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Nov 2020 DOI 10.14302/issn.2470-5020.jnrt-20-3596
Kombate DamelanCorresponding author
University of Kara (Togo)
Background Reversible posterior encephalopathy syndrome (RPE) is a clinical and radiological entity characterized by the acute or subacute fitting of symptoms covering headache, vomiting, visual disturbances, seizures and impairment of consciousness. The pathophysiology of RPE syndrome is poorly described. RPE syndrome is characterized by a reversible cerebral edema of often posterior topography in magnetic resonance imagery (MRI). Cases Presentation We consider RPE syndrome four cases under various conditions that are known as airplane flight, hypertension, non-steroidal anti-inflammatory medication, pregnancy and oldness with several pathologies. The RPE was described with several symptoms like headaches, vomiting, focal motor deficit, paresthesia, seizures, disorders of consciousness and photophobia. The imagery findings were varying from cortical hypersignals in Flair sequences to edema of both cortex and sub cortex. The outcome was good with a complete regression of symptoms and imagery lesions. Conclusion The pathophysiological mechanism of RPE syndrome remains unknown. High blood pressure, renal failure and drugs (anti-depressants, NSAIDs, immunosuppressants) are the most etiological factors. The diagnosis is based on clinical arguments and brain MRI. The main location is posterior. The clinical outcome was good with all the patients in our study, no recurrence was noted.
Dec 2015 DOI 10.14302/issn.2470-5020.jnrt-15-701
Tong Dao-MingCorresponding author
Department of Neurology, Affiliated Shu Yang People′s Hospital, XuZhou Medical University, Jiangsu, China
This case contrasts reversible cerebral lesions with areas of irreversible necrosis following cardiorespiratory arrest. The authors discuss imaging evolution, mechanisms of hypoxic–ischemic injury, and implications for prognostication and rehabilitation.
Feb 2026 DOI 10.14302/issn.2372-6601.jhor-25-5944
Y. Berezin MikhailCorresponding author
Background Oxaliplatin, a widely used chemotherapeutic agent, is associated with hematologic toxicities such as anemia, leukopenia, and thrombocytopenia. Despite their clinical relevance, the molecular mechanisms underlying lineage-specific bone marrow suppression remain poorly understood. Methods We administered oxaliplatin to mice over eight weeks and performed RNA-sequencing (RNA integrity >8) on bone marrow alongside peripheral blood analysis and cytokine profiling. Transcriptomic data were analyzed to identify differentially expressed genes (DEGs) and enriched pathways. For that, we applied a thematic Gene Ontology (thematicGO) enrichment method that groups GO terms into biologically meaningful categories, such as hematopoietic lineage disruption, cell cycle arrest, and cytokine signaling. Results Oxaliplatin induced broad transcriptional suppression of erythropoiesis and lymphopoiesis, with 3,691 DEGs identified (FDR<0.05, |FC|>1.5). Upregulation of Cdkn1a and downregulation of E2f2 suggest G1/S cell cycle arrest, correlating with repression of key erythroid maturation genes (e.g., Spta1, Slc4a1, Alas2) and hemoglobin subunits (Hba-a1/2, Hbb-bs/t). Despite a ~3000-fold increase in renal Epo expression, bone marrow Epor was reduced, indicating erythropoietin resistance. B and T cell markers were also significantly downregulated, signifying a collapse in adaptive immunity. Notably, neutrophil populations were largely spared. Cytokine analysis in plasma revealed a pro-inflammatory shift with elevated TNF-α and reduced TGF-β, potentially exacerbating hematopoietic dysfunction. Conclusions Oxaliplatin induces a lineage-dependent suppression of hematopoiesis, driven by coordinated cell cycle arrest, metabolic stress, and disrupted cytokine signaling. RNA-seq analysis enabled integration of transcriptomic findings into coherent biological themes. These findings provide mechanistic insights into oxaliplatin’s hematologic toxicity linking bone marrow failure (potentially reversible) via interconnected inflammatory and metabolic pathways and may inform therapeutic strategies to minimize or restore myelosuppression in cancer patients.
