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https://www.readbyqxmd.com/read/28646567/severe-menses-associated-hypertension-successfully-treated-with-gonadotropin-releasing-hormone-agonist
#1
Luke J Laffin, Munnam S Jafar, George L Bakris
A case of a 32-year-old nulliparous white woman referred for a 5-year history of severe hypertension, hypokalemia, and resultant systolic dysfunction is presented. She additionally had a left ventricular ejection fraction of 30% including left ventricular dilation and normal left ventricular mass index, as measured by cardiac magnetic resonance imaging when she initially presented to us. Her history revealed that her severe hypertension episodes were monthly and would occur around the catamenial (menses-associated) time...
June 23, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28645559/multicenter-prevalence-of-opioid-medication-use-as-abortive-therapy-in-the-emergency-department-treatment-of-migraine-headaches
#2
Neil Young, Daniel Silverman, Heather Bradford, Jeffrey Finkelstein
Despite a range of therapeutic options for treating acute migraine headaches, the use of opioids is still reported to be common practice. This study describes treatment practices in regards to migraines in the ED. It characterizes the prevalence of opioid orders during visits in three different settings, an academic medical center, a non-academic urban ED, and a community ED. Fourteen months of consecutive migraine visits were identified. All medications ordered were separated into first-line and rescue medications...
June 16, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28644160/calcitonin-gene-related-peptide-targeted-therapies-for-migraine-and-cluster-headache-a-review
#3
Nathaniel M Schuster, Alan M Rapoport
Calcitonin gene-related peptide (CGRP) is a signaling neuropeptide released from activated trigeminal sensory afferents in headache and facial pain disorders. There are a handful of CGRP-targeted therapies currently in phase 3 studies for migraine acute treatment or prevention. Currently, 4 monoclonal antibodies targeting either the CGRP ligand or receptor are being studied for migraine prevention: ALD403 (eptinezumab), AMG 334 (erenumab), LY2951742 (galcanezumab), and TEV-48125 (fremanezumab). Meanwhile, 1 small-molecule CGRP receptor antagonist (ubrogepant, MK-1602) is currently in phase 3 studies for the acute treatment of migraine...
June 21, 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28643679/clinical-and-cerebrospinal-fluid-findings-contribute-to-the-early-differentiation-between-infectious-and-noninfectious-encephalitis
#4
Miguel Wilken, Lucía Ameghino, Ángel Cammarota, Martín A Nogués, Marcelo Del Castillo, Mauricio F Farez
Early recognition and prompt specific treatment are crucial factors influencing the outcome of patients with acute encephalitis. The aim of this study was to determine the main causes of acute encephalitis in our population and to find predictors that may lead to specific diagnosis. Adult patients admitted to our hospital with suspected diagnosis of encephalitis in the period 2006-2013 were included. One hundred and five medical records were analyzed. Eighty-two patients with infectious encephalitis were identified (78% of total cases), 53 (65%) men and 29 (35%) women, mean age 47...
2017: Medicina
https://www.readbyqxmd.com/read/28642065/severe-and-resistant-hypertension-in-an-older-woman-with-claudication
#5
Puneet Gupta, Robert Hagberg, Electra Kaloudis, Anika Lucas, Parth Shah, William B White
Coarctation of the aorta is an uncommon cause of treatment-resistant hypertension in adults. It is typically detected and treated in infancy or childhood with surgical or endovascular procedures. Most cases of recurrence of coarctation after repair occur in childhood or early adulthood; recurrence in older persons (>70 years) has rarely been reported. A 73-year-old woman was referred to us for the management of treatment-resistant hypertension accompanied by symptoms of claudication and headaches, which had resulted in multiple emergency room visits...
June 1, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28634821/cavernous-malformations-of-central-nervous-system-in-pediatric-patients-our-single-centered-experience-in-50-patients-and-review-of-literature
#6
Dattaraj Paramanand Sawarkar, Suveen Janmatti, Rajinder Kumar, Pankaj Kumar Singh, Hitesh Kumar Gurjar, Shashank Sharad Kale, Bhawani Shanker Sharma, Ashok Kumar Mahapatra
PURPOSE: Cavernous malformations (CMs) are rare developmental cerebrovascular malformations of the central nervous system with a childhood prevalence of 0.3 to 0.53%. Our purpose was to assess the clinical features and microsurgical outcome in pediatric central nervous system (CNS) CMs. MATERIAL AND METHODS: We retrospectively enrolled all the CM patients admitted to our institute from 1 January 2001 to 31 December 2014. Data was analyzed for their clinical features and surgical outcome...
