Medical Hypotheses[JOURNAL]
Sun
200 papers
Out of balance: the role of evolutionary mismatches in the sex disparity in autoimmune disease.
Keestra SM, Male V, Salali GD
Med Hypotheses · 2021 Jun · PMID 33964604 · Publisher ↗
Over the past century autoimmune disease incidence has increased rapidly in (post-) industrialised, affluent societies, suggesting that changes in ecology and lifestyle are driving this development. Epidemiological studi...
Over the past century autoimmune disease incidence has increased rapidly in (post-) industrialised, affluent societies, suggesting that changes in ecology and lifestyle are driving this development. Epidemiological studies show that (i) 80% of autoimmune disease patients are female, (ii) autoimmune diseases co-occur more often in women, and (iii) the incidence of some autoimmune diseases is increasing faster in women than in men. The female preponderance in autoimmunity is most pronounced between puberty and menopause, suggesting that diverging sex hormone levels during the reproductive years are implicated in autoimmune disease development. Using an evolutionary perspective, we build on the hypotheses that female immunity is cyclical in menstruating species and that natural selection shaped the female immune system to optimise the implantation and gestation of a semi-allogeneic foetus. We propose that cyclical immunomodulation and female immune tolerance mechanisms are currently out of balance because of a mismatch between the conditions under which they evolved and (post-)industrialised, affluent lifestyles. We suggest that current changes in autoimmune disease prevalence may be caused by increases in lifetime exposure to cyclical immunomodulation and ovarian hormone exposure, reduced immune challenges, increased reproductive lifespan, changed reproductive patterns, and enhanced positive energy balance associated with (post-)industrialised, affluent lifestyles. We discuss proximate mechanisms by which oestrogen and progesterone influence tolerance induction and immunomodulation, and review the effect of the menstrual cycle, pregnancy, and contraceptive use on autoimmune disease incidence and symptoms.
Diaphragmatic speckle tracking imaging for 2D-strain assessment in mechanical ventilation weaning test.
Crognier L, Poette M, Conil JM … +2 more , Lairez O, Minville V
Med Hypotheses · 2021 Jul · PMID 33934026 · Publisher ↗
Ultrasound (US) is recognized as a useful tool for detecting lung physiology and pathology. Lung US is compared with standard techniques for evaluating lung structure and function such as computed tomography and pulmonar...
Ultrasound (US) is recognized as a useful tool for detecting lung physiology and pathology. Lung US is compared with standard techniques for evaluating lung structure and function such as computed tomography and pulmonary function tests. At present, markers of normal physiology and pathology are detected using expected image patterns. Detecting the latter depends on the experience of the operator. Diaphragmatic dysfunction is a particularly frequent problem in intensive care. Diaphragmatic dysfunction is easily assessed using lung US. Speckle tracking analysis, a known method for assessing tissue displacement and deformation in cardiology, is proposed to be utilized in lung US for detecting and quantifying lung sliding. Using speckle tracking analysis to diaphragmatic deformation quantification could be an informative and new tool for weaning from mechanical ventilation.
Etiopathogenesis of adolescent idiopathic scoliosis: Review of the literature and new epigenetic hypothesis on altered neural crest cells migration in early embryogenesis as the key event.
Zaydman AM, Strokova EL, Pahomova NY … +6 more , Gusev AF, Mikhaylovskiy MV, Shevchenko AI, Zaidman MN, Shilo AR, Subbotin VM
Med Hypotheses · 2021 Jun · PMID 33932710 · Publisher ↗
Adolescent idiopathic scoliosis (AIS) affects 2-3% of children. Numerous hypotheses on etiologic/causal factors of AIS were investigated, but all failed to identify therapeutic targets and hence failed to offer a cure. T...
