Database : MEDLINE
Search on : hypokinesia [Words]
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[PMID]: 29523179
[Au] Autor:Ralapanawa DMPUK; Kumarihamy KWMPP; Sundararajah M; Jayalath WATA
[Ad] Address:Department of Medicine, University of Peradeniiya, Peradeniya, Sri Lanka. udayapralapanawa@yahoo.com.
[Ti] Title:A young female presenting with heart failure secondary to eosinophilic myocarditis: a case report and review of the literature.
[So] Source:BMC Res Notes;11(1):168, 2018 Mar 09.
[Is] ISSN:1756-0500
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Eosinophilic myocarditis is one of the fatal complications of idiopathic hypereosinophilic syndromes. Given the rarity of this form of myocarditis, it is often under-recognized. We describe a young girl who presented with features of heart failure. To our knowledge, this is the first reported case of eosinophilic myocarditis in a young Sri Lankan female. CASE PRESENTATION: A previously healthy 21 year old Sri Lankan female admitted with shortness of breath for 1 week duration with associated low grade fever and profuse sweating. She was mildly febrile and dyspnoeic with absent ankle oedema. She was tachycardic and had elevated Jugular venous pressure with negative Kussmaul sign. Blood pressure was 100/70 mmHg. Clinically there was no cardiomegaly and heart sounds were slightly muffled with gallop rhythm. Bilateral basal fine end inspiratory crackles and mild hepatosplenomegaly were noted. The laboratory examinations showed leucocytosis with severe eosinophilia with no abnormal cells. Her ESR, Troponin I and Brain natriuretic peptide were elevated with normal CRP and electrocardiogram showed sinus tachycardia with wide spread ST depression. Heart failure was evident on chest X-ray and 2D-echocardiogram showed global left ventricular hypokinesia with 40% ejection fraction and a thin layer of pericardial effusion. Mild hepatosplenomegaly without lymphadenopathy was detected in the ultrasound scan. Bone marrow biopsy showed hypereosinophilia with no evidence of bone marrow infiltration. FIP1L1-PDGFRA fusion transcript and BCR-ABL transcript were not detected. Secondary causes for hypereosinophilia were excluded and the diagnosis of idiopathic hypereosinophilic syndrome and eosinophilic myocarditis was made. She had good response to steroids clinically and biochemically with complete recovery of left ventricular function. She is now on steroid to be continued at least 6 months to 1 year. CONCLUSION: Eosinophilic myocarditis is a rare but fatal disease if left untreated. Hence clinicians should have high index of suspicion to diagnose eosinophilic myocarditis in clinical context of heart failure due to myocarditis. The diagnoses of eosinophilic myocarditis may often be challenged especially in a poor recourse setting. However available investigation should be used to diagnose this condition without delay. Early treatment with systemic steroids may prevent fatal outcome and therapies for this disease have yet to be validated in large prospective studies.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:In-Process
[do] DOI:10.1186/s13104-018-3273-1

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[PMID]: 29377921
[Au] Autor:Caixeta DC; Teixeira RR; Peixoto LG; Machado HL; Baptista NB; de Souza AV; Vilela DD; Franci CR; Salmen Espindola F
[Ad] Address:Institute of Biotechnology, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
[Ti] Title:Adaptogenic potential of royal jelly in liver of rats exposed to chronic stress.
[So] Source:PLoS One;13(1):e0191889, 2018.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Restraint and cold stress increase both corticosterone and glycemia, which lead to oxidative damages in hepatic tissue. This study assessed the effect of royal jelly (RJ) supplementation on the corticosterone level, glycemia, plasma enzymes and hepatic antioxidant system in restraint and cold stressed rats. Wistar rats were allocated into no-stress, stress, no-stress supplemented with RJ and stress supplemented with RJ groups. Initially, RJ (200mg/Kg) was administered for fourteen days and stressed groups were submitted to chronic stress from the seventh day. The results showed that RJ supplementation decreases corticosterone levels and improves glycemia control after stress induction. RJ supplementation also decreased the body weight, AST, ALP and GGT. Moreover, RJ improved total antioxidant capacity, SOD activity and reduced GSH, GR and lipoperoxidation in the liver. Thus, RJ supplementation reestablished the corticosterone levels and the hepatic antioxidant system in stressed rats, indicating an adaptogenic and hepatoprotective potential of RJ.
