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https://www.readbyqxmd.com/read/29137615/advance-directives-proxy-opinions-and-treatment-restrictions-in-patients-with-severe-stroke
#1
Floor A S de Kort, Marjolein Geurts, Paul L M de Kort, Julia H van Tuijl, Ghislaine J M W van Thiel, L Jaap Kappelle, H Bart van der Worp
BACKGROUND: Patients with severe stroke often do not have the capacity to participate in discussions on treatment restrictions because of a reduced level of consciousness, aphasia, or another cognitive disorder. We assessed the role of advance directives and proxy opinions in the decision-making process of incapacitated patients. METHODS: Sixty patients with severe functional dependence (Barthel Index ≤6) at day four after ischemic stroke or intracerebral hemorrhage were included in a prospective two-center cohort study...
November 14, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29126870/susceptibility-to-unconscious-influences-is-unaffected-by-a-challenging-inhibitory-task-or-mental-exhaustion
#2
Angela Gurney, Anna-Nepheli L Lagos, Abigail Manning, Ryan B Scott
Unconscious influences have been demonstrated in a variety of behavioural contexts, however, a key question remains - to what extent do such influences vary with our changing mental states? We examine whether a prior inhibitory challenge increases susceptibility to subliminal priming in a stem completion task employing neutral (Experiment 1) and reward salient terms (Experiment 2). Results show stem completions to be significantly influenced by unconscious priming, and the challenging inhibitory task (the Stroop) to be significantly more mentally exhausting than the control task...
November 7, 2017: Consciousness and Cognition
https://www.readbyqxmd.com/read/29121879/hypnotic-susceptibility-and-affective-states-in-bipolar-i-and-ii-disorders
#3
Bingren Zhang, Jiawei Wang, Qisha Zhu, Guorong Ma, Chanchan Shen, Hongying Fan, Wei Wang
BACKGROUND: Highly hypnotizable individuals have impaired executive function, elevated motor impulsivity and increased emotional sensitivity, which are sometimes found in bipolar disorder patients. It is then reasonable to assume that certain aspects of hypnotic susceptibility differ with the types of bipolar disorder. METHODS: The Stanford Hypnotic Susceptibility Scale: Form C (SHSS:C) test, the Mood Disorder Questionnaire (MDQ), the Hypomanic Checklist-32 (HCL-32) and the Plutchick-van Praag Depression Inventory (PVP) were applied to 62 patients with bipolar I disorder, 33 bipolar II disorder, and 120 healthy volunteers...
November 9, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/29120013/primary-polydipsia-in-the-medical-and-psychiatric-patient-characteristics-complications-and-therapy
#4
Clara Sailer, Bettina Winzeler, Mirjam Christ-Crain
Primary polydipsia (PP) has been defined as excessive intake of fluids. However, the pathogenesis of PP remains unexplored. Different theories include a dysfunction in the thirst mechanism, involvement of the hippocampus, stress-reducing behaviour and lesion occurrences in specific areas of the brain. Most studies have been performed in the psychiatric setting, indicating that PP coincides with schizophrenia, anxiety disorder and depression. However, an increasing number of case reports emphasise the incidence of PP in non-psychiatric patients...
November 9, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29119462/syncope-in-pediatric-practice
#5
REVIEW
Pratibha Singhi, Arushi Gahlot Saini
Syncope is defined as a sudden, self-limited loss of consciousness and postural tone followed by spontaneous and complete recovery without any neurological sequelae. It is one of the most common paroxysmal disorders in children and adolescents. The three major causes of syncope in children are neural, cardiovascular and other non-cardiovascular causes. The common unifying mechanism is transient global hypoperfusion of the brain. The diagnosis is primarily clinical and objective laboratory investigations add little to the diagnosis in children especially in neurocardiogenic subtype...
November 9, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29118714/advances-in-roles-of-mir-132-in-the-nervous-system
#6
REVIEW
Yun Qian, Jialin Song, Yuanming Ouyang, Qixin Han, Wei Chen, Xiaotian Zhao, Yangmei Xie, Yinghui Chen, Weien Yuan, Cunyi Fan
miR-132 is an endogenous small RNA and controls post-transcriptional regulation of gene expression via controlled degradation of mRNA or transcription inhibition. In the nervous system, miR-132 is significant for regulating neuronal differentiation, maturation and functioning, and widely participates in axon growth, neural migration, and plasticity. The miR-132 is affected by factors like mRNA expression, functional redundancy, and signaling cascades. It targets multiple downstream molecules to influence physiological and pathological neuronal activities...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29118705/oxaliplatin-induced-hyperammonemic-encephalopathy-in-a-patient-with-metastatic-pancreatic-cancer-a-case-report
#7
Takatsugu Ogata, Hironaga Satake, Misato Ogata, Yukimasa Hatachi, Hisateru Yasui
Oxaliplatin-based chemotherapy is widely used to treat advanced cancer. Oxaliplatin-induced hyperammonemic encephalopathy is rarely reported. Here, we report a case of oxaliplatin-induced hyperammonemic encephalopathy occurring after gemcitabine plus oxaliplatin (GEMOX) chemotherapy in a patient with pancreatic cancer. A 76-year-old man received GEMOX regimen as first-line treatment for pancreatic adenocarcinoma with peritoneal dissemination. GEMOX consists of gemcitabine (1,000 mg/m(2)) and oxaliplatin (100 mg/m(2)) on day 1, repeated every 2 weeks...
