Is there a rendezvous for SARS-CoV-2 and Agmatine?

The catastrophe of the ongoing COVID-19 pandemic is caused by Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2). The respiratory system appears to be ground zero in the majority of the patients. However, many other organs can get infected by cytokines, chemokines and other mediators released in response to the presence of the virus. The neurotropism by the SARS-CoV-2 is established beyond doubt. In addition to non-specific symptoms, the symptoms specific to central and/or peripheral nervous system diseases as well as neuromuscular diseases have been observed in numerous clinical cases. These observations and the experiences with other coronavirus infections earlier and flu pandemics raise concerns not only about the neurological effects in active disease but also about the long-term effects generated by the infection, immune and inflammatory functions. The knowledge of biological actions of agmatine in the backdrop of physiological events instigated by invading SARS-CoV-2 and host’s response, especially in neural events, focuses on the possible overlaps of biomolecular pathways at a number of instances. This is not surprising since the factors stimulated during SARS-CoV-2 infection are the disease-generating neuroinflammatory components altered by agmatine. Hence, we hypothesize the possible beneficial role of agmatine in SARS-CoV-2 infection. Based on a narrative review of the literature, agmatine can be proposed as a plausible beneficial candidate for supporting treatment of SARS-CoV-2 infection and for addressing post-infection neurological complications.

Neuropatia de fibras finas na doença de Wilson: revisão de literatura / Small fiber neuropathy in Wilson's disease: literature review

Introdução: A neuropatia periférica é um distúrbio neurológico bastante comum e vem aumentando sua prevalência devido ao processo de envelhecimento da população e aumento de comorbidades como diabetes e obesidade. A neuropatia periférica de fibras finas (NFF) é considerada uma síndrome que apresenta manifestações sensitivas isoladas, ou a combinação de manifestações sensitivas e autonômicas. A doença de Wilson (DW) é um transtorno autossômico recessivo causado por deficiência na metabolização do cobre decorrente de mutações no gene ATP7B. Entre as alterações neurológicas apresentadas pelos pacientes com DW está a neuropatia periférica. Objetivo: Revisar a literatura acerca da neuropatia de fibras finas na Doença de Wilson aumentando a compreensão dessa disfunção sobre suas causas e tipos de abordagens apresentadas na literatura. Métodos: Foi realizada uma revisão bibliográfica a partir do levantamento de dados presente nas bases de dados Scielo e PUBMED no período de janeiro a junho de 2021, utilizando os descritores: “Small Fiber Neuropathy”, “Wilson’s Disease”, “Peripheral Neuropathy". Resultados: Foram selecionados 29 artigos, cujos originais foram utilizados para composição deste estudo. Para melhor compreensão, os resultados encontrados no levantamento bibliográfico foram divididos em tópicos. Dos 29 artigos recrutados 15 foram excluídos, pois apresentavam outras doenças de base que pudessem justificar a presença de neuropatia além da doença de Wilson. Dos 14 artigos incluídos na pesquisa: 3 descreveram a presença de neuropatia de fibras finas na DW, 4 artigos destacaram a presença de leve polineuropatia sensitivo motora axonal na DW, 7 artigos mostraram evidência de neuropatia autonômica, sendo 2 com disfunção predominantemente simpática e 1 parassimpática. Conclusão: Neuropatia de fibras finas permanece como um diagnóstico desafiador na literatura, podendo estar presente em formas leves, mesmo em doenças com envolvimento predominante do SNC. Na DW também há relatos desse acometimento neurológico periférico, com predomínio de envolvimento de fibras finas autonômicas de repercussões ainda não completamente compreendidas. A compreensão dessa disfunção ainda não está totalmente esclarecida e ainda há muitas coisas a serem compreendidas sobre a doença de Wilson, portanto faz-se necessário mais estudo sobre essa temática uma vez que ainda é escasso na literatura estudos que abordem esse assunto mesmo havendo aumento do número de casos diagnosticados com doença de Wilson e que apresentam queixas sensitivas associadas. Palavras chave: Neuropatia de fibras finas, Doença de Wilson, Doenças do sistema nervoso periférico, Neuropatias periféricas Abstract Introduction: Peripheral neuropathy is a very common neurological disorder and its prevalence is increasing due to the aging process of the population and the increase in comorbidities such as diabetes and obesity. Fine fiber peripheral neuropathy (NFF) is considered a syndrome that presents isolated sensory manifestations, or a combination of sensory and autonomic manifestations. Wilson's disease (WD) is an autosomal recessive disorder caused by impaired copper metabolism due to mutations in the ATP7B gene. Among the neurological alterations presented by patients with WD is peripheral neuropathy. Objective: To review the literature about thin fiber neuropathy in Wilson's Disease, increasing the understanding of this dysfunction about its causes and types of approaches presented in the literature. Methods: A literature review was carried out based on the data survey present in the Scielo and PUBMED databases from January to June 2021, using the descriptors: "Small Fiber Neuropathy", "Wilson's Disease", "Peripheral Neuropathy". Results: 29 articles were selected, whose For a better understanding, the results found in the literature review were divided into topics.From 29 recruited articles, 15 were excluded, as they had other underlying diseases that could justify the presence of neuropathy in addition to Wilson's disease. Of the 14 articles included in the research: 3 described the presence of fine fiber neuropathy in WD, 4 articles highlighted the presence of mild axonal sensory motor polyneuropathy in WD, 7 articles showed evidence of autonomic neuropathy, 2 with predominantly sympathetic dysfunction and 1 parasympathetic. Conclusion: Fine fiber neuropathy remains a challenging diagnosis in the field. and may be present in mild forms, even in diseases with predominant involvement of the CNS. In WD there are also reports of this peripheral neurological involvement, with a predominance of involvement of thin autonomic fibers with repercussions that are not yet completely understood. The understanding of this dysfunction is still not fully clarified and there are still many things to be understood about Wilson's disease, so further study on this topic is necessary since studies addressing this issue are still scarce in the literature, even with an increase in number of cases diagnosed with Wilson's disease and presenting associated sensory complaints. Keywords: Small fiber neuropathy, Wilson disease, Peripheral nervous system diseases, Peripheral neuropathies

