scholarly journals Diaphragm paralysis: a case report

2020 ◽  
Vol 15 ◽  
Author(s):  
Fausta Viccaro ◽  
Antonella Sotgiu ◽  
Krisstopher Richard Flores ◽  
Ernesto Maria Di Biase ◽  
Letizia D’Antoni ◽  
...  
Keyword(s):  
Emergency Room ◽  
Viral Infections ◽  
Diuretic Therapy ◽  
Trauma Surgery ◽  
Pulmonary Atelectasis ◽  
Clinical Disorder ◽  
Beneficial Effects ◽  
Neurologic Disorders ◽  
Diaphragm Paralysis ◽  
Traumatic Fracture

Introduction. Bilateral paralysis of the diaphragm may be an idiopathic clinical condition or associated with several diseases such as trauma, surgery, viral infections, neurologic disorders. The diaphragm is the main respiratory muscle. It is a cupoliform muscle-tendon structure, innervated bilaterally by phrenic nerve, which originates from C3-C5 nerve roots. Diaphragmatic paralysis is a clinical disorder that generates hypoventilation and basal pulmonary atelectasis, predisposing to hypercapnic respiratory failure. The clinic manifestations mimic cardio-respiratory pathologies, therefore often misdiagnosticated. Case presentation. A 55-year-old man with a previous C6-7 traumatic fracture, referred multiple accesses to the emergency room for acute nocturnal dyspnoea, treated with antibiotic therapy, diuretic therapy and long-term oxygen therapy, without beneficial effects. He referred to our pulmonary clinic for evaluation of persistent and worsening orthopnoea due to unknown cause for about 2 years. Clinical examination, respiratory functional tests and diaphragm ultrasound revealed a strong suspicion of diaphragmatic deficit, confirmed by electromyography. Conclusions. The patient accesses to the emergency room numerous times and the clinical frame have been always oriented towards a cardio-respiratory origin. From the onset of the symptom to the respiratory evaluation, about 2.5 years have passed. The manifestation of clear orthopnoea has addressed the functional respiratory study towards a more thorough diaphragmatic evaluation assessed by ultrasound.

scholarly journals MSC Secretome as a Promising Tool for Neuroprotection and Neuroregeneration in a Model of Intracerebral Hemorrhage

Pharmaceutics ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2031
Author(s):  
Maxim Karagyaur ◽  
Stalik Dzhauari ◽  
Nataliya Basalova ◽  
Natalia Aleksandrushkina ◽  
Georgy Sagaradze ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Neurological Outcome ◽  
Multipotent Mesenchymal Stromal Cells ◽  
Lesion Volume ◽  
Therapeutic Approaches ◽  
Beneficial Effects ◽  
Tissue Repair And Regeneration ◽  
Promising Tool ◽  
Neurologic Disorders ◽  
The Brain

Multipotent mesenchymal stromal cells (MSCs) are considered to be critical contributors to injured tissue repair and regeneration, and MSC-based therapeutic approaches have been applied to many peripheral and central neurologic disorders. It has been demonstrated that the beneficial effects of MSC are mainly mediated by the components of their secretome. In the current study, we have explored the neuroprotective potential of the MSC secretome in a rat model of intracerebral hemorrhage and shown that a 10-fold concentrated secretome of human MSC and its combination with the brain-derived neurotrophic factor (BDNF) provided a better survival and neurological outcome of rats within 14 days of intracerebral hemorrhage compared to the negative (non-treated) and positive (BDNF) control groups. We found that it was due to the ability of MSC secretome to stimulate neuron survival under conditions of glutamate-induced neurotoxicity. However, the lesion volume did not shrink in these rats, and this also correlated with prominent microglia activation. We hypothesize that this could be caused by the species-specificity of the used MSC secretome and provide evidence to confirm this. Thus, we have found that allogenic rat MSC secretome was more effective than xenogenic human MSC secretome in the rat intracerebral hemorrhage model: it reduced the volume of the lesion and promoted excellent survival and neurological outcome of the treated rats.

scholarly journals Role of Acupuncture in the Management of Severe Acquired Brain Injuries (sABIs)

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Loredana Cavalli ◽  
Lucia Briscese ◽  
Tiziana Cavalli ◽  
Paolo Andre ◽  
Maria Chiara Carboncini
Keyword(s):  
Brain Injuries ◽  
Neuronal Regeneration ◽  
Asian Countries ◽  
Rehabilitative Treatment ◽  
Beneficial Effects ◽  
Nervous System Activity ◽  
Neurologic Disorders ◽  
Central Nervous System Activity ◽  
The Brain

