Neuro endocrinology letters最新文献

Objective: Both panic disorder (PD) and obstructive sleep apnea (OSA) are frequent conditions that can be comorbid. This article reviews the current state of knowledge about the comorbidity of PD and OSA and the effectiveness of therapy in patients with this comorbidity.

Method: Articles obtained via PubMed and Web of Science search were selected; the publishing date was between January 1990 and December 2022. The applied search terms were: obstructive sleep apnea; panic disorder; CPAP; antidepressants; anxiolytics; antipsychotics. Eighty-one articles were chosen by primary search via keywords. After a complete assessment of the full texts, 60 papers were chosen. Secondary papers from the references of the primary documents were investigated, evaluated for suitability, and included in the list of documents (n = 18). Thus, seventy-eight papers were incorporated into the review article.

Results: Studies describe a greater prevalence of panic disorder in OSA patients. So far, there is no data on the prevalence of OSA in PD patients. Limited evidence is found regarding the influence of CPAP treatment on PD, and this evidence suggests that CPAP can partially alleviate PD symptoms. Medication used in PD treatment can significantly impact comorbid OSA, as explored in several studies.

Conclusions: The relationship between the two conditions seems bidirectional, and it is necessary to assess OSA patients for comorbid panic disorder and vice versa. Both disorders can worsen the other and must be treated with a complex approach to ensure improvement in patients' physical health and psychological well-being.

Role-play helps the supervisor present a moment of therapy, and reflect on what has happened to the therapist to the patient and further model the therapeutic skills. Usually, the supervisor or other supervisees (in group supervision) play the patient, and the therapist plays a significant moment in the psychotherapeutic session. Supervisors or supervisees in group supervision can play the patient in different situations, and can also reverse roles when the therapist plays their patient, and the supervisor plays the therapist. Before role-playing, there is a need to set a specific goal. Playing roles in supervision can focus on (a) conceptualizing the case; (b) assessing and optimizing therapeutic strategies; (c) a better understanding of the therapeutic relationship. A specific goal needs to be set before role-playing. The technique can focus on (a) case conceptualization; (b) assessment and optimization therapeutic strategies; (c) a better understanding of the therapeutic relationship. A variety of approaches can be used for role-playings, such as pattern learning, modelling, chaining, encouragement and feedback, or psychodrama techniques such as monologue, an empty chair, role change, alter-ego, using multiple chairs or toys.

Purpose: Extrapontine myelinolysis (EPM) is a highly uncommon, life-threatening disease, particularly in individuals who initially appear with severe clinical symptoms. Here, we describe a case of EPM caused by the rapid correction of hyponatremia that had severe clinical signs at first but parkinsonism symptoms were fully improved after treatment.

Case report: A 46-year-old female patient was admitted to the hospital due to impaired consciousness. Her medical history reveals that she has PAI, or primary adrenal insufficiency. Initial laboratory measurements showed that the serum's sodium (Na) concentration was 104 mEq/L, chloride (Cl) content was 70 mmol/L, potassium (K) content was 4.95 mEq/L, glucose was 42 mg/dL, hydrogen potential (Ph) was 7.12, and bicarbonate (HCO3) concentration was 10 mmol/l. The adrenocorticotropic hormone (ACTH) level was 21 mg/ml, while the cortisol level was 1.2ug/dl. Her mental state was unclear, she had sluggish hypophonic speech, generalized akinesia/rigidity in both upper and lower extremities, trouble swallowing solid and liquid meals, and sialorrhea were all discovered after the Na level was corrected. Hyperintense lesions were visible in the bilateral putamen and caudate nuclei of the Magnetic Resonance Imaging (MRI) T2 and flair-weighted scans, which indicate EPM. EPM was treated with corticosteroids and dopamine agonists, and she was eventually released after complete recovery.

Conclusion: Even if there are severe clinical symptoms at first, prompt diagnosis and treatment, such as dopaminergic, corticosteroid, and palliative therapy, can save a patient's life.

Niemann-Pick type C (NPC) disease is an autosomal recessive disease of lysosomal lipid storage disorder caused by mutations in either the NPC1 (95%) or the NPC2 (5%) gene. We report a case of a 23-year-old woman who initially showed ataxia, altered gait and tremor. She subsequently developed cognitive decline and psychiatric symptoms. She had asphyxia at birth and was diagnosed as hypoxic-ischemic encephalopathy and cerebral palsy before. The chest computed tomography (CT) incidentally showed splenomegaly. Brain magnetic resonance imaging (MRI) showed no significant abnormalities. Genetic analysis revealed compound heterozygous mutations of NPC1. The clinical picture of NPC can be markedly variable, so comprehensive clinical evaluation, neurological examination and laboratory test are quite important for the diagnosis of NPC.

