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Zhang W, Liu Y, Liao Y, Zhu C, Zou Z. GPX4, ferroptosis, and diseases. Biomed Pharmacother 2024; 174:116512. [PMID: 38574617 DOI: 10.1016/j.biopha.2024.116512] [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: 12/07/2023] [Revised: 03/03/2024] [Accepted: 03/27/2024] [Indexed: 04/06/2024] Open
Abstract
GPX4 (Glutathione peroxidase 4) serves as a crucial intracellular regulatory factor, participating in various physiological processes and playing a significant role in maintaining the redox homeostasis within the body. Ferroptosis, a form of iron-dependent non-apoptotic cell death, has gained considerable attention in recent years due to its involvement in multiple pathological processes. GPX4 is closely associated with ferroptosis and functions as the primary inhibitor of this process. Together, GPX4 and ferroptosis contribute to the pathophysiology of several diseases, including sepsis, nervous system diseases, ischemia reperfusion injury, cardiovascular diseases, and cancer. This review comprehensively explores the regulatory roles and impacts of GPX4 and ferroptosis in the development and progression of these diseases, with the aim of providing insights for identifying potential therapeutic strategies in the future.
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Affiliation(s)
- Wangzheqi Zhang
- School of Anesthesiology, Naval Medical University, 168 Changhai Road, Shanghai 200433, China
| | - Yang Liu
- School of Anesthesiology, Naval Medical University, 168 Changhai Road, Shanghai 200433, China
| | - Yan Liao
- School of Anesthesiology, Naval Medical University, 168 Changhai Road, Shanghai 200433, China
| | - Chenglong Zhu
- School of Anesthesiology, Naval Medical University, 168 Changhai Road, Shanghai 200433, China.
| | - Zui Zou
- School of Anesthesiology, Naval Medical University, 168 Changhai Road, Shanghai 200433, China.
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García-Azorín D, Moya-Alarcón C, Armada B, Sánchez Del Río M. Societal and economic burden of migraine in Spain: results from the 2020 National Health and Wellness Survey. J Headache Pain 2024; 25:38. [PMID: 38486155 PMCID: PMC10941425 DOI: 10.1186/s10194-024-01740-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/29/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND The burden of migraine goes beyond the pain and associated symptoms. We aimed to describe the impact of migraine in healthcare resource utilization (HCRU), work productivity, and mood disorders, as well as its economic cost. METHODS Case-control study nested in a cross-sectional analysis of patient-reported data collected between 30/12/2019 and 20/04/2020 as part of the National Health and Wellness Survey, from respondents located in Spain. Adults (≥ 18 years old) who reported a physician diagnosis of migraine and ≥ 1 monthly headache days (MHD) in the previous 30 days were included. HCRU, health-related quality-of-life, depression scores, work and activity impairment, and the associated direct and indirect costs were assessed for four cohorts of migraine patients, according to the frequency of headache (MHD: 1-3, 4-7, 8-14, ≥ 15) and compared to a no-migraine control, matched to migraine cases by a propensity score based on demographic and clinical variables. RESULTS The survey was completed by 595 people with active migraine, of whom 461 (77.4%) experienced < 8 MHDs and 134 (22.6%) ≥ 8 MHDs, and 1,190 non-migraine matched controls. Migraine patients presented worse mental and physical health functioning (SF-12 MCS: 41.9 vs. 44.7, p < 0.001; SF-12 PCS: 48.6 vs. 51.5, p < 0.001), worse self-reported health (EQ-5D VAS: 65.8 vs. 73.5, p < 0.001), more severe depression (PHQ-9: 8.9 vs. 6.1, p < 0.001), and higher overall work impairment (WPAI: 41.4 vs. 25.5, p < 0.001). People with migraine had higher HCRU, twice higher hospitalization rates (17.0% vs. 8.3%, p < 0.001) and 1.6 higher emergency room (ER) visit rates (51.4% vs. 31.2%, p < 0.001). Having migraine translated into higher annual costs with HCRU (€894 vs. €530) and productivity losses (€8,000 vs. €4,780) per person. Respondents with more MHDs presented worse outcomes and higher costs but suffering from 1-3 MHD also increased costs by 51.3%. CONCLUSIONS Having migraine not only causes a massive impact on patients' quality of life and ability to work, but it also generates considerable economic costs for society. In Spain, having migraine was associated to 1.7 higher costs per patient. The clinical and economic burden increases with the frequency of headaches but is higher than controls even in patients suffering from 1-3 MHD.
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Affiliation(s)
- David García-Azorín
- Headache Unit, Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid Health Research Institute (VALLHRI), Calle Rondilla Sta.Teresa, S/N, Valladolid, 47010, Spain.
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Gu BD, Wang Y, Ding R. Impact of a multidisciplinary collaborative nutritional treatment model in patients who are critically ill with neurological disorders: A randomized controlled trial. Technol Health Care 2024; 32:1767-1780. [PMID: 38073348 DOI: 10.3233/thc-230791] [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: 05/12/2024]
Abstract
BACKGROUND Malnutrition is a widespread problem in critically ill patients with neurological disorders. OBJECTIVE The purpose of this study is to investigate the effect of a multidisciplinary collaborative nutritional treatment mode based on a standardized unit for nutritional support on the outcome metrics in patients with neurological disorders who are critically ill. METHODS We enrolled 84 participants who were hospitalized in the intensive care unit (ICU) of Yancheng No. 1 People's Hospital for neurological disorders between June 2018 and December 2021. The participants were randomly assigned to the control group and the test group. The control group received traditional nutritional support, while the test group was treated with a multidisciplinary collaborative nutritional treatment mode based on a standardized unit for nutritional support. We collected the general information, feeding tolerance (FT), nutritional risk score, and laboratory indicators before intervention, after intervention for one week, and after intervention for 2 weeks, and other data of the participants. RESULTS After the intervention, the test group scored significantly lower than the control group in the incidence of gastroparesis and diarrhea, as well as the NUTRIC score, with statistically significant differences (P< 0.001). The prealbumin levels in the test group increased progressively prior to intervention, after intervention for one week, and after intervention for two weeks. Compared to the control group, the test group had higher prealbumin levels prior to intervention, after intervention for one week, and after intervention for two weeks, with statistically significant differences (P< 0.001). CONCLUSION We developed a multidisciplinary collaborative nutritional treatment model based on a standard unit for nutritional support. This model can improve neural function, FT, and pertinent outcome indicators and is generally applicable.
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Affiliation(s)
- Bao-Di Gu
- Department of Critical Care Medicine, Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, The First People's Hospital of Yancheng, Yancheng, Jiangsu, China
| | - Yun Wang
- Department of Neurology, Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, The First People's Hospital of Yancheng, Yancheng, Jiangsu, China
| | - Rong Ding
- Department of Nursing, Yancheng First Hospital, Affiliated Hospital of Nanjing University Medical School, The First People's Hospital of Yancheng, Yancheng, Jiangsu, China
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Yu Q, Wu T, Xu W, Wei J, Zhao A, Wang M, Li M, Chi G. PTBP1 as a potential regulator of disease. Mol Cell Biochem 2023:10.1007/s11010-023-04905-x. [PMID: 38129625 DOI: 10.1007/s11010-023-04905-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/16/2023] [Indexed: 12/23/2023]
Abstract
Polypyrimidine tract-binding protein 1 (PTBP1) is a member of the heterogeneous nuclear ribonucleoprotein (hnRNP) family, which plays a key role in alternative splicing of precursor mRNA and RNA metabolism. PTBP1 is universally expressed in various tissues and binds to multiple downstream transcripts to interfere with physiological and pathological processes such as the tumor growth, body metabolism, cardiovascular homeostasis, and central nervous system damage, showing great prospects in many fields. The function of PTBP1 involves the regulation and interaction of various upstream molecules, including circular RNAs (circRNAs), microRNAs (miRNAs) and long non-coding RNAs (lncRNAs). These regulatory systems are inseparable from the development and treatment of diseases. Here, we review the latest knowledge regarding the structure and molecular functions of PTBP1 and summarize its functions and mechanisms of PTBP1 in various diseases, including controversial studies. Furthermore, we recommend future studies on PTBP1 and discuss the prospects of targeting PTBP1 in new clinical therapeutic approaches.
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Affiliation(s)
- Qi Yu
- The Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, 130021, Jilin, People's Republic of China
| | - Tongtong Wu
- The Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, 130021, Jilin, People's Republic of China
| | - Wenhong Xu
- The Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, 130021, Jilin, People's Republic of China
| | - Junyuan Wei
- The Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, 130021, Jilin, People's Republic of China
| | - Anqi Zhao
- The Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, 130021, Jilin, People's Republic of China
| | - Miaomiao Wang
- The Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, 130021, Jilin, People's Republic of China
| | - Meiying Li
- The Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, 130021, Jilin, People's Republic of China.
| | - Guangfan Chi
- The Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, 130021, Jilin, People's Republic of China.
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Mittly V, Farkas-Kirov C, Zana Á, Szabó K, Ónodi-Szabó V, Purebl G. The effect of animal-assisted interventions on the course of neurological diseases: a systematic review. Syst Rev 2023; 12:224. [PMID: 38007472 PMCID: PMC10675848 DOI: 10.1186/s13643-023-02387-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 11/10/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND In our experience, working with a therapy animal strengthens endurance, maintains motivation, provides a sense of achievement, and boosts overall mental resilience. The aims of this work were to summarize the results of quantitative research on the possibilities of animal-assisted intervention (AAI) among people with neurodegenerative and cerebrovascular diseases and to attempt to assess the effects of animal-assisted interventions in an objective manner and to find supporting evidence based on published literature. METHODS Our target groups are people diagnosed with Parkinson's disease, multiple sclerosis, or stroke. A systematic search of relevant articles was conducted by two independent researchers in April 2021 and August 2023. The search for studies was conducted using PubMed, Google Scholar, Web of Science, Scopus, and Ovid databases, specifying keywords and search criteria. The qualitative evaluation of the research reports was conducted by four independent researchers, using the Newcastle-Ottawa Quality Assessment Form. RESULTS According to the scientific criteria and based on the Newcastle-Ottawa Quality Assessment Form, thirteen publications met the search criteria, out of which 9 publications were rated good and 4 publications were rated poor. Evaluating the publications we found evidence that AAI had a measurable impact on participants, as their physical and mental health status significantly improved; however, mental health improvement was more prominent. CONCLUSIONS By developing evidence-based research methodology and standardized research settings, AAI could be measured effectively as part of health care practice. This would bring significant benefits to the rehabilitation of patients in need. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021255776.
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Affiliation(s)
- Veronika Mittly
- Institute of Behavioral Sciences, Semmelweis University, Nagyvárad Square 4, 1089, Budapest, Hungary.
- South-Pest Central Hospital National Institute of Haematology and Infectology, Centre for Rehabilitation, Jahn Ferenc, Street 62-66, 1196, Budapest, Hungary.
| | - Cecilia Farkas-Kirov
- Creanova Organisation and Management Development Consulting Ltd., Zichy Géza Street 5, 1146, Budapest, Hungary
| | - Ágnes Zana
- Institute of Behavioral Sciences, Semmelweis University, Nagyvárad Square 4, 1089, Budapest, Hungary
| | - Kata Szabó
- Támasz Foundation, Sándor Street 1, 7626, Pécs, Hungary
| | | | - György Purebl
- Institute of Behavioral Sciences, Semmelweis University, Nagyvárad Square 4, 1089, Budapest, Hungary
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Chang XQ, Xu L, Zuo YX, Liu YG, Li J, Chi HT. Emerging trends and hotspots of Nuclear factor erythroid 2-related factor 2 in nervous system diseases. World J Clin Cases 2023; 11:7833-7851. [DOI: 10.12998/wjcc.v11.i32.7833] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/04/2023] [Accepted: 10/30/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND The Nuclear factor erythroid 2-related factor 2 (NRF2) transcription factor has attracted much attention in the context of neurological diseases. However, none of the studies have systematically clarified this field's research hotspots and evolution rules.
AIM To investigate the research hotspots, evolution patterns, and future research trends in this field in recent years.
METHODS We conducted a comprehensive literature search in the Web of Science Core Collection database using the following methods: (((((TS=(NFE2 L2)) OR TS=(Nfe2 L2 protein, mouse)) OR TS=(NF-E2-Related Factor 2)) OR TS=(NRF2)) OR TS=(NFE2L2)) OR TS=(Nuclear factor erythroid2-related factor 2) AND (((((((TS=(neurological diseases)) OR TS=(neurological disorder)) OR TS=(brain disorder)) OR TS=(brain injury)) OR TS=(central nervous system disease)) OR TS=(CNS disease)) OR TS=(central nervous system disorder)) OR TS=(CNS disorder) AND Language = English from 2010 to 2022. There are just two forms of literature available: Articles and reviews. Data were processed with the software Cite-Space (version 6.1. R6).
RESULTS We analyzed 1884 articles from 200 schools in 72 countries/regions. Since 2015, the number of publications in this field has increased rapidly. China has the largest number of publications, but the articles published in the United States have better centrality and H-index. Among the top ten authors with the most published papers, five of them are from China, and the author with the most published papers is Wang Handong. The institution with the most articles was Nanjing University. To their credit, three of the top 10 most cited articles were written by Chinese scholars. The keyword co-occurrence map showed that "oxidative stress", "NRF2", "activation", "expression" and "brain" were the five most frequently used keywords.
CONCLUSION Research on the role of NRF2 in neurological diseases continues unabated. Researchers in developed countries published more influential papers, while Chinese scholars provided the largest number of articles. There have been numerous studies on the mechanism of NRF2 transcription factor in neurological diseases. NRF2 is also emerging as a potentially effective target for the treatment of neurological diseases. However, despite decades of research, our knowledge of NRF2 transcription factor in nervous system diseases is still limited. Further studies are needed in the future.
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Affiliation(s)
- Xue-Qin Chang
- Department of Neurology, Xinhua Hospital Affiliated with Dalian University, Dalian 116011, Liaoning Province, China
| | - Ling Xu
- Department of Neurology, Xinhua Hospital Affiliated with Dalian University, Dalian 116011, Liaoning Province, China
| | - Yi-Xuan Zuo
- Department of Neurology, Xinhua Hospital Affiliated with Dalian University, Dalian 116011, Liaoning Province, China
| | - Yi-Guo Liu
- Department of Neurology, Xinhua Hospital Affiliated with Dalian University, Dalian 116011, Liaoning Province, China
| | - Jia Li
- Department of Neurology, Xinhua Hospital Affiliated with Dalian University, Dalian 116011, Liaoning Province, China
| | - Hai-Tao Chi
- Department of Neurology, Xinhua Hospital Affiliated with Dalian University, Dalian 116011, Liaoning Province, China
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Gavriilaki M, Papaliagkas V, Stamperna A, Moschou M, Notas K, Papagiannopoulos S, Arnaoutoglou M, Kimiskidis VK. Biomarkers of therapeutic efficacy in adolescents and adults with 5q spinal muscular atrophy: a systematic review. Acta Neurol Belg 2023; 123:1735-1745. [PMID: 35861914 DOI: 10.1007/s13760-022-02028-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 02/23/2022] [Accepted: 07/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND The therapeutic landscape of spinal muscular atrophy (SMA) was dramatically transformed with the introduction of three disease-modifying therapies (DMTs). A systematic review was performed to assess available evidence regarding quantitative therapeutic biomarkers used in SMA patients older than 11 years under treatment with DMTs. METHODS Latest literature search in MEDLINE, EMBASE, Cochrane databases and gray literature resources was performed in June 2021. Studies reporting only motor function or muscle strength scales or pulmonary function tests were excluded. Primary outcome was the change from baseline score of any serum, cerebrospinal fluid (CSF) or neurophysiologic biomarker examined. RESULTS Database and gray literature search yielded a total of 8050 records. We identified 14 records published from 2019 until 2021 examining 18 putative serum, CSF or neurophysiologic biomarkers along with routine CSF parameters in 295 SMA nusinersen-treated type 2-4 patients older than 11 years of age. There is evidence based on real-world observational studies suggesting that serum creatinine, creatine kinase activity levels along with CSF Αβ42, glial fibrillary acidic protein concentration as well as ulnar compound motor action potential amplitude and single motor unit potential amplitude changes may depict therapeutic response in this population. CONCLUSION This systematic review explored for the first-time biomarkers used to monitor therapeutic efficacy in SMA adolescents and adults treated with DMTs. Research in this area is in its early stages, and our systematic review can facilitate selection of quantitative therapeutic biomarkers that may be used as surrogate measures of treatment efficacy in future trials. PROTOCOL REGISTRATION PROSPERO CRD42021245516.