Jul 2023 DOI 10.14302/issn.2470-5020.jnrt-23-4576
HECHAM N.Corresponding author
Background The evolution of multiple sclerosis (MS) is highly variable. Predicting this evolution at the beginning of the disease will help in the therapeutic management. The objective of this study was to describe the clinical characteristics and to identify early predictors of long-term disability among MS patients in Algeria. Methods We performed a descriptive and retrospective study of 400 MS patients followed over a 4-years period from July 2012 to July 2016 in the neurology department of Mustapha Bacha hospital in Algiers. The following parameters were systematically assessed for each patient: Age at onset, gender, relapses, initial demyelinating event, interval between first and second attack, residual deficit after first attack, onset of the progressive course, time of assignment of the successive scores of irreversible disability and type of disease modifying therapies. Univariate and multivariate Cox models were used to determine factors influencing time to Expanded Disability Status Scale (EDSS) 4 and 6. Results During the follow-up of this cohort of MS patients, a total of 144 (36%) and 83 (20%) patients reached EDSS scores 4 and 6 respectively. The median times from the onset of MS to assignment of a score 4 and 6 was 10 years and 19 years, respectively. Using the MSSS severity score, and after univariate analysis we identified several risk factors predictive of disease severity. These included male sex (P= 0.002), age of onset ≥ 40 years (P= 0.001), pyramidal (P= 0.0001), cerebellar (P= 0.002), and poly-symptomatic (P=0.0001) onset of the disease, incomplete recovery after the first attack (P= 0.0001), a high number of attacks during the first 2 years (P= 0.04) and the progressive form (P=0.001), and all these factors were correlated with a high MSSS score. However, prognostic factors in the multivariate binomial logistic regression analysis were limited to pyramidal onset, incomplete recovery after the first attack, short interval between the first and second attack, and progressive onset. Conclusion On the whole, the early predictive factors of disability in MS among Algerian patients were age of onset over 40 years, pyramidal onset, incomplete recovery after the first attack, short interval between the first and second attack and progressive form at onset. To increase the generalizability of findings, a national MS registry is strongly recommended, as well as long-term follow-up epidemiological studies.
Mar 2022 DOI 10.14302/issn.2642-9241.jrd-22-4132
Wu JianqingCorresponding author
Healthier World (Independent researcher for cause), P. O. Box 689, Beltsville, MD 20704. USA
To understand lung damages caused by COVID-19, we deduced two phases lung damage mechanisms. After the lungs are infected with COVID-19, the affected lung tissue swells and surface properties of pulmonary capillaries change, both contributing to an increased flow resistance of the capillaries. The initial damages are mainly fluid leakage in a limited number of involved alveoli. The increased vascular resistance results in retaining more white blood cells (“WBCs”) in pulmonary capillaries. Some of the WBCs may get into interstitial spaces. When more and more WBCs are dynamically retained, the vascular resistance of pulmonary capillaries further rises; and thus the overall vascular resistance of the lungs rises and pulmonary pressure rises. The rise in the pulmonary pressure in turn results in elevated capillary pressures. When pulmonary capillary pressures around the alveoli are sufficiently high, the elevated pressure causes interstitial pressures to change from normally negative values to positive values. The positive pressures cause fluid leakage to the alvoeli and thus degrade lung function. Tissue swelling, and occupation of WBCs in interstitial spaces and occupation of alvoelar spaces by leaked water result in reduced deformable and compressible spaces, and thus causes a further rise of the vascular resistance of the lungs. When the pulmonary pressure has reached a critical point as in the second phase, the blood breaks capillary walls and squeezes through interstitial spaces to reach alveolar spaces, resulting in irreversible lung damages. Among potential influencing factors, the available space in the thorax cage, temperature, and humid are expected to have great impacts. The free space in the thorax cage, lung usable capacity, and other organ usable capacities are the major factors that determine the arrival time of last- phase irreversible damage. The mechanisms imply that the top priority for protecting lungs is maintaining pulmonary micro-circulation and preserving organ functions in the entire disease course while controlling viral reproduction should be stressed in the earliest time possible. The mechanisms also explain how leukecytes are “recruited and migrated” into inflamed tissues by dynamic retention.