Acupuncture therapy has been used to treat several disorders in Asian countries and its use is increasing in Western countries as well. Current literature assessed the safety and efficacy of acupuncture in the acute management and rehabilitation of patients with neurologic disorders. In this paper, the role of acupuncture in the treatment of acute severe acquired brain injuries is described, acting on neuroinflammation, intracranial oedema, oxidative stress, and neuronal regeneration. Moreover, beneficial effects of acupuncture on subacute phase and chronic outcomes have been reported in controlling the imbalance of IGF-1 hormone and in decreasing spasticity, pain, and the incidence of neurovegetative crisis. Moreover, acupuncture may have a positive action on the arousal recovery. Further work is needed to understand the effects of specific acupoints on the brain. Allegedly concurrent neurophysiological measurements (e.g., EEG) may help in studying acupuncture-related changes in central nervous system activity and determining its potential as an add-on rehabilitative treatment for patients with consciousness disorders.

Plant-derived medicines for neuropathies: a comprehensive review of clinical evidence

2019 ◽  
Vol 30 (6) ◽  
pp. 671-684 ◽  
Author(s):  
Farnaz Ebrahimi ◽  
Mohammad Hosein Farzaei ◽  
Roodabeh Bahramsoltani ◽  
Mojtaba Heydari ◽  
Kiana Naderinia ◽  
...  
Keyword(s):  
Medicinal Plants ◽  
Viral Infections ◽  
Cannabis Sativa ◽  
Linseed Oil ◽  
Curcuma Longa ◽  
Herbal Medicines ◽  
Cochrane Library ◽  
Congenital Diseases ◽  
Beneficial Effects ◽  
Long Time

AbstractNeuropathy is defined as the damage to the peripheral or central nervous system accompanied by pain, numbness, or muscle weakness, which can be due to congenital diseases or environmental factors such as diabetes, trauma, or viral infections. As current treatments are not sufficiently able to control the disease, studies focusing on the identification and discovery of new therapeutic agents are necessary. Natural products have been used for a long time for the management of different neurological problems including neuropathies. The aim of the present study is to review the current clinical data on the beneficial effects of medicinal plants in neuropathy. Electronic databases including PubMed, Scopus, and Cochrane Library were searched with the keywords ‘neuropathy’ in the title/abstract and ‘plant’ or ‘extract’ or ‘herb’ in the whole text from inception until August 2017. From a total of 3679 papers, 22 studies were finally included. Medicinal plants were evaluated clinically in several types of neuropathy, including diabetic neuropathy, chemotherapy-induced peripheral neuropathy, carpal tunnel syndrome, and HIV-associated neuropathy. Some studies reported the improvement in pain, nerve function, nerve conduction velocity, and quality of life.Cannabis sativa(hemp),Linum usitatissimum(linseed oil), capsaicin, and a polyherbal Japanese formulation called Goshajinkigan had the most evidence regarding their clinical efficacy. Other investigated herbal medicines in neuropathy, such asMatricaria chamomilla(chamomile),Curcuma longa(turmeric), andCitrullus colocynthis(colocynth), had only one clinical trial. Thus, future studies are necessary to confirm the safety and efficacy of such natural medicines as a complementary or alternative treatment for neuropathy.

scholarly journals On the use of immune checkpoint inhibitors in patients with viral infections including COVID-19

2020 ◽  
Vol 8 (2) ◽  
pp. e001145 ◽  
Author(s):  
Thilo Gambichler ◽  
Judith Reuther ◽  
Christina H Scheel ◽  
Jürgen Christian Becker
Keyword(s):  
Hepatitis B ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Viral Infections ◽  
Checkpoint Inhibitors ◽  
Immunosuppressive Drugs ◽  
Risk Of Infection ◽  
Beneficial Effects ◽  
Available Information

The present review summarizes up-to-date evidence addressing the frequently discussed clinical controversies regarding the use of immune checkpoint inhibitors (ICIs) in cancer patients with viral infections, including AIDS, hepatitis B and C, progressive multifocal leukoencephalopathy, influenza, and COVID-19. In detail, we provide available information on (1) safety regarding the risk of new infections, (2) effects on the outcome of pre-existing infections, (3) whether immunosuppressive drugs used to treat ICI-related adverse events affect the risk of infection or virulence of pre-existing infections, (4) whether the use of vaccines in ICI-treated patients is considered safe, and (5) whether there are beneficial effects of ICIs that even qualify them as a therapeutic approach for these viral infections.

