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Erickson Malmberg posted an update 1 week, 2 days ago
Hyponatremia, defined as serum sodium concentration less then 135 mEq/l, is the most common electrolyte balance disorder in clinical practice. Many causes are listed, but syndrome of inappropriate antidiuretic hormone secretion (SIADH) is certainly the most relevant, mainly in oncological and hospitalized patients. In this review, the pathophysiological and clinical aspects are described in detail. Patients’ extensive medical history and structured physical and biochemical tests are considered the milestones marking the way of the SIADH management as to provide early detection and proper correction. We focused our attention on the poor prognostic role and negative effect on patient’s quality of life of SIADH-induced hyponatremia in both malignant and non-malignant settings, stressing how optimal management of this electrolyte imbalance can result in improved outcomes and lower health costs.The emergence of the novel coronavirus disease 2019 (COVID-19) pandemic has become a major public health challenge of global concern since December 2019, when the virus was recognized in Wuhan, the capital city of Hubei province in China and epicenter of the COVID-19 epidemic. Given the novelty of COVID-19 and the lack of specific anti-virus therapies, the current management is essentially supportive. There is an absence of consensus on guidelines or treatment strategies for complex disorders such as multiple sclerosis (MS), in which the risk of infections is higher than in the general population. This is due to the overall impairment of the immune system typical of autoimmune diseases, in addition to accumulation of disabilities, and the iatrogenic effect generated by corticosteroids and the recommended disease-modifying therapies (DMTs). DMTs have different modes of action, but all modulate and interfere with the patient’s immune response, thereby raising concerns about adverse effects, such as an increased susceptibility to infections. In this review, we analyze the evidence for use of DMTs during the current critical period and ratify an algorithmic approach for management to optimize care between keeping DMTs, with their infection hazards, or coming off them, with the risk of disease activation. We also provide an algorithmic approach to the management of breakthrough activity during the COVID-19 pandemic.
Eating disorders are among the most severe psychiatric disorders. Medical students are subjected to high levels of stress and have a high risk of developing burnout and mental health problems, including eating disorders. Due to societal stigma and lack of awareness, it is plausible that disordered eating behaviors among students may go unrecognized and under-reported. The current study aimed to evaluate the prevalence and possible factors associated with eating disorders among medical students at the American University of Beirut in Lebanon (AUB).
This cross-sectional descriptive study was conducted in 2017 at AUB. Electronic anonymous surveys were sent to all 412 medical students, with a mean age of 23, enrolled in our four-year medical school. In addition to demographic data, students were asked to complete two validated questionnaires, the SCOFF and EAT-26, to assess eating disorders risk.
Total responses were 156, out of which 124 completed the whole survey. A total of 131 participants completed the Eat-26 questionnaire and 124 participants completed the SCOFF questionnaire. Out of those, 17% on EAT-26 and 19% on SCOFF were found to be at high risk of developing eating disorders.
There seems to be a high level of underrecognized and under-treated disordered eating behaviors among female medical students at AUB. Raising awareness among medical students is important, as well as developing better prevention and treatment strategies.
There seems to be a high level of underrecognized and under-treated disordered eating behaviors among female medical students at AUB. Raising awareness among medical students is important, as well as developing better prevention and treatment strategies.
Evidence has shown that microRNAs (miRNAs) are implicated in ischemic diseases. Therefore, the aim of the present study was to identify the functions of astrocyte (ATC)-derived exosomal
on cerebral ischemic-reperfusion (I/R) injury.
A rat model of cerebral I/R injury was initially established, followed by injection of ATC-derived exosomes. BSJ-03-123 Next, the protective function of ATC-derived exosomes in rats with cerebral I/R injury was evaluated, and then the effect of
on rats with cerebral I/R injury was evaluated by changing
expression in exosomes. PC12 cells that underwent oxygen-glucose deprivation/reoxygenation were used to simulate I/R in vitro. The effect of ATC-derived exosomal
on the viability and apoptosis of OGD/R-treated PC12 cells was also assessed. The bioinformatic analysis predicted the targeted gene of
.
It was found that I/R was damaging to the brain nerves of rats, while ATC-derived exosomal
relieved nerve damage caused by I/R. Furthermore, the in vitro experiments demonstrated that ATC-derived exosomal
increased OGD/R-inhibited PC12 cell activity and suppressed cell apoptosis. Bioinformatics predicted that
targeted cathepsin B (
).
upregulation blocked the protective roles of
. In addition,
was found to downregulate the
signaling pathway by targeting
.
The present study demonstrated that ATC-derived exosomal
alleviates nerve damage in rats with cerebral I/R injury by targeting
and downregulating the
pathway. This may offer novel insights into treatment for I/R injury.
The present study demonstrated that ATC-derived exosomal miR-361 alleviates nerve damage in rats with cerebral I/R injury by targeting CTSB and downregulating the AMPK/mTOR pathway. This may offer novel insights into treatment for I/R injury.
Increasing morbidity and misdiagnosis of vestibular migraine (VM) gravely affect the treatment of the disease as well as the patients’ quality of life. A powerful diagnostic prediction model is of great importance for management of the disease in the clinical setting.
Patients with a main complaint of dizziness were invited to join this prospective study. The diagnosis of VM was made according to the International Classification of Headache Disorders. Study variables were collected from a rigorous questionnaire survey, clinical evaluation, and laboratory tests for the development of a novel predictive diagnosis model for VM.
A total of 235 patients were included in this study 73 were diagnosed with VM and 162 were diagnosed with non-VM vertigo. Compared with non-VM vertigo patients, serum magnesium levels in VM patients were lower. Following the logistic regression analysis of risk factors, a predictive model was developed based on 6 variables age, sex, autonomic symptoms, hypertension, cognitive impairment, and serum Mg
concentration.