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1.
Rev. Inst. Invest. Cienc. Salud ; 3(1): 1-20, dic. 1988. Tab
Article in Spanish | ECUADOR | ID: equ-6046

ABSTRACT

La Cisticercosis, es una enfermedad parasitaria que afecta con más frecuencia al sistema nervioso central, especialmente en los países subdesarrolados. Es difícil conocer su real prevalencia en la población en virtud de que muchos casos cursan en froma asintomática y porque no se cuenta con métodos de diagnóstico totalmente seguros. Se estudian un total de 150 pacientes con diferentes patologías neurológicas internados en los hospitales: Vicente Corral Moscoso, Instituto Ecuatoriano de Seguridad Social (IESS), y Hospital Militar de la ciudad de Cuenca. Se analizan muestras de LCR y suero sanguíneo estableciéndose luego de la toma el diagnóstico definitivo mediante la Tomografía Axial Computarizada (TAC). 61 pacientes (40.6%) corresponden a cisticercosis cerebral de diferente localización, mientras 89 pacientes (59,4%) constituyen el grupo control y son portadores de diferentes patologías neurológicas no cisticercosas. En las muestras de LCR se realizan las técnicas de INMUNO-ENZIMOENSAYO (ELISA) e Inmuno Florescencia Indirecta (IFI), y en suero sanguíneo se aplica la técnica de hemoaglutinación Indirecta (HAI). Se realiza la valoración de sensibilidad y especificidad para cada una de estas técnicas; observandose que la técnica de ELISA presenta una sensibilidad de 83.3% y una especificidad del 100%, mientras que la IFI es sensibles en un 59.9% de casos y específica en un 86.6%, la HAI reporta una sensibilidad de 34.7% y especificidad del 85.7%. Los resultados confieren a la técnica de ELISA una sensibilidad y especificidad altamente significativa en relación a las dos técnicas restantes, circunstancia que le hace aplicabel en el diagnóstico de la cisticercosis cerebral, donde la TAC no sea confiable (AU)


Subject(s)
Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , Cysticercosis/diagnosis , Immunologic Tests , Brain Diseases/diagnosis , Hemagglutination Tests , Enzyme-Linked Immunosorbent Assay
2.
BMJ Case Rep ; 14(9)2021 Sep 20.
Article in English | MEDLINE | ID: mdl-34544696

ABSTRACT

A 38-year-old man presented at the emergency department with abdominal pain, vomiting, generalised weakness and altered consciousness. He had been ingesting opioids for over 5 years and had several past hospital admissions for abdominal pain. His investigations showed deranged liver function tests, anaemia and basophilic stippling on the peripheral blood smear. Further investigations revealed a significant increase in the serum lead level. We started chelation with peroral penicillamine 250 mg every 6 hours for 2 days and switched to intramuscular dimercaprol 4 mg/kg every 12 hours and intravenous calcium ethylenediamine tetraacetic acid 50 mg/kg in two divided doses daily for the next 5 days. We then discharged him home; he had become clinically stable by that time. We repeated his lead level and followed him up in the clinic. In this report, we emphasise the consideration of lead toxicity in opioid abusers and bring to attention a rare way of lead chelation in resource-limited settings.


Subject(s)
Brain Diseases , Lead Poisoning , Abdominal Pain , Adult , Analgesics, Opioid/adverse effects , Humans , Lead , Lead Poisoning/diagnosis , Lead Poisoning/drug therapy , Male
3.
BMJ Case Rep ; 14(9)2021 Sep 20.
Article in English | MEDLINE | ID: mdl-34544697

ABSTRACT

A 66-year-old woman presented to us with features of encephalopathy with asterixis, preceded by unsteadiness of gait and behavioural abnormalities. On subsequent investigations, hypercalcaemic crisis and compromised renal function were noted. Stepwise approach to determine the cause behind hypercalcaemia with compromised renal function revealed underlying granulomatous disease (sarcoidosis). Later, development of maculopapular rash and subsequent biopsy from the lesion confirmed the diagnosis of sarcoidosis. Her clinical and biochemical parameters improved considerably on initiation of conservative pharmacological therapy.


