Take your health into your own hands

Take your health into your own hands

Take your health into your own hands

Alzheimer’s, a protein in the blood detects nerve cell degeneration

A new study, recently published in JAMA Neurology, indicates that a simple blood test can reveal whether nerve cells in the brain are deteriorating at an abnormal rate. Researchers analyzed the presence of a protein, the so-called Neurofilament light Chain (NfL), in blood in patients with Alzheimer’s disease, finding a particularly high concentration of the protein.

Blood samples were collected over several years, and on several occasions, from 1,182 patients with varying degrees of cognitive impairment and 401 healthy subjects who made up the control group.

When nerve cells in the brain are damaged or die, the NfL protein enters the cerebrospinal fluid and then the blood: there were already suspicions about this, but long-term studies were lacking.

“We found that, in patients who develop Alzheimer’s disease, the concentration of NfL increases over time and that elevated levels correlate with the extent of accumulated brain damage,” said study coordinator Niklas Mattsson.

As is well known, Alzheimer’s is a complex disease that develops gradually and is difficult to analyze in its early, asymptomatic stages; the disease involves deterioration of cognitive and physical functions along with atrophy and death of brain cells. At present, there is no treatment that can reduce the loss of nerve cells in the brain, and available drugs are able to mitigate cognitive impairment but not slow the course of the disease. Measurements of NfL concentration in blood could be used to assess the effectiveness of a drug in influencing nerve cell loss and determine its optimal dosage.

Mattsson believes the method may soon translate into a standard clinical procedure: “at Sahlgrenska University Hospital in Gothenburg, we are doing the preparatory work to make this method available as a clinical procedure in the near future. Through a simple blood test, doctors will be able to measure nerve cell damage, produced by Alzheimer’s disease or other brain disorders.”.

Mattsson N, Cullen NC, Andreasson U, Zetterberg H, Blennow K. Association Between Longitudinal Plasma Neurofilament Light and Neurodegeneration in Patients With Alzheimer Disease. JAMA Neurol. 2019 Apr 22.

Hematemesis

Hematemesis is the emission oral of blood with vomiting. Symptomatology and objective signs depend on the aetiology. In the case of massive hemorrhage there will be a symptomatology and objectivity in hypovolemic shock. It is necessary to perform immediate procedures such as vein cannulation, the suspension of solid and liquid feeding and the insertion of a tube naso-gastric.

Laboratory tests to be performed are CBC, azotemia, blood glucose, ionogram, endoscopy, angiography, radioactive isotope radiological investigations, ECG, PA. In the case of esophageal varices, urgent perendoscopic sclerotherapy, endoscopic hemostasis and a possible infusion of Samotostatin is essential. For hematemesis of other nature sometimes targeted surgery or random therapy is needed.

Source: Mediserve‘s Medical Emergencies in Pediatrics.

What is hemoperfusion?

This is a system in which blood is brought from the patient, by arterial cannulation, into an extracorporeal circuit. The blood, before returning to the body via the venous route, is cleansed of toxins. Nonionic resins and activated charcoal in granular form are used to perform hemoperfusion .

Just as with hemodialysis, hemoperfusion does not can speak of a universal answer to all problems facing the clinician toxicology. It should be limited only in certain cases:

  • The adsorbent has an affinity for the toxin
  • The amount of circulating toxin must be a good portion of that contained in the body
  • There is a correlation between the concentration plasma toxin and the intensity of poisoning.

Hemoperfusion is contraindicated when:

  • The toxin has a large volume of distribution
  • The natural metabolic inactivation of the toxin is able to proceed faster than the time it takes for staff to health care to proceed with hemoperfusion
  • The toxic mechanism is precise and quick.

Hemoperfusion is, therefore, indicated, when:

  • No other methods of treatment
  • The toxin that threatens the patient has a small volume of distribution in the body
  • The substance has been analytically identified in the blood.

Techniques

Performing a hemoperfusion requires the cooperation of experienced people, as it requires the same degree of experience that is needed for hemodialysis. Facilities must be available to measure drug concentration in the palsma so that electrolyte balance, heparin levels, and other hematologic parameters can be repeatedly checked.

A fall in leukocyte and blood platelet values is possible. Random bleeding can be worrisome and even disastrous, so even minor surgeries should be performed with caution.

Source: Roy Goulding’s Vademecum of Poisoning Therapy.

Epitaxy: what to do?

Epitaxy is a hemorrhage that originates within the nasal passages. Blood may leak through the nostrils or transit posteriorly into the pharynx. If the hemorrhage is posterior or if the situation calls for it, tamponade with Foley’ s balloon catheter can be practiced by introducing it into the nostril and inflating it until tensile resistance is felt.

If the cause of bleeding is not known, a sinus X-ray is needed 2 weeks after tampon removal.

Source: Medical Guard Handbook edited by Piercarlo Salari

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PARENTING
 
THE CULTURE OF HEALTH
 
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NEUROVEGETATIVE DYSTONIA
 
WAYS OF BEING
 
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