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neurological critical and fever

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https://www.readbyqxmd.com/read/27856098/gastric-perforation-and-critical-illness-polyneuropathy-after-steroid-treatment-in-a-patient-with-encephalitis-encephalopathy-with-transient-splenial-lesion
#1
Mitsuru Ikeno, Shinpei Abe, Hirokazu Kurahashi, Michihiko Takasu, Toshiaki Shimizu, Akihisa Okumura
The outcome of mild encephalitis/encephalopathy with reversible splenial lesion (MERS) is favorable whether or not specific treatment is performed. We report a patient with MERS treated with methylprednisolone, complicated by gastric perforation followed by critical illness polyneuropathy. The patient was a 14-year-old male with mildly impaired consciousness and hyponatremia who was treated with methylprednisolone pulse therapy. High fever appeared after methylprednisolone pulse therapy and free air was recognized on an abdomen roentgenogram...
November 14, 2016: Brain & Development
https://www.readbyqxmd.com/read/27581757/pyrexia-aetiology-in-the-icu
#2
REVIEW
Daniel J Niven, Kevin B Laupland
Elevation in core body temperature is one of the most frequently detected abnormal signs in patients admitted to adult ICUs, and is associated with increased mortality in select populations of critically ill patients. The definition of an elevated body temperature varies considerably by population and thermometer, and is commonly defined by a temperature of 38.0 °C or greater. Terms such as hyperthermia, pyrexia, and fever are often used interchangeably. However, strictly speaking hyperthermia refers to the elevation in body temperature that occurs without an increase in the hypothalamic set point, such as in response to specific environmental (e...
2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27435906/neurocritical-care-of-emergent-large-vessel-occlusion-the-era-of-a-new-standard-of-care
#3
Fawaz Al-Mufti, Elie Dancour, Krishna Amuluru, Charles Prestigiacomo, Stephan A Mayer, E Sander Connolly, Jan Claassen, Joshua Z Willey, Philip M Meyers
Acute ischemic stroke continues to be one of the leading causes of morbidity and mortality worldwide. Recent advances in mechanical thrombectomy techniques combined with prereperfusion computed tomographic angiography for patient selection have revolutionized stroke care in the past year. Peri- and postinterventional neurocritical care of the patient who has had an emergent large-vessel occlusion is likely an equally important contributor to the outcome but has been relatively neglected. Critical periprocedural management issues include streamlining care to speed intervention, blood pressure optimization, reversal of anticoagulation, management of agitation, and selection of anesthetic technique (ie, general vs monitored anesthesia care)...
July 19, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27296393/predicting-zika-virus-structural-biology-challenges-and-opportunities-for-intervention
#4
Bryan D Cox, Richard A Stanton, Raymond F Schinazi
BACKGROUND: Zika virus is an emerging crisis as infection is implicated in severe neurological disorders-Guillain-Barré syndrome and fetal microcephaly. There are currently no treatment options available for Zika virus infection. This virus is part of the flavivirus genus and closely related to Dengue Fever Virus, West Nile Virus, and Japanese Encephalitis Virus. Like other flaviviruses, the Zika virus genome encodes three structural proteins (capsid, precursor membrane, and envelope) and seven nonstructural proteins (NS1, NS2A, NS2B, NS3, NS4A, NS4B, and NS5)...
August 2015: Antiviral Chemistry & Chemotherapy
https://www.readbyqxmd.com/read/27165581/dengue-fever-with-diffuse-cerebral-hemorrhages-subdural-hematoma-and-cranial-diabetes-insipidus
#5
Nayomi Shermila Jayasinghe, Eranga Thalagala, Milanka Wattegama, Kanapathipillai Thirumavalavan
BACKGROUND: Neurological manifestations in dengue fever occur in <1 % of the patients and known to be due to multisystem dysfunction secondary to vascular leakage. Occurrence of wide spread cerebral haemorrhages with subdural hematoma during the leakage phase without profound thrombocytopenia and occurrence of cranial diabetes insipidus are extremely rare and had not been reported in published literature earlier, thus we report the first case. CASE PRESENTATION: A 24 year old previously healthy lady was admitted on third day of fever with thrombocytopenia...