September 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/29110977/clinical-mimics-an-emergency-medicine-focused-review-of-syncope-mimics
#8
Diana K Coleman, Brit Long, Alex Koyfman
BACKGROUND: Syncope is an event that causes a transient loss of consciousness (LOC) secondary to global cerebral hypoperfusion. The transient nature of the event can make diagnosis in the emergency department (ED) difficult, as symptoms have often resolved by time of initial presentation. The symptoms and presentation of syncope are similar to many other conditions, which can lead to difficulty in establishing a diagnosis in the ED. OBJECTIVE: This review evaluates patients presenting with a history concerning for possible syncope, mimics of syncope, and approach to managing syncope mimics...
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29101338/in-human-non-rem-sleep-more-slow-wave-activity-leads-to-less-blood-flow-in-the-prefrontal-cortex
#9
Laura Tüshaus, Ximena Omlin, Ruth O'Gorman Tuura, Andrea Federspiel, Roger Luechinger, Philipp Staempfli, Thomas Koenig, Peter Achermann
Cerebral blood flow (CBF) is related to integrated neuronal activity of the brain whereas EEG provides a more direct measurement of transient neuronal activity. Therefore, we addressed what happens in the brain during sleep, combining CBF and EEG recordings. The dynamic relationship of CBF with slow-wave activity (SWA; EEG sleep intensity marker) corroborated vigilance state specific (i.e., wake, non-rapid eye movement (NREM) sleep stages N1-N3, wake after sleep) differences of CBF e.g. in the posterior cingulate, basal ganglia, and thalamus, indicating their role in sleep-wake regulation and/or sleep processes...
November 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29095389/paroxysmal-tonic-upgaze-in-children-three-case-reports-and-a-review-of-the-literature
#10
Ayse Kartal
BACKGROUND: In clinical practice, nonepileptic paroxysmal events during infancy and childhood are common reasons for parents and caregivers to seek for medical advice. These events are mostly unrecognized and considered as an epileptic seizure because of the clinical features resembling an epileptic seizure. Paroxysmal tonic upgaze, which consists of recurrent episodes of sustained upward deviation of the eyes and incomplete downward saccades, and normal horizontal eye movements without impairment of consciousness, is a diagnostic challenge for the pediatrician and pediatric neurologist...
October 31, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29093690/distress-response-to-the-failure-to-an-insoluble-anagrams-task-maladaptive-emotion-regulation-strategies-in-binge-drinking-students
#11
Marie Poncin, Nicolas Vermeulen, Philippe de Timary
Background: Emotion regulation refers to the attempt to influence the latency, magnitude, and duration of an emotion, and to modify the experiential, behavioral, or physiological components of the emotional response. In situations of personal failure, individuals, and in particular those who present a tendency to self-focus, may experience intense emotional distress. Individuals who lack proper adaptive emotion regulation strategies may engage in activities leading to immediate pleasure, such as alcohol drinking, in order to escape the self-relevance of emotional experiences...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/29092102/nosologic-considerations-in-disorders-of-consciousness
#12
James L Bernat
No abstract text is available yet for this article.
November 1, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/29091304/reforming-the-taxonomy-in-disorders-of-consciousness
#13
Tim Bayne, Jakob Hohwy, Adrian M Owen
This paper examines the serious shortcomings that characterize the current taxonomy of post-comatose disorders of consciousness (DoC), and it provides guidelines for how an improved DoC taxonomy might be developed. In particular, it is argued that behavioural criteria for the application of DoC categories should be supplemented with brain-based criteria (e.g., information derived from EEG and fMRI), and that the categorical framework that currently characterizes DoC should be replaced by a more complex framework that better captures the performance of patients across a range of cognitive and behavioural tasks...
November 1, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/29084103/postconcussion-symptom-reporting-after-mild-traumatic-brain-injury-in-female-service-members-impact-of-gender-posttraumatic-stress-disorder-severity-of-injury-and-associated-bodily-injuries
#14
Sara M Lippa, Tracey A Brickell, Jason M Bailie, Louis M French, Jan E Kennedy, Rael T Lange
OBJECTIVE: Examine effects of diagnostically relevant posttraumatic stress disorder (PTSD) symptoms, mild traumatic brain injury (TBI) severity, and associated bodily injury severity on postconcussion symptom reporting in female service members (SM) compared with a matched sample of male SM. SETTING: Six US military medical treatment facilities. PARTICIPANTS: A total of 158 SM (79 females, 79 males) evaluated within 30 months after mild TBI...
