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Narayan R Kissoon, Bryan C Hoelzer, David P Martin, Tim J Lamer
BACKGROUND: New advances in spinal cord stimulation have led to improved treatment of patients suffering from chronic pain. While the overall safety of newer stimulation devices has been established, no published reports exist regarding safety considerations when these devices are implanted in patients with a preexisting cardiac device. CASE REPORT: An 83-year-old man with a history of out-of-hospital cardiac arrest secondary to an episode of ventricular fibrillation underwent automated implantable cardiac defibrillator placement...
October 22, 2016: Pain Practice: the Official Journal of World Institute of Pain
Morteza Behnam, Hossein Pourghassem
BACKGROUND: EEG signal analysis of pediatric patients plays vital role for making a decision to intervene in presurgical stages. NEW METHOD: In this paper, an offline seizure detection algorithm based on definition of a seizure-specific wavelet (Seizlet) is presented. After designing the Seizlet, by forming cone of influence map of the EEG signal, four types of layouts are analytically designed that are called Seizure Modulus Maximas Patterns (SMMP). By mapping CorrEntropy Induced Metric (CIM) series, four structural features based on least square estimation of fitted non-tilt conic ellipse are extracted that are called CorrEntropy Ellipse Features (CEF)...
October 18, 2016: Journal of Neuroscience Methods
S Lühl, H Bode, W Schlötzer, M Bartsakoulia, R Horvath, A Abicht, M Stenzel, J Kirschner, S C Grünert
BACKGROUND: Pontocerebellar hypoplasia type 6 (PCH6) is a mitochondrial disease caused by mutations in the RARS2 gene. RARS2 encodes mitochondrial arginyl transfer RNA synthetase, an enzyme involved in mitochondrial protein translation. A total of 27 patients from 14 families have been reported so far. Characteristic clinical features comprise neonatal lactic acidosis, severe encephalopathy, intractable seizures, feeding problems and profound developmental delay. Most patients show typical neuroradiologic abnormalities including cerebellar hypoplasia and progressive pontocerebellar atrophy...
October 21, 2016: Orphanet Journal of Rare Diseases
Luca Santini, Santiago Saura, Carlo Rondinini
One of the biggest challenges in large-scale conservation is quantifying connectivity at broad geographic scales and for a large set of species. Because connectivity analyses can be computationally intensive, and the planning process quite complex when multiple taxa are involved, assessing connectivity at large spatial extents for many species turns to be often intractable. Such limitation results in that conducted assessments are often partial by focusing on a few key species only, or are generic by considering a range of dispersal distances and a fixed set of areas to connect that are not directly linked to the actual spatial distribution or mobility of particular species...
2016: PloS One
Scott Seaman, Paul Nelson, Jacob Alexander, Andrew Swift, James Fick
The authors present the case of a 53-year-old man who was referred with disabling retching provoked by left arm abduction. At the time of his initial evaluation, a cervical MRI study was available for review and revealed an anatomical variation of the ipsilateral juxtamedullary vertebrobasilar junction. After brain imaging revealed contact of the medulla by a dolichoectatic vertebral artery at the dorsal root entry zone of the glossopharyngeal and vagus nerves, the patient was successfully treated by microvascular decompression of the brainstem and cranial nerves...
October 21, 2016: Journal of Neurosurgery
Yasin Gocgun
We study radiation therapy scheduling problem where dynamically and stochastically arriving patients of different types are scheduled to future days. Unlike similar models in the literature, we consider cancellation of treatments. We formulate this dynamic multi-appointment patient scheduling problem as a Markov Decision Process (MDP). Since the MDP is intractable due to large state and action spaces, we employ a simulation-based approximate dynamic programming (ADP) approach to approximately solve our model...
October 20, 2016: Health Care Management Science
Shanshan Wang, Chao Han, Sisi Wang, Lijuan Bai, Shanshan Li, Jianguang Luo, Lingyi Kong
Cu(II) complexed amino acid ionic liquid, Cu(II)-[1-butyl-3-methylimidazolium][L-Pro] (Cu(II)-[BMIm][L-Pro]), was successfully adopted as chiral ligand to improve the enantioseparation efficiency in high speed counter-current chromatography (HSCCC). For the enantioseparation of intractable naringenin (NRG) racemic mixtures, Cu(II)-[BMIm][L-Pro] coupled with hydroxypropyl-β-cyclodextrin (HP-β-CD) was successfully applied as dual chiral selectors in HSCCC. The influence of important parameters, including the concentration of the chiral selectors, the pH value, and the temperature were investigated...
