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Etiological and Symptomatological Differences Between Hyperactive and Hypoactive Delirium Subtypes 高活性和低活性谵妄亚型的病因和症状差异
Pub Date : 2019-01-02 DOI: 10.32474/OJNBD.2019.02.000134
M. Jedynak, Marta Sudoł Malisz, A. Brodziak, A. Różyk-Myrta
The processes of ageing and the related impairment of maintaining homeostasis, understood as the loss of adaptive abilities, lead to an increased susceptibility to developing delirium among the elderly. The pathophysiological process of delirium development is dependent on the presence of causative and predisposing factors; for example, neurotransmission process disorders (cholinergic, serotonin and dopaminergic regulation), resulting in metabolic inefficiency of the brain. The symptoms of delirium differ in duration and severity; there are 3 clinical subtypes of delirium: hypoactive, hyperactive and mixed. Moreover, subsequent evaluations using methodological tools have made it possible to distinguish an additional subtype of delirium the no-motor subtype. Recognizing the delirium subtype is essential it identifies high-risk patients, has an effect on the procedures, treatment and further prognosis. Medical personnel working with elderly patients ought to be well familiar with the predisposing factors, non-pharmacological procedures, treatment and prognosis of delirium; they also are required to know how to differentiate between each delirium subtype. Physicians should be aware that the hypoactive subtype of delirium indicates a much worse prognosis for patients.
衰老的过程和相关的维持体内平衡的损害,被理解为适应能力的丧失,导致老年人患谵妄的易感性增加。谵妄发展的病理生理过程依赖于病因和易感因素的存在;例如,神经传递过程紊乱(胆碱能、血清素和多巴胺能调节),导致大脑代谢效率低下。谵妄的症状在持续时间和严重程度上有所不同;谵妄有3种临床亚型:低活动性、多活动性和混合性。此外,使用方法学工具的后续评估使得区分谵妄的另一种亚型-无运动亚型成为可能。认识谵妄亚型是必要的,它可以识别高危患者,对手术、治疗和进一步预后有影响。护理老年患者的医务人员应熟悉谵妄的易感因素、非药物治疗方法、治疗方法及预后;他们还需要知道如何区分每种谵妄亚型。医生应该意识到谵妄的低活性亚型表明患者的预后更差。
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引用次数: 0
A Case of Menstrual Psychosis, an Under Recognized Diagnosis 一例月经期精神病,诊断不充分
Pub Date : 2018-12-18 DOI: 10.32474/ojnbd.2018.02.000133
Woodward Kiel, Wright Rhonda, Rathore Geetanjali
Menstrual psychosis is a rare disorder that causes psychotic symptoms in conjunction with a patient’s menstrual cycle. We present a case of a 14-year-old girl who presents with such symptoms. Our patient presented with five days of somnolence, paranoia, and visual hallucinations soon after a diagnosis of streptococcal pharyngitis and being started on antimicrobial therapy. Her neurologic exam was significant for flat affect and psychomotor slowing. A thorough work-up consisting of brain MRI, EEG, LP, encephalopathy panel, along with metabolic, infectious, and inflammatory laboratory analysis was unremarkable, and she recovered without therapy about one week after symptom onset. Patient had recurrence and spontaneous resolution of her symptoms two more times over the next 10 months with repeat work-up negative; her family noted that the onset of her symptoms always seemed to coincide with the onset of her menses. She was started on combination oral contraceptive pills and has had no further recurrence of her symptoms since then.
