Plasma and cerebrospinal fluid concentrations of neuropeptide Y, serotonin, and catecholamines in patients under propofol or isoflurane anesthesia

2000 ◽  
Vol 78 (2) ◽  
pp. 100-107 ◽  
Author(s):  
E Grouzmann ◽  
A Borgeat ◽  
M Fathi ◽  
R C Gaillard ◽  
P Ravussin
Keyword(s):  
Cerebrospinal Fluid ◽  
Neuropeptide Y ◽  
Recovery Period ◽  
Anesthetic Technique ◽  
Strong Increase ◽  
Control Group ◽  
Volatile Agent ◽  
Early Recovery ◽  
Isoflurane Anesthesia ◽  
Early Recovery Period

Propofol is a widely used anesthetic for both induction and maintenance of anesthesia during surgery. A strong feeling of hunger has been reported during the early recovery period after propofol anesthesia. We have investigated the effect of propofol on appetite in 10 patients undergoing a craniotomy and in parallel measured neuropeptide Y (NPY), catecholamines, and serotonin levels in the cerebrospinal fluid and plasma during anesthesia. Ten patients anesthetized with a volatile agent (isoflurane) served as a control group. Plasma NPY and catecholamines levels were not affected by surgery at any time. We observed a strong increase in NPY concentrations in the cerebrospinal fluid independently of the anesthetic technique agent used, whereas catecholamines were unchanged. We found that serotonin concentrations decreased significantly in the plasma (but not in the cerebrospinal fluid) of patients treated by propofol when compared with the control group; this decrease was associated with an increase of hunger early postoperatively. We concluded that the proappetite effect of propofol is mediated through a decrease of serotonin at the peripheral level.Key words: catecholamines, serotonin, neuropeptide Y (NPY), cerebrospinal fluid, serum, appetite.

scholarly journals Efficiency of Leg Exoskeleton Use in Rehabilitation of Cerebral Stroke Patients

2021 ◽  
Vol 22 (3) ◽  
pp. 257-264
Author(s):  
Sergey V. Kotov ◽  
Alexander I. Romanov ◽  
Ekaterina V. Silina ◽  
Victor A. Stupin ◽  
Elena V. Isakova ◽  
...  
Keyword(s):  
Recovery Period ◽  
Rehabilitation Program ◽  
Control Group ◽  
Cerebral Stroke ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Early Recovery ◽  
Lower Limb Exoskeleton ◽  
Group 2 ◽  
Early Recovery Period

Abstract The study aimed to evaluate the effectiveness of functional and motor activity restoration, including the walking function, in patients after an ischemic stroke using the ExoAtlet lower limb exoskeleton. Patients and methods. A clinical study was carried out on 42 patients who had undergone a cerebral infarction in the mid cerebral artery system with a post-stroke paresis of the leg, and who had undergone a rehabilitation course in a round-theclock hospital during the early recovery period. Patients were randomized into two equal groups comparable in terms of the stroke severity: the patients in group 1 were receiving a standard rehabilitation program (control group), the patients in group 2 were additionally receiving a course of gait rehabilitation using the ExoAtlet exoskeleton - 10 sessions, 5 sessions per week for 14 days. Results. The study demonstrated the effectiveness of the ExoAtlet exoskeleton used in the rehabilitation of stroke patients over the standard course of rehabilitation. The advantages include a decrease in the hemiparesis degree, an increase in the muscle strength of the paretic limb, an improvement in balance, an improvement and acceleration of the walking process. The obtained results of the instrumental study confirmed the benefits of physical training on the Exoskeleton, which was demonstrated through an increase in stability and balance, as well as through a decrease in the energy consumption index for maintaining the stable verticalization. Conclusion. The usage of the ExoAtlet exoskeleton increases the effectiveness of rehabilitation measures and improves motor and functional activities of patients who have suffered a cerebral stroke.

scholarly journals Comparative Characterization of Candidate Molecular Markers in Ischemic and Hemorrhagic Stroke

