Colombari, E* Dotaz Zobrazit nápovědu
BACKGROUND AND PURPOSE: Functional motor disorders (FMDs) are frequent and highly disabling conditions. Despite the substantial advances in FMDs diagnosis, mechanisms and treatments, their tangible application to care of patients with FMDs is yet to be established. We aimed to identify the main real-life gaps and barriers in FMDs care, faced by both patients and physicians, in two different European countries, Italy and Czechia. METHODS: A cross-cultural study was performed. RESULTS: Both patients and physicians are face practical difficulties and pay a high price for the poor management of FMDs as a result of outdated classifications and insufficient education. This, in turn, has led to inadequate access to care and the existence of common misbeliefs regarding symptom severity or even suspicion of malingering. FMDs need to be integrated into national healthcare systems and in research priorities so that substantial cost savings can be achieved and appropriate care provided to patients. CONCLUSIONS: We found multiple serious real-life unmet needs in FMD care, ranging from terminology and classification to poor recognition in national healthcare priorities. Based on these findings, we intend to mark the beginning of a collaborative project among researchers even in other different European settings to promote coordinated development efforts and goals in the evolving field of FMDs in clinical and research practice.
The maintenance of plasma sodium concentration within a narrow limit is crucial to life. When it differs from normal physiological patterns, several mechanisms are activated in order to restore body fluid homeostasis. Such mechanisms may be vegetative and/or behavioral, and several regions of the central nervous system (CNS) are involved in their triggering. Some of these are responsible for sensory pathways that perceive a disturbance of the body fluid homeostasis and transmit information to other regions. These regions, in turn, initiate adequate adjustments in order to restore homeostasis. The main cardiovascular and autonomic responses to a change in plasma sodium concentration are: i) changes in arterial blood pressure and heart rate; ii) changes in sympathetic activity to the renal system in order to ensure adequate renal sodium excretion/absorption, and iii) the secretion of compounds involved in sodium ion homeostasis (ANP, Ang-II, and ADH, for example). Due to their cardiovascular effects, hypertonic saline solutions have been used to promote resuscitation in hemorrhagic patients, thereby increasing survival rates following trauma. In the present review, we expose and discuss the role of several CNS regions involved in body fluid homeostasis and the effects of acute and chronic hyperosmotic challenges.
- MeSH
- centrální nervový systém účinky léků fyziologie MeSH
- hemoragický šok farmakoterapie patofyziologie MeSH
- homeostáza účinky léků fyziologie MeSH
- hypertonický solný roztok aplikace a dávkování MeSH
- krevní tlak účinky léků fyziologie MeSH
- ledviny účinky léků fyziologie MeSH
- lidé MeSH
- nervová síť fyziologie MeSH
- osmóza účinky léků fyziologie MeSH
- srdeční frekvence účinky léků fyziologie MeSH
- tělesné tekutiny účinky léků fyziologie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