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Affiliation(s)
- Maria Gavriilaki
- 1st Department of Neurology, School of Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, S. Kyriakidi Str. 1, 546 36, Thessaloniki, Greece.
| | - Vasileios Papaliagkas
- Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Alexandra Stamperna
- 2nd Department of Pediatrics, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Moschou
- 1st Department of Neurology, School of Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, S. Kyriakidi Str. 1, 546 36, Thessaloniki, Greece
| | - Konstantinos Notas
- Laboratory of Clinical Neurophysiology, School of Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sotirios Papagiannopoulos
- 3rd Department of Neurology, School of Medicine, G. Papanicolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Marianthi Arnaoutoglou
- Laboratory of Clinical Neurophysiology, School of Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasilios K Kimiskidis
- 1st Department of Neurology, School of Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, S. Kyriakidi Str. 1, 546 36, Thessaloniki, Greece
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Aldana-Benítez D, Caicedo-Pareja MJ, Sánchez DP, Ordoñez-Mora LT. Dance as a neurorehabilitation strategy: A systematic review. J Bodyw Mov Ther 2023; 35:348-363. [PMID: 37330793 DOI: 10.1016/j.jbmt.2023.04.046] [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: 12/12/2021] [Revised: 01/26/2023] [Accepted: 04/12/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE This systematic review aimed to demonstrate the benefits of dance-based therapeutic interventions in rehabilitation processes in patients with neurological disorders. METHODS Searches on the following databases and electronic search engines were conducted: MEDLINE, LILACS, Science Direct, SCOPUS, PeDro, BVS (virtual health library), and Google Scholar. Data extraction was independently performed by two authors. Twenty-five clinical trial-type studies that included dance and established outcome measures were included, and studies in which a musicalized exercise modality was used without the connotation of dance were excluded. RESULTS From the results of multiple studies, the short-term motor benefits of rhythmic auditory stimulation on gait parameters were highlighted. Furthermore, there was scientific evidence demonstrating the benefits of the cognitive and social parameters of group dancing as significant improvements in cognitive flexibility and processing speed were highlighted. Recent studies showed that interventions based on exercise and/or rhythmic choreography can reduce the risk of falls in patients with neurological disorders, thereby improving their quality of life. CONCLUSION These findings suggest that dance is an innovative and effective method that can be included in therapies as it allows for a promising prognosis in motor, cognitive, and social performances of patients with neurological disorders that alter mobility and quality of life.
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Affiliation(s)
- Daniel Aldana-Benítez
- Faculty of Health, Physiotherapy Program, Health and Movement Research Group, Universidad Santiago de Cali, Colombia; Semillero de investigación Patokinesis, grupo de investigación Salud y Movimiento, Colombia.
| | - María José Caicedo-Pareja
- Faculty of Health, Physiotherapy Program, Health and Movement Research Group, Universidad Santiago de Cali, Colombia; Semillero de investigación Patokinesis, grupo de investigación Salud y Movimiento, Colombia.
| | - Diana Patricia Sánchez
- Faculty of Health, Physiotherapy Program, Health and Movement Research Group, Universidad Santiago de Cali, Colombia; Semillero de investigación Patokinesis, grupo de investigación Salud y Movimiento, Colombia.
| | - Leidy Tatiana Ordoñez-Mora
- Faculty of Health, Physiotherapy Program, Health and Movement Research Group, Universidad Santiago de Cali, Colombia; Semillero de investigación Patokinesis, grupo de investigación Salud y Movimiento, Colombia.
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Al-Abri S, Al-Asmi A, Jose S, Gujjar AR. Initial clinical and radiological features of patients with multiple sclerosis in Oman. Mult Scler Relat Disord 2023; 75:104734. [PMID: 37150051 DOI: 10.1016/j.msard.2023.104734] [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: 12/24/2022] [Revised: 04/10/2023] [Accepted: 04/24/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND AND OBJECTIVE Multiple sclerosis (MS) is a lifelong demyelinating disorder with a varying disease course, resulting in different degrees of physical disability for affected patients. This study aimed to present the initial clinicoradiological features of Omani MS patients presenting to a tertiary care center in Oman. METHODS In this retrospective study, all Omani patients diagnosed with MS from January 2006 to December 2020, whose treatment and followup were conducted in our center, were included. Data was retrieved from the patients' medical records. Disability status was assessed according to the Expanded Disability Status Scale. RESULTS A total of N = 155 Omani patients were diagnosed with MS of whom 68.4% were female. The mean age at diagnosis was 28.6 ± 8 years. The mean duration from symptoms to diagnosis was 1.9 years. Relapsing-remitting MS was diagnosed in 97.4% patients. Most common presenting symptoms were unifocal (84.5%), supratentorial (34.2%) and optic pathway (33.5%). At first assessment, 94.8% patients had no to mild disabilities and 3.2% had severe disabilities. During the mean follow up period of 61.2 months, the frequency of severe disabilities increased to 12.9%. Out of 155 patients, 98 (63.2%) had their initial brain magnetic resonance (MRI) report available for review, 62/98 (63%) of whom showed ≥ 20 T2-weighted (T2W) lesions. Of these lesions, 75/98 (76.5%) were periventricular, 66 (67.3%) juxtacortical, and 56 (57.1%) infratentorial. The most common initially prescribed disease modifying therapies (DMT) were interferons (104/155; 67%), followed by fingolimod (16; 10.3%), natalizumab (14; 9%) and dimethyl fumarate (4; 2.6%). CONCLUSIONS The results of this study indicate that the demographic and clinicoradiological features of MS patients in Oman are similar to those reported elsewhere in the Arabian Gulf region.
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Affiliation(s)
- Salma Al-Abri
- Internal Medicine Program, Oman Medical Specialty Board (OMSB), Muscat, Oman
| | - Abdullah Al-Asmi
- Neurology Unit, Department of Medicine, College of Medicine & Health Sciences and Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman.
| | - Sachin Jose
- Research Department, Oman Medical Specialty Board (OMSB), Muscat, Oman
| | - Arunodaya R Gujjar
- Neurology Unit, Department of Medicine, College of Medicine & Health Sciences and Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
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Villa E, Torres A, Orellana P, de Grazia J, Villanueva ME, Guevara C. Neuro-Sjögren: A clinical-radiological paradox affecting the central nervous system. J Neuroimmunol 2023; 378:578085. [PMID: 37058850 DOI: 10.1016/j.jneuroim.2023.578085] [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: 01/30/2023] [Revised: 03/31/2023] [Accepted: 04/06/2023] [Indexed: 04/16/2023]
Abstract
Neurological manifestations can occur in up to 67% of patients with primary Sjögren's Syndrome, also known as Neuro-Sjogren's syndrome (NSS), and a 5% can present central nervous system involvement, with severe and possibly lethal consequences. We present the radiological follow-up of a patient with NSS who consulted for limb weakness and visual loss, and fourteen years later developed sicca symptoms. She was diagnosed with a saliva gland biopsy, and started treatment with steroids, cyclophosphamide, and then rituximab, achieving a favourable clinical response and stabilization of lesions. We discuss key aspects regarding the clinical presentation, diagnosis, imaging, and treatment of this elusive disease.
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Affiliation(s)
- Eduardo Villa
- Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Alejandra Torres
- Department of Radiology, Faculty of Medicine Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Patricia Orellana
- Department of Radiology, Faculty of Medicine Hospital Clínico Universidad de Chile, Santiago, Chile
| | - José de Grazia
- Department of Radiology, Faculty of Medicine Hospital Clínico Universidad de Chile, Santiago, Chile; Radiology Unit, Clínica Alemana de Osorno, Chile
| | - María Elena Villanueva
- Department of Pathology, Faculty of Medicine, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Carlos Guevara
- Department of Neurology and Neurosurgery, Faculty of Medicine, Hospital Clínico Universidad de Chile, Santiago, Chile.
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Kushnir A, Fedchyshyn B, Kachmar O. Review of effects of spinal manipulative therapy on neurological symptoms. J Bodyw Mov Ther 2023; 34:66-73. [PMID: 37301560 DOI: 10.1016/j.jbmt.2023.04.009] [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: 04/23/2021] [Revised: 11/21/2022] [Accepted: 04/11/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Neurological disorders are the leading cause of disability in the world. Neurological symptoms significantly affect the well-being of the individual. Spinal manipulative therapy (SMT) is a complementary method often used for people with neurological disorders. OBJECTIVE This study aimed to review the existing literature on the effects of SMT on common clinical symptoms of neurologic disorders and the quality of life. METHODS Narrative review was conducted through the literature published between January 2000 and April 2020 in English. The search was performed across four databases: PubMed, Google Scholar, PEDro, and Index to Chiropractic Literature. We used combinations of keywords related to SMT, neurological symptoms, and quality of life. Studies on both symptomatic and asymptomatic populations of different ages were included. RESULTS 35 articles were selected. Evidence for the administration of SMT for neurological symptoms is insufficient and sparse. Most studies focused on the effects of SMT on pain, revealing its benefits for spinal pain. SMT may increase strength in asymptomatic people and populations with spinal pain and stroke. SMT was reported to affect spasticity, muscle stiffness, motor function, autonomic function, and balance problems, but these studies were limited in number to make conclusions. An important finding was the positive influence of SMT on the quality of life in people with spinal pain, balance impairments, and cerebral palsy. CONCLUSION SMT may be beneficial for the symptomatic treatment of neurological disorders. SMT can positively affect the quality of life. However, limited evidence is available, and further high-quality research is required.
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Affiliation(s)
- A Kushnir
- Elita Rehabilitation Center, Kozyavkin Medical Group, Ukraine
| | - B Fedchyshyn
- Elita Rehabilitation Center, Kozyavkin Medical Group, Ukraine
| | - O Kachmar
- Elita Rehabilitation Center, Kozyavkin Medical Group, Ukraine.
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12
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da Silva AR, Novais MCM, Neto MG, Correia HF. Predictors of extubation failure in neurocritical patients: A systematic review. Aust Crit Care 2023; 36:285-291. [PMID: 35197209 DOI: 10.1016/j.aucc.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/20/2021] [Revised: 11/02/2021] [Accepted: 11/19/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE The objective of this study was to identify predictors of extubation failure in neurocritical patients. METHODS This was systematic review performed through a bibliographic search of the databases PubMed/Medline, Lilacs, SciELO, and Web of Science, from February 2020 to October 2021. Cohort studies that investigated the predictors of extubation failure were included, defined as the need for reintubation within 48 h after extubation, in adult neurocritical patients. The risk-of-bias assessment was performed using the Newcastle-Ottawa Scale, for cohort studies. RESULTS Eight studies, totaling 18 487 participants, were included. A total of 15 predictors for extubation failure in neurocritical patients have been identified. Of these, four were the most frequent: low score on the Glasgow Coma Scale (motor score ≤5, 8T-10T), female gender, time on mechanical ventilation (≥7 days, ≥ 10 days), and moderate or large secretion volume. CONCLUSIONS In addition to the conventional parameters of weaning and extubation, other factors, such as a low score on the Glasgow Coma Scale, female gender, mechanical ventilation time, and moderate or large secretion volume, must be taken into account to prevent extubation failure in neurocritical patients in clinical practice.
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Affiliation(s)
- Alanna Ribeiro da Silva
- Physiotherapy Department, Federal University of Bahia (UFBA), Av. Adhemar de Barros, s/nº - Ondina, Salvador, Bahia, CEP 40170-110, Brazil.
| | - Michelli Christina Magalhães Novais
- Graduate Program in Interactive Processes of Organs and Systems, Federal University of Bahia (UFBA), Av. Adhemar de Barros, s/nº - Ondina, Salvador, Bahia, CEP 40170-110, Brazil
| | - Mansueto Gomes Neto
- Physiotherapy Department, Federal University of Bahia (UFBA), Av. Adhemar de Barros, s/nº - Ondina, Salvador, Bahia, CEP 40170-110, Brazil
| | - Helena França Correia
- Physiotherapy Department, Federal University of Bahia (UFBA), Av. Adhemar de Barros, s/nº - Ondina, Salvador, Bahia, CEP 40170-110, Brazil
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13
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Liu X, Yang L, Li G, Jiang Y, Zhang G, Ling J. A novel promising neuroprotective agent: Ganoderma lucidum polysaccharide. Int J Biol Macromol 2023; 229:168-180. [PMID: 36587634 DOI: 10.1016/j.ijbiomac.2022.12.276] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [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: 08/12/2022] [Revised: 12/20/2022] [Accepted: 12/24/2022] [Indexed: 12/30/2022]
Abstract
Nervous system diseases (NSDs) are characterized by a wide range of symptoms, a complex pathophysiology, an unclear etiology, a great deal of variation in treatment response, and lengthy therapy cycles, all of which pose considerable hurdles to clinical treatment. A traditional valuable medicine known as Ganoderma lucidum (GL) has a significant role to play in preserving health and treating diseases. Ganoderma lucidum polysaccharides (GLP) is one of the cardinal effective active ingredients of GL, which has a number of pharmacological actions, including liver protection, immune regulation, antioxidant activity, anticancer activity, antibacterial activity, and antiviral activity. Recently, studies on the structural characterization and biological functions of GLP were presented in this article to review the progress of researches about GLP on NSDs and summarize the potential mechanisms of action. These studies were anticipated to provide new research ideas for GLP as a novel promising neuroprotective agent and provide a reference for better development and utilization of GLP.
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Affiliation(s)
- Xiaojin Liu
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China; Department of Pharmacy, Shandong Medical College, Linyi 276000, China
| | - Luodan Yang
- College of Physical Education and Sports Science, South China Normal University, Guangzhou 510006, China
| | - Guangyao Li
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Yingnan Jiang
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Guoying Zhang
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China.
| | - Jianya Ling
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China; State Key Laboratory of Microbial Technology, Shandong University, Qingdao 266237, China.
