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Investigating the Effects of Phenytoin, Phenobarbital, Topiramate, Carbamazepine and Sodium Valproate on the Neurotransmitter Speed in Treated Seizure Children 苯妥英、苯巴比妥、托吡酯、卡马西平和丙戊酸钠对癫痫患儿神经递质速度的影响
Pub Date : 2019-12-18 DOI: 10.23937/2378-3001/1410093
AhmadabadiF Farzad, Fattahzadeh Ghasem, Atalu Abolfazl, B. Pooya
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引用次数: 1
Challenges and Prospects of Awake Craniotomy in a Resource-Poor Setting 资源贫乏地区清醒开颅术的挑战与前景
Pub Date : 2019-01-01 DOI: 10.15436/2377-1348.19.2516
A. Okunlola, Okunlola F. Abiodun, K. OkunlolaCecilia, F. BabalolaOlakunle, O. Paul, O. OrewoleTesleem, P. AremuAbayomi, B. RabiuTaopheeq, O. AjayiOlabande, Ommega Internationals
Background: The trend in neurosurgery is towards awake craniotomy in a suitable patient to minimize the risk of anesthesia, allow intraoperative monitoring of the patient’s function and reduce operative morbidity. This has not been widely utilized in poor resource settings like our center where both human and material resources are limited. Aim: The aim of this review is to document the challenges and prospects of awake craniotomy in resource-poor settings. Methodology: The Federal Teaching Hospital Ido-Ekiti is located in a suburban community in South Western Nigeria with minimally active neurosurgical practice due to limited human and material resources. Two patients with right frontal brain tumor abutting on the motor cortex had awake craniotomy and gross total tumor excision under low dose sedation with propofol and local anesthesia. Results: Both patients complained of tolerable discomfort during bone work. We achieved a gross total tumor excision in both cases and there was no need to convert to general anesthesia. Both patients were fully awake at the end of their surgery and there was an improvement in their headache and hemiparesis. Conclusion: Awake craniotomy is commonly practiced in well-established neurosurgical facilities across the globe but it should be considered as an option in resource-poor settings in suitable patients to reduce operative morbidity and pressure on the limited human and material resources.
背景:神经外科的趋势是在合适的患者中进行清醒开颅手术,以尽量减少麻醉的风险,允许术中监测患者的功能,降低手术发病率。在像我们中心这样人力和物力资源都有限的资源贫乏的环境中,这种方法还没有得到广泛的应用。目的:本综述的目的是记录资源贫乏地区清醒开颅手术的挑战和前景。方法:Ido-Ekiti联邦教学医院位于尼日利亚西南部的一个郊区社区,由于人力和物力资源有限,其神经外科实践活动很少。在小剂量异丙酚局部麻醉镇静下,对2例毗邻运动皮质的右额叶脑肿瘤行清醒开颅术和肿瘤全切术。结果:两例患者在骨工作时均有可忍受的不适。我们在两个病例中都实现了肿瘤的总切除,没有必要转到全身麻醉。手术结束时,两名患者都完全清醒,头痛和偏瘫也有所改善。结论:清醒开颅术在全球完善的神经外科设施中普遍采用,但在资源贫乏的环境中,应考虑在合适的患者中选择清醒开颅术,以减少手术发病率和有限的人力物力压力。
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引用次数: 2
Late Onset Multiple Sclerosis: An Underlying Disease for Trigeminal Neuralgia 迟发性多发性硬化症:三叉神经痛的潜在疾病
Pub Date : 2019-01-01 DOI: 10.15436/2377-1348.19.2456
Lucas A. Greca, Á. C. B. Eboni, P. Wille, M. Gonçalves, Ommega Internationals
Introduction: Late onset Multiple Sclerosis (LOMS) is a rare condition characterized by the first outbreak of the disease at or above the age of 50 years old. On the other hand, Trigeminal Neuralgia (TN) is a shock-like hemi-facial headache. What both might have in common is the association with the demyelination process. While LOMS is strictly related to loss of myelin sheath, TN if often related to neurovascular compression, but when it doesn’t, demyelination stands for a probable implicated pathophysiology. At certain population, TN might be the first symptom of LOMS. Case Presentation: Our patient is a 65 year-old female who develops a severe hemi-facial shock-like headache. At first, examiners thought to be dealing with a primary form of TN due to absence of motor or other sensorial symptoms referred by the patient. Although, CNS images were not consistent with the initial hypothesis, revealing an impressive LOMS pattern. Conclusion: physicians should always consider LOMS as an underlying disease for patients, at or above 50 years old, manifesting TN as an isolated symptom. This may alert for earlier MS diagnosis and correct therapy strategies for these patients.
