Desórdenes neurológicos

Background: Cerebellar hematoma is thought to result from a collection of blood in the cerebellar parenchyma. It is a rare topographical form, accounting for 5%-10% of hemorrhagic strokes, with an unpredictable and often dreadful prognosis. The aim of our study is to determine the prognostic factors of cerebellar hematomas in the Neurology Department of the CHU Ignace Deen in Conakry.
Methodology: We conducted a retrospective descriptive study lasting four (4) years, from June 1, 2017 to May 31, 2021, in the neurology department of the CHU de Conakry, focusing on patients hospitalized with a cerebellar hematoma confirmed by cerebral CT scan. The variables were epidemiological, clinical, therapeutic and prognostic. Any p-value <0.05 was considered statistically significant.
Results: A total of 33 patients, representing 9.7% of cerebellar hematomas, with a mean age of 60 ± 12.50 years, ranging from 33 to 82 years, and a male predominance of 69.7% (sex ratio 2.3). Hypertension was the main risk factor in 87.9% of cases. The main symptoms were headache in 90.9% of cases, dizziness in 81.8% and vomiting in 60.6%. The factor associated with a favorable outcome was an ICH score ≤ 2 (p-value=0.004)). The mortality rate was 27.3%. A favorable outcome without sequelae was observed in 18.2% of cases, versus 54.6% in cases with neurological sequelae.
Conclusion: At the end of this study, we concluded that cerebellar hematoma constitutes a diagnostic and therapeutic emergency. High ICH and modified Rankin
at re-entry were poor prognostic factors associated with functional sequelae and a high mortality rate.

Objective: Posttraumatic Stress Disorder (PTSD) is a complex condition that represents a significant burden in terms of individual disability and societal costs. Despite decades of research investigating treatment options, PTSD remains a major cause of quality-of-life impairment. We hypothesized that patients with PTSD might benefit from peripheral somatosensory stimulation (PSS) therapy.
Methods: 6 adult patients with clinically diagnosed PTSD were enrolled to undergo daily PSS therapy over a 4-week period. Patients completed two surveys evaluating satisfaction with treatment and overall well-being (Survey 1) and severity of PTSD symptoms (Survey 2). Survey 1 was completed weekly during the course of the study. Survey 2 was based on the 9-question National Stressful Events Survey PTSD Short Scale (NSESSS) and was completed as a baseline prior to initiation of therapy and then at the conclusion of the trial. All data were analyzed by an independent statistician.
Results: 6 male patients were enrolled in the study; all completed the trial. All patients demonstrated a decrease in symptoms within one week of initiation of therapy. This benefit was sustained and appeared to further improve over the course of the trial. For Survey 1, the overall median scores demonstrated a significant time-dependent improvement across measurement times (p<0.001). For Survey 2, patients had statistically significant improvements from baseline regarding feelings of being emotionally upset and being overly alert. Results from a cumulative link mixed model demonstrated that treatment yielded a 38.2-fold higher likelihood of transitioning from a higher PTSD score at baseline to a lower (improved) score at week 4. No adverse events were described by the patients.
Conclusion: PSS stimulation appeared to improve symptoms in all six patients with PTSD symptoms in this trial. Patients had unanimous and clinically meaningful improvement in overall PTSD symptoms with treatment. By week 4, all patients responded that they enjoyed the treatment and would like to keep their device. We suggest that further investigation into the potential usefulness of PSS therapy in patients with PTSD is warranted.

Thanks to the large amount of evidence, a broader and more multidisciplinary vision of the intestine has emerged refers to the role that this anatomical structure plays in human body. A new sophisticated conception has arisen which has imposed a different approach in terms of investigating bowel importance and the repercussions that its functional deficit has towards other systems directly or indirectly related to it. It is, in fact, a complex structure interconnected with other systems (nervous, endocrine and immune) whose efficiency is strongly influenced by a condition of dysbiosis.

Intestinal microbiota attracts daily attention of a growing number of researchers and the data accumulated today allow us to highlight how dysbiosis plays a very important role in Irritable Bowel Syndrome (IBS), Inflamed Bowel Syndrome (IBD), Crohn's disease (CD) and even in Leaky Gut Syndrome (LGS) rather than Polycystic Ovary Syndrome (PCOS), food intolerance, diabetes, metabolic syndrome and fibromyalgia, cancer, etc.. However the composition of the microbiota is influenced diet, use/abuse of drugs, lifestyle and especially from stress and its reverberation on the Autonomous Nervous System (ANS), etc.

In our study we wanted to analyze how a condition of intestinal dysbiosis may be related to chronic fatigue syndrome (CFS) and depression through the exchange of information through the intestinal-brain axis (GBA).

We studied 33 subjects, 13 males and 20 females, who reported chronic fatigue syndrome or/and depression: We investigated their salivary cortisol levels, blood serotonin (5-hydroxytryptamine, 5-HT), omega 3/6 ratio, intestinal dysbiosis (calculated on the levels of urinary metabolites of tryptophan-TRP-: Indoxyl sulfate and skatole), and we looked for the presence of Candida a. or mycetes in the stool.

The data accumulated with this research show a correlation between the presence of Candida a./miceti, indoxyl sulfate urine values ??beyond the physiological (characteristic of dysbiosis) and low 5-HT levels. In addition, data analysis showed that the EPA/DHA values ??also show pro-inflammatory levels in case of dysbiosis and low 5-HT levels.

The relationship, however, with cortisol levels requires further research although this study showed a statistically significant positive correlation between these values, measured at specific times, and 5-HT levels.

With this research we wanted to try to highlight the existing contact points, in some cases not so obvious, among these topics, contact points that, although they give us interesting indications, show the need to be further deepened by analyzing a larger amount of data.

Aim: We investigated the relationship between stress (evaluated through the measurement of salivary cortisol levels) and gastrointestinal efficiency measured as a function of intestinal fermentative and putrefactive dysbiosis, evaluating the levels of urinary indoxyl sulfate in the first case (a possible correlation with the presence of Candida a. or mycetes in the subjects feces was investigated), urinary skatole levels in the second one, in patients with chronic fatigue syndrome (SFC) and depression. In these patients we also have studied omega 3/6 ratio. Finally we have analyzed the impact that the alteration of all these parameters can have on the 5-HT levels.

This research attemps to highlight the contact points, in some cases not so obvious, among these topics, contact points that, although they give us interesting indications, show the need to be further deepened by analyzing a larger amount of data.