RESUMEN
Neurotrauma, especially Traumatic Brain Injury (TBI) is a major health concern not only for the civilian population but also for the military personnel. Currently there are no precision and regenerative therapies available for the successful treatment of TBI patients. Hence, early detection and treatment options may prevent the severity and untoward harmful effects of TBI. However, currently there are no effective biomarkers available for the rapid and robust diagnosis as well as prognosis of TBI. Several biomarkers in blood, cerebrospinal fluid (CSF), saliva and urine have been explored to assess the onset, progression, severity and prognosis of TBI recently. Present knowledge on the blood biomarkers including cytokines and chemokines and in vivo imaging modalities are useful to some extent to detect and treat TBI patients. Here, we review S100B, Glial Fibrillary Acidic Protein (GFAP), Neuron Specific Enolase (NSE), Myelin Basic Protein (MBP), Ubiquitin C-terminal Hydrolase L1 (UCHL1), tau protein, and alpha spectrin II break down products regarding their usefulness as a set of reliable biomarkers for the robust diagnosis of TBI. We suggest that these biomarkers may prove very useful for the diagnosis and prognosis of TBI.
RESUMEN
Multiple sclerosis (MS) is a chronic disorder of the central nervous system (CNS). MS affects 2.1 million individuals every year and is also considered a major cause of economic health burden around the world. Genetics and environmental factors both play a role in the pathogenesis of MS by activating the immune response and causing inflammation. Patients with MS can have various clinical courses, but the most common pattern seen is relapsing-remitting multiple sclerosis (RRMS). Multiple therapeutic options have been studied to prevent RRMS patients from frequent relapses. The oldest and most frequently used medication for MS is interferon beta, either used alone or as add-on therapy with other drugs. Newer treatment options that have been recently approved to control MS symptoms and suppress the inflammation are glatiramer acetate and siponimod. Infusion therapies consisting of monoclonal antibodies and immunosuppressive drugs have also been studied in the recent past. Some trials have been conducted on the use of stem cells for RRMS patients. We have briefly discussed all treatment options and the response of RRMS patients in multiple trials.
RESUMEN
Cerebral venous thrombosis (CVT) is a rare complication of hypercoagulable states such as pregnancy, lupus anticoagulant syndrome, systemic lupus erythematosus, Crohn's disease, ulcerative colitis, malignancies, and the use of oral contraceptive pills. It most commonly occurs in young people, especially women, but can occur in the elderly as well. The signs and symptoms vary from focal neurological deficiencies to alteration in mental status. In this review, we compare the efficacy and safety profile of traditional anticoagulants heparin and vitamin K antagonists (warfarin) to novel oral anticoagulants, which include rivaroxaban, apixaban, dabigatran. The advantages of the new anticoagulants are their effectiveness, short half-life, oral intake instead of parenteral, and the decreased need for constantly monitoring prothrombin time (PT), activated partial thromboplastin time (APTT), and the international normalized ratio (INR). In this review, we discuss studies that demonstrate that these novel oral anticoagulants are effective and safe in treating cerebral venous thrombosis without many adverse effects when compared with traditional treatment options. There are also some case reports that point towards the effectiveness of newer agents; however, we need more studies with bigger samples to reach a conclusion in favor of new oral anticoagulants. The studies that have already been conducted can become the basis for conducting newer studies that can revolutionize the modern treatment for conditions like CVT.
RESUMEN
Progressive multifocal leukoencephalopathy is a fatal demyelinating disease caused by the John Cunningham virus. It causes white matter inflammation in multiple areas of the brain. Although rare, it has been known to occur in patients with immunodeficiency states and those taking chronic immunosuppressive medications for diseases such as multiple sclerosis and psoriasis. In this article, we will discuss about the drug-induced progressive multifocal encephalopathy and its diagnosis and management in patients taking natalizumab and other disease-modifying therapies among patients with multiple sclerosis.
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This article will discuss the effects of physical activity in patients with Parkinson's disease. Presently, the motor and non-motor symptoms are difficult to treat with the current treatment of Parkinson's; therefore, as an adjuvant to the current treatment physical activity, has been recommended. Physical activity has been known to improve many symptoms in patients with Parkinson's disease. Some of these symptoms include the physical capacities, physical and cognitive functional capacities. Physical activity also slows the disease process, decreases the pain associated with Parkinson`s disease, prolongs the independent mobility (gait, balance, strength) and improves sleep, mood, memory hence improving the overall quality of life. Furthermore, physical activity has the potential to improve the non-motor symptoms (depression, apathy, fatigue, constipation) and the secondary complications of immobility (cardiovascular, osteoporosis) in Parkinson's disease.