Adolescent idiopathic scoliosis (AIS) affects 2-3% of children. Numerous hypotheses on etiologic/causal factors of AIS were investigated, but all failed to identify therapeutic targets and hence failed to offer a cure. Therefore, currently there are only two options to minimize morbidity of the patients suffering AIS: bracing and spinal surgery. From the beginning of 1960th, spinal surgery, both fusion and rod placement, became the standard of management for progressive adolescent idiopathic spine deformity. However, spinal surgery is often associated with complications. These circumstances motivate AIS scientific community to continue the search for new etiologic and causal factors of AIS. While the role of the genetic factors in AIS pathogenesis was investigated intensively and universally recognized, these studies failed to nominate mutation of a particular gene or genes combination responsible for AIS development. More recently epigenetic factors were suggested to play causal role in AIS pathogenesis. Sharing this new approach, we investigated scoliotic vertebral growth plates removed during vertebral fusion (anterior surgery) for AIS correction. In recent publications we showed that cells from the convex side of human scoliotic deformities undergo normal chondrogenic/osteogenic differentiation, while cells from the concave side acquire a neuronal phenotype. Based on these facts we hypothesized that altered neural crest cell migration in early embryogenesis can be the etiological factor of AIS. In particular, we suggested that neural crest cells failed to migrate through the anterior half of somites and became deposited in sclerotome, which in turn produced chondrogenic/osteogenic-insufficient vertebral growth plates. To test this hypothesis we conducted experiments on chicken embryos with arrest neural crest cell migration by inhibiting expression of Paired-box 3 (Pax3) gene, a known enhancer and promoter of neural crest cells migration and differentiation. The results showed that chicken embryos treated with Pax3 siRNA (microinjection into the neural tube, 44 h post-fertilization) progressively developed scoliotic deformity during maturation. Therefore, this analysis suggests that although adolescent idiopathic scoliosis manifests in children around puberty, the real onset of the disease is of epigenetic nature and takes place in early embryogenesis and involves altered neural crest cells migration. If these results confirmed and further elaborated, the hypothesis may shed new light on the etiology and pathogenesis of AIS.
Application of intravenous immunoglobulin (IVIG) to modulate inflammation in critical COVID-19 - A theoretical perspective.
Yaqinuddin A, Ambia AR, Elgazzar TA … +2 more , AlSaud MBM, Kashir J
Med Hypotheses · 2021 Jun · PMID 33878626 · Full text
COVID-19 is an airway disease that has affected ~125 million people worldwide, caused by a novel coronavirus termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), spread through respiratory droplets, direct...
COVID-19 is an airway disease that has affected ~125 million people worldwide, caused by a novel coronavirus termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), spread through respiratory droplets, direct contact, and aerosol transmission. Although most patients presenting with absent or mild symptoms recover completely, the highest morbidity and mortality rates are seen in the elderly, and patients with comorbidities such as cardiovascular diseases, cancer, immunosuppressive diseases, diabetes, and pre-existing respiratory illnesses. Several therapeutic strategies have been examined, but a wide-ranging therapeutic option for particularly severe cases of COVID-19 remains to be elucidated. Considering the indications presented by COVID-19 patients who present similarly with inflammatory conditions, intravenous immunoglobulin (IVIG) administration has been examined as a possible route to reduce proinflammatory markers such as ESR, CRP and ferritin by reducing inflammation, based on its anti-inflammatory effects as indicated by utilisation of IVIG for numerous other inflammatory conditions. Herein, summarising the recent key clinical evaluations of IVIG administration, we present our hypothesis that administration of IVIG within a specific dosage would be extremely beneficial towards reducing mortality and perhaps even the length of hospitalisation of patients exhibiting severe COVID-19 symptoms.
The role of carbohydrate antigen 125 in COVID-19.
Dökümcü E
Med Hypotheses · 2021 Jun · PMID 33873150 · Full text
Coronavirus disease 2019 (COVID-19) is an inflammatory process with complex pathophysiology and by affecting the cardiovascular system directly or indirectly that causes life threatening cardiac injuries. Therefore, clar...
Coronavirus disease 2019 (COVID-19) is an inflammatory process with complex pathophysiology and by affecting the cardiovascular system directly or indirectly that causes life threatening cardiac injuries. Therefore, clarifying the effects of this infection on the cardiovascular system is of importance in terms of the clinical course of the disease. The increases in cardiac and inflammatory biomarkers in COVID-19 have been associated with poor prognosis and mortality. However, there are no specific laboratory markers yet to assess the severity of the disease. In this context, the combination of available biomarkers is needed to better define the clinical course of this disease. Carbohydrate antigen 125 (CA-125) has become a remarkable marker in recent years as a result of the correlation of increasing levels in cardiovascular diseases with clinical, hemodynamic, echocardiographic parameters and its relation with mortality or re-hospitalization due to heart failure. These findings suggest that CA-125 might be useful biomarker to identify the damage mechanisms of COVID-19, monitoring the prognosis of the disease and the course of the treatment.
