Articles: function.
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Chronic traumatic encephalopathy (CTE) formerly known as dementia pugilistica is a long-term neurodegenerative disorder associated with repeated subconcussive head injuries in high-contact sports. We reviewed the existing literature on CTE and examined epidemiological trends, risk factors, and its temporal progression, and proposed the underlying pathophysiological mechanisms that may provide unique insights to clinicians with an in-depth understanding of the disease to aid in the diagnosis and prevention, and provide future perspectives for research via search of Medline and Cochrane databases as well as manual review of bibliographies from selected articles and monographs. The prevalence of CTE in recent years is on the rise and almost exclusively affects men, with pathologic signs characterized by progressive memory loss, behavioral changes, and violent tendencies with some patients demonstrating Parkinsonian-like symptoms and signs. ⋯ Postmortem pathologic analysis is characterized by neurofibrillary tangles and Aβ plaques in 50 % of cases. Currently, there are no ante-mortem diagnostic criteria, but modern imaging techniques such as functional magnetic resonance (MR) imaging, MR spectroscopy, and diffusion tension imaging hold promise for delineating the future diagnostic criteria. Further long-term longitudinal studies are warranted to investigate risk factors that will enhance understanding of the disease progression and its pathogenesis.
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Am. J. Respir. Crit. Care Med. · Apr 2014
Conditions Associated with the Cystic Fibrosis Defect Promote Chronic Pseudomonas aeruginosa Infection.
Progress has been made in understanding how the cystic fibrosis (CF) basic defect produces lung infection susceptibility. However, it remains unclear why CF exclusively leads to chronic infections that are noninvasive and highly resistant to eradication. Although biofilm formation has been suggested as a mechanism, recent work raises questions about the role of biofilms in CF. ⋯ Our findings suggest that conditions associated with several CF pathogenesis hypotheses could cause the noninvasive and resistant infection phenotype, independently of the bacterial functions needed for biofilm formation.
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We measured the pulsatility indices in the inferior collateral and posterior recurrent ulnar arteries, which supply the ulnar nerve at the elbow, in 38 conscious adults. Compared with a straight 30° abducted arm, elbow flexion to 120° reduced the mean (SD) pulsatility index in the inferior artery and increased the pulsatility index in the posterior artery: from 3.36 (0.86) to 3.04 (0.94), p = 0.001, and from 3.14 (0.81) to 3.64 (1.05), p < 0.0005, respectively. The mean (95% CI) pulsatility index in the inferior artery was unaffected by shoulder abduction to 120°, but it was decreased in the posterior artery in men, from 3.06 (2.76-3.36) to 2.64 (2.34-2.95), but not women, from 3.22 (2.94-3.50) to 3.25 (2.97-3.53), p = 0.01 for men vs women. Researchers should measure arterial pulsatility indices under general anaesthesia and associate them with measures of nerve function.
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Acta Anaesthesiol Scand · Apr 2014
Post-operative endothelial dysfunction assessment using laser Doppler perfusion measurement in cardiac surgery patients.
Coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) is associated with systemic inflammatory response and endothelial dysfunction. Our hypothesis is that CPB-induced post-operative endothelial dysfunction may be detected using laser Doppler perfusion monitoring (LDPM) in the skin microcirculation. ⋯ We observed a significant impairment of systemic microvascular endothelial function and well-preserved endothelium-independent vasodilatation in the skin microcirculation of patients 1 week after CABG surgery with CPB. Our results suggest that LDPM is a useful tool for the assessment of on-pump CABG-induced subacute post-operative endothelial dysfunctions.