2016: BMC Research Notes
https://www.readbyqxmd.com/read/27111888/crystal-structure-of-the-prefusion-surface-glycoprotein-of-the-prototypic-arenavirus-lcmv
#6
Kathryn M Hastie, Sébastien Igonet, Brian M Sullivan, Pierre Legrand, Michelle A Zandonatti, James E Robinson, Robert F Garry, Félix A Rey, Michael B Oldstone, Erica Ollmann Saphire
Arenaviruses exist worldwide and can cause hemorrhagic fever and neurologic disease. A single glycoprotein expressed on the viral surface mediates entry into target cells. This glycoprotein, termed GPC, contains a membrane-associated signal peptide, a receptor-binding subunit termed GP1 and a fusion-mediating subunit termed GP2. Although GPC is a critical target of antibodies and vaccines, the structure of the metastable GP1-GP2 prefusion complex has remained elusive for all arenaviruses. Here we describe the crystal structure of the fully glycosylated prefusion GP1-GP2 complex of the prototypic arenavirus LCMV at 3...
June 2016: Nature Structural & Molecular Biology
https://www.readbyqxmd.com/read/26755836/a-retrospective-study-of-clinical-profile-and-outcomes-of-critically-ill-patients-with-heat-related-illness
#7
M S Kalaiselvan, M K Renuka, A S Arunkumar
BACKGROUND AND AIMS: Heat-related illness (HRI) due to high ambient temperatures is a common feature during the Indian summer. HRI often results in Intensive Care Unit (ICU) admissions and are associated with significant morbidity and mortality. However, published report on the effects of HRI among the Indian population is lacking. This study was undertaken to identify the profile of patients admitted to ICU with clinical features of HRI and study their clinical outcomes. METHODS: This was a retrospective case series of patients admitted with features of HRI during the summer of 2012 in our multidisciplinary ICU...
November 2015: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/26746342/therapeutic-hypothermia-and-targeted-temperature-management-in-traumatic-brain-injury-clinical-challenges-for-successful-translation
#8
REVIEW
W Dalton Dietrich, Helen M Bramlett
The use of therapeutic hypothermia (TH) and targeted temperature management (TTM) for severe traumatic brain injury (TBI) has been tested in a variety of preclinical and clinical situations. Early preclinical studies showed that mild reductions in brain temperature after moderate to severe TBI improved histopathological outcomes and reduced neurological deficits. Investigative studies have also reported that reductions in post-traumatic temperature attenuated multiple secondary injury mechanisms including excitotoxicity, free radical generation, apoptotic cell death, and inflammation...
June 1, 2016: Brain Research
https://www.readbyqxmd.com/read/26605113/what-are-we-waiting-for-an-argument-for-early-surgery-for-spinal-epidural-abscesses
#9
Nancy E Epstein
BACKGROUND: In the article: Timing and prognosis of surgery for spinal epidural abscess (SEA): A review, Epstein raises one major point; it is imperative that spinal surgeons "take back decision-making" from our medical cohorts and reinstitute early surgery (<24 h) to better treat SEAs. METHODS: Spine surgeons recognize the clinical triad (e.g., fever [50%], spinal pain [92-100%], and neurological deficits [47%]) for establishing the diagnosis of an SEA. We also appreciate the multiple major risk factors for developing SEA; diabetes (15-30%), elevated white blood cell count (>12...
2015: Surgical Neurology International
https://www.readbyqxmd.com/read/26508622/franklin-delano-roosevelt-s-fdr-s-1882-1945-1921-neurological-disease-revisited-the-most-likely-diagnosis-remains-guillain-barr%C3%A3-syndrome
#10
Armond S Goldman, Elisabeth J Schmalstieg, Charles F Dreyer, Frank C Schmalstieg, Daniel A Goldman
In 2003, we published evidence that the most likely cause of FDR's 1921 neurological disease was Guillain-Barré syndrome. Afterwards, several historians and neurologists stated in their publications that FDR had paralytic poliomyelitis. However, significant criticism of our article or new support for that diagnosis was not revealed. One critic claimed that FDR's cerebrospinal fluid indicated poliomyelitis, but we did not find evidence that a lumbar puncture was performed. The diagnosis of FDR's neurological disease still depends upon documented clinical abnormalities...