2021 ◽  
Vol 17 (5) ◽  
pp. 23-34
Author(s):  
A. M. Golubev ◽  
A. V. Grechko ◽  
V. E. Zakharchenko ◽  
M. M. Kanarsky ◽  
M. V. Petrova ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Molecular Markers ◽  
Neurotrophic Factor ◽  
Hemorrhagic Stroke ◽  
Recovery Period ◽  
Control Group ◽  
Early Recovery ◽  
Acute Period ◽  
S 100 ◽  
Early Recovery Period

According to epidemiological studies, the leading cause of morbidity, disability and mortality are cerebrovascular diseases, in particular ischemic and hemorrhagic strokes. In recent years considerable attention has been given to the study of molecular markers of ischemic and hemorrhagic strokes. These studies are relevant because brain-specific protein biomarkers of neurons and glial cells can provide valuable and timely diagnostic information necessary for clinical decision-making.The aim of the study was to reveal the differences in the serum level of molecular markers in acute, subacute and early recovery periods of ischemic and hemorrhagic strokes.Material and methods. The study included 59 patients. Twenty patients were diagnosed with hemorrhagic stroke and 39 had ischemic stroke. The control group included 20 volunteers. Serum levels of molecular CNS markers were determined in acute, subacute, and early recovery stages of stroke. The serum levels of CNS molecular markers of patients with ischemic and hemorrhagic stroke was measured quantitatively by enzyme immunoassay. Statistical analysis was performed by nonparametric Mann-Whitney method.Results. The level of brain-derived neurotrophic factor (BDNF) in the control volunteers was 574.5 [455.5; 615] pg/ml. Significant differences were found for acute and subacute periods of hemorrhagic stroke: it was 674 [560; 749] pg/ml (P=0.003) and 664 [616; 762] pg/ml (P=0.0001).The level of neuron-specific enolase was significantly increased in all periods of the study: it was 4.15 [3.53; 4.8] ng/ml in the control group, 5.4 [4.4; 6.4] ng/ml in acute period of ischemic stroke (P<0.001), 5.4 [4.4; 6.4] ng/ml in early recovery period of ischemic stroke (P=0.001), 5.1 [4.6; 6.4] ng/ml in acute period of hemorrhagic stroke (P=0.014), 664 [616; 762] ng/ml in subacute period of hemorrhagic stroke (P=0.003).In the control group, the serum S-100 protein level was 4.5 [3.8; 5.4] ng/ml. In the acute and early recovery periods of ischemic stroke, S-100 protein level has significantly fallen down to 4.1 [3.4; 4.6] ng/ml (P<0.031) and 3.9 [3.4; 6] ng/ml (P=0.014), respectively. Glial-cell derived neurotrophic factor level was 1.98 [1.64; 2.1] ng/ml in the controls and increased up to 2.4 [2.2; 5] ng/ml (P=0.002) in the acute period and 2.4 [2.3; 2.6] ng/ml (P<0.001) in the subacute period of hemorrhagic stroke.The vascular endothelial growth factor receptor-1 (VEGFR-1) was significantly lower in the subacute period of hemorrhagic stroke: 485 [211; 945] pg/ml in the subacute period vs 903.5 [626; 1115] pg/ml in the controls (P=0.001).Conclusion. We found differences in the serum level of molecular markers in patients with ischemic and hemorrhagic strokes. In the acute period, early recovery period of ischemic stroke, and subacute period of hemorrhagic stroke, there was an increase in the serum level of neuron-specific enolase. The level of brain-derived neurotrophic factor increased significantly in the acute and subacute periods of hemorrhagic stroke. In the acute and early recovery periods of ischemic stroke, the level of S-100 protein decreased. The level of glial cell-derived neurotrophic factor increased in the acute and subacute periods of hemorrhagic stroke. In the subacute period of hemorrhagic stroke, the level of endothelial growth factor receptor-1 significantly decreased. Moreover, there was significant difference between values of this parameter in the subacute period of hemorrhagic stroke and in the early recovery period of ischemic stroke.

scholarly journals A Study of Biofeedback Gait Training in Cerebral Stroke Patients in the Early Recovery Phase with Stance Phase as Target Parameter

Sensors ◽  
2021 ◽  
Vol 21 (21) ◽  
pp. 7217
Author(s):  
Dmitry V. Skvortsov ◽  
Sergey N. Kaurkin ◽  
Galina E. Ivanova
Keyword(s):  
Stance Phase ◽  
Recovery Period ◽  
Biomechanical Analysis ◽  
Control Group ◽  
Cerebral Stroke ◽  
Stroke Patients ◽  
Early Recovery ◽  
Phase Duration ◽  
Gait Symmetry ◽  
Early Recovery Period

