Abstract: Intracerebral haemorrhage is a subtype of stroke which has highest mortality and morbidity rates and currently has no cure. Cannabinoid 2 (CB2) receptor expression is up-regulated in neuronal injuries. CB2 receptor agonists were found to be neuroprotective in brain injuries including ischaemic and haemorrhagic stroke. This study was carried out to investigate the effects of cannabinoid 2 receptor (CB2R) activation by JWH133 on intracerebral haemorrhage (ICH) induced blood brain barrier disruption and oedema formation. ICH was induced in experimental animals by collagenase injection which causes significant vascular disruption and concomitant increase in oedema; animals were then treated with JWH133. Sixty CD-1 mice were randomly divided into sham, vehicle, and JWH133-treated groups (1 mg/kg and 10 mg/kg). Neurobehaviour, brain water content, Evans Blue dye extravasation, haemoglobin content, lung water content, and body weights post ICH were assessed. JWH133 treatment attenuated neurological deficits at 24 and 72 hours post-ICH. The treatment also reduced brain water content and Evans blue dye extravasation but had no effect on haemoglobin content and lung water content. Administration of JWH133 treatment mitigated weight loss at 48 and 72 hours after ICH. The reduction in brain water content and Evans blue dye extravasation indicate that CB2 receptor activation decreases blood brain barrier disruption and brain oedema, resulting in improved neurological functioning. This suggests that activation of the CB2 receptor by JWH133 is neuroprotective after ICH and may be a therapeutic target. Further study is needed to explore the mechanisms by which these effects occur.
Autorzy przedstawili przypadek 30-letniego mężczyzny, u którego doszło do nagłego zatrzymania krążenia w wyniku porażenia prądem wysokiego napięcia. Od 2. tygodnia po wypadku przeprowadzano rehabilitację w warunkach szpitalnych, mającą na celu utrzymanie zakresu ruchomości w stawach oraz od 6. tygodnia przeprowadzano intensywną rehabilitację w warunkach domowych. Mimo przeprowadzanego leczenia zaobserwowano całkowite ograniczenie ruchomości stawów biodrowych oraz w oparciu o radiogram i projekcję przestrzenną TK zdiagnozowano masywne neurogenne skostnienia heterotopowe (NSH). Przeprowadzono dwa zabiegi mające na celu usunięcie NSH: najpierw z okolicy lewego (15. miesiąc od wypadku), a następnie prawego stawu biodrowego (18. miesiąc od wypadku). Po interwencji zaobserwowano istotny wzrost ruchomości obu stawów biodrowych oraz zmniejszenie dolegliwości bólowych, co w efekcie znacznie poprawiło możliwości funkcjonalne pacjenta. Dodatkowo wprowadzono profi laktykę zapobiegającą nawrotom NSH, która polegała na utrzymaniu zarówno biernego, jak i czynnego zakresu ruchu oraz na stosowaniu zabiegów fi zykoterapeutycznych w postaci głębokiej oscylacji. W badaniu TK, wykonanym w 41. miesiącu po wypadku, uwidoczniono NSH w mniejszym stopniu, aniżeli miało to miejsce pierwotnie.
EN
Lower-limb oedemas can be the result of abnormalities in the structure and functioning of the lymphatic system, injuries or inflammation, or can be related to cancer and its treatment; however, they are more often one of the basic symptoms accompanying women in the third trimester of pregnancy due to vein insufficiency. The purpose of this overview is to discuss the current knowledge related to risk factors, prevention and treatment of lower-limb oedemas during pregnancy. The risk factors linked to gravidity-related oedema comprise of increased volume of circulating blood, the augmented uterus, increased body mass and changes to hormonal turnover. Vein insufficiency occurs as a result of venous hypertension caused by insufficiency of the muscle pump and valvar regurgitation. Pregnancy, the application of Caesarean section and the postpartum period predispose to deep vein thrombosis (DVT). The basic and unquestionable method applied in the prophylaxis and treatment of abnormalities to the venous-lymphatic system and corresponding complications consists in compression therapy involving compressive bandaging and the use of compression garments. Compression can be applied either individually or in combination with other methods, such as manual lymph drainage, intermittent pump compression and physical or breathing exercises. Based on the scientific evidence and experts’ recommendations, compression is also considered to be an effective solution in the prevention and treatment of deep vein thrombosis and swelling in pregnant women, but further investigation is needed. Ochałek K., Frydrych-Szymonik A., Szyguła Z. Lower-limb oedema during pregnancy. Med Rehabil 2016; 20(4): 17-21. DOI: 10.5604/01.3001.0009.5481
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