scholarly journals Equilibrium disorders in elderly: diagnostic classification and differential diagnosis

2013 ◽  
pp. 16-22
Author(s):  
Alessandro Castiglione ◽  
Claudia Aimoni ◽  
Giovanni Scanelli
Keyword(s):  
Differential Diagnosis ◽  
Elderly Patients ◽  
Neurological Disorders ◽  
Sensory Input ◽  
Neurological Diseases ◽  
Specific Treatment ◽  
The Body ◽  
Diagnostic Classification ◽  
Main Challenge ◽  
Clinical Conditions

Background: Balance is primarily related to the proper functioning of three sensory input: vestibular, visual and proprioceptive. The integration of these different afferences contributes to the proper attitude of the body in static and dynamic conditions. Equilibrium disorders are common among elderly patients and are responsible for falls and fractures, leading sometimes to catastrophic outcomes, representing a serious health and social problem. Approximately one third of elderly patients at home and about 50% of institutionalized, over 75 year-old, suffer from this particular condition, with at least one fall a year and almost 50% of these with recurrent episodes. Females are more affected than males. Attempts to ascertain the underlying cause of unbalance should be done, leading then to specific treatment. Nevertheless, many elderly patients do not have a single disease but rather a multitude of medical conditions which may cause dizziness, imbalance and vertigo: effects of ageing, drugs, cardiovascular and neurological disorders, ocular and orthopaedic diseases. Aim of the study: A literature review was carried out with the intention to offer practical and useful notions for the management and treatment of equilibrium disorders. Discussion: In clinical practice, the main challenge is to distinguish between peripheral and central imbalance disorders. The data collected from history and clinical exams should be integrated with the intent to include the patient in one of the following clinical conditions: vertiginous syndrome, pre-syncope and/or syncope, neurological diseases, other conditions.Conclusions: Following the differential diagnosis, treatment mainly consists in drug administration (antiemetic and vestibular suppressor drugs) and vestibular rehabilitation (physiotherapy and vestibular exercises).

scholarly journals Store-Operated Calcium Channels in Physiological and Pathological States of the Nervous System

2020 ◽  
Vol 14 ◽  
Author(s):  
Isis Zhang ◽  
Huijuan Hu
Keyword(s):  
Nervous System ◽  
Calcium Channels ◽  
Neurological Disorders ◽  
Neurological Diseases ◽  
Physiological Role ◽  
The Body ◽  
Store Operated Calcium Entry ◽  
Important Pathway ◽  
Molecular Components

Store-operated calcium channels (SOCs) are widely expressed in excitatory and non-excitatory cells where they mediate significant store-operated calcium entry (SOCE), an important pathway for calcium signaling throughout the body. While the activity of SOCs has been well studied in non-excitable cells, attention has turned to their role in neurons and glia in recent years. In particular, the role of SOCs in the nervous system has been extensively investigated, with links to their dysregulation found in a wide variety of neurological diseases from Alzheimer’s disease (AD) to pain. In this review, we provide an overview of their molecular components, expression, and physiological role in the nervous system and describe how the dysregulation of those roles could potentially lead to various neurological disorders. Although further studies are still needed to understand how SOCs are activated under physiological conditions and how they are linked to pathological states, growing evidence indicates that SOCs are important players in neurological disorders and could be potential new targets for therapies. While the role of SOCE in the nervous system continues to be multifaceted and controversial, the study of SOCs provides a potentially fruitful avenue into better understanding the nervous system and its pathologies.

scholarly journals Gluten-free diet for neurological and psychiatric diseases: is it worth expecting an effect?

