Alicardenas9026

Endocrinopathy is an important characteristic of POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome. However, endocrine responses to different regimens were unknown so far. Here we investigated endocrine characteristics in 383 patients with newly diagnosed POEMS syndrome and thyroid responses 1 year after treatment with autologous peripheral stem cell transplantation, melphalan plus dexamethasone, or lenalidomide plus dexamethasone. Overt hypothyroidism and subclinical hypothyroidism were noted in 20.6% (79/383) and 36.0% (138/383) of patients. Adrenal insufficiency was noted in 13.6% (43/316) of patients. Hyperprolactinemia was noted in 62.7% (207/330) of patients. Hypogonadism was noted in 48.0% (60/125) of female and 22.6% (51/226) of male patients. Thyroid function was significantly related with baseline risk stratification (p less then 0.001) and significantly improved regardless of initial regimens. Patients with baseline hypothyroidism had a significant inferior progression-free survival (PFS) (p = 0.028) and overall survival (OS) (p = 0.006). Three-year PFS in patients with and without baseline hypothyroidism were 68.9 vs. 82.5%, respectively. Three-year OS rates in patients with and without baseline hypothyroidism were 82.8 vs. 92.8%, respectively. In summary, hypothyroidism, hyperprolactinemia, and hypogonadism are common endocrinopathies in POEMS syndrome. Thyroid function significantly improved regardless of the initial regimens. Thyroid function parallels with baseline risk stratification, and patients with baseline hypothyroidism have significantly inferior OS and PFS.MicroRNAs (miRNAs) are single-stranded RNA molecules that control gene expression in various processes, such as cancers, Alzheimer's disease, and bone metabolic diseases. However, the regulatory roles of miRNAs in osteoporosis have not been systematically analyzed. Here, we performed a comprehensive analysis to identify the differentially expressed miRNAs involved in osteoporosis. MiRNAs associated with osteoporosis were collected through literature retrieval and further screened based on specific inclusion and exclusion criteria. The osteoporosis therapeutic targets of miRNAs were obtained by the integration of miRWalk 3.0 database and five human disease therapeutic target databases. Then, the network analysis and functional enrichment analysis of miRNAs and their targets were performed. As a result, 11 eligible miRNAs were identified highly associated with osteoporosis. MiRNA-mRNA network demonstrated there were the complex mutual interactions between miRNAs and their targets. Besides, ADRB2, AR, ESR1, FGFR1, TRAF6, etc., were identified as the top hub genes in protein-protein interaction (PPI) network. Functional enrichment analysis revealed that miRNAs and their targets were mainly mapped on processes associated with bone and immune system, such as bone remolding, bone mineralization, PI3K/AKt, TNF signaling pathways and Th17 cell differentiation. RT-PCR results showed that the expression of miR-335-3p was significantly down-regulated in hind limb unloading (HLU) mice tibia samples compared with controls, the remaining 10 miRNAs were significantly up-regulated after HLU (P less then 0.01). In summary, we identified 11 differentially expressed miRNAs and their hub target genes in osteoporosis, which may be novel diagnostic biomarkers for osteoporosis.[This corrects the article DOI 10.3389/fneur.2020.00505.].[This corrects the article DOI 10.3389/fneur.2020.00625.].[This corrects the article DOI 10.3389/fneur.2020.531993.].[This corrects the article DOI 10.3389/fneur.2020.00696.].Severe traumatic brain injury (TBI) is a leading cause of death and disability worldwide, especially in low- and middle-income countries, and in austere, rural, and remote settings. The purpose of this Perspective is to challenge the notion that accurate and actionable diagnosis of the most severe brain injuries should be limited to physicians and other highly-trained specialists located at hospitals. Further, we aim to demonstrate that the great opportunity to improve severe TBI care is in the prehospital setting. Here, we discuss potential applications of prehospital diagnostics, including ultrasound and near-infrared spectroscopy (NIRS) for detection of life-threatening subdural and epidural hemorrhage, as well as monitoring of cerebral hemodynamics following severe TBI. Ultrasound-based methods for assessment of cerebrovascular hemodynamics, vasospasm, and intracranial pressure have substantial promise, but have been mainly used in hospital settings; substantial development will be required for prehospital optimization. Compared to ultrasound, NIRS is better suited to assess certain aspects of intracranial pathology and has a smaller form factor. Thus, NIRS is potentially closer to becoming a reliable method for non-invasive intracranial assessment and cerebral monitoring in the prehospital setting. While one current continuous wave NIRS-based device has been FDA-approved for detection of subdural and epidural hemorrhage, NIRS methods using frequency domain technology have greater potential to improve diagnosis and monitoring in the prehospital setting. In addition to better technology, advances in large animal models, provider training, and implementation science represent opportunities to accelerate progress in prehospital care for severe TBI in austere, rural, and remote areas.