May 2020 DOI 10.14302/issn.2575-7881.jdrr-20-3343
Hussen Abdelrhman AmgedCorresponding author
Assis Professor, Department of Hematology and Immunohematology, Omdurman Islamic university / Sudan
Background Anemia of chronic disease is anemia found in certain chronic disease states, is typically marked by the disturbance of iron homeostasis or hypoferremia. Chronic renal failure is currently known as Chronic Kidney Disease (CKD) or Chronic Renal Insufficiency (CRI) implies long-standing, progressive and irreversible renal parenchyma disease resulting in diminished renal function up to 40 to 60%. Often, chronic kidney disease is diagnosed as a result of screening of people known to be at risk of kidney problems, such as those with high blood pressure or diabetes and those with a blood relative with chronic kidney disease. This disease may also be identified when it leads to one of its recognized complications such as cardiovascular disease, anemia, or pericarditis. Methods Sysmex kx21 used to CBC and the Cobase411 used to iron profile. Enzyme-Linked immunoassay (ELISA) was used to determine the level of serum hepcidin. Sample preparation and PCR detection of HAMP DNA Polymorphisms: Restriction digestion of PCR products was done using Fast Digest. (Figure 1). Results Serum hepcidin levels higher in patients with anemia of chronic kidney disease compared with healthy controls mean. The polymorphisms of the hepcidin gene promoter in Sudanese patients with ACKD showed that the hepcidin HAMP AA genotype 70, AG 23, and GG 7 in 100 patients dialysis-dependent and AA 83, AG 17 and GG 0, and the allele A are more frequent in patients affected by ACKD. Significant statistical association observed between the hepcidin level and end-stage kidney disease. Conclusion This study evaluates for the first time the association between anemia of chronic kidney disease and hepcidin genes promoter polymorphisms and show that the hepcidin HAMP AA genotype and the allele A are more frequent in patients affected by ACKD, further investigation is needed, our data support the hypothesis and hepcidin HAMP are important in the pathophysiology of ACKD.
Feb 2020 DOI 10.14302/issn.2642-3146.jec-20-3179
A. A Berezin.Corresponding author
Independent researcher, Moscow, Russia
A model of a Quantum recurrence in the dynamics of an elementary physical vacuum cell within the framework of four coupled Shrodinger equations has been suggested. The model of an elementary vacuum cell shows that a Quantum recurrence which represents the dynamics of virtual transformations in the cell, qualitatively differs from that of Poincare and the Fermi-Pasta-Ulam. Whereas these recurrences develop in time or space, the Quantum recurrence develops in a sequence of Fourier images represented by non exponentially separating functions. The sequence experiences random energy additions but no exponential separation occurs. The Quantum recurrence can be defined as the most frequent array of Fourier images that appear in a certain quantum system during a period of its observation. Different scenarios of the Fourier images sequences interpreted as bosons (electron and positron) and fermions (photons) apearing in the solutions of the model demonstrate that during some periods of its observation they become indistinguishable. The quantum dynamics of every physical vacuum cell depends on the dynamics of many other vacuum cells interacting with it, thus the quasi periodicity (during the period of observation) of the Fourier images recurrence can have infinite periods of time and space and the amplitudes of the Fourier images can vary many orders in their magnitudes. Such recurrence times does not correspond even roughly to the Poincare recurrence time of an isolated macroscopic system. It reminds the behavior of spatially coupled standard mappings with different parameters. The amount of energy in the physical vacuum is infinite but extracting a part of it and converting, it into a time-space form requires a process of periodical transfer of the reversible microscopic system dynamics into that of a macroscopic system. This process can be realized through a resonant interaction between the classical and quantum recurrences developing in these two systems. However, a technical realization of this problem is problematic.
Oct 2019 DOI 10.14302/issn.2642-3146.jec-19-2977
Tian WufengCorresponding author
University of Wisconsin Eau Claire-Barron County, Rice Lake, WI
The effects of global warming have been causing irreversible damage to the Earth over the past decades. One way we can reduce our individual impact on the environment is to focus on the production and consumption of Eco‐friendly sources of electricity such as solar, wind, or bio-electric energy. Based on the current available and suitable energy options, we have proposed to modify a chosen house from Northern Wisconsin by using a hybrid system including solar energy and wind turbine energy to replace the traditional power grid. Considering sunlight‐time, wind speed in Northern Wisconsin, we have predicted the immediate and long‐term fiscal and environmental impacts. From this cost‐benefit analysis, we project that the best hybrid option is a combination of 95% solar power and 5% wind energy, which would save about $41,000 over the next 30 years.