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Zhang K, Liu Y, Jia H, Wang H, Deng M, Liu Y, Zhao X, Xiu X, Li Z, Yang H, Cheng M. Design, synthesis, and evaluation of N-methyl-propargylamine derivates as isoform-selective monoamine oxidases inhibitors for the treatment of nervous system diseases. Bioorg Chem 2023; 134:106441. [PMID: 36854233 DOI: 10.1016/j.bioorg.2023.106441] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/18/2022] [Revised: 02/16/2023] [Accepted: 02/19/2023] [Indexed: 02/25/2023]
Abstract
A novel series of N-methyl-propargylamine derivates were designed, synthesized, and evaluated as isoform-selective monoamine oxidases (MAO) inhibitors for the treatment of nervous system diseases. The in vitro studies showed some of the compounds exhibited considerable MAO-A selective inhibitory activity (IC50 of 14.86-17.16 nM), while some of the others exhibited great MAO-B selective inhibitory activity (IC50 of 4.37-17.00 nM). Further studies revealed that compounds A2 (IC50 against MAO-A: 17.16 ± 1.17 nM) and A5 (IC50 against MAO-B: 17.00 ± 1.10 nM) had significant abilities to protect PC12 cells from H2O2-induced apoptosis and reactive oxygen species (ROS) production. The parallel artificial membrane permeability assay showed A2 and A5 would be potent to cross the blood-brain barrier. The results indicated that A2 showed potential use in the therapy of MAO-A related diseases, such as depression and anxiety; while A5 exhibited promising ability in the treatment of MAO-B related diseases, such as Alzheimer's disease and Parkinson's disease.
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Affiliation(s)
- Kaicheng Zhang
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Liaoning, Shenyang 110016, China
| | - Yang Liu
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Liaoning, Shenyang 110016, China
| | - Hongwei Jia
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Liaoning, Shenyang 110016, China
| | - Hanxun Wang
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Liaoning, Shenyang 110016, China
| | - Minghui Deng
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Liaoning, Shenyang 110016, China
| | - Yaoyang Liu
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Liaoning, Shenyang 110016, China
| | - Xueqi Zhao
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Liaoning, Shenyang 110016, China
| | - Xiaomeng Xiu
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Liaoning, Shenyang 110016, China
| | - Zhenli Li
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Liaoning, Shenyang 110016, China
| | - Huali Yang
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Liaoning, Shenyang 110016, China.
| | - Maosheng Cheng
- Key Laboratory of Structure-Based Drug Design & Discovery of Ministry of Education, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University, Liaoning, Shenyang 110016, China.
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Sheikh Hassan M, Osman Sidow N, Gökgül A, Ali Adam B, Farah Osman M, Hassan Mohamed H, Gedi Ibrahim I, Ahmed Abdi I. Pattern of Neurological Disorders among Patients Evaluated in the Emergency Department; Cross-Sectional Study. Arch Acad Emerg Med 2023; 11:e20. [PMID: 36743701 PMCID: PMC9887228 DOI: 10.22037/aaem.v11i1.1813] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction Neurologic disorders are common reasons for emergency consultations. Most neurologic disorders seen in the emergency department (ED) are life-threatening and require urgent treatment. The goal of this study is to investigate the pattern of neurological disorders among patients evaluated in the ED. Methods This is a cross-sectional study conducted in the ED of Mogadishu Somali Turkish Training and Research Hospital, from July 2021 to February 2022. The clinical and epidemiological characteristics of adult patients with neurologic manifestations in the ED were evaluated. Age, gender, distribution of neurological disease manifestations, neurological examination findings, and neurological diagnoses made by consultant neurologists were assessed. Results During the study period, 321 patients were assessed (3.7 % of all ED admissions). The majority of the patients in the study were above 50 years of age (62.6% male). Hypertension was the most common comorbidity among these patients with 122 (38%) cases, followed by diabetes mellitus with 65 (20.2%), and heart diseases with 26 (8.1%) cases. The main reasons for neurology consultations were altered mental status with 141 (44%) cases, motor weakness with 102 (31.8%), seizures with 33 (10%), headache with 17 (5.3%), and vertigo with 9 (2.8%) cases. 196 (61%) had hemiplegia, 60 (18.7%) had consciousness impairment, and 38 (11.8%) had normal neurological examination. The most frequent neurological diagnoses were ischemic strokes with 125 (39%) cases, hemorrhagic strokes with 65 (20.2%), epileptic seizures with 28 (8.7%), and metabolic encephalopathies with 13 (4%) cases. The median duration of the neurology consultations was 20 minutes. 251 (78%) of the patients were admitted to the hospital, while 70 (22%) were discharged from the emergency department. After neurology consultation, the neurology department made the most admissions with 226 (90%) cases, while 25 (10%) were admitted by other departments. Of those admitted, 186 (74.2%) were admitted to the neurology ward, and 65 (25.8%) were admitted to the intensive care unit. Conclusion In our study, neurologic emergencies accounted for 3.7% of all emergency admissions. Stroke, epileptic seizures, cerebral venous thrombosis, encephalopathies, and acute spinal cord diseases were the most common neurological disorders. The admission rate was very high following neurologic assessment by neurologists.
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Affiliation(s)
- Mohamed Sheikh Hassan
- Department of Neurology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia. ,Corresponding Author: Mohamed Sheikh Hassan; Department of Neurology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia. Tel: +252615609080, , ORCID: 000-0001-7236-1524
| | - Nor Osman Sidow
- Department of Neurology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Alper Gökgül
- Department of Neurology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Bakar Ali Adam
- Department of Neurology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Mohamed Farah Osman
- Department of Neurology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Hussein Hassan Mohamed
- Department of Emergency Medicine, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Ismail Gedi Ibrahim
- Department of Radiology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia
| | - Ishak Ahmed Abdi
- Department of Cardiology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia
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Knapik JJ, Caldwell JA, Steelman RA, Trone DW, Farina EK, Lieberman HR. Short sleep duration is associated with a wide variety of medical conditions among United States military service members. Sleep Med 2023; 101:283-295. [PMID: 36470164 DOI: 10.1016/j.sleep.2022.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Received: 10/12/2022] [Revised: 11/11/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This cross-sectional study investigated self-reported sleep duration and its association with a comprehensive range of clinically-diagnosed medical condition categories (CDMCs), as well as the relationship between short sleep duration (≤6 h) and demographic/lifestyle factors, among United States military service members (SMs). METHODS A stratified random sample of SMs (n = 20,819) completed an online questionnaire on usual daily hours of sleep and demographic/lifestyle characteristics. CDMCs for a six-month period prior to questionnaire completion were obtained from a comprehensive military electronic medical surveillance system and grouped into 33 CDMCs covering both broad and specific medical conditions. Prevalence of CDMCs was compared among three sleep duration categories (≤4, 5-6 and ≥7 h). RESULTS SMs reported a mean ± standard deviation of 6.3 ± 1.4 h of sleep per day. After adjustment for demographic/lifestyle characteristics, shorter sleep duration was associated with higher odds of a medical condition in 25 of 33 CDMCs, with most (n = 20) demonstrating a dose-response relationship. The five CDMCs with the largest differences between ≤4 vs ≥ 7 h sleep were: diseases of the nervous system (odds ratio [OR] = 2.9, 95% confidence interval [95%CI] = 2.4-3.4), mental/behavioral diseases (OR = 2.7, 95%CI = 2.3-3.2), diseases of the musculoskeletal system (OR = 1.9, 95%CI = 1.6-2.1), diseases of the circulatory system (OR = 1.7, 95%CI = 1.3-2.2), and diseases of the digestive system (OR = 1.6, 95%CI = 1.2-2.0). Six hours of sleep or less was independently associated with older age, less formal education, race, Hispanic ethnicity, higher body mass index, smoking, and military service branch. CONCLUSIONS In this young, physically active population, reporting shorter sleep duration was associated with a higher risk of multiple CDMCs.
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Affiliation(s)
- Joseph J Knapik
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA.
| | - John A Caldwell
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA; Laulima Government Solutions, 5301 Buckystown Pike, STE 460, Frederick, MD, 21704, USA
| | - Ryan A Steelman
- U.S. Army Public Health Center, 8252 Blackhawk Rd, Aberdeen Proving Ground, MD, 21010, USA
| | - Daniel W Trone
- Naval Health Research Center, Building 329, Ryne Rd, San Diego, CA, 92152, USA
| | - Emily K Farina
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
| | - Harris R Lieberman
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, 10 General Greene Ave, Natick, MA, 01760, USA
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Bidaki R, Hekmati Moghaddam SH, Sadeh M. Gut Microbiota and Neuropsychiatric Disorders. Basic Clin Neurosci 2023; 14:167-170. [PMID: 37346870 PMCID: PMC10279994 DOI: 10.32598/bcn.2021.3220.1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 04/30/2021] [Accepted: 06/27/2021] [Indexed: 06/23/2023] Open
Abstract
Numerous studies in humans and animals hypothesize that gut microbiota dysbiosis is involved in the development of behavioral and neurological diseases such as depression, autism spectrum disorder, Parkinson disease, multiple sclerosis, stroke and Alzheimer's disease. Some of the most salient works so far regarding the brain-gut axis are mentioned below. The current knowledge on the impact of gut microbiota on nervous system diseases is far from being directly used for pharmacologic or nutritional advice toward restoration of normal bodily functions. It seems that a more comprehensive approach should be followed so that the individual effect of each kind of intervention on the patient's somatic or psychological status is determined. Future research must address global need for regimens which could reestablish normal composition of gut microorganisms after each neuropsychological disorder.
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Affiliation(s)
- Reza Bidaki
- Research Center of Addiction and Behavioral Sciences, Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Hossein Hekmati Moghaddam
- Department of Advanced Medical Sciences and Technologies, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Sadeh
- Department of Laboratory Sciences, School of Paramedicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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18
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Chang ET, Odo NU, Acquavella JF. Systematic literature review of the epidemiology of glyphosate and neurological outcomes. Int Arch Occup Environ Health 2023; 96:1-26. [PMID: 35604441 PMCID: PMC9823069 DOI: 10.1007/s00420-022-01878-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/26/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Human health risk assessments of glyphosate have focused on animal toxicology data for determining neurotoxic potential. Human epidemiological studies have not yet been systematically reviewed for glyphosate neurotoxicity hazard identification. The objective of this systematic literature review was to summarize the available epidemiology of glyphosate exposure and neurological outcomes in humans. METHODS As of December 2021, 25 eligible epidemiological studies of glyphosate exposure and neurological endpoints were identified and assessed for five quality dimensions using guidance from the U.S. Environmental Protection Agency. Studies that assessed personal use of glyphosate were prioritized, whereas those assessing indirect exposure (other than personal use) were rated as low quality, since biomonitoring data indicate that indirect metrics of glyphosate exposure almost always equate to non-detectable glyphosate doses. RESULTS Overall, the scientific evidence on glyphosate and neurotoxicity in humans is sparse and methodologically limited, based on nine included epidemiological studies of neurodegenerative outcomes (two high quality), five studies of neurobehavioral outcomes (two high quality), six studies of neurodevelopmental outcomes (none high quality), and five studies of other and mixed neurological outcomes (one high quality). The five high-quality studies showed no association between glyphosate use and risk of depression, Parkinson disease, or peripheral nerve conduction velocity. Results were mixed among the eight moderate-quality studies, which did not demonstrate consistent associations with any neurological endpoints or categories. Low-quality studies were considered uninformative about possible neurotoxic effects due primarily to questionable assessments of indirect exposure. CONCLUSIONS No association has been demonstrated between glyphosate and any neurological outcomes in humans. To move the state of science forward, epidemiological studies should focus on scenarios involving direct and frequent use of glyphosate while collecting information on validated health outcomes, concomitant agricultural exposures, and relevant personal characteristics.
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Affiliation(s)
- Ellen T Chang
- Center for Health Sciences, Exponent, Inc., 149 Commonwealth Dr, Menlo Park, CA, 94025, USA.
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
| | - Nnaemeka U Odo
- Center for Health Sciences, Exponent, Inc., Oakland, CA, USA
| | - John F Acquavella
- Department of Clinical Epidemiology, University of Aarhus, Aarhus, Denmark
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Wang J, Song L, Shi DM, Zou HL, Li DD, Zhu QH. [Evaluation of the implementation of Diagnostic Criteria of Occupational Acute Neurotoxic Diseases Caused by Chemicals (GBZ 76-2002)]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2022; 40:742-746. [PMID: 36348554 DOI: 10.3760/cma.j.cn121094-20210809-00387] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To investigate the implementation of Diagnostic Criteria of Occupational Acute Neurotoxic Diseases Caused by Chemicals (GBZ 76-2002) for accumulating basis of standard revision. Methods: In February 2020, 85 experts in occupational diseases and neurology from 39 medical and health institutions were selected as the respondents. The modified Delphi method was used to establish the standard evaluation index system and special group was organized for discussing the pre-survey and completing the questionnaire survey. Questionnaire survey was performed to investigate the grasp of the standards, application and modification suggestions of respondents. Results: The respondents' mastery of standard-related knowledge mainly came from work experience (84.7%, 72/85) , standard learning (81.2%, 69/85) and training (75.3%, 64/85) . Among the institutions in which the respondents worked, 98.8% (84/85) could carry out CT examinations, 96.5% (82/85) could carry out nerve conduction velocity and electromyography examinations, 89.4% (76/85) could carry out EEG examinations, 80% (68/85) could carry out evoked potential examinations and 72.9% (62/85) could carry out MRI examinations. Among the toxicants diagnosed as occupational acute toxic myelopathy, 10.6% (9/85) were organic phosphorus and 9.4% (8/85) were asphyxiating gas; Among the toxicants diagnosed as delayed peripheral neuropathy, pesticides accounted for 25.9% (22/85) and asphyxiating gases accounted for 12.9% (11/85) . 85.9% (73/85) of the respondents believed that the basis for the classification of acute toxic encephalopathy needed to supplement objective evidence; 80.0% (68/85) of the respondents thought that the diagnosis and classification of peripheral neuropathy should be refined according to the abnormal indexes of neuroelectromyography. Conclusion: The applicability of the criteria needs to be improved because the current criteria has a long application cycle without enough objective investigation bases in classification criteria index.
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Affiliation(s)
- J Wang
- Department of Occupational Toxicology, Heilongjiang Institute of Labor Health and Occupational Diseases, Harbin 150000, China
| | - L Song
- Department of Occupational Toxicology, Heilongjiang Institute of Labor Health and Occupational Diseases, Harbin 150000, China
| | - D M Shi
- Department of Occupational Toxicology, Heilongjiang Institute of Labor Health and Occupational Diseases, Harbin 150000, China
| | - H L Zou
- Department of Occupational Toxicology, Heilongjiang Institute of Labor Health and Occupational Diseases, Harbin 150000, China
| | - D D Li
- Department of Occupational Toxicology, Heilongjiang Institute of Labor Health and Occupational Diseases, Harbin 150000, China
| | - Q H Zhu
- Chinese Center for Disease Control and Prevention, Occupational Health and Poison Control Institute, Beijing 100000, China
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Gong Y, Jiang X, Yang S, Huang Y, Hong J, Ma Y, Fang X, Fang Y, Wu J. The Biological Activity of 3-O-Acetyl-11-keto-β-Boswellic Acid in Nervous System Diseases. Neuromolecular Med 2022; 24:374-384. [PMID: 35303275 PMCID: PMC8931781 DOI: 10.1007/s12017-022-08707-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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: 10/10/2021] [Accepted: 03/02/2022] [Indexed: 12/29/2022]
Abstract
Frankincense is a hard gelatinous resin exuded by Boswellia serrata. It contains a complex array of components, of which acetyl-11-keto-beta-boswellic acid (AKBA), a pentacyclic triterpenoid of the resin class, is the main active component. AKBA has a variety of physiological actions, including anti-infection, anti-tumor, and antioxidant effects. The use of AKBA for the treatment of mental diseases has been documented as early as ancient Greece. Recent studies have found that AKBA has anti-aging and other neurological effects, suggesting its potential for the treatment of neurological diseases. This review focuses on nervous system-related diseases, summarizes the functions and mechanisms of AKBA in promoting nerve repair and regeneration after injury, protecting against ischemic brain injury and aging, inhibiting neuroinflammation, ameliorating memory deficits, and alleviating neurotoxicity, as well as having anti-glioma effects and relieving brain edema. The mechanisms by which AKBA functions in different diseases and the relationships between dosage and biological effects are discussed in depth with the aim of increasing understanding of AKBA and guiding its use for the treatment of nervous system diseases.
