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Lumbar puncture

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https://www.readbyqxmd.com/read/28086930/mannose-binding-lectin-associated-serine-protease-2-masp-2-contributes-to-poor-disease-outcome-in-humans-and-mice-with-pneumococcal-meningitis
#1
E Soemirien Kasanmoentalib, Mercedes Valls Seron, Bart Ferwerda, Michael W Tanck, Aeilko H Zwinderman, Frank Baas, Arie van der Ende, Matthijs C Brouwer, Diederik van de Beek
BACKGROUND: Pneumococcal meningitis is the most common and severe form of bacterial meningitis. Fatality rates are substantial, and long-term sequelae develop in about half of survivors. Disease outcome has been related to the severity of the pro-inflammatory response in the subarachnoid space. The complement system, which mediates key inflammatory processes, has been implicated as a modulator of pneumococcal meningitis disease severity in animal studies. METHODS: We investigated mannose-binding lectin-associated serine protease (MASP-2) levels in cerebrospinal fluid (CSF) samples derived from the diagnostic lumbar puncture, which was available for 307 of 792 pneumococcal meningitis episodes included in our prospective nationwide cohort study (39%), and the association between these levels and clinical outcome...
January 3, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28070489/acute-disseminated-histoplasmosis-with-atypical-lymphocytosis-in-an-immunocompetent-host
#2
Ayman Elbadawi, Hamdy M A Ahmed, Hussain Adly, Mohamed A Elkhouly, Samar Abohamed, Ann R Falsey
65 year-old-male presented with a one-week history of high grade fever, fatigue and confusion which began abruptly two days after a cystoscopy procedure. Past medical history included pulmonary sarcoidosis diagnosed by mediastinal lymph biopsy, diabetes and hypertension. On admission he was febrile and confused with stable vital signs. Initial workup included negative Head CT and lumbar puncture. Blood work revealed normal metabolic and liver function tests with progressive anemia, thrombocytopenia and atypical lymphocytosis of 15-20%...
2017: IDCases
https://www.readbyqxmd.com/read/28057275/anatomic-suitability-for-transcaval-access%C3%A2-based-on-computed-tomography
#3
REVIEW
Robert J Lederman, Adam B Greenbaum, Toby Rogers, Jaffar M Khan, Melissa Fusari, Marcus Y Chen
Transcaval access has been used successfully for over 200 transcatheter aortic valve replacements, large-bore percutaneous left ventricular assist devices, and thoracic endovascular aortic aneurysm repairs. This review teaches how to plan transcaval access and closure based on computed tomography. The main planning goals are to: 1) identify calcium-free crossing targets in the abdominal aorta along with optimal fluoroscopic projection angles and level with respect to lumbar vertebrae; 2) identify obstacles such as interposed bowel or pedunculated aortic atheroma; 3) plan covered stent bailout; and 4) identify jeopardized vascular branches such as renal arteries that might be obstructed by bailout covered stents if employed...
January 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28056460/cerebrospinal-fluid-biomarker-based-diagnosis-of-sporadic-creutzfeldt-jakob-disease-a-validation-study-for-previously-established-cutoffs
#4
Franc Llorens, André Karch, Ewa Golanska, Matthias Schmitz, Peter Lange, Beata Sikorska, Pawel P Liberski, Inga Zerr
BACKGROUND: Several biomarkers have been proposed to discriminate sporadic Creutzfeldt-Jakob disease (sCJD) from other dementias and control cases. However, their clinical accuracy depends on the PRNP codon 129 genotype, leaving it unclear how well established markers behave in untested conditions. METHODS: We analyzed 14-3-3, tau, p-tau levels, and the p-tau/tau ratio in a population sample collected from Polish hospitals including nondementia, dementia, and definite sCJD cases and validated their parameters according to previously established cutoffs...
January 6, 2017: Dementia and Geriatric Cognitive Disorders
https://www.readbyqxmd.com/read/28055081/soluble-cd27-levels-in-cerebrospinal-fluid-as-a-prognostic-biomarker-in-clinically-isolated-syndrome
#5
Roos M van der Vuurst de Vries, Julia Y Mescheriakova, Tessel F Runia, Naghmeh Jafari, Theodora A M Siepman, Rogier Q Hintzen
Importance: There is a growing number of therapies that could be administered after the first symptom of central nervous system demyelination. These drugs can delay multiple sclerosis (MS) diagnosis and slow down future disability. However, treatment of patients with benign course may not be needed; therefore, there is a need for biomarkers to predict long-term prognosis in patients with clinically isolated syndrome (CIS). Objective: To investigate whether the T-cell activation marker soluble CD27 (sCD27) measured in cerebrospinal fluid of patients at time of a first attack is associated with a subsequent diagnosis of MS and a higher relapse rate...
