scholarly journals Neurological Complications in Patients with Blood Diseases during Their Treatment

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4970-4970
Author(s):  
Dmitry E Vybornykh ◽  
Vladimir V. Zakharov ◽  
Eduard G. Gemdzhian ◽  
Mikhail Yu. Drokov ◽  
Svetlana Yu. Fedorova ◽  
...  
Keyword(s):  
Risk Factor ◽  
Epileptic Seizure ◽  
Neurological Disorders ◽  
Inpatient Treatment ◽  
Neurological Complication ◽  
Treatment Protocol ◽  
Interval Estimation ◽  
Neurological Complications ◽  
Contingency Table Analysis ◽  
Blood Diseases

Abstract Background: During inpatient treatment of patients (pts) with blood diseases (BD) severe neurological complications (SNC) can occur, which lead treatment protocol interruption. Objective: Determine the types, frequency, symptoms, and predictors of SNC that occurred during inpatient treatment of pts with BD. Patients and Methods: The retrospective exploratory study was conducted on the data analysis of 3,620 pts with BD who were undergoing inpatient treatment from 01. 2018 to 12.2019 in the National Research Center for Hematology (Moscow). 34 pts (with diagnoses: lymphoid neoplasms - 67.7%, myeloid neoplasms - 26.5%, others BD - 5.9%) those who had SNC, were selected: 14 men and 20 women, median age 39 years, interquartile range (IQR): 33-55 years. The neurological complication was estimated as SNC if it was an indication for transition to the intensive care unit. In order to reveal the predictors associated with the development of SNC, the pts who had SNC, were compared with the comparison group of 137 pts (formed using the Kernel matching method) who were similar to the main group by clinical and laboratory characteristics: 59 men and 78 women, median age 36 years, IQR: 26-53 years. Statistical analysis included the multivariate analysis: multiple binary logistic regression with stepwise inclusion of variables (that were found in the preliminary contingency table analysis), control false results (by the false discovery rate method) and odds ratio, OR (95% confidence interval), estimation. Results: SNC in pts with BD, developed in 0.94% of cases. The main SNC in pts with BD were: • epileptic seizure (50.0%, n=17), • ischemic stroke (20.6%, n=7), • hemorrhagic stroke (17.6%, n=6), • and meningoencephalitis (11.8%, n=4) (Figure 1). The following independent statistically significant (Wald test, p≤0.05) predictors associated with the development of SNC in pts with BD during the treatment, were identified: • antibiotic therapy (when more than 5 drugs are prescribed), OR = 2.9 (1.2-7,4); • chemotherapy (when more than 4 drugs are prescribed), OR = 2.9 (1.1-7.8); • thrombocytopenia (with a platelet count less than 50 x 10 9 g/l), OR = 2.3 (1.0-5.2); • the development of delirium in the pts, OR = 3.7 (1.3-10.8); and also the risk factor: • neurological disorders in the pts's medical history, OR = 2.6 (1.1-6.3). Conclusion. In the process of inpatient treatment pts with BD may develop SNC. This life-threatening complication violates the intended therapeutic protocol, which affects the results of BD treatment in general. The main types of SNC detected were: epileptic seizure, ischemic and hemorrhagic strokes, and meningoencephalitis. Four predictors such as massive antibacterial (more than 5 drugs prescribed) and chemotherapeutic effects (more than 4 drugs prescribed), thrombocytopenia and manifestation of delirium, associated with the development of SNC in pts with BD in the process of treatment, as well as one risk factor (the presence of neurological disorders in the patient checked-in history) were identified. All these independent signs must be taken into account and monitored in the treatment, as each of them increases the risk of the SNC development. Figure 1 Figure 1. Disclosures Zakharov: Takeda: Honoraria; EverNeuroPharma: Honoraria; KanonPharma: Honoraria; Merz: Honoraria; Boerhinger Ingelheim: Honoraria; Abbot: Honoraria; Pfizer: Honoraria; Egis: Honoraria; Polysan: Honoraria; SCS: Honoraria; Pharmasoft: Honoraria; Valenta: Honoraria.

