Medical hypotheses最新文献_第2页

Does aberrant electrocortical dynamics pattern imply atypical balance control in adolescents with idiopathic scoliosis? 特发性脊柱侧弯症青少年的异常皮层电动力模式是否意味着非典型平衡控制？

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-11-09 DOI: 10.1016/j.mehy.2024.111520

Carole Fortin , Inga Sophia Knoth , Catherine Bluteau , Sarah Lippé , Martin Simoneau

Adolescent idiopathic scoliosis (AIS) is a developmental disorder described as a three-dimensional spine deformity with multifactorial etiology. The multifactorial model of AIS suggests that the patient population is diverse. Identifying individuals with sensorimotor control impairments could enable personalized treatments, potentially leading to improved outcomes for those with AIS. We hypothesize that abnormal electrocortical dynamics within the sensorimotor cortex will be related to less efficient balance control in standing during ankle proprioception alteration in the absence or presence of vision. To test this hypothesis, the balance control performance of adolescents with AIS will be assessed on a force platform by computing the root mean square value of the scalar distance between the center of pressure and the center of gravity. Electroencephalography will be recorded while challenging balance control by altering ankle proprioception in the presence and absence of visual cues. Time-frequency analyses will be calculated to determine alpha, and beta band power in both conditions. Pilot data from 13 participants with AIS were analyzed to support our hypothesis. Three participants with less efficient balance control showed electrocortical dynamics changes, such as an increase in beta band power in the presence and absence of vision and a decrease in alpha band power in the presence of vision compared to the AIS group with efficient balance control. These findings support our hypothesis of suboptimal sensorimotor information processing in the subgroup of adolescents with AIS with less efficient balance control, which could have significant implications for developing personalized treatments for AIS.

青少年特发性脊柱侧弯症（AIS）是一种发育障碍性疾病，是一种多因素致病的三维脊柱畸形。AIS 的多因素模型表明，患者群体是多样化的。识别有感觉运动控制障碍的个体可实现个性化治疗，从而改善 AIS 患者的预后。我们假设，在无视觉或有视觉的情况下，感觉运动皮层内异常的皮层电动态将与踝关节本体感觉改变时站立时平衡控制效率较低有关。为了验证这一假设，将通过计算压力中心与重心之间标量距离的均方根值，在测力平台上评估患有 AIS 的青少年的平衡控制能力。在有或没有视觉提示的情况下，通过改变脚踝本体感觉来挑战平衡控制能力，同时记录脑电图。将计算时频分析，以确定两种情况下的α和β波段功率。我们分析了 13 名患有 AIS 的参与者的试验数据，以支持我们的假设。与具有高效平衡控制能力的 AIS 组相比，3 名平衡控制能力较弱的参与者表现出了皮层电动态变化，如在有视觉和无视觉时，β 波段功率增加，而在有视觉时，α 波段功率下降。这些发现支持了我们的假设，即在平衡控制能力较差的AIS青少年亚群中，传感器运动信息处理能力处于次优状态，这对开发针对AIS的个性化治疗方法具有重要意义。

{"title":"Does aberrant electrocortical dynamics pattern imply atypical balance control in adolescents with idiopathic scoliosis?","authors":"Carole Fortin , Inga Sophia Knoth , Catherine Bluteau , Sarah Lippé , Martin Simoneau","doi":"10.1016/j.mehy.2024.111520","DOIUrl":"10.1016/j.mehy.2024.111520","url":null,"abstract":"<div><div>Adolescent idiopathic scoliosis (AIS) is a developmental disorder described as a three-dimensional spine deformity with multifactorial etiology. The multifactorial model of AIS suggests that the patient population is diverse. Identifying individuals with sensorimotor control impairments could enable personalized treatments, potentially leading to improved outcomes for those with AIS. We hypothesize that abnormal electrocortical dynamics within the sensorimotor cortex will be related to less efficient balance control in standing during ankle proprioception alteration in the absence or presence of vision. To test this hypothesis, the balance control performance of adolescents with AIS will be assessed on a force platform by computing the root mean square value of the scalar distance between the center of pressure and the center of gravity. Electroencephalography will be recorded while challenging balance control by altering ankle proprioception in the presence and absence of visual cues. Time-frequency analyses will be calculated to determine alpha, and beta band power in both conditions. Pilot data from 13 participants with AIS were analyzed to support our hypothesis. Three participants with less efficient balance control showed electrocortical dynamics changes, such as an increase in beta band power in the presence and absence of vision and a decrease in alpha band power in the presence of vision compared to the AIS group with efficient balance control. These findings support our hypothesis of suboptimal sensorimotor information processing in the subgroup of adolescents with AIS with less efficient balance control, which could have significant implications for developing personalized treatments for AIS.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"193 ","pages":"Article 111520"},"PeriodicalIF":2.1,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142650951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The potential role of fixation eye movements in the development of myopia 固定眼球运动在近视发展中的潜在作用