scholarly journals A Multi-Phenotype System to Discover Therapies for Age-Related Dysregulation of the Immune Response to Viral Infections

2020 ◽  
Author(s):  
Brandon White ◽  
Ben Komalo ◽  
Lauren Nicolaisen ◽  
Matt Donne ◽  
Charlie Marsh ◽  
...  
Keyword(s):  
Older Adults ◽  
Immune Response ◽  
Viral Infection ◽  
Immune Cells ◽  
Viral Infections ◽  
Cell Interaction ◽  
Rapid Identification ◽  
Beneficial Effects ◽  
Susceptibility To Infection ◽  
Age Related

ABSTRACTAge-related immune dysregulation contributes to increased susceptibility to infection and disease in older adults. We combined high-throughput laboratory automation with machine learning to build a multi-phenotype aging profile that models the dysfunctional immune response to viral infection in older adults. From a single well, our multi-phenotype aging profile can capture changes in cell composition, physical cell-to-cell interaction, organelle structure, cytokines, and other hidden complexities contributing to age-related dysfunction. This system allows for rapid identification of new potential compounds to rejuvenate older adults’ immune response. We used our technology to screen thousands of compounds for their ability to make old immune cells respond to viral infection like young immune cells. We observed beneficial effects of multiple compounds, of which two of the most promising were disulfiram and triptonide. Our findings indicate that disulfiram could be considered as a treatment for severe coronavirus disease 2019 and other inflammatory infections.

scholarly journals Establishment of a miRNA profile in paediatric HIV-1 patients and its potential as a biomarker for effectiveness of the combined antiretroviral therapy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Irene Consuegra ◽  
Samanta Gasco ◽  
María Jesús Serramía ◽  
José Luis Jiménez ◽  
Maria Jose Mellado ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Viral Infections ◽  
Mirna Gene ◽  
Mirna Profile ◽  
Control Group ◽  
Virus Infectivity ◽  
Beneficial Effects ◽  
Therapy Effectiveness ◽  
Taqman Array ◽  
Hiv 1

AbstractmiRNAs have been extensively studied in pathological conditions, including viral infections, such as those provoked by HIV-1. Several cellular and circulating miRNAs are altered during HIV-1 infection, with either beneficial effects on host defenses or enhanced virus infectivity. Blood samples were collected in sterile EDTA tubes and plasma was separated and stored, as were PBMCs. RNA was isolated and reverse-transcribed. Finally, the miRNA gene expression profile was assessed using TaqMan Array Human microRNA Card A v2.0. A comprehensive statistical analysis was performed on the results obtained. This is the first study on miRNAs in HIV-1 paediatric patients, and a miRNA profile differentiating patients starting combination antiretroviral therapy (cART) at different times after HIV-1 diagnosis was established. Thirty-four miRNAs were observed to have different expression levels between the control group and the cART group. The data indicates the need to start cART as soon as possible after the establishment of HIV-1 infection to assure the best outcome possible. Finally, the selected 34 miRNAs may be used as biomarkers for prognosis and assessing therapy effectiveness. However, more research must be conducted to establish adequate quantitative correlations.

Cocaine Intoxication and Hypertensive Emergency

2017 ◽  
Author(s):  
Jagan Ramamoorthy ◽  
Noreen E. Murphy
Keyword(s):  
Emergency Room ◽  
Elective Surgery ◽  
Anesthetic Management ◽  
Trauma Surgery ◽  
Illegal Drug ◽  
Hypertensive Emergency ◽  
Physiological Effects ◽  
Emergency Room Visits ◽  
Cocaine Use

Cocaine is a highly addictive, illegal drug with sympathomimetic properties that is responsible for nearly 500,000 emergency room visits per year. In at least one study, nearly 40% of trauma surgery patients and 1% of patients presenting for elective surgery tested positive for recent cocaine use. Given these numbers, anesthesiology providers must understand the physiological effects of cocaine and be able to safely manage these patients in both the intraoperative and perioperative phases. Anesthetic management of cocaine-using patients should focus on avoiding hemodynamic extremes and minimizing the ischemic consequences of vasospasm. This chapter reviews the basic pharmacology of cocaine, the physiologic effects of cocaine use, and the anesthetic management of the cocaine-using patient.

