- Keywords
- BRAIN/diseases *, EDEMA *,
- MeSH
- Brain Edema * MeSH
- Edema * MeSH
- Brain * MeSH
- Brain Diseases * MeSH
- Publication type
- Journal Article MeSH
Neurogenic pulmonary edema (NPE) is a life-threatening complication of central nervous system (CNS) injuries. This review summarizes current knowledge about NPE etiology and pathophysiology with an emphasis on its experimental models, including our spinal cord compression model. NPE may develop as a result of activation of specific CNS trigger zones located in the brainstem, leading to a rapid sympathetic discharge, rise in systemic blood pressure, baroreflex-induced bradycardia, and enhanced venous return resulting in pulmonary vascular congestion characterized by interstitial edema, intra-alveolar accumulation of transudate, and intra-alveolar hemorrhages. The potential etiological role of neurotransmitter changes in NPE trigger zones leading to enhanced sympathetic nerve activity is discussed. Degree of anesthesia is a crucial determinant for the extent of NPE development in experimental models because of its influence on sympathetic nervous system activity. Sympathetic hyperactivity is based on the major activation of either ascending spinal pathways by spinal cord injury or NPE trigger zones by increased intracranial pressure. Attenuation of sympathetic nerve activity or abolition of reflex bradycardia completely prevent NPE development in our experimental model. Suggestions for future research into NPE pathogenesis as well as therapeutic potential of particular drugs and interventions are discussed.
- Keywords
- baroreflex-induced bradycardia, blood pressure rise, blood volume redistribution, central nervous system, neurogenic pulmonary edema, spinal cord injury, sympathetic nervous system,
- MeSH
- Central Nervous System injuries MeSH
- Humans MeSH
- Pulmonary Edema etiology physiopathology MeSH
- Animals MeSH
- Check Tag
- Humans MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
Pulmonary edema is a consequence of high pressures in the pulmonary microcirculation (predominantly capillaries) or an increase in the permeability of the alveolar-capillary barrier (generally of its endothelial aspect) or a combination of both. It occurs when the rate of transudation from the capillaries exceeds the rate of lymphatic drainage from the interstitium. If the plasma oncotic pressure is low due to hypoproteinemia, transudation of fluid occurs at lower pressures. Permeability pulmonary edema is strongly influenced by fluctuations in pulmonary capillary pressures: an increase in pulmonary capillary pressure can add a large component of hemodynamic pulmonary edema to that originating in leaky vessels. Noncardiogenic forms of pulmonary edema are described.
- MeSH
- Humans MeSH
- Pulmonary Edema * etiology physiopathology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- Keywords
- PULMONARY EDEMA/experimental *,
- MeSH
- Pulmonary Edema * MeSH
- Tannins * MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Tannins * MeSH
Together with diabetic retinopathy, diabetic macular edema (DME) ranks among the most common causes of severe loss of vision in working adults. Due to recent developments in imaging methods, new classification schemes of DME have been created. In addition to this, new treatment options have been introduced (new intravitreal drugs as well as treatment protocols). At the same time laser, surgical as well as combination therapy is still available. In this paper we evaluate the current knowledge about DME diagnostic and treatment options and formulate recommended guidelines for the management of DME.
- Keywords
- diabetic macular edema, guidelines, recommended guidelines, treatment, type 2 diabetes,
- MeSH
- Diabetes Mellitus * drug therapy surgery MeSH
- Diabetic Retinopathy * therapy drug therapy MeSH
- Adult MeSH
- Angiogenesis Inhibitors therapeutic use MeSH
- Intravitreal Injections MeSH
- Laser Coagulation adverse effects methods MeSH
- Humans MeSH
- Macular Edema * diagnosis etiology therapy MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Angiogenesis Inhibitors MeSH
- Keywords
- EDEMA/pathology *, LARYNX/diseases *,
- MeSH
- Edema pathology MeSH
- Laryngeal Edema * MeSH
- Larynx * MeSH
- Humans MeSH
- Laryngeal Diseases * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
Neurogenic pulmonary edema is a life-threatening complication, known for almost 100 years, but its etiopathogenesis is still not completely understood. This review summarizes current knowledge about the etiology and pathophysiology of neurogenic pulmonary edema. The roles of systemic sympathetic discharge, central nervous system trigger zones, intracranial pressure, inflammation and anesthesia in the etiopathogenesis of neurogenic pulmonary edema are considered in detail. The management of the patient and experimental models of neurogenic pulmonary edema are also discussed.
- MeSH
- Anesthesia adverse effects MeSH
- Intracranial Pressure physiology MeSH
- Humans MeSH
- Nervous System physiopathology MeSH
- Pulmonary Edema epidemiology etiology physiopathology MeSH
- Sympathetic Nervous System physiopathology MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Review MeSH
Diabetic retinopathy (DR) and diabetic macular edema (DME) are leading causes of severe visual loss in the working population. Therefore, both DR and DME have a significant socioeconomic and health impact, which taking into account the epidemiologic predictions is expected to increase. A crucial role in the management of DR and DME (not only for individuals, but also for the population) is played by an adequate screening program. This is based on the structure and organization of the healthcare system, the latest scientific developments in diagnostics (imaging) as well as technological advancements in computing (artificial intelligence, telemedicine) and their practical use. The recommendation presented by World Health Organization is also important. This paper evaluates all these factors, including evidence-based medicine reports and experience from existing DR and DME screening programs in comparable countries. Based on an evaluation of these parameters, recommended guidelines have been formulated for screening for DR and DME in the Czech Republic, including linkage to the Czech National Screening Center and the organization of the healthcare system.
- Keywords
- Diabetic retinopathy, diabetic macular edema, diabetic retinopathy, guidelines, mass screening, recommended guidelines, screening,
- MeSH
- Diabetes Mellitus * MeSH
- Diabetic Retinopathy * diagnosis MeSH
- Humans MeSH
- Macular Edema * diagnosis etiology MeSH
- Tomography, Optical Coherence adverse effects methods MeSH
- Telemedicine * methods MeSH
- Artificial Intelligence MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Keywords
- BRAIN DISEASE *, EDEMA *,
- MeSH
- Brain Edema * MeSH
- Edema * MeSH
- Brain Diseases * MeSH
- Publication type
- Journal Article MeSH
