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https://www.readbyqxmd.com/read/29761337/-psychogenic-non-epileptic-seizures-differential-diagnostic-features
#1
REVIEW
Philipp S Reif, Laurent M Willems, Adam Strzelczyk, Karl Martin Klein, Felix Rosenow
Psychogenic nonepileptic seizures (PNES) are to be considered in the differential diagnosis of a transient loss of consciousness. Their discrimination from syncope, epileptic seizures or vascular events can be difficult and requires profound knowledge about the semiology and clinical presentation of PNES and their differential diagnoses. Erroneous diagnoses and the resulting therapies lead to elevated morbidity, elevated costs and a poorer outcome. The aim of the present article is to provide an overview on PNES and their delineation from the clinical pictures of epilepsy and syncope...
May 14, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29760857/retrospective-chart-review-of-synthetic-cannabinoid-intoxication-with-toxicologic-analysis
#2
Payal Sud, Miles Gordon, Laura Tortora, Matthew Stripp, Damon Borg, Adam Berman
Introduction: Use of synthetic cannabinoids (SC) has recently emerged as a new drug epidemic. Our emergency departments (EDs) received a surge of SC users presenting with lethargy and bradycardia, contrasting prior reports of SC-induced tachycardia and agitation. Our goal was to describe these novel presentations and characterize the compounds. Methods: We present a case series of patients with SC intoxication who presented to our toxicology service covering two tertiary care EDs between 2/11/2015 and 6/23/2015...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29759843/asystole-and-loss-of-consciousness
#3
EDITORIAL
Richard Sutton
No abstract text is available yet for this article.
December 26, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29759842/temporal-relationship-of-asystole-to-onset-of-transient-loss-of-consciousness-in-tilt-induced-reflex-syncope
#4
Dirk P Saal, Roland D Thijs, Erik W van Zwet, Marianne Bootsma, Michele Brignole, David G Benditt, J Gert van Dijk
OBJECTIVES: The purpose of this study was to investigate the relationship between the onset of asystole and transient loss of consciousness (TLOC) in tilt-induced reflex syncope and estimate how often asystole was the principal cause of TLOC. BACKGROUND: The presence of asystole in vasovagal syncope (VVS) may prompt physicians to consider pacemaker therapy for syncope prevention, but the benefit of pacing is limited in VVS. METHODS: We evaluated electrocardiography, electroencephalography, blood pressure, and clinical findings during tilt-table tests...
December 26, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29757890/pediatric-carbon-monoxide-poisoning-in-southern-israel-a-cross-sectional-study
#5
Yariv Fruchtman, Zvi H Perry, Tom Leibson, Liat Vered Cohen, Matitiahu Lifshitz, Eugene Leibovitz
OBJECTIVES: This study aimed to describe the epidemiology and clinical burden of unintended carbon monoxide (CO) poisoning among children in the Negev region of southern Israel. METHODS: This was a cross-sectional retrospective study of CO poisoning patients admitted to Soroka University Medical Center in 2011 through 2015. RESULTS: Overall, 43 cases of CO poisoning were recorded among children younger than 18 years. Five patients died, all upon admission...
May 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29756058/pupillary-dilation-reflex-and-pupillary-pain-index-evaluation-during-general-anaesthesia-a-pilot-study
#6
Davina Wildemeersch, Michiel Baeten, Natasja Peeters, Vera Saldien, Marcel Vercauteren, Guy Hans
Background: Pupillary response by pupillary dilatation reflex (PDR) is a robust reflex, even measurable during general anaesthesia. However, the ability of infrared pupillometry to detect PDR differences obtained by intraoperative opioid administration in anaesthesized patients remains largely unknown. We analyzed the performance of automated infrared pupillometry in detecting differences in pupillary dilatation reflex response by a inbuilt standardized nociceptive stimulation program in patients under general anesthesia with a standardized propofol/fentanyl scheme...
April 2018: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29753518/application-of-the-canadian-computed-tomography-head-rule-to-patients-with-minimal-head-injury
#7
Kevin Davey, Turandot Saul, Geoffrey Russel, Jonathan Wassermann, Joshua Quaas
STUDY OBJECTIVE: Two clinical decision rules, the Canadian CT Head Rule and the New Orleans Criteria, set the standard to guide clinicians in determining which patients with minor head trauma need computed tomography (CT) imaging. Both rules were derived with patients with minor head injury who had had a loss of consciousness or witnessed disorientation. No evidence exists for evaluating patients and need for CT imaging with minimal head injury; that is, patients who had a head injury but no loss of consciousness or disorientation and therefore would have been excluded from the Canadian CT Head Rule and New Orleans Criteria trials...
