- MeSH
- deprese farmakoterapie MeSH
- extrakt z ginkgo aplikace a dávkování MeSH
- Ginkgo biloba * MeSH
- kardiovaskulární systém účinky léků MeSH
- kombinovaná farmakoterapie MeSH
- léková kontraindikace MeSH
- listy rostlin MeSH
- nemoci mozku farmakoterapie MeSH
- sluch účinky léků MeSH
- terapeutické užití MeSH
- zrak účinky léků MeSH
- Publikační typ
- populární práce MeSH
Statiny se využívají pro léčbu primární hypercholesterolemie a dyslipidemie. Významně snižují kardiovaskulární riziko v primární i sekundární prevenci. V České republice se nejvíce používají atorvastatin a rosuvastatin, méně simvastatin a fluvastatin. Při léčbě statiny je třeba stanovit cílové hodnoty HDL cholesterolu, zvolit vhodný režim (případně s doplňkovou léčbou ezetimibem). Po jejich nasazení se také mohou vyskytovat nežádoucí účinky (nevolnost, únava, myalgie, vzácně statinová myopatie). Řadou studií je prokázáno, že statiny mají neuroprotektivní účinky na mozkovou tkáň. Mohou přestupovat hematoencefalickou bariéru a snížit aktivaci mikroglie i následné vyplavování prozánětlivých mediátorů. Za patologických podmínek navozují v mozku vazodilataci, inhibici proliferace buněk hladkého svalu ve stěně cév, zlepšují funkci endoteliálních buněk, stabilizují aterosklerotický plát. Mají antiagregační, antioxidativní a protizánětlivý účinek.
Statins are used to treat primary hypercholesterolemia and dyslipidemia. They significantly reduce cardiovascular risk in primary and secondary prevention. In the Czech Republic, atorvastatin and rosuvastatin are the most used drugs, otherwise simvastatin and fluvastatin are less prescribed. For statin therapy, appropriate HDL cholesterol target values should be established, and special regimen with adjunctive therapy with ezetimibe in selected patients. Drug side effects may occur with statin therapy, such as nausea, fatigue, myalgia, rarely statin myopathy. A number of studies have shown that statins have neuroprotective effects on the brain tissue. They can cross the blood-brain barrier and reduce microglia activation followed by subsequent leaching of proinflammatory mediators. Under pathological conditions, statins induce vasodilation in the brain, inhibit the proliferation of smooth muscle cells in the vessel wall, improve endothelial cell function, and stabilize the atherosclerotic plaque. They have antiplatelet, antioxidant and anti-inflammatory effect.
- MeSH
- cerebrální krvácení farmakoterapie MeSH
- demence farmakoterapie MeSH
- hodnocení léčiv MeSH
- ischemická cévní mozková příhoda farmakoterapie MeSH
- lidé MeSH
- metabolismus účinky léků MeSH
- nemoci mozku farmakoterapie MeSH
- nemoci svalů chemicky indukované MeSH
- statiny * škodlivé účinky terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
- MeSH
- acyklovir aplikace a dávkování MeSH
- antibakteriální látky aplikace a dávkování MeSH
- dítě MeSH
- encefalitida virová diagnóza farmakoterapie klasifikace MeSH
- herpetická encefalitida diagnostické zobrazování diagnóza farmakoterapie MeSH
- infekční komplikace v těhotenství etiologie klasifikace MeSH
- klíšťová encefalitida MeSH
- lidé MeSH
- lymská neuroborelióza diagnóza epidemiologie farmakoterapie klasifikace patofyziologie MeSH
- meningoencefalitida MeSH
- meningokoková meningitida farmakoterapie patofyziologie MeSH
- nemoci mozku diagnóza etiologie farmakoterapie klasifikace MeSH
- novorozenec MeSH
- polyradikuloneuropatie diagnóza klasifikace MeSH
- zánět * diagnóza etiologie farmakoterapie klasifikace MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- přehledy MeSH
- Klíčová slova
- kmenové reflexy,
- MeSH
- centrální pontinní myelinolýza diagnostické zobrazování patofyziologie patologie MeSH
- diferenciální diagnóza MeSH
- halucinace diagnóza etiologie farmakoterapie patofyziologie MeSH
- infekční encefalitida diagnóza etiologie farmakoterapie patologie MeSH
- lidé MeSH
- mozkový kmen diagnostické zobrazování patologie MeSH
- nádory mozku klasifikace patologie terapie MeSH
- nemoci mozku * diagnostické zobrazování etiologie farmakoterapie klasifikace patofyziologie patologie MeSH
- paraneoplastické neurologické syndromy diagnóza imunologie komplikace MeSH
- paréza diagnóza klasifikace patologie MeSH
- reflex MeSH
- rombencefalon patologie MeSH
- thiamin aplikace a dávkování MeSH
- Wernickeova encefalopatie diagnóza farmakoterapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Rationale: The blood-brain barrier (BBB) is a major obstacle for drug delivery to the brain. Sonopermeation, which relies on the combination of ultrasound and microbubbles, has emerged as a powerful tool to permeate the BBB, enabling the extravasation of drugs and drug delivery systems (DDS) to and into the central nervous system (CNS). When aiming to improve the treatment of high medical need brain disorders, it is important to systematically study nanomedicine translocation across the sonopermeated BBB. To this end, we here employed multimodal and multiscale optical imaging to investigate the impact of DDS size on brain accumulation, extravasation and