Neuro endocrinology letters最新文献

Introduction: Primary aldosteronism is now recognized as the most common cause of secondary hypertension. Increasing evidence has demonstrated increased cardiovascular events in primary aldosteronism patients. Heart failure and atrial fibrillation are the most common cardiovascular complications occurring in these patients, and a few cases of coronary artery disease have been reported. Herein, we report a rare case of primary aldosteronism in a patient who presented with myocardial infarction associated with coronary embolism.

Case report: A 52-year-old woman was admitted to our hospital because of chest pain. ST-segment elevation was observed on an electrocardiogram. Although no significant stenosis was observed, embolization of the far distal left anterior descending artery was noticed on angiography. Blood test results revealed hypokalemia and increased aldosterone-renin ratio. Abdominal computed tomography revealed an adenoma in the left adrenal gland. After adrenalectomy, the serum potassium level normalized, and blood pressure was well controlled.

Conclusion: Primary aldosteronism must be considered in patients who have had various cardiovascular diseases, including embolisms and situations in which the discrimination of secondary hypertension is necessary.

Objective: Needs of psychiatric patients may be to a various degree frustrated. A sole focus on treatment effectiveness can lead to the omission of other patient's needs. Patients with borderline personality disorder present high demands on health and social services that often remain unmet. The review aims to identify common unmet needs of patients with BPD, map the areas in which they appear, and identify ways to manage them.

Method: The PubMed database was used by applying the following key terms: "borderline personality disorder" and "needs" supplemented by a combination of "borderline personality disorder" and "unmet needs"; "treatment"; "therapy"; "management", "quality of life", "pharmacotherapy", "psychotherapy". the Papers were selected from a period between Jan 1, 1990, and Nov 30 2020. Primary keyword search yielded a total of 502 articles, of which 225 articles met the inclusion criteria and were subjected to a complete inspection. Secondary contributions from reference lists of the primary sources were examined, evaluated for suitability, and added to the primary document list (n = 182). After an evaluation of the relevance, a total of 197 papers were included in the review process.

Results: Recognizing patients' unmet needs with borderline personality disorder emphasises the importance of a comprehensive patient assessment. The diagnosis of comorbidities is also essential, especially with bipolar disorder and posttraumatic stress disorder, as comorbid conditions may require different therapeutic approaches. Traditional treatments of BPD tend to be demanding both in time and funding. However, alternatives are being developed to overcome these shortcomings by introducing methods focused on specific goals. Furthermore, supporting the patient's responsibility in the treatment choice can lead to better improvements.

Conclusions: There is a need for further studies that will focus on the needs of this patient group and the possibilities of their treatment in psychotherapy, using psychotropic drugs, or social interventions. The development of step-by-step treatment models, adjunctive treatments, and technology-based interventions can bring greater access to care and reduce costs, especially for newly diagnosed patients or patients waiting for comprehensive treatment.

This report details the case of a 41-year-old woman who was diagnosed with insulinoma. As the patient developed severe life-threatening hypoglycemia, we introduced Dexcom G4 Platinum (DG4P), a modern continuous glucose-monitoring system (CGM). The algorithm of the sensor glucose (SG) values of CGM is based on patients with diabThis report details the case of a 41-year-old woman who was diagnosed with insulinoma. As the patient developed severe life-threatening hypoglycemia, we introduced Dexcom G4 Platinum (DG4P), a modern continuous glucose-monitoring system (CGM). The algorithm of the sensor glucose (SG) values of CGM is based on patients with diabetes; therefore, we evaluated the accuracy of DG4P in this patient. The mean absolute relative differences and absolute differences between SG of DG4P and self-monitoring of blood sugar values were 10.8%±8.3% and 6.8±5.7 mg/dL, respectively, in the hypoglycemic region, which verifies DG4P's accuracy. DG4P was found to be useful for monitoring hypoglycemia not only in patients with diabetes but also in those with insulinoma.etes; therefore, we evaluated the accuracy of DG4P in this patient. The mean absolute relative differences and absolute differences between SG of DG4P and self-monitoring of blood sugar values were 10.8%±8.3% and 6.8±5.7 mg/dL, respectively, in the hypoglycemic region, which verifies DG4P's accuracy. DG4P was found to be useful for monitoring hypoglycemia not only in patients with diabetes but also in those with insulinoma.

Objectives: The purpose of the present study was to investigate the serum levels of endocannabinoids (eCBs; anandamide: AEA and 2-arachidonoylglycerol: 2-AG) and daily intake of polyunsaturated fatty acids (PUFAs; arachidonic acid: ARA, docosahexaenoic acid: DHA, and eicosapentaenoic acid: EPA) among subjects with high and low depressive symptoms.

