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Chi YQ, Yao Y, Zhang WH, Zhang ZH, Wang YH, Hao W. Docosahexaenoic Acid Supplementation for Neonatal Hyperbilirubinemia: A Double-Blind, Randomized Clinical Trial. Clin Pediatr (Phila) 2024:99228241250139. [PMID: 38680033 DOI: 10.1177/00099228241250139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Docosahexaenoic acid (DHA) is an essential component for brain development during fetal and early postnatal life. Hyperbilirubinemia is characterized by abnormally high levels of bilirubin in the bloodstream, frequently leading to jaundice in newborns. In severe instances, this condition can progress to neurological damage or kernicterus, a form of brain damage. Initial cell-based experiments conducted by our research team revealed that DHA significantly enhances the survival rate of nerve cells treated with bilirubin and diminishes the oxidative stress indicated by reduced peroxide activity caused by unconjugated bilirubin (UCB). Further investigations through animal studies demonstrated that DHA effectively mitigates bilirubin-induced brain injury in neonatal rats. However, the potential of DHA to decrease the incidence of bilirubin-induced brain damage in clinical settings has not been previously explored or reported. Infants with neonatal hyperbilirubinemia (n = 30 per group) participated in a double-blind, randomized, placebo-controlled parallel study. They received either 100 mg/d DHA or placebo syrup immediately when they were diagnosed. The study found that the bilirubin level at 48 hours of treatment, serum neuron-specific enolase (NSE) levels, mean phototherapy duration, and abnormal rate of cranial magnetic resonance imaging (MRI) were lower in the DHA group than those in the control group (P < .05). These results suggested that DHA is effective as an adjuvant treatment for hyperbilirubinemia in children. It can reduce the incidence of neonatal hyperbilirubinemia brain injury and plays a certain protective role. Clinical study on protective effect of DHA on neonatal bilirubin injury is registered at Chinese Clinical Trial Registry as ChiCTR2300070250.
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Affiliation(s)
- Yun-Qian Chi
- Pediatric Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yi Yao
- Basic Medical College of GuangXi Medical University, Nanning, China
| | - Wen-Hong Zhang
- Pediatric Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Zi-Han Zhang
- Pediatric Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yun-He Wang
- Pediatric Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Wei Hao
- Pediatric Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
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Kocakaya H, Bayar Muluk N, Bekin Sarikaya PZ. Peripheric and central olfactory measurements in patients with bipolar disorder. Acta Radiol 2023; 64:2594-2602. [PMID: 37312533 DOI: 10.1177/02841851231179174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Bipolar disorder (BD) is a mental health disorder. PURPOSE To investigate the peripheric and central olfactory measurements in patients with BD using magnetic resonance imaging (MRI). MATERIAL AND METHODS This study was conducted retrospectively. Group 1 consisted of 27 euthymic patients with BD (14 men, 13 women) and Group 2 consisted of 27 healthy controls (14 men, 13 women). Olfactory bulb (OB) volume and olfactory sulcus (OS) depth (peripheric), and corpus amygdala and insular gyrus area (central) measurements were performed using cranial MRI. RESULTS OB volume and OS depth value of the bipolar group were lower than the control group, but there were no significant differences between the groups (P > 0.05). The corpus amygdala and left insular gyrus area of the bipolar group were significantly lower than those in the control group (P < 0.05). There were positive correlations between OB volumes and OS depths, the insular gyrus areas, and the corpus amygdala areas (P < 0.05). As the number of depressive episodes and duration of illness increased in bipolar patients, the depth of the sulcus decreased (P < 0.05). CONCLUSION In the present study a correlation was detected between OB volumes and the structures, known as emotional processing (e.g. insular gyrus area, corpus amygdala), and clinical features. Accordingly, new treatment techniques, such as olfactory training, may be considered an option in the treatment of such patients with BD.
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Affiliation(s)
- Hanife Kocakaya
- Psychiatry Department, Faculty of Medicine, Doctor Faculty Member in Kırıkkale University, Kırıkkale, Turkey
| | - Nuray Bayar Muluk
- ENT Department, Faculty of Medicine, Professor in Kırıkkale University, Kırıkkale, Turkey
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Abstract
OBJECTIVE Takayasu arteritis is a rare granulomatous chronic vasculitis that affects the aorta and its main branches. Neurologic manifestations can accompany the disease; however, there is no study on neuroimaging in children with Takayasu arteritis. Therefore, we aimed to evaluate cranial magnetic resonance imaging (MRI) in pediatric Takayasu arteritis patients. MATERIALS AND METHODS Demographic, clinical, and laboratory data were obtained retrospectively. RESULTS The study included 15 pediatric Takayasu arteritis patients. All patients presented with constitutional symptoms. Additionally, 6 patients suffered from headache, 2 had syncope, 1 had loss of consciousness, and 1 had convulsion. All patients underwent cranial and diffusion MRI a median 12 months after diagnosis. Cranial MRI findings were normal in 12 patients, whereas 3 patients had abnormal findings, as follows: stenosis in the M1 and M2 segments of the left middle cerebral artery (n = 1); diffuse thinning of the right internal carotid, middle cerebral, and right vertebral and basilar artery (n = 1); as a sequela, areas of focal gliosis in both the lateral ventricular and posterior periventricular regions (n = 1). Among these 3 patients, 1 had no neurologic complaints. CONCLUSION Abnormal MRI findings can be observed in pediatric Takayasu arteritis patients, even those that are asymptomatic; therefore, clinicians should carefully evaluate neurologic involvement in all pediatric Takayasu arteritis patients.