Subject(s)
Brain Diseases , Hypercalcemia , Sarcoidosis , Aged , Biopsy , Brain Diseases/diagnosis , Brain Diseases/drug therapy , Brain Diseases/etiology , Female , Granuloma , Humans , Hypercalcemia/etiology , Sarcoidosis/complications , Sarcoidosis/diagnosis , Sarcoidosis/drug therapy
4.
Anticancer Res ; 43(2): 663-668, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36697071

ABSTRACT

AIM: The objective of this study was to assess which clinical and radiographic findings may be associated with neurological decline in patients with temporal lobe mass lesions. PATIENTS AND METHODS: This represents a retrospective cohort study. Neurological decline was defined as a decline in Glasgow Coma Scale of 2 or more or new anisocoria. Adult patients aged 18 to 89 years with isolated temporal lobe, intra-axial, contrast-enhancing masses diagnosed between 1/1/2010 and 12/31/2020 were included. Clinical and radiographic findings were collected for each patient. Linear regression analysis was used to identify findings predictive of neurological decline. Patients with neurological decline were compared to stable patients to identify factors that may increase risk for neurological decline. RESULTS: A total of 71 patients met the inclusion criteria. Four out of the 71 patients experienced neurological decline, representing an incidence of 6%. Linear regression analysis identified only radiographic transtentorial herniation as a predictor of neurological decline (ß=0.26, p=0.03). A midline shift greater than 5 mm (100% vs. 40%; odds ratio=1.12, 95% confidence interval=1.00-1.32; p=0.05) and radiographic transtentorial herniation (75% vs. 18%; odds ratio=32.12, 95% confidence interval=3.91-264.18; p=0.03) were significantly more prevalent in patients with neurological decline and were associated with an increased risk of neurological decline. CONCLUSION: Radiographic transtentorial herniation and a midline shift greater than 5 mm may be useful findings to suggest an increased risk of neurological decline in patients with masses of the temporal lobe. This knowledge may be useful to neurosurgeons and physicians in other specialties to best care for this patient population.


Subject(s)
Brain Diseases , Temporal Lobe , Adult , Humans , Retrospective Studies , Temporal Lobe/diagnostic imaging
5.
J Int Med Res ; 51(1): 3000605221149879, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36694984

ABSTRACT

We herein report two cases involving children who died of influenza A (H3N2) virus infection-associated encephalopathy/encephalitis (IAE). Both children developed convulsions and impaired consciousness within a relatively short period and eventually died of brainstem failure. Patient 1 presented with high fever, vomiting, and diarrhea. Laboratory tests indicated persistently high lactate, alanine aminotransferase, and urea nitrogen concentrations in the blood as well as a high protein concentration in the cerebrospinal fluid. Patient 2 presented with persistent hyperthermia and progressive disturbance of consciousness, but the cerebrospinal fluid remained normal during the disease course. Both patients were actively given oseltamivir antiviral treatment after diagnosis of influenza virus infection. However, the disease progressed and invasive mechanical ventilation was performed. Both children's condition quickly progressed to IAE, and they eventually died. IAE is a rare complication of influenza virus infection with high mortality, and its pathogenesis remains unclear. The purpose of this report is to draw attention to the serious central nervous system complications of influenza infection and raise awareness of the fatal consequences of this disease among pediatricians.


Subject(s)
Brain Diseases , Encephalitis , Influenza, Human , Orthomyxoviridae Infections , Humans , Child , Influenza, Human/diagnosis , Influenza A Virus, H3N2 Subtype , Brain Diseases/complications , Brain Diseases/diagnosis , Oseltamivir/therapeutic use
6.
Biomolecules ; 13(1)2022 Dec 22.
Article in English | MEDLINE | ID: mdl-36671411

ABSTRACT

Epidemiological studies and clinical observations show evidence of sexual dimorphism in brain responses to several neurological conditions. It is suggested that sex-related differences between men and women may have profound effects on disease susceptibility, pathophysiology, and progression. Sexual differences of the brain are achieved through the complex interplay of several factors contributing to this phenomenon, such as sex hormones, as well as genetic and epigenetic differences. Despite recent advances, the precise link between these factors and brain disorders is incompletely understood. This review aims to briefly outline the most relevant aspects that differ between men and women in ischemia and neurodegenerative disorders (AD, PD, HD, ALS, and SM). Recognition of disparities between both sexes could aid the development of individual approaches to ameliorate or slow the progression of intractable disorders.


Subject(s)
Brain Diseases , Brain Ischemia , Neurodegenerative Diseases , Male , Female , Humans , Neurodegenerative Diseases/genetics , Sex Characteristics , Brain
7.
Int J Mol Sci ; 24(2)2023 Jan 10.
Article in English | MEDLINE | ID: mdl-36674898

ABSTRACT

Exposure to the toxin thioacetamide (TAA) causes acute hepatic encephalopathy (HE), changes in the functioning of systemic organs, and an imbalance in a number of energy metabolites. The deferred effects after acute HE development are poorly understood. The study considers the balance of the tricarboxylic acid (TCA) cycle metabolites in the blood plasma, liver, kidneys, and brain tissues of rats in the post-rehabilitation period. The samples of the control (n = 3) and TAA-induced groups of rats (n = 13) were collected six days after the administration of a single intraperitoneal TAA injection at doses of 200, 400, and 600 mg/kg. Despite the complete physiological recovery of rats by this date, a residual imbalance of metabolites in all the vital organs was noted. The results obtained showed a trend of stabilizing processes in the main organs of the animals and permit the use of these data both for prognostic purposes and the choice of potential therapeutic agents.


Subject(s)
Brain Diseases , Hepatic Encephalopathy , Liver Failure, Acute , Rats , Animals , Hepatic Encephalopathy/chemically induced , Thioacetamide/toxicity , Tricarboxylic Acids/metabolism , Liver/metabolism , Liver Failure, Acute/chemically induced , Brain Diseases/metabolism
8.
Signal Transduct Target Ther ; 8(1): 39, 2023 Jan 17.
Article in English | MEDLINE | ID: mdl-36650130

ABSTRACT

Nucleic acid drugs have the advantages of rich target selection, simple in design, good and enduring effect. They have been demonstrated to have irreplaceable superiority in brain disease treatment, while vectors are a decisive factor in therapeutic efficacy. Strict physiological barriers, such as degradation and clearance in circulation, blood-brain barrier, cellular uptake, endosome/lysosome barriers, release, obstruct the delivery of nucleic acid drugs to the brain by the vectors. Nucleic acid drugs against a single target are inefficient in treating brain diseases of complex pathogenesis. Differences between individual patients lead to severe uncertainties in brain disease treatment with nucleic acid drugs. In this Review, we briefly summarize the classification of nucleic acid drugs. Next, we discuss physiological barriers during drug delivery and universal coping strategies and introduce the application methods of these universal strategies to nucleic acid drug vectors. Subsequently, we explore nucleic acid drug-based multidrug regimens for the combination treatment of brain diseases and the construction of the corresponding vectors. In the following, we address the feasibility of patient stratification and personalized therapy through diagnostic information from medical imaging and the manner of introducing contrast agents into vectors. Finally, we take a perspective on the future feasibility and remaining challenges of vector-based integrated diagnosis and gene therapy for brain diseases.


Subject(s)
Brain Diseases , Nucleic Acids , Humans , Pharmaceutical Preparations , Nucleic Acids/genetics , Nucleic Acids/therapeutic use , Genetic Therapy , Brain Diseases/diagnosis , Brain Diseases/drug therapy , Brain Diseases/genetics , Drug Delivery Systems/methods
9.
Physiol Res ; 71(S2): S259-S275, 2022 Dec 31.
Article in English | MEDLINE | ID: mdl-36647914

ABSTRACT

Disruption of the blood-brain barrier (BBB) is a key feature of various brain disorders. To assess its integrity a parametrization of dynamic magnetic resonance imaging (DCE MRI) with a contrast agent (CA) is broadly used. Parametrization can be done quantitatively or semi-quantitatively. Quantitative methods directly describe BBB permeability but exhibit several drawbacks such as high computation demands, reproducibility issues, or low robustness. Semi-quantitative methods are fast to compute, simply mathematically described, and robust, however, they do not describe the status of BBB directly but only as a variation of CA concentration in measured tissue. Our goal was to elucidate differences between five semi-quantitative parameters: maximal intensity (Imax), normalized permeability index (NPI), and difference in DCE values between three timepoints: baseline, 5 min, and 15 min (delta5-0, delta15-0, delta15-5) and two quantitative parameters: transfer constant (Ktrans) and an extravascular fraction (Ve). For the purpose of comparison, we analyzed DCE data of four patients 12-15 days after the stroke with visible CA enhancement. Calculated parameters showed abnormalities spatially corresponding with the ischemic lesion, however, findings in individual parameters morphometrically differed. Ktrans and Ve were highly correlated. Delta5-0 and delta15-0 were prominent in regions with rapid CA enhancement and highly correlated with Ktrans. Abnormalities in delta15-5 and NPI were more homogenous with less variable values, smoother borders, and less detail than Ktrans. Moreover, only delta15-5 and NPI were able to distinguish vessels from extravascular space. Our comparison provides important knowledge for understanding and interpreting parameters derived from DCE MRI by both quantitative and semi-quantitative methods.