Origin of post-ictal and post-anesthesia adverse effects and possibly of SUDEP.
Rabinovitch A, Thieberger R, Aviram I … +2 more , Biton Y, Braunstein D
Med Hypotheses · 2021 Jun · PMID 33873149 · Publisher ↗
The origin of post-ictal malfunctions is debatable. We want to propose a novel idea of a cause of these adverse results occurring following epileptic seizures and anesthesia. Previously we have put forward the idea that...
The origin of post-ictal malfunctions is debatable. We want to propose a novel idea of a cause of these adverse results occurring following epileptic seizures and anesthesia. Previously we have put forward the idea that epileptic seizures termination is caused by the function of the glymphatic system in the brain. A new measurement shows that this system can be much faster than what was estimated before. Moreover, the method enabling this speeding was actually measured in brains of epilepsy subjects. So, the main objection to our model is relegated. As a possible consequence of the glymphatic process, there can be an excess cleaning of the brain's interstitial fluid. We discuss possible adverse results of this process. This over-cleaning (that can, to a lower extent, occur also during anesthesia) which results post-ictally from the previous overexpression of fluid materials by the neurons during their seizure operation, can reduce ingredients essential for regular neuronal functioning, thereby leading to function reduction and EEG suppression which last until those materials are replenished. We argue that this ingredients' scarcity is the cause of post-ictal generalized EEG suppression (PGES), of post-ictal immobility (PI) and possibly of Sudden Unexpected Death in Epilepsy Patients (SUDEP). Similarly, such cleaning can lead to morbidity and even mortality problems following anesthesia. If our assumption is correct, this understanding of the process of the problems' origin can lead to a method to remedy them by judicial supplement of the lost materials.
Critical oxygenation: Can muscle oxygenation inform us about critical power?
Feldmann A, Erlacher D
Med Hypotheses · 2021 May · PMID 33857860 · Publisher ↗
The power-duration relationship is well documented for athletic performance and is formulated out mathematically in the critical power (CP) model. The CP model, when applied properly, has great predictive power, e.g. ped...
The power-duration relationship is well documented for athletic performance and is formulated out mathematically in the critical power (CP) model. The CP model, when applied properly, has great predictive power, e.g. pedaling at a specific power output on an ergometer the model precisely calculates the time over which an athlete can sustain this power. However, CP presents physiological inconsistencies and process-oriented problems. The rapid development of near-infrared spectroscopy (NIRS) to measure muscle oxygenation (SmO) dynamics provides a physiological exploration of the CP model on a conceptual and empirical level. Conceptually, the CP model provides two components: first CP is defined as the highest metabolic rate that can be achieved through oxidative means. And second, work capacity above CP named W'. SmO presents a steady-state in oxygen supply and demand and thereby represents CP specifically at a local level of analysis. Empirically, exploratory data quickly illustrates the relationship between performance and SmO, as shown during 3-min all-out cycling tests to assess CP. During these tests, performance and SmO essentially mirror each other, and both CP and W' generate solid correlation with what would be deemed their SmO counterparts: first, the steady-state of SmO correlates with CP. And second, the tissue oxygen reserve represented in SmO, when calculated as an integral corresponds to W'. While the empirical data presented is preliminary, the proposition of a concurring physiological model to the current CP model is a plausible inference. Here we propose that SmO steady-state representing CP as critical oxygenation or CO. And the tissue oxygen reserve above CO would then be identified as O'. This new CO model could fill in the physiological gap between the highly predictive CP model and at times its inability to track human physiology consistently. For simplicity's sake, this would include acute changes in physiology as a result of changing climate or elevation with travel, which can affect performance. These types of acute fluctuations, but not limited to, would be manageable when applying a CO model in conjunction with the CP model. Further, modeling is needed to investigate the true potential of NIRS to model CP, with a focus on repeatability, recovery, and systemic vs local workloads.
