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1.
Colomb Med (Cali) ; 53(2): e2034500, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36415695

RESUMO

Introduction: Triphasic waves (TW) constitute an electroencephalographic pattern associated with certain kinds of encephalopathy. Brain atrophy may be a predisposing factor linked with TW. Objective: To compare the degree of brain atrophy and white matter disease between patients with acute encephalopathy with and without TW. Methods: A retrospective observational study including adult patients with encephalopathy, with and without TW, hospitalized between 2016 and 2017. The degree of brain atrophy and white matter lesion were defined using the Global Cortical Atrophy and Age Related White Matter Changes (ARWMC) scales, respectively. Scores were compared between groups. Mortality rates were registered. Results: Sixteen patients with TW were identified matched by age and sex with 30 patients without TW. The mean age was 80 years in the TW group. Women represented 87.5%. Multifactorial encephalopathy was the most frequent diagnosis followed by metabolic encephalopathy. Patients with TW had more brain atrophy (10.43 vs 6.9, p= 0.03). Mean ARWMC was 9.43±6.5 and 8.5 ±7.89 in patients with and without TW respectively (p= 0.5). Mortality rate was higher in the TW group (31.25 vs 6.66% p= 0.02). Conclusions: Patients with acute encephalopathy and TW had higher degree of cerebral atrophy. It is possible that this structural alteration predisposes to the appearance of TW. There was no significant difference in white matter lesion degree. The mortality of the TW group was high, so future studies are necessary to determine their prognostic value.


Introducción: Las ondas trifásicas (OT) constituyen un patrón electroencefalográfico asociado con diversas encefalopatías. La atrofia cerebral podría predisponer a su aparición. Objetivo: Comparar el grado de atrofia cerebral y de lesión de sustancia blanca en pacientes con encefalopatía aguda con y sin OT. Métodos: Estudio observacional retrospectivo, incluyó pacientes adultos con encefalopatía aguda con y sin OT internados entre 2016 y 2019. El grado de atrofia cerebral y de lesión de sustancia blanca se definieron según las escalas Global Cortical Atrophy y Age Related White Matter Changes (ARWMC), respectivamente. Se compararon los puntajes entre grupos. Se registró la mortalidad. Resultados: Se identificaron 16 pacientes con OT y 30 sin OT pareados según edad y sexo. La edad promedio del grupo con OT fue 80 años. El 87.5% fueron mujeres. La encefalopatía multifactorial fue el diagnóstico más frecuente seguido de la encefalopatía metabólica. El grado de atrofia fue mayor en pacientes con OT (10.43 vs 6.9, p= 0.03). El puntaje ARWMC fue 9.43 ±6.5 y 8.5 ±7.89 en pacientes con y sin OT respectivamente (p= 0.5). La mortalidad fue mayor en el grupo con OT (31.25 vs 6.66% p= 0.02). Conclusiones: Pacientes con encefalopatía aguda y OT tuvieron mayor grado de atrofia cerebral. Dicha alteración estructural podría relacionarse con la aparición de OT. No hubo diferencias significativas en el grado de lesión de sustancia blanca. La mortalidad del grupo con OT fue elevada. Son necesarios estudios para determinar su valor pronóstico.


Assuntos
Encefalopatias , Adulto , Humanos , Feminino , Idoso de 80 Anos ou mais , Encefalopatias/etiologia , Atrofia , Encéfalo/diagnóstico por imagem
2.
Pediatr Crit Care Med ; 23(12): 1027-1036, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36214585