Subject(s)
Blood-Brain Barrier , Brain Diseases , Humans , Blood-Brain Barrier/diagnostic imaging , Reproducibility of Results , Magnetic Resonance Imaging/methods , Contrast Media
10.
J Agric Food Chem ; 71(3): 1577-1592, 2023 Jan 25.
Article in English | MEDLINE | ID: mdl-36634244

ABSTRACT

Ulcerative colitis (UC) is associated with brain neurotransmitter disorders and intestinal dysbiosis. Bacillus amyloliquefaciens fmb50 produces the lipopeptide surfactin, which has a wide range of biological activities. However, the effects of surfactin on DSS-induced colitis have not been reported. In the present study, oral surfactin significantly ameliorated colitis in a mouse model and reduced depression-like behavior, such as slowed walking speed, shortened movement distance in the open field test, and weakened exploration ability in the light-dark shuttle test. Surfactin noticeably improved gut microbial dysbiosis, intestinal barrier dysfunction in the colon, and blood-brain barrier dysfunction in the brain. Furthermore, the colon levels of occludin were upregulated by 68.51%, and the brain levels of occludin and ZO-1 were upregulated by 77.81% and 36.42%, respectively. Surfactin supplementation also inhibited inflammatory responses by inactivating the tumor necrosis factor-α (TNF-α), nuclear factor kappa-B (NF-κB), and NLRP3 signaling pathways in the colon and brain. Thus, we believe that surfactin improved the behavioral disorders by upregulating the levels of 5-hydroxytryptamine (5-HT), 5-hydroxyindoleacetic acid (5-HIAA), norepinephrine (NE), and brain-derived neurotrophic factor (BDNF), suppressing the inflammatory responses, and improving the blood-brain barrier dysfunction. Surfactin also reduced the abundances of gut microbes that are related to colitis, especially targeting facultative anaerobes of the phylum Proteobacteria, and it increased the abundance of beneficial bacteria such as Lactobacillus and unidentified Prevotella. Combined with its nontoxic nature observed in this long-term study in mice, oral surfactin might be a promising intervention strategy for preventing colitis by acting on the microbiota-gut-brain axis.


Subject(s)
Brain Diseases , Coleoptera , Colitis, Ulcerative , Colitis , Animals , Mice , Dextrans , Brain-Gut Axis , Dysbiosis , Occludin , Colitis/chemically induced , Colitis/drug therapy , Colon , Brain , Disease Models, Animal , Dextran Sulfate/adverse effects , Mice, Inbred C57BL
11.
Rev. esp. anestesiol. reanim ; 70(1): 51-55, Ene. 2023. ilus
Article in Spanish | IBECS | ID: ibc-214184

ABSTRACT

El síndrome de encefalopatía posterior reversible es un trastorno neurológico agudo caracterizado por una sintomatología variable e imágenes radiológicas características de edema vasogénico parietooccipital. Está asociado a condiciones clínicas como hipertensión arterial, infección/sepsis o fármacos citotóxicos/inmunosupresores, entre otros. Se caracteriza fisiopatológicamente por daño endotelial con rotura de la barrera hematoencefálica, hipoperfusión cerebral y edema vasogénico. Presentamos 2 casos de pacientes críticos COVID-19 que ingresaron por neumonía con necesidad de ventilación mecánica y que tras retirar la sedación desarrollaron clínica neurológica aguda y reversible consistente en epilepsia y encefalopatía, asociada a lesiones subcorticales hiperintensas en la resonancia magnética cerebral compatibles con síndrome de encefalopatía posterior reversible. El coronavirus SARS-CoV-2 activaría una respuesta inflamatoria que produciría daño en el endotelio cerebral. Este último podría ser desencadenado por la liberación de citocinas, así como por una lesión viral directa, dado que el endotelio expresa receptores ACE2. Esto podría explicar la posible asociación entre el síndrome de encefalopatía posterior reversible y la COVID-19.(AU)