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-11-09 DOI: 10.1016/j.mehy.2024.111515

Hao Yuan , Jiarui Yang , Xuemin Li

Myopia, a globally public health problem, referring to an abnormal refractive state in which the focus falls in front of retina due to extended axial length, is always regarded as an excessive emmetropia process and extreme ocular growth. Fixation eye movements (FEMs), small eye movements occurring incessantly during our gazes to maintain continuous attention and keep clear vision, have been considered to participate in the emmetropization process, yet their role in relation to myopia development has not been clearly demonstrated. It is possible that abnormal fixation eye movements could contribute to the onset and progression of myopia. Although the role of fixation eye movements (FEMs) in the setting of myopia has not yet been investigated, previous researches have demonstrated that patients with myopic refractive error performed significantly abnormal FEMs characteristics, suggesting the potential association between FEMs and myopia development. In this article, we hypothesized that abnormal fixation movements would result in disturbed spatiotemporal and defocus visual signal, abnormal longitudinal chromatic aberration, amplified eye-growth signal and extraocular muscle pressure, thereby inducing myopia development. In order to dissect any association between FEMs and myopia, further work is required to prospectively investigate the characteristics of FEMs during development and/or in populations affected by myopia or hyperopia. Future studies will be needed to update new understanding of myopia mechanism and propose suggestive prevention measures.

近视是一个全球性的公共健康问题，指的是由于轴向长度延长而导致焦点落在视网膜前方的异常屈光状态。固视眼球运动（FEMs）是我们在注视过程中为了保持持续的注意力和清晰的视力而不断发生的眼球小动作，它被认为参与了屈光过程，但其与近视发展的关系尚未得到明确证实。异常的固定眼球运动有可能导致近视的发生和发展。虽然固定眼球运动（FEMs）在近视中的作用尚未得到研究，但以往的研究表明，近视屈光不正患者的固定眼球运动特征明显异常，这表明固定眼球运动与近视发展之间可能存在关联。本文假设，异常定焦运动会导致时空和散焦视觉信号紊乱、纵向色差异常、眼球生长信号和眼外肌压力放大，从而诱发近视发展。为了剖析FEMs与近视之间的任何关联，需要进一步开展工作，前瞻性地调查FEMs在发育过程中和/或在受近视或远视影响的人群中的特征。未来的研究还需要更新对近视发生机制的认识，并提出预防近视的建议性措施。

{"title":"The potential role of fixation eye movements in the development of myopia","authors":"Hao Yuan , Jiarui Yang , Xuemin Li","doi":"10.1016/j.mehy.2024.111515","DOIUrl":"10.1016/j.mehy.2024.111515","url":null,"abstract":"<div><div>Myopia, a globally public health problem, referring to an abnormal refractive state in which the focus falls in front of retina due to extended axial length, is always regarded as an excessive emmetropia process and extreme ocular growth. Fixation eye movements (FEMs), small eye movements occurring incessantly during our gazes to maintain continuous attention and keep clear vision, have been considered to participate in the emmetropization process, yet their role in relation to myopia development has not been clearly demonstrated. It is possible that abnormal fixation eye movements could contribute to the onset and progression of myopia. Although the role of fixation eye movements (FEMs) in the setting of myopia has not yet been investigated, previous researches have demonstrated that patients with myopic refractive error performed significantly abnormal FEMs characteristics, suggesting the potential association between FEMs and myopia development. In this article, we hypothesized that abnormal fixation movements would result in disturbed spatiotemporal and defocus visual signal, abnormal longitudinal chromatic aberration, amplified eye-growth signal and extraocular muscle pressure, thereby inducing myopia development. In order to dissect any association between FEMs and myopia, further work is required to prospectively investigate the characteristics of FEMs during development and/or in populations affected by myopia or hyperopia. Future studies will be needed to update new understanding of myopia mechanism and propose suggestive prevention measures.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"193 ","pages":"Article 111515"},"PeriodicalIF":2.1,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142650950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comment on “Clinically-relevant reductions in oxygen partial pressure as possible contributor to cardiovascular benefits of sauna practice” 关于 "与临床相关的氧分压降低可能是桑拿浴对心血管有益的因素 "的评论

