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Faraguna U, Porciani C, Colitta A, Bruno S, Frumento P, Stagnaro C, Tani C, Vagelli R, Mosca M. Actigraphic and self-reported characterization of sleep in systemic lupus erythematosus patients. Rheumatology (Oxford) 2024; 63:1076-1083. [PMID: 37432350 PMCID: PMC10986802 DOI: 10.1093/rheumatology/kead344] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/09/2023] [Accepted: 06/27/2023] [Indexed: 07/12/2023] Open
Abstract
OBJECTIVES In a cross-sectional study, we explored possible differences in sleep parameters between SLE patients and age- and gender-matched healthy controls through actigraphic and self-reported measures. Furthermore, we aimed to identify possible predictors of such disturbances in the patient cohort. METHODS Participants' sociodemographic data and sleep parameters were collected. Sleep parameters were evaluated through the Pittsburgh Sleep Quality Index, the Insomnia Severity Index and 7-day actigraphic monitoring. The 10-item Perceived Stress Scale was used to investigate stress. Disease activity and daily glucocorticoid dose were assessed in SLE patients. Possible predictors of the SLE group were explored through two binomial logistic models. Within the SLE group, possible predictors of sleep parameters were tested estimating multiple linear regression models. RESULTS A total of 40 SLE patients and 33 controls were included in the study. The SLE group showed worse sleep maintenance actigraphic parameters (i.e. sleep efficiency and wake after sleep onset), higher total sleep time and higher perceived stress. Within the SLE cohort, the daily glucocorticoids dose was associated with an impairment in sleep maintenance despite no reduction in sleep duration, typical of normal sleep duration insomnia, whereas perceived stress was associated with short sleep duration insomnia. CONCLUSION Compared with healthy controls, SLE patients showed worse sleep quality and greater perceived stress severity. As glucocorticoids and perceived stress are associated with different types of insomnia in these patients, a multidimensional approach to both sleep characterization and therapy might be preferred.
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Affiliation(s)
- Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Caterina Porciani
- Department of Clinical Experimental Medicine, Clinical Immunology and Allergy Unit, University of Pisa, Pisa, Italy
| | - Alessandro Colitta
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Simone Bruno
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Paolo Frumento
- Department of Political Sciences, University of Pisa, Pisa, Italy
| | - Chiara Stagnaro
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy
| | - Chiara Tani
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy
| | - Roberta Vagelli
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy
| | - Marta Mosca
- Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy
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Coiacetto FJ, Rossi G, Stephens N, Vaughan-Higgins RJ. Gross and histopathological findings in hindlimb paralysis syndrome in wild Carnaby's black cockatoos (Zanda laitirostris). J Comp Pathol 2024; 210:38-46. [PMID: 38552539 DOI: 10.1016/j.jcpa.2024.02.005] [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] [Received: 10/05/2023] [Revised: 01/09/2024] [Accepted: 02/17/2024] [Indexed: 04/21/2024]
Abstract
The aim of this study was to describe the gross and histopathological features of a neurological syndrome in endangered Western Australian Carnaby's black cockatoos (Zanda laitirostris) that was first observed in 2012. The syndrome, named hindlimb paralysis syndrome in Carnaby's cockatoos (CHiPS), is characterized by annual outbreaks of hindlimb paralysis with occasional loss of deep pain and cloacal tone, typically occurring between January and March. Previous limited investigations suggested a possible toxic aetiology. Full gross necropsy and histopathology examinations were performed on 17 CHiPS cases and on 11 control birds for reference. Histopathological examination was carried out on all major organs including brain, spinal cord, brachial plexus, sciatic nerve and wing and hindlimb muscles. Gross and histopathological examinations did not elucidate a definitive cause of the clinical signs seen in CHiPS cases. There were no substantial gross or histopathological changes within the brain, spinal cord, sciatic nerve or brachial plexus that could explain the hindlimb paralysis. The most noteworthy changes were seen in the hindlimb and wing muscles, with a monophasic to polyphasic myopathy present in the hindlimb muscles of 15 of the 17 CHiPS cases and in the wing muscles in 11 of those cases. The cause and significance of the myopathy is unclear and requires further investigation. Based on the above findings, the most likely differential diagnoses include neurotoxicoses (eg, organophosphate, organochlorine and carbamate) and, less likely, myotoxicosis (eg, ionophore toxicosis), nutritional myopathy (eg, vitamin E/selenium deficiency) or botulism.