[Mh] MeSH terms primary: Fatty Acids
Liver/physiopathology
Stress, Physiological
[Mh] MeSH terms secundary: Animals
Blood Glucose/metabolism
Body Weight
Chronic Disease
Cold Temperature
Corticosterone/blood
Immobilization
Liver/enzymology
Liver/metabolism
Male
Rats
Rats, Wistar
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Name of substance:0 (Blood Glucose); 0 (Fatty Acids); L497I37F0C (royal jelly); W980KJ009P (Corticosterone)
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:IM
[Da] Date of entry for processing:180130
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191889

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[PMID]: 29503154
[Au] Autor:Galazky I; Kaufmann J; Lorenzl S; Ebersbach G; Gandor F; Zaehle T; Specht S; Stallforth S; Sobieray U; Wirkus E; Casjens F; Heinze HJ; Kupsch A; Voges J
[Ad] Address:Department of Neurology, Otto-von-Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany. Electronic address: imke.galazky@med.ovgu.de.
[Ti] Title:Deep brain stimulation of the pedunculopontine nucleus for treatment of gait and balance disorder in progressive supranuclear palsy: Effects of frequency modulations and clinical outcome.
[So] Source:Parkinsonism Relat Disord;, 2018 Feb 19.
[Is] ISSN:1873-5126
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: The pedunculopontine nucleus has been suggested as a potential deep brain stimulation target for axial symptoms such as gait and balance impairment in idiopathic Parkinson's disease as well as atypical Parkinsonian disorders. METHODS: Seven consecutive patients with progressive supranuclear palsy received bilateral pedunculopontine nucleus deep brain stimulation. Inclusion criteria comprised of the clinical diagnosis of progressive supranuclear palsy, a levodopa-resistant gait and balance disorder, age <75 years, and absence of dementia or major psychiatric co-morbidities. Effects of stimulation frequencies at 8, 20, 60 and 130 Hz on motor scores and gait were assessed. Motor scores were followed up for two years postoperatively. Activities of daily living, frequency of falls, health-related quality of life, cognition and mood at 12 months were compared to baseline parameters. Surgical and stimulation related adverse events were assessed. RESULTS: Bilateral pedunculopontine nucleus deep brain stimulation at 8 Hz significantly improved axial motor symptoms and cyclic gait parameters, while high frequency stimulation did not ameliorate gait and balance but improved hypokinesia. This improvement however did not translate into clinically relevant benefits. Frequency of falls was not reduced. Activities of daily living, quality of life and frontal cognitive functions declined, while mood remained unchanged. CONCLUSION: Bilateral pedunculopontine nucleus deep brain stimulation in progressive supranuclear palsy generates frequency-dependent effects with improvement of cyclic gait parameters at low frequency and amelioration of hypokinesia at high frequency stimulation. However, these effects do not translate into a clinically important improvement.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:Publisher

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[PMID]: 29331650
[Au] Autor:Cha KC; Kim HI; Kim OH; Cha YS; Kim H; Lee KH; Hwang SO
[Ad] Address:Department of Emergency Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea.
[Ti] Title:Echocardiographic patterns of postresuscitation myocardial dysfunction.
[So] Source:Resuscitation;124:90-95, 2018 Mar.
[Is] ISSN:1873-1570
[Cp] Country of publication:Ireland
[La] Language:eng
[Ab] Abstract:BACKGROUND: Postresuscitation myocardial dysfunction (PRMD) can develop after successful resuscitation from cardiac arrest. However, echocardiographic patterns of PRMD remain unknown. This study aimed to investigate PRMD manifestations with serial echocardiography during the post-cardiac arrest period. METHODS: We enrolled non-traumatic out-of-hospital cardiac arrest patients older than 19 years who underwent successful cardiopulmonary resuscitation (CPR). We excluded patients with myocardial infarction or pre-existing cardiac disease, including heart failure or myocardial disease. Transthoracic echocardiography (TTE) was performed within 24 h, between 24 and 48 h, and between 72 and 96 h after restoration of spontaneous circulation (ROSC). RESULTS: Of 280 patients, 138 (93 men) were analysed. PRMD was observed in 45 patients (33%), including global dysfunction in 28 patients (20%), regional wall motion abnormalities (RWMA) in 10 (7%), and Takotsubo pattern in 7 (5%). There were no differences in clinical characteristics, laboratory findings, or hospital mortality according to PRMD pattern. Global left ventricular (LV) systolic function gradually improved with time and had recovered to normal by Day 3 in all patients except one with the Takotsubo pattern, which remained on follow-up echocardiography two weeks after ROSC. CONCLUSIONS: PRMD occurs in about one-third of patients resuscitated from cardiac arrest. Echocardiographic patterns of post-cardiac arrest LV dysfunction include global hypokinesia, regional wall motion abnormalities, and Takotsubo pattern.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Data-Review

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[PMID]: 28454185
[Au] Autor:Höhne S; Gerlach K; Irlenbusch L; Schulz M; Kunze C; Finke R
[Ad] Address:Department of Surgical and Conservative Pediatrics and Adolescent Medicine/Pediatric Surgery, Martin-Luther-University Halle-Wittenberg, Halle.