Methods: The participants comprised female community-dwellers aged 40 years or older in Japan. Among 208 females, fourteen participants with high depressive symptoms and ten participants with low depressive symptoms were selected for this study. The depressive symptoms were measured by the Japanese version of the Centre for Epidemiologic Studies Depression Scale (CES-D). The daily intake of PUFAs were assessed utilising the brief-type self-administered diet history questionnaire. The blood samples were analysed for AEA, 2-AG, and the CB receptor 1 gene (CNR1) single nucleotide polymorphism (SNP) rs806377.

Results: The ratio of AEA serum level to ARA intake (AEA/ARA) in high depressive participants was significantly higher compared with those in low depressive participants even after controlling for confounders, whereas there were no significant differences in the serum concentrations of eCBs, daily intake of PUFAs, as well as the CNR1 SNP (rs806377) between the high and low CES-D scored groups.

Conclusion: The elevated level of AEA/ARA among high depressive participants suggests that the conversion rate of ARA to AEA may be accelerated in depressive individuals.

Background and objective: To assess longterm feasibility of low saturated fat diet (less than 15 g of saturated fat per day) in patients with relapsing remitting multiple sclerosis (RRMS) and its effect on the course of the disease.

Materials and methods: Patients were enrolled into a single arm, prospective study. The eligibility criteria included the diagnosis of RRMS according to the McDonald criteria 2010 and the ability to comply with the diet. Patients were allowed to receive disease modifying therapy (DMT) and to take food supplements. Diet adherence was monitored by food diaries. Number of attacks, brain magnetic resonance imaging (MRI) characteristics, Expanded disability status scale (EDSS) and Body mass index (BMI) were recorded.

Results: Twelve patients with RRMS were enrolled. Six patients (50%) continued with the diet for the median duration of 37 months. The high drop-out of patients was caused mainly by patients' inability to strictly adhere to the diet. In six patients who were able to follow the diet - their mean EDSS of 1.30 decreased to 1.17. None of the patients experienced an attack, 5 of 6 patients had stable disease on yearly magnetic resonance imaging (MRI) scans with no new lesions identified.

Conclusion: The low fat diet is safe and seems to be effective in preventing clinical attacks/new MRI lesions. The main drawback is the problem of adhering to the diet longterm in the western-style diet environment.

Backgrounds: The prognosis of patients with osteosarcoma in many cases remains poor, and life expectancy with lung metastases is around 12 months. Chemotherapy and radiotherapy can only temporarily control neoplastic progression, followed by developing chemo and radioresistant tumours.

Methods: This is a retrospective observational study on 15 patients diagnosed with osteosarcoma and treated by a multitherapy approach. The multitherapy consisted of somatostatin and analogous (octreotide) all-trans-retinoic acid (ATRA), β-Carotene, axerophthol dissolved in vitamin E, vitamin D, vitamin C, melatonin (MLT), proteoglycans, glycosaminoglycans, hydroxyurea, and sodium butyrate.

Results: This multitherapy increased the survival rate and life quality, without overt toxicity, compared to the standard treatment for osteosarcomas. The agents in this approach have several functions. They exert antiproliferative, antiangiogenic, cytostatic, antioxidant, antimetastatic, and immunomodulating features. Moreover, the inclusion of ATRA, MLT, and sodium butyrate has reinforced antitumor properties on cancer stem cells. Furthermore, the non-cytolytic and non-cytotoxic metronomic hydroxyurea dosage increased the biological therapy outcome by strengthening antitumor capability.

Findings: This multitherapy approach is effective against osteosarcoma.

Interpretation: The multistrategy of this multitherapy therapy are inhibiting the proliferative-invasiveness and neoplastic angiogenesis, silencing the survival system of cancer stem cells, enhancing the immunomodulatory and antioxidant activities, improving vitality and efficiency of normal cells, and depressing the efficiency and vitality of neoplastic ones.

Objective: Thyroid hormones play important roles in most organs, including the brain. This study aimed to explore the association between thyroid hormones and the severity of white matter hyperintensities (WMH) in patients without intracranial arterial stenosis, which is a common manifestation in the brain.

Methods: This retrospective study included 304 patients at the Department of Neurology in Nantong First People's Hospital between June 2018 and June 2020. Thyroid hormone levels and other laboratory data were collected on the day after admission. The patients were divided into two WMH burden groups based on Fazekas scores as follows: ''mild-moderate group'' and ''severe group.'