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Affiliation(s)
- Flaminia J Coiacetto
- School of Veterinary Medicine, Murdoch University, 90 South Street, Murdoch, Western Australia, 6150, Australia.
| | - Gabriele Rossi
- School of Veterinary Medicine, Murdoch University, 90 South Street, Murdoch, Western Australia, 6150, Australia; Centre for Animal Production and Health, Murdoch University, 90 South Street, Murdoch, Western Australia, 6150, Australia
| | - Nahiid Stephens
- School of Veterinary Medicine, Murdoch University, 90 South Street, Murdoch, Western Australia, 6150, Australia
| | - Rebecca J Vaughan-Higgins
- School of Veterinary Medicine, Murdoch University, 90 South Street, Murdoch, Western Australia, 6150, Australia; Perth Zoo, Veterinary Department, 20 Labouchere Rd, South Perth, Western Australia, 6151, Australia
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Zou Y, Xu Y, Chen X, Wu Y, Fu L, Lv Y. Research Progress on Leucine-Rich Alpha-2 Glycoprotein 1: A Review. Front Pharmacol 2022; 12:809225. [PMID: 35095520 PMCID: PMC8797156 DOI: 10.3389/fphar.2021.809225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/13/2021] [Indexed: 12/18/2022] Open
Abstract
Leucine-rich alpha⁃2 glycoprotein 1 (LRG1) is an important member of the leucine-rich repetitive sequence protein family. LRG1 was mainly involved in normal physiological activities of the nervous system, such as synapse formation, synapse growth, the development of nerve processes, neurotransmitter transfer and release, and cell adhesion molecules or ligand-binding proteins. Also, LRG1 affected the development of respiratory diseases, hematological diseases, endocrine diseases, tumor diseases, eye diseases, cardiovascular diseases, rheumatic immune diseases, infectious diseases, etc. LRG1 was a newly discovered important upstream signaling molecule of transforming growth factor⁃β (TGF⁃β) that affected various pathological processes through the TGF⁃β signaling pathway. However, research on LRG1 and its involvement in the occurrence and development of diseases was still in its infancy and the current studies were mainly focused on proteomic detection and basic animal experimental reports. We could reasonably predict that LRG1 might act as a new direction and strategy for the treatment of many diseases.
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Affiliation(s)
- Yonghui Zou
- Department of Pharmacy, The First Affiliated Hospital of Nanchang University, Nanchang, China.,School of Clinical Medicine, Nanchang University, Nanchang, China
| | - Yi Xu
- Department of Pharmacy, The First Affiliated Hospital of Nanchang University, Nanchang, China.,School of Clinical Medicine, Nanchang University, Nanchang, China
| | - Xiaofeng Chen
- Department of Pharmacy, The First Affiliated Hospital of Nanchang University, Nanchang, China.,School of Clinical Medicine, Nanchang University, Nanchang, China
| | - Yaoqi Wu
- Department of Pharmacy, The First Affiliated Hospital of Nanchang University, Nanchang, China.,College of Pharmacy, Nanchang University, Nanchang, China
| | - Longsheng Fu
- Department of Pharmacy, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yanni Lv
- Department of Pharmacy, The First Affiliated Hospital of Nanchang University, Nanchang, China
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Yang S, Iwanaga J, Olewnik Ł, Konschake M, Loukas M, Dumont AS, Ottone NE, Sañudo J, Tubbs RS. The anterolateral cervicoatlantooccipital plexus: A novel finding with application to skull base and spine surgery and pain disorders of the head and neck. World Neurosurg 2021; 159:e84-e90. [PMID: 34896353 DOI: 10.1016/j.wneu.2021.12.008] [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] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION A novel nerve plexus of the upper neck is described. By exploring how the individual components of this specific anterolateral nerve plexus communicate with each other, patient care may be improved in regard to preoperative diagnosis, intraoperative navigation, and minimally invasive treatments. MATERIALS AND METHODS Using a surgical microscope, 11 adult cadaveric heads (22 sides) were dissected. The region of the junction between the atlantooccipital and craniocervical junctions was explored, specifically, the innervation of this region via adjacent nerve connections. Branches from these regional nerve sources were analyzed for interconnections and when found, these branches were documented and measured. RESULTS A delicate nerve plexus was found overlying