penetration upon sonopermeation. Methods: Two prototypic DDS, i.e. 10 nm-sized pHPMA polymers and 100 nm-sized PEGylated liposomes, were labeled with fluorophores and intravenously injected in healthy CD-1 nude mice. Upon sonopermeation, computed tomography-fluorescence molecular tomography, fluorescence reflectance imaging, fluorescence microscopy, confocal microscopy and stimulated emission depletion nanoscopy were used to study the effect of DDS size on their translocation across the BBB. Results: Sonopermeation treatment enabled safe and efficient opening of the BBB, which was confirmed by staining extravasated endogenous IgG. No micro-hemorrhages, edema and necrosis were detected in H&E stainings. Multimodal and multiscale optical imaging showed that sonopermeation promoted the accumulation of nanocarriers in mouse brains, and that 10 nm-sized polymeric DDS accumulated more strongly and penetrated deeper into the brain than 100 nm-sized liposomes. Conclusions: BBB opening via sonopermeation enables safe and efficient delivery of nanomedicine formulations to and into the brain. When looking at accumulation and penetration (and when neglecting issues such as drug loading capacity and therapeutic efficacy) smaller-sized DDS are found to be more suitable for drug delivery across the BBB than larger-sized DDS. These findings are valuable for better understanding and further developing nanomedicine-based strategies for the treatment of CNS disorders.
- MeSH
- fluorescenční barviva aplikace a dávkování MeSH
- hematoencefalická bariéra diagnostické zobrazování metabolismus MeSH
- liposomy aplikace a dávkování MeSH
- mikrobubliny MeSH
- mozek diagnostické zobrazování MeSH
- myši nahé MeSH
- myši MeSH
- nanomedicína metody MeSH
- nemoci mozku farmakoterapie MeSH
- optické zobrazování metody MeSH
- systémy cílené aplikace léků metody MeSH
- ultrasonografie metody MeSH
- zvířata MeSH
- Check Tag
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Evidence for a neuroprotective effect of lithium has accumulated over the last 2 decades, and this phenomenon has been regarded as an important mechanism of lithium action in mood disorders. It has been reflected by an increase in cerebral gray matter volume in lithium-treated subjects and by the favorable influence of lithium on cognitive functions. A neuroprotective effect of lithium also makes this ion a possible candidate for use as a therapeutic drug in neurology, especially in neurodegenerative disorders. In this paper, neurochemical mechanisms of neuroprotective action of lithium will be characterized. A possible association between the effect of lithium on brain structures reflected in neuroimaging studies, as well as on cognitive functions, and its neuroprotective action, will be considered. Data from experimental, epidemiological, and clinical studies have also pointed to an antidementia effect of lithium, bringing about some promise of using lithium in the treatment of mild cognitive impairment and Alzheimer's disease. The results of attempts of employing lithium in other neurodegenerative disorders will also be discussed.
- MeSH
- lidé MeSH
- nemoci mozku diagnostické zobrazování farmakoterapie MeSH
- neuroprotektivní látky terapeutické užití MeSH
- sloučeniny lithia terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
The purpose was to study the prevalence and predisposing factors of brain lesions in survivors of acute methanol poisoning. Clinical data on 106 patients with methanol poisoning were collected during the Czech mass poisoning outbreak. Of 83 survivors, in 46 (55%) patients, follow-up examinations including magnetic resonance imaging of brain (MR) were performed 3-8 and 24-28 months after discharge from the hospital. Of 46 patients with a median age of 49 (interquartile range, 35-57) years, 24 (52%) patients had a total of 40 abnormal brain findings with haemorrhagic lesions detected in 15 (33%) and non-haemorrhagic lesions found in 9 (19%) patients. The patients with haemorrhagic brain lesions were more acidemic (lower arterial blood pH, higher base deficit) and had higher glycaemia and lactacidaemia on admission than those without haemorrhages (all p < 0.05). Thirteen of 32 (41%) of patients with systemic anticoagulation and 2 of 14 (14%) of patients without it had haemorrhagic lesions (p = 0.080). Bleeding complications during the treatment occurred in 4 of 15 (27%) patients, and 5 of 15 (33%) patients had conditions predisposing to haemorrhage in the group with haemorrhagic lesions. In three cases with a series of computer tomography (CT)/MR performed during hospitalization, the necrotic lesions in the brain remained non-haemorrhagic during hospitalization and haemorrhagic lesions were detected on the follow-up MR examinations only. No association between brain haemorrhages and systemic anticoagulation during dialysis was found: brain haemorrhages might occur in severely poisoned patients treated without systemic anticoagulation, whereas treatment with high doses of heparin might not lead to brain haemorrhages.