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Affiliation(s)
- Hafize Emine Sönmez
- Division of Pediatrics, Department of Pediatric Rheumatology, 52980Kocaeli University, Kocaeli, Turkey
| | - Ferhat Demir
- Department of Pediatric Rheumatology, Ümraniye Research and Training Hospital, University of Health Science, Istanbul, Turkey
| | - Semanur Özdel
- Department of Pediatric Rheumatology, Sami Ulus Research and Training Hospital, Ankara, Turkey
| | - Şerife Gül Karadağ
- Department of Pediatric Rheumatology, Sadi Konuk Research and Training Hospital, University of Health Science, Istanbul, Turkey
| | - Esra Bağlan
- Department of Pediatric Rheumatology, Sami Ulus Research and Training Hospital, Ankara, Turkey
| | - Mehmet Bülbül
- Department of Pediatric Rheumatology, Sami Ulus Research and Training Hospital, Ankara, Turkey
| | - Mustafa Çakan
- Department of Pediatric Rheumatology, Zeynep Kamil Research and Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - Nuray Aktay Ayaz
- Department of Pediatric Rheumatology, Istanbul University Medical School, Istanbul, Turkey
| | - Betül Sözeri
- Department of Pediatric Rheumatology, Ümraniye Research and Training Hospital, University of Health Science, Istanbul, Turkey
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Sánchez-Durán MÁ, Higueras MT, Avilés-García M, Maiz N, Rodríguez-Aliberas M, Arévalo S, Vázquez E, Ruiz Campillo CW, Carreras E. Perinatal outcomes and central nervous system abnormalities following intrauterine fetal transfusion: 17 years' experience in a tertiary center. Transfusion 2020; 60:2557-2564. [PMID: 32955746 DOI: 10.1111/trf.16087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/23/2020] [Accepted: 06/29/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND This study aimed to describe the perinatal outcome and central nervous system (CNS) anomalies in fetuses undergoing red blood cell (RBC) intrauterine transfusion (IUT). METHODS AND MATERIALS This was an observational single-cohort study carried out at Vall d'Hebron University Hospital in Barcelona, Spain, between 2002 and 2018 in women undergoing RBC IUT for suspected fetal anemia. Primary outcomes were adverse perinatal outcome (intrauterine or neonatal death and termination of pregnancy [TOP]), prenatal or postnatal CNS anomalies, and significant neurological impairment. RESULTS A total of 145 RBC transfusions were performed in 68 pregnancies of 60 women. The median gestational age for the first transfusion was 26 weeks (range, 18-32). Twenty-two (32%) fetuses were hydropic at the first transfusion. Fifty-eight pregnancies (85.3%) resulted in live births and 10 (14.7%) in adverse perinatal outcomes. Adverse perinatal outcomes were associated with hydrops (odds ratio [OR], 6.69; 95% confidence interval [CI], 1.53-29.23; P = .012) and gestational age at first transfusion (OR, 0.69; 95% CI, 0.54-0.89; P = .04). Four (5.9%) cases of cerebellar hemorrhage were diagnosed prenatally. In 14 (35%) of the 41 neonates undergoing brain ultrasound and/or magnetic resonance imaging (MRI) abnormalities were reported. The median follow-up was 6.5 years (range, 3 months to 19 years). Significant neurological impairment was reported in two cases (4.2%). CONCLUSION In fetuses undergoing intrauterine RBC transfusion, the survival rate is high, particularly in the absence of hydrops and if the gestational age at first transfusion is above 22 weeks. Significant neurological impairment is uncommon, despite the fact that postnatal CNS anomalies at ultrasound or MRI are frequent.