Introduction: Nonconvulsive status epilepticus (NCSE) is a condition involving seizures without convulsions; it is usually characterized by altered consciousness and behavioral and vegetative abnormalities. Owing to the nonspecific symptoms, NCSE is often overlooked, especially in neurological intensive care unit (NICU) patients. Therefore, we investigated the etiology, clinical features, electroencephalographic (EEG) changes, treatment options, and outcomes of NCSE in NICU patients with altered consciousness.

Methods: This study retrospectively collected the data of 20 patients with altered consciousness in the NICU. NCSE diagnoses were established by the treating neurologist who had been trained to recognize nonspecific clinical signs and recognize complex EEG changes.

Results: We identified 20 patients (43.95±20.70 years) with clinical signs and EEG findings consistent with NCSE; 9 were female. All the patients suffered from altered consciousness. Five patients had established epilepsy. NCSE was attributed to acute pathological conditions. The underlying cause of NCSE was intracranial infection in 6 patients (30%), cerebrovascular disease in 5 patients (25%), irregular use of epilepsy drugs in 2 patients (10%), immune-related inflammation in 1 patient (5%), other infections in 4 patients (20%), and unknown cause in 2 patients (10%). Fifteen patients had diffused, and five patients had temporal focal EEG abnormalities. Six of 20 NCSE cases (30%) resulted in death. All the patients, except for the patients who died, received anticonvulsant therapy and their altered conscious state was promptly altered.

Conclusion: The clinical symptoms of NCSE without convulsions are often obscure and difficult to detect. NCSE can cause serious consequences and even death. Therefore, for patients with a high clinical suspicion of NCSE, continuous EEG monitoring is needed to quickly identify this condition and promptly start treat them.

Cerebral infarction is a rare and severe manifestation of central nervous system damage caused by mycoplasma pneumoniae infection. We report that a 16-year-old girl was hospitalized with cough, expectoration and fever for 5 days and shortness of breath for 1 day. At the time of admission, the chest computed tomography showed double lung fields infiltration and pleural effusion. The detection of mycoplasma pneumoniae antibodies (IgG and IgM) were positive. The right limb movement of the patient was found incapacitated on the seventh day of hospitalization. Computed tomography, magnetic resonance imaging and magnetic resonance angiography of the head demonstrated the acute cerebral infarction after mycoplasma pneumoniae infection. Early anti-infective therapy, microcirculation improvement and rehabilitation treatment improved the prognosis of this child. Craniocerebral imaging examinations and laboratory tests are helpful for diagnosis. Early detection and treatment can improve the prognosis of patients.

Objectives: The current retrospective study focused on evaluation of the relationship between pulmonary embolism during COVID-19 pandemic and demographic, presenting symptoms, comorbidities and laboratory results in patients who underwent CT angiography of the pulmonary arteries.

Methods: The study enrolled all adult patients with suspected acute pulmonary embolism (PE) who underwent computed tomography pulmonary angiography (CTPA) between March 1, 2020, and April 30, 2022, during the SARS-CoV-2 pandemic. 1698 CTPAs were reviewed and various data were collected. Based on examination results, patients were divided into 4 groups: a group with positive PE and a group with negative PE for both COVID-19 and non-COVID-19 patients.

Results: When comparing different predictors of COVID-19 patients and non-COVID-19 patients we noticed lower probability of PE in female gender (OR 0.77, 95% CI: 0.60-1.00, p = 0.052) and in chronic obstructive pulmonary disease (COPD) patients (OR 0.6, 95% CI: 0.38-0.90, p = 0.017). Higher probability of PE was in cases of older age (OR 1.02, 95% CI: 1.01-1.02, p < 0.001), increased heart rate (OR 1.01, 95% CI: 1.01-1.02, p < 0.001) and increased D-dimer levels (OR 1.03, 95% CI: 1.02-1.04, p < 0.001).

Conclusion: Considering predictors of PE there was a significantly lower risk of PE in the female gender and COPD, and a higher risk with increasing age, heart rate, and D-dimer levels.