[Ti] Title:Patellaluxation bei Kindern und Jugendlichen ­ 136 Ereignisse bei 88 Patienten und Literaturübersicht. Patella Dislocation in Children and Adolescents.
[So] Source:Z Orthop Unfall;155(2):169-176, 2017 Apr.
[Is] ISSN:1864-6743
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Patellar dislocation is one of the commonest knee injuries in adolescents. Although treatment usually leads to good results, the influence of anatomical and functional factors on therapeutic strategy has been underestimated, especially in cases of recurrence. The course of treatment has been analysed in 88 patients with 136 patellar dislocations. The importance of anatomical conditions was studied using X-ray and MRI findings. The treatment results were critically evaluated in comparison with current recommendations. From 2000 to 2015, 109 patellar dislocations occurred in 88 patients; a further 27 previous dislocations were reported by the patients (mean age 14 years, 47 boys and 41 girls). About one-third of patients (35.2 %) suffered one or more recurrences. Almost half (48.6 %) of the dislocations occurred during physical exercise, particularly ball sports. Osteochondral flake fracture was found in 9 % of the patients, and a lesion of the medial patellofemoral ligament in 96 %. There was an anatomical predisposition to patellar dislocation in almost all cases. The sulcus angle, patellar and trochlear dysplasia, and patellar height were highly significantly different between the patient group and controls. The TT-TG distance was subsequently calculated, but had no impact on therapy. Seventy-seven patients were treated conservatively and 32 patients surgically. The conservative procedure included partial immobilisation for six weeks. Surgical reconstruction or tightening was performed in 27 cases; in five, in combination with other surgical procedures. Plasty of the medial patellofemoral ligament with a tendon graft was performed in five patients, and osteochondral or meniscal lesions were repaired in 10 patients. Recurrences occurred in 41.7 % of conservatively treated knees and in 29.6 % of surgically treated knees (without reconstruction with a tendon graft). No recurrence was seen after reconstruction of the medial patellofemoral ligament with a tendon graft. Fifty-four patients underwent a follow-up examination. Fourteen of these (25.9 %) had suffered a recurrence. The outcome 16 months after the end of treatment was mostly good, as were the results of self-assessment (Larson-Lauridsen Score). An anatomical predisposition is detectable in almost all cases of patellar dislocation, but frequently occurs with an accident event, e.g. in ball sports. Primary patellar dislocations without serious concomitant injuries may be treated conservatively. In the event of recurrence, the indication for surgery is given, even in young patients and in any patient with an osteochondral flake fracture. Tightening reconstruction of the MPFL used to be frequently performed, but is associated with a high rate of recurrence.
[Mh] MeSH terms primary: Arthroplasty/utilization
Athletic Injuries/diagnosis
Athletic Injuries/therapy
Patellar Dislocation/diagnosis
Patellar Dislocation/therapy
Physical Therapy Modalities/utilization
[Mh] MeSH terms secundary: Adolescent
Athletic Injuries/epidemiology
Combined Modality Therapy/utilization
Female
Germany/epidemiology
Humans
Immobilization/utilization
Male
Patellar Dislocation/epidemiology
Postoperative Complications/epidemiology
Postoperative Complications/prevention & control
Prevalence
Recovery of Function
Recurrence
Risk Factors
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180228
[Lr] Last revision date:180228
[Js] Journal subset:IM
[Da] Date of entry for processing:170429
[St] Status:MEDLINE
[do] DOI:10.1055/s-0042-122855

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[PMID]: 28449698
[Au] Autor:Contesini M; Guberti M; Saccani R; Braglia L; Iotti C; Botti A; Abbati E; Iemmi M
[Ad] Address:Human Resource Development - Training, Azienda Unità Sanitaria Locale, Reggio Emilia, Italy.