the anterolateral C1-C2 junction in all specimens. The plexus was contributed by the sympathetic trunk, vagus nerve, hypoglossal nerve, and C1 and C2 ventral rami. We termed this plexus the anterolateral cervicoatlantooccipital plexus (ALCAO plexus). On all but two sides (91%), the C2 ventral ramus provided the most input into the plexus with 1 to 2 branches. On two sides, the C1 ventral ramus was the primary contribution and on average, this nerve contributed 1 to 2 branches to the plexus. Interestingly, on eight sides (36.4%), the C1 fibers that are known to travel with the hypoglossal nerve and to be distributed to the geniohyoid and thyrohyoid muscles arose from C1 nerve fibers that first traversed the ALCAO plexus. The sympathetic trunk contributed 1 to 4 lateral branches with the majority of these arising superiorly from the superior cervical ganglion. The vagus nerve contributed 1-2 lateral branches and the hypoglossal nerve contributed 1 to 2 anteromedial branches. This plexus was located more or less lateral to the sympathetic trunk and superior cervical ganglion and medial to the transverse process of C1 and C2. The plexus innervated the rectus capitis lateralis, rectus capitis anterior, lateral atlantooccipital joint and on four sides, the atlantoaxial joint. Additionally, small branches were seen traveling to the anterior atlantoaxial and anterior atlantooccipital membranes on 55% and 77.2% of sides, respectively. On six sides, very small branches from the ALCAO plexus ended in the periosteum over the anterolateral aspect of the anterior arch and transverse process of the C1 vertebra. CONCLUSION It is important to recognize that the course of these interneural connections are variable and may pose unforeseen complications during surgical procedures. A comprehensive knowledge of these neural connections is useful when surgery and pathology of the neck and skull base are considered.
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Affiliation(s)
- Seanna Yang
- Tulane University School of Medicine, New Orleans LA, USA
| | - Joe Iwanaga
- Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA; Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, USA.
| | - Łukasz Olewnik
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Poland
| | - Marko Konschake
- Department of Anatomy, Histology and Embryology, Institute of Clinical and Functional Anatomy, Medical University of Innsbruck (MUI), Innsbruck, Austria
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University, Grenada
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Nicolás E Ottone
- Laboratory of Plastination and Anatomical Techniques, Centre for Research in Dental Sciences (CICO), Dental School, Universidad de La Frontera, Temuco, Chile; Department of Integral Adults Odontology, Dental School, Universidad de La Frontera, Temuco, Chile; Center of Excellence in Morphological and Surgical Studies (CEMyQ), School of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Jose Sañudo
- Department of Anatomy and Embryology, University Complutense of Madrid. Madrid, Spain
| | - R Shane Tubbs
- Tulane University School of Medicine, New Orleans LA, USA; Department of Neurology, Tulane University School of Medicine, New Orleans, LA, USA; Department of Neurosurgery, Tulane University School of Medicine, New Orleans, LA, USA; Department of Anatomical Sciences, St. George's University, Grenada; Department of Neurosurgery, Ochsner Health System, New Orleans, LA, USA; Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA; Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA
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Li W, Zhou H, Guo Q, Li G. The Nasopharynx Swab Test for Coronavirus Disease-2019 Is Mild and Will Not Cause Significant Pain and Anxiety: A Cross-Sectional Study Based on Psychiatrists. Front Cell Infect Microbiol 2021; 11:592092. [PMID: 34660331 PMCID: PMC8515122 DOI: 10.3389/fcimb.2021.592092] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 08/18/2021] [Indexed: 11/17/2022] Open
Abstract