Role of NLRP3 inflammasome in COVID-19 and periodontitis: Possible protective effect of melatonin.
Şehirli AÖ, Aksoy U, Koca-Ünsal RB … +1 more , Sayıner S
Med Hypotheses · 2021 Jun · PMID 33848919 · Full text
Daily new information emerges regarding the COVID-19, infection of SARS-CoV-2, which is considered a global pandemic. Angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) are required to c...
Daily new information emerges regarding the COVID-19, infection of SARS-CoV-2, which is considered a global pandemic. Angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) are required to complete the viral invasion pathway and are present in the oral mucosa, gingiva and periodontal pocket. Thus, increasing the likelihood of periodontitis and gingivitis caused by COVID-19. The cytokine storm during COVID-19 similarly arises during periodontal inflammation. Studies have reported that NOD-Like Receptor family pyrin domain-containing 3 (NLRP3) inflammasome is significant in the cytokine storm. Recently, the course of the COVID-19 has been related to the melatonin levels in both COVID-19 and periodontal diseases. It is known that melatonin prevents the activation of NLRP3 inflammasome. In light of these findings, we think that melatonin treatment during COVID-19 or periodontal diseases may prevent the damage seen in periodontal tissues by preventing the activation of NLRP3 inflammasome.
Violence towards women and their decisions to take action: A complex systems approach.
Katerndahl D, Burge S, Del Pilar Montanez Villacampa M … +2 more , Becho J, Rodriguez J
Med Hypotheses · 2021 Jun · PMID 33848918 · Publisher ↗
Intimate partner violence (IPV) is a blight on society. Our traditional understanding suggests that interventions should be straightforward, leading to predictable positive results. However, these assumptions do not refl...
Intimate partner violence (IPV) is a blight on society. Our traditional understanding suggests that interventions should be straightforward, leading to predictable positive results. However, these assumptions do not reflect the reality of IPV, which continues to frustrate physicians. While IPV research has thoroughly described the developmental risks and impacts of IPV, the violent incident itself remains largely unstudied and poorly understood. Although this lack of research may partially explain physician frustration and the limitations of our interventions, the greater problem may be our reliance upon the wrong paradigm in guiding our understanding. Complexity science says that systems are globally understandable, but not completely knowable. Our hypothesis is that IPV needs to be viewed as a complex adaptive system if we are to understand the phenomenon, identify expectations and appropriately intervene. When viewed through the lens of complexity science, IPV becomes less knowable and predictable, suggesting that interventionists should expect variable response. Research has indeed demonstrated that partner violence is a complex phenomenon with multiple, interdependent factors and a nonlinear trajectory. This nonlinearity/unpredictability can impact outcomes in IPV, often more so than the frequency or severity of the violence. Similarly, women's decision-making concerning the violence is also a nonlinear process dependent upon multiple factors and catastrophic influences. Once recognized, complexity science offers a novel approach to explain IPV's obfuscation and resistance to predictable change. Using the tempered expectations of a systems lens, the violent interdependencies can be clarified, the obscure causes of events can be visualized, and the temporal irregularities can be mapped. Not only can the disruptive tipping points, system feedforward propagations, powerful attractors and discontinuities compromise reasoned intervention, but these same factors, if understood, can be harnessed to foster and magnify circumstances that enable positive change.
Acute exercise and cognition: A review with testable questions for future research into cognitive enhancement with blood flow restriction.
Yamada Y, Frith EM, Wong V … +5 more , Spitz RW, Bell ZW, Chatakondi RN, Abe T, Loenneke JP
Med Hypotheses · 2021 Jun · PMID 33848917 · Publisher ↗
Blood flow restriction, in combination with low load/intensity exercise, has consistently been shown to increase both muscle size and strength. In contrast, the effects of blood flow restricted exercise on cognition have...