RESUMO

OBJECTIVES: To validate a computational phenotype that identifies acute brain dysfunction (ABD) based on clinician concern for neurologic or behavioral changes in pediatric sepsis. DESIGN: Retrospective observational study. SETTING: Single academic children's hospital. PATIENTS: Four thousand two hundred eighty-nine index sepsis episodes. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: An existing computational phenotype of ABD was optimized to include routinely collected variables indicative of clinician concern for acute neurologic or behavioral change (completion of CT or MRI, electroencephalogram, or new antipsychotic administration). First, the computational phenotype was compared with an ABD reference standard established from chart review of 527 random sepsis episodes to determine criterion validity. Next, the computational phenotype was compared with a separate validation cohort of 3,762 index sepsis episodes to determine content and construct validity. Criterion validity for the final phenotype had sensitivity 83% (95% CI, 76-89%), specificity 93% (90-95%), positive predictive value 84% (77-89%), and negative predictive value 93% (90-96%). In the validation cohort, the computational phenotype identified ABD in 35% (95% CI 33-36%). Content validity was demonstrated as those with the ABD computational phenotype were more likely to have characteristics of neurologic dysfunction and severe illness than those without the ABD phenotype, including nonreactive pupils (15% vs 1%; p < 0.001), Glasgow Coma Scale less than 5 (44% vs 12%; p < 0.001), greater than or equal to two nonneurologic organ dysfunctions (50% vs 25%; p < 0.001), and need for intensive care (81% vs 65%; p < 0.001). Construct validity was demonstrated by higher odds for mortality (odds ratio [OR], 6.9; 95% CI, 5.3-9.1) and discharge to rehabilitation (OR, 11.4; 95% CI 7.4-17.5) in patients with, versus without, the ABD computational phenotype. CONCLUSIONS: A computational phenotype of ABD indicative of clinician concern for new neurologic or behavioral change offers a valid retrospective measure to identify episodes of sepsis that involved ABD. This computational phenotype provides a feasible and efficient way to study risk factors for and outcomes from ABD using routinely collected clinical data.


Assuntos
Encefalopatias , Sepse , Humanos , Estudos Retrospectivos , Mortalidade Hospitalar , Sepse/diagnóstico , Encefalopatias/diagnóstico , Encefalopatias/etiologia , Fenótipo , Encéfalo/diagnóstico por imagem
3.
Medwave ; 22(9): e2566, 2022 Oct 18.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36260762

RESUMO

Hashimoto's encephalopathy is a rare disease, first reported in 1966, with a prevalence of 2.1 in 1000 inhabitants. We present the case of a 42- year- old woman, with no relevant medical history, who suddenly started having symptoms of altered consciousness, visual hallucinations and de-lusions. Laboratory tests showed anti- thyroperoxidase antibodies greater than 600 U/ml, thy-roxin 0.93 U/ml, and thyroid stimulating hormone 1.60 U/ml. Magnetic resonance imaging showed bilateral subcortical focal lesions with a nonspecific demyelinating appearance. The electroencephalogram was nonspecific. The diagnosis of Hashimoto encephalopathy was made, and symptoms remitted after treatment with steroids. This article highlights the importance of conducting a comprehensive evaluation of patients with atypical psychiatric symptoms and a thorough differential diagnosis.


La encefalopatía de Hashimoto es una enfermedad rara reportada por primera vez en 1966 con una prevalencia de 2,1/1000 habitantes. Se presenta el caso de una mujer de 42 años, sin antecedentes médicos de importancia, quien inició un cuadro de manera súbita con alteración de conciencia, alucinaciones visuales y delusiones. En los exámenes de laboratorio se tuvo anticuerpos antiperoxidasa tiroidea mayor a 600 U/ml, tiroxina 0,93, hormona estimulante de la tiroides 1,60 U/ml, resonancia magnética con lesiones focales subcorticales bilaterales de aspecto desmielinizante inespecífico, electroencefalograma sin particularidades. Se realizó el diagnóstico de encefalopatía de Hashimoto y el cuadro remitió luego del tratamiento con corticoides. El artículo resalta la importancia de realizar una evaluación integral de los pacientes con sintomatología psiquiátrica atípica y ahondar en el diagnóstico de exclusión.