Background Laboratory viral nucleic acid testing (NAT), such as the nasopharyngeal swab test, is now recommended as the gold standard for the diagnosis of Coronavirus disease-2019 (COVID-19). However, the nasopharyngeal swab testing process may cause some discomfort. Objective To investigate the influence of nasopharyngeal swab tests on the anxiety and pain felt by psychiatric medical staff. Methods A total of 174 psychiatric medical staff (namely 97 doctors, 68 nurses, and nine administrators) and 27 controls were included in the current study. A self-designed questionnaire was used to collect their general demographic information (age, gender, marriage, occupation, profession, smoking history, alcohol consumption history, tea drinking history, previous history of anxiety and depression) as well as their subjective experience, such as nausea, vomiting, coughing, worry, fear, etc, during nasopharyngeal swab collection. The Numerical Rating Scale (NRS) and the State-Trait Anxiety Inventory (STAI) were used to assess the subjects’ pain and state anxiety, respectively. Results There were no statistical differences (p>0.05) in age, marriage, smoking history, a history of anxiety and depression, pain scores, and anxiety scores between different professions and genders. The results of partial correlation analysis (controlled for gender and history of depression or anxiety) indicated that the male gender was negatively correlated with being anxious (r=-0.148, p=0.037) and nervous (r=-0.171 p=0.016), although there was no significant difference in pain and anxiety between men and women. In addition, marriage might help women resist negative emotions. Conclusions 1) There will be mild discomfort during nucleic acid testing, but not enough to cause pain and anxiety; 2) women are more likely to be anxious and nervous during the nucleic acid testing.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Han Zhou
- Department of Early Psychotic Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Guo
- Department of Early Psychotic Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guanjun Li
- Department of Early Psychotic Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Abalymov A, Parakhonskiy B, Skirtach AG. Polymer- and Hybrid-Based Biomaterials for Interstitial, Connective, Vascular, Nerve, Visceral and Musculoskeletal Tissue Engineering. Polymers (Basel) 2020; 12:E620. [PMID: 32182751 PMCID: PMC7182904 DOI: 10.3390/polym12030620] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/19/2020] [Accepted: 03/03/2020] [Indexed: 12/11/2022] Open
Abstract
In this review, materials based on polymers and hybrids possessing both organic and inorganic contents for repairing or facilitating cell growth in tissue engineering are discussed. Pure polymer based biomaterials are predominantly used to target soft tissues. Stipulated by possibilities of tuning the composition and concentration of their inorganic content, hybrid materials allow to mimic properties of various types of harder tissues. That leads to the concept of "one-matches-all" referring to materials possessing the same polymeric base, but different inorganic content to enable tissue growth and repair, proliferation of cells, and the formation of the ECM (extra cellular matrix). Furthermore, adding drug delivery carriers to coatings and scaffolds designed with such materials brings additional functionality by encapsulating active molecules, antibacterial agents, and growth factors. We discuss here materials and methods of their assembly from a general perspective together with their applications in various tissue engineering sub-areas: interstitial, connective, vascular, nervous, visceral and musculoskeletal tissues. The overall aims of this review are two-fold: (a) to describe the needs and opportunities in the field of bio-medicine, which should be useful for material scientists, and (b) to present capabilities and resources available in the area of materials, which should be of interest for biologists and medical doctors.
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Affiliation(s)
- Anatolii Abalymov
- Department of Biotechnology, Faculty of Bioscience Engineering, Ghent University, 9000 Ghent, Belgium
| | | | - Andre G. Skirtach
- Department of Biotechnology, Faculty of Bioscience Engineering, Ghent University, 9000 Ghent, Belgium
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Abstract
Libman-Sacks endocarditis (LSE) is one of the most characteristic cardiac lesions in systemic lupus erythematosus (SLE). Patients may remain asymptomatic, while symptomatic patients often suffer with systemic emboli. These commonly test positive for anti-phospholipid antibody (aPA). The association of LSE with an overlap of rheumatoid arthritis (RA) and lupus (also known as 'rhupus') is rare. We report such a patient, who had been diagnosed as having RA seven years before and had suffered an acute ischaemic stroke one year previously and had echocardiographic evidence of LSE found during routine evaluation. However, she tested negative for aPA.