Blood flow restriction, in combination with low load/intensity exercise, has consistently been shown to increase both muscle size and strength. In contrast, the effects of blood flow restricted exercise on cognition have not been well studied. Therefore, the purpose of this paper is 1) to review the currently available literature investigating the impact of blood flow restricted exercise on cognition and 2) to provide some hypotheses for how blood flow restriction might provide an additive stimulus for augmenting specific cognitive domains above exercise alone. Given the lack of research in this area, the effects of blood flow restricted exercise on cognition are still unclear. We hypothesize that blood flow restricted exercise could potentially enhance several cognitive domains (such as attention, executive functioning, and memory) through increases in lactate production, catecholamine concentration, and PGC-1α expression. We review work that suggests that blood flow restriction is not only a beneficial strategy to improve musculoskeletal function but could also be a favorable method for enhancing multiple domains of cognition. Nonetheless, it must be emphasized this is a hypothesis that currently has only minimal experimental support, and further investigations in the future are necessary to test the hypothesis.
Are prion proteins and magnetite involved in the immune cells memory system connected to the covid-19?
Størmer FC
Med Hypotheses · 2021 May · PMID 33836419 · Full text
Abstract loading — click title to view on PubMed.
Could SARS-CoV-2 blocking of ACE2 in endothelial cells result in upregulation of CX3CL1, promoting thrombosis in COVID-19 patients?
Rivas-Fuentes S, Valdés VJ, Espinosa B … +2 more , Gorocica-Rosete P, Salgado-Aguayo A
Med Hypotheses · 2021 Jun · PMID 33836338 · Full text
SARS-CoV-2 is the causal agent of COVID-19 disease. Currently, infection with SARS-CoV-2 has been the cause of death of over 2.5 million people globally, and there is still no effective curative treatment. Clinically, th...
SARS-CoV-2 is the causal agent of COVID-19 disease. Currently, infection with SARS-CoV-2 has been the cause of death of over 2.5 million people globally, and there is still no effective curative treatment. Clinically, the severe symptoms caused by COVID-19, in addition to pneumonia, are associated with the development of hyperinflammatory syndrome and thrombosis. It is urgent to expand our understanding of the molecular mechanisms involved in the pathophysiology of COVID-19. This article discusses the potential role that the chemokine CX3CL1 could have in the development of COVID-19-associated thrombosis. CX3CL1 is abundantly expressed by activated endothelium and is an important regulator of many aspects of endothelial function and dysfunction, including thrombosis. The generation of hypotheses about molecules that could be relevant in well-defined aspects of the pathophysiology of COVID-19 encourages the development of basic and clinical studies, that could help find effective and much needed treatments.
Testicles, adipose organ and heart: A new axis in the management of SARS-CoV-2?
Bertuccioli A, Cardinali M, Di Pierro F … +1 more , Balducci D
Med Hypotheses · 2021 May · PMID 33831722 · Full text
Abstract loading — click title to view on PubMed.
Endotheliitis, endothelin, and endothelin receptor blockers in COVID-19.
Sanghavi DK, Titus A, Caulfield TR … +1 more , David Freeman W
Med Hypotheses · 2021 May · PMID 33823371 · Full text
We summarize the role of endothelin as a potent vasoconstrictor, pro-inflammatory, pro-oxidative agent in the pathophysiologic effects and end-organ dysfunction of coronavirus disease 2019 (COVID-19). Endotheliitis is an...
We summarize the role of endothelin as a potent vasoconstrictor, pro-inflammatory, pro-oxidative agent in the pathophysiologic effects and end-organ dysfunction of coronavirus disease 2019 (COVID-19). Endotheliitis is an under-recognized pathophysiologic process that causes various types of dysfunction in end organs, including heart, lung, kidney, and brain. Endothelin receptor blockers, such as bosentan and sitaxentan, can pave a path ahead in the realm of COVID-19 therapies. These agents have a potential role against COVID-19 and should be studied in research trials to determine their efficacy in treatment of this severe disease.
Right Broca's area is hyperactive in right-handed subjects during meditation: Possible clinical implications?
Magan D, Yadav RK
Med Hypotheses · 2021 May · PMID 33812300 · Publisher ↗
Broca's area, conventionally located in left (categorical) hemisphere of brain, is responsible for integrating linguistic and non-linguistic processing however, functionality of its right homolog remains partly understoo...