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-11-08 DOI: 10.1016/j.mehy.2024.111518

David C. Poole, Andrew G. Horn

引用次数: 0

COVID-19 era and GLP-1 RA era: Is it a renaissance when the dusk of global tragedy co-occurring with the dawn of magical remedy? COVID-19 时代和 GLP-1 RA 时代：当全球悲剧的黄昏与神奇疗法的黎明同时到来时，这是否是一种复兴？

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-11-08 DOI: 10.1016/j.mehy.2024.111516

Deepak Gupta , Berhane Seyoum , Sarwan Kumar , Shushovan Chakrabortty

The hypothesis is that the world should explore to either validate or refute whether glucagon-like peptide–1 receptor agonists (GLP-1 RAs) are drawing some if not all of their all-rounder multisystem capacities in general and their weight-reducing capabilities in particular as catalyzed by natural and/or vaccine-induced immunities against SARS-CoV-2 and their variants implicated as the causative agents for onset and evolution of COVID-19 pandemic globally. The simplest initial exploration could be healthcare systems running queries in their historical databases to assess whether patients who have been receiving GLP-1 RAs since before the pandemic are reporting significantly larger weight-loss since after the pandemic, and if it is so, then whether those significant results could be validated with laboratory and basic research to demonstrate antibodies against SARS-CoV-2 acting as catalysts for larger weight-loss with GLP-1 RAs.

我们的假设是，全世界都应该探索胰高血糖素样肽-1 受体激动剂（GLP-1 RAs）是否正在通过天然免疫和/或疫苗诱导免疫来抵御 SARS-CoV-2 及其变种（被认为是 COVID-19 在全球范围内爆发和演变的致病因子），从而在总体上（如果不是全部的话）发挥其全面的多系统能力，特别是减轻体重的能力。最简单的初步探索可以是医疗保健系统在其历史数据库中进行查询，以评估自大流行前就开始接受 GLP-1 RAs 的患者是否报告自大流行后体重明显减轻，如果是，那么这些重要结果是否可以通过实验室和基础研究进行验证，以证明针对 SARS-CoV-2 的抗体是 GLP-1 RAs 带来更大体重减轻的催化剂。

引用次数: 0

The anti-inflammatory role of therapeutic ultrasound and low-level laser in chronic rhinosinusitis: A fractional exhaled nitric oxide outcome hypothesis 治疗性超声波和低强度激光在慢性鼻炎中的抗炎作用：分量呼出一氧化氮结果假设

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-11-08 DOI: 10.1016/j.mehy.2024.111519

Mina Kashi-Alashti , Noureddin Nakhostin Ansari , Soofia Naghdi , Mojtaba Fathali , Jim Bartley

Chronic rhinosinusitis is defined as a complex of disorders whose main feature is nasal and paranasal sinus mucosal inflammation for at least three months. Inflammation plays a key role in chronic rhinosinusitis. Fractional exhaled nitric oxide is used to monitor eosinophilic airway inflammation in the human lower airways. Fractional exhaled nitric oxide levels are paradoxically low in some chronic rhinosinusitis patients. This has been attributed to sinus ostia obstruction. However, a recent study has demonstrated that fractional exhaled nitric oxide levels could serve as a chronic rhinosinusitis inflammation biomarker independent of lower airway inflammatory disease and could be used as a treatment response biomarker. Therapeutic ultrasound and low-level laser therapy have been used in chronic rhinosinusitis management. Through a variety of mechanisms, ultrasound enhances bacterial killing. Low level laser therapy increases nitric oxide release and ATP levels. It also reduces inflammation and accelerates tissue repair. Fractional exhaled nitric oxide levels could be used to evaluate the anti-inflammatory actions of therapeutic ultrasound and low-level laser therapy in chronic rhinosinusitis patients. A hypothesis that fractional expired nitric oxide measurements could be a useful biomarker to evaluate their potential anti-inflammatory mechanisms and monitor their treatment efficacy is proposed. This could contribute to a better understanding of these therapies in chronic rhinosinusitis management. An improved understanding of treatment efficacy could lead to improved management strategies.

慢性鼻炎被定义为以鼻腔和副鼻窦粘膜炎症为主要特征、持续至少三个月的疾病综合征。炎症在慢性鼻炎中起着关键作用。分量呼出一氧化氮用于监测人体下呼吸道的嗜酸性粒细胞气道炎症。在一些慢性鼻炎患者中，分量呼出一氧化氮的水平很低。这被归因于窦口阻塞。然而，最近的一项研究表明，分数呼气一氧化氮水平可作为一种独立于下气道炎症疾病的慢性鼻炎炎症生物标志物，并可用作治疗反应生物标志物。治疗性超声波和低强度激光疗法已被用于慢性鼻炎的治疗。通过多种机制，超声波可增强杀灭细菌的能力。低强度激光疗法可增加一氧化氮的释放和 ATP 水平。它还能减轻炎症，加速组织修复。分量呼气一氧化氮水平可用于评估治疗性超声波和低水平激光疗法对慢性鼻炎患者的抗炎作用。有一种假设认为，分量呼出一氧化氮测量值可作为一种有用的生物标志物，用于评估其潜在的抗炎机制和监测其治疗效果。这将有助于更好地理解这些疗法在慢性鼻炎治疗中的作用。加深对疗效的了解有助于改进管理策略。

{"title":"The anti-inflammatory role of therapeutic ultrasound and low-level laser in chronic rhinosinusitis: A fractional exhaled nitric oxide outcome hypothesis","authors":"Mina Kashi-Alashti , Noureddin Nakhostin Ansari , Soofia Naghdi , Mojtaba Fathali , Jim Bartley","doi":"10.1016/j.mehy.2024.111519","DOIUrl":"10.1016/j.mehy.2024.111519","url":null,"abstract":"<div><div>Chronic rhinosinusitis is defined as a complex of disorders whose main feature is nasal and paranasal sinus mucosal inflammation for at least three months. Inflammation plays a key role in chronic rhinosinusitis. Fractional exhaled nitric oxide is used to monitor eosinophilic airway inflammation in the human lower airways. Fractional exhaled nitric oxide levels are paradoxically low in some chronic rhinosinusitis patients. This has been attributed to sinus ostia obstruction. However, a recent study has demonstrated that fractional exhaled nitric oxide levels could serve as a chronic rhinosinusitis inflammation biomarker independent of lower airway inflammatory disease and could be used as a treatment response biomarker. Therapeutic ultrasound and low-level laser therapy have been used in chronic rhinosinusitis management. Through a variety of mechanisms, ultrasound enhances bacterial killing. Low level laser therapy increases nitric oxide release and ATP levels. It also reduces inflammation and accelerates tissue repair. Fractional exhaled nitric oxide levels could be used to evaluate the anti-inflammatory actions of therapeutic ultrasound and low-level laser therapy in chronic rhinosinusitis patients. A hypothesis that fractional expired nitric oxide measurements could be a useful biomarker to evaluate their potential anti-inflammatory mechanisms and monitor their treatment efficacy is proposed. This could contribute to a better understanding of these therapies in chronic rhinosinusitis management. An improved understanding of treatment efficacy could lead to improved management strategies.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"193 ","pages":"Article 111519"},"PeriodicalIF":2.1,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142650739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lidocaine nebulization for airway topical anesthesia can be improved by diminish ex-cannula lost and alkalization 利多卡因雾化用于气道局部麻醉可通过减少呼气管外损失和碱化得到改善

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-11-08 DOI: 10.1016/j.mehy.2024.111511

Ran Duan , Yingying Zhang , Yanxin Cheng , Lei Zhang , Senming Zhao

Lidocaine nebulization is noninvasive, safe, and easy to perform. However, it does not provide adequate anesthesia due to the following reasons: 1. There is a high wastage of lidocaine aerosol, with at least 70 % of the lidocaine aerosol being lost from the cannula. This loss of lidocaine results in a lower amount of inhaled lidocaine, which is insufficient to provide adequate anesthesia. 2. The commercial lidocaine preparation has a low penetrating potency. The onset of anesthesia is directly related to the amount of local anesthetic in the lipid-soluble form. However, there are only a few lipid-soluble prototypes in the commercially available lidocaine cartridges. This is because the lidocaine is purposely formulated as acidic solutions (with pH levels between 3.5 and 5.5) in order to enhance the solubility and stability of the anesthetic salts. To address these issues and improve lidocaine anesthesia potency while reducing wastage, a “Y” type cannula was used for aerosol inhalation. Additionally, 1/5 vol of 5 % sodium bicarbonate solution was added to 2 % lidocaine to enhance the pH value to 7.2. This alkalized lidocaine nebulization provides an effective topical anesthesia for bronchoscopy.