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Affiliation(s)
- Shahana Zaman
- Junior Consultant, Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
| | - Muhammad Abdur Rahim
- Associate Professor, Department of Nephrology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka, Bangladesh
| | - Lima Asrin Sayami
- Junior Consultant, Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
| | - Shaila Nabi
- Associate Professor, Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
| | - Akm Monwarul Islam
- Associate Professor, Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh
| | - Mohammad Ullah
- Associate Professor, Department of Cardiology, Colonel Malek Medical College, Manikgonj, Bangladesh
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Svistunov AA, Tarasov VV, Shakhmardanova SA, Sologova SS, Bagaturiya ET, Chubarev VN, Galenko-Yaroshevsky PA, Avila-Rodriguez MF, Barreto GE, Aliev G. Urotensin II: Molecular Mechanisms of Biological Activity. Curr Protein Pept Sci 2019; 19:924-934. [PMID: 28875851 DOI: 10.2174/1389203718666170829162335] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 06/01/2017] [Revised: 07/01/2017] [Accepted: 07/18/2017] [Indexed: 12/12/2022]
Abstract
Urotensin II (UT II) is an important factor of cellular homeostasis. This regulatory peptide is involved in the pathophysiology of many disorders. For example, it plays an important role in the pathogenesis of acute and chronic diseases, stressful and adaptive reactions of the body, in the development of cardiovascular pathologies, metabolic syndrome, inflammation, liver cirrhosis, renal failure, diabetic nephropathy, reproductive dysfunction, progression of psychosomatic, psychoendocrinal and psychiatric disorders. In this concern, the involvement of UT II in the pathophysiology of many processes determines the perspectives for the development of blockers of urotensin receptors for the treatment of the aforementioned diseases. It is important that even today this kind of perspective is feasible due to the synthesis of a series of GPR14 blockers. The objective of this review is to discuss current molecular mechanisms of biological activity, regulatory functions of UT II, its role in the pathogenesis of different nosologies, as well as analysis of the possible routes of exposure to GPR14 as potential therapeutic targets.
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Affiliation(s)
- Andrey A Svistunov
- Institute of Pharmacy and Translational Medicine, Sechenov First Moscow State Medical University, 19991 Moscow, Russian Federation
| | - Vadim V Tarasov
- Institute of Pharmacy and Translational Medicine, Sechenov First Moscow State Medical University, 19991 Moscow, Russian Federation
| | - Svetlana A Shakhmardanova
- Institute of Pharmacy and Translational Medicine, Sechenov First Moscow State Medical University, 19991 Moscow, Russian Federation
| | - Susanna S Sologova
- Institute of Pharmacy and Translational Medicine, Sechenov First Moscow State Medical University, 19991 Moscow, Russian Federation
| | - Ekaterina T Bagaturiya
- Institute of Pharmacy and Translational Medicine, Sechenov First Moscow State Medical University, 19991 Moscow, Russian Federation
| | - Vladimir N Chubarev
- Institute of Pharmacy and Translational Medicine, Sechenov First Moscow State Medical University, 19991 Moscow, Russian Federation
| | | | - Marco Fidel Avila-Rodriguez
- Facultad de Ciencias de la Salud- Departamento de Ciencias Clínicas- Universidad del Tolima, Ibague, Colombia
| | - George E Barreto
- Departamento de Nutricion y Bioquimica, Facultad de Ciencias, Pontificia Universidad Javeriama, Bogota D.C., Colombia.,Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Santiago, Chile
| | - Gjumrakch Aliev
- GALLY International Biomedical Research Consulting LLC., 7733, Louis Pasteur, Drive, #330, San Antonio, TX, 78229, United States.,School of Health Science and Healthcare Administration, University of Atlanta, E. Johns Crossing, #175, Johns Creek, GA, 30097, United States.,Institute of Physiologically Active Compounds, Russian Academy of Sciences, Chernogolovka, 142432, Russian Federation
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Abstract
Chikungunya fever is a benign and self-limiting disease caused by an RNA virus belonging to genus alphavirus and transmitted by infected Aedes mosquitoes. However, a number of atypical presentations involving various systems have been reported. Among the neurological complications, encephalitis, myelitis, Guillain-Barre syndrome and optic neuritis are commonly seen. However, its presentation as isolated inflammatory myositis causing quadriplegia is extremely rare. We report a 35-year-old woman with quadriplegia caused by chikungunya-induced inflammatory myositis. The diagnosis was confirmed with clinical examination, electromyography study, muscle biopsy findings and exclusion of other causes. There have been case reports of inflammatory myositis in association with various infections as well as in association with other neurological presentations in chikungunya. However, this may be the first case report of isolated inflammatory myositis associated with chikungunya fever.
