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Continuum (Minneapolis, Minn.) Feb 2019Since it was first described in 1965, normal pressure hydrocephalus (NPH) has been a controversial subject. New studies have shed light on its epidemiology and... (Review)
Review
PURPOSE OF REVIEW
Since it was first described in 1965, normal pressure hydrocephalus (NPH) has been a controversial subject. New studies have shed light on its epidemiology and pathogenesis and provided objective ways to measure outcome in patients with NPH. Neuroimaging has improved and allows better recognition of both NPH and the presence of overlapping diseases RECENT FINDINGS: Several recent epidemiologic studies confirm that NPH is a rare disease, but the presence of large ventricles is a common finding with aging. NPH may be multifactorial, including congenital causes, vascular disease, and impaired CSF absorption. MRI features of NPH include enlarged ventricular size and CSF fluid collection outside the ventricles not due to atrophy. The term disproportionately enlarged subarachnoid space hydrocephalus (DESH) has been used to describe prognostic MRI features in NPH, including a "tight high convexity" and enlargement of CSF spaces in the sylvian fissure. DESH has been included in the Japanese guideline for the diagnosis and treatment of NPH. A new NPH scale has been published that provides an objective framework for evaluating patients with NPH before and after shunt placement. Programmable shunts can noninvasively manage overdrainage complications. Surgical outcome has been improving over time. Recent studies have led to improved recognition of overlapping diseases such as Alzheimer pathology, which co-occurs in about 30% of NPH cases. Fludeoxyglucose positron emission tomography (FDG-PET) is a promising imaging modality for diagnosing NPH and detecting concomitant degenerative disease.
SUMMARY
A systematic approach to patients with possible NPH allows recognition of the subset of patients who will respond to shunt surgery and identification of those with alternative diagnoses.
Topics: Atrophy; Brain; Humans; Hydrocephalus, Normal Pressure; Magnetic Resonance Imaging; Prognosis; Risk Factors
PubMed: 30707192
DOI: 10.1212/CON.0000000000000689 -
Biomedicine & Pharmacotherapy =... Jul 2021Muscle atrophy and weakness are the adverse effects of long-term or high dose usage of glucocorticoids. In the present study, we explored the effects of fucoxanthin...
Muscle atrophy and weakness are the adverse effects of long-term or high dose usage of glucocorticoids. In the present study, we explored the effects of fucoxanthin (10 μM) on dexamethasone (10 μM)-induced atrophy in C2C12 myotubes and investigated its underlying mechanisms. The diameter of myotubes was observed under a light microscope, and the expression of myosin heavy chain (MyHC), proteolysis-related, autophagy-related, apoptosis-related, and mitochondria-related proteins was analyzed by western blots or immunoprecipitation. Fucoxanthin alleviates dexamethasone-induced muscle atrophy in C2C12 myotubes, indicated by increased myotubes diameter and expression of MyHC, decreased expression of muscle atrophy F-box (Atrogin-1) and muscle ring finger 1 (MuRF1). Through activating SIRT1, fucoxanthin inhibits forkhead box O (FoxO) transcriptional activity to reduce protein degradation, induces autophagy to enhance degraded protein clearance, promotes mitochondrial function and diminishes apoptosis. In conclusion, we identified fucoxanthin ameliorates dexamethasone induced C2C12 myotubes atrophy through SIRT1 activation.
Topics: Animals; Apoptosis; Atrophy; Autophagy; Cell Line; Cell Survival; Dexamethasone; Forkhead Box Protein O3; Mice; Muscle Fibers, Skeletal; Proto-Oncogene Proteins c-akt; Sirtuin 1; Xanthophylls
PubMed: 33865017
DOI: 10.1016/j.biopha.2021.111590 -
Cell Death & Disease May 2023Astrocyte atrophy is the main histopathological hallmark of major depressive disorder (MDD) in humans and in animal models of depression. Here we show that...
Astrocyte atrophy is the main histopathological hallmark of major depressive disorder (MDD) in humans and in animal models of depression. Here we show that electroacupuncture prevents astrocyte atrophy in the prefrontal cortex and alleviates depressive-like behaviour in mice subjected to chronic unpredictable mild stress (CUMS). Treatment of mice with CUMS induced depressive-like phenotypes as confirmed by sucrose preference test, tail suspension test, and forced swimming test. These behavioural changes were paralleled with morphological atrophy of astrocytes in the prefrontal cortex, revealed by analysis of 3D reconstructions of confocal Z-stack images of mCherry expressing astrocytes. This morphological atrophy was accompanied by a decrease in the expression of cytoskeletal linker Ezrin, associated with formation of astrocytic leaflets, which form astroglial synaptic cradle. Electroacupuncture at the acupoint ST36, as well as treatment with anti-depressant fluoxetine, prevented depressive-like behaviours, astrocytic atrophy, and down-regulation of astrocytic ezrin. In conclusion, our data further strengthen the notion of a primary role of astrocytic atrophy in depression and reveal astrocytes as cellular target for electroacupuncture in treatment of depressive disorders.
Topics: Humans; Mice; Animals; Depression; Antidepressive Agents; Astrocytes; Depressive Disorder, Major; Electroacupuncture; Hippocampus; Atrophy; Disease Models, Animal
PubMed: 37248211
DOI: 10.1038/s41419-023-05839-4 -
International Journal of Molecular... Oct 2020Intensive care unit-acquired weakness (ICUAW) occurs in critically ill patients stemming from the critical illness itself, and results in sustained disability long after... (Review)
Review
Intensive care unit-acquired weakness (ICUAW) occurs in critically ill patients stemming from the critical illness itself, and results in sustained disability long after the ICU stay. Weakness can be attributed to muscle wasting, impaired contractility, neuropathy, and major pathways associated with muscle protein degradation such as the ubiquitin proteasome system and dysregulated autophagy. Furthermore, it is characterized by the preferential loss of myosin, a distinct feature of the condition. While many risk factors for ICUAW have been identified, effective interventions to offset these changes remain elusive. In addition, our understanding of the mechanisms underlying the long-term, sustained weakness observed in a subset of patients after discharge is minimal. Herein, we discuss the various proposed pathways involved in the pathophysiology of ICUAW, with a focus on the mechanisms underpinning skeletal muscle wasting and impaired contractility, and the animal models used to study them. Furthermore, we will explore the contributions of inflammation, steroid use, and paralysis to the development of ICUAW and how it pertains to those with the corona virus disease of 2019 (COVID-19). We then elaborate on interventions tested as a means to offset these decrements in muscle function that occur as a result of critical illness, and we propose new strategies to explore the molecular mechanisms of ICUAW, including serum-related biomarkers and 3D human skeletal muscle culture models.
Topics: Animals; COVID-19; Coronavirus Infections; Critical Care; Humans; Iatrogenic Disease; Muscle Weakness; Muscular Atrophy; Pandemics; Pneumonia, Viral
PubMed: 33105809
DOI: 10.3390/ijms21217840 -
Journal of Cosmetic Dermatology Jan 2020A common complication of acne vulgaris is clinically significant scarring, which can greatly impact patient quality of life. While treatment options have included... (Review)
Review
A common complication of acne vulgaris is clinically significant scarring, which can greatly impact patient quality of life. While treatment options have included microneedling, the recent addition of platelet-rich plasma (PRP) to this regimen has led to an increased popularity of combination treatment. Here, we offer backgrounds on microneedling and PRP therapies and review the literature on combination treatment for acne scars.
Topics: Acne Vulgaris; Atrophy; Cicatrix; Combined Modality Therapy; Cosmetic Techniques; Humans; Needles; Patient Satisfaction; Platelet-Rich Plasma; Quality of Life; Randomized Controlled Trials as Topic; Severity of Illness Index; Skin; Treatment Outcome
PubMed: 31070298
DOI: 10.1111/jocd.12988 -
The Journal of Pathology Apr 2022Benign prostatic hyperplasia (BPH) is a progressive expansion of peri-urethral prostate tissue common in aging men. Patients with enlarged prostates are treated with...
Benign prostatic hyperplasia (BPH) is a progressive expansion of peri-urethral prostate tissue common in aging men. Patients with enlarged prostates are treated with 5-alpha reductase inhibitors (5ARIs) to shrink prostate volume by blocking the conversion of testosterone to dihydrotestosterone (DHT). A reduction in DHT levels can elicit atrophy and apoptosis of prostate secretory luminal cells, which results in a favorable clinical response characterized by improved lower urinary tract symptoms. However, the histologic response to 5ARI treatment is often heterogeneous across prostate acini and lower urinary tract symptoms can persist to require surgical intervention. We used two spatial profiling approaches to characterize gene expression changes across histologically normal and atrophied regions in prostates from 5ARI-treated men. Objective transcriptomic profiling using the Visium spatial gene expression platform showed that 5ARI-induced atrophy of prostate luminal cells correlated with reduced androgen receptor signaling and increased expression of urethral club cell genes including LTF, PIGR, OLFM4, SCGB1A1, and SCGB3A1. Prostate luminal cells within atrophied acini adapted to decreased DHT conditions by increasing NF-κB signaling and anti-apoptotic BCL2 expression, which may explain their survival. Using GeoMx digital spatial profiling with a probe set to assess ~18 000 RNA targets, we confirmed that atrophied acini expressing SCGB3A1 displayed higher levels of club cell markers compared with histologically normal acini with NKX3-1 expression. In addition, club-like cells within regions of 5ARI-induced atrophy closely resembled true club cells from the prostatic urethra. A comparison of histologically normal regions from 5ARI-treated men and histologically normal regions from untreated men revealed few transcriptional differences. Taken together, our results describe a heterogeneous response to 5ARI treatment where cells in atrophied acini undergo an adaptation from a prostate secretory luminal to a club cell-like state in response to 5ARI treatment. © 2021 The Pathological Society of Great Britain and Ireland.
Topics: 5-alpha Reductase Inhibitors; Atrophy; Dihydrotestosterone; Humans; Lower Urinary Tract Symptoms; Male; Prostate; Prostatic Hyperplasia
PubMed: 34928497
DOI: 10.1002/path.5857 -
Advances in Experimental Medicine and... 2020The incidence of muscle atrophy is increasing with each passing year, which imposes a huge burden on the quality of life of patients. It is a public health issue that... (Review)
Review
The incidence of muscle atrophy is increasing with each passing year, which imposes a huge burden on the quality of life of patients. It is a public health issue that causes a growing concern around the world. Exercise is one of the key strategies to prevent and treat various diseases. Appropriate exercise is conducive to compensatory muscle hypertrophy, to improve muscle strength and elasticity, and to train muscle coordination, which is also beneficial to the recovery of skeletal muscle function and the regeneration of muscle cells. Sequelae of paralysis of patients with limb dyskinesia caused by muscle atrophy will be significantly alleviated after regular exercise therapy. Furthermore, exercise therapy can slow down or even reverse muscle atrophy. This article aims to introduce the characteristics of muscle atrophy and summarize the role and mechanism of exercise in the treatment of muscle atrophy in the existing studies, in order to further explore the mechanism of exercise to protect muscle atrophy and provide protection for patients with muscular atrophy.
Topics: Exercise; Humans; Muscle Strength; Muscle, Skeletal; Muscular Atrophy; Quality of Life
PubMed: 32342463
DOI: 10.1007/978-981-15-1792-1_17 -
The Journal of Sexual Medicine Mar 2022Genitourinary syndrome of menopause (GSM) is a widespread condition with a great impact on quality of life and self-image. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Genitourinary syndrome of menopause (GSM) is a widespread condition with a great impact on quality of life and self-image.
AIM
We aimed to systematically review the current literature on CO2-Laser therapy efficacy for the treatment of GSM.
METHODS
MEDLINE and Embase databases were systematically queried in December 2020 Studies included women with a diagnosis of Vulvo-Vaginal Atrophy (VVA) or GSM without an history of gynaecological and/or breast cancer, pelvic organ prolapse staged higher than 2, pelvic radiotherapy or Sjogren's Syndrome. The quality of the evidence was assessed with the Cochrane risk of bias tool. This study is registered on PROSPERO, number CRD42021238121.
OUTCOMES
Effects of CO2-Laser therapy on GSM symptoms assessed through subjective or objective efficacy measurement methods.