- MeSH
- antikoagulancia terapeutické užití MeSH
- dospělí MeSH
- formiáty krev MeSH
- heparin terapeutické užití MeSH
- hospitalizace MeSH
- koncentrace vodíkových iontů MeSH
- krvácení chemicky indukované farmakoterapie epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lineární modely MeSH
- longitudinální studie MeSH
- magnetická rezonanční tomografie MeSH
- methanol krev otrava MeSH
- mozek účinky léků patologie MeSH
- následné studie MeSH
- nemoci mozku chemicky indukované farmakoterapie epidemiologie MeSH
- otrava farmakoterapie epidemiologie MeSH
- prevalence MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Klíčová slova
- Zaostřený ultrazvuk,
- MeSH
- Alzheimerova nemoc farmakoterapie MeSH
- biomedicínský výzkum * metody trendy MeSH
- hematoencefalická bariéra * metabolismus účinky léků ultrasonografie MeSH
- lidé MeSH
- nádory mozku * farmakoterapie krevní zásobení metabolismus MeSH
- nemoci mozku farmakoterapie krev metabolismus MeSH
- neurochirurgické výkony metody trendy využití MeSH
- statistika jako téma MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Kanada MeSH
BACKGROUND AND PURPOSE: The relationship between lesion formation and brain atrophy development in the early phase of multiple sclerosis is unclear. We investigated the association between new lesion accumulation and brain atrophy progression in patients with clinically isolated syndrome over 48 months. MATERIALS AND METHODS: Patients with clinically isolated syndrome (n = 210) were evaluated with 1.5T MR imaging at baseline and at 6, 12, 24, 36, and 48 months as part of a multicenter observational study of early administration of intramuscular interferon β-1a. Mixed-effect model analyses, adjusted for age, sex, and treatment status, investigated the association between accumulation of contrast-enhancing and T2 lesions and brain-volume percent changes in a 48-month period. RESULTS: In patients with clinically isolated syndrome, the average whole-brain volume decreased 2.5%, the mean lateral ventricle volume increased 16.9%, and a mean of 7.7 new/enlarging T2 lesions accumulated over the follow-up period. Patients with clinically isolated syndrome who showed greater percentages of change in whole-brain, white and gray matter, cortical, and lateral ventricle volumes over the follow-up period had more severe lesion outcomes at baseline (all P < .007). There were significant associations between decreased individual brain-volume measures at baseline and greater percentages of change during follow-up (P < .05). We found a significant association between the total cumulative number of new/enlarging T2 lesions and the evolution of whole-brain (P < .001), lateral ventricle (P = .007), gray matter and thalamic (P = .013), subcortical deep gray matter (P = .015), and cortical (P = .036) volumes over the follow-up period. CONCLUSIONS: Lesion accumulation and brain-volume changes occur simultaneously in the early phase of clinically isolated syndrome. More severe lesion and brain-volume outcomes at baseline were associated with greater development of brain atrophy over the follow-up period in patients with clinically isolated syndrome.
- MeSH
- adjuvancia imunologická terapeutické užití MeSH
- atrofie patologie MeSH
- demyelinizační nemoci farmakoterapie patologie MeSH
- dospělí MeSH
- interferon beta 1a terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- nemoci mozku farmakoterapie patologie MeSH
- progrese nemoci MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
NMDA receptors have received much attention over the last few decades, due to their role in many types of neural plasticity on the one hand, and their involvement in excitotoxicity on the other hand. There is great interest in developing clinically relevant NMDA receptor antagonists that would block excitotoxic NMDA receptor activation, without interfering with NMDA receptor function needed for normal synaptic transmission and plasticity. This review summarizes current understanding of the structure of NMDA receptors and the mechanisms of NMDA receptor activation and modulation, with special attention given to data describing the properties of various types of NMDA receptor inhibition. Our recent analyses point to certain neurosteroids as NMDA receptor inhibitors with desirable properties. Specifically, these compounds show use-dependent but voltage-independent block, that is predicted to preferentially target excessive tonic NMDA receptor activation. Importantly, neurosteroids are also characterized by use-independent unblock, compatible with minimal disruption of normal synaptic transmission. Thus, neurosteroids are a promising class of NMDA receptor modulators that may lead to the development of neuroprotective drugs with optimal therapeutic profiles.
- MeSH
- gating iontového kanálu účinky léků MeSH
- konformace proteinů MeSH
- lidé MeSH
- mozek účinky léků metabolismus MeSH
- nemoci mozku farmakoterapie metabolismus MeSH
- nervový přenos účinky léků MeSH
- neurony účinky léků metabolismus MeSH
- neuroprotektivní látky terapeutické užití MeSH
- receptory N-methyl-D-aspartátu chemie účinky léků metabolismus ultrastruktura MeSH
- vztahy mezi strukturou a aktivitou MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH