scholarly journals Cardioprotective Therapy in the Practice of an Anaesthesiologist

2020 ◽  
Author(s):  
Arina Viacheslavovna Balan
Keyword(s):  
Neurological Status ◽  
Underlying Disease ◽  
Research Papers ◽  
Vital Functions ◽  
Level Of Consciousness ◽  
Life Threatening ◽  
Published Research ◽  
The Brain ◽  
Careful Assessment

All components of anaesthesia have a direct or indirect depressing effect on the myocardium and functional activity of the brain. Given the initial failure of the coronary blood flow, life-threatening disorders of the heart are possible. The higher the severity of the underlying disease, the greater the risk of transient neurological deficit, stroke. Extended continuous monitoring of vital functions, careful assessment of the neurological status of the patient with special attention to the level of consciousness, the presence or absence of symptoms of increased ICP is necessary. The purpose of this study is to evaluate the beneficial effect of cardioprotectors Mexicor, Meldonium in the fight against ischemia in patients with CHD, GB in the department of surgical profile. The following methods have been used: review of literature, previously published research papers. Results: this article discusses the main drugs with cardioprotective properties, describes the positive experience of using them by specialists, and proves the effectiveness of using drugs in the long term.

Heavy Metals Pollution and Its Studies in Coimbatore District, Tamil Nadu

2021 ◽  
pp. 338-356
Author(s):  
Rajendrakumar S. ◽  
Ramachandran V. S.
Keyword(s):  
Heavy Metals ◽  
Tamil Nadu ◽  
Ground Surface ◽  
Research Papers ◽  
Animal Products ◽  
Coimbatore District ◽  
Heavy Metals Pollution ◽  
Research Organisations ◽  
Published Research

This chapter is a review of published research papers, books, book chapters, unpublished scientific reports prepared by research organisations, and expert talk about heavy metal pollution. This chapter also summarises the research studies conducted in Coimbatore and a summary of the studies says that very tiny information is available on heavy metals in soil, water, and air components. Till now heavy metals in plants, plant products, animals, animal products, bioaccumulation in humans, and its impacts are not accounted in this region. Further, these chapters identify the research gaps, and research interventions are required to assess the heavy metals contaminations in different ecosystems. It also highlights the need for long-term monitoring of heavy metals in the ground, surface water, food materials, agricultural products produced in the contaminated regions. The chapter concludes with a need for study on human health impacts, restoration, and remediation measures required in Coimbatore regions.

scholarly journals Multipattern botulinum toxin therapy of post-comatose long-term consciousness disorders: central effects

2019 ◽  
Vol 21 (2) ◽  
pp. 78-87
Author(s):  
Yu I Vainshenker ◽  
V A Zinserling ◽  
L A Melucheva ◽  
V V Bobrova ◽  
A D Korotkov ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Functional State ◽  
Proliferating Cells ◽  
Gradual Improvement ◽  
Consciousness Disorders ◽  
Positron Emission ◽  
Botulinum Toxin Therapy ◽  
Level Of Consciousness ◽  
The Brain

The data of electroencephalography, evoked potentials of the brain and positron emission tomography are analyzed before and 3 weeks after the multipattern botulinum toxin therapy of spasticity in 25 patients with post-comatose long-term consciousness disorders, including one patient who died against the backdrop gradual improvement of consciousness from acute heart failure four months after the end of second course of multipattern botulinum toxin therapy. Found that improvements of the brain functional state against the backdrop of reduced spasticity were observed regardless of primary brain damage origin, level of consciousness and of multipattern botulinum toxin therapy course repeatability. The observed dynamics of neurophysiological indicators had a normalizing direction, some differences associated with the initial level of consciousness. Electrophysiological changes during the improvement of consciousness against the background of multipattern botulinum toxin therapy were not specific. Features of improving energy metabolism in the certain areas of the brain could be caused by just such treatment, and reflected the contribution of pathological sensorimotor integration in maintaining impaired consciousness. Postmortem neuromorphological study of the patient brain identified progenitor stem and proliferating cells and newly formed neurons in brain areas whose in-life functional state was continuously improving, newly formed neurons migrating flow through the corpus callosum and diffuse activation of axonogenesis. We assume that the central effect of multipattern botulinum toxin therapy associated with improvement of consciousness, may be a double. The first is immediate, due to a decrease in pathological afferentation from the muscles, the second - apparently deferred and prolonged, manifested in the activation of functional neurogenesis and axonogenesis in the brain. The continuation of complex multimodal research on the study of post-comatose long-term consciousness disorders seems promising.

