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https://www.readbyqxmd.com/read/29232836/spasticity-management-in-disorders-of-consciousness
#1
REVIEW
Géraldine Martens, Steven Laureys, Aurore Thibaut
Background: Spasticity is a motor disorder frequently encountered after a lesion involving the central nervous system. It is hypothesized to arise from an anarchic reorganization of the pyramidal and parapyramidal fibers and leads to hypertonia and hyperreflexia of the affected muscular groups. While this symptom and its management is well-known in patients suffering from stroke, multiple sclerosis or spinal cord lesion, little is known regarding its appropriate management in patients presenting disorders of consciousness after brain damage...
December 9, 2017: Brain Sciences
https://www.readbyqxmd.com/read/29232800/-a-case-of-fulminant-hepatitis-after-administration-of-abiraterone-acetate
#2
Satoru Yumiba, Kazuhiko Komori, Toshichika Iwanishi, Youhei Koida, Masao Kobayashi, Yutaka Ono
A 77-year-old man with castration-resistant prostate cancer (CRPC) received abiraterone acetate in October 2014. He visited our outpatient clinic because of general malaise and anorexia 27 days after starting abiraterone acetate. The lab test showed hepatic dysfunction (aspartate transaminase, AST 440 U/l, alanine transaminase, ALT 420 U/l) and the elevation of liver enzymes continued on the next day even after stopping abiraterone acetate. Three days later, he was hospitalized due to severe elevation of liver enzymes (AST 1,171 U/l, ALT 1,487 U/l) , and the decreased prothrombin activity (60...
November 2017: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/29209270/transcranial-direct-current-stimulation-in-patients-with-prolonged-disorders-of-consciousness-combined-behavioral-and-event-related-potential-evidence
#3
Ye Zhang, Weiqun Song, Jubao Du, Su Huo, Guixiang Shan, Ran Li
Background: The electrophysiological evidence supporting the therapeutic efficacy of multiple transcranial direct current stimulation (tDCS) sessions on consciousness improvement in patients with prolonged disorders of consciousness (DOCs) has not been firmly established. Objectives: To assess the effects of repeated tDCS in patients with prolonged DOCs by Coma Recovery Scale-Revised (CRS-R) score and event-related potential (ERP). Method: Using a sham-controlled randomized double-blind design, 26 patients were randomly assigned to either a real [five vegetative state (VS) and eight minimally conscious state (MCS) patients] or sham (six VS and seven MCS patients) stimulation group...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29163104/transcranial-random-noise-stimulation-does-not-improve-behavioral-and-neurophysiological-measures-in-patients-with-subacute-vegetative-unresponsive-wakefulness-state-vs-uws
#4
Mauro Mancuso, Laura Abbruzzese, Stefania Canova, Giulia Landi, Simone Rossi, Emiliano Santarnecchi
Background: The absence of efficient treatments capable to promote central nervous system recovery in patients in vegetative state (VS) due to a severe acquired brain injury highlights the need of exploring alternative neuromodulatory treatments that can lead to neurobehavioral gains. Some encouraging preliminary observations suggest that transcranial direct current stimulation could be effective in disorders of consciousness (DoC) patients, especially when applied on the dorsolateral prefrontal cortex (DLPFC) in patients with minimally conscious state (MCS) but not in those with VS...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/29160761/fronto-parietal-coherence-response-to-tdcs-modulation-in-patients-with-disorders-of-consciousness
#5
Yang Bai, Xiaoyu Xia, Yong Wang, Yongkun Guo, Yi Yang, Jianghong He, Xiaoli Li
A transcranial direct current stimulation (tDCS) protocol (2 min, 2 mA, anodal electrode at the left dorsolateral prefrontal cortex and cathodal electrode at the right supraorbital area) was applied in patients with different degrees of disorders of consciousness (DoC). Although previous research indicates that it could improve patients' coma recovery scale-revised (CRS-R) scores, the brain's electrophysiological responses to tDCS are still unclear. Therefore, the present study was performed to explore the underlying brain responses of patients in a minimally conscious state (MCS) and a Unresponsive Wakefulness Syndrome (UWS) to tDCS modulation...
November 21, 2017: International Journal of Neuroscience
https://www.readbyqxmd.com/read/29120973/acute-intoxications-and-fatalities-from-illicit-fentanyl-and-analogues-an-update
#6
Simona Pichini, Renata Solimini, Paolo Berretta, Roberta Pacifici, Francesco Paolo Busardò
Illicit fentanyl and its analogues are very dangerous synthetic opioids, with high abuse potential and severe adverse effects including coma and death. They are used as adulterants in street heroin, cocaine, and methamphetamine, or as heroin substitutes sold to unaware users with a high risk of overdoses. Fentanyl and its analogues have also been identified in counterfeit medicinal products, such as oxycodone, hydrocodone, and alprazolam tablets, or as components of speedball mixtures together with cocaine or other stimulants...
November 8, 2017: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/28970284/stress-induced-microrna-708-impairs-%C3%AE-cell-function-and-growth
#7
Júlia Rodríguez-Comas, Alba Moreno-Asso, Juan Moreno-Vedia, Mercè Martín, Carlos Castaño, Anna Marzà-Florensa, Xavier Bofill-De Ros, Joan Mir-Coll, Joel Montané, Cristina Fillat, Rosa Gasa, Anna Novials, Joan-Marc Servitja
The pancreatic β-cell transcriptome is highly sensitive to external signals such as glucose oscillations and stress cues. MicroRNAs (miRNAs) have emerged as key factors in gene expression regulation. Here, we aimed to identify miRNAs that are modulated by glucose in mouse pancreatic islets. We identified miR-708 as the most upregulated miRNA in islets cultured at low glucose concentrations, a setting that triggers a strong stress response. miR-708 was also potently upregulated by triggering endoplasmic reticulum (ER) stress with thapsigargin and in islets of ob/ob mice...
October 2, 2017: Diabetes
https://www.readbyqxmd.com/read/28962188/dynamic-changes-of-%C3%AE-melanocyte-stimulating-hormone-levels-in-the-serum-of-patients-with-craniocerebral-trauma
#8
Xiaoguang Du, Baozhong Dong, Chen Li, Faxue Zhang, Yanwei Ji, Jianbin Zhang, Changjiang Yin
The aim of the study was to investigate dynamic changes in α-melanocyte-stimulating hormone (α-MSH) levels in the serum of patients with craniocerebral trauma. Forty-eight patients with acute craniocerebral injury were selected between January 2015 and October 2016. The patients were divided into three groups: severe (18 cases), moderate (16 cases) and mild (14 cases), according to the Glasgow Coma Scale (GCS) score at the time of admission. At the same time, 10 adults with a similar age distribution to the patients were also selected as a control group...
September 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28902713/long-lasting-repetitive-transcranial-magnetic-stimulation-modulates-electroencephalography-oscillation-in-patients-with-disorders-of-consciousness
#9
Xiaoyu Xia, Yang Liu, Yang Bai, Ziyuan Liu, Yi Yang, Yongkun Guo, Ruxiang Xu, Xiaorong Gao, Xiaoli Li, Jianghong He
Repetitive transcranial magnetic stimulation (rTMS) has been applied for the treatment of patients with disorders of consciousness (DOC). Timely and accurate assessments of its modulation effects are very useful. This study evaluated rTMS modulation effects on electroencephalography (EEG) oscillation in patients with chronic DOC. Eighteen patients with a diagnosis of DOC lasting more than 3 months were recruited. All patients received one session of 10-Hz rTMS at the left dorsolateral prefrontal cortex and then 12 of them received consecutive rTMS treatment everyday for 20 consecutive days...
September 11, 2017: Neuroreport
https://www.readbyqxmd.com/read/28870240/neuron-derived-ccl2-contributes-to-microglia-activation-and-neurological-decline-in-hepatic-encephalopathy
#10
Li Zhang, Jinyun Tan, Xiaoping Jiang, Weiwei Qian, Ting Yang, Xijun Sun, Zhaohui Chen, Qiwen Zhu
BACKGROUND: CCL2 was up-regulated in neurons and involved in microglia activation and neurological decline in mice suffering from hepatic encephalopathy (HE). However, no data exist concerning the effect of neuron-derived CCL2 on microglia activation in vitro. METHODS: The rats were pretreated with CCL2 receptor inhibitors (INCB or C021, 1 mg/kg/day i.p.) for 3 days prior to thioacetamide (TAA) administration (300 mg/kg/day i.p.) for inducing HE model. At 8 h following the last injection (and every 4 h after), the grade of encephalopathy was assessed...