利多卡因雾化疗法是一种无创、安全且易于操作的方法。但是，由于以下原因，它不能提供充分的麻醉：1.利多卡因气溶胶的损耗率很高，至少有 70% 的利多卡因气溶胶会从插管中流失。利多卡因的流失导致吸入的利多卡因量减少，不足以提供充分的麻醉。2.2. 商用利多卡因制剂的穿透力较低。麻醉的开始与脂溶性局麻药的量直接相关。然而，市售利多卡因盒中仅有少数几种脂溶性原型。这是因为利多卡因被特意配制成酸性溶液（pH 值在 3.5 到 5.5 之间），以提高麻醉盐的溶解度和稳定性。为了解决这些问题，提高利多卡因的麻醉效力，同时减少浪费，使用了 "Y "型插管进行气溶胶吸入。此外，在 2% 的利多卡因中加入 1/5 体积的 5% 碳酸氢钠溶液，将 pH 值提高到 7.2。这种碱化的利多卡因雾化为支气管镜检查提供了有效的局部麻醉。

{"title":"Lidocaine nebulization for airway topical anesthesia can be improved by diminish ex-cannula lost and alkalization","authors":"Ran Duan , Yingying Zhang , Yanxin Cheng , Lei Zhang , Senming Zhao","doi":"10.1016/j.mehy.2024.111511","DOIUrl":"10.1016/j.mehy.2024.111511","url":null,"abstract":"<div><div>Lidocaine nebulization is noninvasive, safe, and easy to perform. However, it does not provide adequate anesthesia due to the following reasons: 1. There is a high wastage of lidocaine aerosol, with at least 70 % of the lidocaine aerosol being lost from the cannula. This loss of lidocaine results in a lower amount of inhaled lidocaine, which is insufficient to provide adequate anesthesia. 2. The commercial lidocaine preparation has a low penetrating potency. The onset of anesthesia is directly related to the amount of local anesthetic in the lipid-soluble form. However, there are only a few lipid-soluble prototypes in the commercially available lidocaine cartridges. This is because the lidocaine is purposely formulated as acidic solutions (with pH levels between 3.5 and 5.5) in order to enhance the solubility and stability of the anesthetic salts. To address these issues and improve lidocaine anesthesia potency while reducing wastage, a “Y” type cannula was used for aerosol inhalation. Additionally, 1/5 vol of 5 % sodium bicarbonate solution was added to 2 % lidocaine to enhance the pH value to 7.2. This alkalized lidocaine nebulization provides an effective topical anesthesia for bronchoscopy.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"194 ","pages":"Article 111511"},"PeriodicalIF":2.1,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bortezomib-based regimen affects cognitive functions in multiple myeloma patients through the VEGF pathway – Hypothesis that connects different knowledge streams 硼替佐米疗法通过血管内皮生长因子途径影响多发性骨髓瘤患者的认知功能--连接不同知识流的假设

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-11-02 DOI: 10.1016/j.mehy.2024.111510

Marija Stanić Damić , Toni Valković , Duška Petranović , Andrej Belančić , Zinaida Perić

Multiple myeloma is a chronic hematological malignancy that usually affects older adults. Cancer-related cognitive impairment in multiple myeloma patients significantly impacts the everyday quality of life, however its pathophysiology remains poorly understood. Bortezomib is a commonly used drug in the treatment of multiple myeloma that does not pass the blood–brain barrier. Nevertheless, it can still affect central nervous system (CNS) through yet unknown mechanisms. This article discusses the potential effect of bortezomib-based treatment on cognitive functions in multiple myeloma patients. We hypothesize that bortezomib impairs cognition by decreasing the levels of a neuroprotective cytokine – vascular endothelial growth factor (VEGF). The generation of hypotheses about the pathophysiology of cognitive impairment paves the way for future basic and clinical studies to improve multiple myeloma management. VEGF could serve as a biomarker of cognitive dysfunction while systematic evaluation of cognition could enable early detection of cognitive impairment. Timely recognition of cognitive impairment might be crucial when selecting the most appropriate treatment. Furthermore, this could allow the implementation of preventive measures against further deterioration in cognitive function and quality of life for patients with multiple myeloma.

