Neuro endocrinology letters最新文献

The fast spread of COVID-19, which was caused by SARS-CoV-2 infection, has posed a major challenge to public health systems around the world. Morbidity and mortality are higher in the elderly than in the young, due to a loss in immune function and more comorbidities. In this case, we describe a 106-year-old female patient, the oldest COVID-19 patient since 2019, who had not previously received the SARS-CoV-2 vaccine. Her clinical symptoms included cough and sputum production. Images of her chest CT showed double lung pneumonia, and laboratory tests revealed elevated serum KL-6 levels. She was mostly on oral medication during her hospitalization and recovered well. With the case, we discuss the risk factors and biomarkers correlated to COVID-19 severity. Following the COVID outbreak, it's vital to explore the possible risk factors that can help with disease risk stratification, identifying high-risk individuals, developing precise treatment regimens, and lowering mortality rates.

Background: Clinically, the incidence of ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) is often obscured, making it difficult to identify the primary lesion. This can pose challenges in both diagnosing and treating the disease. Therefore, this paper presents two cases of EAS to share insights and guide diagnosis and treatment approaches.

Description of cases: Case 1 is a male patient aged 71, and Case 2 is a female patient aged 61. EAS was considered for both patients according to the medical history and auxiliary examination results. After the blood glucose and blood potassium were slightly stable, Case 1 received the total right adrenalectomy and the left subtotal adrenalectomy. After the surgery, a positron emission tomography-computed tomography (PET-CT) was used to identify the primary lesion in Case 1, and the result showed primary neuroendocrine tumors originating from the thymus with metastasis. A chest CT scan with contrast for Case 2 confirmed the presence of multiple soft tissue nodules in both lungs, suspected of being tumor lesions, along with mediastinal lymph node enlargement. A CT-guided lung puncture was not performed due to a progressive decrease in platelets, and the patient died due to severe lung infection eventually.

Conclusions: PET-CT can be an effective method for diagnosing EAS. Early control of hypercortisolism is vital in preventing life-threatening infections in EAS patients.

Choroid plexus insufficiency or glymphatic stasis are often classified as prequels to harmful accretion of toxic proteins in neurodegenerative disease. Cognitive decline and disordered neuronal signaling subsequently become cardinal features of Alzheimer's disease (AD), typically progressing with amyloid-ß and tau protein accumulation. For Parkinson's disease (PD), α-synuclein deposits and dopamine depletion are linked to impaired movement, resting tremor, and rigidity. Importantly, both diagnoses feature hyperinflammation and intrathecal cytokine changes. Thus far, numerous clinical trials have produced nothing effective for AD or PD, yet the anti-inflammatory and regenerative potential of autologous platelet-rich plasma (PRP) remains largely unexamined in this context. Our report explores a proposed Phase I study on intrathecal condensed plasma growth factors processed from thrombin-activated PRP as monotherapy for AD or PD. The concept gains support from related work where cytokines of platelet origin successfully lowered inflammation, corrected background fibrosis, deactivated abnormal cells, and recovered local tissue function-all desirable outcomes in AD and PD. While PRP-mediated effects on membrane potentials, cellular signaling, electrolyte balance, and water clearance are less well characterized, experimental data suggest these pathways could likewise influence glymphatic drainage to ameliorate proteinopathies. As a well-tolerated 'orthobiologic' with no hypersensitivity risk, intrathecal PRP and its derivatives bring advantages over synthetic pharmaceuticals. If age-associated neuroinflammation in AD and PD is an upstream event inciting or contributing to neural disruption, then dampening local oxidative stress by a patient's own platelet cytokines (successful in other contexts) could offer therapeutic relevance to these neurodegenerative conditions as well.

Purpose: This study was aimed to investigate the influence of carotid hemodynamics in common carotid artery (CCA) and internal carotid artery (ICA) on carotid plaque location.

Methods: A total of 4444 participants from Anhui Maanshan People's Hospital were selected from December 2013 to December 2018. Doppler ultrasound was used to measure the location of carotid plaque. Patients were divided into four groups according to plaque location: LEFT, RIGHT, BOTH, and NONE. Multiple logistic regression and smooth curve were applied to determine the relationship of carotid plaque location and hemodynamic indexes.