September 4, 2017: Biological Research
https://www.readbyqxmd.com/read/28865377/assessing-pain-in-patients-with-chronic-disorders-of-consciousness-are-we-heading-in-the-right-direction
#11
Antonino Naro, Placido Bramanti, Alessia Bramanti, Rocco Salvatore Calabrò
The deterioration of sensory-motor integration within the pain matrix in patients with chronic Disorders of Consciousness (DoC) is one of the principal mechanisms responsible for non-conscious pain perception. The present study aimed to assess whether the variability in the inter-peak interval (IPI) between the N2 and P2 components of laser evoked potentials (LEP) could represent an objective marker of the behavioral responsiveness to nociceptive stimulation, as measured by the Nociception Coma Scale-Revised (NCS-R), and regardless of the sensory part of pain processing...
October 2017: Consciousness and Cognition
https://www.readbyqxmd.com/read/28844160/the-nature-of-eeg-reactivity-to-light-sound-and-pain-stimulation-in-neurosurgical-comatose-patients-evaluated-by-a-quantitative-method
#12
Birger Johnsen, Kristoffer B Nøhr, Christophe H V Duez, Mads Q Ebbesen
EEG reactivity (EEG-R) is regarded as an important parameter in coma prognosis but knowledge is sparse on the nature of EEG changes due to different kinds of stimulation and their prognostic significance. EEG-R was quantified in a study of 39 comatose neurosurgical patients. Six 30-second standardized visual, auditory, and painful stimulations were applied. EEG-R in the delta, theta, alpha, and beta band was normalized in z-scores as the power of a stimulation epoch relative to average power of 6 resting epochs...
November 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/28821639/amyloid-induced-%C3%AE-cell-dysfunction-and-islet-inflammation-are-ameliorated-by-4-phenylbutyrate-pba-treatment
#13
Joel Montane, Sara de Pablo, Carlos Castaño, Júlia Rodríguez-Comas, Lisa Cadavez, Mercè Obach, Montse Visa, Gema Alcarraz-Vizán, Melchor Sanchez-Martinez, Alfons Nonell-Canals, Marcelina Parrizas, Joan-Marc Servitja, Anna Novials
Human islet amyloid polypeptide (hIAPP) aggregation is associated with β-cell dysfunction and death in type 2 diabetes (T2D). we aimed to determine whether in vivo treatment with chemical chaperone 4-phenylbutyrate (PBA) ameliorates hIAPP-induced β-cell dysfunction and islet amyloid formation. Oral administration of PBA in hIAPP transgenic (hIAPP Tg) mice expressing hIAPP in pancreatic β cells counteracted impaired glucose homeostasis and restored glucose-stimulated insulin secretion. Moreover, PBA treatment almost completely prevented the transcriptomic alterations observed in hIAPP Tg islets, including the induction of genes related to inflammation...
August 15, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28693604/right-median-nerve-electrical-stimulation-for-acute-traumatic-coma-the-asia-coma-electrical-stimulation-trial-study-protocol-for-a-randomised-controlled-trial
#14
Xiang Wu, Chao Zhang, Junfeng Feng, Qing Mao, Guoyi Gao, Jiyao Jiang
BACKGROUND: Traumatic brain injury (TBI) has become the most common cause of death and disability in persons between 15 and 30 years of age, and about 10-15% of patients affected by TBI will end up in a coma. Coma caused by TBI presents a significant challenge to neuroscientists. Right median nerve electrical stimulation has been reported as a simple, inexpensive, non-invasive technique to speed recovery and improve outcomes for traumatic comatose patients. METHODS/DESIGN: This multicentre, prospective, randomised (1:1) controlled trial aims to demonstrate the efficacy and safety of electrical right median nerve stimulation (RMNS) in both accelerating emergence from coma and promoting long-term outcomes...