RESULTS
A total of 803 articles were identified. Of these, 25 studies were included in this review for a total of 1,152 patients. All studies showed a significant reduction in VVA and/or GSM symptoms (dryness, dyspareunia, itching, burning, dysuria). The pooled mean differences for the symptoms were: dryness -5.15 (95% CI:-5.72,-4.58; P < .001; I:62%; n = 296), dyspareunia -5.27 (95% CI:-5.93,-4.62; P < .001; I:68%; n = 296), itching -2.75 (95% CI:-4.0,-1.51; P < .001; I:93%; n = 281), burning -2.66 (95% CI:-3.75, -1.57; P < .001; I:86%; n = 296) and dysuria -2.14 (95% CI:-3.41,-0.87; P < .001; I:95%; n = 281). FSFI, WHIS and VMV scores also improved significantly. The pooled mean differences for these scores were: FSFI 10.8 (95% CI:8.41,13.37; P < .001; I:84%; n = 273), WHIS 8.29 (95% CI:6.16,10.42; P < .001; I:95%; n = 262) and VMV 30.4 (95% CI:22.38,38.55; P < .001; I:24%; n = 68). CO2-Laser application showed a beneficial safety profile and no major adverse events were reported.
CLINICAL IMPLICATIONS
Vaginal laser treatment resulted in both a statistically and clinically significant improvement in GSM symptoms. FSFI improved significantly in all 8 included studies but it reached a clinically relevant level only in 2 of them.
STRENGTHS & LIMITATIONS
The strength of the current meta-analysis is the comprehensive literature search. We reported data from a high number of patients (1,152) and high number of laser applications (more than 3,800). The main limitations are related to the high heterogeneity of the included studies investigating laser effects. Moreover, most of them are single center and nonrandomized studies.
CONCLUSION
The data suggest that CO2-Laser is a safe energy-based therapeutic option for the management of VVA and/or GSM symptoms in postmenopausal women; however, the quality of the body of evidence is "very low" or "low". Filippini M, Porcari I, Ruffolo AF, et al., CO2-Laser therapy and Genitourinary Syndrome of Menopause: A Systematic Review and Meta-Analysis. J Sex Med 2022;19:452-470.
Topics: Atrophy; Carbon Dioxide; Female; Humans; Laser Therapy; Lasers, Gas; Menopause; Quality of Life; Treatment Outcome; Vagina; Vaginal Diseases
PubMed: 35101378
DOI: 10.1016/j.jsxm.2021.12.010 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2023Monomelic amyotrophy, also known as Hirayama disease, is a rare neurological disorder characterized by focal and latent onset of upper limb weakness and atrophy in the...
Monomelic amyotrophy, also known as Hirayama disease, is a rare neurological disorder characterized by focal and latent onset of upper limb weakness and atrophy in the absence of sensory deficits, bulbar or pyramidal signs. It usually occurs in young patients. The disease usually begins unnoticeably and progresses slowly, and can manifest itself as unilateral or asymmetrical weakness, as well as atrophy of the distal upper limb. Sensory disturbances, reflex changes and signs of lesions of lower motor neurons are rare. This article describes a case of a patient with complaints of weakness not only in the upper but also in the lower extremities.
Topics: Humans; Spinal Muscular Atrophies of Childhood; Atrophy; Lower Extremity; Motor Neurons; Rare Diseases
PubMed: 37796075
DOI: 10.17116/jnevro2023123091101 -
British Journal of Pharmacology Jul 2022The mineralocorticoid receptor (MR or NR3C2) is expressed in all types of cells from the different skin compartments. The binding and activation by glucocorticoids has a... (Review)
Review
The mineralocorticoid receptor (MR or NR3C2) is expressed in all types of cells from the different skin compartments. The binding and activation by glucocorticoids has a higher affinity than that on the closely related glucocorticoid receptor (GR or NR3C1). As both corticosteroid receptors are co-express in the skin and considering the therapeutic relevance of glucocorticoids to combat skin inflammatory diseases, it was proposed that several of the major side effects of topical glucocorticoids, such as skin atrophy and delayed wound healing, were due to unintended activation of the MR. Indeed, cutaneous MR blockade using genetic and pharmacological approaches in mice and human reduced corticosteroid-associated skin atrophy in conditions of endogenous and pharmacological glucocorticoid excess. Although data support the safety of topical MR antagonists combined with glucocorticoid, it is crucial to address the efficacy of treatment in skin inflammatory conditions and its impact on the overall metabolism. LINKED ARTICLES: This article is part of a themed issue on Emerging Fields for Therapeutic Targeting of the Aldosterone-Mineralocorticoid Receptor Signaling Pathway. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.13/issuetoc.
Topics: Animals; Atrophy; Glucocorticoids; Humans; Mice; Receptors, Glucocorticoid; Receptors, Mineralocorticoid; Skin; Skin Diseases
PubMed: 34788475
DOI: 10.1111/bph.15736