October 27, 2015: Journal of Medical Biography
https://www.readbyqxmd.com/read/26481105/temperature-control-in-critically-ill-patients-with-a-novel-esophageal-cooling-device-a-case-series
#11
Ahmed F Hegazy, Danielle M Lapierre, Ron Butler, Eyad Althenayan
BACKGROUND: Mild hypothermia and fever control have been shown to improve neurological outcomes post cardiac arrest. Common methods to induce hypothermia include body surface cooling and intravascular cooling; however, a new approach using an esophageal cooling catheter has recently become available. METHODS: We report the first three cases of temperature control using an esophageal cooling device (ECD). The ECD was placed in a similar fashion to orogastric tubes...
2015: BMC Anesthesiology
https://www.readbyqxmd.com/read/26413933/fever-control-management-is-preferable-to-mild-therapeutic-hypothermia-in-traumatic-brain-injury-patients-with-abbreviated-injury-scale-3-4-a-multi-center-randomized-controlled-trial
#12
Toru Hifumi, Yasuhiro Kuroda, Kenya Kawakita, Susumu Yamashita, Yasutaka Oda, Kenji Dohi, Tsuyoshi Maekawa
In our prospective, multi-center, randomized controlled trial (RCT)-the Brain Hypothermia (B-HYPO) study-we could not show any difference on neurological outcomes in patients probably because of the heterogeneity in the severity of their traumatic condition. We therefore aimed to clarify and compare the effectiveness of the two therapeutic temperature management regimens in severe (Abbreviated Injury Scale [AIS] 3-4) or critical trauma patients (AIS 5). In the present post hoc B-HYPO study, we re-evaluated data based on the severity of trauma as AIS 3-4 or AIS 5 and compared Glasgow Outcome Scale score and mortality at 6 months by per-protocol analyses...
June 1, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/26377985/neurological-presentation-of-hemophagocytic-lymphohistiocytosis
#13
Żur-Wyrozumska Kamila, Rog Teresa, Mensah-Glanowska Patrycja, Szczudlik Andrzej
Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory disorder arising from defects in critical regulatory pathways responsible for termination of inflammatory response. We are presenting a case report of a 20-year-old male, admitted to the Department of Neurology because of left lower limb weakness and balance disturbances. After a few days of hospitalization, fever occurred. Laboratory tests revealed anemia, neutropenia, lymphopenia, and thrombocytopenia. The clinical course and laboratory tests results confirmed the diagnosis of HLH...
2015: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/26375934/what-can-biosignal-entropy-tell-us-about-health-and-disease-applications-in-some-clinical-fields
#14
REVIEW
Borja Vargas, David Cuesta-Frau, Raúl Ruiz-Esteban, Eva Cirugeda, Manuel Varela
Many physiological systems are paradigmatic examples of complex networks, displaying behaviors best studied by means of tools derived from nonlinear dynamics and fractal geometry. Furthermore, while conventional wisdom considers health as an 'orderly' situation (and diseases are often called 'disorders'), truth is that health is characterized by a remarkable (pseudo)-randomness, and the loss of this pseudo-randomness (i.e., the 'decomplex-ification' of the system's output) is one of the earliest signs of the system's dysfunction...
October 2015: Nonlinear Dynamics, Psychology, and Life Sciences
https://www.readbyqxmd.com/read/26268237/-outbreak-of-six-cases-of-nosocomial-legionella-pneumophila-pneumonia
#15
Yan Li, Yuhua Zhang, Haojun Fan, Luqing Wei
OBJECTIVES: To describe the clinical characteristics, diagnosis, treatment and the causes of outbreak of nosocomial pneumonia due to Legionella pneumophila. METHODS: The medical records of 6 cases of nosocomial Legionella pneumophila pneumonia were retrospectively reviewed, and the clinical data of clinical presentation, treatment, and etiologic diagnosis were analyzed. RESULTS: The 6 patients were health care providers of the Department of Respiratory and Critical Care Medicine of the Affiliated Hospital of Logistics University of PAPF...