月经期精神病是一种罕见的疾病,会随着患者的月经周期而引起精神病症状。我们报告了一个14岁女孩出现这种症状的病例。我们的患者在被诊断为链球菌性咽炎并开始接受抗菌治疗后不久,出现了五天的嗜睡、偏执和幻觉。她的神经系统检查对轻度情感和精神运动迟缓有重要意义。由大脑MRI、脑电图、LP、脑病小组以及代谢、感染和炎症实验室分析组成的彻底检查并不显著,她在症状出现后约一周未经治疗就康复了。在接下来的10个月里,患者又两次复发和症状自行缓解,重复检查呈阴性;她的家人注意到,她的症状似乎总是与月经的发作相吻合。她开始服用联合口服避孕药,此后症状没有进一步复发。
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引用次数: 0
Aseptic meningitis revealing isolated Kikuchi-Fujimoto disease 无菌性脑膜炎显示孤立的菊池-藤本病
Pub Date : 2018-11-08 DOI: 10.32474/OJNBD.2018.02.000129
S. Bouomrani, Nesrine Regaïeg
Introduction: Kikuchi-Fujimoto’s disease (KFD) or histiocytic necrotizing lymphadenitis is a rare entity that may represent a real diagnostic challenge for the clinician because of its highly polymorphous and sometimes unusual presentations. We report an original observation of KFD with aseptic meningitis as inaugural manifestation. Case report: 30-year-old woman, without pathological medical history, was hospitalized via the emergency department for exploration of a meningeal syndrome with cervical lymphadenopathies. The lumbar puncture showed aseptic meningitis: clear, normotensive cerebrospinal fluid with leukocytes at 28/mm3 (90% lymphocytes), red blood cells at 2/mm3, proteinrrhachia at 0.58 g/l, glucorrachia at 4 mmol/l for venous glycemia at 8 mmol/l, and negative direct examination and culture. Cerebromedullary MRI and cerebral angio-MR were without abnormalities. Further infectious and immunological investigations were negative. Cervical lymph node biopsy showed histological and Immunohistochemical aspects suggesting KFD. Treated with systemic corticosteroids, the evolution was favorable with no recurrence. Conclusion: KFD-associated aseptic meningitis remains rare, and the inaugural forms are exceptional and often difficult to diagnose. A better knowledge of this association avoids unnecessary investigations, recurrence, and improves the prognosis of the disease.
简介:Kikuchi-Fujimoto病(KFD)或组织细胞坏死性淋巴结炎是一种罕见的疾病,由于其高度多形性和有时不寻常的表现,对临床医生来说可能是一个真正的诊断挑战。我们报告一个原始观察的KFD与无菌性脑膜炎的首次表现。病例报告:30岁女性,无病理病史,因脑膜综合征伴颈淋巴肿大经急诊科住院。腰椎穿刺显示无菌性脑膜炎:脑脊液清晰,血压正常,白细胞28/mm3(90%淋巴细胞),红细胞2/mm3, rrachia蛋白0.58 g/l,葡萄糖4 mmol/l,静脉血糖8 mmol/l,直接检查和培养阴性。脑髓核磁共振、脑血管核磁共振未见异常。进一步的感染和免疫检查均为阴性。颈部淋巴结活检显示组织学和免疫组化提示KFD。全身性皮质类固醇治疗后,病情发展良好,无复发。结论:kfd相关的无菌性脑膜炎仍然是罕见的,并且最初的形式是特殊的,往往难以诊断。更好地了解这种联系可以避免不必要的调查,复发,并改善疾病的预后。
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引用次数: 1
Rituximab-Rescue Therapy in Autoimmune Neurological Disorders 利妥昔单抗治疗自身免疫性神经疾病
Pub Date : 2018-10-22 DOI: 10.32474/OJNBD.2018.02.000128
A. K. Roy, Saurabh Sadekar, R. Maloo, S. Murali
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引用次数: 0
A Double-Blind Placebo-Controlled Trial of Acediprol (Valproate Sodium) For Global Severity in Child Autism Spectrum Disorders Acediprol(丙戊酸钠)治疗儿童自闭症谱系障碍全球严重程度的双盲安慰剂对照试验
Pub Date : 2018-09-28 DOI: 10.32474/OJNBD.2018.02.000127
Aliyev Na, Z. Aliyev
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引用次数: 1
Beta-Propeller Protein-Associated Neurodegeneration Syndrome β -螺旋桨蛋白相关神经变性综合征
Pub Date : 2018-09-26 DOI: 10.32474/OJNBD.2018.02.000126
S. Asadi, Mahsa Jamali, Gholnesa Valizadeh, N. Ghafouri
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引用次数: 0
Neurosis and Psychosis in German and French Nosography 德国和法国医院诊断学中的神经症和精神病
Pub Date : 2018-09-20 DOI: 10.32474/ojnbd.2018.01.000125
Ronaldo Chicre Araujo
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引用次数: 0
Running head: PEN-3 Model Cultural Framework for Health Intervention and Prevention 项目负责人:PEN-3健康干预与预防模式文化框架
Pub Date : 2018-09-05 DOI: 10.32474/OJNBD.2018.01.000123
Lisa Marie Portugal
The PEN-3 Model Cultural Framework can be used to design culturally specific, locally relevant health intervention and prevention programs to educate communities. This health intervention and prevention involves educating Hispanic females and males between the ages of 15 to 32. The health and wellness program design involve educating this group about the use of marijuana and its damaging effects on the body leading to mental illness, Diabetes, Cancer, lung and other organ damage, obesity, cognitive disorders, lowered IQ and EQ (emotional quotient), and various other damaging effects. Finally, a summary of the PEN-3 Model Cultural findings are discussed and analyzed to help health educators, practitioners, and advocates serve and address the needs of the target population.