Assuntos
Encefalopatias , Encefalite , Doença de Hashimoto , Feminino , Humanos , Adulto , Doença de Hashimoto/complicações , Doença de Hashimoto/diagnóstico , Encefalopatias/diagnóstico , Encefalopatias/etiologia , Encefalite/diagnóstico , Tireotropina , Esteroides
6.
J R Coll Physicians Edinb ; 52(1): 42-45, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-36146977

RESUMO

Hyperammonaemia is a life-threatening condition with numerous aetiologies and a variable presentation. It is increasingly associated with bariatric weight-loss procedures and significant mortality despite treatment. Symptoms often occur long after surgery and at times in association with other trigger illnesses. Patients can present to general medicine, general practice and intensive care as well as surgical and anaesthetic teams. We present the case of a male patient who underwent a sleeve gastrectomy with subsequent weight loss and suffered from hyperammonaemic encephalopathy on multiple occasions. His delayed postoperative complication was likely to be multifactorial in nature, and this is outlined in the case. We discuss presentation, investigation, management and patient outcomes.


Assuntos
Cirurgia Bariátrica , Encefalopatias , Síndromes Neurotóxicas , Obesidade Mórbida , Cirurgia Bariátrica/efeitos adversos , Cirurgia Bariátrica/métodos , Encefalopatias/etiologia , Encefalopatias/cirurgia , Gastrectomia/efeitos adversos , Gastrectomia/métodos , Humanos , Masculino , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Resultado do Tratamento , Redução de Peso
7.
Sci Adv ; 8(37): eadc9317, 2022 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-36112688

RESUMO

Lipids are crucial components of cellular function owing to their role in membrane formation, intercellular signaling, energy storage, and homeostasis maintenance. In the brain, lipid dysregulations have been associated with the etiology and progression of neurodegeneration and other neurological pathologies. Hence, brain lipids are emerging as important potential targets for the early diagnosis and prognosis of neurological diseases. This review aims to highlight the significance and usefulness of lipidomics in diagnosing and treating brain diseases. We explored lipid alterations associated with brain diseases, paying attention to organ-specific characteristics and the functions of brain lipids. As the recent advances in brain lipidomics would have been impossible without advances in analytical techniques, we provide up-to-date information on mass spectrometric approaches and integrative analysis with other omic approaches. Last, we present the potential applications of lipidomics combined with artificial intelligence techniques and interdisciplinary collaborative research for treating brain diseases with clinical heterogeneities.


Assuntos
Encefalopatias , Lipidômica , Inteligência Artificial , Encéfalo , Encefalopatias/diagnóstico , Encefalopatias/etiologia , Humanos , Metabolismo dos Lipídeos , Lipídeos/química
8.
Turk J Med Sci ; 52(2): 405-412, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36161629

RESUMO

BACKGROUND: Mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a rare clinicoradiological syndrome that typically presents with central nervous system symptoms such as loss of consciousness, seizure, headache, and ophthalmoparesis. METHODS: Here, we highlight the characteristics of this syndrome together with the clinical and MRI findings of 6 pediatric patients with MERS. RESULTS: Between January 2017 and October 2020, 6 patients with MERS (3 boys and 3 girls) presented to our center. The mean age was 122 ± 54.6 (min-max: 44-180) months. None of the patients had a chronic disease. In our study, infectious agents were detected in 4 patients (66.6%), while noninfectious causes (one seizure and the other hyponatremia) were detected in two patients. All of our cases were discharged without any sequelae after an average of 12.1 ± 7 (min-max: 4-20) days of hospitalization. In 1 patient (case 6), control MRI could not be performed, and the radiological recovery of our other patients was shown to be between 14 days and 2 months. DISCUSSION: MERS is an acute encephalopathy with good prognosis and should be considered by neurologists in differential diagnosis due to its variable clinical presentation and specific MRI findings.