多发性骨髓瘤是一种慢性血液恶性肿瘤，通常影响老年人。多发性骨髓瘤患者与癌症相关的认知障碍严重影响了他们的日常生活质量，但人们对其病理生理学仍知之甚少。硼替佐米是治疗多发性骨髓瘤的常用药物，它不能通过血脑屏障。然而，它仍可通过未知的机制影响中枢神经系统（CNS）。本文讨论了硼替佐米治疗对多发性骨髓瘤患者认知功能的潜在影响。我们假设硼替佐米通过降低神经保护细胞因子--血管内皮生长因子（VEGF）的水平来损害认知功能。认知障碍病理生理学假设的提出为未来的基础和临床研究铺平了道路，从而改善多发性骨髓瘤的治疗。血管内皮生长因子可作为认知功能障碍的生物标志物，而对认知功能进行系统评估则可及早发现认知功能障碍。在选择最合适的治疗方法时，及时发现认知障碍可能至关重要。此外，这还有助于采取预防措施，防止多发性骨髓瘤患者的认知功能和生活质量进一步恶化。

{"title":"Bortezomib-based regimen affects cognitive functions in multiple myeloma patients through the VEGF pathway – Hypothesis that connects different knowledge streams","authors":"Marija Stanić Damić , Toni Valković , Duška Petranović , Andrej Belančić , Zinaida Perić","doi":"10.1016/j.mehy.2024.111510","DOIUrl":"10.1016/j.mehy.2024.111510","url":null,"abstract":"<div><div>Multiple myeloma is a chronic hematological malignancy that usually affects older adults. Cancer-related cognitive impairment in multiple myeloma patients significantly impacts the everyday quality of life, however its pathophysiology remains poorly understood. Bortezomib is a commonly used drug in the treatment of multiple myeloma that does not pass the blood–brain barrier. Nevertheless, it can still affect central nervous system (CNS) through yet unknown mechanisms. This article discusses the potential effect of bortezomib-based treatment on cognitive functions in multiple myeloma patients. We hypothesize that bortezomib impairs cognition by decreasing the levels of a neuroprotective cytokine – vascular endothelial growth factor (VEGF). The generation of hypotheses about the pathophysiology of cognitive impairment paves the way for future basic and clinical studies to improve multiple myeloma management. VEGF could serve as a biomarker of cognitive dysfunction while systematic evaluation of cognition could enable early detection of cognitive impairment. Timely recognition of cognitive impairment might be crucial when selecting the most appropriatetreatment. Furthermore, this could allow the implementation of preventive measures against further deterioration in cognitive function and quality of life for patients with multiple myeloma.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"193 ","pages":"Article 111510"},"PeriodicalIF":2.1,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142650949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reactive retinal vasodilation may mask capillary loss in eyes without diabetic retinopathy and isolated neurodegeneration 反应性视网膜血管扩张可能会掩盖没有糖尿病视网膜病变和孤立神经变性的眼睛中毛细血管的缺失

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-11-02 DOI: 10.1016/j.mehy.2024.111513

Virgilio Lima-Gómez , Miguel Angel Quiroz-Reyes , Selma Alin Somilleda-Ventura

Reactive retinal vasodilation occurs in healthy individuals when the demand for oxygen surpasses the supply that the vascular bed can provide. This phenomenon may also occur in individuals with diabetes who do not have diabetic retinopathy, potentially masking circulation deficiencies caused by early capillary closure. As a result, eyes with reactive retinal vasodilation may show a seemingly normal circulation area, while also displaying other diabetes-related changes such as neurodegeneration. Our hypothesis suggests that in eyes without overt ischemia, which is one of the phenotypes of diabetic retinal disease, neurodegeneration could be the result of undetected ischemia in the presence of reactive retinal vasodilation. We propose methodologies to investigate this hypothesis, including the assessment of retinal capillaries using optical coherence tomography angiography, as well as the measurement of neurodegeneration markers such as retinal sensitivity, electroretinogram amplitude reductions, and retinal layer thinning. Additionally, we outline an approach for estimating the contribution of large retinal vessels to the percentage of circulation within a measured retinal area, using variables such as vessel length density and vessel area density. If our hypothesis is confirmed, it could lead to the early identification of ischemia before the onset of diabetic retinopathy and offer an opportunity to assess interventions when endothelial and neural damage can still be mitigated.