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Affiliation(s)
- Yuqing Gong
- Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Key Laboratory of Aging and Cancer Biology of Zhejiang Province, and Key Laboratory of Inflammation and Immunoregulation of Hangzhou, Hangzhou Normal University, No. 2318, Yuhang Tang Road, Hangzhou, 310000, Zhejiang, People's Republic of China
| | - Xinyi Jiang
- Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Key Laboratory of Aging and Cancer Biology of Zhejiang Province, and Key Laboratory of Inflammation and Immunoregulation of Hangzhou, Hangzhou Normal University, No. 2318, Yuhang Tang Road, Hangzhou, 310000, Zhejiang, People's Republic of China
| | - Suibi Yang
- Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Key Laboratory of Aging and Cancer Biology of Zhejiang Province, and Key Laboratory of Inflammation and Immunoregulation of Hangzhou, Hangzhou Normal University, No. 2318, Yuhang Tang Road, Hangzhou, 310000, Zhejiang, People's Republic of China
| | - Yue Huang
- Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Key Laboratory of Aging and Cancer Biology of Zhejiang Province, and Key Laboratory of Inflammation and Immunoregulation of Hangzhou, Hangzhou Normal University, No. 2318, Yuhang Tang Road, Hangzhou, 310000, Zhejiang, People's Republic of China
| | - Jinhui Hong
- Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Key Laboratory of Aging and Cancer Biology of Zhejiang Province, and Key Laboratory of Inflammation and Immunoregulation of Hangzhou, Hangzhou Normal University, No. 2318, Yuhang Tang Road, Hangzhou, 310000, Zhejiang, People's Republic of China
| | - Yanxiu Ma
- Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Key Laboratory of Aging and Cancer Biology of Zhejiang Province, and Key Laboratory of Inflammation and Immunoregulation of Hangzhou, Hangzhou Normal University, No. 2318, Yuhang Tang Road, Hangzhou, 310000, Zhejiang, People's Republic of China
| | - Xin Fang
- Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Key Laboratory of Aging and Cancer Biology of Zhejiang Province, and Key Laboratory of Inflammation and Immunoregulation of Hangzhou, Hangzhou Normal University, No. 2318, Yuhang Tang Road, Hangzhou, 310000, Zhejiang, People's Republic of China
| | - Yong Fang
- Department of Microbiology, WU Lien-Teh Institute, Harbin Medical University, Harbin, 150081, China.
| | - Jing Wu
- Department of Immunology and Pathogen Biology, School of Basic Medical Sciences, Key Laboratory of Aging and Cancer Biology of Zhejiang Province, and Key Laboratory of Inflammation and Immunoregulation of Hangzhou, Hangzhou Normal University, No. 2318, Yuhang Tang Road, Hangzhou, 310000, Zhejiang, People's Republic of China.
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Lee JH. Invertebrate Model Organisms as a Platform to Investigate Rare Human Neurological Diseases. Exp Neurobiol 2022; 31:1-16. [PMID: 35256540 PMCID: PMC8907251 DOI: 10.5607/en22003] [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: 01/22/2022] [Revised: 02/07/2022] [Accepted: 02/07/2022] [Indexed: 01/16/2023] Open
Abstract
Patients suffering from rare human diseases often go through a painful journey for finding a definite molecular diagnosis prerequisite of appropriate cures. With a novel variant isolated from a single patient, determination of its pathogenicity to end such "diagnostic odyssey" requires multi-step processes involving experts in diverse areas of interest, including clinicians, bioinformaticians and research scientists. Recent efforts in building large-scale genomic databases and in silico prediction platforms have facilitated identification of potentially pathogenic variants causative of rare human diseases of a Mendelian basis. However, the functional significance of individual variants remains elusive in many cases, thus requiring incorporation of versatile and rapid model organism (MO)-based platforms for functional analyses. In this review, the current scope of rare disease research is briefly discussed. In addition, an overview of invertebrate MOs for their key features relevant to rare neurological diseases is provided, with the characteristics of two representative invertebrate MOs, Drosophila melanogaster and Caenorhabditis elegans, as well as the challenges against them. Finally, recently developed research networks integrating these MOs in collaborative research are portraited with an array of bioinformatical analyses embedded. A comprehensive survey of MO-based research activities provided in this review will help us to design a wellstructured analysis of candidate genes or potentially pathogenic variants for their roles in rare neurological diseases in future.
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Affiliation(s)
- Ji-Hye Lee
- Department of Oral Pathology & Life Science in Dentistry, School of Dentistry, Pusan National University, Yangsan 50612, Korea.,Dental Life Science Institute, Pusan National University, Yangsan 50612, Korea.,Periodontal Disease Signaling Network Research Center, Pusan National University, Yangsan 50612, Korea
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22
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Mühlbauer J, Klotz D, Büttner S, Stein R, Younsi N. Bladder cancer in patients with neurogenic bladder disorder: a comparative study of different etiologies. World J Urol 2022; 40:1929-1937. [PMID: 35034168 DOI: 10.1007/s00345-021-03922-z] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/27/2021] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The objective of this study was to conduct a comparative study of different etiologies of neurogenic bladder disorders (NBDs) in patients with bladder cancer (BC) regarding patient- and tumor-related parameters and their oncological outcome. METHODS Out of 98 patients with bladder tumors and neurogenic disease, 23 patients with BC and NBDs from Jan 1, 2010, to Dec 31, 2020, were included. The different etiologies of NBDs were merged in three groups based on the level of the nervous system (NS)-lesion: (i) central (n = 6), (ii) spinal cord (n = 10), and (iii) peripheral lesions (n = 7). RESULTS Patients with lesions at the spinal cord level were younger at the time of BC diagnosis compared to patients with central or peripheral NS lesions (54 vs. 68 vs. 78 years, p = 0.0219). However, the latency to malignant transformation was more than twice as long (33 vs. 15 years, p = 0.0108). Most tumors were muscle-invasive or locally advanced BCs (62%) and presented lymph node metastases (55%), resulting in a poor mean overall survival of 30.9 ± 3.6 months. No significant differences regarding histopathology, tumor stage, and oncological outcome could be observed between the groups. CONCLUSION Patients with NBDs have a poor prognosis regardless of their etiology or the level of NS lesion. Patients with spinal cord lesions, including congenital NBDs, appear to develop BC at a young age, but compared to other etiologies latency from NBD to BC is longer.
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Affiliation(s)
- Julia Mühlbauer
- Department of Urology and Urological Surgery, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
| | - David Klotz
- Department of Urology and Urological Surgery, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Sylvia Büttner
- Department for Biomathematics and Medical Statistics, Faculty of Medicine Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Raimund Stein
- Center for Pediatric, Adolescent and Reconstructive Urology, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Nina Younsi
- Center for Pediatric, Adolescent and Reconstructive Urology, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
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Su X, Song H, Cheng Y, Yao X, Li Y. The mortality burden of nervous system diseases attributed to ambient temperature: A multi-city study in China. Sci Total Environ 2021; 800:149548. [PMID: 34388642 DOI: 10.1016/j.scitotenv.2021.149548] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUNDS Studies on the association between ambient temperature and human mortality have been widely reported, focusing on common diseases such as cardiopulmonary diseases. However, multi-city studies on the association between both high and low temperatures and mortality of nervous system diseases were scarce, especially on the evidence of vulnerable populations. METHODS Weekly meteorological data, air pollution data and mortality data of nervous system were collected in 5 cities in China. A quasi-Poisson regression with distributed lag non-linear model (DLNM) was applied to quantify the association between extreme temperatures and mortality of nervous system diseases. Multivariate meta-analysis was applied to estimate the pooled effects at the overall levels. The attributable fractions (AFs) were calculated to assess the mortality burden attributable to both high and low temperatures. Stratified analyses were also performed by gender and age-groups through the above steps. RESULTS A total of 12,132 deaths of nervous system diseases were collected in our study. The overall minimum mortality temperature was 23.9 °C (61.9th), the cumulative relative risks of extreme heat and cold for nervous system diseases were 1.33(95%CI: 1.10, 1.61) and 1.47(95%CI: 1.27, 1.71). The mortality burden attributed to non-optimal temperatures accounted for 29.54% (95%eCI: 13.45%, 40.52%), of which the mortality burden caused by low temperature and high temperature accounted for 25.89% (95%eCI: 13.03%, 34.36%) and 3.65% (95%eCI: 0.42%, 6.17%), respectively. The mortality burden attributable to ambient temperature was higher in both males and the elderly (>74 years old), with the AF of 31.85% (95%eCI: 20.68%, 39.88%) and 31.14% (95%eCI: -6.83%, 49.51%), respectively. CONCLUSIONS The non-optimal temperature can increase the mortality of nervous system diseases and the males and the elderly over 74 years have the highest attributable burden. The findings add the evidence of vulnerable populations of nervous system diseases against ambient temperatures.
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Affiliation(s)
- Xuemei Su
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Daxing District Center for Disease Control and Prevention, Beijing 102600, China
| | - Hejia Song
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Yibin Cheng
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Xiaoyuan Yao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Yonghong Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.
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Arjmand B, Roudsari PP, Alavi-Moghadam S, Rezaei-Tavirani M, Tayanloo-Beik A, Mehrdad N, Adibi H, Larijani B. Potential for Stem Cell-Based Therapy in the Road of Treatment for Neurological Disorders Secondary to COVID-19. Regen Eng Transl Med 2021;:1-15. [PMID: 34746370 DOI: 10.1007/s40883-021-00234-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 09/19/2021] [Accepted: 10/01/2021] [Indexed: 11/30/2022]
Abstract
Abstract
The severe acute respiratory syndrome coronavirus 2 has led to the worldwide pandemic named coronavirus disease 2019 (COVID-19). It has caused a significant increase in the number of cases and mortalities since its first diagnosis in December 2019. Although COVID-19 primarily affects the respiratory system, neurological involvement of the central and peripheral nervous system has been also reported. Herein, the higher risk of neurodegenerative diseases in COVID-19 patients in future is also imaginable. Neurological complications of COVID-19 infection are more commonly seen in severely ill individuals; but, earlier diagnosis and treatment can lead to better long-lasting results. In this respect, stem cell biotechnologies with considerable self-renewal and differentiation capacities have experienced great progress in the field of neurological disorders whether in finding out their underlying processes or proving them promising therapeutic approaches. Herein, many neurological disorders have been found to benefit from stem cell medicine strategies. Accordingly, in the present review, the authors are trying to discuss stem cell-based biotechnologies as promising therapeutic options for neurological disorders secondary to COVID-19 infection through reviewing neurological manifestations of COVID-19 and current stem cell-based biotechnologies for neurological disorders. Lay Summary Due to the substantial burden of neurological disorders in the health, economic, and social system of society, the emergence of neurological manifestations following COVID-19 (as a life-threatening pandemic) creates the need to use efficient and modern methods of treatment. Since stem cell-based methods have been efficient for a large number of neurological diseases, it seems that the use of mentioned methods is also effective in the process of improving neurological disorders caused by COVID-19. Hereupon, the current review aims to address stem cell-based approaches as treatments showing promise to neurological disorders related to COVID-19.
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Telles JP, Fernandes R, Barros TD, Maestri A, Vitoriano T, Borges L, Teixeira R, Marcusso R, Haziot M, De Oliveira AP, Vidal JE. Neurological manifestations in people living with HIV/AIDS in the late cART era: a prospective observational study at a tertiary healthcare center in São Paulo, Brazil. HIV Res Clin Pract 2021; 22:87-95. [PMID: 34529920] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background:The aim of this study was to evaluate the frequency, spectrum, in-hospital mortality rate, and factors associated with death in people living with HIV/AIDS (PLWHA) presenting with neurological diseases from a middle-income country, as well as estimate its one-year global death rate.Methods:This prospective observational cohort study was conducted at a Brazilian tertiary health center between January and July 2017. HIV-infected patients above 18 years of age who were admitted due to neurological complaints were consecutively included. A standardized neurological examination and patient and/or medical assistant interviews were performed weekly until the patient's discharge or death. The diagnostic and therapeutic management of the included cases followed institutional routines.Results:A total of 105 (13.2%) patients were included among the 791 hospitalized PLWHA. The median age was 42.8 [34-51] years, and 61% were men. The median CD4+ lymphocyte cell count was 70 (27-160) cells/mm3, and 90% of patients were experienced in combined antiretroviral therapy. The main diseases were cerebral toxoplasmosis (36%), cryptococcal meningitis (14%), and tuberculous meningitis (8%). Cytomegalovirus causing encephalitis, polyradiculopathy, and/or retinitis was the third most frequent pathogen (12%). Moreover, concomitant neurological infections occurred in 14% of the patients, and immune reconstitution inflammatory syndrome-related diseases occurred in 6% of them. In-hospital mortality rate was 12%, and multivariate analysis showed that altered level of consciousness (P = 0.04; OR: 22.7, CI 95%: 2.6-195.1) and intensive care unit (ICU) admission (P = 0.014; OR: 6.2, CI 95%: 1.4-26.7) were associated with death. The one-year global mortality rate was 31%.Conclusion:In this study, opportunistic neurological diseases were predominant. Cytomegalovirus was a frequent etiological agent, and neurological concomitant diseases were common. ICU admission and altered levels of consciousness were associated with death. Although in-hospital mortality was relatively low, the one-year global death rate was higher.
