首页 > 最新文献

Neuro endocrinology letters最新文献

英文 中文
Correlation between insulin-degrading enzyme versus total tau and selected cytokines in patients with Alzheimer´s disease compared to non-demented controls. 阿尔茨海默病患者与非痴呆对照组相比,胰岛素降解酶与总tau和选定细胞因子的相关性。
Pub Date : 2023-07-05
Helena Kullenberg, Thomas Nyström, Maria Kumlin, Marie M Svedberg

Objective: It has been increasingly recognized that the pathological progress of Alzheimer´s disease (AD) is connected to metabolic function and inflammation. Insulin-degrading enzyme (IDE) is essential for glucose metabolism and the degradation of amyloid-β. We aimed to explore the associations between IDE, total tau, and cytokines levels in plasma from subjects with AD and non-demented controls.

Methods and material: Plasma samples (18 patients diagnosed with AD and 6 non-demented controls) from the Netherlands Brain Bank were used to analyze IDE levels and total tau with an enzyme-linked immunosorbent assay. Cytokines were analyzed with Luminex custom plex assays for interleukin (IL)-6, IL-8, IL-10, and tumor necrosis factor-alpha (TNF-α). Results were analyzed using the Mann-Whitney U and Spearman´s rank correlation tests.

Results: Total tau in plasma was significantly increased in AD subjects compared to non-demented control subjects (p = 0.044). Total tau was positively correlated with IDE levels in plasma in all subjects (r = 0.494, p = 0.017). Significant correlations could be demonstrated between plasma levels of IDE and IL-6 (r = 0.546, p = 0.019), IL-8 (r = 0.664, p = 0.003), IL-10 (r = 0.833, p < 0.001), and TNF-α (r = 0.633, p = 0.005) in subjects with AD, but not in non-demented controls.

Conclusion: Results from this study suggest that plasma IDE levels may be associated with inflammation and neurodegeneration and could potentially be a target for future diagnostic and treatment strategies.

目的:人们越来越认识到阿尔茨海默病的病理进展与代谢功能和炎症有关。胰岛素降解酶(IDE)是葡萄糖代谢和淀粉样蛋白-β降解所必需的。我们旨在探索AD患者和非痴呆对照组血浆中IDE、总τ和细胞因子水平之间的关系。方法和材料:使用来自荷兰脑库的血浆样本(18名诊断为AD的患者和6名非痴呆对照),通过酶联免疫吸附测定法分析IDE水平和总tau。细胞因子用Luminex定制的白细胞介素(IL)-6、IL-8、IL-10和肿瘤坏死因子-α(TNF-α)复合物分析。使用Mann-Whitney U和Spearman秩相关检验对结果进行分析。结果:与非痴呆对照组相比,AD受试者血浆中总tau显著增加(p=0.044)。所有受试者的总tau与血浆IDE水平呈正相关(r=0.494,p=0.017)。IDE与IL-6(r=0.546,p=0.019)、IL-8(r=0.664,p=0.003)、IL-10(r=0.833,p<0.001)、,和TNF-α(r=0.633,p=0.005),但在非痴呆对照组中没有。结论:这项研究的结果表明,血浆IDE水平可能与炎症和神经退行性变有关,并可能成为未来诊断和治疗策略的靶点。
{"title":"Correlation between insulin-degrading enzyme versus total tau and selected cytokines in patients with Alzheimer´s disease compared to non-demented controls.","authors":"Helena Kullenberg, Thomas Nyström, Maria Kumlin, Marie M Svedberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>It has been increasingly recognized that the pathological progress of Alzheimer´s disease (AD) is connected to metabolic function and inflammation. Insulin-degrading enzyme (IDE) is essential for glucose metabolism and the degradation of amyloid-β. We aimed to explore the associations between IDE, total tau, and cytokines levels in plasma from subjects with AD and non-demented controls.</p><p><strong>Methods and material: </strong>Plasma samples (18 patients diagnosed with AD and 6 non-demented controls) from the Netherlands Brain Bank were used to analyze IDE levels and total tau with an enzyme-linked immunosorbent assay. Cytokines were analyzed with Luminex custom plex assays for interleukin (IL)-6, IL-8, IL-10, and tumor necrosis factor-alpha (TNF-α). Results were analyzed using the Mann-Whitney U and Spearman´s rank correlation tests.</p><p><strong>Results: </strong>Total tau in plasma was significantly increased in AD subjects compared to non-demented control subjects (p = 0.044). Total tau was positively correlated with IDE levels in plasma in all subjects (r = 0.494, p = 0.017). Significant correlations could be demonstrated between plasma levels of IDE and IL-6 (r = 0.546, p = 0.019), IL-8 (r = 0.664, p = 0.003), IL-10 (r = 0.833, p < 0.001), and TNF-α (r = 0.633, p = 0.005) in subjects with AD, but not in non-demented controls.</p><p><strong>Conclusion: </strong>Results from this study suggest that plasma IDE levels may be associated with inflammation and neurodegeneration and could potentially be a target for future diagnostic and treatment strategies.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hemoglobin-to-Red Cell Distribution Width Ratio is Associated with All-Cause Mortality in Critically Ill Patients with Traumatic Brain Injury. 血红蛋白与红细胞分布宽度比与重型颅脑损伤患者的全因死亡率相关。
Pub Date : 2023-07-05
Duo Yang, Jinxin Lan, Ruiyuan Xue, Kaihong Zhang, Shujun Ye, Zhiliang Huang, Longsheng Zhang

Background: Hemoglobin-to-red cell distribution width ratio (HRR) has shown good prognostic value in various cancers. However, the relationship between HRR and outcomes in critically ill patients with traumatic brain injury (TBI) remains unclear. This study aimed to investigate the association between HRR and mortality among critically ill patients with TBI.

Methods: The Medical Information Mart for Intensive Care-IV (MIMIC-IV) database was utilized to conduct this retrospective cohort study. TBI patients were divided into four quartiles according to their HRR values. The primary outcome was 30-day mortality, whereas the secondary outcomes were 60-day and 120-day mortality. Univariable and multivariable Cox proportional risk models were performed to evaluate the hazard ratio (HR) and 95% confidence interval (CI) for the relationship between HRR and mortality. Receiver operating characteristic (ROC) curves were conducted to assess the prognostic value of HRR.