当氧气需求超过血管床所能提供的氧气供应时，健康人的视网膜血管就会发生反应性扩张。这种现象也可能发生在没有糖尿病视网膜病变的糖尿病患者身上，有可能掩盖毛细血管早期闭合造成的循环缺陷。因此，患有反应性视网膜血管扩张的眼睛可能会显示出看似正常的循环区域，同时也显示出其他与糖尿病相关的变化，如神经变性。我们的假设表明，在没有明显缺血的眼睛中（缺血是糖尿病视网膜病变的表型之一），神经变性可能是反应性视网膜血管扩张导致的未被发现的缺血的结果。我们提出了研究这一假设的方法，包括使用光学相干断层血管造影术评估视网膜毛细血管，以及测量神经变性标志物，如视网膜敏感性、视网膜电图振幅降低和视网膜层变薄。此外，我们还概述了一种方法，利用血管长度密度和血管面积密度等变量来估算视网膜大血管对测量视网膜区域内循环百分比的贡献。如果我们的假设得到证实，就能在糖尿病视网膜病变发生之前及早识别缺血，并在内皮和神经损伤仍可减轻时提供评估干预措施的机会。

{"title":"Reactive retinal vasodilation may mask capillary loss in eyes without diabetic retinopathy and isolated neurodegeneration","authors":"Virgilio Lima-Gómez , Miguel Angel Quiroz-Reyes , Selma Alin Somilleda-Ventura","doi":"10.1016/j.mehy.2024.111513","DOIUrl":"10.1016/j.mehy.2024.111513","url":null,"abstract":"<div><div>Reactive retinal vasodilation occurs in healthy individuals when the demand for oxygen surpasses the supply that the vascular bed can provide. This phenomenon may also occur in individuals with diabetes who do not have diabetic retinopathy, potentially masking circulation deficiencies caused by early capillary closure. As a result, eyes with reactive retinal vasodilation may show a seemingly normal circulation area, while also displaying other diabetes-related changes such as neurodegeneration. Our hypothesis suggests that in eyes without overt ischemia, which is one of the phenotypes of diabetic retinal disease, neurodegeneration could be the result of undetected ischemia in the presence of reactive retinal vasodilation. We propose methodologies to investigate this hypothesis, including the assessment of retinal capillaries using optical coherence tomography angiography, as well as the measurement of neurodegeneration markers such as retinal sensitivity, electroretinogram amplitude reductions, and retinal layer thinning. Additionally, we outline an approach for estimating the contribution of large retinal vessels to the percentage of circulation within a measured retinal area, using variables such as vessel length density and vessel area density. If our hypothesis is confirmed, it could lead to the early identification of ischemia before the onset of diabetic retinopathy and offer an opportunity to assess interventions when endothelial and neural damage can still be mitigated.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"193 ","pages":"Article 111513"},"PeriodicalIF":2.1,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

When to intervene in aortic stenosis; can cardiac troponin I in the first morning urine be our guide? 何时干预主动脉瓣狭窄；晨尿中的心肌肌钙蛋白 I 能作为我们的指南吗？

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-11-01 DOI: 10.1016/j.mehy.2024.111512

Tomo Svaguša , Marko Žarak , Ingrid Prkačin , Frane Paić

Aortic stenosis is one of the most prevalent acquired valvular diseases in the Western world. Despite its high incidence, timely intervention through valve replacement remains a diagnostic challenge. Recent studies suggest that measuring cardiac troponins in the first morning urine may have potential clinical applications. In healthy individuals, concentrations of troponin I in the first morning urine are several times higher than in plasma. Various conditions that damage the heart, such as arterial emergencies or cardiotoxic therapy, lead to an increased concentration of cardiac troponin I in the first morning urine. Conversely, in patients with severe aortic stenosis scheduled for operative treatment, concentrations of cardiac troponin I in the first morning urine are barely detectable. This phenomenon may result from myocardial remodeling and altered clearance of troponin I from the heart. We hypothesize that reduction in the concentration of troponin I in the first morning urine indicates the onset of cardiomyocyte necrosis, adverse myocardial remodeling, and myocardial fibrosis during the progression of aortic stenosis.