Broca's area, conventionally located in left (categorical) hemisphere of brain, is responsible for integrating linguistic and non-linguistic processing however, functionality of its right homolog remains partly understood and explored. This perception is based on the fact that in 96% of right-handed individuals, who constitute 91% of human population, the left hemisphere is dominant or categorical hemisphere. Here, we introduce novel scientific-based hypothesis that the right homolog of Broca's region which we observed hyperactive during attention focused meditation, might further play an important role in patients with attention deficits and language and speech disorders. Meditation includes self-regulation practices that focus on attention and awareness to achieve better control on mental processes. The positron emission tomography of brain in twelve (12) apparently healthy male, right-handed long-term meditators showed that the right Broca's area was significantly hyperactive (p = 0.002) during Meditation vs. Baseline while there was only a subtle increase in the activity of left Broca's area. Our results suggest that hitherto partly explored and understood right homolog of the Broca's area (referred to as right Broca's area) may have some important role, especially during meditation which needs to be explored further.
Strengthening CoViD-19 therapy via combinations of RAS modulators.
Uzunova VV, Todev A, Zarkos J … +5 more , Addai D, Ananiev J, Rashev P, Alexandrova R, Tolekova A
Med Hypotheses · 2021 May · PMID 33799164 · Full text
Evidence has accumulated that the pathology of CoViD-19 is strongly related to the renin-angiotensin system (RAS). The blockage of the angiotensin converting enzyme 2 (ACE2) by the SARS-CoV-2 virus leads to downstream co...
Evidence has accumulated that the pathology of CoViD-19 is strongly related to the renin-angiotensin system (RAS). The blockage of the angiotensin converting enzyme 2 (ACE2) by the SARS-CoV-2 virus leads to downstream consequences such as increased vascular tone, extensive fibrosis and pronounced immune reactions. Different approaches to tackle the adverse viral effects by compensating the lost ACE2 function have been suggested. Here, we use an unequal-arm lever model to describe a simplified version of the biased regulation exercised by the angiotensin II and angiotensin-(1-7) hormones, which are the substrate and the product of ACE2, respectively. We reason upon the lever dynamics and its disruptions caused by the virus, and propose that a combination of RAS modulators will most efficiently compensate the imbalance due to the excess of angiotensin II and the scarcity of angiotensin-(1-7). Specifically, we focus on the possible benefits of the simultaneous application of two agents, a MAS-receptor agonist and an angiotensin-II-type-2-receptor agonist. We conjecture that this combination has the potential to introduce a beneficial synergistic action that promotes anti-hypoxic, anti-fibrotic and anti-proliferative effects, thereby improving the clinical management of acute and chronic CoViD-19 pathologies.
Hypothesis: Intravenous administration of mesenchymal stem cells is effective in the treatment of Alzheimer's disease.
Shigematsu K, Takeda T, Komori N … +2 more , Tahara K, Yamagishi H
Med Hypotheses · 2021 May · PMID 33799163 · Publisher ↗
We propose the intravenous administration of autologous adipose-derived stem cells as a new treatment for Alzheimer's disease. We hypothesize that the stem cells will secrete neprilysin in the brain to break down and rem...
We propose the intravenous administration of autologous adipose-derived stem cells as a new treatment for Alzheimer's disease. We hypothesize that the stem cells will secrete neprilysin in the brain to break down and remove amyloid deposits in the Alzheimer's brain. We have shown a case of skin amyloid deposition that disappeared after stem cell administration and confirmed that the stem cells administered had neprilysin activity. In addition to neprilysin secretion, other mechanisms of action of stem cells include nerve regeneration, nerve repair, growth factor secretion, anti-inflammatory effects, and angiogenesis. The harvesting of adipose-derived stem cells is minimally invasive, and intravenous administration can be safely repeated. We hope that the efficacy of this new treatment will be verified and that it will bring a ray of hope to patients suffering from this incurable disease.
Extracorporeal shock wave therapy (ESWT): An emerging treatment for peri-implantitis.
Elisetti N
Med Hypotheses · 2021 May · PMID 33799162 · Publisher ↗
Implants have captivated dental fraternity with their attractive benefits alongside patient satisfaction. Nonetheless, success rate depends on the durability of implants without persisting symptoms. Many challenges have...