Assuntos
Encefalopatias , Encefalite , Encefalopatias/complicações , Encefalopatias/etiologia , Criança , Corpo Caloso/diagnóstico por imagem , Corpo Caloso/patologia , Encefalite/diagnóstico , Encefalite/etiologia , Encefalite/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Convulsões , Síndrome
9.
Am J Emerg Med ; 61: 18-28, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36029667

RESUMO

INTRODUCTION: Carbon monoxide (CO) poisoning can cause serious neurological sequelae. However, there is neither effective treatment strategy nor reliable indicators to determine the prognosis of patients with CO poisoning. The present study aimed to observe the changes of neurological function score, disease severity score, cerebral oxygen utilization (O2UCc), bispectral (BIS) index and neuron-specific enolase (NSE) concentration, and to elucidate the clinical significance of these potential indicators and the neuroprotective effect of mild hypothermia on brain injury in patients with severe acute CO poisoning. MATERIALS AND METHODS: A total of 277 patients with acute severe CO poisoning from 2013 to 2018 were enrolled in our hospital. Patients were divided into three groups according to their body temperature on the day of admission and their willingness to treat: a fever group (n = 78), a normal temperature group (NT group, n = 113), and a mild hypothermia group (MH group, n = 86). All patients were given hyperbaric oxygen therapy, while those in the MH group received additional mild hypothermia treatment. The severity of the disease, the neurobehavioral status, the incidence of delayed encephalopathy after acute carbon monoxide poisoning (DEACMP), and other indicators including BIS, O2UCc, NSE were further evaluated in all patients at given time-points. RESULTS: Mild hypothermia therapy improved the prognosis of patients with CO poisoning, significantly decreased the value of O2UCc and NSE, and up-regulated BIS. The incidence of DEACMP at 6 months was 27% in the fever group, 23% in the NT group, and 8% in the MH group. The values of Glasgow-Pittsburgh coma scale (G-P score), BIS index and NSE were closely related to the occurrence of DEACMP, the cutoff values were 12.41, 52.17 and 35.20 ng/mL, and the sensitivity and specificity were 79.3%, 77.6%, 79.3% and 67.6%, 89.5%, 88.6% in the receiver operating characteristic curve (ROC), respectively. CONCLUSIONS: Early mild hypothermia treatment could significantly reduce the severity of brain injury after CO poisoning, and might be further popularized in clinic. G-P scores, NSE and BIS index can be regarded as the prediction indicators in the occurrence and development of DEACMP. CLINICAL TRIAL REGISTRATION: The study protocol was granted from Qingdao University Research Ethics Committee (Clinical trial registry and ethical approval number: QD81571283).


Assuntos
Encefalopatias , Lesões Encefálicas , Intoxicação por Monóxido de Carbono , Hipotermia , Fármacos Neuroprotetores , Humanos , Intoxicação por Monóxido de Carbono/complicações , Intoxicação por Monóxido de Carbono/terapia , Neuroproteção , Monóxido de Carbono , Hipotermia/complicações , Fosfopiruvato Hidratase , Oxigênio , Encefalopatias/etiologia , Encefalopatias/terapia
11.
Int J Infect Dis ; 123: 76-79, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35998873

RESUMO

COVID-19 is a global health crisis that has impacted the world with heavy economic and social losses. In the early days of the pandemic, pediatric COVID-19 was well-known for its low infectivity and mortality rates as well as its benign clinical outcomes. Herein, we report the case of a 6-year-old girl with COVID-19-associated encephalopathy without respiratory symptoms. To the best of our knowledge, this is the first child reported from Saudi Arabia with COVID-19-induced encephalopathy. A 6-year-old patient with COVID-19 was presented to the Abha Maternity and Child Hospital in southeastern Saudi Arabia. Routine clinical and laboratory examinations revealed normal findings. Despite the absence of COVID-19 respiratory manifestations, the patient manifested COVID-19-related encephalopathy. The patient responded well to pulse steroid, favipiravir, and symptomatic seizure therapies. The patient recovered completely without any neurologic morbidities. A COVID-19-related encephalopathy was observed for the first time in Saudi Arabia among pediatric patients. Clinicians should be alert to potential neurologic complications associated with COVID-19. It should be considered in the differential diagnosis of children presenting with acute encephalopathy, even in the absence of respiratory symptoms. To avoid long-term neurologic sequelae, prompt seizure and immunosuppressive therapies are essential.