June 20, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28630942/antimalarial-drugs-and-the-prevalence-of-mental-and-neurological-manifestations-a-systematic-review-and-meta-analysis
#7
Mary A Bitta, Symon M Kariuki, Clifford Mwita, Samson Gwer, Leah Mwai, Charles R J C Newton
Background: Antimalarial drugs affect the central nervous system, but it is difficult to differentiate the effect of these drugs from that of the malaria illness. We conducted a systematic review to determine the association between anti-malarial drugs and mental and neurological impairment in humans.  Methods: We systematically searched online databases, including Medline/PubMed, PsychoInfo, and Embase, for articles published up to 14th July 2016. Pooled prevalence, heterogeneity and factors associated with prevalence of mental and neurological manifestations were determined using meta-analytic techniques...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/28629768/does-the-duration-of-symptoms-of-anal-fissure-impact-its-response-to-conservative-treatment-a-prospective-cohort-study
#8
Sameh Hany Emile, Hesham Elgendy, Hossam Elfeki, Alaa Magdy, Ahmed Aly Abdelmawla, Mahmoud Abdelnaby, Wael Khafagy
BACKGROUND: Conservative treatment is the first line of treatment for anal fissure. The current study aimed to evaluate the impact of symptom duration on the response of anal fissure to conservative treatment. PATIENTS AND METHODS: This prospective study was conducted on sixty patients with acute or chronic anal fissure who were treated conservatively with bulking agents, Sitz baths, and topical glyceryl trinitrate (GTN) 0.2%. Pain and constipation were assessed prior to treatment and at 6 weeks after therapy using visual analogue scale (VAS) and Wexner constipation score...
June 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28626987/prolactinomas-diagnosed-in-the-postmenopausal-period-clinical-phenotype-and-outcomes
#9
Sandhya Santharam, Metaxia Tampourlou, Wiebke Arlt, John Ayuk, Neil Gittoes, Andrew Toogood, Rachel Webster, Niki Karavitaki
OBJECTIVE: Most prolactinomas in females are diagnosed during the reproductive age and the majority are microadenomas. Prolactinomas detected in the postmenopausal period are less common with limited published data on their presentation and prognosis. Our objective was to assess the presenting clinical, biochemical and imaging findings, as well as the outcomes of women diagnosed with a prolactinoma in the postmenopausal period. DESIGN AND METHODS: We undertook a retrospective cohort study of women diagnosed with prolactinoma after menopause and followed-up in a large UK pituitary center...
June 19, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28625338/acute-diplopia-in-the-pediatric-emergency-department-a-cohort-multicenter-italian-study
#10
Umberto Raucci, Pasquale Parisi, Nicola Vanacore, Francesco La Penna, Valentina Ferro, Lucia Calistri, Claudia Bondone, Fabio Midulla, Agnese Suppiej, Raffaele Falsaperla, Duccio Maria Cordelli, Antonella Palmieri, Alberto Verrotti, Sabrina Becciani, Sonia Aguzzi, Mario Mastrangelo, Federica Pelizza, Filippo Greco, Giulia Carbonari, Ramona Tallone, Gabriella Bottone, Italo Trenta, Stefano Masi, Maria Pia Villa, Antonino Reale
BACKGROUND: Acute diplopia (AD) is an uncommon and distressing symptom of numerous ocular and neurological conditions, with potentially serious sequelaes. No data are present in pediatrics on the presentation and management of AD. AIM: This study investigated characteristics, etiology and health care utilization of the pediatric population with AD accessed to pediatric Emergency Departments (ED), trying to identify "red flags" associated with potentially life-threatening (LT) conditions...