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Affiliation(s)
- María Ángeles Sánchez-Durán
- Obstetrics Department, Vall d'Hebron Hospital Universitari, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - María Teresa Higueras
- Obstetrics Department, Vall d'Hebron Hospital Universitari, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Mayte Avilés-García
- Obstetrics Department, Vall d'Hebron Hospital Universitari, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Nerea Maiz
- Obstetrics Department, Vall d'Hebron Hospital Universitari, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | | - Silvia Arévalo
- Obstetrics Department, Vall d'Hebron Hospital Universitari, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Elida Vázquez
- Universitat Autònoma de Barcelona, Bellaterra, Spain.,Paediatric Radiology Department, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - César W Ruiz Campillo
- Universitat Autònoma de Barcelona, Bellaterra, Spain.,Neonatology Department, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - Elena Carreras
- Obstetrics Department, Vall d'Hebron Hospital Universitari, Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
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Zhang JZ, Chen Q, Zheng P, Xie LN, Yi XL, Ren HT, Yang J. [A comparative analysis of anti-N-methyl-D-aspartate receptor encephalitis with or without abnormal findings on cranial magnetic resonance imaging]. Zhongguo Dang Dai Er Ke Za Zhi 2018; 20:48-51. [PMID: 29335082 PMCID: PMC7390311 DOI: 10.7499/j.issn.1008-8830.2018.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 12/06/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate the clinical features of children with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis with normal or abnormal cranial magnetic resonance imaging (MRI) findings via a comparative analysis. METHODS A retrospective analysis was performed for the clinical data of 33 children with anti-NMDAR encephalitis. The clinical features and prognosis were compared between the children with normal and abnormal cranial MRI findings. RESULTS In the 33 children with anti-NMDAR encephalitis, the most common initial symptoms were seizures (61%) and involuntary movement (61%), followed by language disorder (54%), mental and behavioral abnormalities (52%), and disturbance of consciousness (30%). All children had positive anti-NMDAR antibody in the cerebrospinal fluid, and 29 children (88%) had positive serum antibody. Of all the children, 15 (46%) had increased leukocytes in the cerebrospinal fluid, 3 (9%) had an increase in protein, and 29 (88%) had positive oligoclonal band; 26 children (79%) had electroencephalographic abnormalities (epileptic wave, slow wave, or a combination of these two types of waves). One child experienced respiratory failure. One child was found to have germinoma in the sellar region during follow-up. Of all the 33 children, 13 (39%) had abnormal cranial MRI findings, with hypointensity or isointensity on T1W1 and hyperintensity on T2WI and T2-FLAIR; 2 children had dural enhancement. As for the location of lesion, 5 children (38%) had lesions in the temporal lobe, 3 (23%) in the frontal lobe, 3 (23%) in the basal ganglia, 2 (15%) in the parietal lobe, 2 (15%) in the occipital lobe, 2 (15%) in the brainstem, 1 (8%) in the thalamus, and 1 (8%) in the cerebellum. Among the 13 children with abnormal cranial MRI findings, 5 (38%) had lesions mainly in the grey matter and 8 (62%) had lesions mainly in the white matter. Compared with the children with normal cranial MRI findings, the children with abnormal cranial MRI findings had significantly higher proportion of children with prodromal infection, incidence rate of disturbance of consciousness, probability of recurrence, Glasgow score, incidence rate of increased leukocytes in the cerebrospinal fluid, and application rate of second-line treatment (P<0.05). CONCLUSIONS Children with anti-NMDAR encephalitis and abnormal cranial MRI findings have certain clinical features, which may provide guidance for the evaluation of disease conditions and the selection of diagnostic and treatment measures.
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Affiliation(s)
- Jian-Zhao Zhang
- Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China.
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Oeinck M, Rozeik C, Wattchow J, Meckel S, Schlageter M, Beeskow C, Reinhard M. Why a standard contrast-enhanced MRI might be useful in intracranial internal carotid artery stenosis. Neuroradiol J 2016; 29:208-12. [PMID: 26988083 DOI: 10.1177/1971400916638354] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In patients with ischemic stroke of unknown cause cerebral vasculitis is a rare but relevant differential diagnosis, especially when signs of intracranial artery stenosis are found and laboratory findings show systemic inflammation. In such cases, high-resolution T1w vessel wall magnetic resonance imaging (MRI; 'black blood' technique) at 3 T is preferentially performed, but may not be available in every hospital. We report a case of an 84-year-old man with right hemispheric transient ischemic attack and signs of distal occlusion in the right internal carotid artery (ICA) in duplex sonography. Standard MRI with contrast agent pointed the way to the correct diagnosis since it showed an intramural contrast uptake in the right ICA and both vertebral arteries. Temporal artery biopsy confirmed the suspected diagnosis of a giant cell arteritis and dedicated vessel wall MRI performed later supported the suspected intracranial large artery inflammation. Our case also shows that early diagnosis and immunosuppressive therapy may not always prevent disease progression, as our patient suffered several infarcts in the left middle cerebral artery (MCA) territory with consecutive high-grade hemiparesis of the right side within the following four months.
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Affiliation(s)
- Maximilian Oeinck
- Department of Neurology, Neurocenter, University of Freiburg, Germany
| | | | - Jens Wattchow
- Department of Neurology, Kreiskliniken Lörrach, Germany
| | - Stephan Meckel
- Department of Neuroradiology, Neurocenter, University of Freiburg, Germany
| | | | | | - Matthias Reinhard
- Department of Neurology, Neurocenter, University of Freiburg, Germany
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