Results: For 30-day mortality, after adjustment for all potential covariates, the relationship remained significant with HRR treated as a continuous variable (HR, 95% CI: 0.87 [0.81, 0.92]; p < 0.001). In the fully adjusted model, the HR with 95% CI for the second, third, and fourth quartile groups were 0.67 (0.5, 0.9), 0.65 (0.46, 0.94), and 0.5 (0.32, 0.79), respectively, compared to the first quartile group. A similar relationship was also observed for 60-day mortality and 120-day mortality. HRR had a better predictive value than hemoglobin and red cell distribution width (RDW).

Conclusions: A lower level of HRR is significantly associated with higher all-cause mortality among critically ill patients with TBI.

背景:血红蛋白与红细胞分布宽度比(HRR)在各种癌症中显示出良好的预后价值。然而,HRR与创伤性脑损伤(TBI)危重患者预后之间的关系尚不清楚。本研究旨在探讨重型脑外伤患者的HRR与死亡率之间的关系。方法:利用重症监护IV医学信息集市(MIMIC-IV)数据库进行本回顾性队列研究。TBI患者根据其HRR值分为四个四分位数。主要结果为30天死亡率,而次要结果为60天和120天死亡率。采用单变量和多变量Cox比例风险模型来评估HRR与死亡率之间关系的风险比(HR)和95%置信区间(CI)。受试者操作特征(ROC)曲线用于评估HRR的预后价值。结果:对于30天死亡率,在校正了所有潜在协变量后,将HRR作为连续变量处理,这种关系仍然显著(HR,95%CI:0.87[0.81,0.92];p<0.001)。在完全校正的模型中,第二、第三和第四四分位数组的95%CI的HR分别为0.67(0.5,0.9)、0.65(0.46,0.94)和0.5(0.32,0.79),与第一个四分位数组相比。60天死亡率和120天死亡率也观察到类似的关系。HRR比血红蛋白和红细胞分布宽度(RDW)具有更好的预测价值。结论:在TBI危重患者中,较低的HRR水平与较高的全因死亡率显著相关。
{"title":"Hemoglobin-to-Red Cell Distribution Width Ratio is Associated with All-Cause Mortality in Critically Ill Patients with Traumatic Brain Injury.","authors":"Duo Yang,&nbsp;Jinxin Lan,&nbsp;Ruiyuan Xue,&nbsp;Kaihong Zhang,&nbsp;Shujun Ye,&nbsp;Zhiliang Huang,&nbsp;Longsheng Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Hemoglobin-to-red cell distribution width ratio (HRR) has shown good prognostic value in various cancers. However, the relationship between HRR and outcomes in critically ill patients with traumatic brain injury (TBI) remains unclear. This study aimed to investigate the association between HRR and mortality among critically ill patients with TBI.</p><p><strong>Methods: </strong>The Medical Information Mart for Intensive Care-IV (MIMIC-IV) database was utilized to conduct this retrospective cohort study. TBI patients were divided into four quartiles according to their HRR values. The primary outcome was 30-day mortality, whereas the secondary outcomes were 60-day and 120-day mortality. Univariable and multivariable Cox proportional risk models were performed to evaluate the hazard ratio (HR) and 95% confidence interval (CI) for the relationship between HRR and mortality. Receiver operating characteristic (ROC) curves were conducted to assess the prognostic value of HRR.</p><p><strong>Results: </strong>For 30-day mortality, after adjustment for all potential covariates, the relationship remained significant with HRR treated as a continuous variable (HR, 95% CI: 0.87 [0.81, 0.92]; p < 0.001). In the fully adjusted model, the HR with 95% CI for the second, third, and fourth quartile groups were 0.67 (0.5, 0.9), 0.65 (0.46, 0.94), and 0.5 (0.32, 0.79), respectively, compared to the first quartile group. A similar relationship was also observed for 60-day mortality and 120-day mortality. HRR had a better predictive value than hemoglobin and red cell distribution width (RDW).</p><p><strong>Conclusions: </strong>A lower level of HRR is significantly associated with higher all-cause mortality among critically ill patients with TBI.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41170027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effect of hypoxia on Hydrogen Sulfide concentration of brain tissue in AD transgenic mice and its mechanism. 缺氧对AD转基因小鼠脑组织硫化氢浓度的影响及其机制。
Pub Date : 2023-07-05
Xiumei Cheng, Meixia Ding, Churong Wei, Feng Xiao, Jiawan Liao, Mengjun Li, Zhiyong Xiao, Xiaoai Liu, Yougen Luo

Objective: Research has shown that hydrogen sulfide (H2S) plays a protective role in many diseases of the nervous system. The aim of this study is to investigate the effect of hypoxia on endogenous H2S concentration in the cerebral cortex of Alzheimer's disease (AD) transgenic mice and its mechanism.

Methods: AD transgenic mice were raised in closed boxes and pure nitrogen was introduced to reduce the oxygen concentration to 8%-10%, establishing an animal model of hypoxia. Oxygen partial pressure was measured with an oxygen meter. The expression of cystathionine-β-synthase (CBS) in cerebral cortex tissue was determined by Western blot, and H2S concentration was measured by a modified methylene blue method.

Results: (1) Hypoxia down-regulated CBS expression in cerebral cortex tissue of AD transgenic mice (p < 0.05). (2) The concentration of H2S in the cerebral cortex tissue of the hypoxic transgenic group was significantly lower than that of the Control group (p < 0.01). (3) Overexpression of CBS reversed the hypoxia-induced decrease of H2S concentration in the cerebral cortex tissue of AD transgenic mice (p < 0.01).

Conclusions: Hypoxia decreased the concentration of endogenous H2S in the cerebral cortex tissue of AD transgenic mice by down-regulating the expression of CBS.