Severe Hypomagnesemia with Long-Term Use of a Proton Pump Inhibitor: A Case Report

2015 ◽  
Vol 10 (3) ◽  
Author(s):  
Amy M Trottier MSc MD ◽  
Paul S Gibson MD FRCPC
Keyword(s):  
Proton Pump ◽  
Hormone Level ◽  
Serum Magnesium ◽  
Electrolyte Disorders ◽  
Annual Basis ◽  
Level Of Consciousness ◽  
Life Threatening ◽  
Baseline Testing ◽  
Electrolyte Abnormalities

Hypomagnesemia is a rare, though likely under-recognized, adverse effect of long-term use of proton pump inhibitors (PPIs), one of the most commonly prescribed classes of medications in North America. Hypomagnesemia can cause potentially life-threatening neurologic abnormalities, cardiac arrhythmias, and secondary electrolyte disorders. In this manuscript we present the case of a long-term PPI user who presented with an episode of decreased level of consciousness. He was found to have severe hypomagnesemia with avid renal retention of magnesium, secondary hypocalcemia with an inappropriately normal parathyroid hormone level, and hypokalemia. His serum magnesium and other electrolyte abnormalities rapidly corrected with cessation of PPI use and electrolyte supplementation. Given the propensity for patients with hypomagnesemia associated with PPI use to go unrecognized until they present with severe symptomatic hypomagnesemia, we recommend that patients being started on a PPI for an intended long-term course have baseline testing of serum magnesium and monitoring of magnesium on an annual basis, or sooner, if they develop symptoms.

scholarly journals Unpredicted Sudden Death due to Recurrent Infratentorial Hemangiopericytoma Presenting as Massive Intratumoral Hemorrhage: A Case Report and Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Toshihide Tanaka ◽  
Naoki Kato ◽  
Yuzuru Hasegawa ◽  
Yuichi Murayama
Keyword(s):  
Sudden Death ◽  
Neurological Status ◽  
Massive Hemorrhage ◽  
Long Term Follow Up ◽  
Life Threatening ◽  
Morning Headache ◽  
Cranial Fossa ◽  
The Right

Unpredicted sudden death arising from hemangiopericytoma with massive intracranial hemorrhage is quite rare. We encountered a patient with recurrent infratentorial hemangiopericytoma presenting as life-threatening massive intracerebral hemorrhage. A 43-year-old man who had undergone craniotomy for total resection of an infratentorial hemangiopericytoma 17 months earlier presented with morning headache and generalized convulsions. Computed tomography revealed a massive hematoma in the right infratentorial region causing tonsillar herniation and emergency surgery was performed to evacuate the hematoma. Histological findings revealed hemangiopericytoma with hemorrhage. Neurological status remained unimproved and brain death was confirmed postoperatively. Hemangiopericytoma presenting as massive hemorrhage is quite rare. Since the risk of life-threatening massive hemorrhage should be considered, careful postoperative long-term follow-up is very important to identify tumor recurrences, particularly in the posterior cranial fossa, even if the tumor is completely removed.

scholarly journals Rehabilitation of Patients with Long-Term Complications of Mild Closed Traumatic Brain Injuries Using Sensory Deprivation

2020 ◽  
Vol 62 (4) ◽  
pp. 216-220
Author(s):  
Volodymyr O. Korshnyak ◽  
Tetyana A. Donnik
Keyword(s):  
Nervous System ◽  
Brain Injuries ◽  
Sensory Deprivation ◽  
Neurological Status ◽  
Traumatic Brain Injuries ◽  
The Body ◽  
Vegetative Nervous System ◽  
Ability To Act ◽  
Vital Functions

Introduction: This study’s primary goal was to develop and implement a new non-pharmacological method of therapy to increase the effectiveness of rehabilitation treatment of patients with long-term complications of mild closed traumatic brain injuries. Material and Methods: We examined 100 patients with complications of mild closed traumatic brain injuries in the stage of decompensation. We studied the dynamics of subjective and objective neurological symptoms, vegetative indices (vegetative tonus, vegetative responsiveness, vegetative provisioning), and neuro mediators levels (adrenaline, noradrenaline, serotonin, dopamine, and melatonin) before and after sensory deprivation. Results: During rehabilitation, we observed the positive changes in neurological status as well as in the balance restoration of the nervous system and the neurohormonal normalization of the sympathoadrenal system. It contributed to a more adequate generalized adaptive response of the body. After a series of rehabilitation procedures, the difference between the maximal and control markers of melatonin excretion significantly decreased, which might confirm the evidence of normalization of the processes’ rhythmicity and vital functions, as well as the improvement of complex neuroprotection. Also, the normalization of melatonin excretion in patients was associated with sleep improvement, decreased intensity of the headache syndromes, and increased activity and ability to act. Conclusions: Long-term complications of mild closed traumatic brain injury develop due to activity imbalance of supratentorial structures of the vegetative nervous system, desynchronization of the cortex’s activity, and desynchronization of humoral mechanisms of vegetative activity realization. The use of sensory deprivation promotes much faster rehabilitation of this group of patients, reduces the pharmacological burden on the patient’s body, and improves the brain system’s functioning.

