BACKGROUND: Spinal cord injury results in permanent neurological impairment and disability due to the absence of spontaneous regeneration. NG101, a recombinant human antibody, neutralises the neurite growth-inhibiting protein Nogo-A, promoting neural repair and motor recovery in animal models of spinal cord injury. We aimed to evaluate the efficacy of intrathecal NG101 on recovery in patients with acute cervical traumatic spinal cord injury. METHODS: This randomised, double-blind, placebo-controlled phase 2b clinical trial was done at 13 hospitals in the Czech Republic, Germany, Spain, and Switzerland. Patients aged 18-70 years with acute, complete or incomplete cervical spinal cord injury (neurological level of injury C1-C8) within 4-28 days of injury were eligible for inclusion. Participants were initially randomly assigned 1:1 to intrathecal treatment with 45 mg NG101 or placebo (phosphate-buffered saline); 18 months into the study, the ratio was adjusted to 3:1 to achieve a final distribution of 2:1 to improve enrolment and drug exposure. Randomisation was done using a centralised, computer-based randomisation system and was stratified according to nine distinct outcome categories with a validated upper extremity motor score (UEMS) prediction model based on clinical parameters at screening. Six intrathecal injections were administered every 5 days over 4 weeks, starting within 28 days of injury. Investigators, study personnel, and study participants were masked to treatment allocation. The primary outcome was change in UEMS at 6 months, analysed alongside safety in the full analysis set. The completed trial was registered at ClinicalTrials.gov, NCT03935321. FINDINGS: From May 20, 2019, to July 20, 2022, 463 patients with acute traumatic cervical spinal cord injury were screened, 334 were deemed ineligible and excluded, and 129 were randomly assigned to an intervention (80 patients in the NG101 group and 49 in the placebo group). The full analysis set comprised 78 patients from the NG101 group and 48 patients from the placebo group. 107 (85%) patients were male and 19 (15%) patients were female, with a median age of 51·5 years (IQR 30·0-60·0). Across all patients, the primary endpoint showed no significant difference between groups (with UEMS change at 6 months 1·37 [95% CI -1·44 to 4·18]; placebo group mean 19·20 [SD 11·78] at baseline and 30·91 [SD 15·49] at day 168; NG101 group mean 18·23 [SD 15·14] at baseline and 31·31 [19·54] at day 168). Treatment-related adverse events were similar between groups (nine in the NG101 group and six in the placebo group). 25 severe adverse events were reported: 18 in 11 (14%) patients in the NG101 group and seven in six (13%) patients in the placebo group. Although no treatment-related fatalities were reported in the NG101 group, one fatality not related to treatment occurred in the placebo group. Infections were the most common adverse event affecting 44 (92%) patients in the placebo group and 65 (83%) patients in the NG101 group. INTERPRETATION: NG101 did not improve UEMS in patients with acute spinal cord injury. Post-hoc subgroup analyses assessing UEMS and Spinal Cord Independence Measure of self-care in patients with motor-incomplete injury indicated potential beneficial effects that require investigation in future studies. FUNDING: EU program Horizon2020; Swiss State Secretariat for Education, Research and Innovation; Wings for Life; the Swiss Paraplegic Foundation; and the CeNeReg project of Wyss Zurich (University of Zurich and Eidgenössische Technische Hochschule Zurich).
- MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- krční mícha * zranění MeSH
- krční obratle MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- Nogo proteiny * MeSH
- poranění míchy * farmakoterapie MeSH
- senioři MeSH
- spinální injekce * MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze II MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
BACKGROUND: Reminiscence therapy (RT) is a widely used approach to promote well-being among older adults and is an effective intervention method for older adults with diverse health conditions, including community-dwelling older adults. OBJECTIVES: The aim of the study was to determine the impact of group RT on assessments of depression, anxiety and self-esteem in older adults living in the community. METHODS: We implemented sessions of group simple RT. The sample consisted of 24 older adults living in the community who attended a 12-week RT course. The duration of each reminiscence session was 60 min. The average age of the sample was 74.7 years. We used the Geriatric Depression Scale, the Geriatric Anxiety Inventory, the Rosenberg self-esteem scale, the Older adults' Quality of Life-Brief version and the Sense of Coherence scale to assess mental health outcomes before and after intervention. RESULTS: After intervention, we observed statistically significant improvements in assessments of depression (p < 0.001), anxiety (p = 0.011), self-esteem (p = 0.007) and the comprehensibility dimension of the sense of coherence scale (p = 0.039). Depression showed the largest effect size (Cohen's d = 0.870; 95% CI: 0.392 to 1.335), indicating a large effect, followed by self-esteem (Cohen's d = 0.612; 95% CI: -1.044 to -0.170) and anxiety (Cohen's d = 0.543; 95% CI: 0.108 to 0.967), both of which demonstrated a moderate effect. CONCLUSIONS: We found group RT to be effective for several outcomes among older adults. Reminiscence is a good non-invasive treatment for the promotion of mental health in community-dwelling older adults. IMPLICATIONS FOR PRACTICE: As research has now established RT to be an essential component of activities for older adults in senior care facilities, we should also offer it to those living in the community as an effective activity for the promotion of healthy aging among older adults.
- MeSH
- deprese * terapie psychologie MeSH
- geriatrické hodnocení MeSH
- kvalita života MeSH
- lidé MeSH
- samostatný způsob života * MeSH
- sebepojetí * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- skupinová psychoterapie metody MeSH
- úzkost * terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Hepatorenal tyrosinaemia (HT1) is an autosomal recessive disorder of tyrosine degradation resulting in hepatic and renal dysfunction, neurological sequelae may occur in some patients. The use of nitisinone (NTBC) has revolutionised treatment and outcome of this disorder. NTBC has to be combined with a low protein diet. While NTBC modulates the disease course in HT1 patients, several issues are open. Optimal dosage, doses per day, therapeutic range of NTBC concentration, mode of protein restriction and biomarkers are not well defined. HCC and neurocognitive deficits are long-term sequelae. Early diagnosis and treatment are essential to minimise the risk for these complications. Clinical guidance for management of HT1-patients is required. Randomised clinical studies are difficult in the presence of therapeutic options. We discussed these issues in a consensus group of 10 paediatricians, 1 adult hepatologist, 1 geneticist, 2 dieticians, 2 newborn screening specialists with experience in HT1, 1 psychologist and 2 representatives of a patient group from the German-speaking countries (DACH). Recommendations were based on scientific literature and expert opinion, also taking into account recent experience with newborn screening. There was strong consensus that newborn screening using succinylacetone (SA) and early treatment are essential for a good outcome. The dose of NTBC should be as low as possible without losing metabolic control. This has to be accompanied by a low protein diet, in some patients a simplified diet without calculation of protein intake. Specific education and psychosocial support are recommended. Indications for liver transplantation were defined. Monitoring shall include clinical findings, levels of SA, tyrosine, phenylalanine and NTBC in (dried) blood.