Implants have captivated dental fraternity with their attractive benefits alongside patient satisfaction. Nonetheless, success rate depends on the durability of implants without persisting symptoms. Many challenges have yet been addressed by the clinicians, be it the patient selection criteria, implant material susceptibility to microbial environment, procedural errors, etc. Evolving techniques focusing on these issues have resolved to a certain extent but research is still progressing towards perfection. ESWT presents itself as a non-invasive treatment modality beneficial both for the patients as well as the clinicians. Focusing on many of its benefits with its antimicrobial function to bone regeneration has attracted us.
Hystero-epilepsy in the Tuesday Lessons and NMDA receptor function: A hypothesis for dissociative disorder.
Komagamine T, Kokubun N, Hirata K
Med Hypotheses · 2021 May · PMID 33799161 · Publisher ↗
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis patients demonstrate characteristic multistage progression and movement disorders, which are analogous to hystero-epilepsy in Jean-Martin Charcot's Tuesday Lessons....
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis patients demonstrate characteristic multistage progression and movement disorders, which are analogous to hystero-epilepsy in Jean-Martin Charcot's Tuesday Lessons. First, based on a review of the Tuesday Lessons recorded by Charcot's pupils, we hypothesized that there were patients with anti-NMDAR encephalitis among those diagnosed with hystero-epilepsy in the nineteenth century. We found acute-onset multiple neuropsychiatric manifestations resembling anti-NMDAR encephalitis among patients with hystero-epilepsy. Patients with drug withdrawal syndrome, dissociative and conversion disorders and patients under hypnosis from the modern point of view were also identified. These results suggested that hystero-epilepsy in the Tuesday Lessons could encompass dissociative and conversion disorders, hypnosis, drug withdrawal syndrome, and anti-NMDAR encephalitis-like manifestations. Based on Charcot's observations and current progress in molecular biology, such as the identification of glutamate/NMDAR system dysfunction in drug withdrawal syndrome, we then hypothesized that patients with dissociative and conversion disorders and those under hypnosis could also have hypofunction of the glutamatergic system. The NMDAR hypofunction hypothesis is emerging as a pathogenesis of schizophrenia. NMDAR antagonists are known to evoke symptoms similar to schizophrenia, anti-NMDAR encephalitis and near-death experiences. In current clinical reports, spectrum disorders such as dissociative disorder and conversion disorder have been observed in patients with anti-NMDAR encephalitis. Our hypothesis will offer an expansion of the NMDAR hypofunction hypothesis from psychosis to functional neurological disorders and normal specific situations, such as hypnosis, thanatosis, and near-death experiences.
Dual engineered gold nanoparticle based synergistic prophylaxis delivery system for HIV/AIDS.
Rawat P, Gupta S
Med Hypotheses · 2021 May · PMID 33799160 · Publisher ↗
HIV is a pandemic and continuously raises problem across the world. This disease puts an immense pressure on treatment modalities. There are only few clinically accepted drugs available for the treatment and few molecule...
HIV is a pandemic and continuously raises problem across the world. This disease puts an immense pressure on treatment modalities. There are only few clinically accepted drugs available for the treatment and few molecules under clinical development. Although, the antiretroviral drugs give reliable and positive response on control of virus replication but during the long treatment, it has been affirmed that there are number of side effects. With recent advancements in biotechnology, nanomaterials such as gold and silver etc. are proving to be a game changer in targeted drug delivery treatment. As gold nanoparticles (AuNPs) are biocompatible natural excipients, a lot of scientists are very eager to investigate more about the immune effects of AuNPs to create a safe and cost effective treatment that could potentially help in the reduction of numerous toxic effects present in the existing treatments of various critical diseases like cancer and HIV etc. In this context, the present hypothesis recommends the use of combination drug delivery strategy based on gold nanoparticles that could pave the way to overcome adverse results of existing delivery techniques of antiretroviral drugs to treat HIV. This review also highlights the fact that a proper development of this gold nanoparticle combination antiretroviral drug delivery approach will not only help to suppress the virus multiplication but also target the viral entry area by attaching with gp120 (glycoprotein 120), and inhibit the binding with CD4 (Cluster of differentiation 4) T cells.
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