- Parkinson's Disease: The Emerging Role of Gut Dysbiosis, Antibiotics, Probiotics, and Fecal Microbiota Transplantation. [Review]
- JNJ Neurogastroenterol Motil 2019 Jul 01; 25(3):363-376
- The role of the microbiome in health and human disease has emerged at the forefront of medicine in the 21st century. Over the last 2 decades evidence has emerged to suggest that inflammation-derived …
The role of the microbiome in health and human disease has emerged at the forefront of medicine in the 21st century. Over the last 2 decades evidence has emerged to suggest that inflammation-derived oxidative damage and cytokine induced toxicity may play a significant role in the neuronal damage associated with Parkinson's disease (PD). Presence of pro-inflammatory cytokines and T cell infiltration has been observed in the brain parenchyma of patients with PD. Furthermore, evidence for inflammatory changes has been reported in the enteric nervous system, the vagus nerve branches and glial cells. The presence of α-synuclein deposits in the post-mortem brain biopsy in patients with PD has further substantiated the role of inflammation in PD. It has been suggested that the α-synuclein misfolding might begin in the gut and spread "prion like" via the vagus nerve into lower brainstem and ultimately to the midbrain; this is known as the Braak hypothesis. It is noteworthy that the presence of gastrointestinal symptoms (constipation, dysphagia, and hypersalivation), altered gut microbiota and leaky gut have been observed in PD patients several years prior to the clinical onset of the disease. These clinical observations have been supported by in vitro studies in mice as well, demonstrating the role of genetic (α-synuclein overexpression) and environmental (gut dysbiosis) factors in the pathogenesis of PD. The restoration of the gut microbiome in patients with PD may alter the clinical progression of PD and this alteration can be accomplished by carefully designed studies using customized probiotics and fecal microbiota transplantation.
- SUCCESSFUL REHABILITATION OF PATIENT DISABLED BY THE AUTISTIC SPECTRUM DISORDER AND THE MODIFIED EPIGENETIC STATUS (POLYMORPHISMS DRD2 2137 T/T, MTRR 66 A/G, MTHFR 677 C/T, MTHFR 1298 A/C) - CASE REPORT. [Journal Article]
- GMGeorgian Med News 2019; (290):124-127
- Autism spectrum disorders (ASD) are considered an epidemic - only in the last 5 years the incidence of pathology has increased from 1: 166 to 1:68 children. The main role in the pathogenesis of ASD c…
Autism spectrum disorders (ASD) are considered an epidemic - only in the last 5 years the incidence of pathology has increased from 1: 166 to 1:68 children. The main role in the pathogenesis of ASD currently belongs to the violation of the epigenetic status in the form of gene polymorphisms. An example is the polymorphic variants of the genes of the folate-methionine cycle enzymes, which regulate the epigenetic status through a methylation process. The article presents a case of autism spectrum disorder against the background of impaired epigenetic status (metabolic dopamine neurotransmitters and the methylation cycle). Individually selected metabolic correction based on biochemical parameters allowed improving behavior, stimulating speech development, stopping long subfebrile and hypersalivation.
- IncobotulinumtoxinA for hypersalivation in patients with amyotrophic lateral sclerosis: an open-label single-centre study. [Journal Article]
- JNJ Neural Transm (Vienna) 2019 Jul 17
- The objective of this study is to discover whether incobotulinumtoxinA (inco) can reduce relative hypersalivation in patients with amyotrophic lateral sclerosis (ALS). 14 patients with ALS (8 males a…
The objective of this study is to discover whether incobotulinumtoxinA (inco) can reduce relative hypersalivation in patients with amyotrophic lateral sclerosis (ALS). 14 patients with ALS (8 males and 6 females, age 55.4 ± 16.3 years) received ultrasound-guided injection of inco 100 MU in both parotid glands and inco 50 MU in both submandibular glands. Saliva production was gravimetrically measured with three cotton rolls placed in the mouth. Weight increase after 5 min was measured on an electronic scale. Subjective saliva production was registered with drooling frequency scale (DFS) and drooling severity scale (DSS). Saliva production was gravimetrically reduced at week 4 (p = 0.04), week 8 (p = 0.01) but not after week 12 after BT application. DFS was reduced at week 4 (p = 0.04), week 8 (p = 0.02), but not after week 12. DSS was reduced at week 4 (p = 0.03), week 8 (p = 0.04) and week 12 (p = 0.04). Patients in our study did not experience changes in their swallowing patterns or any other safety-relevant events. Inco is effective and well tolerated for saliva reduction in patients with ALS for 8-12 weeks.
- Botulinum Toxin for Side-Effect Management and Prevention of Surgical Complications in Patients Treated for Head and Neck Cancers and Esophageal Cancer. [Review]
- JAJ Adv Pract Oncol 2019 Jan-Feb; 10(1):40-52
- The management of head and neck cancers (HNC) and esophageal cancer (EC) is complex and often involves multiple modalities of treatment, including chemotherapy, radiation therapy, and surgery. The si…
The management of head and neck cancers (HNC) and esophageal cancer (EC) is complex and often involves multiple modalities of treatment, including chemotherapy, radiation therapy, and surgery. The side effects associated with these therapies and disease processes are extensive. A literature review was performed to evaluate the use of botulinum toxin as an intervention for side-effect management in patients with HNC and EC. Specific adverse events reviewed included salivary function (hypersalivation, fistula, hyposalivation) and gastrointestinal motility (esophageal stricture, delayed gastric emptying after esophagectomy). Published results demonstrate an improvement in hypersalivation and, when botulinum toxin was used as an adjunct to treatment, a reduction in symptoms associated with salivary fistula, or an inappropriate communication between the salivary gland and the skin that causes the leakage of saliva through the skin. Positive effects were also demonstrated in regard to esophageal stricture and equivalent effects in the management of gastric emptying to prevent complications after esophagectomy when compared to currently available interventions. However, the potential for increased symptoms associated with botulinum toxin injection related to its use in the management of gastric secretions was noted in one of the studies reviewed.
- Macroglossia in Primary Lateral Sclerosis: a Case Report. [Journal Article]
- IJInt J Neurosci 2019 Jul 16; :1-3
- We describe a 62-year-old woman presented with macroglossia in the early stages of motor neuron disease. She was referred to the department of physical medicine and rehabilitation of a university hos…
We describe a 62-year-old woman presented with macroglossia in the early stages of motor neuron disease. She was referred to the department of physical medicine and rehabilitation of a university hospital for rehabilitation with the diagnosis of motor neuron disease, most likely primary lateral sclerosis. Her speech was incomprehensible, and she also showed significant sialorrhea and had difficulty in chewing large solid food. Her tongue was enlarged on examination, and she could not close her mouth fully. No other possible causes of macroglossia was found. She showed nocturnal hypercapnia on overnight capnography examination coupled with desaturation, which was believed to result from the macroglossia. After commencing non-invasive ventilation with pressure control mode, follow-up overnight capnography revealed EtCO2 values within the normal range. To the best of our knowledge, this is the first report of macroglossia in PLS. Further study would be needed to ascertain the pathogenesis of this phenomenon.
- Rabies Outbreak in Captive Big Brown Bats (Eptesicus fuscus) Used in a White-nose Syndrome Vaccine Trial. [Journal Article]
- JWJ Wildl Dis 2019 Jul 11
- An outbreak of rabies occurred in a captive colony of wild-caught big brown bats (Eptesicus fuscus). Five of 27 bats exhibited signs of rabies virus infection 22-51 d after capture or 18-22 d after c…
An outbreak of rabies occurred in a captive colony of wild-caught big brown bats (Eptesicus fuscus). Five of 27 bats exhibited signs of rabies virus infection 22-51 d after capture or 18-22 d after contact with the index case. Rabid bats showed weight loss, aggression, increased vocalization, hypersalivation, and refusal of food. Antigenic typing and virus sequencing confirmed that all five bats were infected with an identical rabies virus variant that circulates in E. fuscus in the United States. Two bats with no signs of rabies virus infection were seropositive for rabies virus-neutralizing antibodies; the brains of these bats had no detectable viral proteins by the direct fluorescence antibody test. We suspect bat-to-bat transmission of rabies virus occurred among our bats because all rabies-infected bats were confined to the cage housing the index case and were infected with viruses having identical sequences of the entire rabies nucleoprotein gene. This outbreak illustrated the risk of rabies virus infection in captive bats and highlights the need for researchers using bats to assume that all wild bats could be infected with rabies virus.