2021 ◽  
pp. 170-177
Author(s):  
Y. A. Dmitrieva ◽  
I. N. Zakharova ◽  
E. R. Radchenko ◽  
E. A. Doroshina
Keyword(s):  
Neurological Disorders ◽  
Neurological Diseases ◽  
Adaptive Immune Response ◽  
Chronic Fatigue ◽  
The Body ◽  
Gluten Free Diet ◽  
Molecular Characteristics ◽  
Gluten Free ◽  
Immunological Mechanisms ◽  
Objective Evidence

Gluten represents an alcohol- soluble fraction of endosperm proteins of some cereals (wheat, rye, barley). The molecular characteristics of gluten, in particular, the high content of proline in the composition, determines its high resistance to human gastric, pancreatic and intestinal enzymes. Accordingly, gluten peptides retain their immunogenicity when they enter the internal environment of the body, which determines their ability to activate both the innate and adaptive immune response, and maintain pathological immune- mediated reactions that underlie the complex of gluten- associated diseases and pathological conditions. The question of how gluten consumption may be associated with various neurological disorders continues to be discussed. Despite the lack of sufficient objective evidence, the peculiarities of gliadin metabolism suggest the possibility of an association between the consumption of gluten- containing products with the development of neuropsychiatric disorders.. Of particular interest is the efficacy of gluten-free diet in the complex therapy of such diseases as autism, schizophrenia, as well as some neurological disorders, including chronic fatigue syndrome, various cognitive impairments, depression, etc. The article presents a number of research results, as well as discusses the potential mechanisms of the neurotropic action of gluten. The article discusses the potential metabolic and immunological mechanisms of the neurotropic action of gluten, analyzes the literature data regarding the effectiveness of a gluten-free diet in various neurological diseases and psychiatric disorders.

scholarly journals Microglia and astrocyte involvement in neurodegeneration and brain cancer

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Arthur A. Vandenbark ◽  
Halina Offner ◽  
Szymon Matejuk ◽  
Agata Matejuk
Keyword(s):  
Neurological Disorders ◽  
Neurological Diseases ◽  
The Body ◽  
Normal Brain ◽  
Key Factors ◽  
Therapeutic Outcomes ◽  
Brain Structure And Function ◽  
And Function ◽  
Different Origins ◽  
Frontotemporal Lobar Dementia

AbstractThe brain is unique and the most complex organ of the body, containing neurons and several types of glial cells of different origins and properties that protect and ensure normal brain structure and function. Neurological disorders are the result of a failure of the nervous system multifaceted cellular networks. Although great progress has been made in the understanding of glia involvement in neuropathology, therapeutic outcomes are still not satisfactory. Here, we discuss recent perspectives on the role of microglia and astrocytes in neurological disorders, including the two most common neurodegenerative conditions, Alzheimer disease and progranulin-related frontotemporal lobar dementia, as well as astrocytoma brain tumors. We emphasize key factors of microglia and astrocytic biology such as the highly heterogeneic glial nature strongly dependent on the environment, genetic factors that predispose to certain pathologies and glia senescence that inevitably changes the CNS landscape. Our understanding of diverse glial contributions to neurological diseases can lead advances in glial biology and their functional recovery after CNS malfunction.

scholarly journals Firm mass in thyroid of an elderly patient: not always cancer

2020 ◽  
Vol 2020 ◽  
Author(s):  
Alessandro Prete ◽  
Giada Cosentino ◽  
Luca Manetti ◽  
Carlo Enrico Ambrosini ◽  
Piermarco Papini ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Elderly Patients ◽  
Oral Antibiotic ◽  
List Type ◽  
Suppurative Thyroiditis ◽  
Pathological Analysis ◽  
Inflammatory Status ◽  
Thyroid Mass ◽  
Acute Suppurative Thyroiditis ◽  
Clinical Conditions