[This corrects the article DOI 10.3389/fneur.2020.00802.].Objective To compare utricular dysfunction with saccular dysfunction in benign paroxysmal positional vertigo (BPPV), based on ocular vestibular evoked myogenic potentials (oVEMP) and cervical VEMP (cVEMP), respectively. Materials and Methods We performed a literature search exploring utricular and saccular dysfunction in BPPV patients through June 2020 using oVEMP and cVEMP, respectively. selleck chemicals The databases included Pubmed, Embase, CENTRAL, CNKI, Wan Fang Data, and CBM. The literatures were limited to Chinese and English. link2 Inclusion criteria and exclusion criteria were defined. We adopted abnormal rate as the outcome. All statistical processes were conducted through software Review Manager. link3 Considering the air-conducted sound (ACS) and bone conducted vibration (BCV) may have different mechanisms, and three types of diagnostic criteria for abnormal VEMP were available, sub-group analysis was performed simultaneously according to the sound stimuli and the diagnostic criteria of abnormal VEMP. Results We retrieved 828 potentially relevant literatures, and finally 12 studies were included for meta-analysis of abnormal rate after duplication removal, titles and abstracts screening, and full-text reading. The abnormal rate of oVEMP was not significantly different from cVEMP (OR = 1.59, 95% CI = 0.99-2.57). But the abnormal rate was obviously different between the subgroups adopting ACS oVEMP and BCV oVEMP. In studies adopting ACS oVEMP, the abnormal rate of oVEMP was higher than cVEMP (OR = 1.85, 95% CI = 1.38-2.49). The abnormal rate of oVEMP was also higher than cVEMP when adopting asymmetry ratio (AR) and no response (NR) as diagnostic criteria (OR = 2.16, 95% CI = 1.61-2.89). Conclusion The meta-analysis reveals that utricular dysfunction may be more predominant in BPPV compared with saccular dysfunction.Objectives Vestibular migraine (VM) is a common vestibular disorder, and familial aggregation of VM with autosomal-dominant inheritance has been described, which supports a genetic background. This study aimed to describe the clinical phenotype of a family with VM, and identify a candidate gene for VM. Methods We recruited six individuals (four affected and two unaffected) from three consecutive generations of a Korean family with VM, and performed whole-exome sequencing to search for candidate genes. Results All affected individuals presented with recurrent vertigo, headache, and nausea/vomiting that fulfilled the diagnostic criteria of VM. Two individuals also experienced transient hemiparesis or dysarthria during the episodes. The symptoms were triggered by physical or emotional stress. Interictal examinations showed uni- or bi-directional horizontal gaze-evoked nystagmus in three of the individuals. They had no causative mutations in genes causing familial hemiplegic migraine or episodic ataxia. Through whole-exome sequencing from three affected individuals, we identified a nonsense mutation c.3526C>T in TRPM7 that encodes a cation channel selective to Ca2+ and Mg2+. Conclusions Alterations in intracellular Ca2+ and Mg2+ homeostasis by TRPM7 mutation may contribute to the development of the VM phenotype. Our result suggest that TRPM7 is a novel candidate gene for VM.Background and Purpose Tacrolimus (TAC) has been proven to be a rapid-acting, steroid-sparing agent for myasthenia gravis (MG) therapy. However, evidence related to the effectiveness of TAC alone is rare. Therefore, this study was performed to investigate the effect of TAC monotherapy in MG patients. Methods Forty-four MG patients who received TAC monotherapy were retrospectively analyzed. A mixed effect model was used to analyze improvements in MG-specific activities of daily living scale (MG-ADL), quantitative MG score (QMG) and MG-ADL subscores. Kaplan-Meier analysis was used to estimate the cumulative probability of minimal manifestations (MM) or better. Adverse events (AEs) were recorded for safety analyses. Results Of the patients receiving TAC monotherapy, MG-ADL scores were remarkably improved at 3, 6 and 12 months compared with scores at baseline (mean difference and 95% CIs -3.29 [-4.94, -1.64], -3.97 [-5.67, -2.27], and -4.67 [-6.48, -2.85], respectively). QMG scores significantly decreased at 6 and 12 months, with mean differences and 95% CIs of -4.67(-6.88, -2.45) and -5.77 (-7.55, -4.00), respectively. Estimated median period to achieve "MM or better" was 5.0 (95% CIs, 2.8, 7.2) months. Ocular MG (OMG) and generalized MG (GMG) showed similar therapeutic effects in cumulative probabilities of "MM or better" (P-value = 0.764). A better response was observed in MG-ADL subscores for ptosis and bulbar symptoms. AEs occurred in 37.5% of patients and were generally mild and reversible. Conclusions TAC monotherapy is a promising option to rapidly alleviate all symptoms of MG, especially for ptosis and bulbar symptoms.Background In Deep Brain Stimulation (DBS), stimulation field steering is used to achieve stimulation spatial specificity, which is critical to obtain clinical benefits and avoid side effects. Multiple Independent Current Control (MICC) and Interleaving/Multi Stim Set (Interleaving/MSS) are two stimulation field steering paradigms in commercially available DBS systems. This work investigates the stimulation field steering accuracy and energy efficiency of these two paradigms in directional DBS. Methods Volumes of Tissue Activated (VTAs) were generated in silico using pulse widths of 60 μs and five pulse amplitude fractionalizations intended to steer the VTAs radially in 12° steps. For each fractionalization, VTAs were generated with nine pre-defined target radii. Stimulation field steering accuracy was assessed based on the VTAs rotation angle. Energy efficiency was inferred from current draw from battery values, which were calculated based on the pulse amplitudes needed to generate and steer the VTAs, as well as electrode impedance measurements of clinically implanted directional leads.