19 research outputs found

    Neural Correlates of Executed Compared to Imagined Writing and Drawing Movements: A Functional Magnetic Resonance Imaging Study

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    Objective In this study we used functional magnetic resonance imaging (fMRI) to investigate whether motor imagery (MI) of handwriting and circle drawing activates a similar handwriting network as writing and drawing itself. Methods Eighteen healthy right-handed participants wrote the German word "Wellen" and drew continuously circles in a sitting (vertical position) and lying position (horizontal position) to capture kinematic handwriting parameters such as velocity, pressure and regularity of hand movements. Afterward, they performed the same tasks during fMRI in a MI and an executed condition. Results The kinematic analysis revealed a general correlation of handwriting parameters during sitting and lying except of pen pressure during drawing. Writing compared to imagined writing was accompanied by an increased activity of the ipsilateral cerebellum and the contralateral sensorimotor cortex. Executed compared to imagined drawing revealed elevated activity of a fronto-parieto-temporal network. By contrasting writing and drawing directly, executed writing induced an enhanced activation of the left somatosensory and premotor area. The comparison of the MI of these tasks revealed a higher involvement of occipital activation during imagined writing. Conclusion The kinematic results pointed to a high comparability of writing in a vertical and horizontal position. Overall, we observed highly overlapping cortical activity except of a higher involvement of motor control areas during motor execution. The sparse difference between writing and drawing can be explained by highly automatized writing in healthy individuals

    Modulation of the inflammatory response in experimental bacterial meningitis

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    In bacterial meningitis, tissue damage in the central nervous system (CNS) is inflicted by the host's inflammatory response to invading pathogens, rather than by the bacteria itself. Adjuvant treatment with anti-inflammatory drugs in experimental bacterial meningitis has demonstrated beneficial effects on CNS pathology. Of all the anti-inflammatory agents tested experimentally, only corticosteroids (dexamethasone) have attained clinical application. However, the efficacy of this use of dexamethasone in patients has been limited. In the search for better adjunctive treatment in bacterial meningitis, two anti-inflammatory substances, namely fucoidin and CNI- 1493, have been evaluated in the present study. Fucoidin, a carbohydrate, block leukocyte rolling by binding to selectin receptors, thereby preventing leukocyte adhesion to vessel endothelium and migration to the site of tissue inflammation. In a rabbit model, meningitis was induced by intracisternal injection of Streptococcus pneumoniae. Intravenous fucoidin treatment resulted in an almost complete inhibition of leukocyte accumulation in the subarachnoid space (SAS). Fucoidin also reduced cerebrospinal fluid (CSF) concentrations of the pro- inflammatory cytokines tumor necrosis factor alpha (TNF[alpha]) and interleukin- 1 (IL- 1), in the early phase of meningitis. Moreover, fucoidin efficiently prevented the CSF inflammatory burst induced by ampicillin in the same model of experimental meningitis (Papers I-III). CNI- 1493, a tetravalent guanylhydrazone, inhibits macrophage activation, primarily by attenuating TNF[alpha] production. CNI- 1493 was tested in a meningitis model in infant rats infected with Haemophilus influezae type b (Hib), injected intraperitoneally (i.p.). The group of animals pre-treated with CNI- 1493 i.p. had a 75 percent survival. In contrast, the untreated control group all died within 3 days. CNI- 1493 therapy significantly reduced the number of infiltrating granulocytes in the brain and the number of cells producing TNF[alpha] and IL- 1ß in the spleen (Paper IV). Conclusion: This study has demonstrated, for the first time in an in vivo disease model, that blocking of leukocyte rolling with a carbohydrate attenuate inflammation. Furthermore, its shown for the first time, that treatment with fucoidin and CNI-1493 have the capacity to markedly attenuate CNS inflammation evoked by bacteria. These findings illustrate novel, therapeutic approaches to the treatment of bacterial meningitis

    Vitamin D3 Supplementation and Antibiotic Consumption - Results from a Prospective, Observational Study at an Immune-Deficiency Unit in Sweden.

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    BACKGROUND:Vitamin D supplementation has been proposed to improve clinical symptoms during respiratory tract infections (RTIs), but results from randomized, placebo-controlled trials (RCT) are inconclusive. Previously, we performed an RCT in patients with various immune-disorders and observed that supplementation with 4000 IU vitamin D/day during 12 months significantly reduced antibiotic consumption and RTIs. This formed the basis for new guidelines at our unit; i.e. patients with insufficient levels of 25-hydroxyvitamin D (≤75 nmol/L) are now offered vitamin D supplementation. The aim of this prospective follow-up study was to evaluate the outcome of these new recommendations with regard to antibiotic consumption in our unit. METHOD:277 patients with insufficiency were supplemented with vitamin D3, 1500-1600 IU/day for 12 months. Each patient was its own control and data on antibiotic consumption was monitored 12 months before and 12 months after initiation of vitamin D3 supplementation. RESULTS:Vitamin D3 supplementation resulted in a significantly reduced antibiotic consumption, from 20 to 15 days/patient (p<0.05). The number of antibiotic-free patients increased from 52 to 81 after vitamin D3 supplementation; OR 1.79; 95% CI 1.20-2.66 (p<0.01). The number of antibiotic-prescriptions decreased significantly, a finding that mainly was attributed to a reduction of respiratory tract antibiotics (p<0.05). Subgroup analysis showed that only patients without immunoglobulin substitution (n = 135) had a significant effect of vitamin D supplementation. CONCLUSION:Vitamin D3 supplementation of 1600 IE /day is safe to use in immunodeficient patients with 25-OHD levels less than 75 nmol/L and significantly reduced the antibiotic consumption in patients without immunoglobulin substitution

    Vitamin D<sub>3</sub> Supplementation and Antibiotic Consumption – Results from a Prospective, Observational Study at an Immune-Deficiency Unit in Sweden - Fig 2

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    <p>Number of days with antibiotics (A) and number of prescriptions (B) per patients the year before and after starting on vitamin D treament. The lines shows median and boxes show interquartile range. Statistical test was performed using Wilcoxon matched-pairs signed rank test.</p

    Days with antibiotics for each patient (n = 277) the year before and after starting on vitamin D treament in the study cohort.

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    <p>Vitamin D supplementation resulted in more patients that could be without antibiotics during the year, the number of patients with no antibiotics increased from 52 to 81; Fischer exact test showed OR 1.79; 95% CI 1.20–2.66 (p<0.01).</p

    Diagnoses in the study cohort.

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    <p>CVID, Common Variable Immuno-Deficiency. ‘IgG Suppl’, number of patients with Immunoglobulin supplementation.</p
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