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BMJ Case Reports Jan 2024Vertebral artery dissections are a rare pathology that carries a high risk of stroke in a younger population. They may be caused by minor mechanisms and the index of...
Vertebral artery dissections are a rare pathology that carries a high risk of stroke in a younger population. They may be caused by minor mechanisms and the index of suspicion should be high. Treatment with anticoagulation or antiplatelets should follow if no surgical management is indicated.We describe a case of a female in her 30s who fell backward off a swing and rolled over her head and complained of continued posterior neck pain. The patient was found to have a vertebral artery dissection on MRI. The patient was then anticoagulated with high-dose apixaban and low-dose aspirin.The emergency medicine provider should be aware of possible low-impact mechanisms that can cause vertebral artery dissection and should have a high index of suspicion. If surgical management is not indicated, anticoagulation should be initiated.
Topics: Female; Humans; Affect; Anticoagulants; Aspirin; Awareness; Vertebral Artery Dissection; Adult
PubMed: 38195187
DOI: 10.1136/bcr-2023-255923 -
Brain and Behavior Nov 2023Mood swings have been observed in patients with intracranial aneurysm (IA), but it is still unknown whether mood swings can affect IA.
BACKGROUND
Mood swings have been observed in patients with intracranial aneurysm (IA), but it is still unknown whether mood swings can affect IA.
AIM
To explore the causal association between mood swings or experiencing mood swings and IA through a two-sample Mendelian randomization (MR) study.
METHODS
Summary-level statistics of mood swings, experiencing mood swings, IA, aneurysm-associated subarachnoid hemorrhage (aSAH), and non-ruptured IA (uIA) were collected from the genome-wide association study. Two-sample MR and various sensitivity analyses were employed to explore the causal association between mood swings or experiencing mood swings and IA, or aSAH, or uIA. The inverse-variance weighted method was used as the primary method.
RESULTS
Genetically determined mood swings (odds ratio [OR] = 5.23, 95% confidence interval (95%CI): 1.65-16.64, p = .005) and experiencing mood swings (OR = 2.50, 95%CI: 1.37-4.57, p = .003) were causally associated with an increased risk of IA. Mood swings (OR = 5.67, 95%CI: 1.40-23.04, p = .015) and experiencing mood swings were causally associated with the risk of aSAH (OR = 2.91, 95%CI: 1.47-5.75, p = .002). Neither mood swings (OR = 1.95, 95%CI: .31-12.29, p = .478) nor experiencing mood swings (OR = 1.20, 95%CI: .48-3.03, p = .693) were associated with uIA.
CONCLUSIONS
Mood swings and experiencing mood swings increased the risk of IA and aSAH incidence. These results suggest that alleviating mood swings may reduce IA rupture incidence and aSAH incidence.
Topics: Humans; Subarachnoid Hemorrhage; Intracranial Aneurysm; Risk Factors; Mendelian Randomization Analysis; Genome-Wide Association Study
PubMed: 37632147
DOI: 10.1002/brb3.3233 -
Frontiers in Physiology 2023Esophageal pressure is the closest estimate of pleural pressure. Changes in esophageal pressure reflect changes in intrathoracic pressure and affect transpulmonary... (Review)
Review
Esophageal pressure is the closest estimate of pleural pressure. Changes in esophageal pressure reflect changes in intrathoracic pressure and affect transpulmonary pressure, both of which have multiple effects on right and left ventricular performance. During passive breathing, increasing esophageal pressure is associated with lower venous return and higher right ventricular afterload and lower left ventricular afterload and oxygen consumption. In spontaneously breathing patients, negative pleural pressure swings increase venous return, while right heart afterload increases as in passive conditions; for the left ventricle, end-diastolic pressure is increased potentially favoring lung edema. Esophageal pressure monitoring represents a simple bedside method to estimate changes in pleural pressure and can advance our understanding of the cardiovascular performance of critically ill patients undergoing passive or assisted ventilation and guide physiologically personalized treatments.
PubMed: 37538376
DOI: 10.3389/fphys.2023.1221829 -
Current Rheumatology Reviews 2024Fibromyalgia (FM) is a complex, widespread pain disorder characterized by symptoms such as fatigue, sleep deprivation, mental fog, mood swings, and headaches. Currently,... (Review)
Review
Fibromyalgia (FM) is a complex, widespread pain disorder characterized by symptoms such as fatigue, sleep deprivation, mental fog, mood swings, and headaches. Currently, there are only three FDA-approved medications for FM patients: duloxetine, milnacipran, and pregabalin, with outcomes frequently being inadequate. This research team aims to investigate the effects of diet and lifestyle modifications on FM, with emphasis on anti-inflammatory diet, antioxidants, and gluten-free diets, as well as supplementation with Magnesium, CQ10, and Vitamin D, microbiome, sleep, exercise, and cognitive behavioral therapy. We reviewed the pathophysiology of certain foods that can be proinflammatory with the release of cytokines leading to activation of pain, fatigue and aggravation of the majority of Fibromyalgia symptoms. A literature review was performed by identifying FM articles published between 1994 and 2022 PubMed and EMBASE databases, with particular emphasis on randomized controlled trials, meta-analysis, and evidence-based treatment guidelines. This review article was completed by a comprehensive narrative review process, in which our team systematically examined relevant scientific literature to provide a comprehensive overview of the significant role that diet and other lifestyle modifications play in mediating symptoms of Fibromyalgia. We propose that diet modifications and lifestyle changes, such as sleep, exercise, and weight loss, can be important steps in managing FM.
