Neuro endocrinology letters最新文献

This report presents a rare case of adolescent patient treated by novel antidepressant vortioxetine for depressive disorder comorbid to narcolepsy type 1 (NT1) and newly diagnosed REM behavior disorder (RBD) and describes the overall clinical improvement of the conditions. Additionally, we discuss effect of vortioxetine on sleep architecture by evaluating objective polysomnographic studies before and on the treatment. We propose a possible efficacy of this multimodal serotoninergic agent in treatment of RBD associated with NT1.

Objectives: The main aim of this study was to analyse selected biomechanical aspects of the asymmetrical loading of the human postural system when riding the C1 speed canoe and their influence on the development of muscular imbalances.

Methods: 3D kinematic analysis of a simulated forward stroke of the canoeist in a pool with a counter-current (N = 9) and analysis of MRI data with selected individuals (N = 5), videoanalysis of actual paddling top athletes (N = 12), the kinesiological analysis of movement.

Results: Can be stated that when riding a C1 speed canoe the postural system is exposed to two types of asymmetric loading. In the first place, there is lateral asymmetry, which stems from the very nature of the one-sided paddling on this type of vessel. The canoeist has to compensate for the consequent instability by shifting the body's centre of gravity higher above the kneeling lower limb. This effect is achieved by the so-called pelvic lateralisation from the paddling side and by this side's skewing to the kneeling lower limb. Another asymmetry is connected to the forward-backward body movement and its time-dependent deviation from the neutral posture. A significant disproportion between generally fixation movements of the lower part of the body and phasic movements of the upper part of the body has been confirmed. These asymmetrical positions result in a significant unilateral overloading of the quadratus lumborum on the side of the supporting lower limb (side without the paddle), as well as an overloading of the spine straighteners in the lumbar area, in particular on the part of a supporting lower limb, and bilateral yet asymmetric overloading of m. iliopsoas, which in addition takes place in different isometries. The analysis of MRI data indicates that, during longitudinal training, lateral disproportion in the volume and intensity of postural system loading is the cause of different cross sections of the iliopsoas muscle and quadratus lumborum muscle on the side of the kneeling and supporting lower limbs. With both muscles, larger cross sections with a statistical significance level α = 0.05 and thus also strength on the side of the supporting lower limb can be expected.

Conclusion: When canoeing on the C1, a significant unilateral overloading occurs with m. quadratus lumborum on the part of the supporting lower limb (side without paddle). Furthermore, spine straighteners in the lumbar area are overloaded, in particular in the part of the supporting lower limb. Last but not least however, the bilateral asymmetric overloading of m. iliopsoas occurs.

Objective: To evaluate the efficacy and safety of acupuncture and moxibustion for bell's palsy in the acute phase compared with the non-acute phase.

Methods: Computer retrieval of PubMed, Embase, The Cochrane Library, Web of Science, China National Knowledge Internet (CNKI), Wanfang data, were conducted. According to the inclusion and exclusion criteria, the quality of literature was evaluated, and useful data was extracted. All statistical analyses were performed by RevMan5.3 software.

Results: 17 eligible RCTs with a total of 2644 patients were included in this meta-analysis. The meta-analysis results demonstrated the cure rate of acupuncture and moxibustion for Bell's palsy in the acute phase were lower than that in the non-acute phase (P<0.05). The time to cure of acupuncture and moxibustion for Bell's palsy in the acute phase was shorter than that in the non-acute phase (P<0.05), and the incidence of sequelae during the treatment period of acupuncture and moxibustion for Bell's palsy in the acute phase were lower than that in non-acute phase (P<0.05).

Conclusions: Acupuncture and moxibustion were safe and effective stimulation for Bell's palsy in the acute phase compared with the non-acute phase, improving the cure rate of Bell's palsy, shorten the time to cure, and reduce the occurrence of sequelae. However, more multicenter RCTs with a large sample number and high quality should verify the conclusion mentioned above.

Background and objective: Sleep-disordered breathing (SDB) is more prevalent in patients with stroke than in the population without a history of stroke. SDB is an independent risk factor for stroke. SDB impairs cerebral circulation by several mechanisms, and therefore possibly contributes to wake-up stroke. Ultrasound-tagged near-infrared spectroscopy (UT-NIRS) is a novel technology able to detect cerebral blood flow noninvasively and in real-time, displaying cerebral flow as cerebral flow index (CFI). Positive airway pressure (PAP) is the most effective approach in the treatment of SDB. We aimed to assess if single-night PAP impacts cerebral blood flow in sleep apnea patients after stroke and without a history of stroke.