Jul 2019 DOI 10.14302/issn.2474-3585.jpmc-19-2947
Asadzandi MinooCorresponding author
Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
Objectives Death is the only definitive phenomenon in life, and everyone is sure that it will happen in the future. Based on the philosophical perspective, the concept of death differs in different cultures. The purpose of this study was “explaining the difference between the concept of death from the perspective of theology and empirical science”. Methods In this qualitative evolutionary study, a targeted review was conducted to answer the question “what is the difference between the concept of death from the perspective of theology and empirical science?” Articles published between 1990 and 2018 were extracted from the PubMed, science direct, google scholar, SID, and Cochrane databases. At the same time, Islamic religious evidence (Quran and Hadiths) was investigated for understanding the concept of the death in Islam. The “Shia Seminary” research methodology was used to avoid interpretations of the Quran verses and to ensure the authenticity of the Hadiths. Findings Empirical sciences consider death as a biological phenomenon, which results from irreversible damage to cerebral hemispheres and brain stem (brain death) that causes grief process, fear, anxiety, and sadness. From the perspective of Islam, death is an existential phenomenon, the transfer of the soul from one world to another. Death is the complete reception of the soul from the body by the angels and the beginning of another life, in the "world of grief. Conclusion Given that in Islam, death does not mean destruction. It is imperative that the spiritual counselors teach the patient and the family about the life after death and the blessings of paradise. In pastoral care at the end of life, reducing patients’ anxiety and fear of death, with hope in God's mercy is necessary.
Apr 2019 DOI 10.14302/issn.2328-0182.japst-19-2759
Sterner OlovCorresponding author
Centre for Analysis and Synthesis, Lund University, P.O.Box 124, 22100 Lund, Sweden
Cancer is the leading cause of death worldwide, and there is a constant need for new treatment strategies. Sesquiterpene lactones containing a 3-methylenedihydrofuran-2(3H)-one (or α-methylene-γ-lactone) moiety, for example damsin (1), are Michael acceptors that affect biological processes such as cell proliferation, death/apoptosis, and cell migration, by interfering with cell signalling pathways. Although the reactivity of the α-methylene-γ-lactone moiety is important for these effects, the Michael addition is reversible and it can be assumed that also other parts of the molecules will moderate any given biological activity. In this investigation, the cytotoxicity of 23 -methylene--lactones towards normal breast epithelial MCF-10A cells as well as breast cancer JIMT-1 cells is compared. Most of the investigated compounds are semisynthetic derivatives prepared by the condensation of the natural product damsin (1) with aldehydes. The two cell lines were treated with various concentrations of the compounds in dose response assays, and the 50 % inhibitory concentration (IC50) was determined from dose response curves. The IC50 values were found to depend strongly on the overall structure. The ratio between the IC50 values for MCF-10A and JIMT-1 cells, as a measure for the selectivity of a compound to kill cancer cells, was calculated, and found to vary between just over 1 to more than 10. The most potent derivatives formed from the condensation of 1 with aromatic aldehydes towards JIMT-1 cells are 3a and 3i, both with ratios between the IC50 values for MCF-10A and JIMT-1 cells close to 5. Also some aldol condensation products with acyclic aldehydes, i.e. 3r and 3u, were equally potent, and the latter showed the highest selectivity (ratio > 10). Structure-activity relationships that may explain the observed differences in potency and selectivity are discussed.