迟发性多发性硬化症(LOMS)是一种罕见的疾病,其特征是在50岁或50岁以上首次发病。另一方面,三叉神经痛(TN)是一种休克样的半面部头痛。两者的共同之处可能是与脱髓鞘过程有关。虽然LOMS与髓鞘的丧失密切相关,但TN通常与神经血管压迫有关,但如果不是,脱髓鞘可能与病理生理有关。在某些人群中,TN可能是LOMS的首发症状。病例介绍:我们的病人是一位65岁的女性,她出现了严重的半面部休克样头痛。起初,由于患者没有运动或其他感觉症状,检查人员认为这是一种原发性TN。然而,中枢神经系统图像与最初的假设不一致,显示出令人印象深刻的LOMS模式。结论:对于50岁或以上的患者,医生应始终将LOMS视为潜在疾病,TN表现为孤立症状。这可能提醒早期MS的诊断和正确的治疗策略,这些患者。
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引用次数: 1
1: Hou ZJ et al. Magnetic Resonance Imaging in Temporal Lobe Epilepsy [1]侯志杰等。颞叶癫痫的磁共振成像
Pub Date : 2019-01-01 DOI: 10.17554/j.issn.2313-5611.2019.05.80
Z. Hou, N. Shrestha
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引用次数: 0
Geography and demography of Alzheimer's 阿尔茨海默氏症的地理和人口统计学
Pub Date : 2019-01-01 DOI: 10.15436/2377-1348.19.2503
Alexander Kholmanskly, Ommega Internationals
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引用次数: 0
Bilateral Rasmussen’s Encephalitis in an African Child: A Case Report 非洲儿童双侧拉斯穆森脑炎1例报告
Pub Date : 2019-01-01 DOI: 10.15436/2377-1348.19.2517
A. Okunlola, A. Okunlola, C. Okunlola, O. Babalola, O. T. Bamigboye-Taiwo, A. Adaje, C. Onyema, Ommega Internationals
Rasmussen’s encephalitis is a rare neurological disease characterized by unilateral hemispheric atrophy, focal intractable seizures, and progressive neurological deficits. The bilateral subtype is extremely rare with few reported cases in the literature. We present a seven year old boy with bilateral Rasmussen’s encephalitis which could have been missed if there is no imaging facility. We also highlighted the possible associated etiological factors and sociocultural challenges in the management.
拉斯穆森脑炎是一种罕见的神经系统疾病,其特征是单侧半球萎缩,局灶性难治性癫痫发作和进行性神经功能缺损。双侧亚型极为罕见,文献中报道的病例很少。我们提出一个七岁的男孩与双侧拉斯穆森脑炎可能会被遗漏,如果没有影像学设备。我们还强调了可能的相关病因和管理中的社会文化挑战。
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引用次数: 0
The Neurological Manifestations as an Onset Symptom of Antiphospholipid Syndrome: Report of Two Cases 作为抗磷脂综合征起病症状的神经学表现:附两例报告
Pub Date : 2019-01-01 DOI: 10.15436/2377-1348.19.2033
Saeed Shahbeigi, S. Karamolahi, H. Pakdaman, S. Nazarbaghi, A. Altıntaş, Ommega Internationals
The Antiphospholipid Syndrome (APS) is defined by the occurrence of multiple venous and arterial thrombosis. In this condition, the presence of anti-phospholipid antibodies (aPL), namely lupus anticoagulant (LA), anti-Cardiolipin antibodies (acl) or anti-beta 2 glycoprotein 1 antibodies is necessary for diagnosis[1,2]. The prevalence of aPL seropositive ranges between 1-5% in the general population, but only a minority of these individuals develop the APS[1]. For the definite diagnosis of APS at least one clinical feature such as vascular thrombosis or pregnancy morbidity and one laboratory abnormality must be observed. The laboratory abnormalities must be present on two or more occasions at least 12 weeks apart[3]. The cerebral involvement in APS is common and characterized by different clinical manifestations; they could be the first presenting feature or appear in the course of the disease. The reported manifestations of the cerebral involvement are: cerebral ischemic events such as CVA and TIA, epilepsy, dementia, cognitive deficit, headache, psychiatric disorders, chorea, MSlike syndrome, transverse myelitis and ocular symptoms. It is notable to mention that the presence of aPL in patients without criteria for APS may also be associated with neuropsychiatric and cognitive disturbances.