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Affiliation(s)
- João Paulo Telles
- Departamento de Infectologia, Instituto de Infectologia Emílio Ribas, São Paulo, SP, Brazil
- Departamento de Moléstias Infecciosas e Parasitárias, Hospital de Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ruan Fernandes
- Departamento de Infectologia, Instituto de Infectologia Emílio Ribas, São Paulo, SP, Brazil
| | - Tiago Dahrug Barros
- Departamento de Infectologia, Instituto de Infectologia Emílio Ribas, São Paulo, SP, Brazil
| | - Alvino Maestri
- Departamento de Infectologia, Instituto de Infectologia Emílio Ribas, São Paulo, SP, Brazil
| | - Thiago Vitoriano
- Departamento de Infectologia, Instituto de Infectologia Emílio Ribas, São Paulo, SP, Brazil
| | - Luciana Borges
- Departamento de Infectologia, Instituto de Infectologia Emílio Ribas, São Paulo, SP, Brazil
| | - Ralcyon Teixeira
- Departamento de Infectologia, Instituto de Infectologia Emílio Ribas, São Paulo, SP, Brazil
| | - Rosa Marcusso
- Departamento de Infectologia, Instituto de Infectologia Emílio Ribas, São Paulo, SP, Brazil
| | - Michel Haziot
- Departamento de Infectologia, Instituto de Infectologia Emílio Ribas, São Paulo, SP, Brazil
| | | | - José Ernesto Vidal
- Departamento de Infectologia, Instituto de Infectologia Emílio Ribas, São Paulo, SP, Brazil
- Departamento de Neurologia, Instituto de Infectologia Emílio Ribas, São Paulo, SP, Brazil
- Departamento de Moléstias Infecciosas e Parasitárias, Hospital de Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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Rhee B, Kim HH, Choi S, Min YG. Incidence patterns of nervous system diseases after carbon monoxide poisoning: a retrospective longitudinal study in South Korea from 2012 to 2018. Clin Exp Emerg Med 2021; 8:111-119. [PMID: 34237816 PMCID: PMC8273670 DOI: 10.15441/ceem.20.099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 08/13/2020] [Accepted: 09/16/2020] [Indexed: 01/25/2023] Open
Abstract
Objective To analyze the incidence patterns of nervous system diseases in survivors of carbon monoxide (CO) poisoning using nationwide claims data from South Korea. Methods A national cohort was abstracted from a database that includes patients diagnosed with CO poisoning between January 2012 and December 2018. For all nervous system diseases, we investigated the frequency, pattern of incidence, effect of intensive care unit admission, and the standardized incidence ratios (SIRs) to estimate the risk of nervous system disease after CO poisoning. Results Of 26,778 patients, 18,720 (69.9%) were diagnosed with nervous system diseases after CO poisoning. The most common disease was disorders of sleep initiation and maintenance (n=701, 3.74%), followed by tension-type headache (n=477, 2.55%) and anoxic brain injury (n=406, 2.17%). Over half of the nervous system diseases occurred within the first year after CO poisoning. The cumulative hazard ratio for nervous system diseases in patients admitted to the intensive care unit was 2.25 (95% confidence interval [CI], 2.07–2.44). Among the frequent nervous system diseases after CO poisoning, patients had a higher risk of disorders of initiating and maintaining sleep (SIR, 1.61; 95% CI, 1.52–1.71), tension-type headache (SIR, 2.41; 95% CI, 2.23–2.61), anoxic brain injury (SIR, 58.76; 95% CI, 53.95–63.88), and post-zoster neuralgia (SIR, 1.94; 95% CI, 1.70–2.20). Conclusion Patients who experience CO poisoning are at higher risk for several nervous system diseases. Therefore, monitoring for specific nervous system diseases is important after CO poisoning within the first year.
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Affiliation(s)
- Bangshill Rhee
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Hyuk-Hoon Kim
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Sangchun Choi
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Young Gi Min
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea
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García-Azorín D, Seeher KM, Newton CR, Okubadejo NU, Pilotto A, Saylor D, Winkler AS, Charfi Triki C, Leonardi M. Disruptions of neurological services, its causes and mitigation strategies during COVID-19: a global review. J Neurol 2021; 268:3947-3960. [PMID: 34021772 PMCID: PMC8140556 DOI: 10.1007/s00415-021-10588-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 04/26/2021] [Accepted: 04/29/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND The COVID-19 pandemic leads to disruptions of health services worldwide. To evaluate the particular impact on neurological services a rapid review was conducted. METHODS Studies reporting the provision of neurological services during the pandemic and/or adopted mitigation strategies were included in this review. PubMed and World Health Organization's (WHO) COVID-19 database were searched. Data extraction followed categories used by WHO COVID-19 pulse surveys and operational guidelines on maintaining essential health services during COVID-19. FINDINGS The search yielded 1101 articles, of which 369 fulfilled eligibility criteria, describing data from 210,419 participants, being adults (81%), children (11.4%) or both (7.3%). Included articles reported data from 105 countries and territories covering all WHO regions and World Bank income levels (low income: 1.9%, lower middle: 24.7%, upper middle: 29.5% and high income; 44.8%). Cross-sectoral services for neurological disorders were most frequently disrupted (62.9%), followed by emergency/acute care (47.1%). The degree of disruption was at least moderate for 75% of studies. Travel restrictions due to lockdowns (81.7%) and regulatory closure of services (65.4%) were the most commonly reported causes of disruption. Authors most frequently described telemedicine (82.1%) and novel dispensing approaches for medicines (51.8%) as mitigation strategies. Evidence for the effectiveness of these measures is largely missing. INTERPRETATION The COVID-19 pandemic affects all aspects of neurological care. Given the worldwide prevalence of neurological disorders and the potential long-term neurological consequences of COVID-19, service disruptions are devastating. Different strategies such as telemedicine might mitigate the negative effects of the pandemic, but their efficacy and acceptability remain to be seen.
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Affiliation(s)
- David García-Azorín
- Headache Unit, Department of Neurology. Hospital, Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47005, Valladolid, Spain.
| | - Katrin M Seeher
- Department of Mental Health and Substance Use, World Health Organization, Geneve, Switzerland
| | | | - Njideka U Okubadejo
- Neurology Unit, Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Andrea Pilotto
- Department of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Brescia, Italy
| | - Deanna Saylor
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrea Sylvia Winkler
- Centre for Global Health, Department of Neurology, Technical University of Munich, Munich, Germany.,Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Chahnez Charfi Triki
- Child neurology department-Hedi Chaker Hospital, LR19ES 15-Sfax University, Sfax, Tunisia
| | - Matilde Leonardi
- Neurology, Public Health, Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
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Tang JJ, Feng S, Chen XD, Huang H, Mao M, Wang HY, Li S, Lu XM, Wang YT. The Effects of P75NTR on Learning Memory Mediated by Hippocampal Apoptosis and Synaptic Plasticity. Curr Pharm Des 2021; 27:531-539. [PMID: 32938344 DOI: 10.2174/1381612826666200916145142] [Citation(s) in RCA: 1] [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] [Received: 02/06/2020] [Accepted: 08/18/2020] [Indexed: 11/22/2022]
Abstract
Neurological diseases bring great mental and physical torture to the patients, and have long-term and sustained negative effects on families and society. The attention to neurological diseases is increasing, and the improvement of the material level is accompanied by an increase in the demand for mental level. The p75 neurotrophin receptor (p75NTR) is a low-affinity neurotrophin receptor and involved in diverse and pleiotropic effects in the developmental and adult central nervous system (CNS). Since neurological diseases are usually accompanied by the regression of memory, the pathogenesis of p75NTR also activates and inhibits other signaling pathways, which has a serious impact on the learning and memory of patients. The results of studies shown that p75NTR is associated with LTP/LTD-induced synaptic enhancement and inhibition, suggest that p75NTR may be involved in the progression of synaptic plasticity. And its proapoptotic effect is associated with activation of proBDNF and inhibition of proNGF, and TrkA/p75NTR imbalance leads to pro-survival or proapoptotic phenomena. It can be inferred that p75NTR mediates apoptosis in the hippocampus and amygdale, which may affect learning and memory behavior. This article mainly discusses the relationship between p75NTR and learning memory and associated mechanisms, which may provide some new ideas for the treatment of neurological diseases.
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Affiliation(s)
- Jun-Jie Tang
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China
| | - Shuang Feng
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China
| | - Xing-Dong Chen
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China
| | - Hua Huang
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China
| | - Min Mao
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China
| | - Hai-Yan Wang
- State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Sen Li
- State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - Xiu-Min Lu
- College of Pharmacy and Bioengineering, Chongqing University of Technology, Chongqing 400054, China
| | - Yong-Tang Wang
- State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, Army Medical University, Chongqing 400042, China
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Ying Y, Jiang P. Research progress on transient receptor potential melastatin 2 channel in nervous system diseases. Zhejiang Da Xue Xue Bao Yi Xue Ban 2021; 50:267-276. [PMID: 34137233 PMCID: PMC8710270 DOI: 10.3724/zdxbyxb-2021-0110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/15/2020] [Accepted: 01/30/2021] [Indexed: 11/25/2022]
Abstract
Transient receptor potential M2 (TRPM2) ion channel is a non-selective cationic channel that can permeate calcium ions, and plays an important role in neuroinflammation, ischemic reperfusion brain injury, neurodegenerative disease, neuropathic pain, epilepsy and other neurological diseases. In ischemic reperfusion brain injury, TRPM2 mediates neuronal death by modulating the different subunits of glutamate N-methyl-D-aspartic acid receptor in response to calcium/zinc signal. In Alzheimer's disease, TRPM2 is activated by reactive oxygen species generated by β-amyloid peptide to form a malignant positive feedback loop that induces neuronal death and is involved in the pathological process of glial cells by promoting inflammatory response and oxidative stress. In epilepsy, the TRPM2-knockout alleviates epilepsy induced neuronal degeneration by inhibiting autophagy and apoptosis related proteins. The roles of TRPM2 channel in the pathogenesis of various central nervous system diseases and its potential drug development and clinical application prospects are summarized in this review.
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Camargo-Martínez W, Lozada-Martínez I, Escobar-Collazos A, Navarro-Coronado A, Moscote-Salazar L, Pacheco-Hernández A, Janjua T, Bosque-Varela P. Post-COVID 19 neurological syndrome: Implications for sequelae's treatment. J Clin Neurosci 2021; 88:219-25. [PMID: 33992187 DOI: 10.1016/j.jocn.2021.04.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/17/2021] [Accepted: 04/04/2021] [Indexed: 02/06/2023]
Abstract
Study design Literature review. Objectives Describe the implications of post-COVID syndrome due to neurological sequelae including treatment and the differences that may exist between this group of patients and those who present these events not associated with COVID-19. Methods A non-systematic review of the literature was carried out in PubMed and Science Direct databases, using the keywords “Post-acute COVID-19 syndrome”; “Neurological complications”; “Neurologic Manifestations” “COVID-19″ and ”Rehabilitation“, as well as synonyms, which were combined with the operators ”AND“ and ”OR“. Results The COVID-19 viral caustive agent, SARS-CoV-2, has a high affinity for human angiotensin-converting enzyme 2 receptor on type II pneumocytes. This receptor is also expressed in neurons and glial cells. Based on the foregoing and other not so clear mechanisms, it is stated that SARS-CoV-2 has tropism for the nervous system, being evident through the neurological manifestations observed in patients with mild, moderate and severe phenotype of the disease such as anosmia, ageusia, headache, cerebrovascular accidents, Guillain-Barré syndrome, seizures, and encephalopathy. This can generate severe sequelae and even fatal outcomes in those affected. Conclusions Neurological complications caused by COVID-19 are frequent and represent a risk that compromises the functional capacity and the life of patients. The suspicion of these conditions, the strict control of metabolic alterations and cardiovascular risk factors, the effective and safe treatment of these entities, are a current challenge throughout the pandemic. The rehabilitation process in these patients is a challenge. This is due to the limitations generated by multi-organ damage, as well as risk of brain death.
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Li F, Huang L, Yan Y, Wang X, Hu Y. A novel nomogram for early prediction of death in severe neurological disease patients with electroencephalographic periodic discharges. Clin Neurophysiol 2021; 132:1304-1311. [PMID: 33867264 DOI: 10.1016/j.clinph.2021.03.002] [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: 11/06/2020] [Revised: 02/24/2021] [Accepted: 03/02/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate death-related factors in patients with electroencephalographic (EEG) periodic discharges (PDs) and to construct a model for death prediction. METHODS This case-control study enrolled a total of 80 severe neurological disease patients with EEG PDs within 72 h of admission to the neuroscience intensive care unit (NICU). According to modified Rankin scale (mRS) scores half a year after discharge, patients were divided into a survival group (<6 points) and a death group (6 points). Their relevant clinical and biochemical indicators as well as EEG characteristics were retrospectively analyzed. Logistic regression analysis was used to identify the risk factors associated with the death of patients with EEG PDs. A death risk prediction model and an individualized nomogram prediction model were constructed, and the prediction performance and concordance of the models were evaluated. RESULTS Multivariate logistic regression analysis showed that the involvement of both gray and white matter in imaging, disappearance of EEG reactivity, occurrence of stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs), and an interval time of 0.5-4 s were independent risk factors for death. A regression model was established according to the multivariate logistic regression analysis, and the area under the curve of this model was 0.9135. The accuracy of the model was 87.01%, the sensitivity was 87.17%, and the specificity was 89.17%. A nomogram model was constructed, and a concordance index of 0.914 was obtained after internal validation. CONCLUSION The regression model based on risk factors has high accuracy in predicting the risk of death of patients with EEG PDs. SIGNIFICANCE This model can help clinicians in the early assessment of the prognosis of severe neurological disease patients with EEG PDs.
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Affiliation(s)
- Feng Li
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Lihong Huang
- Chongqing Medical University, Chongqing 400016, People's Republic of China
| | - Yin Yan
- Department of Neurology, The Ninth People's Hospital of Chongqing, Chongqing 400700, People's Republic of China
| | - Xuefeng Wang
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People's Republic of China.
| | - Yida Hu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, People's Republic of China.
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Mentis AFA, Dardiotis E, Efthymiou V, Chrousos GP. Non-genetic risk and protective factors and biomarkers for neurological disorders: a meta-umbrella systematic review of umbrella reviews. BMC Med 2021; 19:6. [PMID: 33435977 PMCID: PMC7805241 DOI: 10.1186/s12916-020-01873-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 11/26/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The etiologies of chronic neurological diseases, which heavily contribute to global disease burden, remain far from elucidated. Despite available umbrella reviews on single contributing factors or diseases, no study has systematically captured non-purely genetic risk and/or protective factors for chronic neurological diseases. METHODS We performed a systematic analysis of umbrella reviews (meta-umbrella) published until September 20th, 2018, using broad search terms in MEDLINE, SCOPUS, Web of Science, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, ProQuest Dissertations & Theses, JBI Database of Systematic Reviews and Implementation Reports, DARE, and PROSPERO. The PRISMA guidelines were followed for this study. Reference lists of the identified umbrella reviews were also screened, and the methodological details were assessed using the AMSTAR tool. For each non-purely genetic factor association, random effects summary effect size, 95% confidence and prediction intervals, and significance and heterogeneity levels facilitated the assessment of the credibility of the epidemiological evidence identified. RESULTS We identified 2797 potentially relevant reviews, and 14 umbrella reviews (203 unique meta-analyses) were eligible. The median number of primary studies per meta-analysis was 7 (interquartile range (IQR) 7) and that of participants was 8873 (IQR 36,394). The search yielded 115 distinctly named non-genetic risk and protective factors with a significant association, with various strengths of evidence. Mediterranean diet was associated with lower risk of dementia, Alzheimer disease (AD), cognitive impairment, stroke, and neurodegenerative diseases in general. In Parkinson disease (PD) and AD/dementia, coffee consumption, and physical activity were protective factors. Low serum uric acid levels were associated with increased risk of PD. Smoking was associated with elevated risk of multiple sclerosis and dementia but lower risk of PD, while hypertension was associated with lower risk of PD but higher risk of dementia. Chronic occupational exposure to lead was associated with higher risk of amyotrophic lateral sclerosis. Late-life depression was associated with higher risk of AD and any form of dementia. CONCLUSIONS We identified several non-genetic risk and protective factors for various neurological diseases relevant to preventive clinical neurology, health policy, and lifestyle counseling. Our findings could offer new perspectives in secondary research (meta-research).