Summary In elderly patients presenting with a solid thyroid mass, the differential diagnosis between benign and malignant lesion is not always straightforward. We present the case of an 85-year-old woman with fever and an enlarged, firm and painful thyroid mass. Blood exams documented a mild thyrotoxicosis with a moderate inflammatory status. Thyroid scintiscan showed an absent uptake of 131I. Ultrasound and CT scan documented a 3 cm hypoechoic nodule with infiltration of the sternocleidomastoid muscle, very suspicious for neoplastic nature. Fine-needle aspiration and tru-cut biopsy were performed. During biopsy, the lesion was partially drained and a brownish fluid was extracted. The culture resulted positive for Klebsiella pneumoniae whereas the pathological analysis of the specimen was not conclusive due to the presence of an intense inflammatory response. A targeted oral antibiotic therapy was then initiated, obtaining only a partial response thus, in order to achieve a definite diagnosis, a minimally invasive hemithyroidectomy was performed. The pathological analysis documented acute suppurative thyroiditis and the clinical conditions of the patient significantly improved after surgical removal of thyroid abscess. In elderly patients with a solid thyroid mass, although neoplastic origin is quite frequent, acute suppurative thyroiditis should be considered as a differential diagnosis. Learning points: A solid and rapidly growing thyroid mass in elderly patients can hide a multifaceted variety of diseases, both benign and malign. A multidisciplinary team (endocrinologist, surgeon, radiologist and pathologist) could be necessary in order to perform a correct differential diagnosis and therapeutic approach. Surgery can be decisive not only to clarify a clinically uncertain diagnosis, but also to rapidly improve the clinical conditions of the patient.

scholarly journals STEM CELLS THERAPY IN HUMAN WELFARE AND DISEASE

2020 ◽  
Vol 7 (2) ◽  
pp. 229-234
Author(s):  
Ravi Prakash ◽  
Santosh Kumar Yadav ◽  
Syed Shadab Raza
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Neurological Disorders ◽  
Therapeutic Potential ◽  
Neurological Diseases ◽  
The Body ◽  
Human Welfare ◽  
Developmental Issues ◽  
Cell Based Therapy ◽  
Stem Cells Therapy

The study Global Burden of Disease (GBD) drew international healthcare community's attention to the burden of neurological disorders and many other chronic conditions. This study highlighted that the burden of neurological disorders was seriously underrated by traditional epidemiological and health statistical methods that prefer only mortality rates but not disability rates. There has recently been a great deal of interest in stem cells and the nervous system, in terms of their potential for deciphering developmental issues as well as their therapeutic potential. With the advancement in cell culture, isolation techniques, and molecular analyses, various types of stem cells have now been broadly classified, isolated, and characterized from different parts of the body, even from brain and heart. The concept of stem cell-based therapy provided new hope for the treatment of neurological diseases. In this review we will discuss about ongoing stem cell therapy for neurodegenerative disease.

DIAGNOSTICS AND TREATMENT OF POISONING WITH THALLIUM

2018 ◽  
pp. 9-15 ◽  
Author(s):  
L. B. Zavaliy ◽  
A. Yu. Simonova ◽  
M. M. Potskhveriya ◽  
Yu. N. Ostapenko ◽  
M. G. Gadzhieva ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Clinical Picture ◽  
Clinical Guidelines ◽  
The Body ◽  
Biological Media ◽  
Pathophysiological Mechanisms ◽  
Thallium Poisoning ◽  
The World

Cases of thallium poisonings are regularly reported in media. In the present work, the world experience in diagnostics and treatment of victims with thallium poisoning has been compiled and summarized, search for clinical guidelines for the diagnostics, treatment and rehabilitation of patients has been carried out. The toxicokinetics and toxicodynamics, as well as pathophysiological mechanisms of thallium influence on the body are described in detail. Toxic and lethal concentrations of poison in biological media, as well as its tropicity to various tissues and body systems were determined. The clinical picture depending on the timing of poisoning and the dose of poison is described in detail. Difficulties of the differential diagnosis are defined. The most interesting cases of criminal and household poisonings with various terms of establishment of the diagnosis, doses of poisoning and outcomes are presented.