抗磷脂综合征(APS)的定义是出现多种静脉和动脉血栓形成。在这种情况下,抗磷脂抗体(aPL),即狼疮抗凝血剂(LA),抗心磷脂抗体(acl)或抗β 2糖蛋白1抗体的存在是诊断的必要条件[1,2]。在一般人群中,aPL血清阳性的患病率在1-5%之间,但只有少数人会发展为APS[1]。为了明确诊断APS,必须观察到至少一项临床特征,如血管血栓形成或妊娠发病率和一项实验室异常。实验室异常必须至少间隔12周出现两次或两次以上[3]。APS累及大脑较为常见,临床表现各异;它们可能是第一个表现特征,也可能出现在疾病的过程中。脑受累的报告表现为:脑缺血事件,如CVA和TIA,癫痫,痴呆,认知障碍,头痛,精神障碍,舞蹈病,ms样综合征,横贯脊髓炎和眼部症状。值得注意的是,在没有APS标准的患者中存在aPL也可能与神经精神和认知障碍有关。
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引用次数: 1
Cerebral Function Monitoring In Neonatal Intensive Care Units 新生儿重症监护病房脑功能监测
Pub Date : 2018-12-22 DOI: 10.17554/J.ISSN.2313-5611.2018.04.78
A. Orman, N. Hakan, M. Aydin
Amplitude-integrated electroencephalography (aEEG) is a method for continuous monitoring of brain activity that is increasingly used in the neonatal intensive care unit. aEEG is accessible by non-expert person, and offers continuous bedside cerebral function monitoring (CFM). In its simplest form, aEEG is a processed single-channel electroencephalogram that is filtered and time-compressed. Several classifications are currently in use to describe patient tracings, incorporating voltage criteria, pattern recognition, cyclicity, and the presence or absence of seizures. The main usage of the CFM currently is for monitoring term newborns after birth asphyxia. Another well-established indication for CFM is monitoring for seizure activity with an addition advantage of monitoring the treatment effect. Current evidences demonstrate that aEEG is useful to monitor cerebral background activity, diagnose and treat seizures and predict neurodevelopmental outcomes for newborns. Thus, the main advantages of this device are its simplicity for both application and interpreting on one hand and the possibility of continuous long-term monitoring with real time assessment of clinical events on the other. This review aims to explain the fundamentals behind aEEG and its clinical applications.