October 14, 2016: Journal of Chromatography. A
Asami Fujii, Naoya Inoue, Mikio Watanabe, Chisa Kawakami, Yoh Hidaka, Yoshihide Hayashizaki, Yoshinori Iwatani
BACKGROUND: Graves' disease (GD) and Hashimoto's disease (HD) are autoimmune thyroid diseases distinguished by the presence or absence of an anti-thyroid stimulating hormone receptor (TSHR) antibody (TRAb). TSHR gene polymorphisms determine the amount of TSHR expressed, which may in turn influence TRAb production. The FANTOM5 project identified six GD-associated SNPs within the enhancer regions of TSHR and unknown genes. In this study, we examined the association of 11 TSHR and unknown gene polymorphisms, 5 of which are located in TSHR enhancer regions, with the development and prognosis of GD and HD...
October 20, 2016: Thyroid: Official Journal of the American Thyroid Association
Michelle Hook, Sarah Woller, Eric Bancroft, Miriam Aceves, Mary Katherine Funk, John Hartman, Sandra M Garraway
Opioids and NSAIDs are commonly used to manage pain in the early phase of spinal cord injury (SCI). Despite its analgesic efficacy, however, our studies suggest that intrathecal (i.t.) morphine undermines locomotor recovery and increases lesion size in a rodent model of SCI. Similarly, intravenous (i.v.) morphine attenuates locomotor recovery. The current study explores whether i.v. morphine also increases lesion size after a spinal contusion (T12) injury, and quantifies the cell types that are affected by early opioid administration...
October 20, 2016: Journal of Neurotrauma
Youfang Cao, Anna Terebus, Jie Liang
The discrete chemical master equation (dCME) provides a fundamental framework for studying stochasticity in mesoscopic networks. Because of the multi-scale nature of many networks where reaction rates have large disparity, directly solving dCMEs is intractable due to the exploding size of the state space. It is important to truncate the state space effectively with quantified errors, so accurate solutions can be computed. It is also important to know if all major probabilistic peaks have been computed. Here we introduce the Accurate CME (ACME) algorithm for obtaining direct solutions to dCMEs...
2016: Multiscale Modeling & Simulation: a SIAM Interdisciplinary Journal
Letícia Pereira de Brito Sampaio
The ketogenic diet (KD), a high-fat, low-carbohydrate, and adequate-protein diet is an established, effective nonpharmacologic treatment option for intractable childhood epilepsy. The KD was developed in 1921 and even though it has been increasingly used worldwide in the past decade, many neurologists are not familiar with this therapeutic approach. In the past few years, alternative and more flexible KD variants have been developed to make the treatment easier and more palatable while reducing side effects and making it available to larger group of refractory epilepsy patients...
October 2016: Arquivos de Neuro-psiquiatria
Andres M Alvarez-Pinzon, Aizik L Wolf, Heather N Swedberg, Kory A Barkley, Juan Cucalon, Luciana Curia, Jose E Valerio
OBJECTIVE: The purpose of this retrospective study was to compare and evaluate Percutaneous Retrogasserian Balloon Compression (PBC) and Gamma Knife Radiosurgery (GKRS) for the treatment of trigeminal neuralgia (TN) in patients with multiple sclerosis (MS). METHODS: In this single-center, retrospective comparative study, 202 patients with MS and concomitant TN were evaluated. A minimum follow-up of 24 months was required. Patients with a history of microvascular decompression or previous intervention were excluded...
October 15, 2016: World Neurosurgery
Dirk De Ridder, Sook Ling Leong, Patrick Manning, Sven Vanneste, Paul Glue
BACKGROUND: Obsessive compulsive disorder (OCD) is a brain disorder with a lifetime prevalence of 2.3%, causing severe functional impairment as a result of anxiety and distress, persistent and repetitive, unwanted, intrusive thoughts (obsessions), and repetitive ritualized behavior (compulsions). Approximately 40-60% of patients with OCD fail to satisfactorily respond to standard treatments. Intractable OCD has been treated by anterior capsulotomy and cingulotomy, but more recently neurostimulation approaches have become more popular due to their reversibility...