Microbiota-Immune System Interactions in Human Neurological Disorders

2020 ◽  
Vol 19 (7) ◽  
pp. 509-526
Author(s):  
Qin Huang ◽  
Fang Yu ◽  
Di Liao ◽  
Jian Xia
Keyword(s):  
Immune System ◽  
Gut Microbiota ◽  
Neurological Disorders ◽  
Brain Function ◽  
Neurological Diseases ◽  
Host Immune System ◽  
Gut Dysbiosis ◽  
Characteristic Features ◽  
Novel Therapeutic Strategies

: Recent studies implicate microbiota-brain communication as an essential factor for physiology and pathophysiology in brain function and neurodevelopment. One of the pivotal mechanisms about gut to brain communication is through the regulation and interaction of gut microbiota on the host immune system. In this review, we will discuss the role of microbiota-immune systeminteractions in human neurological disorders. The characteristic features in the development of neurological diseases include gut dysbiosis, the disturbed intestinal/Blood-Brain Barrier (BBB) permeability, the activated inflammatory response, and the changed microbial metabolites. Neurological disorders contribute to gut dysbiosis and some relevant metabolites in a top-down way. In turn, the activated immune system induced by the change of gut microbiota may deteriorate the development of neurological diseases through the disturbed gut/BBB barrier in a down-top way. Understanding the characterization and identification of microbiome-immune- brain signaling pathways will help us to yield novel therapeutic strategies by targeting the gut microbiome in neurological disease.

scholarly journals Speech Processing Disorder in Neural Hearing Loss

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Joseph P. Pillion
Keyword(s):  
Speech Processing ◽  
Auditory Processing ◽  
Neurological Disorders ◽  
Auditory Neuropathy ◽  
Central Auditory Processing ◽  
Temporal Lobes ◽  
Electrophysiological Tests ◽  
Bilateral Lesions ◽  
Clinical Conditions ◽  
Inferior Colliculi

Deficits in central auditory processing may occur in a variety of clinical conditions including traumatic brain injury, neurodegenerative disease, auditory neuropathy/dyssynchrony syndrome, neurological disorders associated with aging, and aphasia. Deficits in central auditory processing of a more subtle nature have also been studied extensively in neurodevelopmental disorders in children with learning disabilities, ADD, and developmental language disorders. Illustrative cases are reviewed demonstrating the use of an audiological test battery in patients with auditory neuropathy/dyssynchrony syndrome, bilateral lesions to the inferior colliculi, and bilateral lesions to the temporal lobes. Electrophysiological tests of auditory function were utilized to define the locus of dysfunction at neural levels ranging from the auditory nerve, midbrain, and cortical levels.

scholarly journals Epigenetic Regulation of Cannabinoid-Mediated Attenuation of Inflammation and Its Impact on the Use of Cannabinoids to Treat Autoimmune Diseases

2021 ◽  
Vol 22 (14) ◽  
pp. 7302
Author(s):  
Bryan Latrell Holloman ◽  
Mitzi Nagarkatti ◽  
Prakash Nagarkatti
Keyword(s):  
Autoimmune Diseases ◽  
Chronic Inflammation ◽  
Cannabinoid Receptors ◽  
T Regulatory Cells ◽  
Neurological Diseases ◽  
Suppressor Cells ◽  
The Body ◽  
New Class ◽  
Wide Range ◽  
Clinical Disorders

Chronic inflammation is considered to be a silent killer because it is the underlying cause of a wide range of clinical disorders, from cardiovascular to neurological diseases, and from cancer to obesity. In addition, there are over 80 different types of debilitating autoimmune diseases for which there are no cure. Currently, the drugs that are available to suppress chronic inflammation are either ineffective or overtly suppress the inflammation, thereby causing increased susceptibility to infections and cancer. Thus, the development of a new class of drugs that can suppress chronic inflammation is imperative. Cannabinoids are a group of compounds produced in the body (endocannabinoids) or found in cannabis (phytocannabinoids) that act through cannabinoid receptors and various other receptors expressed widely in the brain and immune system. In the last decade, cannabinoids have been well established experimentally to mediate anti-inflammatory properties. Research has shown that they suppress inflammation through multiple pathways, including apoptosis and inducing immunosuppressive T regulatory cells (Tregs) and myeloid-derived suppressor cells (MDSCs). Interestingly, cannabinoids also mediate epigenetic alterations in genes that regulate inflammation. In the current review, we highlight how the epigenetic modulations caused by cannabinoids lead to the suppression of inflammation and help identify novel pathways that can be used to target autoimmune diseases.

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