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Ischemic stroke is one of the catastrophic neurological events that are being increasingly recognized among Coronavirus Disease (COVID)-19 patients. The recent studies have revealed about a possible connection among COVID-19, ischemic stroke, and excessive Neutrophil Extracellular Traps (NETs) formation. This paper establishes an overview of coronaviruses and NETs, NETs in pathogenesis of COVID-19 induced-ischemic stroke, and future directions using related recent literatures. NETs are normally functioned for a defense against pathogens, but in immoderate amount, they can trigger series of destructive events. Vasculopathy and neuroinflammation are the pathological mechanisms of NETs suggested to link COVID-19 and ischemic stroke. Based on newly discovered possible mechanisms, the potential clinical implications that could be applied consists of inhibition of NET formation, disrupting cholesterol synthesis, and interfering inflammatory pathway. A considerable number of scientific works are needed in order to complete the current understanding of the emerging relationship among COVID-19, NETs, and ischemic stroke. Although the exact mechanism is still unknown, these novel findings are a worthwhile contribution in defining future studies, suitable future frameworks, and therapeutic strategies.
RESUMO
BACKGROUND: Musical artwork using Balinese flutes made from bamboo (timing buluh) by Agus Teja Sentosa, S.Sn is a combination of music played with flute as the main instrument which contains certain components resembling music therapy such as in western classical music by Antonio Lucio Vivaldi. AIM: This study aims to determine the improvement of cognitive function and increase in serum dopamine in the elderly after listening to music with Balinese flute as the main instrument. METHOD: The current study allocated 18 subjects in the control group listened to western classical music by Antonio Lucio Vivaldi, while 18 subjects in the intervention group listened to western classical music and music from Balinese flute as the main instrument by Agus Teja Sentosa, S.Sn. MoCA-Ina assessment and examination of serum dopamine levels were carried out initially and 21 days after listening to music intervention. RESULTS: The mean increase in cognitive function score was higher in the intervention group (5.22; p < 0.001) than in the control group (4.67; p < 0.001), this increase was not statistically significant with a value of p = 0.562 (p > 0.005). The mean increase in dopamine levels in the control group (3.60) was greater than in the treatment group (3.56), but the mean increase was not statistically significant (p = 0.085). CONCLUSION: There was a significant relationship between listening to the main instrumental Balinese flute music and the improvement of cognitive function, especially in the memory domain in all study subjects, but the mean increase in cognitive function and serum dopamine level did not reach statistical significance.
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BACKGROUND: Air pollution due to lead contained in motor vehicle fuel is inhaled for a long period causing cognitive impairment. Cognitive disorders in general fuel station operators are found in developing countries as a negative impact of environmental pollution. AIM: This study aims to find out that high levels of lead in the blood increase the risk of cognitive impairment in operators of Public Fuel Filling Stations. METHODS: This was a case-control study design to determine high lead levels in the blood increasing the risk of cognitive impairment in operators of General Fuel Filling Stations. There were 76 study subjects consisting of 38 case groups and 38 control groups. RESULTS: Obtained lead levels of all research subjects in normal criteria (1.1-5.58 µg/dL). We used MoCA-Ina (a validated Indonesian version of MoCA questionnaire) to evaluate the cognitive function. High lead levels in the blood in the case group were 28 subjects (66.7%) and 14 subjects (33.7%) in the control group. Factors that significantly affected the occurrence of cognitive disorders are work periods of more than 3 years, which are 4 times higher risk of experiencing cognitive impairment (p = 0.021). CONCLUSION: High lead levels in the blood have a 6 times greater risk of cognitive impairment than subjects with not high blood lead levels and work periods of more than 3 years have a risk of 6 times greater cognitive impairment.
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BACKGROUND: Brain vitalisation gymnastics (BVG) is a form of physical exercise which attempts to synchronise bodily movements with cognition within the same time frame. AIM: This study aims to prove BVG can improve cognitive function among the elderly. METHODS: The impact of BVG was evaluated as opposed to elderly gymnastics (regarded as a control group) for a 4-week study period. Outcomes measured were improvements of cognitive function assessed by MoCA-Ina questionnaire, as well as the difference in serum levels of BDNF, IL-6, and S100ß. An experimental pretest-posttest control design was applied to evaluate BDNF and IL-6 levels, while the post-test only designed to evaluate S100ß levels. Parametric data were tested for normality before being proceeded into either parametric (independent student' t) or non-parametric (Mann Whitney) test. RESULTS: BVG significantly improved cognitive function better than elderly gymnastics with MoCA-Ina score of 1.53 ± 1.58 dan 0.11 ± 2.54, respectively (p ≤ 0.047). BVG group also had increased BDNF levels when compared with control (-6020.58 ± 7857.22 dan 0.11 ± 2.54; p = 0.027). Whereas BVG had lower IL-6 levels as opposed to the control group (median pre-test IL-6: 2212, median post-test IL-6: 3197.50; p = 0.004). Meanwhile, S100ß levels were found lower among BVG when compared with the control group, although statistically insignificant (p = 0.40). CONCLUSION: BVG programme for 4 weeks improved: (1) brain plasticity as shown by increased serum BDNF and S100ß levels (although the latter was statistically not-significant), as well as marked decrease of IL-6 levels, (2) cognitive function as proven by an increase of MoCA-Ina score when compared with elderly gymnastics.