Walking function disorders are typical for patients after cerebral stroke. Biofeedback technology (BFB) is currently considered effective and promising for training walking function, including in patients after cerebral stroke. Most studies recognize that BFB training is a promising tool for improving walking function; however, the data on the use of highly selective walking parameters for BFB training are very limited. The aim of our study was to investigate the feasibility of using BFB training targeting one of the basic parameters of gait symmetry—stance phase duration—in cerebral stroke patients in the early recovery period. The study included 20 hemiparetic patients in the early recovery period after the first hemispheric ischemic stroke. The control group included 20 healthy subjects. The BFB training and biomechanical analysis of walking (before and after all BFB sessions) were done using an inertial system. The mean number of BFB sessions was nine (from 8 to 11) during the three weeks in clinic. There was not a single negative response to BFB training among the study patients, either during the sessions or later. The spatiotemporal parameters of walking showed the whole syndrome complex of slow walking and typical asymmetry of temporal walking parameters, and did not change significantly as a result of the study therapy. The changes were more significant for the functioning of hip and knee joints. The contralateral hip amplitude returned to the normal range. For the knee joint, the amplitude of the first flexion increased and the value of the amplitude of hyperextension decreased in the middle of the stance phase. Concerning muscle function, the observed significant decrease in the function of m. Gastrocnemius and the hamstring muscles on the paretic side remained without change at the end of the treatment course. We obtained positive dynamics of the biomechanical parameters of walking in patients after the BFB training course. The feasibility and efficacy of their use for targeted correction need further research.

Patterns of development of insomnia in patients with early recovery period of stroke

2019 ◽  
Vol 17 (7) ◽  
pp. 95-99
Author(s):  
O. V. Kurushina ◽  
◽  
E. A. Kurakova ◽  
Keyword(s):  
Recovery Period ◽  
Early Recovery ◽  
Early Recovery Period

Opportunities of ultrasound diagnostics of lung injury in SARS-CoV-2 infection (COVID-19): a clinical case

2020 ◽  
Vol 98 (11) ◽  
pp. 51-56
Author(s):  
G. V. Neklyudova ◽  
А. V. Chernyak ◽  
N. А. Tsareva ◽  
S. N. Аvdeev
Keyword(s):  
Lung Injury ◽  
Clinical Case ◽  
Ultrasound Examination ◽  
Recovery Period ◽  
Early Recovery ◽  
Acute Period ◽  
Ultrasound Diagnostics ◽  
Early Recovery Period

The article describes a clinical case demonstrating the results of the lungs ultrasound examination in the COVID-19 patient during the acute period of the disease and early recovery period.

Neurorehabilitation in the Early Recovery Period of Ischemic Stroke. Pharmacology Support

2021 ◽  
Vol 63 (1) ◽  
pp. 22-25
Author(s):  
Denys N. Khramtsov ◽  
Olexandr N. Stoyanov ◽  
Tetiana N. Muratova ◽  
Olexandr R. Pulyk
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Recovery Period ◽  
Rehabilitation Medicine ◽  
Neuroprotective Agents ◽  
Early Recovery ◽  
National Medical ◽  
Cholinergic Agents ◽  
Early Recovery Period ◽  
Medical University

Aim: The aim of the study was to evaluate the clinical outcome in the use of neuroprotective agents in the acute period of ischemic stroke. Material and Methods: The study was performed on the basis of the stroke of the Center for Reconstructive and Rehabilitation Medicine (University Clinic) of the Odessa National Medical University. A retrospective analysis of clinical outcomes of 115 patients with acute stroke was conducted. Results: An average NIHSS score at discharge was 4.1±0.1 points when treated with no refinery, then it reached 3.6±0.1 points when using peptidergic drugs, and 3.4±0.1 when using D-fdf. 3.1±0.1 points. When using D-FDF, the MMSE score was 3.5±0.1 points, whereas when using cholinergic agents, this index did not exceed 26.9±1.5 points, and when using peptidergic agents - 26.8±1.4 points. Conclusion: The use of neuroprotective agents positively affects the effectiveness of neuro-rehabilitation in patients with acute stroke. The best results in three months after the hospitalization were obtained for peptidergic agents and D-fructose-1,6-diphosphate.

