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Asian Pacific Journal of Cancer... May 2019Leuprorelin is a synthetic analogue of naturally occurring gonadotropin-releasing hormone. It is currently approved in the United States, Europe and Asia and has... (Review)
Review
Leuprorelin is a synthetic analogue of naturally occurring gonadotropin-releasing hormone. It is currently approved in the United States, Europe and Asia and has indications in advanced prostate cancer, endometriosis, breast cancer and precocious puberty. This review examined clinical trials of leuprorelin in women with breast cancer in Asia. Methods: Four studies were identified, involving 999 premenopausal females with breast cancer. Leuprorelin was administered subcutaneously at doses of 3.75 mg every 4 weeks, 11.25 mg every 12 weeks or 22.5 mg every 24 weeks in addition to either adjuvant chemotherapy or hormonal therapy. Results: Leuprorelin was shown to preserve ovarian function, reduce symptoms of ovarian failure, the occurrence of early menopause, and the time to resumption of menses. Leuprorelin-related adverse events included hot flush, mood swings and urogenital symptoms. Conclusion: Clinical studies in breast cancer patients from Asia have primarily investigated the effect of leuprorelin on the protection of ovarian function in patients who receive chemotherapy, assessed the ability of leuprorelin to suppress serum estradiol to menopausal levels, or to determine the efficacy and safety of leuprorelin in daily medical practice.
Topics: Antineoplastic Agents, Hormonal; Asia; Breast Neoplasms; Humans; Leuprolide; Menopause; Premenopause
PubMed: 31127911
DOI: 10.31557/APJCP.2019.20.5.1475 -
Orthopaedic Surgery Sep 2022To determine whether unilateral chronic ankle instability (CAI) affects the kinematics of the uninjured contralateral ankle.
OBJECTIVE
To determine whether unilateral chronic ankle instability (CAI) affects the kinematics of the uninjured contralateral ankle.
METHODS
In this case-control study, 15 adult patients with unilateral CAI and 15 healthy controls were studied. Both the unstable and uninjured ankles in patients with unilateral CAI (CAI group, n = 15) were compared with that of healthy individuals (control group, n = 15). Applying body photo-reflective markers, the participant's motion during gait was measured. Biomechanical variables including overall ankle-toe angle, linear velocity, linear acceleration, angular velocity, angular acceleration, range of motion (RoM) in dorsiplantar flexion, and inversion-eversion at initial contact, loading response, mid-stance, terminal stance, pre-swing, and swing phase of the gait were measured.
RESULTS
In patients with CAI, the injured and uninjured ankles were significantly different regarding angle-toe angle, inversion-eversion RoM, dorsiplantar flexion in mid-stance, inversion-eversion at initial contact and terminal stance as well as the pre-swing and swing phases (p < 0.01). The uninjured ankles of patients showed lower ankle-toe velocity (p = 0.01) and acceleration (p = 0.01) compared to both the left and right ankles of the controls. In addition, the uninjured ankles of the patients showed decreased ankle dorsiflexion and increased inversion during initial contact, loading response, mid-stance, terminal stance, pre-swing, and swing compared to the control group (p < 0.017).
CONCLUSION
The results suggest that unilateral CAI can affect gait biomechanics in the contralateral uninjured ankle. Left unaddressed, unilateral CAI may lead to increased morbidity to the contralateral uninjured side. When surgery is not preferred for the management of unilateral CAI, rehabilitation protocols should focus on both sides.
Topics: Adult; Ankle; Ankle Joint; Biomechanical Phenomena; Case-Control Studies; Chronic Disease; Gait; Humans; Joint Instability
PubMed: 35852096
DOI: 10.1111/os.13307 -
BMC Sports Science, Medicine &... Nov 2023The effect of listening to audiobooks, podcasts, and other audio files while walking on gait performance has not been well studied. Although the number of audio users is...
BACKGROUND
The effect of listening to audiobooks, podcasts, and other audio files while walking on gait performance has not been well studied. Although the number of audio users is growing annually. Evidence suggests that a posture-first strategy contributes to gait stability in healthy individuals during dual-task conditions, but this effect may be diminished when the cognitive task is consciously prioritized.
OBJECTIVES
To study the effect of listening to an audiobook while walking, as a daily life-like dual-task, on spatiotemporal gait parameters.