Materials and methods: 11 stroke patients and six controls with sleep apnea were enrolled. Stroke patients underwent overnight pulse oximetry within seven days after stroke. Desaturation index ≥ 15/hour was considered a positive screening. Six weeks after stroke, patients with positive screening underwent overnight polysomnography together with cerebral blood flow monitoring using UT-NIRS (diagnostic night) and also with additional PAP therapy (therapeutic night).

Results: The number of respiratory events decreased significantly in the group of stroke patients (apnea-hypopnea index [AHI] from 22.6±9.0 to 9.9±9.9) and controls (AHI from 58.1±14.9 to 7.0±9.7). CFI showed no significant changes between a diagnostic and therapeutic night in both groups.

Conclusion: Despite the significant reduction of respiratory events, single-night PAP therapy does not improve overall cerebral blood flow, as defined by CFI.

Objective: Pituicytomas (PTs) are rare and benign neoplasms. The variable imaging and clinical features of PTs, which overlap with other sellar pathologies, can make preoperative diagnosis challenging. In the interest of a more comprehensive understanding of the diagnostic aspects of PTs, it is necessary to report and synthesize the variable imaging and clinical features of PTs.

Methods: We retrospectively included and analysed four pathologically proven PTs with unusual imaging and/or clinical features. Additionally, we reviewed the literature on PT between 2007 and 2019 in the PubMed database to provide context for the individual patient data described herein.

Results: Our series included three female and one male adult patient (mean age: 44.75, age range: 20-56 y). Based on clinical symptoms, we noticed that case 1 had Cushing's syndrome, case 2 had increased prolactin, case 3 had extremity enlargement but with a normal level of human growth factor, and case 4 presented with tinnitus and dizziness. On radiograph, inconsistent with the main imaging findings of PTs in the literature, there was one case in the pituitary anterior lobe, three cases with hypointensity on T2-weighted images, two patients with reduced homogeneous contrast enhancement, and one case demonstrating invasion potential. In addition, one of our patients underwent PET-CT examination, and the lesion had a slight increase in glucose uptake and no significant decrease in ammonia uptake. Postoperative follow-up monitoring revealed no tumour recurrence.

Conclusion: Our cases highlight the unusual imaging manifestations of PTs. Recognizing these imaging features plays an important role in the preoperative diagnosis, treatment, and postsurgery monitoring of PTs.

Context: Pregnancy in acromegaly is rare, there have been few case reports and series published to date. Also breastfeeding under acromegaly treatment is extremely rare. The late diagnosis of pregnancy in acromegaly will sometimes dictate the treatment and management of the patient.

Material and method: We present a 32-year-old woman with acromegaly, a late diagnosed pregnancy and a completed fetal organogenesis. Due to the gestation time and bothersome headaches accompanying a pituitary macroadenoma, we decided to continue long lasting somatostatin analogues treatment but with increased injection intervals of 6 weeks. We also continued this treatment during 12 months of breastfeeding.

Results: Our treatment did not cause any complication of premature birth or any health problems with the newborn baby. The child has since developed normally up to the age of 5.

Conclusion: The course of acromegaly disease and the time of pregnancy diagnosis may prompt suitable drug and treatment regimes. We administered effective and safe somatostatin analogues treatment during gestation and breastfeeding which was safe for both mother and baby.

Background: Anxiety and depression are common comorbidities of excessive daytime sleepiness (EDS). Sleep-related breathing disorders (SBD) and central disorders of hypersomnolence (like narcolepsy [NA]) are the most frequent causes of EDS. This study aimed to evaluate mood disorders in NA patients compared to the subjects with EDS due to SBD (SBD-EDS).

Methods: In a retrospective analysis, subjects with NA and SBD-EDS were compared. All subjects underwent overnight polysomnography. NA patients underwent also multiple sleep latency test. Epworth sleepiness scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Becks questionnaire, and Zung depression scale were used to assess EDS, sleep quality, anxiety, and depression, respectively.

Results: We enrolled 24 NA and 41 SBD-EDS subjects. Values of PSQI and Zung scale were significantly worse in the SBD-EDS group than in NA patients (8.34±3.84 vs. 6.83±2.25, p=0.04; 46.86±12.69 vs. 40.81±11.27, p=0.03, respectively). Anxiety was significantly more frequent in SBD-EDS subjects compared to NA (63.4% vs. 37.5%, p=0.04). Out of all observed sleep-related indices, PSQI was the only factor, that significantly correlated with the measures of anxiety in both groups (NA: r=0.65, p=0.001; SBD-EDS: r=0.45, p=0.003) and with the measures of depression in NA subjects (r=0.51, p=0.01). In SBD-EDS group, measures of depression significantly correlated with PSQI (r=0.46, p=0.002), oxygen desaturation index (r=0.35, p=0.03), and ESS (r=0.5, p=0.001).