June 3, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28621821/an-unusual-case-of-dental-infection-by-pseudomonas-aeruginosa-causing-a-brain-abscess-case-report
#11
Rodrigo Dos Santos Pereira, João Paulo Bonardi, Arthur da Conceição Dias Ferreira, Gustavo Lima Latini
A brain abscess may result when dental infection reaches the brain through contiguous anatomic cavities such as the maxillary sinus, the ethmoid sinus and the orbital cavity. It is an important complication and should be treated aggressively. Such treatment would include the excision of the etiological factor, drainage and adjuvant antibiotic therapy. The present case concerns a 23-year-old woman who presented at the General Hospital of Nova Iguaçu with complaints of pain in the right side of the face and was diagnosed with acute sinusitis...
June 16, 2017: Australian Dental Journal
https://www.readbyqxmd.com/read/28616673/contribution-of-sellar-dura-integrity-to-symptom-manifestation-in-pituitary-adenomas-with-intratumoral-hemorrhage
#12
Yasuhiko Hayashi, Yasuo Sasagawa, Daisuke Kita, Issei Fukui, Masahiro Oishi, Osamu Tachibana, Fumiaki Ueda, Mitsutoshi Nakada
PURPOSE: Although hemorrhage within pituitary adenomas frequently exacerbates the symptoms, there are many grades of severity. Moreover, the contributing factors for symptom severity are still controversial. METHODS: This retrospective study included 82 patients who underwent transsphenoidal surgery for pituitary adenomas with intratumoral hemorrhage. The grades of preoperative symptoms were classified into group A, asymptomatic or minor symptoms; group B, moderate symptoms sufficient for complain; and group C, severe symptoms disturbing daily life...
June 14, 2017: Pituitary
https://www.readbyqxmd.com/read/28616617/comparison-of-granisetron-and-metoclopramide-in-the-treatment-of-pain-and-emesis-in-migraine-patients-a-randomized-controlled-trial-study
#13
Hassan Amiri, Niloufar Ghodrati, Mehrnaz Nikuyeh, Samad Shams-Vahdati, Mehran Jalilzadeh-Binazar
OBJECTIVES: One of the irritating features of migraine is emesis that can compromise taking oral medications. We designed this study to compare the effectiveness of granisetron and metoclopramide in reducing pain and treating emesis in migraine patients. METHODS: We included a total of 148 patients with migraine headache presenting to two referral hospitals in a prospective, double-blinded randomized controlled trial. We compared the effect of granisetron (2 mg intravenous) with metoclopramide (10 mg intravenous)...
June 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611163/angle-closure-as-a-cause-for-intermittent-headache-in-a-child
#14
Nuno Pinto Ferreira, Joana Medeiros Pinto, Filomena Pinto, Luis Abegão Pinto
Angle closure is usually associated with older patients, as it typically manifests in middle to later life, being associated with an age-related increased lens volume. However, angle closure can occur in any age group if there is an anatomical predisposition that promotes pupillary block or an anterior pulling of the iris. During an acute angle closure, patients generally experience ocular pain, headache, nausea, vomiting and conjunctival hyperaemia. These attacks can be misinterpreted as migraine, particularly if subacute or chronic and the demographic characteristics of the patient do not suggest a primary angle closure event...
June 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28609593/travelling-safely-to-places-at-high-altitude-understanding-and-preventing-altitude-illness
#15
Ivan Parise
BACKGROUND: Greater numbers of people are travelling to places at high altitude each year. Altitude illness is common in places at high altitude and may be life-threatening. General practitioners (GPs) are best placed to provide evidence-based advice to keep travellers well informed of the possible risks they may encounter in places at high altitude. OBJECTIVE: The aim of this article is to review knowledge on altitude illness in order to help GPs assist patients to travel safely to places at high altitude...
June 2017: Australian Family Physician
https://www.readbyqxmd.com/read/28606112/acute-cerebellitis-in-children-an-eleven-year-retrospective-multicentric-study-in-italy
#16
Laura Lancella, Susanna Esposito, Maria Luisa Galli, Elena Bozzola, Valeria Labalestra, Elena Boccuzzi, Andrzej Krzysztofiak, Laura Cursi, Guido Castelli Gattinara, Nadia Mirante, Danilo Buonsenso, Claudia Tagliabue, Luca Castellazzi, Carlotta Montagnani, Chiara Tersigni, Piero Valentini, Michele Capozza, Davide Pata, Maria Di Gangi, Piera Dones, Silvia Garazzino, Luca Baroero, Alberto Verrotti, Maria Luisa Melzi, Michele Sacco, Michele Germano, Filippo Greco, Elena Uga, Giovanni Crichiutti, Alberto Villani
BACKGROUND: Acute cerebellitis (AC) and acute cerebellar ataxia (ACA) are the principal causes of acute cerebellar dysfunction in childhood. Nevertheless. there is no accepted consensus regarding the best management of children with AC/ACA: the aim of the study is both to assess clinical, neuroimaging and electrophysiologic features of children with AC/ACA and to evaluate the correlation between clinical parameters, therapy and outcome. METHODS: A multicentric retrospective study was conducted on children ≤ 18 years old admitted to 12 Italian paediatric hospitals for AC/ACA from 01/01/2003 to 31/12/2013...