波幅综合脑电图(aEEG)是一种连续监测大脑活动的方法,越来越多地用于新生儿重症监护病房。aEEG可由非专业人员使用,并提供连续的床边脑功能监测(CFM)。在其最简单的形式中,aEEG是经过过滤和时间压缩的处理过的单通道脑电图。目前有几种分类用于描述患者的跟踪,包括电压标准、模式识别、周期和癫痫发作的存在或不存在。目前CFM的主要用途是监测出生后窒息的足月新生儿。CFM的另一个公认的适应症是监测癫痫发作活动,它具有监测治疗效果的额外优势。目前的证据表明,aEEG可用于监测脑背景活动,诊断和治疗癫痫发作,并预测新生儿的神经发育结果。因此,该设备的主要优点是一方面易于应用和解释,另一方面可以连续长期监测并实时评估临床事件。这篇综述旨在解释aEEG背后的基础及其临床应用。
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引用次数: 0
Possible Critical Role of Latent Chronic Toxoplasma Gondii Infection in Triggering, Development and Persistence of Autoimmune Diseases 潜伏性慢性弓形虫感染在自身免疫性疾病的触发、发展和持续中可能发挥的关键作用
Pub Date : 2018-12-22 DOI: 10.17554/J.ISSN.2313-5611.2018.04.79
J. Prandota
T. gondii is globally distributed with a high proportion of the world population estimated to be seropositive, and in the U.S. the parasite is responsible for approximately million infections each year. T. gondii tachyzoites infect almost all nucleated cells and their intracellular multiplication and lifelong persistence in the host cells play an important role in triggering and development of autoimmune diseases (ADs). Latent chronic T. gondii infection may be associated with iron, iodine, and folic acid  deficiencies that facilitate development and/or progression of ADs. The oral route is the natural portal of entry for the parasite and gastrointestinal manifestations are frequently reported in patients with ADs. Prolactin was found to bind to tachyzoites and this process impairs their adhesion and penetration into the host cells. Hyperprolactinemia (HPRL) demonstrated in patients with different ADs may therefore reflect host defense against T. gondii infection, and several antipsychotic drugs that induce HPRL also have antitoxoplasmatic activity. Leptin and obesity play an important role of in triggering and maintenance of inflammation and autoimmunity. T. gondii infection causes a significant increase in leptin levels and there is a significant positive association between the parasite seropositivity and obesity. Nitric oxide (NO) acts as a proapoptotic as well as an antiapoptotic biomodulator, and have a variety effects on autophagy. Overproduction of NO during T. gondii infection causes dysfunction of both  these processes and therefore hinders cleaning service of the apoptotic/autophagic cell-derived antigenic remnants, finally leading to triggering and development of ADs. Damage of the olfactory system associated with chronic latent T. gondii infection may affect olfactory bulb volume and various olfactory functions, being therefore at least in part responsible for the smell impairment in ADs. The potent proinflammatory response of macrophages to infection with T. gondii type II may explain the ability of the strain to cause pathology after oral infection. The parasite also triggers the secretion of antiinflammatory cytokines, such as IL-10, TGF-b, and generation of reactive nitrogen intermediates, thus suppressing the development of the T H 1 immune responses and deactivating macrophages. Toxoplasma chronic infection-induced cytotoxic T lymphocyte exhaustion leads to development of ADs because of decreased polyfunctionality, cytotoxic capability,  cytokine production, proliferative capacity, and metabolic deficiency. The process of CD4 + and CD8 + T-cell immune exhaustion inhibits the immune response, thus facilitating pathogen persistence. Systemic T. gondii infection triggers a rapid and persistent decrease in the size of naive CD4 + T lymphocyte pool, and a long-term thymic atrophy and output due to destruction of the thymic epithelium. Chronic parasite infections characterized by lower pathogen burden usually restricted to tissues, s