Jan 2018 DOI 10.14302/issn.2470-5020.jnrt-17-1926
Nagel SimonCorresponding author
Department of Neurology, University of Heidelberg, Germany
Since the first description in 2013, 39 cases of anti-DPPX-encephalitis have been described. Main features of this autoimmune encephalitis characterized by antibodies against the potassium-channel-associated regulatory protein DPPX are gastrointestinal symptoms, cognitive dysfunction and signs of CNS hyperexcitability. While the majority of patients responds to immunotherapy relapses are frequent and often successfully treated with rituximab. Here we report another case of anti-DPPX-encephalitis presenting with the above mentioned triad. However, this is the first case of anti-DPPX-encephalitis in the context of a connective tissue disease combined with cerebral arteriopathy along with brain parenchymal lesions that we interpreted as a secondary, CTD-associated cerebral vasculitis. While the latter resolved under immunosuppressive treatment, comprising glucocorticosteroids, cyclophosphamide, rituximab and plasmapheresis, deterioration of the CTD and multiple infectious complications finally led to the patient's death. As histological evidence for cerebral vasculitis is lacking, other differential diagnoses for the observed cerebral arteriopathy, especially reversible cerebral vasoconstriction syndrome, have to be considered.
Nov 2017 DOI 10.14302/issn.2574-4526.jddd-17-1792
Angelou AnastasiosCorresponding author
Department of Surgery, Laiko Hospital, School of Medicine, University of Athens, Athens, Greece
Objectives: Bariatric surgery has been established as the cornerstone of treatment of morbid obesity with good immediate and long-term results. Nutrient deficiencies though, can be an important long-term complication and may lead to hematological, metabolic and especially neurological disorders which are not always reversible. Thiamine (vitamin B1) deficiency has been reported both after restrictive and malabsorptive procedures. The aim of this study is to review all cases that presented with Wernicke Encephalopathy after sleeve gastrectomy. Methods: A review of the literature was conducted to evaluate all sleeve gastrectomies performed till today and caused Wernicke encephalopathy to the patients. Demographic data, operative parameters, postoperative outcomes were collected and assessed. Results: A total of 13 studies, including 13 patients were analyzed. Patients ranged in age from 17 to 55 years. The onset of Wernicke encephalopathy occurred as early as 3 weeks after surgery to as late as 60 weeks after surgery. When symptoms of Wernicke encephalopathy developed, patients had lost from 19 kg up to 60 kg of body weight. Conclusions: Micronutrient deficiencies and particularly B1 deficiency can occur after LSG, although rarely. Preoperative nutritional assessment and postoperative follow-up plan, should signs of Wernicke’s encephalopathy be traced, is recommended in all patients.
Feb 2016 DOI 10.14302/issn.2574-4488.jna-15-712
Bernieh BassamCorresponding author
Nephrology, Department of Internal Medicine, Tawam Hospital, Al-Ain, United Arab Emirates.
Background Dapagliflozin; the new oral hypoglycemic agent; is a sodium-glucose cotransporter-2 (SGLT2) inhibitor that acts by inhibiting glucose reabsorption in the proximal tubule of the nephron. Main reported side effects are osmotic diuresis, dehydration, urinary tract and genital infections. Here, we report a case of acute bilateral hydronephrosis after the introduction of dapagliflozin. Case Presentation A 52 year old nurse lady, with 15 year history of type2 diabetes mellitus (T2 DM) complicated by type4-renal tubular acidosis, hypertension, proteinuria, and hyperlipidemia. Patient had two episodes of UTI’s in 2011 required full urologic work up, were successfully treated with simple courses of oral antibiotics. CT pyelography done in 2011 was normal. Dapagliflozin was added to her therapeutic regimen in March 2015. Results Within 48 hours after starting dapagliflozin, she reported increased urine output. Ten days later; she developed severe bilateral loin and lower back pain, followed by suprapubic pain, dysuria and fever. Urine analysis and cultures confirmed E. coli urosepsis. Renal US revealed echogenic kidneys with 12 mm bilateral hydronephrosis, normal ureters and urinary bladder. Discontinuation of dapagliflozin in April 2015 resulted in resolution of symptoms. Repeat CT of the abdomen in July 2015 revealed no hydro nephrosis. Conclusions This is the first case report of reversible bilateral hydronephrosis after the use of dapagliflozin. The cause of hydronephrosis, could be explained by over-diuresis and/or by the unmasking of underlying subclinical obstruction in both uretero-pelvic junctions (UPJ).