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Affiliation(s)
- Nishant Dev
- 1 Assistant Professor, Department of Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Rahul Kumar
- 2 PG Resident, Department of Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Arun Gogna
- 3 Professor, Department of Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Shruti Sharma
- 4 Scientist C, National Institute of Pathology, ICMR, Safdarjung Hospital, New Delhi, India
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10
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Agrwal S, Dabas A, Mantan M, Yadav S. Hemophagocytic lymphohistiocytosis with neurological manifestations in an infant with scrub typhus: a rare fatal occurrence. Trop Doct 2018; 49:52-53. [PMID: 30360694 DOI: 10.1177/0049475518804696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 11/15/2022]
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a syndrome of unchecked activation of the immune system leading to phagocytosis of blood cells and proliferation of histiocytes in solid organs. HLH can be primary or secondary to infective, autoimmune and malignant conditions. Scrub typhus is an infective illness caused by Orientia tsutsugamushi, transmitted by mite. The illness ranges from mild fever with rash to severe multisystem illness. Scrub typhus has rarely been associated with secondary HLH. We report an infant with scrub typhus who progressed to develop HLH with central nervous system involvement with fatal outcome.
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Affiliation(s)
- Shipra Agrwal
- 1 Senior Resident, Department of Pediatrics, Maulana Azad Medical College, New Delhi, India
| | - Aashima Dabas
- 2 Assistant Professor, Department of Pediatrics, Maulana Azad Medical College, New Delhi, India
| | - Mukta Mantan
- 3 Professor, Department of Pediatrics, Maulana Azad Medical College, New Delhi, India
| | - Sangeeta Yadav
- 4 Director Professor and Head, Department of Pediatrics, Maulana Azad Medical College, New Delhi, India
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Pannu AK, Sharma N. Thyrotoxic hypokalemic periodic paralysis: a life-threatening disorder in Asian men. Trop Doct 2018; 49:49-51. [PMID: 30305000 DOI: 10.1177/0049475518803251] [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] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Thyrotoxicosis can present as a sporadic form of hypokalaemic periodic paralysis. The condition is associated with massive intracellular shift of potassium, mainly in skeletal muscles. As the total body stores of potassium remain normal, overzealous potassium supplementation targeting serum potassium level results in a poor outcome. We present a fatal case of thyrotoxic hypokalaemic periodic paralysis.
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Affiliation(s)
- Ashok Kumar Pannu
- 1 Assistant Professor, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Navneet Sharma
- 2 Professor, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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12
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Affiliation(s)
- Aditya Singh Kutiyal
- 1 Senior Resident, Internal Medicine, 28862 Maulana Azad Medical College , New Delhi, India
| | - Chetanya Malik
- 1 Senior Resident, Internal Medicine, 28862 Maulana Azad Medical College , New Delhi, India
| | - Gitika Hyanki
- 2 Post Graduate Resident, Department Of Pathology, Government Medical College, Haldwani, India
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13
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Adebiyi A, Lagunju I, Ogunniyi A. Epilepsy in transition from child care to adult service: a missing link in sub-Saharan Africa. Trop Doct 2016; 47:273-275. [PMID: 27578858 DOI: 10.1177/0049475516666245] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Epilepsy is a common chronic neurological disease which predominantly affects children and young adults. The disease is highly stigmatised and transition from child care to adult services is not routine in many low- and middle-income countries. Where a treatment system follows routines which cannot be sustained in such countries because of specialised manpower challenges, it becomes imperative that appropriate care models be sought for patients whose seizures fail to remit in childhood. In teaching hospitals, well-organised, multidisciplinary meetings and a planned transfer between paediatric and adult neurologists will be feasible. However, an alternative model is advocated at the community level where the majority of the patients reside which involves task shifting to general practitioners and community healthcare workers. The latter can organise home visits to ensure management compliance. This will ensure better seizure outcomes and a good quality of life for epileptic patients.
