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Frontiers in Human Neuroscience 2014Ischemic stroke is responsible for many deaths and long-term disability world wide. Development of effective therapy has been the target of intense research.... (Review)
Review
Ischemic stroke is responsible for many deaths and long-term disability world wide. Development of effective therapy has been the target of intense research. Accumulating preclinical literature has shown that substantial functional improvement after stroke can be achieved using subacutely administered cell-based and pharmacological therapies. This review will discuss some of the latest findings on bone marrow-derived mesenchymal stem cells (BMSCs), human umbilical cord blood cells, and off-label use of some pharmacological agents, to promote recovery processes in the sub-acute and chronic phases following stroke. This review paper also focuses on molecular mechanisms underlying the cell-based and pharmacological restorative processes, which enhance angiogenesis, arteriogenesis, neurogenesis, and white matter remodeling following cerebral ischemia as well as an analysis of the interaction/coupling among these restorative events. In addition, the role of microRNAs mediating the intercellular communication between exogenously administered cells and parenchymal cells, and their effects on the regulation of angiogenesis and neuronal progenitor cell proliferation and differentiation, and brain plasticity after stroke are described.
PubMed: 25018718
DOI: 10.3389/fnhum.2014.00382 -
Tremor and Other Hyperkinetic Movements... 2019
Topics: Female; Humans; Male; Middle Aged; Subacute Sclerosing Panencephalitis
PubMed: 31566624
DOI: 10.7916/tohm.v0.719 -
British Journal of Neurosurgery 2015Ultrasonic blades have been shown to cause less acute electrophysiological damage when applied near nerves than monopolar electrosurgery (ES). This study was performed...
Ultrasonic blades have been shown to cause less acute electrophysiological damage when applied near nerves than monopolar electrosurgery (ES). This study was performed to determine whether the acute nerve damage observed for ES, as well as the relative lack of damage observed for ultrasonic dissection, extends through a subacute timeframe. Muscle incisions were made in rat with the Harmonic(®) Blade (HB) and ES at a distance of 2 mm from the sciatic nerve. Sham surgery was also performed which consisted of similar exposure of the sciatic nerve without use of an energized device. Electrophysiological function was assessed acutely over a 3-h period, and subacutely after a 7-day survival, by monitoring the sciatic nerve compound action potential (CAP), conduction velocity (CV), von Frey hair (VFH) stimulation force, leukocyte infiltration, and impaired axonal transport via β-amyloid precursor protein (β-APP) immunocytochemistry. During the acute period, ES produced significantly lower CAP and CV, and higher levels of leukocytes and β-APP than sham, whereas the ultrasonic blade was not significantly different from sham, and had significantly lower VFH force than ES. After the subacute survival, ES continued to display significantly lower CAP and CV, and higher levels of leukocytes and β-APP than sham, whereas ultrasonic blade had higher CAP and CV than sham, and lower VFH than ES. This study confirms that incisions made with an ultrasonic blade cause less acute nerve damage than monopolar ES, and are comparable to sham surgery at a distance of 2 mm from the sciatic nerve. The negative effects of electrosurgery extend through at least a 7-day survival period, whereas subacute recovery after application of the ultrasonic blade was comparable to that of sham surgery. For surgical procedures in the vicinity of vital nerves, use of the ultrasonic blade represents a lower risk than ES for both acute and subacute neural trauma.
Topics: Animals; Electrosurgery; Male; Models, Animal; Neurosurgical Procedures; Rats; Rats, Sprague-Dawley; Sciatic Nerve; Surgical Instruments; Ultrasonic Waves
PubMed: 25812024
DOI: 10.3109/02688697.2015.1023772 -
The Neurohospitalist Jul 2020Hyponatremia is a well-known disorder commonly faced by clinicians managing neurologically ill patients. Neurological disorders are often associated with hyponatremia... (Review)
Review
Hyponatremia is a well-known disorder commonly faced by clinicians managing neurologically ill patients. Neurological disorders are often associated with hyponatremia during their acute presentation and can be associated with specific neurologic etiologies and symptoms. Patients may present with hyponatremia with traumatic brain injury, develop hyponatremia subacutely following aneurysmal subarachnoid hemorrhage, or may manifest with seizures due to hyponatremia itself. Clinicians caring for the neurologically ill patient should be well versed in identifying these early signs, symptoms, and etiologies of hyponatremia. Early diagnosis and treatment can potentially avoid neurologic and systemic complications in these patients and improve outcomes. This review focuses on the causes and findings of hyponatremia in the neurologically ill patient and discusses the pathophysiology, diagnoses, and treatment strategies for commonly encountered etiologies.
PubMed: 32549945
DOI: 10.1177/1941874419895124 -
Journal of Hand Surgery Global Online Mar 2022This study investigated the long-term outcomes of direct scapholunate ligament (SLL) repairs with or without dorsal capsulodesis performed within 6 weeks (acute repair)...