scholarly journals Application of rhythmic transcranial magnetic stimulation with low-intensive running pulsed magnetic field in the rehabilitation of patients with post-stroke cognitive impairment syndrome

2020 ◽  
Vol 12 (2) ◽  
pp. 51-62
Author(s):  
Alexey Е. Tereshin ◽  
Vera V. Kiryanova ◽  
Dmitry A. Reshetnik ◽  
Marina V. Karyagina ◽  
Elena K. Savelyeva ◽  
...  
Keyword(s):  
Magnetic Field ◽  
Cognitive Impairment ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Modulation Frequency ◽  
Recovery Period ◽  
Pulsed Magnetic Field ◽  
Control Group ◽  
Early Recovery ◽  
Post Stroke

The purpose of the investigation was to study the nootropic effects of rhythmic transcranial magnetic stimulation (rTMS) using low-intensity magnetic field with the induction rate of 45 mT, base frequency of 50 Hz, modulation frequency of 10 Hz in combination with standard medical and psychological therapy in the rehabilitation of patients with post-stroke cognitive impairment (PSCI). Materials and methods. The rehabilitation outcomes in 98 patients with PSCI syndrome were studied. The patients were subdivided into 2 groups: 53 patients of the control group were treated with the standard nootropic medications and neuropsychological procedures; 45 patients of the main group were additionally treated with rTMS by the low-intensive running pulsed magnetic field of 10 Hz modulation frequency. The dynamics of the score increase according to Rivermid, Karnovsky, Roshina, MMSE, mRS, HDRS, SF-36 scales were analyzed. Conclusion. Application of rTMS with low-intensive running pulsed magnetic field of 10 Hz modulation frequency in combination with a standard program of cognitive rehabilitation contributes to a significant improvement in the recovery of mental calculation function in ischemic stroke patients, as well as normalization in mood swings in the patients who had suffered a hemorrhagic stroke and post-stroke depression. This variant of rTMS can be safely used in patients with PSCI syndrome in the early recovery period, 3 weeks after the onset of stroke.

scholarly journals Combination Preemptive Peripheral Nerve Block in Limb Surgery. A Prospective Study

Medicina ◽  
2020 ◽  
Vol 56 (8) ◽  
pp. 388
Author(s):  
I-Cheng Lu ◽  
Shu-Hung Huang ◽  
David Vi Lu ◽  
Chun Dan Hsu ◽  
Sheng Hua Wu
Keyword(s):  
Pain Management ◽  
Peripheral Nerve ◽  
Nerve Block ◽  
Peripheral Nerve Block ◽  
Recovery Period ◽  
Controlled Study ◽  
Control Group ◽  
Single Shot ◽  
Early Recovery ◽  
The Impact

Background and objectives: Patients often suffer from moderate to severe pain during the early recovery period in orthopedic surgery. We investigated the impact of a single-shot preoperative peripheral nerve block (PNB) on post-anesthesia recovery parameters and interleukin (IL)-6 level during limb surgery. Materials and Methods: A prospective randomized controlled study was conducted, and patients scheduled for limb surgery were recruited. Sixty patients were randomly assigned to either the PNB group or control group, who received morphine as a primary analgesic. The peak verbal numeric rating scale (NRS) score in the post-anesthesia care unit (PACU) was evaluated as a primary outcome. We also recorded rescue analgesics requirement and wake-up time from anesthesia in the PACU. In addition, the change of plasma IL-6 level after incision was measured. Results: Fifty-two patients completed the study, 27 and 25 cases in the PNB and control group, respectively. Preemptive PNB significantly reduced peak NRS score in the PACU compared to control group. Lower rescue analgesics requirement and rapid wake-up from anesthesia were also noted in PNB group. The IL-6 concentration increased less in the PNB group at 2 h after incision. Conclusions: Preemptive PNB attenuates IL-6 expression 2 h after incision and improves pain management in the PACU. PNB was considered as an essential part of pain management in limb surgery.

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