[Ti] Title:Setup errors in patients with head-neck cancer (HNC), treated using the Intensity Modulated Radiation Therapy (IMRT) technique: how it influences the customised immobilisation systems, patient's pain and anxiety.
[So] Source:Radiat Oncol;12(1):72, 2017 Apr 27.
[Is] ISSN:1748-717X
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: In patients with head-neck cancer treated with IMRT, immobility of the upper part of the body during radiation is maintained by means of customised immobilisation devices. The main purpose of this study was to determine how the procedures for preparation of customised immobilisation systems and the patients characteristics influence the extent of setup errors. METHODS: A longitudinal, prospective study involving 29 patients treated with IMRT. Data were collected before CT simulation and during all the treatment sessions (528 setup errors analysed overall); the correlation with possible risk factors for setup errors was explored using a linear mixed model. RESULTS: Setup errors were not influenced by the patient's anxiety and pain. Temporary removal of the thermoplastic mask before carrying out the CT simulation shows statistically borderline, clinically relevant, increase of setup errors (+24.7%, 95% CI: -0.5% - 55.8%). Moreover, a unit increase of radiation therapists who model the customised thermoplastic mask is associated to a -18% (-29.2% - -4.9%) reduction of the errors. The setup error is influenced by the patient's physical features; in particular, it increases both in patients in whom the treatment position is obtained with 'Shoulder down' (+27.9%, 2.2% - 59.7%) and in patients with 'Scoliosis/kyphosis' problems (+65.4%, 2.3% - 164.2%). Using a 'Small size standard plus customized neck support device' is associated to a -52.3% (-73.7% - -11.2%) reduction. The increase in number of radiation therapists encountered during the entire treatment cycle does not show associations. Increase in the body mass index is associated with a slight reduction in setup error by (-2.8%, -5% - -0.7%). CONCLUSION: The position of the patient obtained by forcing the shoulders downwards, clinically significant scoliosis or kyphosis and the reduction of the number of radiation therapists who model the thermoplastic mask are found to be statistically significant risk factors that can cause an increase in setup errors, while the use of 'Small size' neck support device and patient BMI can diminish them.
[Mh] MeSH terms primary: Anxiety/etiology
Head and Neck Neoplasms/radiotherapy
Immobilization/instrumentation
Pain/etiology
Radiation Injuries/etiology
Radiotherapy Setup Errors/adverse effects
Radiotherapy, Intensity-Modulated/adverse effects
[Mh] MeSH terms secundary: Adolescent
Adult
Aged
Aged, 80 and over
Female
Follow-Up Studies
Humans
Longitudinal Studies
Male
Middle Aged
Prognosis
Prospective Studies
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted/methods
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[Js] Journal subset:IM
[Da] Date of entry for processing:170429
[St] Status:MEDLINE
[do] DOI:10.1186/s13014-017-0807-y

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[PMID]: 29336905
[Au] Autor:Bhidayasiri R; Trenkwalder C
[Ad] Address:Chulalongkorn Center of Excellence on Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org.
[Ti] Title:Getting a good night sleep? The importance of recognizing and treating nocturnal hypokinesia in Parkinson's disease.
[So] Source:Parkinsonism Relat Disord;, 2018 Jan 05.
[Is] ISSN:1873-5126
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:When Parkinson's disease (PD) patients are asked about the quality of their sleep, their answers are dominated by difficulties associated with impaired mobility in bed, medically referred to as nocturnal hypokinesia. Nocturnal hypokinesia is symptomatic from the mid-stage of the disease, affecting up to 70% of PD patients, and contributes to poor sleep quality, and increased carer burden. Here we explore four areas of nocturnal hypokinesia that are relevant to clinical practice, namely: manifestations and definition; clinical assessment and objective monitoring; etiologies and contributing factors; and evidence-based therapeutic approaches. In addition, we provide an operational definition of what constitutes nocturnal hypokinesia and outline different methods of assessment, ranging from clinical interviews and rating scales to objective night-time monitoring with inertial sensors. Optimal management of nocturnal hypokinesia in PD begins with recognizing its manifestation by inquiring about cardinal symptoms and contributing factors from, not only patients, but also carers, followed by formal assessment, and the application of individualized evidence-based treatment. Night-time dopaminergic treatment is the primary therapy; however, careful clinical judgment is required to balance the benefits with the potential adverse events related to nocturnal dopaminergic stimulation. Future studies are needed to explore the practicality of home-based objective assessment of nocturnal hypokinesia, new therapeutic options not limited to dopaminergic medications, and non-pharmacologic approaches, including training on compensatory strategies and bedroom adaptations.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1801
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[St] Status:Publisher

  8 / 15391 MEDLINE  
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[PMID]: 29324797
[Au] Autor:Fuentes S; Carrasco J; Hatto A; Navarro J; Armario A; Monsonet M; Ortiz J; Nadal R
[Ad] Address:Institut de Neurociències, Universitat Autònoma de Barcelona, Barcelona, Spain.
[Ti] Title:Sex-dependent impact of early-life stress and adult immobilization in the attribution of incentive salience in rats.
[So] Source:PLoS One;13(1):e0190044, 2018.
[Is] ISSN:1932-6203
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Early life stress (ELS) induces long-term effects in later functioning and interacts with further exposure to other stressors in adulthood to shape our responsiveness to reward-related cues. The attribution of incentive salience to food-related cues may be modulated by previous and current exposures to stressors in a sex-dependent manner. We hypothesized from human data that exposure to a traumatic (severe) adult stressor will decrease the attribution of incentive salience to reward-associated cues, especially in females, because these effects are modulated by previous ELS. To study these factors in Long-Evans rats, we used as an ELS model of restriction of nesting material and concurrently evaluated maternal care. In adulthood, the offspring of both sexes were exposed to acute immobilization (IMO), and several days after, a Pavlovian conditioning procedure was used to assess the incentive salience of food-related cues. Some rats developed more attraction to the cue predictive of reward (sign-tracking) and others were attracted to the location of the reward itself, the food-magazine (goal-tracking). Several dopaminergic markers were evaluated by in situ hybridization. The results showed that ELS increased maternal care and decreased body weight gain (only in females). Regarding incentive salience, in absolute control animals, females presented slightly greater sign-tracking behavior than males. Non-ELS male rats exposed to IMO showed a bias towards goal-tracking, whereas in females, IMO produced a bias towards sign-tracking. Animals of both sexes not exposed to IMO displayed an intermediate phenotype. ELS in IMO-treated females was able to reduce sign-tracking and decrease tyrosine hydroxylase expression in the ventral tegmental area and dopamine D1 receptor expression in the accumbens shell. Although the predicted greater decrease in females in sign-tracking after IMO exposure was not corroborated by the data, the results highlight the idea that sex is an important factor in the study of the long-term impact of early and adult stressors.
[Mh] MeSH terms primary: Immobilization
Motivation
Stress, Physiological
[Mh] MeSH terms secundary: Animals
Behavior, Animal
Biomarkers/metabolism
Dopamine/metabolism
Female
Male
Rats
Rats, Long-Evans
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Name of substance:0 (Biomarkers); VTD58H1Z2X (Dopamine)
[Em] Entry month:1801
[Cu] Class update date: 180210
[Lr] Last revision date:180210
[Js] Journal subset:IM
[Da] Date of entry for processing:180112
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190044

  9 / 15391 MEDLINE  
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[PMID]: 29250896
[Au] Autor:Ivica N; Richter U; Sjöbom J; Brys I; Tamtè M; Petersson P
[Ad] Address:Department of Experimental Medical Sciences, Integrative Neurophysiology and Neurotechnology, Neuronano Research Center, Lund University, BMC, S-221 84, Lund, Sweden.
[Ti] Title:Changes in neuronal activity of cortico-basal ganglia-thalamic networks induced by acute dopaminergic manipulations in rats.
[So] Source:Eur J Neurosci;47(3):236-250, 2018 Feb.