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Affiliation(s)
- Alexios-Fotios A Mentis
- Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece; and, Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece.
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Vasiliki Efthymiou
- University Research Institute of Maternal and Child Health and Precision Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine, and UNESCO Chair on Adolescent Health Care, National and Kapodistrian University of Athens, Athens, Greece
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Braly T, Muriathiri D, Brown JC, Taylor BM, Boustani MA, Holden RJ. Technology intervention to support caregiving for Alzheimer's disease (I-CARE): study protocol for a randomized controlled pilot trial. Pilot Feasibility Stud 2021; 7:23. [PMID: 33431027 PMCID: PMC7798342 DOI: 10.1186/s40814-020-00755-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 06/23/2020] [Accepted: 12/16/2020] [Indexed: 12/21/2022] Open
Abstract
Background Informal caregivers of patients with Alzheimer’s disease and related dementias (ADRD) manage a complex spectrum of patient behavioral and psychological symptoms of dementia (BPSD). Mobile health information technologies have quickly become sources for modern social support and chronic disease management. These technologies can improve our understanding of how to care for patients with ADRD and their informal caregivers. A mobile telehealth intervention could help reduce caregiver burden and BPSD. Methods This is a pilot randomized controlled trial of 60 dyads of patients living with ADRD and their caregivers, to test the feasibility and estimate the potential effect of the Brain CareNotes (BCN) mobile telehealth system. Participants will be recruited from two health systems. Participants will be randomly assigned to either the BCN intervention arm or usual care comparator. Data will be collected at baseline, 3- and 6-month follow-up. The primary objectives of this trial are to assess feasibility outcomes: (a) recruitment rate, (b) data completion, (c) BCN usability, (d) BCN acceptance, and (e) BCN use and assessed either on an ongoing basis or at 3- and 6-month post-intervention. A secondary objective was to estimate the intervention’s effects on caregiver burden and patient BPSD outcomes at 3 and 6 months, assessed by the Neuropsychiatric Inventory. Discussion The study will assess the intervention feasibility and potential effect size of the BCN telehealth system as a potentially scalable and lower-cost solution for addressing the ADRD public health crisis. Trial registration Clinical Trials. NCT03119259. Registered on April 18, 2017.
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Affiliation(s)
- Tyler Braly
- Center of Health Innovation and Implementation Science, Indiana Clinical and Translational Sciences Institute, 410 W. 10th St, Indianapolis, IN, 46202, USA.,Indiana University Center of Aging Research, Regenstrief Institute, 1101 W. 10th St, Indianapolis, IN, 46202, USA
| | - Doris Muriathiri
- Center of Health Innovation and Implementation Science, Indiana Clinical and Translational Sciences Institute, 410 W. 10th St, Indianapolis, IN, 46202, USA.,Indiana University Center of Aging Research, Regenstrief Institute, 1101 W. 10th St, Indianapolis, IN, 46202, USA
| | - Janetta C Brown
- Center of Health Innovation and Implementation Science, Indiana Clinical and Translational Sciences Institute, 410 W. 10th St, Indianapolis, IN, 46202, USA.,Indiana University School of Medicine, 340 W 10th St #6200, Indianapolis, IN, 46202, USA
| | - Britain M Taylor
- Center of Health Innovation and Implementation Science, Indiana Clinical and Translational Sciences Institute, 410 W. 10th St, Indianapolis, IN, 46202, USA.,The Luddy School of Informatics, Computing, and Engineering, Indiana University, 919 E 10th St, Bloomington, IN, 47408, USA
| | - Malaz A Boustani
- Center of Health Innovation and Implementation Science, Indiana Clinical and Translational Sciences Institute, 410 W. 10th St, Indianapolis, IN, 46202, USA.,Indiana University Center of Aging Research, Regenstrief Institute, 1101 W. 10th St, Indianapolis, IN, 46202, USA.,Indiana University School of Medicine, 340 W 10th St #6200, Indianapolis, IN, 46202, USA
| | - Richard J Holden
- Center of Health Innovation and Implementation Science, Indiana Clinical and Translational Sciences Institute, 410 W. 10th St, Indianapolis, IN, 46202, USA. .,Indiana University Center of Aging Research, Regenstrief Institute, 1101 W. 10th St, Indianapolis, IN, 46202, USA. .,Indiana University School of Medicine, 340 W 10th St #6200, Indianapolis, IN, 46202, USA.
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Al-Kaisy A, Vajramani G, Love-Jones S, Patel NK, Royds J, Palmisani S, Pang D, Wesley S, Park HJ, Raza A, Agnesi F. Multicentre, clinical trial of burst spinal cord stimulation for neck and upper limb pain NU-BURST: a trial protocol. Neurol Sci 2021; 42:3285-96. [PMID: 33387056 DOI: 10.1007/s10072-020-04907-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 11/13/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Spinal cord stimulation (SCS) is an established therapy for chronic neuropathic pain and most frequently utilised for Failed Back Surgery Syndrome (FBSS). BurstDR™ also known as DeRidder Burst-SCS, a novel waveform, has demonstrated superiority to conventional tonic stimulation of the thoracic spine in FBSS. There are case reports of an improvement in multidimensional pain outcomes using DeRidder Burst-SCS in the cervical spine for chronic neck and cervical radicular pain. The safety and efficacy of cervical DeRidder Burst-SCS stimulation still however remain undetermined. METHODS/DESIGN This is a prospective, multicentre feasibility trial evaluating the safety and therapeutic efficacy of DeRidder Burst-SCS stimulation for the treatment of chronic intractable neck pain with or without radiation to the arm, shoulder, and upper back. After baseline evaluation, subjects will undergo an SCS trial using the Abbott Invisible Trial system according to standard clinical procedures. During the trial phase, SCS leads will be implanted in the cervical epidural space. At the end of the SCS trial, subjects experiencing at least 50% pain relief will be considered for permanent implant. Pain intensity, medication usage, and other multidimensional pain outcomes will be collected. The timing of these will be at baseline, end of the SCS trial and at 3-, 6-, and 12-month visits. Incidence of adverse events will be collected throughout the study duration. DISCUSSION The results of this feasibility study will validate the efficacy and safety of DeRidder Burst-SCS stimulation in the cervical spine. The results obtained in this study will potentially be used to generate a level 1 evidence-based study with formal statistical hypotheses testing. TRIAL REGISTRATION www.clinicaltrials.gov Identifier: NCT03159169.
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Regauer V, Seckler E, Müller M, Bauer P. Physical therapy interventions for older people with vertigo, dizziness and balance disorders addressing mobility and participation: a systematic review. BMC Geriatr 2020; 20:494. [PMID: 33228601 PMCID: PMC7684969 DOI: 10.1186/s12877-020-01899-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 11/12/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Vertigo, dizziness and balance disorders (VDB) are among the most relevant contributors to the burden of disability among older adults living in the community and associated with immobility, limitations of activities of daily living and decreased participation. The aim of this study was to identify the quality of evidence of physical therapy interventions that address mobility and participation in older patients with VDB and to characterize the used primary and secondary outcomes. METHODS A systematic search via MEDLINE (PubMed), Cochrane Library, CINAHL, PEDro, forward citation tracing and hand search was conducted initially in 11/2017 and updated in 7/2019. We included individual and cluster-randomized controlled trials and trials with quasi-experimental design, published between 2007 and 2017/2019 and including individuals ≥65 years with VDB. Physical therapy and related interventions were reviewed with no restrictions to outcome measurement. Screening of titles, abstracts and full texts, data extraction and critical appraisal was conducted by two independent researchers. The included studies were heterogeneous in terms of interventions and outcome measures. Therefore, a narrative synthesis was conducted. RESULTS A total of 20 randomized and 2 non-randomized controlled trials with 1876 patients met the inclusion criteria. The included studies were heterogeneous in terms of complexity of interventions, outcome measures and methodological quality. Vestibular rehabilitation (VR) was examined in twelve studies, computer-assisted VR (CAVR) in five, Tai Chi as VR (TCVR) in three, canal repositioning manoeuvres (CRM) in one and manual therapy (MT) in one study. Mixed effects were found regarding body structure/function and activities/participation. Quality of life and/or falls were assessed, with no differences between groups. VR is with moderate quality of evidence superior to usual care to improve balance, mobility and symptoms. CONCLUSION To treat older individuals with VDB, VR in any variation and in addition to CRMs seems to be effective. High-quality randomized trials need to be conducted to inform clinical decision making. TRIAL REGISTRATION PROSPERO 2017 CRD42017080291 .
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Affiliation(s)
- Verena Regauer
- Centre for Research, Development and Technology Transfer, Rosenheim Technical University of Applied Sciences, Hochschulstraße 1, 83024, Rosenheim, Germany.
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Marchioninistraße 17, 81377, Munich, Germany.
| | - Eva Seckler
- Centre for Research, Development and Technology Transfer, Rosenheim Technical University of Applied Sciences, Hochschulstraße 1, 83024, Rosenheim, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Marchioninistraße 17, 81377, Munich, Germany
| | - Martin Müller
- Faculty for Applied Health and Social Sciences and Centre for Research, Research, Development and Technology Transfer, Rosenheim Technical University of Applied Sciences, Hochschulstraße 1, 83024, Rosenheim, Germany
| | - Petra Bauer
- Faculty for Applied Health and Social Sciences and Centre for Research, Research, Development and Technology Transfer, Rosenheim Technical University of Applied Sciences, Hochschulstraße 1, 83024, Rosenheim, Germany
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Léotard A, Levy J, Pérennou D, Pépin JL, Lofaso F, Bensmail D, Lebret M, Baillieul S. Sleep might have a pivotal role in rehabilitation medicine: A road map for care improvement and clinical research. Ann Phys Rehabil Med 2020; 64:101392. [PMID: 32445976 DOI: 10.1016/j.rehab.2020.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/31/2020] [Accepted: 04/13/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Antoine Léotard
- Département de physiologie, explorations fonctionnelles, unité des pathologies du sommeil, AP-HP, Hôpital Raymond-Poincaré, 104, boulevard Raymond-Poincaré, 92380 Garches, France; Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR Des sciences de la sante-Simone-Veil, Versailles, France; Sleep Lab Initiative In PMR group (SLIIP), Garches, France.
| | - Jonathan Levy
- Service de médecine physique et de réadaptation, Hôpital Raymond Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR Des sciences de la sante-Simone-Veil, Versailles, France; Sleep Lab Initiative In PMR group (SLIIP), Garches, France
| | - Dominic Pérennou
- Département de Rééducation Neurologique, CHU Grenoble Alpes, Grenoble, France; Laboratoire Psychologie et Neurocognition (LPNC), Univ Grenoble Alpes, Grenoble, 38000, Grenoble, France
| | - Jean-Louis Pépin
- HP2, Inserm U1042, Univ Grenoble Alpes, Grenoble, 38000 France; Laboratoire Sommeil et exercice, pole thorax-vaisseaux, CHU Grenoble Alpes, Grenoble, France
| | - Frédéric Lofaso
- Département de physiologie, explorations fonctionnelles, unité des pathologies du sommeil, AP-HP, Hôpital Raymond-Poincaré, 104, boulevard Raymond-Poincaré, 92380 Garches, France; Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR Des sciences de la sante-Simone-Veil, Versailles, France
| | - Djamel Bensmail
- Service de médecine physique et de réadaptation, Hôpital Raymond Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France
| | - Marius Lebret
- Groupe de recherche en hypertension pulmonaire, Institut universitaire de cardiologie et de pneumologie de Québec, 2725, Chemin Sainte-Foy, G1V 4G5 Québec, Canada; Sleep Lab Initiative In PMR group (SLIIP), Garches, France
| | - Sebastien Baillieul
- HP2, Inserm U1042, Univ Grenoble Alpes, Grenoble, 38000 France; Laboratoire Sommeil et exercice, pole thorax-vaisseaux, CHU Grenoble Alpes, Grenoble, France; Sleep Lab Initiative In PMR group (SLIIP), Garches, France
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Abstract
The Tacr3 gene encodes tachykinin receptor 3 (NK3R), which belongs to the tachykinin receptor family. This family of proteins includes typical G protein-coupled receptors and belongs to the rhodopsin subfamily. NK3R functions by binding to its high-affinity ligand, neurokinin B(NKB). The role of Tacr3/NK3R in growth and reproduction has been extensively studied, but Tacr3/NK3R is also widely expressed in the nervous system from the spinal cord to the brain and is involved in both physiological and pathological processes in the nervous system, including mood disorders, chronic pain, learning and memory deficiencies, Alzheimer's disease, Parkinson's disease, addiction-related processes, hypoxic-ischemic encephalopathy, body fluid management, neural development, and schizophrenia. Here, we summarize the structure of NK3R/NKB and its cellular signaling as well as the expression of Tacr3/NK3R in the nervous system, and we provide a comprehensive summary of the role of Tacr3/NK3R in neurological diseases, including reproduction-related disorders and other neurological diseases. At the end of this review, we propose the hypothesis that Tacr3/NK3R mediates a variety of brain functions by affecting the excitability of different neurons with specific functions. On the basis of this "excited or not" hypothesis, more studies related to Tacr3 should be carried out in other nervous system diseases in order to better understand the biological roles of Tacr3.
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Affiliation(s)
- Wen-wen Zhang
- Department of Integrative Medicine and Neurobiology, Institutes of Integrative Medicine, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Yanqing Wang
- Department of Integrative Medicine and Neurobiology, Institutes of Integrative Medicine, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Yu-Xia Chu
- Department of Integrative Medicine and Neurobiology, Institutes of Integrative Medicine, School of Basic Medical Sciences, Institutes of Brain Science, Brain Science Collaborative Innovation Center, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
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Abou L, Alluri A, Fliflet A, Du Y, Rice LA. Effectiveness of Physical Therapy Interventions in Reducing Fear of Falling Among Individuals With Neurologic Diseases: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2020; 102:132-154. [PMID: 32745544 DOI: 10.1016/j.apmr.2020.06.025] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [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: 01/31/2020] [Revised: 06/23/2020] [Accepted: 06/30/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To summarize the effectiveness of physical therapy interventions to reduce fear of falling (FOF) among individuals living with neurologic diseases. DATA SOURCES PubMed, Physiotherapy Evidence Database, Scopus, Web of Science, PsycINFO, Cumulative Index to Nursing and Allied Health, and SportDiscuss were searched from inception until December 2019. STUDY SELECTION Clinical trials with either the primary or secondary aim to reduce FOF among adults with neurologic diseases were selected. DATA EXTRACTION Potential articles were screened for eligibility, and data were extracted by 2 independent researchers. Risk of bias was assessed by the Cochrane Risk of Bias tool for randomized controlled trials and the National Institutes of Health Quality Assessment Tool for pre-post studies. A meta-analysis was performed among trials presenting with similar clinical characteristics. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to rate the overall quality of evidence. RESULTS Sixty-one trials with 3954 participants were included in the review and 53 trials with 3524 participants in the meta-analysis. The included studies presented, in general, with a low to high risk of bias. A combination of gait and balance training was significantly more effective compared with gait training alone in reducing FOF among individuals with Parkinson disease (PD) (mean difference [MD]=11.80; 95% CI, 8.22-15.38; P<.001). Home-based exercise and leisure exercise demonstrated significant improvement in reducing FOF over usual care in multiple sclerosis (MS) (MD=15.27; 95% CI, 6.15-24.38; P=.001). No statistically significant between-groups differences were reported among individuals with stroke and spinal cord injury. The overall quality of evidence presented in this review ranges from very low to moderate according to the assessment with the GRADE approach. CONCLUSIONS Gait with lower limb training combined with balance training is effective in reducing FOF in individuals with PD. Also, home-based or leisure exercise is effective among individuals with MS. However, because of several limitations of the included studies, further research is needed to examine the effectiveness of FOF intervention among individuals with neurologic diseases.