弓形虫分布在全球,据估计,世界人口中有很高比例的人血清呈阳性,在美国,这种寄生虫每年造成大约100万例感染。弓形虫速殖子感染几乎所有有核细胞,其在宿主细胞内的增殖和终身存留在自身免疫性疾病(ADs)的触发和发展中起重要作用。潜伏的慢性弓形虫感染可能与铁、碘和叶酸缺乏有关,这促进了ad的发生和/或进展。口服途径是寄生虫的天然入口,ad患者经常报告胃肠道症状。催乳素被发现与速殖子结合,这一过程损害了它们对宿主细胞的粘附和渗透。因此,不同ad患者的高催乳素血症(HPRL)可能反映了宿主对弓形虫感染的防御,并且几种诱导高催乳素血症的抗精神病药物也具有抗弓形虫活性。瘦素和肥胖在炎症和自身免疫的触发和维持中起着重要作用。弓形虫感染导致瘦素水平显著升高,弓形虫血清阳性与肥胖之间存在显著正相关。一氧化氮(NO)作为促凋亡和抗凋亡的生物调节剂,对细胞自噬有多种作用。弓形虫感染过程中NO的过量产生会导致这两个过程的功能障碍,从而阻碍凋亡/自噬细胞衍生的抗原残留物的清洁服务,最终导致ad的触发和发展。慢性潜伏性弓形虫感染相关的嗅觉系统损伤可能会影响嗅球体积和各种嗅觉功能。因此,至少在一定程度上导致了ad的嗅觉障碍。巨噬细胞对II型弓形虫感染的强促炎反应可能解释了该菌株在口腔感染后引起病理的能力。寄生虫还触发抗炎细胞因子的分泌,如IL-10、TGF-b和活性氮中间体的产生,从而抑制t1免疫反应的发展,使巨噬细胞失活。由于弓形虫慢性感染诱导的细胞毒性T淋巴细胞衰竭导致多功能性、细胞毒性、细胞因子产生、增殖能力和代谢缺陷的降低,从而导致ad的发展。CD4 +和CD8 + t细胞的免疫衰竭过程抑制了免疫应答,从而促进了病原体的持续存在。全身弓形虫感染触发初始CD4 + T淋巴细胞池大小的快速和持续下降,由于胸腺上皮的破坏,长期的胸腺萎缩和输出。慢性寄生虫感染的特点是病原体负担较低,通常局限于组织,提示诱导T细胞衰竭的其他驱动力,如寄生虫囊化。据报道,与对照组相比,某些ad患者持续病毒感染抗体的发生率显著降低,这可能是由于宿主B细胞功能受到抑制(耗尽)。弓形虫和病毒相关的炎症过程可能相互重叠,这取决于最终的临时或稳定的促炎/抗炎细胞因子星座,从而导致ad的临床病程恶化或改善。双亲和T细胞受体可能至少在一定程度上负责经常观察到的弓形虫与某些病毒和细菌的共感染。通常报道的ad合并症至少可以部分解释为由病原体引起的肝损害。ad患者通常缺乏维生素D,大量证据表明维生素D对先天免疫和获得性免疫都有重要的有益影响。此外,维生素D具有杀弓形虫作用,因此应该在ad的治疗方案中占有一席之地。
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引用次数: 5
Oxytocin Release during the Meditation of Altruism and Appreciation (Arigato-Zen) 利他和欣赏冥想中催产素的释放
Pub Date : 2018-03-18 DOI: 10.17554/J.ISSN.2313-5611.2018.04.75
Sōhō Machida, M. Sunagawa, Toku Takahashi
A number of modern researchers have studied the relationship between religion and health. In every religious tradition, virtues such as self-sacrifice, altruism, and appreciation have been considered quite essential. Arigato-Zen (AZ) (Gratitude Zen) is an easy and simple voice-meditation developed by Dr. Machida, which motivates the feeling of altruism and appreciation. By performing AZ, one is able to cleanse the negative subconscious memories that underlie problematic phenomena. Hypothalamic oxytocin (OT) plays an important role in the ability to form social attachments, including parental care and pair bonding. It has been shown that social interaction is important to adapt to our daily life stress via the OT expression. It is hypothesized that OT is stimulated via the AZ meditation of altruism and appreciation. Using saliva samples, OT levels were measured in 32 participants before and after AZ. Salivary OT levels were significantly increased after AZ from 66.3 ± 6.7 pg/ml to 90.6 ± 18.7 pg/mL (M ± SE, n = 32, p = 0.028). AZ practice is a quite unique type of meditation, which combines voice-vibration system and traditional Zen meditation in order to synergistically stimulate OT system.
许多现代研究人员研究了宗教与健康之间的关系。在每一种宗教传统中,自我牺牲、利他主义和感恩等美德都被认为是必不可少的。Arigato-Zen (AZ)(感恩禅)是町田博士发明的一种简单易行的声音冥想,它能激发利他主义和感激之情。通过执行AZ,一个人能够清除潜藏在问题现象背后的消极潜意识记忆。下丘脑催产素(OT)在形成社会依恋的能力中起着重要作用,包括亲代关怀和伴侣关系。研究表明,社会互动对于通过OT表达适应日常生活压力非常重要。假设OT是通过利他主义和欣赏的AZ冥想来刺激的。利用唾液样本测量32名受试者AZ前后的OT水平,AZ后唾液OT水平从66.3±6.7 pg/ml显著升高至90.6±18.7 pg/ml (M±SE, n = 32, p = 0.028)。AZ练习是一种非常独特的冥想方式,它将声频振动系统与传统禅宗冥想相结合,以协同刺激OT系统。
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引用次数: 4
期刊
International journal of neurology
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