October 15, 2016: World Neurosurgery
Garima Shukla, Anupama Gupta, Priya Agarwal, Shivani Poornima
PURPOSE: Levetiracetam (LEV) is often chosen early in the treatment of refractory epilepsy; however, its adverse effects have largely been studied as part of clinical trials. Oxcarbazepine and valproate (VPA) are the other commonly used AEDs and, hence, serve as good comparators. This study was conducted to evaluate behavioral abnormalities and somnolence among patients with epilepsy being treated with LEV and/or OXC compared with those receiving VPA. METHOD: Data of consecutive patients attending our intractable epilepsy clinic over a 2 1/2-year period were reviewed, and patients with at least one seizure a month, who had been initiated on either or a combination of LEV, VPA, or OXC, were included for analysis...
October 15, 2016: Epilepsy & Behavior: E&B
Solène Le Pennec-Prigent, Erwan Flecher, Vincent Auffret, Guillaume Leurent, Jean-Claude Daubert, Christophe Leclercq, Philippe Mabo, Jean-Philippe Verhoye, Raphael P Martins
OBJECTIVES: Extracorporeal life support is used for patients with severe heart failure as a bridge to heart transplantation or recovery. We aimed at analyzing the efficacy and safety of extracorporeal life support to treat refractory arrhythmic storm responsible for cardiogenic shock in patients resistant to antiarrhythmic drugs. DESIGN: Retrospective study. SETTING: University Hospital of Rennes, France. PATIENTS: Patients with refractory arrhythmic storm admitted between January 2005 and March 2015...
October 14, 2016: Critical Care Medicine
Julie M Waldfogel, Suzanne Nesbit, Steven P Cohen, Sydney M Dy
Opioids remain the mainstay of treatment for severe cancer pain, but up to 20% of patients have persistent or refractory pain despite rapid and aggressive opioid titration, or develop refractory pain after long-term opioid use. In these scenarios, alternative agents and mechanisms for analgesia should be considered. This case report describes a 28-year-old man with metastatic pancreatic neuroendocrine cancer with severe, intractable pain despite high-dose opioids including methadone and a hydromorphone patient-controlled analgesia (PCA)...
October 18, 2016: Journal of Pain & Palliative Care Pharmacotherapy
Jonathan Sandoval-Castillo, Catherine R M Attard, Shashikanth Marri, Chris J Brauer, Luciana M Möller, Luciano B Beheregaray
Captive breeding programs are often a necessity for the continued persistence of a population or species. They typically have the goal of maintaining genetic diversity and minimizing inbreeding. However, most captive breeding programs have been based on the assumption that the founding breeders are unrelated and outbred, even though in situ anthropogenic impacts often mean these founders may have high relatedness and substantial inbreeding. In addition, polygamous group-breeding species in captivity often have uncertain pedigrees, making it difficult to select the group composition for subsequent breeding...
October 18, 2016: Molecular Ecology Resources
Dongsheng Xu, Aini Wan, Jingjing Zhang, Lin Peng, Yun Chen, Yang He, Jianfeng Yang, Jian Jin
Hepatocyte growth factor (HGF) is a potent multi-functional protein that stimulates proliferation, survival, motility, scattering and differentiation during growth and development, and has been considered to be a potential therapeutic agent for the treatment of a number of intractable diseases. The aim of this study was to enhance the expression of recombinant fusion protein HSA-HGF (R494E) in CHO cells by inhibiting the intracellular ubiquitin ligase activity. The high stable expression sub-clones with different signal peptides were selected by western blot (WB) analysis and used for suspension culture...
October 18, 2016: Bioengineered
Katherine Moore, Rachel Haroz
BACKGROUND: Intractable bone pain is a notorious adverse effect of granulocyte-colony stimulating factors (G-CSFs), such as pegfilgrastim and filgrastim, which are given to help prevent neutropenia in patients who are undergoing chemotherapy. G-CSF-induced bone pain is surprisingly common and often refractory to treatment with conventional analgesics. CASE REPORT: This article describes an emergency department case of opiate and nonsteroidal anti-inflammatory drug-resistant pegfilgrastim-induced bone pain that was successfully alleviated with 10 mg of oral loratadine, allowing for discharge home...
October 14, 2016: Journal of Emergency Medicine
Yuka Morita, Kuniyuki Takahashi, Shuji Izumi, Yamato Kubota, Shinsuke Ohshima, Arata Horii
OBJECTIVE: Otitis media (OM) with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV) is a novel concept of ear disease that is characterized by progressive mixed or sensorineural hearing loss with occasional systemic involvement. Considering the accumulating knowledge about the characteristics of and treatment for auditory dysfunction in OMAAV, the objective of this study was to investigate the vestibular function and symptoms of patients with OMAAV. STUDY DESIGN: Retrospective chart review...
September 30, 2016: Otology & Neurotology
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