Posterior reversible encephalopathy syndrome is an acute neurological disorder characterized by variable symptoms and radiological images characteristic of vasogenic parietal-occipital edema. It is associated with clinical conditions such as high blood pressure, infection/sepsis, or cytotoxic/immunosuppressive drugs, among others. It is characterized pathophysiologically by endothelial damage with breakdown of blood-brain barrier, cerebral hypoperfusion, and vasogenic edema. The cases are presented on 2 critical COVID-19 patients who were admitted to pneumonia requiring mechanical ventilation and who, after removing sedation, developed acute and reversible neurological symptoms consisting of epilepsy and encephalopathy, associated with hyperintense subcortical lesions on brain magnetic resonance imaging compatible with posterior reversible encephalopathy syndrome. SARS-CoV-2 coronavirus would activate an inflammatory response that would damage brain endothelium. It could be triggered by cytokine release, as well as by direct viral injury, given that endothelium expresses ACE2 receptors. It could explain the possible association between posterior reversible encephalopathy syndrome and COVID-19.(AU)


Subject(s)
Humans , Male , Aged , Brain Diseases , Coronavirus Infections , Epilepsy , Inpatients , Physical Examination , Leukoencephalopathy, Progressive Multifocal , Nervous System Diseases
12.
Biomed Res Int ; 2022: 9692804, 2022.
Article in English | MEDLINE | ID: mdl-36624852

ABSTRACT

Purpose: The diagnosis of tuberculous meningitis (TBM) is difficult and relies on the patient's clinical presentation and initial cerebrospinal fluid testing. Treatment outcomes for some patients with early consideration of TBM meningitis are often poor. Patients and Methods. In this study, we retrospectively analyzed 24 non-TBM patients whose early changes of cerebrospinal fluid were similar to those of TBM through the second-generation cerebrospinal fluid sequencing technology. Results: All patients included in this study had an acute onset, including 5 patients with a history of upper respiratory tract infection, 9 patients with fever, 6 patients with headache, 5 patients with psychiatric symptoms, 6 patients with cognitive impairment, 9 patients with signs of meningeal irritation, and 6 patients with seizures. Sixteen patients presented with altered content and level of consciousness during their admission. The leukocyte counts (median, 124.0 × 106/L) and total protein concentrations (median, 1300 mg/L) were higher than normal reference values in all patients, whereas glucose (median, 1.345 mmol/L) and chloride concentration values (average, 111.7 ± 5.2 mmol/L) were lower than normal reference values. The patients included 2 cases of Liszt's meningitis, 2 cases of Brucella infection in the CNS, 4 cases of Varicella zoster virus encephalitis, 2 cases of human herpes simplex virus type 1, 2 cases of lupus encephalopathy, 2 cases of anti-NMDAR receptor encephalitis, 2 cases of meningeal carcinomatosis, 5 cases of cryptococcal meningitis, 2 cases of CNS sarcoidosis, and a case of invasive Rhizopus oryzae infection. All patients were tested for NGS in cerebrospinal fluid. Eight patients were diagnosed with anti-NMDAR encephalitis, meningeal carcinomatosis, lupus encephalopathy, and CNS sarcoidosis. Nine patients experienced death; 15 patients had a good prognosis and left no significant sequelae. Conclusion: The analysis of patients with TBM-like cerebrospinal fluid changes will help improve the diagnostic accuracy of the disease and reduce misdiagnosis and underdiagnosis.


Subject(s)
Brain Diseases , Encephalitis , Meningeal Carcinomatosis , Sarcoidosis , Tuberculosis, Meningeal , Humans , Tuberculosis, Meningeal/diagnosis , Retrospective Studies , Meningeal Carcinomatosis/complications , Cerebrospinal Fluid
13.
Cochrane Database Syst Rev ; 1: CD013808, 2023 01 10.
Article in English | MEDLINE | ID: mdl-36625680

ABSTRACT

BACKGROUND: Continuous fetal heart rate monitoring by cardiotocography (CTG) is used in labour for women with complicated pregnancies. Fetal heart rate abnormalities are common and may result in the decision to expedite delivery by caesarean section. Fetal scalp stimulation (FSS) is a second-line test of fetal well-being that may provide reassurance that the labour can continue. OBJECTIVES: To evaluate methods of FSS as second-line tests of intrapartum fetal well-being in cases of non-reassuring CTG. FSS and CTG were compared to CTG alone, and to CTG with fetal blood sampling (FBS). SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register (which includes trials from CENTRAL, MEDLINE, Embase, CINAHL, the WHO ICTRP and conference proceedings), ClinicalTrials.gov (18 October 2022), and reference lists of retrieved studies. SELECTION CRITERIA: Eligible studies were randomised controlled trials (RCTs) that compared any form of FSS to assess fetal well-being in labour. Quasi-RCTs, cluster-RCTs and studies published in abstract form were also eligible for inclusion, but none were identified. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for inclusion and risk of bias, extracted data and checked them for accuracy. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS: Two trials, involving 377 women, met the inclusion criteria for this review. Both trials were conducted in hospital settings and included women with singleton, term (37+0 weeks or more) pregnancies, a cephalic presentation, and abnormal CTG. Follow-up was until hospital discharge after the birth. A pilot trial of 50 women in a high-income country (Ireland) compared CTG and digital fetal scalp stimulation (dFSS) with CTG and fetal blood sampling (FBS). A single-centre trial of 327 women in a lower middle-income country (India) compared CTG and manual fetal stimulation (abdominal or vaginal scalp stimulation) with CTG alone. The two included studies were at moderate or unclear risk of bias. Both trials provided clear information on allocation concealment but it was not possible to blind participants or health professionals in relation to the intervention. Although objective outcome measures were reported, outcome assessment was not blinded or blinding was unclear. dFSS and CTG versus FBS and CTG There were no perinatal deaths and data were not reported for neurodevelopmental disability at >/= 12 months. The risk of caesarean section (CS) may be lower with dFSS compared to FBS (risk ratio (RR) 0.38, 95% confidence interval (CI) 0.16 to 0.92; 1 pilot trial, 50 women; very low-certainty evidence) but the evidence is very uncertain. There were no cases of neonatal encephalopathy reported. The evidence was also very uncertain between dFSS and FBS for assisted vaginal birth (RR 1.44, 95% CI 0.76 to 2.75; very low-certainty evidence) and for the spontaneous vaginal birth rate (RR 2.33, 95% CI 0.68 to 8.01, very low-certainty evidence). Maternal acceptability of the procedures was not reported. FSS and CTG versus CTG alone Manual stimulation of the fetus was performed either abdominally (92/164) or vaginally (72/164). There were no perinatal deaths and data were not reported for neurodevelopmental disability at >/= 12 months. There may be little differences in the risk of CS on comparing manual fetal stimulation and CTG with CTG alone (RR 0.83, 95% CI 0.59 to 1.18; 1 trial, 327 women; very low-certainty evidence), but again the evidence was very uncertain. There were no cases of neonatal encephalopathy reported. There may be no differences in the risk of assisted vaginal birth (RR 1.43, 95% CI 0.78 to 2.60; very low-certainty evidence) or in the rates of spontaneous vaginal birth (RR 1.01, 95% CI 0.85 to 1.21, very low-certainty evidence), but again the evidence is very uncertain. Maternal acceptability of abdominal stimulation/FSS was not reported although 13 women withdrew consent after randomisation due to concerns about fetal well-being. AUTHORS' CONCLUSIONS: There is very low-certainty evidence available which makes it unclear whether stimulating the fetal scalp is a safe and effective way to confirm fetal well-being in labour. Evidence was downgraded based on limitations in study design and imprecision. Further high-quality studies of adequate sample size are required to evaluate this research question. In order to be generalisable, these trials should be conducted in different settings, including broad clinical criteria at both preterm and term gestational ages, and standardising the method of stimulation. There is an ongoing study (FIRSST) that will be incorporated into this review in a subsequent update.


Subject(s)
Brain Diseases , Labor, Obstetric , Perinatal Death , Infant, Newborn , Female , Pregnancy , Humans , Scalp , Parturition , Fetus
14.
Psicosom. psiquiatr ; (23): 60-62, Oct-Dic. 2022.
Article in English, Spanish | IBECS | ID: ibc-214152

ABSTRACT

El artículo presenta la definición actual y comprehensible de la Esquizofrenia, incluyendo todos los aspectos que involucran al concepto.(AU)


The article present the current comprehensive definition of Schizophrenia, including all the aspects involves in the concept.(AU)


Subject(s)
Humans , Schizophrenia , Cerebrum , Brain Diseases , Psychic Symptoms , Psychosomatic Medicine , Psychiatry
15.
Sensors (Basel) ; 23(1)2022 Dec 27.
Article in English | MEDLINE | ID: mdl-36616876

ABSTRACT

Brain abnormality causes severe human problems, and thorough screening is necessary to identify the disease. In clinics, bio-image-supported brain abnormality screening is employed mainly because of its investigative accuracy compared with bio-signal (EEG)-based practice. This research aims to develop a reliable disease screening framework for the automatic identification of schizophrenia (SCZ) conditions from brain MRI slices. This scheme consists following phases: (i) MRI slices collection and pre-processing, (ii) implementation of VGG16 to extract deep features (DF), (iii) collection of handcrafted features (HF), (iv) mayfly algorithm-supported optimal feature selection, (v) serial feature concatenation, and (vi) binary classifier execution and validation. The performance of the proposed scheme was independently tested with DF, HF, and concatenated features (DF+HF), and the achieved outcome of this study verifies that the schizophrenia screening accuracy with DF+HF is superior compared with other methods. During this work, 40 patients' brain MRI images (20 controlled and 20 SCZ class) were considered for the investigation, and the following accuracies were achieved: DF provided >91%, HF obtained >85%, and DF+HF achieved >95%. Therefore, this framework is clinically significant, and in the future, it can be used to inspect actual patients' brain MRI slices.


Subject(s)
Brain Diseases , Ephemeroptera , Schizophrenia , Animals , Humans , Schizophrenia/diagnostic imaging , Magnetic Resonance Imaging/methods , Algorithms , Brain/diagnostic imaging
16.
Cells ; 12(1)2022 Dec 26.
Article in English | MEDLINE | ID: mdl-36611896

ABSTRACT

Brain-derived extracellular vesicles (BDEVs) are released from the central nervous system. Brain-related research and diagnostic techniques involving BDEVs have rapidly emerged as a means of diagnosing brain disorders because they are minimally invasive and enable repeatable measurements based on body fluids. However, EVs from various cells and organs are mixed in the blood, acting as potential obstacles for brain diagnostic systems using BDEVs. Therefore, it is important to screen appropriate brain EV markers to isolate BDEVs in blood. Here, we established a strategy for screening potential BDEV biomarkers. To collect various molecular data from the BDEVs, we propose that the sensitivity and specificity of the diagnostic system could be enhanced using machine learning and AI analysis. This BDEV-based diagnostic strategy could be used to diagnose various brain diseases and will help prevent disease through early diagnosis and early treatment.


Subject(s)
Artificial Intelligence , Brain Diseases , Humans , Biomarkers , Brain , Brain Diseases/diagnosis , Early Diagnosis
17.
BMC Neurol ; 23(1): 7, 2023 Jan 07.
Article in English | MEDLINE | ID: mdl-36609211

ABSTRACT

BACKGROUND: Cytokine levels have been measured in acute encephalopathy (AE) to determine its pathology or as a diagnostic biomarker to distinguish it from febrile seizures (FS); however, the dynamics of cytokine level changes have not yet been fully captured in these two neurological manifestations. Thus, we aimed to explore the time course of serum cytokine level changes within 72 h after onset in AE and FS. METHODS: We retrospectively measured cytokine level in residual serum samples at multiple timepoints in seven children whose final diagnoses were AE or FS. RESULTS: The levels of 13 cytokines appeared to increase immediately after onset and peaked within 12-24 h after onset: interleukin (IL)-1ß, IL-4 IL-5, IL-6, IL-8, IL-10, IL-17, eotaxin, fibroblast growth factor, granulocyte colony-stimulating factor, interferon gamma, interferon-inducible protein-10, and macrophage chemoattractant protein-1. There were no dynamic changes in the levels of three cytokines (IL-1 receptor agonist, macrophage inflammatory protein-1α, and platelet-derived growth factor-bb) 72 h after onset. Levels of some cytokines decreased to around control levels within 48 h after onset: IL-1ß, IL-4, IL-5, IL-17, fibroblast growth factor, and interferon gamma. The levels of most cytokines appeared to be higher in AE, especially in hemorrhagic shock encephalopathy syndrome, than in FS. CONCLUSIONS: Cytokine levels in both AE and FS change dynamically, such as the levels of several cytokines increased within a few hours after onset and decreased at 12-24 h after onset. Therefore, it will be desirable to make clinical decisions regarding the administration of anti-inflammatory therapy in 24 h after onset in AE.