- Salivary Flow Alteration in Patients Undergoing Treatment for Schizophrenia: Disease-Drug-Target Gene/Protein Association Study for Side-effects. [Journal Article]
- JOJ Oral Biol Craniofac Res 2019 Jul-Sep; 9(3):286-293
- CONCLUSIONS: The possible genetic pathway of SA in schizophrenic patients are discussed in light of pharmacotherapeutics. Using the knowledge effectively would help to increase the quality of life of schizophrenic besides increasing the understanding to use saliva as a biomarker of prognosis of schizophrenia and its drug effects.
- A 48-Year-Old Man With Excessive Drooling and Descending Paralysis Requiring Mechanical Ventilation. [Journal Article]
- ChestChest 2019; 156(1):e9-e13
- A 48-year-old man presented with a chief report of worsening dysphagia for 5 days. Initially, he had difficulty swallowing solids, but it has progressed to difficulty with liquids. There was associat…
A 48-year-old man presented with a chief report of worsening dysphagia for 5 days. Initially, he had difficulty swallowing solids, but it has progressed to difficulty with liquids. There was associated sialorrhea, hypophonia, slurring of speech, hoarseness of voice, cough, and prominent upper extremity weakness. Of note, 2 weeks ago, the patient had an upper respiratory tract infection (including otitis media) that was treated with amoxicillin-clavulanate. His wife and son were also recently sick with an upper respiratory tract infection. His medical history included hypertension managed with amlodipine; he denied any history of TB, recent travel, or canned food ingestion. He denied fevers, stridor, dyspnea, rash, odynophagia, nausea, vomiting, or diarrhea.
- Pharmacokinetics of pentoxifylline and its 5-hydroxyhexyl metabolite after intravenous administration of increasing doses to sheep. [Journal Article]
- AJAm J Vet Res 2019; 80(7):702-708
- CONCLUSIONS: Results indicated that pharmacokinetic parameters for PTX and M-I varied in a dose-dependent linear manner in healthy sheep. Further studies are warranted to determine the therapeutic threshold and optimal dosage for PTX in sheep.
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- [Sublingual use of atropine for clozapine-induced sialorrhoea: literature review and two case reports]. [Journal Article]
- TPTijdschr Psychiatr 2019; 61(6):403-410
- In patients taking clozapine, about 30% experience sialorrhoea, with its related potentially important medical and psychosocial implications. Until now, systemic treatments have been unsuccessful and…
In patients taking clozapine, about 30% experience sialorrhoea, with its related potentially important medical and psychosocial implications. Until now, systemic treatments have been unsuccessful and also have unfavourable side-effects.<br/> AIM: To examine the current evidence regarding the use of local atropine in clozapine-induced sialorrhoea (cis), as well as for sialorrhoea of other etiology.<br/> METHOD: PubMed and Google Scholar were searched using the keywords 'sialorrhea', 'clozapine' and 'atropine' to investigate the use of sublingual atropine for cis, as well as for sialorrhoea of other etiology. Two patients are described and discussed.<br/> RESULTS: Of 24 identified patients, 21 experienced a beneficial effect on cis with sublingually administered atropine eye drops or 1% ipratropium bromide nasal spray (0.03%). Side-effects, such as a dry mouth, unpleasant taste and short duration of action of the eye drops, were reported. Of the 67 patients treated with local atropine for sialorrhoea of other etiology, generally a beneficial effect and few side-effects were reported.<br/> CONCLUSION: The sublingual administration of atropine appears to be effective in the treatment of cis, as well as in sialorrhoea of other etiology. The dose is usually 1-2 eye drops, two to three times per day.