scholarly journals Epileptic seizures in patients with COVID-19: A systematic review of early evidences

2021 ◽  
Vol 8 (1) ◽  
pp. 33-44
Author(s):  
B Roy ◽  
I Banerjee
Keyword(s):  
Systematic Review ◽  
Epileptic Seizure ◽  
Case Reports ◽  
Neurological Complication ◽  
Epileptic Seizures ◽  
Neurological Complications ◽  
Cross Sectional Study ◽  
Cerebrovascular Diseases ◽  
Cross Sectional ◽  
Demyelinating Lesions

Background: Global emergence of SARS-CoV-2 surfaced neurological complications amongst the patients. COVID-19 resembles with other coronavirus strains follows a trend of neurological complication, damage and encephalopathy, which entails considerable risks, requires attention for the neurologists. This is, to our knowledge, the first systematic review of the literature to investigate solely to elucidate the seizure spectrum by unfolding epileptogenicity of the SARS CoV-2 and potential pathways of neuroinvasion. Methods: A systematic literature search was performed in PubMed and Embase database following standard guidelines, using specific keywords based on epileptic seizure onset described from December 01, 2019, to July 17, 2020 Results: A total of 17 studies were included ranging from case reports, series of cases, multicentre cross-sectional study with the first-time onset of seizure associated with an epileptic origin. We excavated causes of complex COVID-19 related neurological manifestations, e.g., cerebrovascular diseases, encephalitis, demyelinating lesions, cytokine storm and proposed routes of SARS-CoV-2 entry into the nervous system to understand the mechanism of an epileptic seizure. Conclusion: COVID-19 is a potent neuropathogen which causes the new onset of epileptic seizures should get diagnostic recognition to evade possible deterioration of neurological conditions. However, more shreds of evidence from the future will further elucidate the epileptogenic potential of the pandemic.

Presence and Persistence of Sleep-Related Symptoms and Suicidal Ideation in Psychiatric Inpatients

Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 398-405 ◽  
Author(s):  
Michael R. Nadorff ◽  
Thomas E. Ellis ◽  
Jon G. Allen ◽  
E. Samuel Winer ◽  
Steve Herrera
Keyword(s):  
Risk Factor ◽  
Suicidal Ideation ◽  
Inpatient Treatment ◽  
Improve Method ◽  
Sleep Problems ◽  
Psychiatric Inpatients ◽  
Poor Sleep ◽  
Treatment Termination ◽  
Suicidal Patients ◽  
The Relationship

Background: Although sleep is an important risk factor for suicidal behavior, research has yet to examine the association between sleep problems and suicidality across the course of inpatient treatment. This study examined the relationship among sleep-related symptoms and suicidal ideation across inpatient treatment. Aims: To examine whether poor sleep at admission longitudinally predicts less improvement in suicidal ideation over the course of treatment. Further, to examine whether suicidal ideation is reduced in patients whose sleep does not improve. Method: The study utilized the Beck Depression Inventory (BDI)-II, which contains items measuring depressive symptoms, sleep-related symptoms, and suicidal ideation. The study sample consisted of 1,529 adult psychiatric inpatients. Patients were assessed at admission, biweekly, and at treatment termination. Results: Admission fatigue, loss of energy, and change in sleep pattern were associated with higher levels of suicidal ideation at admission and discharge. Fatigue at admission predicted suicidal ideation at termination independent of admission depression and suicidal ideation. Individuals whose sleep did not improve over the course of treatment had significantly higher suicidal ideation scores at termination relative to those whose sleep symptoms improved, after controlling for sleep, depression, and suicidal ideation scores at admission. Conclusion: These findings suggest that persistence of sleep-related symptoms warrants clinical attention in the treatment of suicidal patients.

scholarly journals Melittin, a honeybee venom derived peptide for the treatment of chemotherapy-induced peripheral neuropathy

2021 ◽  
Vol 38 (5) ◽  
Author(s):  
Tenzin Tender ◽  
Rakesh Ravishankar Rahangdale ◽  
Sridevi Balireddy ◽  
Madhavan Nampoothiri ◽  
K. Krishna Sharma ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Motor Nerve ◽  
Symptomatic Relief ◽  
Neurological Complication ◽  
Treatment Protocol ◽  
Chemotherapeutic Agents ◽  
Lens Protein ◽  
Active Constituent ◽  
Honeybee Venom ◽  
Eye Lens Protein

Abstract Chemotherapy-induced peripheral neuropathy (CIPN) is the most prevalent neurological complication of cancer treatment which involves sensory and motor nerve dysfunction. Severe CIPN has been reported in around 5% of patients treated with single and up to 38% of patients treated with multiple chemotherapeutic agents. Present medications available for CIPN are the use of opioids, nonsteroidal anti-inflammatory agents, and tricyclic antidepressants, which are only marginally effective in treating neuropathic symptoms. In reality, symptom reappears after these drugs are discontinued. The pathogenesis of CIPN has not been sufficiently recognized and methods for the prevention and treatment of CIPN remain vulnerable to therapeutic problems. It has witnessed that the present medicines available for the disease offer only symptomatic relief for the short term and have severe adverse side effects. There is no standard treatment protocol for preventing, reducing, and treating CIPN. Therefore, there is a need to develop curative therapy that can be used to treat this complication. Melittin is the main pharmacological active constituent of honeybee venom and has therapeutic values including in chemotherapeutic-induced peripheral neuropathy. It has been shown that melittin and whole honey bee venom are effective in treating paclitaxel and oxaliplatin-induced peripheral neuropathy. The use of melittin against peripheral neuropathy caused by chemotherapy has been limited despite having strong therapeutic efficacy against the disease. Melittin mediated haemolysis is the key reason to restrict its use. In our study, it is found that α-Crystallin (an eye lens protein) is capable of inhibiting melittin-induced haemolysis which gives hope of using an appropriate combination of melittin and α-Crystallin in the treatment of CIPN. The review summarizes the efforts made by different research groups to address the concern with melittin in the treatment of chemotherapeutic-induced neuropathy. It also focuses on the possible approaches to overcome melittin-induced haemolysis. Graphic Abstract

scholarly journals Neurochemical Effects of 4-(2Chloro-4-Fluorobenzyl)-3-(2-Thienyl)-1,2,4-Oxadiazol-5(4H)-One in the Pentylenetetrazole (PTZ)-Induced Epileptic Seizure Zebrafish Model

2021 ◽  
Vol 22 (3) ◽  
pp. 1285
Author(s):  
Seong Soon Kim ◽  
Hyemin Kan ◽  
Kyu-Seok Hwang ◽  
Jung Yoon Yang ◽  
Yuji Son ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Epileptic Seizure ◽  
Neurological Disorders ◽  
Aminobutyric Acid ◽  
Oxygen Species ◽  
Gamma Aminobutyric Acid ◽  
Zebrafish Model ◽  
Neuroprotective Effects ◽  
Drug Discovery And Development ◽  
Spontaneous Seizures

Epilepsy is one of the most common neurological disorders, and it is characterized by spontaneous seizures. In a previous study, we identified 4-(2-chloro-4-fluorobenzyl)-3-(2-thienyl)-1,2,4-oxadiazol-5(4H)-one (GM-90432) as a novel anti-epileptic agent in chemically- or genetically-induced epileptic zebrafish and mouse models. In this study, we investigated the anti-epileptic effects of GM-90432 through neurochemical profiling-based approach to understand the neuroprotective mechanism in a pentylenetetrazole (PTZ)-induced epileptic seizure zebrafish model. GM-90432 effectively improved PTZ-induced epileptic behaviors via upregulation of 5-hydroxytryptamine, 17-β-estradiol, dihydrotestosterone, progesterone, 5α -dihydroprogesterone, and allopregnanolone levels, and downregulation of normetanephrine, gamma-aminobutyric acid, and cortisol levels in brain tissue. GM-90432 also had a protective effect against PTZ-induced oxidative stress and zebrafish death, suggesting that it exhibits biphasic neuroprotective effects via scavenging of reactive oxygen species and anti-epileptic activities in a zebrafish model. In conclusion, our results suggest that neurochemical profiling study could be used to better understand of anti-epileptic mechanism of GM-90432, potentially leading to new drug discovery and development of anti-seizure agents.

Concrescence of the cervical vertebrae and neurological complications

2021 ◽  
pp. 195-201
Author(s):  
Sabiyat Abdulaevna Yakhyaeva ◽  
Naida Isagadzhievna Garabova ◽  
Madina Garunovna Burzhunova
Keyword(s):  
Cervical Spine ◽  
Clinical Practice ◽  
Research Methods ◽  
Neurological Disorders ◽  
Cervical Vertebrae ◽  
Clinical Manifestations ◽  
Neurological Complications ◽  
Timely Diagnosis ◽  
Number Of Patients ◽  
Genetically Determined

In clinical practice, a sufficiently large number of patients complain of neurological disorders caused by osteochondrosis of the cervical spine. Despite this, in some cases, the development and progression of this symptomatology may be due to an anomaly in the structure of the cervical spine (Klippel-Feil syndrome), which is genetically determined. Timely diagnosis of this pathology with the implementation of complex research methods allows you to develop individual tactics for each individual patient, taking into account the severity of clinical manifestations to slow the progression of complications.

scholarly journals Imaging findings of neurologic complications in lung transplantation: Review of a 9-year cohort

2021 ◽  
Vol 10 (8) ◽  
pp. 205846012110387
Author(s):  
Elena Marín-Díez ◽  
Marta Drake-Pérez ◽  
Natalia Valle-San Román ◽  
Víctor Manuel Mora Cuesta ◽  
Miguel Ángel Hernández-Hernández ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Therapeutic Option ◽  
Neurological Complication ◽  
Underlying Disease ◽  
Neurological Complications ◽  
Critical Illness Polyneuropathy ◽  
Imaging Findings ◽  
Post Transplant ◽  
Elevated Rate ◽  
Lung Transplant Recipients

Background Lung transplantation (LT) requires complex multidisciplinary organization and constitutes a therapeutic option and a life-saving procedure. Although the number of lung recipients continues to increase, neurological complications and death rates following lung transplantation are still higher than desirable. Purpose This study aims to analyse the neuroimaging findings in a cohort of adult patients with LT. Material and Methods A retrospective cohort study of all lung transplant recipients (344 patients: 205 men and 139 women) at a single institution from January 2011 to January 2020. The collected data included demographic features, clinical data and evaluation of the imaging findings. We also recorded the date of neurological complication(s) and the underlying disease motivating lung transplantation. Results We found an elevated rate of neuroimaging findings in patients following LT with 32.6% of positive studies. In our cohort, the average time after LT to a neurological complication was 4.9 months post-transplant. Encephalopathy, critical illness polyneuropathy and stroke, in that order, were the most frequent neurological complications. Structural abnormalities in brain imaging were more often detected using MRI than CT for indications of encephalopathy and seizures. Conclusions LT recipients constitute an especially vulnerable group that needs close surveillance, mainly during the early post-transplant period.

scholarly journals Evaluation of Teratogenic Activity of Antiepileptic Drug Lamotrigine in Mouse Fetuses

Folia Medica ◽  
2019 ◽  
Vol 61 (1) ◽  
pp. 84-89
Author(s):  
Gholam Reza Mobini ◽  
Abbas Karimi ◽  
Abolfazl Akbari ◽  
Forouzan Rahmani
Keyword(s):  
Risk Factor ◽  
Antiepileptic Drug ◽  
Congenital Abnormalities ◽  
Newborn Infants ◽  
Treatment Protocol ◽  
Teratogenic Effects ◽  
Increased Risk ◽  
Pregnant Mice ◽  
Mock Treatment ◽  
Mouse Fetuses

Abstract Background: Use of antiepileptic drugs during pregnancy can be associated with an increased risk of teratogenicity as well as congenital abnormalities. However, there are numerous discrepancies to determine whether lamotrigine, as an antiepileptic drug, can significantly induce malformation in newborn infants or not. Thus, the purpose of the study was to evaluate the teratogenic effects of lamotrigine on mouse fetuses. Materials and methods: In the present study, 21 pregnant mice were assigned to four groups. Groups 1 and 2 (controls) received mock treatment and ethanol 20%, respectively. Groups 3 and 4 (treatment) were intraperitoneally administered with 25 and 75 mg/kg lamotrigine for three days, respectively. The treatment protocol was performed within the gestational days of 9-18 in all groups. On gestational day 18, 117 fetuses were taken out of the fallopian tube of studied mice and then examined for any anomalies (vertebral, limbs and cranial), followed by a measurement of their height and weight. Results: The results revealed that, in the treated groups, the weight and the height had significantly decreased (p<0.01) and also various anomalies were evident. Moreover, as the dose of lamotrigine increased, the decrease in the weight and the height and rising trend in anomalies were intensified. Conclusion: According to the findings, lamotrigine (LTG) could be considered as a risk factor for the development of the anomalies examined.

scholarly journals Not All Embolizations Are Created Equally in the Management of Posterior Epistaxis: Discussion of Safety Measures Avoiding Neurological Complications

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Mareike Franke ◽  
Jasper Franke ◽  
Christian Saager ◽  
Sven Barthel ◽  
Randolf Riemann ◽  
...  
Keyword(s):  
Neurological Complication ◽  
Neurological Complications ◽  
Surgical Approaches ◽  
Success Rates ◽  
Artery Ligation ◽  
Retrospective Data Analysis ◽  
First Choice ◽  
Surgical Methods ◽  
Choice Of Treatment ◽  
Meta Analyses

Today, there are still no uniform guidelines for the treatment of epistaxis. Furthermore, it is widely debated whether embolization or surgical approaches should be the first choice of treatment for intractable posterior epistaxis after conservative measures have failed. In several meta-analyses, it is reported that endoscopic sphenopalatine artery ligation and embolization have similar success rates, but embolization was associated with more severe neurological complications. Regarding existing literature, there are many comparative analyses of surgical methods but none for embolization protocols. Against this backdrop of a lack of uniform standards in embolization techniques, we present a retrospective evaluation of what has emerged to be best procedural practice for endovascular treatment of epistaxis in our department using microsphere particles and microcoils, in particular regarding precaution measures to avoid neurological complications. In our retrospective data analysis of 141 procedures in 123 patients, performed between 2008 and 2019, we find success rates very similar to those reported in other studies (95.1% immediate-stop-of-bleeding success and 90.2% overall embolization success) but did not encounter any major neurological complication opposed to other reports. We suggest some aspects of our protocol as precaution measure to avoid neurological complications. More generally and perhaps even more importantly, we make a strong case for standardization for embolization techniques to the level of details in surgical procedure standardization to enable an apples to apples comparison of embolization techniques to each other and of intervention vs. surgery.

scholarly journals Multimodality MRI Findings in Patients with End-Stage Renal Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Hui Juan Chen ◽  
Long Jiang Zhang ◽  
Guang Ming Lu
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Neurological Disorders ◽  
Neurological Complications ◽  
Mri Findings ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Patients with end-stage renal disease (ESRD) suffer from a number of complex neurological complications including vascular damage and cognitive dysfunction. It is of great significance to detect the neurological complications and improve the prognosis of ESRD patients. Many new noninvasive MRI techniques have been steadily used for the diagnosis of occult central nervous system complications in ESRD patients. This gives an opportunity to understand the pathophysiological mechanisms of these neurological disorders. This paper is a review that presents the MRI findings of occult brain damage in ESRD patients, outlines the applications of advanced MRI techniques, and introduces a brief perspective in this study field.

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