Introduction: The intermittent use of recombinant human parathyroid hormone (iPTH) alters calcium metabolism and induces osteogenesis in experimental models. However, the real effects of iPTH in excitable cells and neurons that require membrane receptors to undergo membrane depolarization/repolarization (Na+K+ATPase) to generate ATP, voltage-gated calcium channel (calcium-IP3R-calponin) as well as GABAergic (GABAA) signaling remains unclear.

Objectives: In this study, the expression of IP3R, Na+K+-ATPase, GABAA and calmodulin proteins were evaluated in histological sections of the cerebellum of rats following prolonged injection of iPTH.

Methods: Twenty Wistar rats were used in this study and randomly assigned as either or control group. The test group were subcutaneously injected with 20 μg/kg of iPTH, 3×/week for 8 weeks, while the control group received 1 ml/kg of 0.9% saline solution. The rats were euthanized on the 60th day after the first administration, and their cerebellar vermis was removed and submitted to histological and immunohistochemical evaluation for detection of IP3R, Na+K+-ATPase, GABAA and calmodulin proteins. The expression of proteins was evaluated in the areas corresponding to the Purkinje cells as well as in neuropil of molecular layer of cerebellum. All results were transformed into a percentage for each area analyzed to verify significance between groups.

Results: Rats that received iPTH demonstrated significant reduction of IP3R, calmodulin and GABAA in Purkinje cells and neuropil of molecular layer while the expression of Na+K+-ATPase was similar.

Conclusion: It was concluded that iPTH decreased the expression of IP3R and calmodulin while it did not alter the expression of Na+K+-ATPase. These changes insinuate the ionic activity of calcium and sodium/potassium. Yet, the iPTH alters GABAergic signaling in Purkinje cells, suggesting neurotransmission activity changes in the cerebellum.

Background: Percutaneous microballoon compression (PMC) is an important clinical technique for the treatment of trigeminal neuralgia (TN). Some studies have shown that patients may be infected with herpes simplex virus type 1 (HSV-1) after surgery. However, the prevalence and associated risk factors are unclear yet. This study aimed to explore the potential risk factors of facial herpes simplex (FHS) in patients with TN treated by PMC retrospectively.

Methods: A retrospective study included 181 patients with TN undergoing PMC treatment between September 2019 and August 2020 in Sichuan Cancer Hospital and Institute. Depending on whether the patient was infected with HSV-1 after PMC operation or not, the patients were divided into two groups, FHS group and non-FHS group, respectively. Demographic, clinical, laboratory, and surgical data of the patients were collected. Univariable and multivariable logistic regression analysis were used to explore the risk factors of infecting with HSV-1 in patients with TN after PMC.

Results: Among 181 patients with TN treated by PMC surgery without FHS. 49 patients were diagnosed with FHS after operation, and the diagnosis was confirmed by PCR detection of HSV-1. All patients had no FHS before operation, the occurrence of FHS was 27.07% (49/181) in patients underwent PMC. Variables with p<0.05 in univariable analysis included gender (male/female), age, duration of disease and CD8+ T cells count. The results of multivariable logistic regression analysis showed the independent risk factors of FHS after PMC were gender (male/female) (p<0.01, OR 0.061, 95% CI 0.009~0.428), age (p<0.001, OR 1.169, 95% CI 1.065~1.283), duration of disease (p<0.001, OR 1.361, 95% CI 1.206~1.535) and CD8+T cells count (p<0.01, OR 0.993, 95% CI 0.989~0.998).

Conclusions: In our study, we found that elderly patients and duration of disease were the risk factors of occurring FHS in TN patients after PMC surgery. CD8+T cells count and male gender were the protective factors for not developing FHS.

Ethical reflection is a process that comes from the deeper attitudes and values of the therapist and supervisor. The capability to recognize one's perspectives and ethical dimensions and how they affect own practice is one of the crucial tasks of a responsible therapist. Attitudes and values of an individual or a group may significantly influence the therapeutic process and a choice of strategies and behaviour towards the patient, often working at an unconscious, unreflected levels. Ethics is closely connected with psychotherapeutic treatment. Basic principles, such as expediency, honesty, integrity, justice, and respect, apply to all people equally, including psychologists, psychiatrists, psychotherapists, and supervisors. The goal of supervision is to cultivate the therapeutic process in the client's best interest. The supervisor-supervisee relationship is then grounded on principles similar to those in the therapeutic relationship.