Subject(s)
Brain Diseases , Seizures, Febrile , Child , Humans , Cytokines , Interleukin-17 , Interferon-gamma , Interleukin-4 , Retrospective Studies , Interleukin-5
18.
Nat Commun ; 14(1): 105, 2023 Jan 06.
Article in English | MEDLINE | ID: mdl-36609405

ABSTRACT

Myelination processes are closely related to higher brain functions such as learning and memory. While their longitudinal observation has been crucial to understanding myelin-related physiology and various brain disorders, skull opening or thinning has been required to secure clear optical access. Here we present a high-speed reflection matrix microscope using a light source with a wavelength of 1.3 µm to reduce tissue scattering and aberration. Furthermore, we develop a computational conjugate adaptive optics algorithm designed for the recorded reflection matrix to optimally compensate for the skull aberrations. These developments allow us to realize label-free longitudinal imaging of cortical myelin through an intact mouse skull. The myelination processes of the same mice were observed from 3 to 10 postnatal weeks to the depth of cortical layer 4 with a spatial resolution of 0.79 µm. Our system will expedite the investigations on the role of myelination in learning, memory, and brain disorders.


Subject(s)
Brain Diseases , Microscopy , Mice , Animals , Myelin Sheath , Brain/diagnostic imaging , Brain/physiology , Skull/physiology
19.
Diagn Pathol ; 18(1): 1, 2023 Jan 04.
Article in English | MEDLINE | ID: mdl-36597112

ABSTRACT

BACKGROUND: Hyperammonemic encephalopathy (HE) is a rare and life-threatening complication of multiple myeloma, with underlying mechanisms that are not fully understood. In contrast to previously reported cases, most of which have been associated with IgG or IgA isotypes, we describe a patient with HE as the presenting symptom of non-producer multiple myeloma (NPMM). CASE PRESENTATION: A 60-year-old man developed lethargy that progressed into coma. He was found to have an elevated ammonia level, despite normal hepatic function. He was diagnosed with HE secondary to NPMM, demonstrating 80% plasma cells without light chain expression in the bone marrow and absence of a monoclonal protein in the serum or urine, including by matrix-assisted laser desorption ionization time-of-flight mass-spectrometry (MASS-FIX). Myeloma-directed therapy with daratumumab, bortezomib, cyclophosphamide and dexamethasone successfully reversed his HE. At clinical relapse, he received salvage chemotherapy followed by venetoclax therapy, leading to a short period of neurological recovery. CONCLUSIONS: This case demonstrates that HE can occur in a patient with NPMM and challenges the mechanism suggested by limited prior studies; i.e., that excess ammonia in multiple myeloma arises from degradation of M-proteins. We postulate that the neoplastic plasma cells in NPMM have amplified amino acid metabolism, despite lacking detectable intracellular or secreted immunoglobulins.


Subject(s)
Brain Diseases , Multiple Myeloma , Male , Humans , Middle Aged , Multiple Myeloma/complications , Multiple Myeloma/diagnosis , Ammonia/therapeutic use , Neoplasm Recurrence, Local , Bortezomib/therapeutic use
20.
BMJ Case Rep ; 15(12)2022 Dec 30.
Article in English | MEDLINE | ID: mdl-36585049

ABSTRACT

Clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a clinicoradiologic syndrome diagnosed by temporary hyperintense lesion in the area, including the splenium of the corpus callosum, on diffusion-weighted imaging and neuropsychiatric symptoms that recover without sequelae. MERS is rare in adults, especially elderly people. We herein report a man in his 60s diagnosed with MERS caused by Legionella pneumonia. He completely recovered with only the administration of levofloxacin and azithromycin despite the risk factors of an advanced age, medical history of untreated hypertension, bilateral spontaneous pneumothoraxes, smoking and drinking habits and pulmonary emphysema. To our knowledge, this is the oldest case of MERS due to Legionella pneumonia and extremely old among total MERS cases. Our research revealed that Legionella species are the most common pathogens of adult-onset MERS, while viruses are the main causative factors in children. This case helps clarify the features of MERS in high-risk adults.


Subject(s)
Brain Diseases , Encephalitis , Legionella , Legionnaires' Disease , Pneumonia , Male , Adult , Child , Humans , Aged , Brain Diseases/complications , Encephalitis/diagnostic imaging , Encephalitis/etiology , Legionnaires' Disease/complications , Legionnaires' Disease/diagnosis , Legionnaires' Disease/drug therapy , Corpus Callosum/diagnostic imaging , Corpus Callosum/pathology , Pneumonia/complications , Magnetic Resonance Imaging
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