目的:研究表明,硫化氢(H2S)对多种神经系统疾病具有保护作用。本研究旨在探讨缺氧对阿尔茨海默病(AD)转基因小鼠大脑皮层内源性H2S浓度的影响及其机制。方法:将AD转基因小鼠关箱饲养,引入纯氮使氧浓度降至8%-10%,建立缺氧动物模型。用氧气计测量氧气分压。Western印迹法检测大脑皮层组织中胱硫醚-β-合酶(CBS)的表达,改良亚甲蓝法测定H2S浓度。结果:(1)缺氧可下调AD转基因小鼠大脑皮层组织CBS的表达(p<0.05);(2)缺氧转基因组大脑皮层组织中H2S浓度明显低于对照组(p<0.01)结论:缺氧通过下调CBS的表达,降低了AD转基因小鼠大脑皮层组织中内源性H2S的浓度。
{"title":"The effect of hypoxia on Hydrogen Sulfide concentration of brain tissue in AD transgenic mice and its mechanism.","authors":"Xiumei Cheng,&nbsp;Meixia Ding,&nbsp;Churong Wei,&nbsp;Feng Xiao,&nbsp;Jiawan Liao,&nbsp;Mengjun Li,&nbsp;Zhiyong Xiao,&nbsp;Xiaoai Liu,&nbsp;Yougen Luo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Research has shown that hydrogen sulfide (H2S) plays a protective role in many diseases of the nervous system. The aim of this study is to investigate the effect of hypoxia on endogenous H2S concentration in the cerebral cortex of Alzheimer's disease (AD) transgenic mice and its mechanism.</p><p><strong>Methods: </strong>AD transgenic mice were raised in closed boxes and pure nitrogen was introduced to reduce the oxygen concentration to 8%-10%, establishing an animal model of hypoxia. Oxygen partial pressure was measured with an oxygen meter. The expression of cystathionine-β-synthase (CBS) in cerebral cortex tissue was determined by Western blot, and H2S concentration was measured by a modified methylene blue method.</p><p><strong>Results: </strong>(1) Hypoxia down-regulated CBS expression in cerebral cortex tissue of AD transgenic mice (p < 0.05). (2) The concentration of H2S in the cerebral cortex tissue of the hypoxic transgenic group was significantly lower than that of the Control group (p < 0.01). (3) Overexpression of CBS reversed the hypoxia-induced decrease of H2S concentration in the cerebral cortex tissue of AD transgenic mice (p < 0.01).</p><p><strong>Conclusions: </strong>Hypoxia decreased the concentration of endogenous H2S in the cerebral cortex tissue of AD transgenic mice by down-regulating the expression of CBS.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41166259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Problems in Cognitive-Behavioral Supervision: Theoretical Background and Clinical Application. 认知行为监督中的问题:理论背景与临床应用。
Pub Date : 2023-07-05
Jan Prasko, Marija Abeltina, Ilona Krone, Julija Gecaite-Stonciene, Jakub Vanek, Julius Burkauskas, Roman Liska, Tomas Sollar, Alicja Juskiene, Milos Slepecky, Lina Bagdonaviciene, Marie Ociskova

Cognitive-behavioural therapists and trainees are encouraged to undergo supervision when offering therapy to troubled clients and to process personal attitudes and events likely to affect their therapeutic work. We discuss common problems in cognitive behavioural therapy (CBT) supervision, which may arise at the client, supervisee, or supervisor level. These issues include difficulties with case formulation, therapeutic strategies, and the therapeutic relationship. A supervisor can help their supervisee deal with clients with multifaceted or particularly challenging problems, such as difficulties with compliance, complex psychosocial problems, or chronic mental disorders. We also discuss matters related to the supervision process, the supervisor's role, different supervisory styles, and issues affecting a supervisee's feelings of vulnerability and shame. Furthermore, we analyze distinct supervision styles and potential problems arising from the supervision of experienced CBT therapists.

鼓励认知行为治疗师和受训人员在为有问题的客户提供治疗时接受监督,并处理可能影响其治疗工作的个人态度和事件。我们讨论了认知行为疗法(CBT)监督中的常见问题,这些问题可能出现在客户、被监督人或监督人层面。这些问题包括病例制定、治疗策略和治疗关系方面的困难。主管可以帮助其主管处理多方面或特别具有挑战性的问题,如合规困难、复杂的心理社会问题或慢性精神障碍。我们还讨论了与监督过程、监督人的角色、不同的监督风格以及影响被监督人脆弱感和羞耻感的问题有关的问题。此外,我们还分析了经验丰富的CBT治疗师在监督中出现的不同监督风格和潜在问题。
{"title":"Problems in Cognitive-Behavioral Supervision: Theoretical Background and Clinical Application.","authors":"Jan Prasko,&nbsp;Marija Abeltina,&nbsp;Ilona Krone,&nbsp;Julija Gecaite-Stonciene,&nbsp;Jakub Vanek,&nbsp;Julius Burkauskas,&nbsp;Roman Liska,&nbsp;Tomas Sollar,&nbsp;Alicja Juskiene,&nbsp;Milos Slepecky,&nbsp;Lina Bagdonaviciene,&nbsp;Marie Ociskova","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cognitive-behavioural therapists and trainees are encouraged to undergo supervision when offering therapy to troubled clients and to process personal attitudes and events likely to affect their therapeutic work. We discuss common problems in cognitive behavioural therapy (CBT) supervision, which may arise at the client, supervisee, or supervisor level. These issues include difficulties with case formulation, therapeutic strategies, and the therapeutic relationship. A supervisor can help their supervisee deal with clients with multifaceted or particularly challenging problems, such as difficulties with compliance, complex psychosocial problems, or chronic mental disorders. We also discuss matters related to the supervision process, the supervisor's role, different supervisory styles, and issues affecting a supervisee's feelings of vulnerability and shame. Furthermore, we analyze distinct supervision styles and potential problems arising from the supervision of experienced CBT therapists.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41149195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Morphological peculiarities of the autonomic nervous system in the thoracic region. 胸部自主神经系统的形态学特征。
Pub Date : 2023-06-14
Stefan Galbavy, Jan Sikuta, Peter Ocko, Lubomír Mikulas, David Toma, Michal Kovac, Enrico Cambal

Background: The aim of the work is to define the morphological peculiarities of the autonomic nervous system (ANS) in the thoracic region.

Material and methods: An anatomical study was performed on 20 cadavers, 17 men and 3 women. We studied cadavers within 24 h of death. We observed the vertebral and prevertebral section of the truncus sympathicus, their morphological peculiarities depending on the type of ANS. To show the intimate relationship of both systems, we also focused on the details of the structure related to the connections of the ANS with the spinal nervous system.

Results: In the thoracic region, the segmental arrangement of the truncus sympathicus ganglia prevailed in 16 (80%) cases. Rami communicantes gave anastomoses to spinal nerves. Small ganglia were observed on the rami communicantes to the spinal nerves. In the case of the concentrated type, in 4 cases (20%), we observed a reduction in the number of ganglia, as well as the absence of small ganglia on the connecting branches. Connections between n. vagus and sympathetic branches were poorly developed. We observed right-left asymmetry and differences in the formation of ganglia and anastomoses in the truncus sympathicus in the vertebral and prevertebral section. Variations of distance of n. splanchnicus major were observed in 16 cases (80%).

Conclusion: This study allowed us to identify and describe the morphological peculiarities of the thoracic ANS. The variations were numerous; their preoperative diagnosis is difficult to impossible. The knowledge gained can be helpful in clarifying clinical signs and symptoms.

背景:这项工作的目的是定义胸部自主神经系统(ANS)的形态特征。材料与方法:对20具尸体进行解剖研究,其中男17具,女3具。我们研究了死亡后24小时内的尸体。我们观察了交感干的椎骨和椎前段,它们的形态特征取决于ANS的类型。为了显示这两个系统的密切关系,我们还重点研究了与ANS与脊神经系统连接相关的结构细节。结果:16例(80%)胸区交感干神经节节段性排列占优势。拉米通信使脊神经吻合。在脊神经的交通支上观察到小神经节。在集中型的情况下,在4例(20%)中,我们观察到神经节数量减少,并且在连接分支上没有小神经节。迷走神经和交感神经分支之间的联系发育不良。我们观察了左右不对称性,以及椎骨和椎前节交感干神经节和吻合的形成差异。观察了16例(80%)内脏大神经距离的变化。结论:本研究使我们能够识别和描述胸部ANS的形态特征。变化范围广泛;他们的术前诊断很难甚至不可能。所获得的知识有助于阐明临床体征和症状。
{"title":"Morphological peculiarities of the autonomic nervous system in the thoracic region.","authors":"Stefan Galbavy,&nbsp;Jan Sikuta,&nbsp;Peter Ocko,&nbsp;Lubomír Mikulas,&nbsp;David Toma,&nbsp;Michal Kovac,&nbsp;Enrico Cambal","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The aim of the work is to define the morphological peculiarities of the autonomic nervous system (ANS) in the thoracic region.</p><p><strong>Material and methods: </strong>An anatomical study was performed on 20 cadavers, 17 men and 3 women. We studied cadavers within 24 h of death. We observed the vertebral and prevertebral section of the truncus sympathicus, their morphological peculiarities depending on the type of ANS. To show the intimate relationship of both systems, we also focused on the details of the structure related to the connections of the ANS with the spinal nervous system.</p><p><strong>Results: </strong>In the thoracic region, the segmental arrangement of the truncus sympathicus ganglia prevailed in 16 (80%) cases. Rami communicantes gave anastomoses to spinal nerves. Small ganglia were observed on the rami communicantes to the spinal nerves. In the case of the concentrated type, in 4 cases (20%), we observed a reduction in the number of ganglia, as well as the absence of small ganglia on the connecting branches. Connections between n. vagus and sympathetic branches were poorly developed. We observed right-left asymmetry and differences in the formation of ganglia and anastomoses in the truncus sympathicus in the vertebral and prevertebral section. Variations of distance of n. splanchnicus major were observed in 16 cases (80%).</p><p><strong>Conclusion: </strong>This study allowed us to identify and describe the morphological peculiarities of the thoracic ANS. The variations were numerous; their preoperative diagnosis is difficult to impossible. The knowledge gained can be helpful in clarifying clinical signs and symptoms.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41176071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nightmares in borderline personality disorder - narrative review. 边缘型人格障碍中的噩梦——叙事评论。
Pub Date : 2023-06-14
Kamila Belohradova, Jan Prasko, Jakub Vanek, Marie Ociskova, Samuel Genzor, Jonas Bocek

Background: Borderline personality disorder (BPD) patients commonly suffer from nightmares. Still, the prevalence of this issue does not match the little clinical attention it usually receives. Nightmares impact sleep and daily functioning and may play a role in BPD symptomatology, including suicidality. Since BPD has been linked with high rates of suicide, the potential connection with suicidality is crucial to address.

Aims: To create an up-to-date review of current knowledge on nightmares in BPD and to explore the links between nightmares, insomnia, and suicidality or self-harm in BPD patients.

Method: This narrative review was conducted using the PubMed, Web of Science, and Google Scholar databases to search for articles published between January 1990 and October 2022, using the following key terms: 'borderline personality disorder' and 'nightmares' or 'insomnia' and 'suicidality' or 'self-harm' or 'self-injuring'. The final list consisted of 99 publications.

Results: Sleep disturbances often occur in BPD patients. The prevalence of nightmares in BPD is higher than in general or clinical populations. Nightmares influence borderline personality traits and vice versa through emotional dysregulation, poorer sleep quality, nightmare anxiety, higher arousal, and worsened self-control. A link between nightmares and suicidal behaviour was established in some psychiatric conditions (depression, insomnia); studies on BPD are lacking in this area. Studies comparing nightmares in BPD to other disorders are also missing. There are some suggestions for pharmaceuticals or psychotherapy in treating nightmares, but their application to BPD needs more research.