Nerve Biopsy in Peripheral Neuropathies: Not All Water Is under the Bridge

Sural nerve biopsy has long been a valuable diagnostic tool for the study of peripheral neuropathies, although the recent introduction of non-invasive techniques (e.g., neuroimaging techniques, skin biopsy) and advanced genetic and immunological testing has changed the diagnostic workup of peripheral nervous system diseases. [...]

Innovations, advances, and updates in neurosurgery

Neuroscience plays an important role in the basic study to control the coordination of the human body, thinking, and behavioral patterns that keeps pace with time. It is a complex and multidisciplinary scientific body of knowledge related to the nervous system. There are different and overlapping aspects in this field, which are closely interconnected to several elementary professional subjects such as science, technology, engineering, and mathematics. The number of aging population is expected to rise abruptly in the future, such that more than one in six adults globally will be 65 years or older by the year 2050. Advancing age of the elderly would obviously correlate to a rise in the burden of neurological diseases. Neurosurgery comprises surgical interventions involved in the management of central and peripheral nervous system diseases. Rapid technical and technological advances in the neurosurgical field in the past decades have revolutionized better outcomes and prognoses for patients. The present paper discusses selected relevant innovations, advances, and updates in neurosurgery. Further theragnostic strategies and perspectives to treat victims with neurological deficits are also summarized. We hereby outline some noteworthy, major, plus recent innovations, advances, and updates in the field of neurosurgery.

Paraneoplastic Neurological Syndromes: Study of Prevalence in a Province of the Lombardy Region, Italy

Paraneoplastic neurological syndromes (PNSs) are a heterogeneous group of rare immune-mediated diseases associated with cancer. The aim of this study was to investigate the prevalence of PNSs in the province of Brescia. PNS prevalence was calculated using the Lombardy regional hospital admission records from 1998 to 2003. We used the website “Epidemiologic and Economic Atlas of Hospital Activities in Lombardy” and the “International Statistical Classification of Diseases and Related Health Problems”. In the province of Brescia, we found 54 cases of PNSs, 29 with subacute neuropathies, five with paraneoplastic cerebellar degeneration and 20 with encephalomyelitis. Peripheral nervous system diseases were the most frequent neurological disorders. In Lombardy, the number of PNS patients admitted was 322 (133 with encephalomyelitis, 21 with paraneoplastic cerebellar degeneration, 166 with polyneuropathies and two with optic degeneration). In Lombardy, the prevalence of PNSs was 25 in 100,000 hospital admissions and 5.92 in 100,000 for the Lombardy population. Our results show a discrete presence of PNS patients in the province of Brescia and in the Lombardy region as a whole.