- MeSH
- cyklohexanony * terapeutické užití MeSH
- heptanoáty MeSH
- konsensus MeSH
- lidé MeSH
- nitrobenzoany * terapeutické užití MeSH
- nízkoproteinová dieta MeSH
- novorozenec MeSH
- novorozenecký screening * metody MeSH
- transplantace jater MeSH
- tyrosinemie * diagnóza terapie MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Geografické názvy
- Německo MeSH
Alterations in tricarboxylic acid (TCA) cycle metabolism are associated with hepatic metabolic disorders. Elevated hepatic acetate concentrations, often attributed to high caloric intake, are recognized as a pivotal factor in the etiology of obesity and metabolic syndrome. Therefore, the assessment of acetate breakdown and TCA cycle activity plays a central role in understanding the impact of diet-induced alterations on liver metabolism. Magnetic resonance-based deuterium metabolic imaging (DMI) could help to unravel the underlying mechanisms involved in disease development and progression, however, the application of conventional deuterated glucose does not lead to substantial enrichment in hepatic glutamine and glutamate. This study aimed to demonstrate the feasibility of DMI for tracking deuterated acetate breakdown via the TCA cycle in lean and diet-induced fatty liver (FL) rats using 3D DMI after an intraperitoneal infusion of sodium acetate-d3 at 9.4T. Localized and nonlocalized liver spectra acquired at 10 time points post-injection over a 130-min study revealed similar intrahepatic acetate uptake in both animal groups (AUCFL = 717.9 ± 131.1 mM▯min-1, AUClean = 605.1 ± 119.9 mM▯min-1, p = 0.62). Metabolic breakdown could be observed in both groups with an emerging glutamine/glutamate (Glx) peak as a downstream metabolic product (AUCFL = 113.6 ± 23.8 mM▯min-1, AUClean = 136.7 ± 41.7 mM▯min-1, p = 0.68). This study showed the viability of DMI for tracking substrate flux through the TCA cycle, underscoring its methodological potential for imaging metabolic processes in the body.
- MeSH
- acetáty metabolismus MeSH
- analýza metabolického toku MeSH
- citrátový cyklus * MeSH
- deuterium * MeSH
- játra * metabolismus diagnostické zobrazování MeSH
- krysa rodu rattus MeSH
- magnetická rezonanční tomografie MeSH
- potkani Sprague-Dawley MeSH
- potkani Wistar MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Angelman Syndrome (AS) is a neurodevelopmental disorder caused by the loss of function of ubiquitin-protein ligase E3A (UBE3A), resulting in marked changes in synaptic plasticity. In AS mice, a dysregulation of Ca2+/calmodulin-dependent protein kinase II alpha (CaMKIIα) was previously described. This has been convincingly validated through genetic rescue of prominent phenotypes in mouse cross-breeding experiments. Selective ligands that specifically stabilize the CaMKIIα central association (hub) domain and affect different conformational states in vitro are now available. Two of these ligands, 3-hydroxycyclopent-1-enecarboxylic acid (HOCPCA) and (E)-2-(5-hydroxy-2-phenyl-5,7,8,9-tetrahydro-6H-benzo[7]annulen-6-ylidene)acetic acid (Ph-HTBA), confer neuroprotection after ischemic stroke in mice where CaMKIIα is known to be dysregulated. Here, we sought to investigate whether pharmacological modulation with these prototypical CaMKIIα hub ligands presents a viable approach to alleviate AS symptoms. We performed an in vivo functional evaluation of AS mice treated for a total of 14 days with either HOCPCA or Ph-HTBA (7 days pre-treatment and 7 days of behavioural assessment). Both compounds were well-tolerated but unable to revert robust phenotypes of motor performance, anxiety, repetitive behaviour or seizures in AS mice. Biochemical experiments subsequently assessed CaMKIIα autophosphorylation in AS mouse brain tissue. Taken together our results indicate that pharmacological modulation of CaMKIIα via the selective hub ligands used here is not a viable treatment strategy in AS.