Conclusion: Sleep disturbance and nightmares are common among individuals with BPD yet underrepresented in research. Nightmares have been linked with suicidality in other conditions (depression, PTSD) but only indirectly in BPD. More clinical studies are needed to explore the phenomenon further.

背景:边缘型人格障碍(BPD)患者通常会做噩梦。尽管如此,这个问题的普遍性与它通常受到的很少的临床关注并不匹配。噩梦影响睡眠和日常功能,可能在BPD症状中发挥作用,包括自杀。由于BPD与高自杀率有关,因此与自杀的潜在联系至关重要。目的:对BPD中噩梦的最新知识进行回顾,并探讨BPD患者的噩梦、失眠与自杀或自残之间的联系。方法:使用PubMed、Web of Science和Google Scholar数据库进行叙述性综述,搜索1990年1月至2022年10月期间发表的文章,使用以下关键词:“边缘型人格障碍”、“噩梦”、“失眠”、“自杀”、“自残”或“自伤”。最终名单包括99份出版物。结果:BPD患者经常出现睡眠障碍。BPD中噩梦的发生率高于普通人群或临床人群。噩梦通过情绪失调、睡眠质量差、噩梦焦虑、更高的唤醒和更差的自制力影响边缘人格特征,反之亦然。在某些精神疾病(抑郁症、失眠)中,噩梦与自杀行为之间存在联系;该领域缺乏对BPD的研究。将BPD的噩梦与其他疾病进行比较的研究也不多见。有一些关于药物或心理治疗噩梦的建议,但它们在BPD中的应用还需要更多的研究。结论:睡眠障碍和噩梦在BPD患者中很常见,但在研究中代表性不足。噩梦在其他情况下(抑郁症、创伤后应激障碍)与自杀有关,但在BPD中只是间接的。需要更多的临床研究来进一步探索这一现象。
{"title":"Nightmares in borderline personality disorder - narrative review.","authors":"Kamila Belohradova,&nbsp;Jan Prasko,&nbsp;Jakub Vanek,&nbsp;Marie Ociskova,&nbsp;Samuel Genzor,&nbsp;Jonas Bocek","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Borderline personality disorder (BPD) patients commonly suffer from nightmares. Still, the prevalence of this issue does not match the little clinical attention it usually receives. Nightmares impact sleep and daily functioning and may play a role in BPD symptomatology, including suicidality. Since BPD has been linked with high rates of suicide, the potential connection with suicidality is crucial to address.</p><p><strong>Aims: </strong>To create an up-to-date review of current knowledge on nightmares in BPD and to explore the links between nightmares, insomnia, and suicidality or self-harm in BPD patients.</p><p><strong>Method: </strong>This narrative review was conducted using the PubMed, Web of Science, and Google Scholar databases to search for articles published between January 1990 and October 2022, using the following key terms: 'borderline personality disorder' and 'nightmares' or 'insomnia' and 'suicidality' or 'self-harm' or 'self-injuring'. The final list consisted of 99 publications.</p><p><strong>Results: </strong>Sleep disturbances often occur in BPD patients. The prevalence of nightmares in BPD is higher than in general or clinical populations. Nightmares influence borderline personality traits and vice versa through emotional dysregulation, poorer sleep quality, nightmare anxiety, higher arousal, and worsened self-control. A link between nightmares and suicidal behaviour was established in some psychiatric conditions (depression, insomnia); studies on BPD are lacking in this area. Studies comparing nightmares in BPD to other disorders are also missing. There are some suggestions for pharmaceuticals or psychotherapy in treating nightmares, but their application to BPD needs more research.</p><p><strong>Conclusion: </strong>Sleep disturbance and nightmares are common among individuals with BPD yet underrepresented in research. Nightmares have been linked with suicidality in other conditions (depression, PTSD) but only indirectly in BPD. More clinical studies are needed to explore the phenomenon further.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41159131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The common neurological basis and targeted therapeutic approaches for chronic pain and opioid addiction. 慢性疼痛和阿片类药物成瘾的常见神经基础和靶向治疗方法。
Pub Date : 2023-06-14
Chao-Jie Han, Zhen Shen, Tao Li, Mingze Tang, Wei Jiang, Cai Tie, Huihui Guo, Jun Gao, Yanxing Han, Tianle Gao

Chronic pain and drug addiction seriously threaten human health and generate a large loss of labor. Most highly addictive drugs are derived from opioids, which have severe side effects and are difficult to quit completely. On the other hand, opioid analgesics are widely used in detoxification for opioid addiction. These opioids are effective for controlling acute withdrawal symptoms, but can be problematic under long-term usage as maintenance therapy. Both chronic pain and opioid abuse are related to neurotransmitters and central reward pathways in the brain. As to provide new weapons for defending human health, this article summarized the similarities and differences between chronic pain and opioid addiction, based on their common neurobiological basis, and discussed the breakthroughs in targeted therapeutic approaches. Furthermore, we have brought out an innovative and integrative therapeutic scheme by combining drugs, medical devices, and phycological / behavioral therapies, according to the patient's individual situation, aiming at achieving better effects against these two types of diseases.