主动脉瓣狭窄是西方国家最常见的后天性瓣膜疾病之一。尽管发病率很高，但通过瓣膜置换进行及时干预仍是一项诊断挑战。最近的研究表明，测量晨尿中的心肌肌钙蛋白可能具有潜在的临床应用价值。健康人晨尿中肌钙蛋白 I 的浓度比血浆中高数倍。各种损害心脏的情况，如动脉急症或心脏毒性治疗，都会导致晨尿中的心肌肌钙蛋白 I 浓度升高。相反，在计划接受手术治疗的严重主动脉瓣狭窄患者中，晨尿中几乎检测不到心肌肌钙蛋白 I 的浓度。这种现象可能是由于心肌重塑和心脏对肌钙蛋白 I 的清除发生了改变。我们推测，晨尿中肌钙蛋白 I 浓度的降低预示着主动脉瓣狭窄进展过程中心肌细胞坏死、心肌重塑和心肌纤维化的开始。

{"title":"When to intervene in aortic stenosis; can cardiac troponin I in the first morning urine be our guide?","authors":"Tomo Svaguša , Marko Žarak , Ingrid Prkačin , Frane Paić","doi":"10.1016/j.mehy.2024.111512","DOIUrl":"10.1016/j.mehy.2024.111512","url":null,"abstract":"<div><div>Aortic stenosis is one of the most prevalent acquired valvular diseases in the Western world. Despite its high incidence, timely intervention through valve replacement remains a diagnostic challenge. Recent studies suggest that measuring cardiac troponins in the first morning urine may have potential clinical applications. In healthy individuals, concentrations of troponin I in the first morning urine are several times higher than in plasma. Various conditions that damage the heart, such as arterial emergencies or cardiotoxic therapy, lead to an increased concentration of cardiac troponin I in the first morning urine. Conversely, in patients with severe aortic stenosis scheduled for operative treatment, concentrations of cardiac troponin I in the first morning urine are barely detectable. This phenomenon may result from myocardial remodeling and altered clearance of troponin I from the heart. We hypothesize that reduction in the concentration of troponin I in the first morning urine indicates the onset of cardiomyocyte necrosis, adverse myocardial remodeling, and myocardial fibrosis during the progression of aortic stenosis.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"193 ","pages":"Article 111512"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Potential circadian rhythms impacts on amblyopia treatment outcomes 昼夜节律对弱视治疗效果的潜在影响

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Medical hypotheses

Pub Date : 2024-11-01 DOI: 10.1016/j.mehy.2024.111514

Saeed Aljohani

Traditional treatments for amblyopia, such as patching and atropine penalization, often yield variable outcomes, underscoring the need for alternative or supplementary strategies. Circadian rhythms, which regulate various physiological processes including those associated with ocular health, may significantly influence the success of these treatments. The report proposes three hypotheses: (1) aligning amblyopia treatments with circadian rhythms through the modulation of melatonin and dopamine levels may enhance treatment responsiveness, (2) synchronizing treatment schedules with the patient’s diurnal rhythms could improve effectiveness, and (3) disruptions in circadian rhythms might negatively affect treatment outcomes. The expected implications of these hypotheses suggest a need for further research into the interplay between circadian rhythms and amblyopia therapy to optimize outcomes.

传统的弱视治疗方法，如贴眼膜和阿托品惩罚法，往往会产生不同的结果，这凸显了对替代或辅助策略的需求。昼夜节律调节着各种生理过程，包括与眼部健康相关的生理过程，可能会极大地影响这些治疗方法的成功与否。报告提出了三个假设：（1）通过调节褪黑激素和多巴胺水平，使弱视治疗与昼夜节律保持一致，可能会提高治疗的反应性；（2）使治疗计划与患者的昼夜节律同步，可以提高治疗效果；（3）昼夜节律的紊乱可能会对治疗效果产生负面影响。这些假设的预期影响表明，有必要进一步研究昼夜节律与弱视治疗之间的相互作用，以优化治疗效果。

引用次数: 0