Assuntos
Encefalopatias , COVID-19 , Encefalopatias/diagnóstico , Encefalopatias/tratamento farmacológico , Encefalopatias/etiologia , COVID-19/complicações , Criança , Feminino , Humanos , Pandemias , Gravidez , Arábia Saudita , Convulsões/etiologia
12.
Brain Dev ; 44(10): 737-742, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36030148

RESUMO

BACKGROUND: Encephalitis due to vaccination for mumps is a rare complication that occurs in 0.00004% of recipients, and there has been no report of serious neurological sequelae. Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) has been reported as the most frequent type among acute encephalopathy syndromes in the pediatric population in Japan. There has been no report of AESD caused by vaccinations. Case presentation We present the clinical course of a 1-year and 10-month-old boy who had no preexisting condition, and developed mumps vaccine-induced severe primary encephalitis. Refractory status epilepticus due to encephalitis persisted for 16 h and resulted in secondary encephalopathy as a form of AESD mimic. He had serious neurological sequelae, such as West syndrome, transient spastic tetraplegia, and intellectual disability, despite intensive treatments. DISCUSSION: The presented boy is the first patient to develop mumps vaccine-induced primary encephalitis with severe central nervous system (CNS) damage. Screening of the immunological background in the presented patient revealed no abnormalities; therefore, it is unclear why he developed such severe adverse events. In patients with acute encephalitis caused by the herpes simplex virus 1, inborn immune errors in CNS based on mutations in single genes are involved in its pathophysiology. Consequently, some immunogenetic alterations could be found by further analysis in the presented patient.


Assuntos
Encefalopatias , Encefalite Viral , Encefalite , Encefalomielite Aguda Disseminada , Caxumba , Estado Epiléptico , Masculino , Humanos , Criança , Lactente , Vacina contra Caxumba , Caxumba/complicações , Encefalopatias/etiologia , Encefalopatias/complicações , Convulsões/etiologia , Estado Epiléptico/etiologia , Estado Epiléptico/complicações , Encefalite/etiologia , Encefalite/complicações , Encefalomielite Aguda Disseminada/complicações , Febre/complicações
13.
Brain Nerve ; 74(7): 845-851, 2022 Jul.
Artigo em Japonês | MEDLINE | ID: mdl-35860930

RESUMO

Coronavirus disease (COVID-19) causes neurological symptoms in a high percentage of patients and is associated with various types of encephalitides and encephalopathies, which are etiologically classified into (a)direct infection of the central nervous system with severe acute respiratory syndrome coronavirus 2 and resultant meningoencephalitis (this is a rare presentation), (b)COVID-19-induced cytokine storms, which trigger endothelial cell injury, blood-brain barrier disruption, and microangiopathy and consequent encephalopathy and, (c)autoimmune encephalitis secondary to para- or post-infectious mechanisms that play a key role during the acute or post-COVID-19 phase. Notably, some patients present with neurological symptoms as the first manifestation. Radiologically characteristic encephalitides and encephalopathies, such as acute necrotizing encephalopathy, acute disseminated encephalomyelitis, posterior reversible encephalopathy syndrome, and clinically mild encephalitis/encephalopathy with a reversible splenial lesion are also complicated by COVID-19. Further investigations and appropriate treatments are warranted in patients with COVID-19, who develop new neurological symptoms.


Assuntos
Encefalopatias , COVID-19 , Encefalite , Meningoencefalite , Síndrome da Leucoencefalopatia Posterior , Encefalopatias/etiologia , COVID-19/complicações , Encefalite/diagnóstico , Encefalite/etiologia , Humanos , Meningoencefalite/complicações
14.
Khirurgiia (Mosk) ; (7): 58-63, 2022.
Artigo em Russo | MEDLINE | ID: mdl-35775845