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Affiliation(s)
- Libak Abou
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Aditya Alluri
- Department of Molecular and Cellular Biology, College of Liberal Arts & Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Alexander Fliflet
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Yiting Du
- Department of Interdisciplinary Health Sciences, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Laura A Rice
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois.
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Trigo J, García-Azorín D, Planchuelo-Gómez Á, Martínez-Pías E, Talavera B, Hernández-Pérez I, Valle-Peñacoba G, Simón-Campo P, de Lera M, Chavarría-Miranda A, López-Sanz C, Gutiérrez-Sánchez M, Martínez-Velasco E, Pedraza M, Sierra Á, Gómez-Vicente B, Arenillas JF, Guerrero ÁL. Factors associated with the presence of headache in hospitalized COVID-19 patients and impact on prognosis: a retrospective cohort study. J Headache Pain 2020; 21:94. [PMID: 32727345 PMCID: PMC7388434 DOI: 10.1186/s10194-020-01165-8] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/22/2020] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Headache is one of the most frequent neurologic manifestations in COVID-19. We aimed to analyze which symptoms and laboratory abnormalities were associated with the presence of headache and to evaluate if patients with headache had a higher adjusted in-hospital risk of mortality. METHODS Retrospective cohort study. We included all consecutive patients admitted to the Hospital with confirmed SARS-CoV-2 infection between March 8th and April 11th, 2020. We collected demographic data, clinical variables and laboratory abnormalities. We used multivariate regression analysis. RESULTS During the study period, 576 patients were included, aged 67.2 (SD: 14.7), and 250/576 (43.3%) being female. Presence of headache was described by 137 (23.7%) patients. The all-cause in-hospital mortality rate was 127/576 (20.0%). In the multivariate analysis, patients with headache had a lower risk of mortality (OR: 0.39, 95% CI: 0.17-0.88, p = 0.007). After adjusting for multiple comparisons in a multivariate analysis, variables that were independently associated with a higher odds of having headache in COVID-19 patients were anosmia, myalgia, female sex and fever; variables that were associated with a lower odds of having headache were younger age, lower score on modified Rankin scale, and, regarding laboratory variables on admission, increased C-reactive protein, abnormal platelet values, lymphopenia and increased D-dimer. CONCLUSION Headache is a frequent symptom in COVID-19 patients and its presence is an independent predictor of lower risk of mortality in COVID-19 hospitalized patients.
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Affiliation(s)
- Javier Trigo
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain
| | - David García-Azorín
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain.
| | | | - Enrique Martínez-Pías
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Blanca Talavera
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Isabel Hernández-Pérez
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Gonzalo Valle-Peñacoba
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Paula Simón-Campo
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Mercedes de Lera
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Alba Chavarría-Miranda
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Cristina López-Sanz
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain
| | - María Gutiérrez-Sánchez
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Elena Martínez-Velasco
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain
| | - María Pedraza
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Álvaro Sierra
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Beatriz Gómez-Vicente
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain
| | - Juan Francisco Arenillas
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain
- Department of Medicine, University of Valladolid, Valladolid, Spain
- Neurovascular Research Laboratory. Instituto de Biología y Genética Molecular, Universidad de Valladolid - Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Ángel L Guerrero
- Department of Neurology, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47003, Valladolid, Spain
- Department of Medicine, University of Valladolid, Valladolid, Spain
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Xiang C, Zhang Y, Guo W, Liang XJ. Biomimetic carbon nanotubes for neurological disease therapeutics as inherent medication. Acta Pharm Sin B 2020; 10:239-248. [PMID: 32082970 PMCID: PMC7016289 DOI: 10.1016/j.apsb.2019.11.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [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: 04/30/2019] [Revised: 08/26/2019] [Accepted: 08/29/2019] [Indexed: 01/01/2023] Open
Abstract
Nowadays, nanotechnology is revolutionizing the approaches to different fields from manufacture to health. Carbon nanotubes (CNTs) as promising candidates in nanomedicine have great potentials in developing novel entities for central nervous system pathologies, due to their excellent physicochemical properties and ability to interface with neurons and neuronal circuits. However, most of the studies mainly focused on the drug delivery and bioimaging applications of CNTs, while neglect their application prospects as therapeutic drugs themselves. At present, the relevant reviews are not available yet. Herein we summarized the latest advances on the biomedical and therapeutic applications of CNTs in vitro and in vivo for neurological diseases treatments as inherent therapeutic drugs. The biological mechanisms of CNTs-mediated bio-medical effects and potential toxicity of CNTs were also intensely discussed. It is expected that CNTs will exploit further neurological applications on disease therapy in the near future.
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Key Words
- AD, Alzheimer's disease
- ALS, amyotrophic lateral sclerosis
- BBB, blood–brain barrier
- CNS, central nervous system
- CNT-N, nitrogen-doped carbon nanotubes
- CNTs, carbon nanotubes
- Carbon nanotubes
- CpG, oligodeoxynucleotides
- DTPA, diethylentriaminepentaacetic
- Drug delivery
- EBs, embryoid bodies
- EDC·HCl, 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride
- GO, graphene oxide
- HD, Huntington's disease
- Inherent medication
- MCAO, middle cerebral artery occlusion
- METH, methamphetamine
- MPO, myeloperoxidase
- MWCNTTs, multi-walled nanotube towers
- MWCNTs, multi-walled carbon nanotubes
- ND, nanodiamond
- NHS, N-hydroxysuccinimide
- NR, nanorod
- NSCs, neural stem cells
- Nervous system diseases
- PBEC, porcine brain endothelial cells
- PCL, polycaprolactone
- PD, Parkinson's disease
- PEG, polyethylene-glycol
- PET, position emission tomography
- PMo11V, tetrabutylammonium salt of phosphovanadomolybdate
- POCs, polycyclic organic compounds
- PPy/SWCNT, polypyrrole/single-walled carbon nanotube
- RES, reticuloendothelial system
- SWCNTP, single-walled nanotube paper
- SWCNTs, single-walled carbon nanotubes
- TLR9, the toll-like receptor-9
- TMZ, temozolomide
- Therapeutic drug
- Toxicity
- aSWCNTs, aggregated SWCNTs
- f-CNTs, functionalized carbon nanotubes
- hNSCs, human neural stem cells
- siRNA, small interfering RNA
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Affiliation(s)
- Chenyang Xiang
- Translational Medicine Center, Key Laboratory of Molecular Target & Clinical Pharmacology and the State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences & the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
| | - Yuxuan Zhang
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing 100190, China
| | - Weisheng Guo
- Translational Medicine Center, Key Laboratory of Molecular Target & Clinical Pharmacology and the State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences & the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
| | - Xing-Jie Liang
- Translational Medicine Center, Key Laboratory of Molecular Target & Clinical Pharmacology and the State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences & the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou 510260, China
- CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology of China, Beijing 100190, China
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Abstract
INTRODUCTION Although fatigue is a well-studied concept in neurological disease, cognitive fatigability (CF) is less understood. While most studies measure fatigue using subjective self-report, fewer have measured CF objectively. Given the negative impact of CF on quality-of-life, there is a need for targeted interventions. The objective of this review was to determine which procedural, behavioural and pharmacological treatments for objectively measured CF are available to people living with neurological conditions. METHODS In accordance with the PRISMA guidelines, systematic searches for randomized control trials (RCTs), case-controlled studies and case reports/series were conducted across the Ovid Medline, PsycInfo, EMBASE and Cochrane Library databases. English-language articles published between 1980 and February 2019 were considered for eligibility. Included were those that objectively measured CF in individuals with neurological disease/disorder/dysfunction between the ages of 18 and 65 years. Studies were reviewed using a modified Cochrane Data Extraction Template. Risk of bias was assessed using the Cochrane Risk of Bias tool. The review process was facilitated using Covidence software (www.covidence.org). Two authors reviewed articles independently, with a third resolving conflicts regarding article inclusion. RESULTS The search identified 450 records. After duplicates were removed and remaining titles/abstracts were screened for eligibility, 28 full-text articles were assessed, and two studies were included in the qualitative synthesis. Studies were a priori divided into those with pharmacological, procedural or behavioural interventions. Two studies met eligibility criteria; both of these included participants with multiple sclerosis. One study utilized a procedural intervention (i.e. transcranial direct current stimulation), while the other utilized a pharmacological intervention (i.e. fampridine-SR). Studies were evaluated for risk of bias, and evidence from both eligible studies was discussed. CONCLUSION Despite the positive results of the procedural intervention, the paucity of eligible studies and the nascent nature of the field suggests that more studies are required before firm conclusions can be drawn regarding the amenability of CF to treatment. TRIAL REGISTRATION The review was registered with PROSPERO (CRD42019118706).
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Affiliation(s)
- Lisa A S Walker
- Ottawa Hospital Research Institute, Ottawa, Canada.
- University of Ottawa Brain and Mind Research Institute, Ottawa, Canada.
- Carleton University, Ottawa, Canada.
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Baymakova M, Christova I, Panayotova E, Trifonova I, Chobanov A, Daskalov I, Popov GT, Plochev K. WEST NILE VIRUS INFECTION WITH NEUROLOGICAL DISORDERS: A CASE REPORT AND A BRIEF REVIEW OF THE SITUATION IN BULGARIA. Acta Clin Croat 2019; 58:546-549. [PMID: 31969770 PMCID: PMC6971811 DOI: 10.20471/acc.2019.58.03.21] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
A case of a 66-year-old man with West Nile neuroinvassive disease manifested with fever, weakness, fatigue, consciousness disorders and underlying diabetes mellitus type 2 and cardiovascular diseases is presented. Laboratory data showed elevated erythrocyte sedimentation rate and fibrinogen. Serological tests revealed West Nile virus specific antibodies of class IgM and IgG in serum. West Nile virus RNA was detected in urine sample. Supportive therapy was applied.
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Affiliation(s)
| | - Iva Christova
- 1Department of Infectious Diseases, Military Medical Academy, Sofia, Bulgaria; 2Department of Microbiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria; 3Emergency Center, Military Medical Academy, Sofia, Bulgaria
| | - Elitsa Panayotova
- 1Department of Infectious Diseases, Military Medical Academy, Sofia, Bulgaria; 2Department of Microbiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria; 3Emergency Center, Military Medical Academy, Sofia, Bulgaria
| | - Iva Trifonova
- 1Department of Infectious Diseases, Military Medical Academy, Sofia, Bulgaria; 2Department of Microbiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria; 3Emergency Center, Military Medical Academy, Sofia, Bulgaria
| | - Aleksandar Chobanov
- 1Department of Infectious Diseases, Military Medical Academy, Sofia, Bulgaria; 2Department of Microbiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria; 3Emergency Center, Military Medical Academy, Sofia, Bulgaria
| | - Ivaylo Daskalov
- 1Department of Infectious Diseases, Military Medical Academy, Sofia, Bulgaria; 2Department of Microbiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria; 3Emergency Center, Military Medical Academy, Sofia, Bulgaria
| | - Georgi T Popov
- 1Department of Infectious Diseases, Military Medical Academy, Sofia, Bulgaria; 2Department of Microbiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria; 3Emergency Center, Military Medical Academy, Sofia, Bulgaria
| | - Kamen Plochev
- 1Department of Infectious Diseases, Military Medical Academy, Sofia, Bulgaria; 2Department of Microbiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria; 3Emergency Center, Military Medical Academy, Sofia, Bulgaria
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Wang HM, Wang XH, Wu HS, Wu Y, Zhuo XW. [Clinical and laboratory characteristics and genetic diagnosis of Kabuki syndrome]. Zhonghua Er Ke Za Zhi 2019; 56:846-849. [PMID: 30392209 DOI: 10.3760/cma.j.issn.0578-1310.2018.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical features, laboratory characteristics and genetic diagnosis of Kabuki syndrome (KS). Methods: Between September 2014 and September 2016, seven children with clinically diagnosed KS from the neurology department, Beijing Children Hospital, Capital Medical University were included in this study. Three of them were male and 4 were female aged from 19 days to 6 years and 4 months with a median age of 3 years and 1 month. The clinical features, laboratory and imaging materials, gene tests were analyzed prospectively. Results: Clinical manifestation: cephalofacial anomaly: all seven cases had unusual facies presented as long palpebral fissures, eversion of the lateral third of lower eyelids, arched eyebrow with brow sparse, epicanthus, orbital hypertelorism, short columella with broad and depressed nasal tip; six cases presented with palatal arch deformity; four cases presented with ptosis; three cases presented with dental abnormalities and hearing impairment respectively; two cases presented with strabismus and earlap malformation respectively; one case presented with amblyopia. Six cases presented with skeletal anomalies. Six cases presented with dermatoglyphic anomalies. All cases presented with mild to moderate mental retardation. Three cases presented with short stature. Four cases presented with cardiac abnormalities. Three cases presented with epileptic seizures. Others: three cases presented with dystonia and neonatal hyperbilirubinemia respectively; two cases presented with feeding problem and hypoglycemia respectively; one case presented with micropenis and fetal finger pads respectively. All seven patients received magnetic resonance imaging (MRI) tests, and none demonstrated an abnormal finding. Five patients received electroencephalogram (EEG) tests, and three of them presented with seizures and EEG abnormalities. Five patients received genetic testing and all presented with KMT2D heterozygous mutations which were new mutations proved by parents validation (three cases were nonsense mutations, one was frameshift mutation, one was missense mutation). All patients received rehabilitation training and symptomatic treatments. Three patients presented with epileptic seizures received antiepileptic therapy. At a median follow-up of 11 months (from 4 months to 2 years), one patient died, one lost to follow-up and five had improved intellectual and physical development. Epileptic seizures were controlled or reduced significantly in three patients presented with epileptic seizures. Conclusions: KS is a multisystem disease with complicated manifestations, which needs a combination of various diagnosis and treatments. Genetic testing can help determine the diagnosis. Unusual facies and mental retardation are the main clinical features and diagnostic clue. It is important to improve prognosis through increasing the knowledge of KS, early diagnosis, and treatment.