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Affiliation(s)
- Ayoade Adebiyi
- 1 Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife and University College Hospital, Ibadan, Nigeria
| | - IkeOluwa Lagunju
- 2 Department of Paediatrics, University of Ibadan/University College Hospital, Ibadan, Nigeria
| | - Adesola Ogunniyi
- 3 Department of Medicine, University of Ibadan/University College Hospital, Ibadan, Nigeria
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Abstract
A chronic progressive neurological condition in an Alexandrine parrot (Psittacula eupatria) was manifest as intention tremors, incoordination, and seizure activity. Histology revealed large eosinophilic bodies throughout the central nervous system, and electron microscopy demonstrated that these bodies were greatly expanded axons distended by short filamentous structures that aggregated to form long strands. The presence of periodic acid-Schiff-positive material within the neuronal bodies of Purkinje cells and ganglionic neurons is another distinctive feature of this disease. The histological features of this case display some features consistent with giant axonal neuropathy as reported in humans and dogs. Based on investigation of the lineage in this case, an underlying inherited defect is suspected, but some additional factor appears to have altered the specific disease presentation in this bird.
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Affiliation(s)
- Andrew Stent
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia (Stent, Tatarczuch, Summers)Greencross Springvale Animal Hospital, Springvale South, Victoria, Australia (Gosbell)
| | - Matthew Gosbell
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia (Stent, Tatarczuch, Summers)Greencross Springvale Animal Hospital, Springvale South, Victoria, Australia (Gosbell)
| | - Liliana Tatarczuch
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia (Stent, Tatarczuch, Summers)Greencross Springvale Animal Hospital, Springvale South, Victoria, Australia (Gosbell)
| | - Brian A Summers
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Victoria, Australia (Stent, Tatarczuch, Summers)Greencross Springvale Animal Hospital, Springvale South, Victoria, Australia (Gosbell)
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15
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Kossaify A, Garcia A, Ziade F. Assessment of heart rate turbulence in hypertensive patients: rationale, perspectives, and insight into autonomic nervous system dysfunction. Heart Views 2014; 15:68-73. [PMID: 25538819 PMCID: PMC4268613 DOI: 10.4103/1995-705x.144790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Heart rhythm turbulence is classically impaired in patients with previous myocardial infarction and congestive heart failure and is poorly investigated in patients with essential hypertension. Objective: To evaluate heart rhythm turbulence parameters (turbulence onset, (TO); turbulence slope, (TS) in a series of hypertensive patients while gaining insight into autonomic nervous system dysfunction. Setting and Design: University hospital, cross-sectional monocentric study. Materials and Methods: Heart rhythm turbulence was assessed in 50 hypertensive (case group) and 40 normotensive patients (control group). Results: TO and TS were found independently correlated with hypertension. The mean TO was found at -1.64% ± 2.85% in the normotensive patients compared to 1.21% ± 1.95% in the hypertensive patients; the mean TS was found at 4.29 ± 3.18 ms/RR in the normotensive patients compared to 2.27 ± 0.93 ms/RR in the hypertensive patients. Hypertension has a predictive value on heart rhythm turbulence impairment (OR 4.99, 95% CI 1.28-19.41, P = 0.02). Insights into the role of autonomic nervous system dysfunction for the management of hypertensive patients and prevention of malignant ventricular arrhythmia are presented and discussed with regard to heart rhythm turbulence. Conclusion: Essential hypertension is correlated with blunted heart rhythm turbulence parameters.
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Affiliation(s)
- Antoine Kossaify
- Electrophysiology Unit, Cardiology Division, University Hospital Notre Dame de Secours, St Charbel Street, Byblos, Lebanon
| | - Annie Garcia
- Electrophysiology Unit, Cardiology Division, University Hospital Notre Dame de Secours, St Charbel Street, Byblos, Lebanon
| | - Fouad Ziade
- Faculty of Public Health, Lebanese University, Beirut, Lebanon
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16
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Lazar JW. A contextual analysis of nervous force in medico-scientific and literary writings in English of the nineteenth and early-twentieth centuries. J Hist Neurosci 2014; 24:244-267. [PMID: 25297565 DOI: 10.1080/0964704x.2014.956562] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study concerns the context of use of the term "nervous force," as it appears in scientific and literary publications in English over the course of the nineteenth century and the first two decades of the twentieth century. The context of use, loss, or waste of nervous force and the context of nervous force as an expression of an attribute are analyzed in 189 scientific and 105 literary writings. Both contexts appeared in literary writings, where nervous force expresses the attributes of strength, forcefulness, vigor, or energy and use, loss or waste of nervous force explains such nonmorbid conditions as why someone is tired or needs rest. Only the context of use-loss-waste appeared in the medico-scientific literature, but here it explained both nonmorbid conditions (for example, effects of old age) and morbid conditions (like epilepsy). Changes in the number of these references give insights into the medico-scientific and the literary disciplines. Discussions include why nervous force is associated with explanation of disease, the persistence of its use in this capacity, and its influence on a similar use in literary writings.
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17
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Abstract
Glycemic control is an important aspect of patient care in the surgical Infections of the nervous system are among the most difficult infections in terms of the morbidity and mortality posed to patients, and thereby require urgent and accurate diagnosis. Although viral meningitides are more common, it is the bacterial meningitides that have the potential to cause a rapidly deteriorating condition that the physician should be familiar with. Viral encephalitis frequently accompanies viral meningitis, and can produce focal neurologic findings and cognitive difficulties that can mimic other neurologic disorders. Brain abscesses also have the potential to mimic and present like other neurologic disorders, and cause more focal deficits. Finally, other infectious diseases of the central nervous system, such as prion disease and cavernous sinus thrombosis, are explored in this review.
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Affiliation(s)
- Vevek Parikh
- University of California, San Francisco, CA, USA
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18
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Kasatkina EP, Samsonova LN, Ivakhnenko VN, Ibragimova GV, Ryabykh AV, Naumenko LL, Yevdokunova YA. [Gestational hypothyroxinemia and cognitive functions of offsprings]. Probl Endokrinol (Mosk) 2005; 51:27-31. [PMID: 31627594 DOI: 10.14341/probl200551527-31] [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] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Indexed: 11/06/2022]
Abstract
То study the impact of gestational hypothyroxinemia on the neurointellectual prognosis in infants living in an industrial megapolis who had mild-to-moderate iodine deficiency, the authors used a "Gnome" mental development scale to assess cognitive function in 13 babies bom to mothers who had first-trimester gestational hypothyroxinemia corrected with thyroid hormonal preparations and in 10 babies born to mothers who had normal free thyroxine levels when the babies were 6,9, and 12 months old. The study indicated that the maternal level of free thyroxine in early (at weeks 5-9) pregnancy significantly correlated with the mental development index of babies at the age of 6,9, and 12 months, i.e. it is one of the determinants of offspring's nervous and mental development. Moreover, early (not later than 9 weeks of pregnancy) correction of gestational hypothyroxinemia with levothyroxine in a mean daily dose of at least 1.2 fig/kg improves the prognosis of progeny's neurointellectual prognosis, by increasing the mental development index up to 92-97 scores in babies in the first year of life, which are consistent with that in babies bom to mothers having normal thyroxine levels.
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Affiliation(s)
| | | | | | | | - A V Ryabykh
- Russian Medical Academy for Postgraduate Education
| | - L L Naumenko
- Russian Medical Academy for Postgraduate Education
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