May 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29750692/trainability-of-cricoid-pressure-force-application-a-simulation-based-study
#8
Eric Noll, Shivam Shodhan, Arnavi Varshney, Christopher Gallagher, Pierre Diemunsch, F Barry Florence, Jamie Romeiser, Elliott Bennett-Guerrero
BACKGROUND: Aspiration of gastric contents is a leading cause of airway management-related mortality during anesthesia practice. Cricoid pressure (CP) is widely used during rapid sequence induction to prevent aspiration. National guidelines for CP suggest a target force of 10 N before and 30 N after loss of consciousness. However, few studies have rigorously assessed whether clinicians can be trained to consistently achieve these levels of force. We hypothesized that clinicians can be trained effectively to deliver 10-30 N during application of CP...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29747708/efficacy-of-treatment-with-belladonna-in-children-with-severe-pallid-breath-holding-spells
#9
M Cecilia Gonzalez Corcia, Adrien Bottosso, Isabelle Loeckx, Françoise Mascart, Guy Dembour, Geneviève François
IntroductionPallid breath-holding spells are common and dramatic forms of recurrent syncope in infancy. They are very stressful despite their harmless nature and sometimes require treatment. OBJECTIVE: The objective of this study was to evaluate the efficacy of belladonna in severe breath-holding spells. METHODS: This is a multicentric, retrospective series involving 84 children with severe pallid breath-holding spells. Inclusion criteria were >1 pallid breath-holding spell with loss of consciousness, paediatric cardiology evaluation, and follow-up >6 months...
May 11, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29745258/-transient-reactionary-physiological-asystole-trap-phenomenon-cause-of-fall-or-loss-of-consciousness-after-sub-arachnoid-hemorrhage-sah
#10
Krishan Kumar Bansal, Parshant Kumar Singh
No abstract text is available yet for this article.
May 10, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29739759/reflex-anoxic-seizures-ras-in-an-adult-patient-a-separate-entity-from-epilepsy
#11
Laith Cebe, Harpreet Singh
Reflex anoxic seizures (RAS) are essential in the differential diagnosis of non-epileptic paroxysmal seizures. They are precipitated by vagally mediated brief cardiac asystole, which in turn leads to transient cerebral ischaemia. RAS are usually seen in infants and preschool children, but in this case happened in a middle-aged man. Our patient is a 61-year-old man who presented with sudden, repeated contractions of his left upper arm and urine incontinence, followed by loss of consciousness for about 30 s...
May 8, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29738554/repeated-mild-traumatic-brain-injury-can-cause-acute-neurologic-impairment-without-overt-structural-damage-in-juvenile-rats
#12
Alicia Meconi, Ryan C Wortman, David K Wright, Katie J Neale, Melissa Clarkson, Sandy R Shultz, Brian R Christie
Repeated concussion is becoming increasingly recognized as a serious public health concern around the world. Moreover, there is a greater awareness amongst health professionals of the potential for repeated pediatric concussions to detrimentally alter the structure and function of the developing brain. To better study this issue, we developed an awake closed head injury (ACHI) model that enabled repeated concussions to be performed reliably and reproducibly in juvenile rats. A neurological assessment protocol (NAP) score was generated immediately after each ACHI to help quantify the cumulative effects of repeated injury on level of consciousness, and basic motor and reflexive capacity...
2018: PloS One
https://www.readbyqxmd.com/read/29737490/regional-entropy-of-functional-imaging-signals-varies-differently-in-sensory-and-cognitive-systems-during-propofol-modulated-loss-and-return-of-behavioral-responsiveness
#13
Xiaolin Liu, Kathryn K Lauer, B Douglas Ward, Christopher J Roberts, Suyan Liu, Suneeta Gollapudy, Robert Rohloff, William Gross, Zhan Xu, Shanshan Chen, Lubin Wang, Zheng Yang, Shi-Jiang Li, Jeffrey R Binder, Anthony G Hudetz
The level and richness of consciousness depend on information integration in the brain. Altered interregional functional interactions may indicate disrupted information integration during anesthetic-induced unconsciousness. How anesthetics modulate the amount of information in various brain regions has received less attention. Here, we propose a novel approach to quantify regional information content in the brain by the entropy of the principal components of regional blood oxygen-dependent imaging signals during graded propofol sedation...
May 8, 2018: Brain Imaging and Behavior
https://www.readbyqxmd.com/read/29729337/electrospray-assisted-encapsulation-of-caffeine-in-alginate-microhydrogels
#14
Alireza Mehregan Nikoo, Rassoul Kadkhodaee, Behrouz Ghorani, Hussam Razzaq, Nick Tucker
One of the major challenges with microencapsulation and delivery of low molecular weight bioactive compounds is their diffusional loss during storage and process conditions as well as under gastric conditions. In an attempt to slow down the release rate of core material, electrospray fabricated calcium alginate microhydrogels were coated with low molecular weight and high molecular weight chitosans. Caffeine as a hydrophilic model compound was used due to its several advantages on human behavior especially increasing consciousness...
May 2, 2018: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/29721651/-indications-for-loop-recorder-implantation-for-syncope
#15
REVIEW
Andreas Schuchert
Implantable loop recorder with discontinuous ECG recording enables monitoring of heart rhythm over several years. Consequently, in patients with recurrent syncope it is possible to record an ECG during the next syncopal event to obtain symptom-ECG correlations. In patients with recurrent syncope of unknown origin, the implantation of a loop recorder leads to an earlier diagnosis and an asystole is more often detected as the cause of the recurrent syncope. In addition, the loop recorder identifies patients who will benefit from pacemaker implantation...
May 2, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29721358/mirror-image-of-bilateral-daca-aneurysm-with-its-successful-surgical-management
#16
Saraj K Singh, Kapil Jain, Vijendra K Jain, Arun Saroha
Background: Among various locations of intracranial aneurysms reported in the literature, two different aneurysms situated symmetrically opposite on bilateral distal anterior cerebral arteries (DACA) are very rare. Case Description: Here, we report a rare case of mirror image distal anterior cerebral aneurysm in a middle-aged male patient. The patient presented with severe headache and loss of consciousness. Angiography was done which suggested mirror imaging of two aneurysms located over both DACA...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29718854/neurologic-manifestations-in-anaphylaxis-due-to-subcutaneous-allergy-immunotherapy-a-case-report
#17
Michelle Mangold, Mahboob Qureshi
RATIONALE: Life-threatening anaphylactic shock is a rare (1 in 1 million) but documented occurrence in response to subcutaneous immunotherapy. Immediate administration of Epinephrine (Epi) is critical to save lives in these situations. The current protocol for systemic reactions in immunotherapy is for the prescribing physician to reassess the dosing and schedule as well as the risk:benefit assessment for the therapy and determine whether or not to proceed. PATIENT CONCERNS: The patient revealed concerns regarding the neurologic sequela sustained after undergoinig life-threatening anaphylactic shock...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29717103/angina-pectoris-in-young-male-due-to-agenesis-of-left-circumflex-artery
#18
Thomas J Guterbaum, Kristian A Øvrehus, Karsten T Veien, Jacob E Møller, Hans Mickley
BACKGROUND This case study demonstrated that although highly symptomatic, agenesis of the left circumflex artery was a benign finding. Anomalies of the coronary arteries were found to be the cause of sudden death in a young individual. Left circumflex anomalies were not associated with major cardiac events. CASE REPORT A 20-year-old male was admitted due to syncope preceded by chest pain. His electrocardiogram (ECG) showed global ST segment elevation as well as biphasic T waves in anterior precordial leads...
May 2, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29699513/case-of-convulsive-seizure-developing-during-electroretinographic-recordings-a-case-report
#19
Yuko Hayashi, Gen Miura, Akiyuki Uzawa, Takayuki Baba, Shuichi Yamamoto
BACKGROUND: To present our findings in a case of convulsive seizures and loss of consciousness that developed during recording electroretinograms (ERG). CASE PRESENTATION: A 34-year-old man had reduced vision in his left eye for about 15 years, and night blindness for about two years. His visual acuity was 20/15 in the right eye and 20/50 in the left eye. The fundus was normal but the sensitivity in the macular region of the left eye was decreased. Optical coherence tomography (OCT) showed partial loss of the interdigitation zone...
April 25, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29698064/intracranial-meningioma-with-carcinoma-tumor-to-tumor-metastasis-two-case-reports
#20
Jason T Pham, Ronald C Kim, Anna Nguyen, Daniela Bota, Xiao-Tang Kong, Sumeet Vadera, Frank Hsu, Jose A Carrillo
Meningiomas have been implicated as the most common primary intracranial tumor to contain tumor-to-tumor metastasis. In the following two case reports, we describe cases of adenocarcinoma and breast carcinoma that metastasized into an intracranial meningioma. The first patient was a 64-year-old man presenting to the emergency department with seizures and loss of consciousness. After a left frontal mass resection, pathology reported a heterogeneous mass consisting of a meningioma and a metastatic adenocarcinoma component...
April 26, 2018: CNS Oncology
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