Deep brain stimulation (DBS) is an innovative method using neuromodulation in treatment of various diseases, most commonly used in Parkinson’s disease, tremor and dystonia. Due to method’s minimally invasive nature and very low incidence of severe adverse effects, the research upon its use in other indications is conducted. Treatment-resistant depression (TRD) is one of these emerging indications. Currently available data regarding the matter concentrate mainly of electrode placement within seven particular structures of the brain: the subgenual anterior cingulate cortex, the ventral capsule/ventral striatum, the lateral habenula, the nucleus accumbens, the inferior thalamic peduncle, the bed nucleus of the stria terminalis and the medial forebrain bundle. It is yet to be determined which stimulation targets bring the most optimal effect. Published clinical trials give basis to theorize that stimulation of each DBS target results in different neurotransmitter modulation. Antidepressant effects vary also depending on stimulation parameters and overall duration. The aim of this review is to compare various targets for stimulation and underlying physiological mechanisms in therapy of TRD. It is needed to keep in mind that there is still high demand on well-designed, randomized, double-blind trials on bigger groups of patients in order to exclude potential inconsistency between results of clinical research.
Nowadays, herbal preparations are increasingly used in medicine. These preparations are cheaper, more available and they have fewer side effects than synthetic ones. Nigella Sativa, commonly known as Black Cumin, has been used in traditional medicine since antiquity. This herb is known to have many properties. The prophet Muhammad himself has already mentioned them, claiming that “Black Cumin is a cure for all diseases except death". Researches on N. Sativa confirmed that it has anti-diabetic, anti-asthmatic, pro-fertility, antioxidant, hepatoprotective, neuroprotective, gastroprotective, immunomodulatory, analgesic, antibacterial, anti-inflammatory and anti-ischemic effects. Many of these properties are due to thymoquinone, which is the main component of black cumin essential oil. This present review is an attempt to provide a specific overview of researches and literatures of pharmacognostical profile and pharmacological activity of the seeds of this plant. It will be helpful for scientists, researchers and other healthcare professionals, who are working with this plant and who need to be up to date about it.
Primary cardiac tumors are very rare in the population. About 20% of it are malignant. The most common type of cardiac malignant tumor is angiosarcoma. This tumor has the ability to infiltrate surrounding tissues and form distant metastases. Angiosarcoma is most often located in the right atrium and it mostly attacks men. This neoplasm is difficult to diagnose, because it has no specific symptoms. Patients with this tumor may complain of a chest pain, cardiac arrhythmias, suffocation and distal oedema. The rarity of occurrence and the lack of specyfic symptoms contribute to late diagnosis of the disease and worse prognosis of patients. Angiosarcoma can also be misdiagnosed as pneumonia or more common cardiovascular disease for example coronary artery disease. In advanced stage, this tumor can even lead to myocardial rupture. Various imaging methods are used in the diagnostics of this neoplasm for example: CT, MRI, PET-CT or Echocardiography. Histopathological examinations are less frequently used due to the risk of serious complications like hemothorax. Due to the very uncommon occurrence of the angiosarcoma, guidelines describing treatment of patients with this neoplasm, have not been developed yet. Currently, surgical removal of the tumor (if it is possible), chemiotherapy and radiotherapy are used. Reaserches on the genetic mutations which cause angiosarcoma and the development of appropriate drugs may give patients a chance for more effective treatment in the future
The importance of brachial plexus palsy treatment is associated with its significant severity, along with Brachial plexus palsies can be treated by means of many different surgical and non-surgical methods which allow regeneration of full efficiency of the affected limb. The choice of method depends on such factors as type and region of injury, patient’s age or clinical presentation of the injury. The purpose of this review is to present current strategies of treating brachial plexus palsies, depending on therapeutic needs of the particular patient. This is a review study based upon selective literature overview, with emphasis on works published within past 13 years. 6 separate methods of brachial plexus palsy were assessed, without distinction of the reason of palsy occurring. Some of the invasive methods include operative treatment performed directly on occupied nervous tissue, such as microneural plexus reconstruction and nerve transfers (lower subscapular nerve transfer and contralateral C7 nerve transfer) whilst the others revolve around restoration of function of affected neighboring structures by themselves, e.g. shoulder tendon transfers. Rehabilitation and botulinum toxin-based treatment are non-operative methods revolving around enhancement of the function of the affected upper limb. Main measure of effectiveness of the treatment is assessment of the range of motion of the affected limb (ROM). There is still not enough information available regarding long-term efficiency of microneural plexus reconstruction and botulinum toxin-based treatment. They require further investigation while other methods are used commonly.
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