scholarly journals Analysis of immediate and long-term outcomes of perimesencephalic subarachnoid hemorrhage according to the hospital register data

2020 ◽  
pp. 8-14
Author(s):  
A. A. Kulesh ◽  
V. E. Drobakha ◽  
Ju. A. Nurieva ◽  
V. V. Shestakov
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Functional Limitations ◽  
Neurological Status ◽  
Frequency Of Occurrence ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Perimesencephalic Subarachnoid Hemorrhage ◽  
Stroke Center ◽  
The Brain

Introduction. Perimesencephalic subarachnoid hemorrhage (PMSAH) accounts for approximately half of all cases of non-aneurysmal hemorrhage, has a typical pattern on computed tomography (CT) of the brain, and favorable clinical course. Moreover, in the domestic literature there are no studies devoted to this problem.The purpose of the study: to study the frequency of occurrence, clinical and CT features of PMSAH in comparison with nonaneurismatic non-PMSAH according to the hospital register of the regional stroke center.Materials and methods. The data of 383 patients who underwent treatment with a diagnosis of spontaneous SAH in the regional stroke center of Perm Clinical Hospital №4 in 2014–2019 were analyzed. All patients underwent a standard examination, including CT of the brain and digital selective angiography (DSA). According to the pattern of SAH on CT, patients are divided into the groups PM-1 (isolated preptine), PM-2 (traditional) and PM-3 (diffuse). Evaluation of the long-term outcome was carried out using a telephone interview, as well as according to the regional electronic medical system.Results. Of 383 patients with SAH, aneurysms were identified in 350 patients (91,3%). Non-aneurysmal SAH was found in 20 patients (5,2%), in 8 patients (2,1%) − PMSAH. The age of patients averaged 48 years, women predominated. Intense headache in the onset of the disease was observed in the vast majority of patients. Nausea was significantly more often observed in patients with PMSAР (50%) compared with patients with non-PMSAР (8,3%). Loss of consciousness occurred in every fourth patient with PMSAР and only 8% of patients with non-PMSAH. The neurological status of the patients also did not differ and was characterized by a normal consciousness, meningeal syndrome (in 63% of patients with PMSAH) in the absence of focal symptoms. The level of neurological deficit according to NIHSS averaged 0 points, the severity of SAH on the Hunt-Hess scale averaged 2 points. At the time of completion of treatment, most patients did not have a neurological and functional deficit. According to CT, in 4 patients (50%), PM-2 was visualized, in 3 patients (38%) − PM-3, and in one patient − PM-1 (12%). On average, after 15 months, none of the treated patients developed repeated SAH, patients did not have functional limitations.Conclusions. This study for the first time made it possible to characterize the approximate frequency of occurrence, clinical and CT picture, as well as the long-term prognosis of PMSAH in a cohort of patients from a large regional stroke center in Russia.

The unconscious patient

2020 ◽  
pp. 5901-5908
Author(s):  
David Bates
Keyword(s):  
Specific Treatment ◽  
Systemic Infection ◽  
Bowel Function ◽  
Irreversible Damage ◽  
Metabolic Derangement ◽  
Skin Circulation ◽  
Level Of Consciousness ◽  
Traumatic Coma ◽  
The Brain

Prolonged loss of consciousness (coma, defined as a Glasgow Coma Score of 8 or less) is seen commonly: (1) following head injury, (2) after an overdose of sedating drugs, and (3) in the situation of ‘non-traumatic coma’, where there are many possible diagnoses, but the most common are postanoxic, postischaemic, systemic infection, and metabolic derangement (e.g. hypoglycaemia). Urgent assessment is required to identify and, where possible, correct the pathological cause, and protect the brain from the development of irreversible damage. Specific treatment (if any) will depend upon the particular cause of coma, but—whatever the cause—long-term attention is required to the patient’s respiration, skin, circulation, and bladder and bowel function, seizures must be controlled, and the level of consciousness should be regularly assessed and monitored.

Delir erkennen in 3 Schritten

2019 ◽  
Vol 144 (23) ◽  
pp. 1619-1628
Author(s):  
Rebecca von Haken ◽  
Hans-Christian Hansen
Keyword(s):  
Hospital Setting ◽  
Altered Mental Status ◽  
Altered Level ◽  
Curative Therapy ◽  
Medical Interventions ◽  
Operative Care ◽  
Level Of Consciousness ◽  
Triggering Mechanisms ◽  
The Brain

Abstract Background Clinicians are commonly confronted with the differential diagnosis of altered mental status, impaired cognition and altered level of consciousness in hospitalized patients including those admitted to medical, geriatric, emergency, intensive and post-operative care units. Although delirium is the most common acute neuropsychiatric condition in the acute hospital setting this diagnosis is commonly delayed, made too late or missed altogether. Difficulties and importance of timely diagnosis The causes of delirious states are manifold. Both, direct damage to the brain tissue as well as encephalopathy as a result of other medical diseases, can be the cause of delirium. Depending on the predisposition delirious syndromes can be provoked by minor medical interventions. Clinical presentation is very variable, but remains largely independent of the triggering mechanisms. Purely catatonic, hypoactive, hyperactive and excitatory types as well as mixed forms can be distinguished.Immediate diagnosis of a delirious syndrome and rapid elucidation of its causes are keys for the implementation of curative therapy. There is a need to act fast because delirious phases are associated with significantly longer hospital stay and increased morbidity as a result of long-term cognitive deficits as well as increased mortality. As negative outcome is closely linked to the duration of a delirious episode, early diagnosis and rapid termination of the delirium constitute a significant positive predictor of outcome. In this respect, delirium represents an emergency, with or without concomitant cerebral or extracerebral symptoms.

The Acute Effect of Alcohol on Various Memory Processes

2010 ◽  
Vol 24 (4) ◽  
pp. 249-252 ◽  
Author(s):  
Márk Molnár ◽  
Roland Boha ◽  
Balázs Czigler ◽  
Zsófia Anna Gaál
Keyword(s):  
Low Dose ◽  
Short Term Memory ◽  
Acute Effect ◽  
Long Term Memory ◽  
Term Memory ◽  
Memory Processes ◽  
Different Types ◽  
The Brain ◽  
Legal Consequences

This review surveys relevant and recent data of the pertinent literature regarding the acute effect of alcohol on various kinds of memory processes with special emphasis on working memory. The characteristics of different types of long-term memory (LTM) and short-term memory (STM) processes are summarized with an attempt to relate these to various structures in the brain. LTM is typically impaired by chronic alcohol intake but according to some data a single dose of ethanol may have long lasting effects if administered at a critically important age. The most commonly seen deleterious acute effect of alcohol to STM appears following large doses of ethanol in conditions of “binge drinking” causing the “blackout” phenomenon. However, with the application of various techniques and well-structured behavioral paradigms it is possible to detect, albeit occasionally, subtle changes of cognitive processes even as a result of a low dose of alcohol. These data may be important for the consideration of legal consequences of low-dose ethanol intake in conditions such as driving, etc.

Moving past the vaccine/autism controversy - to examine potential vaccine neurological harms

2020 ◽  
pp. 1-15
Author(s):  
Peter R. Breggin
Keyword(s):  
Neurological Disorders ◽  
Developmental Disorder ◽  
Physical Symptoms ◽  
Psychosocial Disorders ◽  
The Us ◽  
Potential Vaccine ◽  
Research And Education ◽  
The Brain ◽  
New Vaccines

BACKGROUND: The vaccine/autism controversy has caused vast scientific and public confusion, and it has set back research and education into genuine vaccine-induced neurological disorders. The great strawman of autism has been so emphasized by the vaccine industry that it, and it alone, often appears in authoritative discussions of adverse effects of the MMR and other vaccines. By dismissing the chimerical vaccine/autism controversy, vaccine defenders often dismiss all genuinely neurological aftereffects of the MMR (measles, mumps, and rubella) and other vaccines, including well-documented events, such as relatively rare cases of encephalopathy and encephalitis. OBJECTIVE: This report explains that autism is not a physical or neurological disorder. It is not caused by injury or disease of the brain. It is a developmental disorder that has no physical origins and no physical symptoms. It is extremely unlikely that vaccines are causing autism; but it is extremely likely that they are causing more neurological damage than currently appreciated, some of it resulting in psychosocial disabilities that can be confused with autism and other psychosocial disorders. This confusion between a developmental, psychosocial disorder and a physical neurological disease has played into the hands of interest groups who want to deny that vaccines have any neurological and associated neuropsychiatric effects. METHODS: A review of the scientific literature, textbooks, and related media commentary is integrated with basic clinical knowledge. RESULTS: This report shows how scientific sources have used the vaccine/autism controversy to avoid dealing with genuine neurological risks associated with vaccines and summarizes evidence that vaccines, including the MMR, can cause serious neurological disorders. Manufacturers have been allowed by the US Food and Drug Administration (FDA) to gain vaccine approval without placebo-controlled clinical trials. CONCLUSIONS: The misleading vaccine autism controversy must be set aside in favor of examining actual neurological harms associated with vaccines, including building on existing research that has been ignored. Manufacturers of vaccines must be required to conduct placebo-controlled clinical studies for existing vaccines and for government approval of new vaccines. Many probable or confirmed neurological adverse events occur within a few days or weeks after immunization and could be detected if the trials were sufficiently large. Contrary to current opinion, large, long-term placebo-controlled trials of existing and new vaccines would be relatively easy and safe to conduct.

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