Conclusion: Compared to NA, our results suggest significantly worse measures of depression and a significantly higher frequency of anxiety in the SBD-EDS population. Measures of anxiety and depression significantly correlated with quality of sleep in both groups.

Objective: This study explored that the possible effects and mechanism of ATG16L1 in pseudomonas aeruginosa lung infection.

Methods: C57BL/6J mice were anesthetized with isoflurane and intratracheally (I.T.) inoculated with 5 × 106 CFU of Pseudomonas aeruginosa strain PA14. RAW264.7 macrophages were stimulated with 0.1 mg/ml of lipopolysaccharide (LPS). RAW264.7 macrophages were stimulated with 0.1 mg/ml LPS. Hematoxylin-Eosin (H&E), Immunofluorescence, sample acquisition, qPCR validation, Enzyme linked immunosorbent assay (ELISA) and immunofluorescence analysis were used this experiment.

Results: ATG16L1 mRNA and protein expressions in mice with pseudomonas aeruginosa lung infection were also suppressed. ATG16L1 gene reduced inflammation and INF-γ levels in vitro model. On the other hand, ATG16L1 protein presented lung injury and inflammation levels in mice of pseudomonas aeruginosa lung infection. ATG16L1 regulated cGAS/IL-22 signal passage in model of pseudomonas aeruginosa lung onfection.

Conclusion: These findings indicate that ATG16L1 reduced IL-22 induced IFN level in pseudomonas aeruginosa lung infection via cGAS signal passage, which may provide a new therapeutic scheme for viral diseases or inflammatory diseases and its associated complications.

The adverse events of immune checkpoint inhibitors (ICIs) are mostly immune mediated reactions. In this study, we presented a patient who developed coexisting of myasthenia gravis, myocarditis and anemia after treatment with nivolumab only 1 cycle for ureteral epithelial cancer. A 66-year-old woman was admitted to our department with the complaint of recurrent hematuria and backache for 2 months. This patient was diagnosed with stage IV, T4N3M1, urothelial carcinoma of the right kidney. She received immune checkpoint therapy consisting of nivolumab. Then, the physical and neurological examination found the ptosis of eyes especially the right eye and weakness of proximal limb muscles. Patient presented with sub-sternal chest discomfort, shortness of breath, electrocardiograms suggested atrial fibrillation and possible acute myocardial ischemic. One week later, this patient died of ventricular arrhythmia. This patient has increased clinical awareness by indicating that the immune-related adverse events (irAEs) could simultaneously involve multiple systems and progress quickly. Early recognition of aberrant immune activation and complete evaluation upon the occurrence of irAEs are critical.

Objective: To investigate the diagnosis and treatment of Multiple Endocrine Neoplasia Type 1 (MEN1), improve our understanding of the disease and highlight the importance of life-long follow-up of affected individuals.

Methods: A retrospective analysis was performed on 1 MEN1 patient with long-term follow-up at the First Affiliated Hospital of Anhui Medical University.

Results: A 51-year-old woman was diagnosed with MEN1 14 years ago, but exhibited a suspected disease course of at least 20 years. Prior to admission, the patient reported a cough lasting for two months. The patient's thyroid hormone, sex hormone, insulin, cortisol, parathyroid hormone, and ACTH circadian rhythm findings were within normal ranges. The patient exhibited elevated blood calcium levels. Examination led to the detection of thymoma and pancreatic neoplasms, whereas no obvious abnormalities were detected in her parathyroid gland or adrenal gland as determined via computed tomography (CT). Genetic analyses revealed a mutation in the MEN1 gene in this patient. As the patient had no relevant clinical symptoms, she refused surgical treatment, and follow-up was continued. It was learned through follow-up that the patient underwent anterior mediastinal lesion resection and partial rib resection in June 2020 because she re-examined the chest CT showed that the anterior mediastinal mass was significantly larger than that in 2019. Pathology suggested neuroendocrine tumors. The patient is currently recovering well.

Conclusion: MEN1 is an uncommon condition in clinical settings, and it is important that clinicians be made aware of this disorder so that they can provide patients with appropriate and timely treatments.