慢性疼痛和药物成瘾严重威胁人类健康,并造成大量劳动力损失。大多数高度成瘾的药物都是由阿片类药物衍生而来的,这些药物有严重的副作用,很难完全戒除。另一方面,阿片类镇痛剂被广泛用于阿片类成瘾的解毒。这些阿片类药物对控制急性戒断症状有效,但在长期用作维持治疗时可能会出现问题。慢性疼痛和阿片类药物滥用都与大脑中的神经递质和中枢奖赏通路有关。为了为捍卫人类健康提供新的武器,本文根据慢性疼痛和阿片类药物成瘾的共同神经生物学基础,总结了它们的异同,并讨论了靶向治疗方法的突破。此外,我们还根据患者的个人情况,将药物、医疗器械和心理/行为疗法相结合,提出了一种创新的综合治疗方案,旨在达到更好的治疗这两类疾病的效果。
{"title":"The common neurological basis and targeted therapeutic approaches for chronic pain and opioid addiction.","authors":"Chao-Jie Han,&nbsp;Zhen Shen,&nbsp;Tao Li,&nbsp;Mingze Tang,&nbsp;Wei Jiang,&nbsp;Cai Tie,&nbsp;Huihui Guo,&nbsp;Jun Gao,&nbsp;Yanxing Han,&nbsp;Tianle Gao","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Chronic pain and drug addiction seriously threaten human health and generate a large loss of labor. Most highly addictive drugs are derived from opioids, which have severe side effects and are difficult to quit completely. On the other hand, opioid analgesics are widely used in detoxification for opioid addiction. These opioids are effective for controlling acute withdrawal symptoms, but can be problematic under long-term usage as maintenance therapy. Both chronic pain and opioid abuse are related to neurotransmitters and central reward pathways in the brain. As to provide new weapons for defending human health, this article summarized the similarities and differences between chronic pain and opioid addiction, based on their common neurobiological basis, and discussed the breakthroughs in targeted therapeutic approaches. Furthermore, we have brought out an innovative and integrative therapeutic scheme by combining drugs, medical devices, and phycological / behavioral therapies, according to the patient's individual situation, aiming at achieving better effects against these two types of diseases.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41161676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of prepubertal obesity induced by high-fat diet during lactation and post-weaning on puberty initiation and neuroendocrine function in a female mouse model. 哺乳期和断奶后高脂肪饮食诱导的青春期前肥胖对雌性小鼠模型青春期发育和神经内分泌功能的影响。
Pub Date : 2023-06-14
Mengmeng Shi, Shi Ren, Yue Zhang, Qinling Yang, Lingling Zhai

Purpose: To explore the effects of prepubertal obesity induced by high-fat diet during lactation and post-weaning on puberty onset and the neuroendocrine changes before puberty onset in a female mouse model, which may explain obesity in children starting early puberty.

Methods: A total of 72 female mice were assigned to the high fat diet group (HFD) and the control diet group (CONT) during lactation and post-weaning. The bodily indexes; pathological changes; and protein and gene expression levels in the hypothalamus were examined on postnatal days (P) 15, 28, and 45, respectively.

Results: The average vaginal opening time in HFD mice occurred significantly earlier than that in CONT mice (p < 0.05). On P15, no significant difference in the MKRN3, kisspeptin, GPR54 and GnRH level between HFD and CONT mice was noted (p > 0.05). Whereas on P28 and 45, compared to CONT mice, GnRH expression in HFD mice was significantly increased (p < 0.05); kisspeptin and GPR54 expression in HFD mice was also significantly increased (p < 0.05); but the MKRN3 level in HFD mice was significantly lower than that in CONT mice (p < 0.05). On P15, 28, and 45, compared with CONT mice, miR-30b expression in HFD mice increased (p < 0.05). Compared to P15, miR-30b, KiSS-1, GPR54 and GnRH mRNA level increased significantly, however MKRN3 decreased significantly in HFD mice on P28 and 45 (p < 0.01).

Conclusions: Prepubertal obesity induced by high-fat diet during lactation and post-weaning may advance the time of pubertal initiation in female mice. The increased expression of miR-30b, kisspeptin, GPR54 and GnRH, decreased the expression of MKRN3 may explain the early onset of puberty in obese female mice.

目的:在雌性小鼠模型中,探讨哺乳期和断奶后高脂肪饮食诱导的青春期前肥胖对青春期开始的影响以及青春期开始前的神经内分泌变化,这可能解释青春期早期儿童的肥胖。方法:将72只雌性小鼠分为哺乳期和断奶后的高脂饮食组(HFD)和对照饮食组(CONT)。身体指标;病理变化;分别在出生后第15、28和45天检测下丘脑中的蛋白质和基因表达水平(P)。结果:HFD小鼠平均阴道开放时间明显早于CONT小鼠(p<0.05)。在P15,HFD和CONT小鼠的MKRN3、kisspeptin、GPR54和GnRH水平没有显著差异(p>0.05)。而在P28和45,与CONT小鼠相比,HFD小鼠的GnRH表达显著增加(p<0.05);kisspeptin和GPR54在HFD小鼠中的表达也显著增加(p<0.05);但HFD小鼠的MKRN3水平明显低于CONT小鼠(p结论:哺乳期和断奶后高脂饮食诱导的青春期前肥胖可能提前了雌性小鼠青春期发育的时间。miR-30b、kisspeptin、GPR54和GnRH的表达增加,MKRN3的表达减少,这可能解释了肥胖雌性小鼠青春期提前的原因。
{"title":"Impact of prepubertal obesity induced by high-fat diet during lactation and post-weaning on puberty initiation and neuroendocrine function in a female mouse model.","authors":"Mengmeng Shi,&nbsp;Shi Ren,&nbsp;Yue Zhang,&nbsp;Qinling Yang,&nbsp;Lingling Zhai","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the effects of prepubertal obesity induced by high-fat diet during lactation and post-weaning on puberty onset and the neuroendocrine changes before puberty onset in a female mouse model, which may explain obesity in children starting early puberty.</p><p><strong>Methods: </strong>A total of 72 female mice were assigned to the high fat diet group (HFD) and the control diet group (CONT) during lactation and post-weaning. The bodily indexes; pathological changes; and protein and gene expression levels in the hypothalamus were examined on postnatal days (P) 15, 28, and 45, respectively.</p><p><strong>Results: </strong>The average vaginal opening time in HFD mice occurred significantly earlier than that in CONT mice (p < 0.05). On P15, no significant difference in the MKRN3, kisspeptin, GPR54 and GnRH level between HFD and CONT mice was noted (p > 0.05). Whereas on P28 and 45, compared to CONT mice, GnRH expression in HFD mice was significantly increased (p < 0.05); kisspeptin and GPR54 expression in HFD mice was also significantly increased (p < 0.05); but the MKRN3 level in HFD mice was significantly lower than that in CONT mice (p < 0.05). On P15, 28, and 45, compared with CONT mice, miR-30b expression in HFD mice increased (p < 0.05). Compared to P15, miR-30b, KiSS-1, GPR54 and GnRH mRNA level increased significantly, however MKRN3 decreased significantly in HFD mice on P28 and 45 (p < 0.01).</p><p><strong>Conclusions: </strong>Prepubertal obesity induced by high-fat diet during lactation and post-weaning may advance the time of pubertal initiation in female mice. The increased expression of miR-30b, kisspeptin, GPR54 and GnRH, decreased the expression of MKRN3 may explain the early onset of puberty in obese female mice.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41143736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Constant light and single housing alter novelty-induced locomotor activity and sociability in female Swiss Webster mice. 恒定的光照和单一的外壳改变了雌性瑞士韦伯斯特小鼠新奇诱导的运动活动和社交能力。
Pub Date : 2023-06-14
Fernanda Medeiros Contini, Joseph A Seggio

