ABSTRACT
BACKGROUND: To suggest a new way of eliciting pyramidal tract dysfunction in adults since the most widely utilized plantar reflex, which is the Babinski reflex, has limitations with different reliability and consistency among different examiners. MATERIALS AND METHODS: 168 adult subjects were examined for the new sign in addition. It consists of just an observation of the patient's feet and toes in a conscious patient looking for the extension of the great toe along with fanning, spreading and plantar flexion of the small toes either at rest or when patient elevates one leg up at a time. RESULTS: We were able to observe the extension of the great toe along with fanning, spreading and plantar flexion of the small toes in patients with impairment of pyramidal tract. The specificity was 94% while the sensitivity was 96%. CONCLUSION: Pyramidal tract lesion in adults can be elicited by this new test that observes the extension of the great toe along with fanning, spreading and plantar flexion of the small toes in patients. We suggest this sign as a complement to established signs like Babinski reflex.
Subject(s)
Brain Infarction/physiopathology , Cerebral Small Vessel Diseases/physiopathology , Foot , Multiple Sclerosis/physiopathology , Neurologic Examination/methods , Pyramidal Tracts/physiopathology , Toes , Adolescent , Adult , Aged , Aged, 80 and over , Case-Control Studies , Female , Humans , Male , Middle Aged , Reflex, Babinski/physiology , Reproducibility of Results , Sensitivity and Specificity , Young AdultSubject(s)
Depressive Disorder/drug therapy , Dopamine Uptake Inhibitors/adverse effects , Serotonin and Noradrenaline Reuptake Inhibitors/adverse effects , Tachycardia, Sinus/chemically induced , Venlafaxine Hydrochloride/adverse effects , Dopamine Uptake Inhibitors/administration & dosage , Humans , Serotonin and Noradrenaline Reuptake Inhibitors/administration & dosage , Venlafaxine Hydrochloride/administration & dosageSubject(s)
Celiac Disease/complications , Cholesterol/blood , Depressive Disorder, Major/complications , Dermatitis Herpetiformis/complications , Antidepressive Agents/therapeutic use , Celiac Disease/blood , Depressive Disorder, Major/blood , Dermatitis Herpetiformis/blood , Female , Humans , Middle Aged , Sertraline/therapeutic useSubject(s)
Hallucinations/etiology , Platelet Aggregation Inhibitors/adverse effects , Ticlopidine/analogs & derivatives , Aged, 80 and over , Auditory Perception/drug effects , Clopidogrel , Female , Hallucinations/therapy , Humans , Platelet Aggregation Inhibitors/therapeutic use , Ticlopidine/adverse effects , Ticlopidine/therapeutic use , Visual Perception/drug effectsABSTRACT
Celery root belongs to a group of plants classified as the umbelliferous family, which contains phytoestrogens. Phytoestrogens are structurally similar to estrogen as they share a pair of hydroxyl groups and phenolic ring, which enables them to bind to estrogen receptors directly, making them a herbal remedy for low estrogen states such as menopause. We present a case of a female patient with depression who was stabilized on venlafaxine and St John's Wort, and who developed a manic episode due to elevated serum venlafaxine levels after she started taking celery extracts for menopausal related issues. We proffer a hypothesis for this unusual occurrence.
Subject(s)
Apium/adverse effects , Bipolar Disorder , Depressive Disorder, Major/drug therapy , Hypericum , Phytotherapy , Venlafaxine Hydrochloride/administration & dosage , Antidepressive Agents, Second-Generation/administration & dosage , Bipolar Disorder/chemically induced , Bipolar Disorder/diagnosis , Bipolar Disorder/therapy , Depressive Disorder, Major/diagnosis , Female , Herb-Drug Interactions , Humans , Menopause/drug effects , Middle Aged , Phytotherapy/adverse effects , Phytotherapy/methods , Plant Preparations/administration & dosage , Plant Preparations/adverse effects , Plant Roots/adverse effects , Psychiatric Status Rating Scales , Treatment Outcome , Withholding TreatmentABSTRACT
Very few studies have shown associations between autism spectrum disorder, attention deficit hyperactivity disorder and Chiari 1 malformation. Here, we report an 10-year-old male that presented after having seizures with a history of Chiari 1 malformation, autism spectrum disorder and ADHD with moderate mental retardation and speech delay. This case highlights the fact that autism spectrum disorder as biologically based neurodevelopmental disorder with altered brain growth may be associated with Chiari 1 malformation and ADHD.
Subject(s)
Arnold-Chiari Malformation/complications , Autism Spectrum Disorder/etiology , Arnold-Chiari Malformation/diagnosis , Arnold-Chiari Malformation/pathology , Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/etiology , Autism Spectrum Disorder/diagnosis , Brain/pathology , Child , Humans , Intellectual Disability/diagnosis , Intellectual Disability/etiology , Language Development Disorders/diagnosis , Language Development Disorders/etiology , MaleABSTRACT
Blunt trauma causing facial nerve palsy and facial nerve trauma due to seat belt injury is rarely reported. We describe a 63 year old female who was involved in a road traffic accident without any imaging evidence of temporal bone fracture developing left facial nerve palsy on the second day. We discuss the pathophysiology of this condition and the need to be aware of this unusual complication when evaluating patient with blunt trauma to the face.
Subject(s)
Delayed Diagnosis , Facial Injuries/complications , Facial Nerve Diseases/etiology , Facial Paralysis/etiology , Seat Belts/adverse effects , Wounds, Nonpenetrating/complications , Accidents, Traffic , Diagnostic Imaging , Facial Injuries/diagnosis , Facial Nerve Diseases/diagnosis , Facial Nerve Diseases/therapy , Facial Paralysis/diagnosis , Facial Paralysis/therapy , Female , Humans , Middle Aged , Time FactorsABSTRACT
Olanzapine has previously been shown to stimulate the growth of neuronal cells in culture. A major goal of the present studies was to determine if olanzapine also provided neuroprotection to pheochromocytoma (PC12) cells, SH-SY5Y neuroblastoma cells, and primary cultures of rat cortical neurons. Olanzapine was mitogenic and enhanced the survival of PC12 cells, SH-SY5Y cells and 3T3 preadipocytes, but not L6 myoblasts or myeloma cells. It protected neuronal cells from death induced by serum and glutamine deprivation, amyloid beta peptide (25-35), and fluphenazine. Molecular mechanisms of the neuroprotection by olanzapine were explored, specifically the activation of various protein kinase signaling pathways including Akt/protein kinase B (PKB), extracellular-regulated kinase (ERK), ERK1/2, and mitogen-activated protein kinase (MAPK), p38. Olanzapine treatment led to rapid phosphorylation of kinases from all three pathways in PC12 cells. Phosphorylation of Akt was blocked with selective inhibitors (wortmannin and LY294002), which implicates phosphoinositide 3-kinase (PI3K) in the signaling cascade. Short-term mitogenic effects of olanzapine were abolished with a selective inhibitor of Akt, but not by inhibition of the ERK pathway. Other antipsychotic drugs stimulated phosphorylation of a subset of the kinase panel, but not all three kinases. The present findings demonstrate that olanzapine has both mitogenic and neuroprotective effects in neuronal cells.
Subject(s)
Benzodiazepines/pharmacology , Mitogen-Activated Protein Kinase 1/metabolism , Mitogen-Activated Protein Kinases/metabolism , Protein Serine-Threonine Kinases/metabolism , 3-Phosphoinositide-Dependent Protein Kinases , Amyloid beta-Peptides/pharmacology , Animals , Antipsychotic Agents/pharmacology , Blotting, Western/methods , Bromodeoxyuridine/metabolism , Cell Division/drug effects , Cells, Cultured , Cerebral Cortex/cytology , Cerebral Cortex/drug effects , Culture Media, Serum-Free/pharmacology , Dose-Response Relationship, Drug , Drug Interactions , Enzyme Activation/drug effects , Enzyme Inhibitors/pharmacology , Humans , Mice , Mitogen-Activated Protein Kinase 3 , Neuroblastoma , Neurons/drug effects , Neurons/enzymology , Olanzapine , Peptide Fragments/pharmacology , Pertussis Toxin/pharmacology , Phosphorylation/drug effects , Rats , Tetrazolium Salts , Thiazoles , Time Factors , p38 Mitogen-Activated Protein KinasesABSTRACT
BACKGROUND: This was an open-label, single-center study of the long-term efficacy and effectiveness of venlafaxine extended release (XR) in the treatment of chronic pain and depression in outpatients. All patients have been diagnosed with major depressive disorder (MDD) of various types, with or without chronic pain, and had previously failed treatment with either tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs). METHODS: Efficacy of treatment was determined using the 21-item Hamilton Rating Scale for Depression (HAMD-21), the Visual Analogue Scale (VAS) for the evaluation of pain, and a 12-item quality of life scale (QOL). Patients were treated in an unblended open trial for 1 year with 150 mg or more of venlafaxine XR once daily. RESULTS: After 1 year of treatment, 21-item Hamilton Rating Scale for Depression, Visual Analogue Scale, and quality of life scores were significantly improved from permanent baseline scores. CONCLUSION: These data show long-term efficacy and effectiveness of venlafaxine XR, a serotonin (5-HT) and norepinephrine (NE) and dopamine (DA) reuptake inhibitor antidepressant agent, having analgesic properties.
Subject(s)
Analgesics/therapeutic use , Antidepressive Agents, Second-Generation/therapeutic use , Cyclohexanols/therapeutic use , Depressive Disorder, Major/drug therapy , Pain/drug therapy , Selective Serotonin Reuptake Inhibitors/therapeutic use , Adult , Analgesics/administration & dosage , Antidepressive Agents, Second-Generation/administration & dosage , Chronic Disease , Cyclohexanols/administration & dosage , Delayed-Action Preparations , Depressive Disorder, Major/complications , Female , Humans , Male , Pain/complications , Pain Measurement , Selective Serotonin Reuptake Inhibitors/administration & dosage , Severity of Illness Index , Time Factors , Treatment Outcome , Venlafaxine HydrochlorideABSTRACT
The goal of these studies was to analyze the cytotoxicity of both the conventional and atypical antipsychotic drugs in relation to their effects on glucose metabolism. The drugs were evaluated for their effects on the viability of PC12 cells, which are an established model of neuronal cells in culture. In general, the conventional drugs, such as chlorpromazine, fluphenazine and pimozide, were more toxic than the atypical drugs, including clozapine, quetiapine and risperidone. Olanzapine was unique in that it stimulated cell proliferation in this system. There was a good correlation between the cytotoxicity of a drug and its ability to block glucose transport, although there were some exceptions to this trend. Conventional antipsychotics also affected the expression of glucose transporter proteins in whole cell extracts and at the cell surface. Overall, the data support the notion that many of the antipsychotic drugs associated with the development of movement disorders in patients are cytotoxic for cultured cells.