' results: The severe WMH group had higher ages (P=0.000), higher serum concentration of fibrinogen (P=0.040), higher concentration of creatinine (P=0.040), lower concentration of low-density lipoprotein (P=0.013), and higher concentration of free thyroxine (FT4) (P=0.003). The prevalence of cerebral microbleeds (CMBs) increased with increasing quartiles (P=0.023). Multivariable logistic regression and ordinal regression analysis showed that higher concentrations of FT4, age, and CMBs were also independent risk factors for severe WMH. The concentrations of FT4 were grouped according quartiles. The results showed that the prevalence of severe WMH increased with higher quartiles. This correlation persisted after adjusting for risk factors such as sex, age, history of hypertension, diabetes, drinking history, and smoking history.

Conclusion: Our results support the hypothesis that FT4 is associated with the severity of WMH in patients without intracranial arterial stenosis. In addition, age and CMBs are independently related to the severity of WMH.

Objectives: This study aimed to assess the processing of clicks and tone pips in the auditory brainstem of tree shrews and analyze the long-term evolution of postlesion plasticity in the auditory system and its ability to self-repair.

Methods: The auditory brainstem response (ABR) was measured in the normal control group (n=10) and the electrolytic damage group (n=10) before and 0 h, 24 h, 48 h, 72 h, and 25 d after electrolytic damage. Recordings were performed under closed-field conditions using clicks and tone pips, followed by statistical analysis of the ABR threshold, amplitude and latency.

Results: The results were as follows: (1) After electrolytic damage to the tree shrew medial geniculate body (MGB), the latency and amplitude of ABR waveforms from the left ear changed from 0 h to 25 d. All parameters were lower at 25 d than they were preoperatively. The amplitude of ABR wave VI (using click sound stimulation) decreased or disappeared in both ears. (2) The ABR threshold was significantly different in both ears at 72 h postoperatively compared with preoperatively (0 h) (P < 0.05) but recovered by 25 d.

Conclusion: Based on these results, we conclude the following: (1) The origin of wave VI in tree shrews may be associated with the MGB. After electrolytic damage to the MGB, the changes in the ABR waveforms at different frequencies indicated that the MGB nucleus had a certain characteristic frequency. (2) Unilateral injury to the MGB can lead to similar levels of hearing impairment in both ears.

Introduction: The first report of oculomotor neuromyotonia (ONM) in a child induced by thyroid peroxidase antibodies (anti-TPO) in the absence of thyroid eye disease (TED).

Case: 14-year-old girl complained of left eye (LE) paroxysmal upper lid fluttering and ptosis precipitated by hyperventilation or sustained left gaze. On sustained left gaze, right eye (RE) upper lid retraction and LE upper lid fluttering with ptosis ensued.

Results: Diagnostic work-up revealed markedly elevated anti-TPO (> 600 IU/ml) and no TED. Brain MRI was normal with no signs of tortuous vessels presenting focal demyelination. We hypothesized that anti-TPO directly induced demyelination and set the ground for right ONM with ephaptic transmission between neurons supplying right medial rectus and levator muscle.

Conclusions: Plethora of theories try to decode the ONM. TED associated ONM is not reported in children but is the second most common cause of ONM in adults, advocated to be of compressive origin. Conversely, this case holds true for cross talk hypothesis. All extraocular muscles must be tested to determine the triggering one. ONM should not be overlooked due to its positive response to carbamazepine.

Objective: The purpose of this study was to investigate the effects of moderately extended cycling exercise on oxidative DNA damage (accounted for by urinary 8-hydroxy-2´-deoxyguanosine) in adolescent males and females matched for aerobic capacity.

Materials and methods: Twenty-nine aerobically active adolescent males and females matched for peak oxygen uptake (VO2peak) relative to fat free mass (ml/kg FFM/min) participated in this study. Two-hour urinary samples were taken at three time points before (-2-0h), immediately (0-2h) after and 24-26 h after 60 min of cycling exercise at 65%VO2peak, followed by the analysis of urinary 8-OHdG (a potential marker of whole-body DNA damage and repair) determined with high performance liquid chromatography with electrochemical detection.

Results: The two-way (time x sex) analysis of variance demonstrated no significant main effects for time, sex or interaction regarding urinary 8-hydroxy-2´-deoxyguanosine level following moderate-intensity endurance exercise.

Conclusions: These results of the present study suggest that no detrimental DNA damage can be observed after moderately prolonged exercise in aerobically fit males and females, potentially because of the enhanced antioxidant defense responses. Furthermore, the endurance-trained adolescent males and females appear to have similar DNA oxidation responses at the whole-body level when normalized to peak oxygen uptake relative to fat free mass.