PEN-3模型文化框架可用于设计具有文化特殊性的、与当地相关的健康干预和预防方案,以教育社区。这种健康干预和预防包括对15至32岁的西班牙裔男女进行教育。健康和健康项目的设计包括教育这群人使用大麻及其对身体的破坏性影响,导致精神疾病、糖尿病、癌症、肺和其他器官损伤、肥胖、认知障碍、智商和情商降低,以及其他各种破坏性影响。最后,对PEN-3模型的文化发现进行了总结讨论和分析,以帮助健康教育者、从业者和倡导者服务和解决目标人群的需求。
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引用次数: 1
The Sodium Valproate: Doctor Jekyll and Mister Hyde 丙戊酸钠:化身博士和海德先生
Pub Date : 2018-08-29 DOI: 10.32474/OJNBD.2018.01.000122
J. Bossu
The sodium valproate (VPA) is a very simple structural compound derived from the valeric acid produced by a plant “Valeriana officinalis†. Extract s of this this plant were used by the doctors of Ancient Greece to cure insomnia and by the Romans to treat palpitations and arrhythmia. VPA was used for the first time as an anticonvulsant in 1963 [1] and in 1974 Jevson and Clark [2] after their clinical study on 63 patients whom 40 of them had failed to respond to other anticonvulsants concluded that in 43% of patients, epilepsy stopped completely, and in 22% of patients, the attacks were reduced by 50%. An unusual side effect was temporary hair loss. Since then VPA is widely used to treat almost all types of seizures and epilepsy syndromes, and is used successfully, for patients displaying epilepsy resistant to other medications [3]. Behind its anticonvulsants effect, VPA targets also a wide range of neurological diseases including some neurodegenerative pathologies, addiction, bipolar and obsessive-compulsive disorders and migraine [4].
丙戊酸钠(VPA)是一种结构非常简单的化合物,由植物 - œValeriana officinalis -产生的戊酸衍生而来。这种植物的提取物被古希腊医生用来治疗失眠,罗马人用来治疗心悸和心律失常。VPA于1963年首次被用作抗惊厥药,1974年Jevson和Clark在对63例患者(其中40例对其他抗惊厥药无效)进行临床研究后得出结论,43%的患者癫痫完全停止,22%的患者癫痫发作减少50%。一个不寻常的副作用是暂时性脱发。从那时起,VPA被广泛用于治疗几乎所有类型的癫痫发作和癫痫综合征,并成功地用于对其他药物产生抗性的癫痫患者。在其抗惊厥作用的背后,VPA还针对广泛的神经系统疾病,包括一些神经退行性病变、成瘾、双相情感障碍和强迫症以及偏头痛。
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引用次数: 0
Neurological Diseases and Relation of TRP Channels 神经系统疾病与TRP通道的关系
Pub Date : 2018-07-25 DOI: 10.32474/OJNBD.2018.01.000120
Y. Yazğan
Is currently used as a comprehensive definition covering “brain disorders”, neurological diseases and mental disorders. While schizophrenia, depression, panic disorder, drug addiction and insomnia are referred to as “mental disorders”, Epilepsy, Alzheimer, Parkinson, Huntington’s disease (HD) and multiple sclerosis are considered as “neurological disorders”. Current therapies of these very common diseases require continuous drug use and at the same time cause many different side effects. Therefore preclinical and clinical investigations for new treatment approaches are on the rise. Especially the identification of the molecular basis of these diseases is the focus of researches. Examination of transient receptor potential (TRP) channels is at an early stage in the investigation of the molecular principle of these diseases, but clear results regarding the efficacy of substances activating or inhibiting these channels have not been obtained. Some diseases have been based on mutations of TRP channels. However, only a few