Topics: Humans; Fibromyalgia; Diet; Life Style; Exercise
PubMed: 38279728
DOI: 10.2174/0115733971274700231226075717 -
Science (New York, N.Y.) Mar 2024Three years ago, addressing racial justice in the United States moved firmly into the mainstream. Following the murder of George Floyd, the ongoing struggle for social...
Three years ago, addressing racial justice in the United States moved firmly into the mainstream. Following the murder of George Floyd, the ongoing struggle for social justice was again laid bare, and pledges to improve diversity, equity, and inclusion (DEI) began sprouting everywhere. Now, the pendulum is swinging back on these commitments. A backlash against DEI initiatives is rising across all sectors, especially at the state level. Last year's decision by the US Supreme Court to strike down the consideration of students' racial status in college admissions has emboldened many who oppose any advancement of DEI. Although there has been specific attention to higher education, other sectors have also been attacked. The retreat includes recent anti-DEI legislation that would affect structures, programs, practices, and curricula that aim to support success for all, including persons who have been historically excluded from or marginalized within science, technology, engineering, mathematics, and medicine (STEMM). Before this backlash worsens, DEI advocates, the scientific community, universities, and federal agencies need to collectively call out the dangers of setting aside DEI and come up with robust ways to demonstrate its value to society.
PubMed: 38547281
DOI: 10.1126/science.adp4397 -
Frontiers in Physiology 2023Asthma encompasses of respiratory symptoms that occur intermittently and with varying intensity accompanied by reversible expiratory airflow limitation. In acute... (Review)
Review
Asthma encompasses of respiratory symptoms that occur intermittently and with varying intensity accompanied by reversible expiratory airflow limitation. In acute exacerbations, it can be life-threatening due to its impact on ventilatory mechanics. Moreover, asthma has significant effects on the cardiovascular system, primarily through heart-lung interaction-based mechanisms. Dynamic hyperinflation and increased work of breathing caused by a sharp drop in pleural pressure, can affect cardiac function and cardiac output through different mechanisms. These mechanisms include an abrupt increase in venous return, elevated right ventricular afterload and interdependence between the left and right ventricle. Additionally, Pulsus paradoxus, which reflects the maximum consequences of this heart lung interaction when intrathoracic pressure swings are exaggerated, may serve as a convenient bedside tool to assess the severity of acute asthma acute exacerbation and its response to therapy.
PubMed: 37781226
DOI: 10.3389/fphys.2023.1232345 -
Nano Letters Dec 2023The physical properties of graphene nanoribbons (GNRs) are closely related to their morphology; meanwhile GNRs can easily slide on surfaces (e.g., superlubricity), which...
The physical properties of graphene nanoribbons (GNRs) are closely related to their morphology; meanwhile GNRs can easily slide on surfaces (e.g., superlubricity), which may largely affect the configuration and hence the properties. However, the morphological evolution of GNRs during sliding remain elusive. We explore the intriguing tail swing behavior of GNRs under various sliding configurations on Au substrate. Two distinct modes of tail swing emerge, characterized by regular and irregular swings, depending on the GNR width and initial position relative to the substrate. The mechanism can be explained by the moiré effect, presenting both symmetric and asymmetric patterns, resembling a mesmerizing nanomillipede. We reveal a compelling correlation between the tail swing mode and the edge wrinkle patterns of GNRs induced by the moiré effect. These findings provide fundamental understanding of how edge effects influence the tribomorphological responses of GNRs, offering valuable insights for precise manipulation and operation of GNRs.
PubMed: 37823533
DOI: 10.1021/acs.nanolett.3c03084 -
Cureus Oct 2023This conversation with ChatGPT explores the use of lithium in pregnancy for bipolar disorder, a topic of significant importance in psychiatry. Bipolar disorder is...
This conversation with ChatGPT explores the use of lithium in pregnancy for bipolar disorder, a topic of significant importance in psychiatry. Bipolar disorder is characterized by extreme mood swings, and its prevalence varies globally. ChatGPT provides valuable information on bipolar disorder, its prevalence, age of onset, and gender differences. It also discusses the use of lithium during pregnancy, emphasizing the need for individualized decisions, close monitoring, and potential risks and benefits. However, it is essential to note that ChatGPT's responses lack specific references, raising concerns about the reliability of the information provided. Further research is needed to quantify the correctness and dependability of ChatGPT-generated answers in the healthcare context.
PubMed: 37933339
DOI: 10.7759/cureus.46548