RESUMEN
Vitamin D is vital for our body as it regulates calcium homeostasis and maintains bone integrity. In this article, we will discuss how vitamin D aids in the function of neuronal and glial tissue and the many health consequences in a person with vitamin D deficiency. Some of the effects of vitamin D deficiency that will be discussed include the development of dementia caused by the increase of cerebral soluble and insoluble amyloid-ß (Aß) peptides and a decrease of its anti-inflammatory/antioxidant properties, the link to depression by a reduction of the buffering of increased calcium in the brain, and vitamin D deficiency in expecting mothers linking to the development of autism and schizophrenic-like disorders, hypoxic brain injury, and other mental illnesses. Lastly, we will discuss how vitamin D deficiency is linked to the development of diabetes mellitus, its role in neuronal development and a decrease of microglial inflammatory function leading to increased brain infections.
RESUMEN
Needle electromyography is a common procedure used by physicians to detect an underlying neuromuscular disorder. It is performed by inserting a needle electrode in different locations of the muscles and measures the muscle reaction or electrical activity in response to a nerve's stimulation of the muscle on an oscilloscope. The procedure is usually safe, however, in rare cases, the insertion of the needle in the pleura or lung can cause a pneumothorax, which can be life-threatening. Here, we have reported a case in which a puncture in the right cervical paraspinal muscle during a needle electromyography procedure caused a right-sided pneumothorax in a 49-year-old female patient who was further treated in the hospital until the pneumothorax resolved. In addition, a technique that can be used to prevent this life-threatening complication will also be discussed. To our knowledge, one similar case report has been presented in the past.
RESUMEN
Necrotizing fasciitis is a progressive inflammatory disease that requires an early diagnosis to avoid limb salvage and other deadly manifestations. The current protocol is the microbiological and histopathological sampling of the tissue. Once the diagnosis is made, it should be managed with antimicrobial therapy, debridement, and surgical interventions. Such interventions can be invasive and increase the time to treat, which may increase morbidity. Our article discusses procalcitonin, C-reactive protein, and other markers, such as "pain out of proportion," lactate, creatinine, and creatine kinase, to make a quicker diagnosis before proceeding with invasive procedures. We discussed a similar non-invasive approach called the "Laboratory Risk Indicator for Necrotizing Fasciitis" scoring system that can aid in the early diagnosis of necrotizing fasciitis, which can prompt rapid empiric therapy, reducing the chances of morbidity. This scoring system comprises C-reactive protein, white blood cell count, hemoglobin level, creatinine, sodium, and glucose. Such non-invasive, bedside, and quick tests can help in reducing the time required to make the diagnosis and can affect the course of the disease, hence, improving patient outcomes.
RESUMEN
Sugar-sweetened beverages containing caffeine are widely used among humans nowadays and can have negative consequences on the overall health. Our study aims to discuss the effects of these sugar-sweetened beverages (SSB) and how they can impact the health in different ways particularly on the brain. Some of the mechanisms by which soft drinks can exert adverse effects include an increase in glutathione-6-dehydrogenase level, increased levels of gamma-aminobutyric acid (GABA), glutamate and dopamine alteration in brain waves on electroencephalography (EEG) eventually leading to stroke and dementia. They can increase the oxidative stress by a decreasing monoamine oxidase and acetylcholine esterase and antioxidants such as glutathione and catalase. The sleep quality and duration of sleep is also significantly affected by their increased consumption. Also, the consumption of sodium benzoate (found in beverages) on impairing memory, motor coordination, affecting reduced glutathione (GSH), increasing the malondialdehyde (MDA) level in the brain and producing attention deficit hyperactivity disorder (ADHD) in children is emphasized. Finally, we will highlight how diet drinks can also be harmful and the maternal consumption of chocolate or soft drinks during pregnancy and postnatal period can be linked to cognitive impairment and child obesity.
RESUMEN
Obesity and dementia are both associated with an increased risk of Alzheimer's disease (AD), and underlying neurodegenerative changes. Review articles provide evidential support that obesity and dementia result in an early old-age memory crisis. Obesity triggering vascular dementia decreases not only blood supply to the brain, but also increases fat cells that damage the brain white matter leading to loss of cognitive and intellectual behaviour. Adipocyte-secreted proteins and inflammatory cytokines explain the association between obesity and increased risk of dementia. Late-life elevated body mass index (BMI) confers a lower risk of having dementia. The hormone leptin explained the mechanism for the reverse association. Future studies need to reveal the linkage between adiposity and excess risk of dementia and AD.