Objective: Light exposure at night is known to produce behavioral aberrations in both human and animal models. One way to mimic light-at-night is through constant light exposure (LL), wherein animals are placed in an environment where a dark phase never occurs. Additionally, the type of housing condition for the rodents in experiments - grouped-housed vs singly-housed - can produce different behavioral responses, even in female mice. This study investigated whether LL produces alterations to emotionality and sociability, and whether group housing can alleviate some of those negative behavioral outcomes in female mice.

Methods: Female Swiss Webster mice were placed into group or single housing conditions and either into a standard 12:12 light:dark cycle or LL. Novelty-induced (open-field, light-dark box) and circadian locomotor activity, sociability, and serum oxytocin were measured during the middle of the day.

Results: LL and group-housing produced alterations to circadian home-cage activity and increases novelty-induced locomotor activity in the open-field and light-dark box. LL led to increased aggression in both group-housed and single-housed mice, while single-housed/LL mice showed reduced encounters towards the social mouse. Group-housed/LL mice exhibited increased interactions with the empty enclosure. Additionally, both LL and group-housing increased oxytocin levels.

Conclusions: The increase in oxytocin may be a contributing factor to why female mice exhibit increased aggression and other impaired social behaviors in LL. Socialization via group housing was ineffective in reducing the negative sociability seen in mice under LL. These results indicate that aberrant light exposure and circadian misalignment are correlated with impaired social behaviors and emotionality.

目的:众所周知,夜间光照会在人类和动物模型中产生行为异常。模拟夜间光线的一种方法是通过持续曝光(LL),将动物置于从不出现暗相的环境中。此外,实验中啮齿动物的居住条件类型——分组居住和单独居住——可以产生不同的行为反应,即使在雌性小鼠中也是如此。这项研究调查了LL是否会改变雌性小鼠的情绪和社交能力,以及集体住房是否可以缓解一些负面行为结果。方法:将雌性Swiss Webster小鼠置于成组或单一饲养条件下,并置于标准的12:12光:暗周期或LL中。在中午测量新奇感诱导(开阔场地、明暗盒)和昼夜节律运动活动、社交能力和血清催产素。结果:LL和集体住房对昼夜节律的家庭笼活动产生了改变,并增加了在开阔地和明暗箱中新奇诱导的运动活动。LL导致组饲养和单饲养小鼠的攻击性增加,而单饲养/LL小鼠对社交小鼠的接触减少。分组饲养/LL小鼠表现出与空围栏的相互作用增加。此外,LL和集体住房都增加了催产素水平。结论:催产素的增加可能是雌性小鼠在LL中表现出攻击性增加和其他社会行为受损的原因之一。通过集体住房进行的社交活动在降低LL小鼠的负面社交能力方面无效。这些结果表明,异常的光照和昼夜节律失调与社会行为和情绪受损有关。
{"title":"Constant light and single housing alter novelty-induced locomotor activity and sociability in female Swiss Webster mice.","authors":"Fernanda Medeiros Contini,&nbsp;Joseph A Seggio","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Light exposure at night is known to produce behavioral aberrations in both human and animal models. One way to mimic light-at-night is through constant light exposure (LL), wherein animals are placed in an environment where a dark phase never occurs. Additionally, the type of housing condition for the rodents in experiments - grouped-housed vs singly-housed - can produce different behavioral responses, even in female mice. This study investigated whether LL produces alterations to emotionality and sociability, and whether group housing can alleviate some of those negative behavioral outcomes in female mice.</p><p><strong>Methods: </strong>Female Swiss Webster mice were placed into group or single housing conditions and either into a standard 12:12 light:dark cycle or LL. Novelty-induced (open-field, light-dark box) and circadian locomotor activity, sociability, and serum oxytocin were measured during the middle of the day.</p><p><strong>Results: </strong>LL and group-housing produced alterations to circadian home-cage activity and increases novelty-induced locomotor activity in the open-field and light-dark box. LL led to increased aggression in both group-housed and single-housed mice, while single-housed/LL mice showed reduced encounters towards the social mouse. Group-housed/LL mice exhibited increased interactions with the empty enclosure. Additionally, both LL and group-housing increased oxytocin levels.</p><p><strong>Conclusions: </strong>The increase in oxytocin may be a contributing factor to why female mice exhibit increased aggression and other impaired social behaviors in LL. Socialization via group housing was ineffective in reducing the negative sociability seen in mice under LL. These results indicate that aberrant light exposure and circadian misalignment are correlated with impaired social behaviors and emotionality.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41166258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The safety of withholding hydrocortisone during preoperative periods in pituitary adenomas patients with an intact HPA axis: A meta-analysis of randomized controlled trials. HPA轴完整的垂体腺瘤患者术前停用氢化可的松的安全性:一项随机对照试验的荟萃分析。
Pub Date : 2023-06-14
Fenjie Lin, Yonghe Su, Xun Zhang, Biyan Liang, Mingjun Qin

Objectives: For patients with pituitary adenomas with an intact hypothalamus-pituitary-adrenal axis before surgery, whether routine steroid therapy is needed is still controversial. We conducted a meta-analysis to assess the safety of withholding hydrocortisone compared with hydrocortisone in pituitary adenoma patients during preoperative periods.

Material and methods: We searched PubMed, Embase, Web of Science, and Cochrane Library databases up to November 2022 using inclusion and exclusion criteria. We employed either a fixed-effect or random-effect model for the analysis and assessed heterogeneity using the I2 statistic.

Results: Three studies involving 512 patients out of 400 studies were conducted. The pooled data revealed a higher incidence of postoperative transient diabetes insipidus in the no-hydrocortisone group than in the hydrocortisone group (RR, 1.88; 95% CI, 1.13 to 3.12; p = 0.02). The cortisol level in the no-hydrocortisone group was lower than in the hydrocortisone group after tumor removal (mean difference, -36.82; 95% CI, -44.27 to -29.38; p < 0.00001) but higher on the second day after surgery (mean difference, 4.04; 95% CI, 2.38 to 5.71; p < 0.00001). No significant differences were observed in early adrenal insufficiency (RR, 1.04; 95% CI, 0.37 to 2.96; p = 0.93), adrenal insufficiency in the third month after surgery (RR, 1.56; 95% CI, 0.70 to 3.48; p = 0.28), cortisol level on the first day after surgery (mean difference, 0.24; 95% CI, -11.25 to 11.73; p = 0.97), postoperative permanent diabetes insipidus (RR, 1.61; 95% CI, 0.43 to 6.07; p = 0.48), postoperative delayed hyponatremia (RR, 1.06; 95% CI, 0.41 to 2.74; p = 0.91), or postoperative blood glucose level (mean difference, -0.41; 95% CI, -1.19 to 0.37; p = 0.31) between the no-hydrocortisone and hydrocortisone groups.

Conclusion: Withholding preoperative steroid therapy is safe for pituitary adenomas patients with an intact hypothalamus-pituitary-adrenal axis.

目的:对于术前下丘脑-垂体-肾上腺轴完整的垂体腺瘤患者,是否需要常规类固醇治疗仍有争议。我们进行了一项荟萃分析,以评估垂体腺瘤患者术前停用氢化可的松与氢化可的松的安全性。材料和方法:我们使用纳入和排除标准搜索了截至2022年11月的PubMed、Embase、Web of Science和Cochrane Library数据库。我们采用固定效应或随机效应模型进行分析,并使用I2统计量评估异质性。结果:进行了三项研究,涉及400项研究中的512名患者。汇总数据显示,非氢化可的松组术后短暂性尿崩症的发生率高于氢化可的松对照组(RR,1.88;95%CI,1.13至3.12;p=0.02)。肿瘤切除后,非氢化可的松组的皮质醇水平低于氢化可的松小组(平均差异为-36.82;95%CI为-44.27至-29.38;p<0.0001)术后第二天(平均差异,4.04;95%可信区间,2.38-5.71;p<0.00001)。早期肾上腺功能不全(RR,1.04;95%置信区间,0.37-2.96;p=0.93)、术后第三个月肾上腺功能不全无显著差异(RR,1.56;95%置信度,0.70-3.48;p=0.28),术后第一天的皮质醇水平(平均差异,0.24;95%可信区间,-11.25-11.73;p=0.097)、术后永久性尿崩症(RR,1.61;95%置信区间,0.43-6.07;p=0.48)、术后迟发性低钠血症(RR,1.06;95%CI,0.41-2.74;p=0.91),或术后血糖水平(平均差异-0.41;95%可信区间-1.19至0.37;p=0.31)。结论:对于下丘脑-垂体-肾上腺轴完整的垂体腺瘤患者,术前不使用类固醇治疗是安全的。
{"title":"The safety of withholding hydrocortisone during preoperative periods in pituitary adenomas patients with an intact HPA axis: A meta-analysis of randomized controlled trials.","authors":"Fenjie Lin,&nbsp;Yonghe Su,&nbsp;Xun Zhang,&nbsp;Biyan Liang,&nbsp;Mingjun Qin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>For patients with pituitary adenomas with an intact hypothalamus-pituitary-adrenal axis before surgery, whether routine steroid therapy is needed is still controversial. We conducted a meta-analysis to assess the safety of withholding hydrocortisone compared with hydrocortisone in pituitary adenoma patients during preoperative periods.</p><p><strong>Material and methods: </strong>We searched PubMed, Embase, Web of Science, and Cochrane Library databases up to November 2022 using inclusion and exclusion criteria. We employed either a fixed-effect or random-effect model for the analysis and assessed heterogeneity using the I2 statistic.</p><p><strong>Results: </strong>Three studies involving 512 patients out of 400 studies were conducted. The pooled data revealed a higher incidence of postoperative transient diabetes insipidus in the no-hydrocortisone group than in the hydrocortisone group (RR, 1.88; 95% CI, 1.13 to 3.12; p = 0.02). The cortisol level in the no-hydrocortisone group was lower than in the hydrocortisone group after tumor removal (mean difference, -36.82; 95% CI, -44.27 to -29.38; p < 0.00001) but higher on the second day after surgery (mean difference, 4.04; 95% CI, 2.38 to 5.71; p < 0.00001). No significant differences were observed in early adrenal insufficiency (RR, 1.04; 95% CI, 0.37 to 2.96; p = 0.93), adrenal insufficiency in the third month after surgery (RR, 1.56; 95% CI, 0.70 to 3.48; p = 0.28), cortisol level on the first day after surgery (mean difference, 0.24; 95% CI, -11.25 to 11.73; p = 0.97), postoperative permanent diabetes insipidus (RR, 1.61; 95% CI, 0.43 to 6.07; p = 0.48), postoperative delayed hyponatremia (RR, 1.06; 95% CI, 0.41 to 2.74; p = 0.91), or postoperative blood glucose level (mean difference, -0.41; 95% CI, -1.19 to 0.37; p = 0.31) between the no-hydrocortisone and hydrocortisone groups.</p><p><strong>Conclusion: </strong>Withholding preoperative steroid therapy is safe for pituitary adenomas patients with an intact hypothalamus-pituitary-adrenal axis.</p>","PeriodicalId":94154,"journal":{"name":"Neuro endocrinology letters","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41149139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Neuro endocrinology letters
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1