Cryotherapy for the prevention of chemotherapy-induced peripheral neuropathy: A systematic review

Objective Chemotherapy induced peripheral neuropathy (CIPN) is an adverse effect of certain chemotherapy agents that can result in dose reductions, permanent nerve damage, and chronic pain. Although pharmacological agents have been studied in this setting, there is no standard of care for the prevention of CIPN. Thus, the objective of this systematic review is to assess the efficacy and safety of cryotherapy for the prevention of CIPN. Data sources PubMed (1946 to February 2020) and Embase (1947 to February 2020) were utilized to conduct a literature search using the following search terms: antineoplastic agent(s), taxoid(s), or chemotherapy and neuralgia, peripheral nervous system diseases, peripheral neuropathy, or paclitaxel-induced peripheral neuropathy and cryotherapy, cryotherapy device, hypothermia, low temperature procedures, or ice. Data summary A total of 11 studies were included in the final assessment. Results of this systematic review indicate that the efficacy of cryotherapy in preventing CIPN is conflicting. This may be due to studies utilizing differing cryotherapy administration methods, study design, and including only a small number of patients. All included studies utilized cryotherapy with taxane-based chemotherapy treatments and cooling gloves and socks was the most common method of administration. Overall, cryotherapy was well-tolerated and no serious adverse effects were noted. Conclusions Due to the absence of serious adverse effects, cryotherapy is a reasonable option to consider to prevent CIPN in patients receiving taxane-based chemotherapy. However, additional research is needed, including larger, better designed studies, to fully delineate the role of cryotherapy for CIPN.

Structure Modeling of the Norepinephrine Transporter

The norepinephrine transporter (NET) is one of the monoamine transporters. Its X-ray crystal structure has not been obtained yet. Inhibitors of human NET (hNET) play a major role in the treatment of many central and peripheral nervous system diseases. In this study, we focused on the spatial structure of a NET constructed by homology modeling on Drosophila melanogaster dopamine transporter templates. We further examined molecular construction of primary binding pocket (S1) together with secondary binding site (S2) and extracellular loop 4 (EL4). The next stage involved docking of transporter inhibitors: Reboxetine, duloxetine, desipramine, and other commonly used drugs. The procedure revealed the molecular orientation of residues and disclosed ones that are the most important for ligand binding: Phenylalanine F72, aspartic acid D75, tyrosine Y152, and phenylalanine F317. Aspartic acid D75 plays a key role in recognition of the basic amino group present in monoamine transporter inhibitors and substrates. The study also presents a comparison of hNET models with other related proteins, which could provide new insights into their interaction with therapeutics and aid future development of novel bioactive compounds.

INFLUENCE OF SEASONAL FACTORS ON MORBIDITY OF teachers of GENERAL EDUCATION INSTITUTIONS IN THE OMSK REGION

The unfavorable trend of loss of health of teachers is determined by the growth of neglected forms of diseases and the influence of seasonal factors. Purpose. To study the influence of seasonal factors on the dynamics of primary morbidity of teachers of general educational institutions. Methods. The study of the incidence was carried out on the data of the appeal of teachers for medical care and data of medical examinations. The seasonal oscillation index was used to determine seasonal factors. Results. The incidence of teachers living in Omsk had a clear tendency to worsen in the following nosological forms: anemia, diabetes, obesity, peripheral nervous system diseases (neuritis, neuralgia, etc.), eye disease (myopia), diseases characterized by high blood pressure, coronary heart disease from 1.3 to 3.6 times (p<0.05), most of these forms are detected during medical examinations. In the structure of primary morbidity, the first three rank places were occupied by diseases of the respiratory, circulatory, endocrine system and metabolism. The total share of the first three groups of the above nosologies in the formation of pathologies was about 65%, and there was an increase in the average duration of temporary incapacity from 3 to 15 days. In addition, the effect of seasonal factors on the level of primary morbidity in diseases characterized by high blood pressure, diabetes, anaemia, which is associated with the cyclicality of the educational process and the date of medical examinations. Conclusions. 1. The deterioration of the health of teachers is due to an increase in primary morbidity, aggravated forms of diseases, including coronary heart disease, diabetes, anaemia, obesity, as well as an increase in the duration of days of temporary incapacity in these nosological forms. 2. Seasonal risk factors associated with the cyclicality of the learning process have been identified. Scope of application. The data can be used in the development and implementation of regional targeted prevention programs. Keywords: morbidity;nosological forms; teachers; seasonality; disability.