- MeSH
- Angelmanův syndrom * farmakoterapie genetika MeSH
- chování zvířat účinky léků MeSH
- fenotyp * MeSH
- ligandy MeSH
- modely nemocí na zvířatech * MeSH
- mozek účinky léků metabolismus MeSH
- myši inbrední C57BL MeSH
- myši MeSH
- neuroprotektivní látky farmakologie MeSH
- proteinkinasa závislá na vápníku a kalmodulinu typ 2 * metabolismus MeSH
- ubikvitinligasy metabolismus genetika MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- myši MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
Ageing is a complex phenomenon affecting a wide range of coexisting biological processes. The homogeneity of the studied population is an essential parameter for valid interpretations of outcomes. The presented study capitalises on the MRI data available in the Human Connectome Project-Aging (HCP-A) and, within individuals over 55 years of age who passed the HCP-A section criteria, compares a subgroup of 37 apparently neurocognitively healthy individuals selected based on stringent criteria with 37 age and sex-matched individuals still representative of typical ageing but who did not pass the stringent definition of neurocognitively healthy. Specifically, structural scans, diffusion weighted imaging and T1w/T2w ratio were utilised. Furthermore, data of 26 HCP-A participants older than 90 years as notional 'super-agers' were analysed. The relationship of age and several microstructural MRI metrics (T1w/T2w ratio, mean diffusivity, intracellular volume fraction and free water volume fraction) differed significantly between typical and healthy ageing cohort in areas highly relevant for ageing such as hippocampus, prefrontal and temporal cortex and cerebellum. However, the trajectories of the healthy ageing population did not show substantially better overlap with the findings in people older than 90 than those of the typical population. Therefore, caution must be exercised in the choice of adequate study group characteristics relevant for respective ageing-related hypotheses. Contrary to typical ageing group, the healthy ageing cohort may show generally stable levels of several MRI metrics of interest.
- MeSH
- kognice * fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mozek diagnostické zobrazování MeSH
- šedá hmota * diagnostické zobrazování MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stárnutí * fyziologie MeSH
- zdravé stárnutí fyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
A case report of a 68-year-old otherwise-healthy female patient with Spetzler-Martin (SM) grade I arteriovenous malformation (AVM) in her left frontal region is presented. After an uneventful surgery, cerebral venous infarction developed, and the patient was rendered hemiparetic with motor aphasia. After bony decompression, slow improvement was seen, and 3 months after surgery, the patient was neurologically intact. Six months after AVM resection, cranioplasty was performed. Infarction was caused by the thrombosis of a long primary draining vein, which finished its course in the normal cortical venous system. The case supports the venous origin of postoperative bleeding after AVM resection instead of the normal perfusion pressure phenomenon.
- MeSH
- cerebrální infarkt * etiologie chirurgie MeSH
- intrakraniální arteriovenózní malformace * chirurgie komplikace MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- mozkové žíly chirurgie diagnostické zobrazování MeSH
- pooperační komplikace etiologie chirurgie MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
INTRODUCTION: Assistive technologies (ATs) offer significant potential to improve the quality of life for individuals with Amyotrophic Lateral Sclerosis (ALS). This study explores the concept of integrated user value (IUV), focusing on five key aspects: quality, user experience, cost-effectiveness, safety, and accessibility. Understanding IUV is crucial for enhancing the development and deployment of ATs in ALS disease management. METHODS: A systematic search approach was utilized to collect data from Facebook ALS support groups, comprising posts from individuals with ALS and their caregivers. Using a predefined set of keywords, 416 posts were analyzed. The posts were categorized based on the five aspects of IUV, and an in-depth content analysis was conducted to explore patterns, challenges, and experiences associated with AT usage. RESULTS: The analysis revealed significant challenges across all aspects of IUV. Quality and user experience were interlinked, with users frequently citing inadequate designs and unmet customization needs. Cost-effectiveness was a key concern, with high costs and limited insurance coverage contributing to financial strain. Accessibility issues, including delays in acquiring devices and insufficient public facilities, further highlighted systemic challenges. Safety concerns emphasized the need for personalized and intuitive AT designs. DISCUSSION: The findings underscore the importance of a holistic approach to AT development, integrating all five aspects of IUV. Recommendations include enhancing product quality, ensuring affordability, prioritizing user-centered design, and addressing accessibility gaps. Collaboration between AT designers, healthcare providers, and policymakers is essential to optimize AT value and improve the quality of life for individuals with ALS and their caregivers.