PURPOSE
This study investigated the long-term outcomes of direct scapholunate ligament (SLL) repairs with or without dorsal capsulodesis performed within 6 weeks (acute repair) of a SLL tear versus 6 to 12 weeks following injury (subacute repair).
METHODS
A review of medical records from April 1996 to April 2012 identified 24 patients who underwent SLL repair (12 acute, 12 subacute). Patients returned to the clinic for radiographic examinations of the injured wrist, standardized physical examinations, and validated questionnaires.
RESULTS
The mean follow-up times for the acute and subacute groups were 7.2 and 6.2 years, respectively. At the final examination, patients with acute surgery regained more wrist extension (acute = 55°, subacute = 47°). The total wrist flexion-extension arcs, grip strengths, pinch strengths, and patient-rated outcome scores were found to be similar between groups. The final scapholunate gap, scapholunate angle, and the prevalence of arthritis were also found to be similar between the acute and subacute groups.
CONCLUSIONS
Although SLL repair is more commonly recommended for treatment of acute SLL injuries, there were no significant long-term differences between acute and subacute SLL surgeries (repair ± capsulodesis).
TYPE OF STUDY/LEVEL OF EVIDENCE
Prognostic III.
PubMed: 35434576
DOI: 10.1016/j.jhsg.2021.10.007 -
The Journal of Clinical Endocrinology... Jul 2020Subacute thyroiditis (SAT) is a thyroid disease of viral or postviral origin. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that began in Wuhan,...
CONTEXT
Subacute thyroiditis (SAT) is a thyroid disease of viral or postviral origin. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that began in Wuhan, China, has spread rapidly worldwide and Italy has been severely affected by this outbreak.
OBJECTIVES
The objective of this work is to report the first case of SAT related to SARS-CoV-2 infection.
METHODS
We describe the clinical, laboratory, and imaging features of an 18-year-old woman who came to our attention for fever, neck pain radiated to the jaw, and palpitations occurring 15 days after a SARS-CoV-2-positive oropharyngeal swab. Coronavirus disease 2019 (COVID-19) had been mild and the patient had completely recovered in a few days.
RESULTS
At physical examination the patient presented with a slightly increased heart rate and a painful and enlarged thyroid on palpation. At laboratory exams free thyroxine and free triiodothyronine were high, thyrotropin undetectable, and inflammatory markers and white blood cell count elevated. Bilateral and diffuse hypoechoic areas were detected at neck ultrasound. One month earlier, thyroid function and imaging both were normal. We diagnosed SAT and the patient started prednisone. Neck pain and fever recovered within 2 days and the remaining symptoms within 1 week. Thyroid function and inflammatory markers normalized in 40 days.
CONCLUSIONS
We report the first case of SAT after a SARS-CoV-2 infection. We alert clinicians to additional and unreported clinical manifestations associated with COVID-19.
Topics: Adolescent; Betacoronavirus; COVID-19; COVID-19 Testing; Clinical Laboratory Techniques; Coronavirus Infections; Female; Humans; Italy; Leukocyte Count; Oropharynx; Pandemics; Pneumonia, Viral; Prednisone; SARS-CoV-2; Thyroid Gland; Thyroiditis, Subacute; Thyroxine; Treatment Outcome; Triiodothyronine; Ultrasonography
PubMed: 32436948
DOI: 10.1210/clinem/dgaa276 -
Endocrine Regulations Jul 2022The present study evaluates the occurrence of subacute thyroiditis in temporal connection with SARS-Cov2 vaccinations described in the literature last year and... (Review)
Review
The present study evaluates the occurrence of subacute thyroiditis in temporal connection with SARS-Cov2 vaccinations described in the literature last year and confirmed by our clinical routine. Systematic literature search in Medline for studies reporting diagnosis of subacute thyroiditis in temporal connection with vaccinations against Covid 19. The literature search yielded 24 relevant references out of which 22 were "case reports" and two "Letters to the Editor" and encompassed 37 patient cases, in total. They had received a SARS-Cov2 vaccination shortly before the diagnosis (median interval to vaccination six days). In none of these cases, infection of the upper respiratory tract had previously been identified as a classic trigger of the disease. Newly occurring hyperthyroidism and increased laboratory signs of inflammation were described in 78% and 74% of cases, respectively. Atypical clinical pictures (asymptomatic, euthyroid, no inflammation marks) have been observed in both the literature and our patients suspected of thyroid cancer referred to surgery. In times of pandemics and the resulting vaccination, new rapidly occurring sonographic changes in the thyroid gland should be revaluated after 2-3 weeks, or recommended to undergo a fine-needle biopsy, in order to avoid unnecessary surgical interventions.
Topics: COVID-19; Humans; RNA, Viral; SARS-CoV-2; Thyroiditis, Subacute; Vaccination
PubMed: 35843718
DOI: 10.2478/enr-2022-0024 -
Endocrinology, Diabetes & Metabolism... Dec 2021There is emerging evidence of an association between COVID-19 vaccination and subacute thyroiditis. We present the case of a 42-year-old female healthcare worker who was...
SUMMARY
There is emerging evidence of an association between COVID-19 vaccination and subacute thyroiditis. We present the case of a 42-year-old female healthcare worker who was diagnosed with subacute thyroiditis 4 days after receiving her second dose of Pfizer-BioNTech vaccine. Her clinical course followed the classical pattern for thyroiditis with spontaneous return to euthyroidism at 6 months post-presentation. The autoimmune/inflammatory syndrome induced by adjuvants has been implicated as a cause of autoimmune conditions post-vaccination and is a potential mechanism for subacute thyroiditis in our case.
LEARNING POINTS
Subacute thyroiditis should be considered in all patients who receive any kind of vaccine for COVID-19 and subsequently develop symptoms or signs of hyperthyroidism or neck pain. Subacute thyroiditis is a self-limiting condition, and recognising it is important as no specific thyroid treatment (antithyroid drugs or thyroid hormone replacement) is necessary for most patients. The autoimmune/inflammatory syndrome induced by adjuvants may be an under-recognised cause of endocrinopathies and should particularly be considered post-vaccination.
PubMed: 34907904
DOI: 10.1530/EDM-21-0142 -
Therapeutic Advances in... 2023Classic serotonergic psychedelics have anecdotally been reported to show a characteristic pattern of subacute effects that persist after the acute effects of the... (Review)
Review
BACKGROUND
Classic serotonergic psychedelics have anecdotally been reported to show a characteristic pattern of subacute effects that persist after the acute effects of the substance have subsided. These transient effects, sometimes labeled as the 'psychedelic afterglow', have been suggested to be associated with enhanced effectiveness of psychotherapeutic interventions in the subacute period.
OBJECTIVES
This systematic review provides an overview of subacute effects of psychedelics.
METHODS
Electronic databases (MEDLINE, Web of Science Core Collection) were searched for studies that assessed the effects of psychedelics (LSD, psilocybin, DMT, 5-MeO-DMT, mescaline, or ayahuasca) on psychological outcome measures and subacute adverse effects in human adults between 1950 and August 2021, occurring between 1 day and 1 month after drug use.
RESULTS
Forty-eight studies including a total number of 1,774 participants were eligible for review. Taken together, the following subacute effects were observed: reductions in different psychopathological symptoms; increases in wellbeing, mood, mindfulness, social measures, spirituality, and positive behavioral changes; mixed changes in personality/values/attitudes, and creativity/flexibility. Subacute adverse effects comprised a wide range of complaints, including headaches, sleep disturbances, and individual cases of increased psychological distress.
DISCUSSION
Results support narrative reports of a subacute psychedelic 'afterglow' phenomenon comprising potentially beneficial changes in the perception of self, others, and the environment. Subacute adverse events were mild to severe, and no serious adverse events were reported. Many studies, however, lacked a standardized assessment of adverse effects. Future studies are needed to investigate the role of possible moderator variables and to reveal if and how positive effects from the subacute window may consolidate into long-term mental health benefits.
PubMed: 37284524
DOI: 10.1177/20451253231172254 -
Nature and Science of Sleep 2023Little is known about sleep after a concussion, a form of mild traumatic brain injury. Given the importance of sleep for both maintaining brain health and recovery from...
PURPOSE
Little is known about sleep after a concussion, a form of mild traumatic brain injury. Given the importance of sleep for both maintaining brain health and recovery from injury, we sought to examine sleep acutely and subacutely after concussion.
METHODS
Athletes who experienced a sports-related concussion were invited to participate. Participants underwent overnight sleep studies within 7 days of the concussion (acute phase), and again eight-weeks after the concussion (subacute phase). Changes in sleep from both the acute and subacute phases were compared to population normative values. Additionally, changes in sleep from acute to subacute phase were analysed.
RESULTS
When compared to normative data, the acute and subacute phases of concussion showed longer total sleep time (p < 0.005) and fewer arousals (p < 0.005). The acute phase showed longer rapid eye movement sleep latency (p = 0.014). The subacute phase showed greater total sleep spent in Stage N3% (p = 0.046), increased sleep efficiency (p < 0.001), shorter sleep onset latency (p = 0.013), and reduced wake after sleep onset (p = 0.013). Compared to the acute phase, the subacute phase experienced improved sleep efficiency (p = 0.003), reduced wake after sleep onset (p = 0.02), and reduced latencies for both stage N3 sleep (p = 0.014) and rapid eye movement sleep (p = 0.006).
CONCLUSION
This study indicated sleep during both the acute and subacute phases of SRC was characterised by longer and less disrupted sleep, along with improvements in sleep from the acute to subacute phases of SRC.
PubMed: 37155471
DOI: 10.2147/NSS.S397900