Results: Compared with the NONE group, the ratio of artery systolic and diastolic blood flow velocity in right internal carotid (RICA S/D) was a risk factor for LEFT group (OR=1.548) after adjustment; artery systolic and diastolic blood flow velocity ratio of left common carotid artery (LCCA S/D) was a risk factor for RIGHT group (OR=1.250); resistance index of right internal carotid (RICA RI) was a protective factor for BOTH group (OR=0.097), while LCCA S/D and RICA S/D were risk factors for BOTH group (OR=1.201, OR=1.457). Compared with the RIGHT group, artery systolic and diastolic blood flow velocity ratio of right common carotid (RCCA S/D) was the risk factor for the LEFT group (OR=1.463), LCCA S/D and RICA S/D were the risk factors for BOTH group (OR=1.706, OR=2.111). After age stratification, resistance index of right common carotid artery (RCCA RI) and resistance index of left internal carotid artery (LICA RI) were protective factors for BOTH group (OR=0.046, OR=0.042) in group younger than 52. RCCA S/D and RICA S/D were risk factors for BOTH group (OR=1.557, OR=1.843). Resistance index of left common carotid artery (LCCA RI) was a protective factor in the LEFT group compared with the RIGHT group (OR=0.476). In group older than 52, RICA S/D was a risk factor for LEFT group (OR=1.388). LCCA S/D was a risk factor for RIGHT group (OR=1.575). LCCA S/D and RICA S/D were risk factors for BOTH group (OR=1.348, OR=1.311). RICA S/D and RCCA S/D were protective factors in the LEFT group compared with the RIGHT group (OR=0.567, OR=0.680).

Objective: To investigate the quantitative electroencephalography features of different brain lobe epilepsy.

Methods: The electroencephalogram data of adult patients diagnosed with epilepsy in the epilepsy clinic of the Second Affiliated Hospital of Shandong First Medical University from January 1, 2012 to December 31, 2016 were collected, 58 cases in total. They included 28 cases of frontal lobe epilepsy,12 cases of temporal lobe epilepsy, 9 cases of occipital lobe epilepsy, and 9 cases of parietal lobe epilepsy. Quantitative electroencephalography analysis technique was used to obtain the δ, θ, α1, α2, β1 and β2 power spectrum value in patients with different brain lobe epilepsy. The δ, θ, α, and β relative power spectrum value are obtained by calculation. By comparing the quantitative electroencephalography indicators of the affected side and the healthy side, the quantitative electroencephalography characteristics of epilepsy in different lobes were obtained.

Results: θ power spectrum can be increased in the discharge lead of temporal lobe epilepsy. δ and θ power spectrum, δ relative power spectrum can be increased in the discharge lead of occipital lobe epilepsy.

Conclusion: The increase in slow wave power spectrum in QEEG can serve as an auxiliary diagnosis for temporal lobe epilepsy and occipital lobe epilepsy.

Background: The need to develop understanding of the posttraumatic growth (PTG) in the population of cancer survivors has increased in recent years. The daily functioning of cancer survivors involves factors that affect the development of PTG and the process by which it arises.

Objectives: The main objective was to explore PTG process and its influencing factors in cancer survivors.

Methods: Using qualitative research design, the study applied in-depth interviews and the method of life-line drawing with seven female cancer survivors, aged between 49 and 73. Data were analyzed using grounded theory methodology.

Results: The main category in the process is persistence in consequences associated with two categories of triggers, external and internal. The various outcomes (PTG, acceptance, uncertainty) depend on perceived possibility of taking control over consequences in cancer survivors. PTG is a result of individual accommodation of illness consequences in which taking control and accommodation lead to self-regulation of pain, self-confidence, and positive self-image.

Conclusion: Possibility of taking control over the disease consequences and active approach to acquiring new skills are central explanatory variables modifying the process of persistence in consequences of illness and the reasons of PTG. The PTG model has the potential to be adapted to other cancer-related outcomes that are relevant to the daily lives of cancer survivors.

Objectives: In a recent study, we found increased antibody reactivity against the insulin receptor-A and insulin-like growth factor 1 receptor and their ligands in patients with schizophrenia or related psychosis, indicating that an autoimmune-mediated process may underlie development of schizophrenia. The aim of this study was to supplement our previous study with analysing additional neuronal- and diabetes-associated autoantibodies of potential interest for schizophrenia in the same patients and controls as in the foregoing study.

Material and methods: Analyses of neuronal (NMDAR, VGKC, AMPAR, GABABR, DPPX, GAD)- and voltage-gated calcium channel (VGCC) autoantibodies in cerebrospinal fluid (12 patients, 11 controls) and of diabetes-associated (GAD, IA-2, ZnT8, insulin)- and VGCC autoantibodies in serum (17 patients, 11 controls) were done by standard methods. Additionally, patients (n = 16) were accessed for clinical symptoms with the Positive and Negative Syndrome Scale (PANSS) for schizophrenia.