June 12, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28605972/resting-state-connectivity-between-default-mode-network-and-insula-encodes-acute-migraine-headache
#17
Gianluca Coppola, Antonio Di Renzo, Emanuele Tinelli, Cherubino Di Lorenzo, Marco Scapeccia, Vincenzo Parisi, Mariano Serrao, Maurizio Evangelista, Anna Ambrosini, Claudio Colonnese, Jean Schoenen, Francesco Pierelli
Background Previous functional MRI studies have revealed that ongoing clinical pain in different chronic pain syndromes is directly correlated to the connectivity strength of the resting default mode network (DMN) with the insula. Here, we investigated seed-based resting state DMN-insula connectivity during acute migraine headaches. Methods Thirteen migraine without aura patients (MI) underwent 3 T MRI scans during the initial six hours of a spontaneous migraine attack, and were compared to a group of 19 healthy volunteers (HV)...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/28603913/a-common-complication-of-myelofibrosis-presenting-as-a-rare-finding-in-cerebrospinal-fluid-cytology
#18
Roberto Ruiz-Cordero, Jeffrey L Jorgensen, Savitri Krishnamurthy, Gene Landon
Herein, we present a rare case of intracranial extramedullary hematopoiesis (EMH) diagnosed by cerebrospinal fluid (CSF) cytology and describe the clinical presentation, radiologic, and pathologic findings. A 65 year-old man with a history of progressing primary myelofibrosis was admitted for headaches and right facial numbness. A brain MRI revealed focal abnormalities that were suspicious for leptomeningeal involvement of acute leukemia. Cytologic examination of CSF demonstrated a hypercellular specimen composed of hematopoietic cells including few blasts, as well as maturing red blood cells and granulocytic cells...
June 11, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28603893/allodynia-is-associated-with-initial-and-sustained-response-to-acute-migraine-treatment-results-from-the-american-migraine-prevalence-and-prevention-study
#19
Richard B Lipton, Sagar Munjal, Dawn C Buse, Alix Bennett, Kristina M Fanning, Rami Burstein, Michael L Reed
OBJECTIVE: In a population sample of persons with migraine treating with a single category of acute migraine medication, to identify rates and factors associated with acute treatment outcomes, including 2-hour pain freedom (2hPF), 24-hour pain response (24hPR), and 24-hour sustained pain response (24hSPR). Key predictors include acute treatment type (triptans and other medication categories), the influence of allodynia on response to medication, and the interaction between medication category and presence of allodynia in response to treatment among people with migraine...
June 11, 2017: Headache
https://www.readbyqxmd.com/read/28601627/effects-of-small-dose-dexmedetomidine-on-hyperdynamic-responses-to-electroconvulsive-therapy
#20
Xiang Li, Fang Tan, Chao-Jun Jian, Na Guo, Zhi-Yong Zhong, Zi-Qing Hei, Shao-Li Zhou
BACKGROUND: Acute hemodynamic responses to electroconvulsive therapy (ECT) may increase the risk of cardiovascular complications in vulnerable patients. The aim of the current study was to assess the effect of small-dose dexmedetomidine on hyperdynamic responses to ECT. METHODS: Seventy-eight patients were enrolled and randomly allocated to receive either 0.2 μg/kg dexmedetomidine (Dex group, n = 39) or saline (Control group, n = 39) prior to ECT. Heart rate (HR) and mean arterial pressure (MAP) were recorded immediately after the administration of dexmedetomidine (T1), and 0, 1, 3, 5 and 10 min after the electrical stimuli ended (T2, T3, T4, T5 and T6)...
June 7, 2017: Journal of the Chinese Medical Association: JCMA
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