scholarly journals Targeting Host Defense System and Rescuing Compromised Mitochondria to Increase Tolerance against Pathogens by Melatonin May Impact Outcome of Deadly Virus Infection Pertinent to COVID-19

Molecules ◽  
2020 ◽  
Vol 25 (19) ◽  
pp. 4410
Author(s):  
Dun-Xian Tan ◽  
Ruediger Hardeland
Keyword(s):  
Infectious Diseases ◽  
Respiratory Diseases ◽  
Viral Infections ◽  
Critical Role ◽  
Virus Infections ◽  
Beneficial Effects ◽  
Mitochondrial Functions ◽  
Seasonal Flu ◽  
Host Defense System ◽  
The Warburg Effect

Fighting infectious diseases, particularly viral infections, is a demanding task for human health. Targeting the pathogens or targeting the host are different strategies, but with an identical purpose, i.e., to curb the pathogen’s spreading and cure the illness. It appears that targeting a host to increase tolerance against pathogens can be of substantial advantage and is a strategy used in evolution. Practically, it has a broader protective spectrum than that of only targeting the specific pathogens, which differ in terms of susceptibility. Methods for host targeting applied in one pandemic can even be effective for upcoming pandemics with different pathogens. This is even more urgent if we consider the possible concomitance of two respiratory diseases with potential multi-organ afflictions such as Coronavirus disease 2019 (COVID-19) and seasonal flu. Melatonin is a molecule that can enhance the host’s tolerance against pathogen invasions. Due to its antioxidant, anti-inflammatory, and immunoregulatory activities, melatonin has the capacity to reduce the severity and mortality of deadly virus infections including COVID-19. Melatonin is synthesized and functions in mitochondria, which play a critical role in viral infections. Not surprisingly, melatonin synthesis can become a target of viral strategies that manipulate the mitochondrial status. For example, a viral infection can switch energy metabolism from respiration to widely anaerobic glycolysis even if plenty of oxygen is available (the Warburg effect) when the host cell cannot generate acetyl-coenzyme A, a metabolite required for melatonin biosynthesis. Under some conditions, including aging, gender, predisposed health conditions, already compromised mitochondria, when exposed to further viral challenges, lose their capacity for producing sufficient amounts of melatonin. This leads to a reduced support of mitochondrial functions and makes these individuals more vulnerable to infectious diseases. Thus, the maintenance of mitochondrial function by melatonin supplementation can be expected to generate beneficial effects on the outcome of viral infectious diseases, particularly COVID-19.

scholarly journals Is the Hygiene Hypothesis an Example of Hormesis?

2003 ◽  
Vol 1 (2) ◽  
pp. 154014203914343 ◽  
Author(s):  
John A. Bukowski ◽  
R. Jeffrey Lewis
Keyword(s):  
Viral Infections ◽  
Hygiene Hypothesis ◽  
Developed Countries ◽  
Protective Effects ◽  
Beneficial Effects ◽  
Hormetic Effect ◽  
Parasitic Burden ◽  
Rising Incidence ◽  
Rigorous Study ◽  
Microbial Agents

The “hygiene hypothesis” has been suggested to explain the rising incidence of allergic disorders in developed countries. The postulated mechanism is that infectious and/or microbial agents stimulate the immune system toward Th1 (allergy fighting) rather than Th2 (allergy promoting) response. This paper reviews the evidence related to early life infectious/microbial exposures and subsequent atopic disorders and evaluates whether these data suggest a hormetic effect. Our review indicates an insufficient and contradictory association for bacterial/viral infections, with protective effects being either absent or specific to certain infections and/or populations. Chronic, heavy parasitic burdens appear to confer protection against atopic disorders, but are associated with considerable pathology. Moreover, light parasitic burden may increase allergic responses (i.e., no “low dose” beneficial effect). In contrast, there is consistent evidence that general microbial exposures, particularly gut commensals, may be protective against allergy development, which is consistent with a hormetic effect (i.e., potentially beneficial effects at low doses and detrimental effects at high levels). Conclusion: General microbial exposures in relation to the “hygiene hypothesis” may represent a hormetic effect, although further research with more rigorous study methods (i.e., prospective designs and measurement of exposure timing, dose, route, etc.) are needed.

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