Results: Concentrations in cerebrospinal fluid of NMDAR-, VGKC-, AMPAR-, GABABR-, DPPX-, GAD- and VGCC autoantibodies were below detection limits in all patients and controls. Concentration in serum of insulin autoantibodies was significantly higher in patients than in controls (p = 0.001), whereas no significant differences were found in concentrations in serum of GAD-, IA-2-, ZnT8- or VGCC autoantibodies between patients and controls. Patients' serum concentrations of insulin autoantibodies tended to inversely correlate to their PANSS scores.

Conclusion: In this study, we show higher concentration in serum of insulin autoantibodies in patients with schizophrenia. This finding is of importance since autoantibodies against insulin may be implicated in the autoimmune-mediated process underlying development of schizophrenia.

Background: Prejudices against individuals with schizophrenia can interfere with diagnostic and treatment processes, particularly with the patient's further adaptation and reintegration. Self-stigma could have significant detrimental consequences for patients suffering from psychotic disorders, including schizophrenia.

Method: This paper reviews findings about self-stigma connected to schizophrenia. The PubMed database used the keywords to find the papers published from January 1997 to March 2023, and 189 articles were included in the review process.

Results: The schizophrenia-related stigma decreases patients' self-confidence, worsens their social functioning, and impedes daily functioning. Feelings of embarrassment are prominent in many patients with schizophrenia. Self-stigma predicts many unfavourable outcomes - more severe social anxiety and depressive symptoms, lower self-confidence, hopelessness, worse social functioning, lower quality of life, worse treatment cooperation, and lower adherence to medication adherence. Addressing self-stigma in psychoeducation or psychotherapy may increase the patient's stigma resistance and well-being. Self-help groups present an underutilised but potentially effective strategy.

Conclusion: Stigma presents a common issue in patients with schizophrenia. Targeting the issue in clinical management or psychotherapy may be beneficial. Still, more high-quality intervention studies are needed.

Background: Cognitive impairment (CI) may be present in people with multiple sclerosis (PwMS) in different stages of the disease, as well as in PwMS with various degrees of disability. This study aimed to investigate cognitive decline over a period of 12 months and to examine an association between cognition and the disability in PwMS, also over a period of 12 months.

Methods: The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery was used, containing the Symbol Digit Modalities Test (SDMT), the Categorical Verbal Learning Test (CVLT), and the Brief Visuospatial Memory Test-Revised (BVMT-R). The Expanded Disability Status Scale (EDSS), Timed 25-Foot Walk (T25FW), and 9-Hole Peg Test (9-HPT) were used to assess the degree of disability. For the analysis of cognitive decline over the period of 12 months, Wilcoxon signed-rank test (paired sample t-test) was used. For the correlation between cognition and disability, Spearman's correlation test was used.

Results: We observed statistically meaningful difference only in one measure of cognition (CVLT), not the other two (SDMT and BVMT-R). SDMT significantly correlated with methods assessing the degree of disability in both time points. In the second examination, we observed a correlation between BICAMS and 9-HPT. Similarly, SDMT and BVMT-R also correlated with EDSS.

Conclusion: To investigate the cognitive decline in PwMS, a longer period of time probably should have been chosen. EDSS is commonly used to monitor disease progression, but it does not include the evaluation of various parameters, such as cognition or upper limb function. Its use with the 9-HPT and cognitive tests may represent a more reliable and comprehensive assessment of a patient's clinical condition.

Background: Individuals with borderline personality disorder (BPD) suffer from an excessive fear of abandonment, leading to tense moments in their intimate relationships. These struggles translate into lower marital satisfaction perceived by both intimate partners. However, this connection is bidirectional, since conflicts with a romantic partner are the most common precipitating factors of decompensation in BPD patients.

Method: This narrative review was performed using PubMed, Web of Science, and Scopus databases with keywords "borderline personality disorder", "partnership", marital problems", and "marital conflicts". Articles, books, and book chapters published within January 1980 - December 2020 were extracted and analysed. Additional sources were found while reviewing references of relevant articles. The total of 131 papers met the inclusion criteria.

Results: Patients with BPD struggle with reaching marital satisfaction. They often find themselves in disharmonic and unfulfilling relationships. The association between the relationship issues and BPD may partly come from misunderstanding one or both partners' behaviour. Individuals with BPD tend to misinterpret their partner's behaviour, struggle with communication, and sometimes be verbally and physically aggressive. They often do not recognize that their intrapersonal processes influence their interpersonal struggles. Understanding the role of the maladaptive personality traits in the relationship and their management could be beneficial for both partners.

Conclusion: Individuals with BPD often report dysfunctional romantic relationships characterized by insecure attachment, maladaptive communication, and lower relationship satisfaction. Future studies should focus on finding effective strategies of couples´ therapy working with this population.