[Is] ISSN:1460-9568
[Cp] Country of publication:France
[La] Language:eng
[Ab] Abstract:The basal ganglia are thought to be particularly sensitive to changes in dopaminergic tone, and the realization that reduced dopaminergic signaling causes pronounced motor dysfunction is the rationale behind dopamine replacement therapy in Parkinson's disease. It has, however, proven difficult to identify which neurophysiological changes that ultimately lead to motor dysfunctions. To clarify this, we have here recorded neuronal activity throughout the cortico-basal ganglia-thalamic circuits in freely behaving rats during periods of immobility following acute dopaminergic manipulations, involving both vesicular dopamine depletion and antagonism of D1 and D2 type dopamine receptors. Synchronized and rhythmic activities were detected in the form of betaband oscillations in local field potentials and as cortical entrainment of action potentials in several basal ganglia structures. Analyses of the temporal development of synchronized oscillations revealed a spread from cortex to gradually also include deeper structures. In addition, firing rate changes involving neurons in all parts of the network were observed. These changes were typically relatively balanced within each structure, resulting in negligible net rate changes. Animals treated with D1 receptor antagonist showed a rapid onset of hypokinesia that preceded most of the neurophysiological changes, with the exception of these balanced rate changes. Parallel rate changes in functionally coupled ensembles of neurons in different structures may therefore be the first step in a cascade of neurophysiological changes underlying motor symptoms in the parkinsonian state. We suggest that balanced rate changes in distributed networks are possible mechanism of disease that should be further investigated in conditions involving dopaminergic dysfunction.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180205
[Lr] Last revision date:180205
[St] Status:In-Data-Review
[do] DOI:10.1111/ejn.13805

  10 / 15391 MEDLINE  
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[PMID]: 28748840
[Au] Autor:Ray HN; Doshi D; Rajan A; Singh AK; Singh SB; Das MK
[Ad] Address:Rajendra Institute of Medical Sciences (RIMS), Bariatu, India.
[Ti] Title:Cardiovascular involvement in severe malaria: A prospective study in Ranchi, Jharkhand.
[So] Source:J Vector Borne Dis;54(2):177-182, 2017 Apr-Jun.
[Is] ISSN:0972-9062
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:BACKGROUND & OBJECTIVES: Malaria is considered as the most important parasitic disease of humans, causing seri- ous illness that can be fatal, if not diagnosed and treated immediately. It is a multisystem disorder affecting nearly every system of the body. The aim of the present study was to evaluate the involvement of cardiovascular system in severe malaria using non-invasive methods. METHODS: This prospective study was conducted on patients of severe malaria who were admitted between June and November 2015 in the Department of Medicine, Rajendra Institute of Medical Sciences and Hospital, Ranchi, Jharkhand, India. A total of 27 cases (18 males and 9 females; age ranging between 15 and 70 yr) of severe malaria (P. falciparum 24; P. vivax 1; mixed 2) were diagnosed by microscopic examination of peripheral blood smear and bivalent rapid diagnostic test (RDT) kit. The assessment of cardiovascular system was done by clinical examination, chest X-ray, ECG and transthoracic echocardiography. RESULTS: In all, 7 (26%) patients were found to be suffering from circulatory failure, out of which one was P. vivax case and rest were cases of P. falciparum infection with high parasite density. One patient died due to cardiovascular collapse. ECG revealed sinus bradycardia [Heart rate (HR): 40-60] in 7% of the cases, extreme tachycardia (HR: 120-150) in 3.7% of cases and premature arterial ectopic with tachycardia in 3.7% of patients (p <0.05). The echo- cardiographic findings were global hypokinesia with decreased left ventricular ejection fraction (<55%) in 11.1%, grade 1 left ventricular diastolic dysfunction in 3.7%, mild tricuspid regurgitation (TR) with mild pulmonary artery hypertension (PAH) in 3.7% and mild pericardial effusion in 3.7% of the cases. The ECG and echocardiography changes indicated myocardial involvement in severe malaria. INTERPRETATION & CONCLUSION: The present study indicated involvement of cardiovascular system in severe malaria as evidenced from ECG and echocardiography. The study also revealed that cardiovascular instabilities are common in falciparum malaria, but can also be observed in vivax malaria.
[Mh] MeSH terms primary: Cardiovascular Diseases/epidemiology
Cardiovascular Diseases/etiology
Malaria, Falciparum/complications
Malaria, Falciparum/pathology
Malaria, Vivax/complications
Malaria, Vivax/pathology
[Mh] MeSH terms secundary: Adolescent
Adult
Aged
Animals
Cardiovascular Diseases/diagnostic imaging
Echocardiography
Electrocardiography
Female
Humans
India
Male
Middle Aged
Prospective Studies
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180129
[Lr] Last revision date:180129
[Js] Journal subset:IM
[Da] Date of entry for processing:170728
[St] Status:MEDLINE


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