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: The aim of this study was to investigate the associations between subjective and objective measures of stress and load in elite male handball players at both the group and individual levels. METHODS: In this 45-week prospective cohort study, 189 elite male handball players weekly reported their perceived stress and load across training, competition, academic, and work domains. Blood samples were collected five times during the 2022/23 season to measure cortisol and the free testosterone to cortisol ratio (FTCR). We derived a "load" variable as the sum of training, competition, academic and work hours and calculated acute, chronic, and acute-to-chronic ratio variables for both load and stress. Associations between subjective and objective measures were analyzed using Spearman's rank correlation. RESULTS: Weak to moderate positive associations were found between load and perceived stress (r = 0.19 to 0.46, p < 0.001), and between perceived stress and cortisol (r = 0.10, p = 0.023). Weak negative associations were found between perceived stress and FTCR (r = -0.18 to -0.20, p < 0.001) and between load and FTCR (r = -0.13, p = 0.003). A total of 86% of athletes had positive associations between stress and load (47% weak, 34% moderate, 5% high); 78% between stress and cortisol (27% weak, 22% moderate, 29% high); and 63% demonstrated negative associations between FTCR and load (18% weak, 32% moderate, 13% high). CONCLUSION: This study highlights the complexity between subjective and objective measures of stress and load in athletes. Understanding the link between these measures may help coaches and sports scientists streamline athlete monitoring. In cases where moderate to strong associations exist, subjective measures might serve as a reliable substitute for objective ones, making the monitoring process more time- and cost-efficient.
- Publikační typ
- časopisecké články MeSH
The novel diiron amine complexes [Fe2Cp2(CO)(NH2R')(μ-CO){μ-CN(Me)(Cy)}]CF3SO3 [R' = H, 3; Cy, 4; CH2CH2NH2, 5; CH2CH2NMe2, 6; CH2CH2(4-C6H4OMe), 7; CH2CH2(4-C6H4OH), 8; Cp = η5-C5H5, Cy = C6H11 = cyclohexyl] were synthesized in 49-92 % yields from [Fe2Cp2(CO)2(μ-CO){μ-CN(Me)(Cy)}]CF3SO3, 1a, using a straightforward two-step procedure. They were characterized by IR and multinuclear NMR spectroscopy, and the structure of 7 was confirmed through X-ray diffraction analysis. Complexes 3-8 and the acetonitrile adducts [Fe2Cp2(CO)(NCMe)(μ-CO){μ-CN(Me)(R)}]CF3SO3 (R = Cy, 2a; Me, 2b; Xyl = 2,6-C6H3Me2, 2c) were assessed for their water solubility, octanol-water partition coefficient and stability in physiological-like solutions. The in vitro antiproliferative activity of 2a-c and 3-8 was tested on seven human cancer cell lines (A2780, A2780R, PC3, A549, MCF7, HOS and HT-29), while the selectivity was evaluated using normal MRC-5 cells. Overall, the complexes exhibited variable cytotoxicity, with IC50 values reaching the low micromolar range for 3, 7 and 8 in A2780 and A2780R cells, along with significant selectivity. Targeted experiments covered cell cycle modification, induction of cell death, mitochondrial membrane potential, ROS production and interaction with DNA and bovine serum albumin (BSA) as a model protein. The interaction of 3 with BSA was further investigated through computational studies. Results showed a negligible increase in intracellular ROS levels (except for 2b) and insignificant changes in mitochondrial membrane potential.
- MeSH
- aminy chemie farmakologie MeSH
- komplexní sloučeniny chemie farmakologie chemická syntéza MeSH
- lidé MeSH
- ligandy MeSH
- molekulární struktura MeSH
- nádorové buněčné linie MeSH
- proliferace buněk * účinky léků MeSH
- protinádorové látky * farmakologie chemie chemická syntéza MeSH
- screeningové testy protinádorových léčiv * MeSH
- vztah mezi dávkou a účinkem léčiva MeSH
- vztahy mezi strukturou a aktivitou MeSH
- železo chemie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH