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https://www.readbyqxmd.com/read/29153725/differentiating-among-attempted-completed-and-multiple-nonfatal-strangulation-in-women-experiencing-intimate-partner-violence
#1
Jill Theresa Messing, Michelle Patch, Janet Sullivan Wilson, Gabor D Kelen, Jacquelyn Campbell
PURPOSE: Because identification of intimate partner violence (IPV) in health care settings is low and strangulation increases lethality risk among women experiencing IPV, we examined the prevalence and correlates of nonfatal strangulation among 1,008 women survivors of IPV. METHODS: Trained researchers conducted semistructured interviews with women survivors of IPV referred by police. Multinomial logistic regression examined differential correlates of attempted, completed, and multiple strangulation...
November 16, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/29138109/mesopontine-neurons-implicated-in-anesthetic-loss-of-consciousness-have-either-ascending-or-descending-axonal-projections-but-not-both
#2
Adi Miriam Goldenberg, Anne Minert, Yelena Fishman, Gilly Wolf, Marshall Devor
The MPTA (mesopontine tegmental anesthesia area) is a key node in a network of axonal pathways that collectively engage the key components of general anesthesia: immobility and atonia, analgesia, amnesia and loss-of-consciousness. In this study we have applied double retrograde tracing to analyze MPTA connectivity, with a focus on axon collateralization. Prior tracer studies have shown that collectively, MPTA neurons send descending projections to spinal and medullary brain targets associated with atonia and analgesia as well as ascending projections to forebrain structures associated with amnesia and arousal...
November 11, 2017: Neuroscience
https://www.readbyqxmd.com/read/29136012/regional-knockdown-of-ndufs4-implicates-a-thalamocortical-circuit-mediating-anesthetic-sensitivity
#3
Renjini Ramadasan-Nair, Jessica Hui, Pavel I Zimin, Leslie S Itsara, Philip G Morgan, Margaret M Sedensky
Knockout of the mitochondrial complex I protein, NDUFS4, profoundly increases sensitivity of mice to volatile anesthetics. In mice carrying an Ndufs4lox/lox gene, adeno-associated virus expressing Cre recombinase was injected into regions of the brain postulated to affect sensitivity to volatile anesthetics. These injections generated otherwise phenotypically wild type mice with region-specific, postnatal inactivation of Ndufs4, minimizing developmental effects of gene loss. Sensitivities to the volatile anesthetics isoflurane and halothane were measured using loss of righting reflex (LORR) and movement in response to tail clamp (TC) as endpoints...
2017: PloS One
https://www.readbyqxmd.com/read/29135903/micturition-syncope-in-childhood-how-to-recognize-and-manage-it
#4
Pierluigi Marzuillo, Stefano Guarino, Vincenzo Tipo, Andrea Apicella, Anna Grandone, Mario Diplomatico, Cesare Polito, Emanuele Miraglia Del Giudice, Angela La Manna, Laura Perrone
Frequently, general pediatricians could face a patient with syncope, which represents approximately 1% to 3% of emergency visits. Micturition syncope is a transient loss of consciousness with onset immediately before, during, or after micturition. Literature evidence indicates that healthy young men are a population with major risk for presenting micturition syncope, with a peak of incidence around 40 to 50 years of age. Usually, this syncope occurs in the morning, after wake-up, or, more generally, when the male patients assume the orthostatic position after a period of supine position in a warm bed...
November 14, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29132975/a-novel-temporal-pattern-of-childhood-cerebral-x-linked-adrenoleukodystrophy
#5
Emanuela C Turco, Francesca Ormitti, Anna Andreolli, Marina Barsacchi, Carlotta Facini, Francesco Pisani
We report a 9-year-old boy, with childhood cerebral X-linked adrenoleukodystrophy (CCALD), presenting with an episode of loss of consciousness, fixed gaze, hypotonia and vomit with spontaneous resolution and post-ictal sleep. Behavioural impairment has been observed since the previous five months. Magnetic Resonance Images (MRI) revealed isolated bilateral, symmetric, confluent temporal white matter lesions involving also corticospinal tracts, with sparing of the parieto-occipital and frontal white matter. This report outlines an atypical neuroradiological localization of X-linked adrenoleukodystrophy and neuropsychological findings not specifically related to the brain involvement seen at the MRI...
November 10, 2017: Brain & Development
https://www.readbyqxmd.com/read/29129117/calls-to-poison-centers-for-hookah-smoking-exposures
#6
Sandra S Retzky, Henry A Spiller, Priscilla Callahan-Lyon
Over the past decade, smoking behaviors have changed in the US. Hookah or waterpipe smoking is increasing, especially among youth and young adults. Social media sites describe the "hookah high" or "buzz", which may be related to nicotine, carbon monoxide, or other inhalants in hookah smoke. Most important is the risk of carbon monoxide poisoning. Case reports include a high number of victims presenting with loss of consciousness from either syncope or seizures. Anaphylaxis and a very rare respiratory hypersensitivity reaction, acute eosinophilic pneumonia, have also been reported from hookah smoking in previously healthy young adults...
November 13, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29128469/the-different-patterns-of-seizure-induced-aphasia-in-temporal-lobe-epilepsies
#7
Agnès Trebuchon, Isabelle Lambert, Bernard Guisiano, Aileen McGonigal, Charline Perot, Francesca Bonini, Romain Carron, Catherine Liegeois-Chauvel, Patrick Chauvel, Fabrice Bartolomei
OBJECTIVES: Ictal language disturbances may occur in dominant hemisphere temporal lobe epilepsy (TLE), but little is known about the precise anatomoelectroclinical correlations. This study investigated the different facets of ictal aphasia in intracerebrally recorded TLE. METHODS: Video-stereoelectroencephalography (SEEG) recordings of 37 seizures in 17 right-handed patients with drug-resistant TLE were analyzed; SEEG electroclinical correlations between language disturbance and involvement of temporal lobe structures were assessed...
November 8, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29123882/a-case-of-circumferential-type-a-aortic-dissection-with-intimal-intussusception-diagnosed-using-repeat-transthoracic-echocardiography-examination
#8
Toshinobu Yamagishi, Masahiro Kashiura, Kazuya Nakata, Kazuki Miyazaki, Takahiro Yukawa, Takahiro Tanabe, Kazuhiro Sugiyama, Akiko Akashi, Yuichi Hamabe
Case: Sometimes it is difficult to diagnose circumferential aortic dissection with enhanced computed tomography alone. A 58-year-old woman presented with sudden-onset chest discomfort and loss of consciousness. Transthoracic echocardiogram showed mild aortic regurgitation. Enhanced computed tomography scans showed no obvious intimal tear or flap at the proximal ascending aorta, but an intimal flap was observed from the aortic arch to both common iliac arteries. Stanford type B dissection was tentatively diagnosed...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29122806/diagnostic-utility-of-appetite-loss-in-addition-to-existing-prediction-models-for-community-acquired-pneumonia-in-the-elderly-a-prospective-diagnostic-study-in-acute-care-hospitals-in-japan
#9
Toshihiko Takada, Yosuke Yamamoto, Kazuhiko Terada, Mitsuyasu Ohta, Wakako Mikami, Hajime Yokota, Michio Hayashi, Jun Miyashita, Teruhisa Azuma, Shingo Fukuma, Shunichi Fukuhara
OBJECTIVE: Diagnosis of community-acquired pneumonia (CAP) in the elderly is often delayed because of atypical presentation and non-specific symptoms, such as appetite loss, falls and disturbance in consciousness. The aim of this study was to investigate the external validity of existing prediction models and the added value of the non-specific symptoms for the diagnosis of CAP in elderly patients. DESIGN: Prospective cohort study. SETTING: General medicine departments of three teaching hospitals in Japan...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29121298/human-neural-correlates-of-sevoflurane-induced-unconsciousness
#10
B J A Palanca, M S Avidan, G A Mashour
Sevoflurane, a volatile anaesthetic agent well-tolerated for inhalation induction, provides a useful opportunity to elucidate the processes whereby halogenated ethers disrupt consciousness and cognition. Multiple molecular targets of sevoflurane have been identified, complementing imaging and electrophysiologic markers for the mechanistically obscure progression from wakefulness to unconsciousness. Recent investigations have more precisely detailed scalp EEG activity during this transition, with practical clinical implications...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29121295/disruption-of-cortical-network-activity-by-the-general-anaesthetic-isoflurane
#11
H Hentschke, A Raz, B M Krause, C A Murphy, M I Banks
Background: Actions of general anaesthetics on activity in the cortico-thalamic network likely contribute to loss of consciousness and disconnection from the environment. Previously, we showed that the general anaesthetic isoflurane preferentially suppresses cortically evoked synaptic responses compared with thalamically evoked synaptic responses, but how this differential sensitivity translates into changes in network activity is unclear. Methods: We investigated isoflurane disruption of spontaneous and stimulus-induced cortical network activity using multichannel recordings in murine auditory thalamo-cortical brain slices...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29121108/spatio-temporal-dynamics-of-multimodal-eeg-fnirs-signals-in-the-loss-and-recovery-of-consciousness-under-sedation-using-midazolam-and-propofol
#12
Seul-Ki Yeom, Dong-Ok Won, Seong In Chi, Kwang-Suk Seo, Hyun Jeong Kim, Klaus-Robert Müller, Seong-Whan Lee
On sedation motivated by the clinical needs for safety and reliability, recent studies have attempted to identify brain-specific signatures for tracking patient transition into and out of consciousness, but the differences in neurophysiological effects between 1) the sedative types and 2) the presence/absence of surgical stimulations still remain unclear. Here we used multimodal electroencephalography-functional near-infrared spectroscopy (EEG-fNIRS) measurements to observe electrical and hemodynamic responses during sedation simultaneously...
2017: PloS One
https://www.readbyqxmd.com/read/29119462/syncope-in-pediatric-practice
#13
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/29119335/unilateral-vertebral-artery-injury-in-a-patient-with-displaced-upper-cervical-spine-fractures-the-treatment-for-one-case-of-vertebral-artery-embolism
#14
Hong-Jun Zou, Jun Wu, Yong Hu, Dong Cheng, Jin-Bo Liu
PURPOSE: To report a novel treatment method for vertebral artery injury. Vertebral artery injuries may be caused during trauma by fracture and excessive motion with subluxation from C2 to C6 in spite of vertebral artery deeply seated and normally well protected inside the transverse foramen. Optimal medical management of the occluded vertebral artery has yet to be determined. METHODS: We report on a severely displaced C2-C3 fracture that was found to have a vertebral artery injury...
November 8, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29114302/contrecoup-extradural-hematoma-with-coronal-suture-diastasis
#15
Pratap Chandra Nath, Sudhansu Sekhar Mishra, Manmath Kumar Dhir, Rama Chandra Deo, Bikash Ranjan Behera, Sitansu Kumar Rout
Extradural hematoma (EDH) generally occurs in the site of impact, that is, coup injury site. EDH is associated with fracture of skull in many a times due to direct impact. However, EDH in counter coup site is a rare occurrence. Hardly, yet, 12 cases have been reported including this case. Here, we reported a case of a 22-year-old male of contrecoup acute EDH who had sustained head injury due to fall from bike. Physical examination revealed direct impact at the left occipito-parietal region with laceration of scalp and bruise with transient loss of consciousness at the time of injury...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29111543/syncope-in-young-women-broadening-the-differential-diagnosis
#16
Nachiket Patel, Naila Choudhary, Christine Tompkins, Khawaja Afzal Ammar, A Jamil Tajik, Krishnaswamy Chandrasekaran, Timothy E Paterick
Syncope is defined as a sudden transient loss of consciousness (TLOC) with concomitant loss of postural tone followed by spontaneous recovery. It is a subset of a broader class of medical conditions, including postural orthostatic tachycardia syndrome (POTS), orthostatic hypotension, and neurally mediated syncope (NMS), that may result in TLOC. The overlap of these clinical conditions leads to confusion regarding syncope classification that can hinder evaluation strategies, and pose challenges for diagnosis and treatment, particularly in young women...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29111501/understanding-variability-in-driving-recommendations-for-patients-with-seizures
#17
Sidrah Mahmud, Sean T Hwang
BACKGROUND: There is lack of consensus regarding driving restrictions for patients with epilepsy. Regulations vary by state. New York State (NYS) recommends driving restrictions for one year in a person with an episode of loss of consciousness (LOC), with physician discretion. Often, providers make recommendations to permit their patients to drive after a shorter seizure-free period than proposed guidelines. The prevalence and reasons behind more lenient recommendations have not been elucidated...
October 27, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29110977/clinical-mimics-an-emergency-medicine-focused-review-of-syncope-mimics
#18
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/29106876/early-signs-and-symptoms-of-intracranial-complications-of-otitis-media-in-pediatric-and-adult-patients-a-different-presentation
#19
N A Van der Poel, E van Spronsen, D A Dietz de Loos, F A Ebbens
OBJECTIVES: The aim of this study was to review the clinical presentation and early signs and symptoms of otogenic intracranial complications (OIC) in children and adults. METHODS: retrospective chart review. The medical records of all children and adults admitted in our center with OIC during the period 2008-2017 were reviewed. Data concerning clinical presentation, treatment and outcomes were reviewed and analyzed. RESULTS: We included 47 patients with OIC: 21 children (range 1-13 years) and 26 adults (range 22-71 years)...
November 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29105672/-sinus-bradycardia-and-syncope-what-pathophysiological-mechanism-and-what-management-of-the-patient
#20
Paolo Alboni, Nicola Stucci, Claudia Parisi
Sick sinus syndrome (SSS) can be diagnosed only when there is a clear correlation between symptoms and sinus node dysfunction. In the absence of such correlation, the mechanism of undocumented intermittent symptoms such as syncopal spells in patients with permanent mild sinus bradycardia remains uncertain. Some clinical data suggest that a reflex mechanism is likely to be involved in many patients with syncope and sinus bradycardia: the course of syncopal recurrences is very variable from patient to patient and transient loss of consciousness does not recur in more than half of unpaced patients during an observation period of several years...
November 2017: Giornale Italiano di Cardiologia
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