METHODS
Forty young healthy (24.05 ± 3.66) subjects participated in the study. Spatiotemporal gait parameters were measured for 5 min on a treadmill once without (single-task) and once while listening to an audiobook through over-ear headphones (dual-task). Measured parameters included spatiotemporal parameters, gait phases, maximum pressure, and dual-task cost. Data were statistically analyzed using SPSS software.
RESULTS
There were no significant differences in any of the studied parameters between the single- and dual-task conditions, even though the subjective cognitive load of listening to audiobooks while walking was high. However, participants with different habits had significant differences in gait phases and maximum pressure. Rare listeners had a shorter stance phase, a longer swing phase, and a higher maximum pressure on the dominant heel. They also had significant differences in dual-task costs.
CONCLUSION
No differences in the spatiotemporal gait parameters for walking with and without listening to audiobooks, as a daily life-like dual-task, were observed. However, the difference between participants who listened rarely and participants who listened often may confirm the "posture first" strategy in young healthy people.
TRIAL REGISTRATION
DRKS00025837, retrospectively registered on 23.11.2021.
PubMed: 38001528
DOI: 10.1186/s13102-023-00773-6 -
Mediators of Inflammation 2021HIV-1 can incite activation of chemokine receptors, inflammatory mediators, and glutamate receptor-mediated excitotoxicity. The mechanisms associated with such immune... (Review)
Review
HIV-1 can incite activation of chemokine receptors, inflammatory mediators, and glutamate receptor-mediated excitotoxicity. The mechanisms associated with such immune activation can disrupt neuronal and glial functions. HIV-associated neurocognitive disorder (HAND) is being observed since the beginning of the AIDS epidemic due to a change in the functional integrity of cells from the central nervous system (CNS). Even with the presence of antiretroviral therapy, there is a decline in the functioning of the brain especially movement skills, noticeable swings in mood, and routine performance activities. Under the umbrella of HAND, various symptomatic and asymptomatic conditions are categorized and are on a rise despite the use of newer antiretroviral agents. Due to the use of long-lasting antiretroviral agents, this deadly disease is becoming a manageable chronic condition with the occurrence of asymptomatic neurocognitive impairment (ANI), symptomatic mild neurocognitive disorder, or HIV-associated dementia. In-depth research in the pathogenesis of HIV has focused on various mechanisms involved in neuronal dysfunction and associated toxicities ultimately showcasing the involvement of various pathways. Increasing evidence-based studies have emphasized a need to focus and explore the specific pathways in inflammation-associated neurodegenerative disorders. In the current review, we have highlighted the association of various HIV proteins and neuronal cells with their involvement in various pathways responsible for the development of neurotoxicity.
Topics: AIDS Dementia Complex; Anti-Retroviral Agents; Astrocytes; Central Nervous System; Genome; HIV Envelope Protein gp120; HIV Envelope Protein gp41; HIV Infections; HIV-1; Human Immunodeficiency Virus Proteins; Humans; Inflammation; Kynurenine; Macrophages; Microglia; Neurons; Oligodendroglia; Receptors, N-Methyl-D-Aspartate; Viral Load; Viral Proteins; Viral Regulatory and Accessory Proteins; Viroporin Proteins; nef Gene Products, Human Immunodeficiency Virus; rev Gene Products, Human Immunodeficiency Virus; tat Gene Products, Human Immunodeficiency Virus; vpr Gene Products, Human Immunodeficiency Virus
PubMed: 34483726
DOI: 10.1155/2021/1267041 -
Neuropsychiatric Disease and Treatment 2017The aim of this paper is to investigate the association between suicide and Lyme and associated diseases (LAD). No journal article has previously performed a...
PURPOSE
The aim of this paper is to investigate the association between suicide and Lyme and associated diseases (LAD). No journal article has previously performed a comprehensive assessment of this subject.
INTRODUCTION
Multiple case reports and other references demonstrate a causal association between suicidal risk and LAD. Suicide risk is greater in outdoor workers and veterans, both with greater LAD exposure. Multiple studies demonstrate many infections and the associated proinflammatory cytokines, inflammatory-mediated metabolic changes, and quinolinic acid and glutamate changes alter neural circuits which increase suicidality. A similar pathophysiology occurs in LAD.
METHOD
A retrospective chart review and epidemiological calculations were performed.
RESULTS
LAD contributed to suicidality, and sometimes homicidality, in individuals who were not suicidal before infection. A higher level of risk to self and others is associated with multiple symptoms developing after acquiring LAD, in particular, explosive anger, intrusive images, sudden mood swings, paranoia, dissociative episodes, hallucinations, disinhibition, panic disorder, rapid cycling bipolar, depersonalization, social anxiety disorder, substance abuse, hypervigilance, generalized anxiety disorder, genital-urinary symptoms, chronic pain, anhedonia, depression, low frustration tolerance, and posttraumatic stress disorder. Negative attitudes about LAD from family, friends, doctors, and the health care system may also contribute to suicide risk. By indirect calculations, it is estimated there are possibly over 1,200 LAD suicides in the US per year.
CONCLUSION
Suicidality seen in LAD contributes to causing a significant number of previously unexplained suicides and is associated with immune-mediated and metabolic changes resulting in psychiatric and other symptoms which are possibly intensified by negative attitudes about LAD from others. Some LAD suicides are associated with being overwhelmed by multiple debilitating symptoms, and others are impulsive, bizarre, and unpredictable. Greater understanding and a direct method of acquiring LAD suicide statistics is needed. It is suggested that medical examiners, the Centers for Disease Control and Prevention, and other epidemiological organizations proactively evaluate the association between LAD and suicide.
PubMed: 28670127
DOI: 10.2147/NDT.S136137 -
International Journal of Bipolar... Oct 2017Bipolar disorder is characterized by recurrent manic and depressive episodes. Patients suffering from this disorder experience dramatic mood swings with a wide variety... (Review)
Review
Bipolar disorder is characterized by recurrent manic and depressive episodes. Patients suffering from this disorder experience dramatic mood swings with a wide variety of typical behavioral facets, affecting overall activity, energy, sexual behavior, sense of self, self-esteem, circadian rhythm, cognition, and increased risk for suicide. Effective treatment options are limited and diagnosis can be complicated. To overcome these obstacles, a better understanding of the neurobiology underlying bipolar disorder is needed. Animal models can be useful tools in understanding brain mechanisms associated with certain behavior. The following review discusses several pathological aspects of humans suffering from bipolar disorder and compares these findings with insights obtained from several animal models mimicking diverse facets of its symptomatology. Various sections of the review concentrate on specific topics that are relevant in human patients, namely circadian rhythms, neurotransmitters, focusing on the dopaminergic system, stressful environment, and the immune system. We then explain how these areas have been manipulated to create animal models for the disorder. Even though several approaches have been conducted, there is still a lack of adequate animal models for bipolar disorder. Specifically, most animal models mimic only mania or depression and only a few include the cyclical nature of the human condition. Future studies could therefore focus on modeling both episodes in the same animal model to also have the possibility to investigate the switch from mania-like behavior to depressive-like behavior and vice versa. The use of viral tools and a focus on circadian rhythms and the immune system might make the creation of such animal models possible.
PubMed: 29027157
DOI: 10.1186/s40345-017-0104-6 -
Nature Communications Jun 2020Future data-intensive applications will have integrated circuit architectures combining energy-efficient transistors, high-density data storage and electro-optic sensing...
Future data-intensive applications will have integrated circuit architectures combining energy-efficient transistors, high-density data storage and electro-optic sensing arrays in a single chip to perform in situ processing of captured data. The costly dense wire connections in 3D integrated circuits and in conventional packaging and chip-stacking solutions could affect data communication bandwidths, data storage densities, and optical transmission efficiency. Here we investigated all-ferroelectric nonvolatile LiNbO transistors to function through redirection of conducting domain walls between the drain, gate and source electrodes. The transistor operates as a single-pole, double-throw digital switch with complementary on/off source and gate currents controlled using either the gate or source voltages. The conceived device exhibits high wall current density and abrupt off-and-on state switching without subthreshold swing, enabling nonvolatile memory-and-sensor-in-logic and logic-in-memory-and-sensor capabilities with superior energy efficiency, ultrafast operation/communication speeds, and high logic/storage densities.
PubMed: 32499502
DOI: 10.1038/s41467-020-16623-9 -
Frontiers in Medicine 2021Pulse pressure variation (PPV) is a mandatory index for hemodynamic monitoring during mechanical ventilation. The changes in pleural pressure (P) and transpulmonary... (Review)
Review
Pulse pressure variation (PPV) is a mandatory index for hemodynamic monitoring during mechanical ventilation. The changes in pleural pressure (P) and transpulmonary pressure (P) caused by mechanical ventilation are the basis for PPV and lead to the effect of blood flow. If the state of hypovolemia exists, the effect of the increased P during mechanical ventilation on the right ventricular preload will mainly affect the cardiac output, resulting in a positive PPV. However, P is more influenced by the change in alveolar pressure, which produces an increase in right heart overload, resulting in high PPV. In particular, if spontaneous breathing is strong, the transvascular pressure will be extremely high, which may lead to the promotion of alveolar flooding and increased RV flow. Asynchronous breathing and mediastinal swing may damage the pulmonary circulation and right heart function. Therefore, according to the principle of PPV, a high PPV can be incorporated into the whole respiratory treatment process to monitor the mechanical ventilation cycle damage/protection regardless of the controlled ventilation or spontaneous breathing. Through the monitoring of PPV, the circulation-protective ventilation can be guided at bedside in real time by PPV.
PubMed: 34926495
DOI: 10.3389/fmed.2021.745164 -
Sensors (Basel, Switzerland) Aug 2022Arm swinging is a typical feature of human walking: Continuous and rhythmic movement of the upper limbs is important to ensure postural stability and walking efficiency....
Arm swinging is a typical feature of human walking: Continuous and rhythmic movement of the upper limbs is important to ensure postural stability and walking efficiency. However, several factors can interfere with arm swings, making walking more risky and unstable: These include aging, neurological diseases, hemiplegia, and other comorbidities that affect motor control and coordination. Objective assessment of arm swings during walking could play a role in preventing adverse consequences, allowing appropriate treatments and rehabilitation protocols to be activated for recovery and improvement. This paper presents a system for gait analysis based on Microsoft Azure Kinect DK sensor and its body-tracking algorithm: It allows noninvasive full-body tracking, thus enabling simultaneous analysis of different aspects of walking, including arm swing characteristics. Sixteen subjects with Parkinson's disease and 13 healthy controls were recruited with the aim of evaluating differences in arm swing features and correlating them with traditional gait parameters. Preliminary results show significant differences between the two groups and a strong correlation between the parameters. The study thus highlights the ability of the proposed system to quantify arm swing features, thus offering a simple tool to provide a more comprehensive gait assessment.
Topics: Arm; Biomechanical Phenomena; Gait; Humans; Parkinson Disease; Walking
PubMed: 36016043
DOI: 10.3390/s22166282 -
Frontiers in Pediatrics 2023Central precocious puberty (CPP) results from premature activation of hypothalamic-pituitary-gonadal axis, with the consequent increase of gonadotropin-releasing hormone...
INTRODUCTION
Central precocious puberty (CPP) results from premature activation of hypothalamic-pituitary-gonadal axis, with the consequent increase of gonadotropin-releasing hormone (GnRH); GnRH agonists (GnRHa) represent the gold-standard therapy in children with CPP although their use might be responsible for pituitary GnRH receptors down-regulation, that in turn suppresses luteinizing hormone (LH) and follicle stimulating hormone (FSH) and blocks of gonadal sex hormones release. The most prescribed GnRHa in the clinical practice are leuprolide and triptorelin, whose use is generally safe and well tolerated; however, mild menopausal-like side effects could appear. The aim of the present study was to investigate and compare the efficacy and tolerability profile of leuprolide and triptorelin in CPP patients.
METHODS
110 girls affected by CPP were enrolled in this retrospective study, carried out from 2018 to 2020. The enrolled patients received leuprolide ( = 48) or triptorelin ( = 62). Efficacy was investigated by the means of clinical parameters and radiological changes and side effects were also recorded to evaluate the possible relationship between the two GnRHa treatments and side effects appearance.
RESULTS
At baseline triptorelin patients had significantly higher LH and LH peak levels than leuprolide patients, whereas no significant difference in other patient characteristics was observed between the two groups. The leuprolide treatment lasted 971 days [790-1,171 days] while the duration of triptorelin administration was 792 days [760-1,003 days] ( < 0.001). Overall 46 (41.8%) of the studied patients reported mild menopausal-like symptoms: among these 27 were treated with triptorelin and 19 with leuprolide ( = 0.558). Patients treated with triptorelin, or leuprolide showed headache (27.4% vs. 16.7%), mood swings (12.9% vs. 16.7%), increased appetite (12.9% vs. 18.8%) and nausea (1.6% vs. 10.4%) respectively. Moreover, the onset of side effects appearance related to GnRHa therapy significantly reduces with the increase of the initial bone age ( = 0.038).
CONCLUSION
Leuprolide and triptorelin treatment appear to be effective and safe without significant difference between the two drugs in term of efficacy and tolerability, making both good options for treating CPP.
PubMed: 37266535
DOI: 10.3389/fped.2023.1170025