Scale, Independence Assessment Scale in Daily Activities (ADL / IADL), Walking Scale for Spinal Cord Injury (WISCI). Results: The paraclinical assessments (cerebral and spinal cord MRI) detect multiple cerebral tumors and micro-nodules adjacent to the lumbar spinal roots, which, associated with the bilateral acoustic neurinoma (diagnosed in 2013), contributed to the suspicion of the NF2 diagnosis. The patient had two admissions in our clinic division, benefited from a complex neuro-muscular rehabilitation program, having a favourable evolution, with an increase in the evaluated scales scores, now performing walking with a support from another person in walking frame, as well as sphincter re-education, with the neurogenic bladder remission. Conclusions: Even if there is no cure for neurofibromatosis and no standard treatment, it is important to promptly diagnose such a rare disease and to give an adequate treatment (AINS or other analgesic drugs, surgery, chemotherapy or radiation –when it’s needed, or psychotherapy) for controlling symptoms and also a personalized rehabilitation program (including nursing measures) enhancing including patient's quality of life. Key words: paraplegia, neurofibromatosis, neuro-muscular rehabilitation,