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Affiliation(s)
- H M Wang
- Department of Neurology, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
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Dijkers MP, Akers KG, Dieffenbach S, Galen SS. Systematic Reviews of Clinical Benefits of Exoskeleton Use for Gait and Mobility in Neurologic Disorders: A Tertiary Study. Arch Phys Med Rehabil 2019; 102:300-313. [PMID: 30849306 DOI: 10.1016/j.apmr.2019.01.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 07/20/2018] [Revised: 12/20/2018] [Accepted: 01/29/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To describe systematic reviews (SRs) of the use of exoskeletons for gait and mobility by persons with neurologic disorders and to evaluate their quality as guidance for research and clinical practice. DATA SOURCES PubMed, EMBASE, Web of Science, CINAHL Complete, PsycINFO, Cochrane Database of Systematic Reviews, PEDro, and Google Scholar were searched from database inception to January 23, 2018. STUDY SELECTION A total of 331 deduplicated abstracts from bibliographic database and ancestor searching were independently screened by 2 reviewers, resulting in 109 articles for which full text was obtained. Independent screening of those 109 articles by 2 reviewers resulted in a final selection of 17 SRs. DATA EXTRACTION Data were extracted by 1 reviewer using a pretested Excel form with 158 fields and checked by a second reviewer. Key data included the purpose of the SR, methods used, outcome measures presented, and conclusions. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses and A MeaSurement Tool to Assess Systematic Reviews version 2 were used to evaluate reporting and methodological quality, respectively, of the SRs. DATA SYNTHESIS The SRs generally were of poor methodological and reporting quality. They failed to report some information on patients (eg, height, weight, baseline ambulatory status) and interventions (eg, treatment hours or sessions planned and delivered) that clinicians and other stakeholders might want to have, and often failed to notice that the primary studies duplicated subjects. CONCLUSIONS Published SRs on exoskeletons have many weaknesses in design and execution; clinicians, researchers, and other stakeholders should be cautious in relying on them to make decisions on the use of this technology. Future primary and secondary studies need to address the multiple methodological limitations.
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Affiliation(s)
- Marcel P Dijkers
- Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, Michigan, the United States.
| | - Katherine G Akers
- Shiffman Medical Library, Wayne State University, Detroit, Michigan, the United States
| | - Sabrina Dieffenbach
- School of Medicine, Wayne State University, Detroit, Michigan, the United States
| | - Sujay S Galen
- Physical Therapy Program, Wayne State University, Detroit, Michigan, the United States
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Habeych ME, Moshayedi P, Rittenberger JC, Gunn SR. Initial absence of N20 waveforms from median nerve somatosensory evoked potentials in a patient with cardiac arrest and good outcomes. Clin Exp Emerg Med 2019; 6:177-182. [PMID: 30743323 PMCID: PMC6614054 DOI: 10.15441/ceem.18.015] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 05/24/2018] [Indexed: 11/23/2022] Open
Abstract
A 34-year-old male was brought to the hospital with a chest gunshot wound. Pulseless upon arrival, blood pressure was absent for 10 minutes. A thoracotomy resulted in return of spontaneous circulation. On hospital day 5, with brainstem reflexes present, he was unresponsive to call or pain, exhibited generalized hyperreflexia and bilateral Babinskys. Median nerve somatosensory evoked potentials (mSSEPs) and brainstem auditory evoked potentials were obtained. International Federation of Clinical Neurophysiology recommendations for mSSEPs and brainstem auditory evoked potentials were followed. Despite absence of the N20 responses from cortical mSSEPs no withdrawal from care was agreed upon. After awaking on day 7, mSSEPs were repeated and present. The patient survived and was discharged with minor deficits. Bilateral absence of N20 responses from mSSEPs performed beyond 48 hours after resuscitation from cardiac arrest is highly associated with bad neurological outcomes. However, variation due to hypothermia, noisy signals, medications, and brain hypo-perfusion must be taken into account.
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Affiliation(s)
- Miguel E Habeych
- Department of Anesthesiology, University of Cincinnati, Cincinnati, OH, USA.,Intraoperative Neurophysiological Monitoring Group, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Pouria Moshayedi
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jon C Rittenberger
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Scott R Gunn
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Critical Care, University of Pittsburgh, Pittsburgh, PA, USA
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Morris NA, Chatterjee A, Adejumo OL, Chen M, Merkler AE, Murthy SB, Kamel H. The Risk of Takotsubo Cardiomyopathy in Acute Neurological Disease. Neurocrit Care 2019; 30:171-6. [PMID: 30094686 DOI: 10.1007/s12028-018-0591-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Case series have reported reversible left ventricular dysfunction, also known as stress cardiomyopathy or Takotsubo cardiomyopathy (TCM), in the setting of acute neurological diseases such as subarachnoid hemorrhage. The relative associations between various neurological diseases and Takotsubo remain incompletely understood. METHODS We performed a cross-sectional study of all adults in the National Inpatient Sample, a nationally representative sample of US hospitalizations, from 2006 to 2014. Our exposures of interest were primary diagnoses of acute neurological disease, defined by ICD-9-CM diagnosis codes. Our outcome was a diagnosis of TCM. Binary logistic regression models were used to examine the associations between our pre-specified neurological diagnoses and TCM after adjustment for demographics. RESULTS Among acute neurological diagnoses, the strongest associations were seen with subarachnoid hemorrhage (odds ratio [OR] 11.7; 95% confidence interval [CI] 10.2-13.4), status epilepticus (OR 4.9; 95% CI 3.7-6.3), and seizures (OR 1.3; 95% CI 1.1-1.5). In a sensitivity analysis including secondary diagnoses of acute neurological diagnoses, associations were also seen with transient global amnesia (OR 2.3; 95% CI 1.5-3.6), meningoencephalitis (OR 2.1; 95% CI 1.7-2.5), migraine (OR 1.7; 95% CI 1.5-1.8), intracerebral hemorrhage (OR 1.3; 95% CI 1.1-1.5), and ischemic stroke (OR 1.2; 95% CI 1.1-1.3). In addition, female sex was strongly associated with Takotsubo (OR 5.1; 95% CI 4.9-5.4). CONCLUSION TCM appears to be associated with varying degrees with several acute neurological diseases besides subarachnoid hemorrhage.
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Abstract
Spinal cord contusion injury is one of the most serious nervous system disorders, characterized by high morbidity and disability. To mimic spinal cord contusion in humans, various animal models of spinal contusion injury have been developed. These models have been developed in rats, mice, and monkeys. However, most of these models are developed using rats. Two types of animal models, i.e. bilateral contusion injury and unilateral contusion injury models, are developed using either a weight drop method or impactor method. In the weight drop method, a specific weight or a rod, having a specific weight and diameter, is dropped from a specific height on to the exposed spinal cord. Low intensity injury is produced by dropping a 5 g weight from a height of 8 cm, moderate injury by dropping 10 g weight from a height of 12.5–25 mm, and high intensity injury by dropping a 25 g weight from a height of 50 mm. In the impactor method, injury is produced through an impactor by delivering a specific force to the exposed spinal cord area. Mild injury is produced by delivering 100 ± 5 kdyn of force, moderate injury by delivering 200 ± 10 kdyn of force, and severe injury by delivering 300 ± 10 kdyn of force. The contusion injury produces a significant development of locomotor dysfunction, which is generally evident from the 0–14th day of surgery and is at its peak after the 28–56th day. The present review discusses different animal models of spinal contusion injury.
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Affiliation(s)
- Renuka Verma
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University Patiala, Patiala, India
| | - Jasleen Kaur Virdi
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University Patiala, Patiala, India
| | - Nirmal Singh
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University Patiala, Patiala, India
| | - Amteshwar Singh Jaggi
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University Patiala, Patiala, India
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Nery TGM, Silva EM, Tavares R, Passetti F. The Challenge to Search for New Nervous System Disease Biomarker Candidates: the Opportunity to Use the Proteogenomics Approach. J Mol Neurosci 2018; 67:150-164. [PMID: 30554402 DOI: 10.1007/s12031-018-1220-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 06/01/2018] [Accepted: 11/18/2018] [Indexed: 12/14/2022]
Abstract
Alzheimer's disease, Parkinson's disease, prion diseases, schizophrenia, and multiple sclerosis are the most common nervous system diseases, affecting millions of people worldwide. The current scientific literature associates these pathological conditions to abnormal expression levels of certain proteins, which in turn improved the knowledge concerning normal and affected brains. However, there is no available cure or preventive therapy for any of these disorders. Proteogenomics is a recent approach defined as the data integration of both nucleotide high-throughput sequencing and protein mass spectrometry technologies. In the last years, proteogenomics studies in distinct diseases have emerged as a strategy for the identification of uncharacterized proteoforms, which are all the different protein forms derived from a single gene. For many of these diseases, at least one protein used as biomarker presents more than one proteoform, which fosters the analysis of publicly available data focusing proteoforms. Given this context, we describe the most important biomarkers for each neurodegenerative disease and how genomics, transcriptomics, and proteomics separately contributed to unveil them. Finally, we present a selection of proteogenomics studies in which the combination of nucleotide and proteome high-throughput data, from cell lines or brain tissue samples, is used to uncover proteoforms not previously described. We believe that this new approach may improve our knowledge about nervous system diseases and brain function and an opportunity to identify new biomarker candidates.
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Affiliation(s)
- Thais Guimarães Martins Nery
- Laboratory of Functional Genomics and Bioinformatics, Oswaldo Cruz Institute, Fundação Oswaldo Cruz (Fiocruz), Manguinhos, Rio de Janeiro, Brazil
- Laboratory of Gene Expression Regulation, Carlos Chagas Institute, Fundação Oswaldo Cruz (Fiocruz), Curitiba, Brazil
| | - Esdras Matheus Silva
- Laboratory of Functional Genomics and Bioinformatics, Oswaldo Cruz Institute, Fundação Oswaldo Cruz (Fiocruz), Manguinhos, Rio de Janeiro, Brazil
- Laboratory of Gene Expression Regulation, Carlos Chagas Institute, Fundação Oswaldo Cruz (Fiocruz), Curitiba, Brazil
| | - Raphael Tavares
- Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Fabio Passetti
- Laboratory of Functional Genomics and Bioinformatics, Oswaldo Cruz Institute, Fundação Oswaldo Cruz (Fiocruz), Manguinhos, Rio de Janeiro, Brazil.
- Laboratory of Gene Expression Regulation, Carlos Chagas Institute, Fundação Oswaldo Cruz (Fiocruz), Curitiba, Brazil.
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Deutsch A, Heinemann AW, Cook KF, Foster L, Miskovic A, Goldsmith A, Cella D. Inpatient Rehabilitation Quality of Care From the Patient's Perspective: Effect of Data Collection Timing and Patient Characteristics. Arch Phys Med Rehabil 2018; 100:1032-1041. [PMID: 30476488 DOI: 10.1016/j.apmr.2018.10.019] [Citation(s) in RCA: 5] [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: 05/15/2018] [Revised: 10/11/2018] [Accepted: 10/19/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare, by collection time and patient characteristics, inpatient rehabilitation quality measure scores calculated using patient-reported data. DESIGN Cohort study of rehabilitation inpatients with neurologic conditions who reported their experience of care and pain status at discharge and 1month after discharge. SETTING Two inpatient rehabilitation facilities (IRFs). PARTICIPANTS Patients with neurologic conditions (N=391). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES We calculated 18 quality measure scores using participants' responses to 55 experience of care and health status questions addressing communication, support and encouragement, care coordination, discharge information, goals, new medications, responsiveness of staff, cleanliness, quietness, pain management, care transitions, overall hospital rating, willingness to recommend, and pain. RESULTS Of the 391 participants reporting at discharge, 277 (71%) also reported postdischarge after multiple attempts by e-mail, mail, and telephone. Discharge experience of care quality scores ranged from 25% (responsiveness of hospital staff) to 75% (willingness to recommend hospital); corresponding postdischarge scores were 32% to 87%, respectively. Five of the 16 experience of care quality scores increased significantly between discharge and postdischarge. The percentage of participants reporting high pain levels at discharge did not change across time periods. Patients with less education, older age, higher motor and cognitive function, and those who were not Hispanic or black had more favorable quality measure scores. CONCLUSION Patients' experience of care responses tended to be more favorable after discharge compared to discharge, suggesting that survey timing is important. Responses were more favorable for patients with selected characteristics, suggesting the possible need for risk adjustment if patient-reported quality measure scores are compared across IRFs.
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Affiliation(s)
- Anne Deutsch
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL; Quality Measurement and Health Policy Program, RTI International, Chicago, IL.
| | - Allen W Heinemann
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Karon F Cook
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Linda Foster
- Alexian Brothers Rehabilitation Hospital, Elk Grove Village, IL
| | - Ana Miskovic
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL
| | - Arielle Goldsmith
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL
| | - David Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Neeleman RA, Wagenmakers MAEM, Koole-Lesuis RH, Mijnhout GS, Wilson JHP, Friesema ECH, Langendonk JG. Medical and financial burden of acute intermittent porphyria. J Inherit Metab Dis 2018; 41:809-817. [PMID: 29675607 PMCID: PMC6133185 DOI: 10.1007/s10545-018-0178-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/21/2018] [Accepted: 03/26/2018] [Indexed: 12/25/2022]
Abstract
INTRODUCTION A small proportion of patients with acute intermittent porphyria (AIP) suffer from recurrent porphyric attacks, with a severely diminished quality of life. In this retrospective case-control study, the burden of disease is quantified and compared among three AIP patient subgroups: cases with recurrent attacks, cases with one or occasional attacks and asymptomatic carriers. METHODS Data from patient records and questionnaires were collected in patients between 1960 and 2016 at the Erasmus Medical Center, Rotterdam, the Netherlands. We collected symptoms related to porphyria, porphyria related complications, attack frequency, hospitalisation frequency, hospitalisation days related to acute porphyric attacks, frequency of heme infusions and medical healthcare costs based on hospitalisations and heme therapy. RESULTS In total 11 recurrent AIP cases, 24 symptomatic AIP cases and 53 AIP carriers as controls were included. All recurrent patients reported porphyria related symptoms, such as pain, neurological and/or psychiatric disorders, and nearly all developed complications, such as hypertension and chronic kidney disease. In the recurrent cases group, the median lifelong number of hospitalisation days related to porphyric attacks was 82 days per patient (range 10-374), and they spent a median of 346 days (range 34-945) at a day-care facility for prophylactic heme therapy; total follow-up time was 243 person-years (PYRS). In the symptomatic non-recurrent group the median lifelong number of hospitalisation days related to porphyric attacks was 7 days per patient (range 1-78), total follow-up time was 528 PYRS. The calculated total medical healthcare cost for recurrent cases group was €5.8 million versus €0.3 million for the symptomatic cases group.
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Affiliation(s)
- Rochus A. Neeleman
- 000000040459992Xgrid.5645.2Porphyria Center, Center for Lysosomal and Metabolic Disease, Department of Internal Medicine, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Margreet A. E. M. Wagenmakers
- 000000040459992Xgrid.5645.2Porphyria Center, Center for Lysosomal and Metabolic Disease, Department of Internal Medicine, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Rita H. Koole-Lesuis
- 000000040459992Xgrid.5645.2Porphyria Center, Center for Lysosomal and Metabolic Disease, Department of Internal Medicine, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - G. Sophie Mijnhout
- 0000 0001 0547 5927grid.452600.5Department of Internal Medicine, Isala Clinics, Zwolle, the Netherlands
| | - J. H. Paul Wilson
- 000000040459992Xgrid.5645.2Porphyria Center, Center for Lysosomal and Metabolic Disease, Department of Internal Medicine, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Edith C. H. Friesema
- 000000040459992Xgrid.5645.2Porphyria Center, Center for Lysosomal and Metabolic Disease, Department of Internal Medicine, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Janneke G. Langendonk
- 000000040459992Xgrid.5645.2Porphyria Center, Center for Lysosomal and Metabolic Disease, Department of Internal Medicine, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands
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