RESUMO

OBJECTIVE: To study the literature data on pancreatogenic encephalopathy in patients with destructive pancreatitis. MATERIAL AND METHODS: Searching for Russian- and English-language literature data was carried out in electronic databases: elibrary, PubMed, the Cochrane Library. We planned a systematic review if studies with evidence level 1 and 2 were available. If these trials were absent, descriptive review was considered. RESULTS: No studies with evidence level 1 and 2 were found in available literature. Therefore, a descriptive review was carried out. Analysis of primary sources showed that the incidence of pancreatogenic encephalopathy is 9-35% and has no direct correlation with etiology of destructive pancreatitis. Major factors of pathogenesis are high serum enzymes, activation of proinflammatory cytokines and hypoxemia, which are accompanied by damage to myelin sheath of the white matter and cytotoxic brain edema. Clinical manifestation of pancreatogenic encephalopathy occurs within two weeks. Acute onset and various symptoms are typical. Possible laboratory predictors of encephalopathy are persistent hyperglycemia, increased hematocrit, fibrinogen-like protein 2 (FPB-2), proinflammatory cytokines TNF-αand interleukin-1-beta. Pancreatogenic encephalopathy is a factor of unfavorable prognosis of treatment. Mortality in patients with pancreatogenic encephalopathy is 57-70%. Favorable course of pancreatic necrosis is followed by regression of cerebral disorders in most cases while residual cognitive disorders are possible in elderly patients. CONCLUSION: Pancreatogenic encephalopathy accompanies severe destructive pancreatitis. It is an unfavorable factor for treatment outcomes requiring further research.


Assuntos
Encefalopatias , Pancreatite Necrosante Aguda , Idoso , Encefalopatias/diagnóstico , Encefalopatias/etiologia , Citocinas , Humanos , Pancreatite Necrosante Aguda/complicações , Pancreatite Necrosante Aguda/diagnóstico , Prognóstico
15.
BMJ Case Rep ; 15(7)2022 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-35817489

RESUMO

Acute encephalitis is a syndromic diagnosis. In the last two decades, a unique clinico-radiological entity, named acute encephalopathy with biphasic seizures and late restricted diffusion (AESD), has been reported in children from Asia. It is characterised by an acute febrile illness with seizures and encephalopathy, with some initial improvement followed by a second flurry of seizures and deep encephalopathy, 3-4 days later. MRI may show a pattern of 'bright tree appearance'. An aetiological agent may not always be identified but an infectious trigger is proposed. Immunomodulatory therapy has been tried with variable results. The prognosis is variable, and children are usually left with neurological sequelae including epilepsy and cognitive impairment. We describe a female infant who presented with the typical clinico-radiological syndrome of AESD and human bocavirus was identified in the stool. She received steroids and antiepileptic drugs. She has persistent cognitive impairment at follow-up but remained seizure free.


Assuntos
Encefalopatias , Epilepsia , Bocavirus Humano , Encefalopatias/diagnóstico por imagem , Encefalopatias/etiologia , Criança , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética , Convulsões/diagnóstico , Convulsões/tratamento farmacológico , Convulsões/etiologia
16.
Brain Dev ; 44(10): 743-747, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35835638

RESUMO

INTRODUCTION: The coronavirus disease 2019 (COVID-19), including the Omicron variant, is less severe in children than in adults. To date, there has been no detailed description of COVID-19-associated severe encephalopathy due to the Omicron variant during the neonatal and early infantile periods. CASE PRESENTATION: During the outbreak of the Omicron variant, a 29-day-old male presented with a pale and ill appearance. The patient was intubated for mechanical ventilation owing to recurrent apnea, which subsequently turned out to be a breath-holding that may have been caused by seizure. In addition, nonconvulsive status epilepticus was observed. Total duration of repetitive seizure activities was approximately 30 min per hour when seizures were most severe. Brain magnetic resonance imaging (MRI) on day 14 revealed extensive hyperintensity in the T2 sequence, hypointensity in the fluid-attenuated inversion recovery (FLAIR) sequence in the deep and subcortical white matter, and diffusion restriction in the corpus callosum. The Omicron BA.1 variant of the severe acute respiratory syndrome coronavirus 2 was detected in his respiratory sample. Follow-up MRI on day 45 revealed multiple cystic cavitations. CONCLUSION: Although COVID-19 is not severe in most children, life-threatening conditions such as COVID-19-associated severe encephalopathy can occur during the neonatal and early infantile periods.