TRP channelopathies, have been conclusively identified so far [1]. Investigation of TRP channels in psychiatric disorders will contribute to a better understanding of the etiology of psychiatric disorders and the development of new pharmacological treatments. Abbreviations: TRP: Transient Receptor Potential; GPCR: G Protein Coupled Receptor; TRPV1: TRP Vanilloid 1; CGRP: Calcitonin Gene Related Peptide; CNS: Central Nervous System; SOC: Store Operated Calcium Channels; BDNF: Brain Derived Neurotrophic Factor; Mwk: Moon Walker Mouse; BD-I: Bipolar Disorder Type I; ALS-G: Guamanian Amyotrophic Lateral Sclerosis ISSN: 2637-6628 DOI: 10.32474/OJNBD.2018.01.000120 On J Neur & Br Disord Copyrights@ Yener Yazğan. Citation: Yener Y, Betül Y. Neurological Diseases and Relation of TRP Channels. On J Neur & Br Disord 1(4)2018. OJNBD. MS.ID.000120. DOI: 10.32474/OJNBD.2018.01.000120. 71 TRP Channels in Brain Disorders TRPV1 and TRPA1 Significant evidence has been obtained that TRPV1 antagonists have anxiolytic activity in preclinical studies, but the antidepressant effect is not clear [6]. There is no direct evidence that TRP channels play a role in schizophrenia. However, the fact that TRPV1 channels play a role in central dopaminergic and cannabinoid mechanisms may suggests the potential role of these channels in schizophrenia [5]. CGRP release from trigeminal vasculature neuron network and neurogenic inflammatory response are currently accepted mechanisms for migraine attack pathophysiology. In particular, the TRP vanilloid 1 (TRPV1) and the TRP ankyrin 1 (TRPA1) are expressed in nociceptive neurons, which also express the sensory neuropeptides, tachykinins, and calcitonin gene-related peptide (CGRP), which mediate neurogenic inflammatory responses. This evidence suggests that these channels may be an important therapeutic goal in migraine treatment [7].
目前被用作涵盖“大脑障碍”、神经系统疾病和精神障碍的综合定义。精神分裂症、抑郁症、恐慌症、毒瘾和失眠被称为“精神障碍”,癫痫、阿尔茨海默病、帕金森病、亨廷顿舞蹈症和多发性硬化症被视为“神经系统疾病”。目前治疗这些非常常见的疾病需要持续用药,同时会导致许多不同的副作用。因此,对新治疗方法的临床前和临床研究正在增加。尤其是这些疾病的分子基础的鉴定是研究的重点。瞬时受体电位(TRP)通道的检查处于研究这些疾病的分子原理的早期阶段,但尚未获得关于激活或抑制这些通道的物质功效的明确结果。一些疾病是基于TRP通道的突变。然而,到目前为止,只有少数TRP通道病被最终确定[1]。对精神障碍中TRP通道的研究将有助于更好地了解精神障碍的病因和开发新的药物治疗方法。缩写:TRP:瞬时受体电位;GPCR:G蛋白偶联受体;TRPV1:TRP香草1;降钙素基因相关肽;中枢神经系统;SOC:存储操作的钙通道;BDNF:脑源性神经营养因子;Mwk:月球漫步鼠;BD-I:I型双相情感障碍;ALS-G:Guamanian肌萎缩性侧索硬化症ISSN:2637-6268 DOI:10.32474/OJNBD.2018.01.000120 On J Neur&Br Disord Copyrights@Yener Yazğan。引文:Yener Y,Betül Y.神经系统疾病与TRP通道的关系。关于J Neur&Br Disord 1(4)2018。OJNBD。MS.ID.000120.DOI:10.32474/OJNBD.2011.01.000120。71脑疾病中的TRP通道TRPV1和TRPA1在临床前研究中已经获得了TRPV1拮抗剂具有抗焦虑活性的重要证据,但抗抑郁作用尚不清楚[6]。没有直接证据表明TRP通道在精神分裂症中起作用。然而,TRPV1通道在中枢多巴胺能和大麻素机制中发挥作用的事实可能表明这些通道在精神分裂症中的潜在作用[5]。CGRP从三叉神经血管系统神经元网络的释放和神经源性炎症反应是目前公认的偏头痛发作病理生理机制。特别地,TRP香草素1(TRPV1)和TRP锚蛋白1(TRPA1)在伤害性神经元中表达,伤害性神经元也表达感觉神经肽、速激肽和降钙素基因相关肽(CGRP),它们介导神经源性炎症反应。这一证据表明,这些通道可能是偏头痛治疗的一个重要治疗目标[7]。
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Online journal of neurology and brain disorders
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