April 2015: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/26148167/clinical-indicators-to-monitor-patients-with-risk-for-ineffective-cerebral-tissue-perfusion
#16
Miriam de Abreu Almeida, Marcos Barragan da Silva, Bruna Paulsen Panato, Ana Paula de Oliveira Siqueira, Mariana Palma da Silva, Bruna Engelman, Isis Marques Severo, Aline Tsuma Gaedke Nomura
OBJECTIVE: Select and validate the clinical indicators to monitor patients on risk for ineffective cerebral tissue perfusion, according to the Nursing Outcomes Classification (NOC). METHODOLOGY: Validation study carried out between November 2012 and August 2013, in a Brazilian hospital. Seventeen judges nurses evaluated the clinical indicators of Nursing Outcomes, according to NOC for patients on risk for ineffective cerebral tissue perfusion. In the first stage, were selected the nursing results for the assessment of the studied diagnosis and, in the second nurses assessment the importance of the indicators of the validated results in the previous step through a five points Likert scale (1 = not important to 5 = extremely important)...
2015: Investigación y Educación en Enfermería
https://www.readbyqxmd.com/read/26044457/diffuse-large-b-cell-lymphoma-presenting-with-central-pontine-myelinolysis-a-case-report
#17
Eri Kawata, Reiko Isa, Junko Yamaguchi, Kazuna Tanba, Yasuhiko Tsutsumi, Yoshinari Nagakane, Hitoji Uchiyama, Teruaki Akaogi, Yutaka Kobayashi, Nobuhiko Uoshima
INTRODUCTION: The most common cause of central pontine myelinolysis is an overly rapid correction of hyponatremia, although it can also occur in patients with any condition leading to nutritional or electrolyte stress. We report a case of diffuse large B-cell lymphoma with central pontine myelinolysis developing at the onset of disease. To the best of our knowledge, hematological malignancies presenting with central pontine myelinolysis have been rarely reported, especially in previously untreated patients, as in our case report...
2015: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/26042193/targeted-temperature-management-in-pediatric-central-nervous-system-disease
#18
Robert Newmyer, Jenny Mendelson, Diana Pang, Ericka L Fink
Acute central nervous system conditions due to hypoxic-ischemic encephalopathy, traumatic brain injury (TBI), status epilepticus, and central nervous system infection/inflammation, are a leading cause of death and disability in childhood. There is a critical need for effective neuroprotective therapies to improve outcome targeting distinct disease pathology. Fever, defined as patient temperature > 38°C, has been clearly shown to exacerbate brain injury. Therapeutic hypothermia (HT) is an intervention using targeted temperature management that has multiple mechanisms of action and robust evidence of efficacy in multiple experimental models of brain injury...
March 1, 2015: Current Treatment Options in Pediatrics
https://www.readbyqxmd.com/read/26021546/acute-fever-and-seizure-in-a-patient-with-recent-atrial-fibrillation-ablation
#19
Alice Gallo de Moraes, Pratik A Patel, Elizabeth Mahal, Christopher L Kramer, Juan C Diaz Soto, Teng Moua
Patients undergoing radiofrequency ablation for treatment of atrial fibrillation may present critically ill with complications of atrial esophageal fistula, commonly manifesting as neurologic deficits and septicemia difficult to distinguish from other acute etiologies without a high index of suspicion. The temporal variability in fistula formation and symptom presentation, along with their nonspecific features, makes diagnosis often a late finding with historically high morbidity and mortality. We present a patient admitted to a medical intensive care unit with status epilepticus and recurrent positive blood cultures for organisms commonly associated with the gastrointestinal (GI) tract...
July 2015: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/25780281/viral-immune-surveillance-toward-a-th17-th9-gate-to-the-central-nervous-system
#20
Andre Barkhordarian, April D Thames, Angela M Du, Allison L Jan, Melissa Nahcivan, Mia T Nguyen, Nateli Sama, Francesco Chiappelli
UNLABELLED: Viral cellular immune surveillance is a dynamic and fluid system that is driven by finely regulated cellular processes including cytokines and other factors locally in the microenvironment and systemically throughout the body. It is questionable as to what extent the central nervous system (CNS) is an immune-privileged organ protected by the blood-brain barrier (BBB). Recent evidence suggests converging pathways through which viral infection, and its associated immune surveillance processes, may alter the integrity of the blood-brain barrier, and lead to inflammation, swelling of the brain parenchyma and associated neurological syndromes...
2015: Bioinformation
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