Assuntos
Encefalopatias , COVID-19 , Recém-Nascido , Adulto , Criança , Humanos , Masculino , COVID-19/complicações , SARS-CoV-2 , Encefalopatias/etiologia , Encefalopatias/complicações , Convulsões/etiologia
17.
Life Sci ; 304: 120689, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-35679915

RESUMO

AIMS: Brain disease, in its many forms, has recently demonstrated a great socio-economic impact and represents one of the hardest challenges of present research. Although each pathology of this highly heterogenous group is characterized by individual features, there is an increasing number of common toxicological mechanisms that have been evidenced. This review aims to summarize the state-of-art knowledge concerning the role of environmental bacteria in brain diseases focusing on different mechanisms of action that could be interacting in an additive or synergistic way. MATERIALS AND METHODS: For this wide-range subject, we focused on two emerging types of bacterial-derived brain exposure and damage and specifically treated representative examples: i) environmental bacterial-derived compounds in the form of the cyanobacterial product BMAA (ß-N-methylamino-L-alanine) toxin and its isomers DAB (2,4-diaminobutyric acid) and AEG (N-(2-aminoethyl)glycine) and ii) toxicity related to bacterial infections in the form of the emerging Lyme neuroborreliosis (LNB), determined by Borrelia burgdorferi (Bb). KEY FINDINGS: Defined as pleiotropic contaminants, BMAA and Bb act through multiple toxicological pathways including inflammation, oxidative stress and excitotoxicity. Multiple investigations in in vitro and in vivo models have underlined the involved mechanisms of action but further investigations are needed to clarify the role of possible cocktail effects and underline possible new targets of intervention. SIGNIFICANCE: Environmental bacteria represent emerging risk factors because of environmental changes, anthropogenic activities and human lifestyle evolutions. Future directions and research ambitions are here discussed in order to evaluate human risk and possible ways of intervention and prevention.


Assuntos
Diamino Aminoácidos , Encefalopatias , Cianobactérias , Diamino Aminoácidos/toxicidade , Encefalopatias/etiologia , Glicina , Humanos , Isomerismo , Neurotoxinas/toxicidade
19.
Sci Rep ; 12(1): 7945, 2022 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-35562399

RESUMO

This study investigated the 3-year clinical outcomes in relation to the severity of encephalopathy in high-survival infants who underwent therapeutic hypothermia. This retrospective observational study was conducted in level II/III neonatal intensive care units in Japan. The nationwide cohort included 474 infants registered in the Baby Cooling Registry of Japan between January 2012 and December 2016. Clinical characteristics, mortality rate and severe neurological impairment at age 3 years were evaluated. Of the infants, 48 (10.4%), 291 (63.1%) and 122 (26.5%) had mild, moderate and severe encephalopathy, respectively, upon admission. By age 3, 53 (11.2%) infants died, whereas 110 (26.1%) developed major disabilities. The mild group survived up to age 3. In the moderate group, 13 (4.5%) died and 44 (15.8%) developed major disabilities. In the severe group, 39 (32.0%) died by age 3. Adverse outcomes were observed in 100 (82.0%) infants. Mortality was relatively low in all subgroups, but the incidence of major disabilities was relatively high in the severe group. The relatively low mortality and high morbidity may be due to Japanese social and ethical norms, which rarely encourage the withdrawal of intensive life support. Cultural and ethical backgrounds may need to be considered when assessing the effect of therapeutic interventions.


Assuntos
Encefalopatias , Hipotermia Induzida , Hipóxia-Isquemia Encefálica , Doenças do Recém-Nascido , Encefalopatias/etiologia , Pré-Escolar , Estudos de Coortes , Humanos , Hipotermia Induzida/efeitos adversos , Hipóxia-Isquemia Encefálica/terapia , Lactente , Recém-Nascido , Doenças do Recém-Nascido/etiologia , Unidades de Terapia Intensiva Neonatal , Resultado do Tratamento
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