July 10, 2017: Trials
https://www.readbyqxmd.com/read/28646329/-unconsciousness-and-clouded-awareness
#15
REVIEW
H J Stemmler, R Pihusch
Stupor and coma are clinical states in which patients have impaired responsiveness or are unresponsive to external stimulation and are either difficult to arouse or are unarousable. The term stupor refer to states between alertness and coma. An alteration in arousal represents an acute life-threatening emergency, requiring prompt intervention for preservation of life and brain function.
June 23, 2017: Der Internist
https://www.readbyqxmd.com/read/28601692/the-effects-of-family-centered-affective-stimulation-on-brain-injured-comatose-patients-level-of-consciousness-a-randomized-controlled-trial
#16
F Salmani, E Mohammadi, M Rezvani, A Kazemnezhad
BACKGROUND: Despite the well-defined effects of sensory stimulation, the knowledge of the pure effects of affective stimulation is scarce. OBJECTIVE: To evaluate the effects of family-centered affective stimulation on the level of consciousness among comatose patients with brain injuries. DESIGN: This study was designed as a three-group double-blinded Randomized Controlled Trial. METHODS: Ninety consecutive patients with traumatic brain injuries and a Glasgow Coma Scale score of 5-8 were selected...
June 4, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28538388/myxedema-coma-a-case-report-of-pediatric-emergency-care
#17
Yueniu Zhu, Wenjuan Qiu, Mengyan Deng, Xiaodong Zhu
RAIONALE: Myxedema coma (MC) is extremely rare but lethal in pediatric patients with hypothyroidism leading to altered mental status and hypothermia. But there is no clinical guideline for such cases. PATIENT CONCERNS: A 6-year-old Chinese girl presented with coma and hypothermia preceded by pneumonia. Her lab results were: free thyroxin (T4) 4.18 pmol/L and thyroid-stimulating hormone (TSH) > 150 μIU/mL with extremely elevated anti-thyroid peroxidase (TPO-Ab) and anti-thyroglobulin...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28515709/effects-of-10-hz-repetitive-transcranial-magnetic-stimulation-of-the-left-dorsolateral-prefrontal-cortex-in-disorders-of-consciousness
#18
Xiaoyu Xia, Yang Bai, Yangzhong Zhou, Yi Yang, Ruxiang Xu, Xiaorong Gao, Xiaoli Li, Jianghong He
BACKGROUND: While repetitive transcranial magnetic stimulation (rTMS) has been applied in treatment of patients with disorders of consciousness (DOC), a standardized stimulation protocol has not been proposed, and its therapeutic effects are inconsistently documented. OBJECTIVES: To assess the efficacy of rTMS in improving consciousness in patients with persistent minimally conscious state (MCS) or unresponsive wakefulness syndrome (UWS), previously known as vegetative state (VS)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28497927/the-potential-role-of-pain-related-sseps-in-the-early-prognostication-of-long-term-functional-outcome-in-post-anoxic-coma
#19
Alessandra Del Felice, Stefano Bargellesi, Federico Linassi, Bruno Scarpa, Emanuela Formaggio, Paolo Boldrini, Stefano Masiero, Paolo Zanatta
BACKGROUND: Cardiac arrest (CA) is a common cause of disability. Multimodal evaluation has improved prognosis but precocious biomarkers are not appropriate in determining long-term functional outcome. AIM: to identify early prognostication markers of long-term functional outcome in post-anoxic coma. DESIGN: retrospective assessment of outcomes. POPULATION: Individuals older than 18 years with post-anoxic coma hospitalized in intensive care units after cardiac arrest (CA) regardless of cause (cardiac or non-cardiac) and location of event (in or out-of-hospital)...
May 12, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28489640/little-black-boxes-noncardiac-implantable-electronic-medical-devices-and-their-anesthetic-and-surgical-implications
#20
REVIEW
Una Srejic, Paul Larson, Philip E Bickler
Implanted electronic medical devices. or stimulators such as pacemakers and nerve stimulators have grown enormously in diversity and complexity over recent decades. The function and potential interaction of these devices with the perioperative environment is of increasing concern for anesthesiologists and surgeons. Because of the innate electromagnetic environment of the hospital (operating room, gastrointestinal procedure suite, and imaging suite), implanted device malfunction, reprogramming, or destruction may occur and cause physical harm (including nerve injury, blindness, deafness, burn, stroke, paralysis, or coma) to the patient...
July 2017: Anesthesia and Analgesia
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