October 27, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/29068830/propofol-induced-changes-in-%C3%AE-%C3%AE-sensorimotor-cortical-connectivity
#15
Mahsa Malekmohammadi, Nicholas AuYong, Collin M Price, Evangelia Tsolaki, Andrew E Hudson, Nader Pouratian
BACKGROUND: Anesthetics are believed to alter functional connectivity across brain regions. However, network-level analyses of anesthesia, particularly in humans, are sparse. The authors hypothesized that propofol-induced loss of consciousness results in functional disconnection of human sensorimotor cortices underlying the loss of volitional motor responses. METHODS: The authors recorded local field potentials from sensorimotor cortices in patients with Parkinson disease (N = 12) and essential tremor (N = 7) undergoing deep brain stimulation surgery, before and after propofol-induced loss of consciousness...
October 25, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29066701/-a-case-of-fournier-s-gangrene-due-to-perforation-of-lower-rectal-cancer-during-chemotherapy
#16
Haruhi Fukuhisa, Kenji Baba, Yoshiaki Kita, Hiroshi Tanabe, Tetsuya Ijichi, Shinichiro Mori, Shoji Natsugoe
Fournier's gangrene is a rapidly progressing bacterial infection, involving the subcutaneous and deep fascia. Although intestinal perforation after treatment with bevacizumab is well known, Fournier's gangrene rarely occurs during chemotherapy. A 73-year-old man with unresectable rectal cancer during chemotherapy involving the mFOLFOX6 plus bevacizumab regimen had a consciousness disorder and was admitted to our hospital on emergency. Computed tomography scans indicated a necrotizing soft tissue infection with large amounts of pneumoderma throughout the perineum...
October 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29066053/insomnia-heterogeneity-characteristics-to-consider-for-data-driven-multivariate-subtyping
#17
REVIEW
Jeroen S Benjamins, Filippo Migliorati, Kim Dekker, Rick Wassing, Sarah Moens, Tessa F Blanken, Bart H W Te Lindert, Jeffrey Sjauw Mook, Eus J W Van Someren
Meta-analyses and systematic reviews have reported surprisingly few consistent insomnia-characteristics with respect to cognitions, mood, traits, history of life events and family history. One interpretation of this limited consistency is that different subtypes of insomnia exist, each with its own specific multivariate profile of characteristics. Because previously unrecognized subtypes will be differentially represented in individual studies and dilute effect sizes of subtype-dependent characteristics of importance, they are unlikely to be reported consistently in individual studies, let alone in meta-analyses...
November 9, 2016: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/29065962/disordered-consciousness-or-disordered-wakefulness-the-importance-of-prolonged-polysomnography-for-the-diagnosis-drug-therapy-and-rehabilitation-of-an-unresponsive-patient-with-brain-injury
#18
Francesca Formica, Marco Pozzi, Paolo Avantaggiato, Erika Molteni, Filippo Arrigoni, Flavio Giordano, Emilio Clementi, Sandra Strazzer
Disorders of consciousness may follow brain injury, due to impairments of wakefulness and/or awareness. Polysomnography can identify elements that may be ascribed to impairments of specific neuroanatomical areas. Recognizing which impairments affect each patient is crucial for diagnosis, prognosis, and to select an appropriate therapy. We present a pediatric case of insufficient wakefulness in a patient with severe disability following a pilocytic astrocytoma. Polysomnography was crucial for diagnosis, as it detected a well-structured pattern with daytime sleep initiations in the REM sleep phase...
October 18, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29064976/considerations-when-treating-cosmetic-concerns-in-men-of-color
#19
REVIEW
Olabola Awosika, Cheryl M Burgess, Pearl E Grimes
BACKGROUND: Men of color include a diverse population encompassing individuals with Fitzpatrick skin Types IV through VI. Yet, there is a paucity of data describing the cosmetic concerns of this population. OBJECTIVE: To review the basic science of advantages and disadvantages of skin of color and pathophysiology, incidence, and treatment of disorders of cosmetic concern in men of color. METHODS: A MEDLINE search was performed for publications on sex and racial differences in basic science of skin, common disorders in men of color, and evidence-based treatments...
November 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/29058581/opsoclonus-myoclonus-syndrome-in-a-patient-with-japanese-encephalitis-a-case-report
#20
Subatharshini Sountharalingam, H M M T B Herath, Dharshana Wijegunasinghe, Sunethra Senanayke
BACKGROUND: Opsoclonus myoclonus syndrome is a rare neurological disorder that usually manifests as a paraneoplastic phenomenon. Although some viruses are reported to cause this condition, opsoclonus myoclonus syndrome by Japanese encephalitis has not been reported previously. CASE PRESENTATION: Here we present the case of a 31-year-old Sri Lankan woman who presented with fever, altered level of consciousness, opsoclonus, and facial myoclonus. She was diagnosed as having Japanese encephalitis based on cerebrospinal fluid and serum Japanese encephalitis-specific immunoglobulin M antibody and characteristic magnetic resonance imaging abnormalities...
October 23, 2017: Journal of Medical Case Reports
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