January 3, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28049383/a-lyme-borreliosis-diagnosis-probability-score-no-relation-with-antibiotic-treatment-response
#6
Violeta T Briciu, Mirela Flonta, Daniel Leucuţa, Dumitru Cârstina, Doina F Ţăţulescu, Mihaela Lupşe
OBJECTIVES: (1) To describe epidemiological and clinical data of patients that present with the suspicion of Lyme borreliosis (LB); (2) to evaluate a previous published score that classifies patients on the probability of having LB, following-up patients' clinical outcome after antibiotherapy. METHODS: Inclusion criteria: patients with clinical manifestations compatible with LB and Borrelia (B.) burgdorferi positive serology, hospitalized in a Romanian hospital between January 2011 and October 2012...
January 3, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28041826/interpretation-of-cerebrospinal-fluid-white-blood-cell-counts-in-young-infants-with-a-traumatic-lumbar-puncture
#7
Todd W Lyons, Andrea T Cruz, Stephen B Freedman, Mark I Neuman, Fran Balamuth, Rakesh D Mistry, Prashant Mahajan, Paul L Aronson, Joanna E Thomson, Christopher M Pruitt, Samir S Shah, Lise E Nigrovic
STUDY OBJECTIVE: We determine the optimal correction factor for cerebrospinal fluid WBC counts in infants with traumatic lumbar punctures. METHODS: We performed a secondary analysis of a retrospective cohort of infants aged 60 days or younger and with a traumatic lumbar puncture (cerebrospinal fluid RBC count ≥10,000 cells/mm(3)) at 20 participating centers. Cerebrospinal fluid pleocytosis was defined as a cerebrospinal fluid WBC count greater than or equal to 20 cells/mm(3) for infants aged 28 days or younger and greater than or equal to 10 cells/mm(3) for infants aged 29 to 60 days; bacterial meningitis was defined as growth of pathogenic bacteria from cerebrospinal fluid culture...
December 29, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28040615/should-procedural-skills-be-a-part-of-the-acute-care-nurse-practitioner-curriculum
#8
Amita Avadhani
Invasive procedures are an integral component of the time sensitive management of the acute and critically ill patients. Acute Care Nurse Practitioner (ACNP) students aspiring to be employed in their roles in the acute care settings cannot be autonomous in their practices unless they have a minimum level of proficiency to perform life sustaining invasive procedures. Offering additional level of benefits of safety and quality in healthcare, simulation as a teaching method has grown in popularity among various levels of education among variety of disciplines...
March 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28033700/brucellosis-with-multi-organ-involvement-in-a-patient-with-history-of-composite-aortic-graft-and-hepatitis-b
#9
Seyed Ali Dehghan Manshadi, Omid Rezahosseini, Zahra Abdi Liaei
The brucellosis with multi-organ involvement in a patient with a history of the composite aortic graft (Bentall procedure) and Hepatitis B infection is rare. A 35-year-old man presented to us with fever and loss of consciousness. Four years ago, he was IDU and underwent cardiac surgery because of endocarditis. Recently lumbar spondylodiscitis was diagnosed. The Wright (1/320) and Coombs Wright tests (1/640) were positive. After CNS imaging, lumbar puncture was done. The CSF pleocytosis was lymphocyte dominant...
November 2016: Acta Medica Iranica
https://www.readbyqxmd.com/read/28024493/-clinicopathological-features-of-primary-central-nervous-system-lymphoma-and-their-influence-on-prognosis-of-desease
#10
Chao-Yang DU, Ru-Yu Yang, Chao Li, Li-Juan Duan
OBJECTIVE: To study the clinical features of of patients with primary central nervous system lymphoma(PCNSL) and their influence on prognosis. METHODS: Forty-two cases of PCNSL hospitallized in our hospital from January 2012 to December 2015 were selected, and the laboratory analysis, imaging examination, bone marrow analysis and pathological examination all were performed, 26 cases were treated by lumbar puncture combined with intrathecal injection of drugs (Ara C, dexamethason and methotrexate), 8 cases were treated by methotrexate combined with rituximab, 8 cases voluntanly abandon treatment after being diagnosed as PCNSL...
December 2016: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/28018689/cryptococcus-gattii-in-an-immunocompetent-patient-in-the-southeastern-united-states
#11
John W Amburgy, Joseph H Miller, Benjamin J Ditty, Patrick Vande Lune, Shaaf Muhammad, Winfield S Fisher
Cryptococcal infections are seen throughout the United States in both immunocompromised and immunocompetent patients. The most common form is C. neoformans. In the Northwestern United States, C. gattii has received considerable attention secondary to increased virulence resulting in significant morbidity and mortality. There are no cases in the extant literature describing a patient with C. gattii requiring neurosurgical intervention in Alabama. A middle-aged immunocompetent male with no recent travel or identifiable exposure presented with meningitis secondary to C...
2016: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28017759/the-monro-kellie-doctrine-in-action-posterior-reversible-leukoencephalopathy-syndrome-pres-due-to-intracranial-hypotension-from-lumbo-peritoneal-shunt-placement
#12
Ioannis Karakis, Audrey H Nuccio, Jordan P Amadio, Arthur J Fountain
BACKGROUND: Posterior reversible leukoencephalopathy syndrome (PRES) is linked to various etiologies, foremost systemic hypertension. Its association with intracranial hypotension (IH), a potential sequela of various neurosurgical procedures, is under-recognized. We report a case of lumbo-peritoneal shunt induced IH resulting in PRES with the goal to increase awareness, and elaborate on the potential biological mechanism, based on the Monro-Kellie hypothesis. CASE DESCRIPTION: A 26-year-old woman with acquired immunodeficiency syndrome and epilepsy was admitted for recurrent cryptococcal meningitis and breakthrough seizures...
December 22, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/28017232/stiff-person-syndrome-masquerading-as-multiple-sclerosis
#13
Joseph J Sabatino, Scott D Newsome
BACKGROUND: Stiff person syndrome (SPS) is a rare neuroimmunological disorder presenting with a wide variety of signs and symptoms that mimic neuro-inflammatory diseases, such as multiple sclerosis (MS), thus delaying diagnosis. METHODS: We performed a retrospective chart review of over 100 patients with SPS who were treated at Johns Hopkins Hospital and identified five patients previously diagnosed with MS. RESULTS: Patients were female with a mean age of 53years old (range 43-64)...
January 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28009771/spontaneous-spinal-subdural-hematoma
#14
Marlijn H de Beer, Marjolein M Eysink Smeets, Hille Koppen
OBJECTIVE: Spinal subdural hematomas (SSDHs) are rare. Causes are (1) posttraumatic, (2) iatrogenic (following surgery or lumbar puncture), (3) spontaneous including underlying malformations or coagulation deficits. With a systematic review of literature we want to shed light on the last group: symptomatology, etiology, treatment and outcome will we discussed. METHODS: Systematic review of literature on PubMed for cases of acute nontraumatic noniatrogenic SSDHs in adults (≥18 y of age)...
January 2017: Neurologist
https://www.readbyqxmd.com/read/28009405/fulminant-idiopathic-intracranial-hypertension-and-venous-stasis-retinopathy-resulting-in-severe-bilateral-visual-impairment
#15
Alexander Voldman, Breanna Durbin, John Nguyen, Brian Ellis, Monique Leys
PURPOSE: To report a complicated case of fulminant idiopathic intracranial hypertension and concomitant venous stasis retinopathy leading to postpapilledema optic atrophy. METHODS: Case report. RESULTS: A 34-year-old morbidly obese woman with a history of idiopathic intracranial hypertension (IIH) presented with a 1-month history of bilateral vision loss, diplopia, and left eye pain after being lost to follow-up for 6 years. Fundus examination revealed florid papilledema with venous tortuosity bilaterally...
December 6, 2016: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28003959/use-of-t1-weighted-t2-weighted-magnetic-resonance-ratio-to-elucidate-changes-due-to-amyloid-%C3%AE-accumulation-in-cognitively-normal-subjects
#16
Fumihiko Yasuno, Hiroaki Kazui, Naomi Morita, Katsufumi Kajimoto, Masafumi Ihara, Akihiko Taguchi, Akihide Yamamoto, Kiwamu Matsuoka, Masato Takahashi, Jyoji Nakagawara, Hidehiro Iida, Toshifumi Kishimoto, Kazuyuki Nagatsuka
The ratio of signal intensity in T1-weighted (T1w) and T2-weighted (T2w) magnetic resonance imaging (MRI) was recently proposed to enhance the sensitivity of detecting changes in disease-related signal intensity. The objective of this study was to test the effectiveness of T1w/T2w image ratios as an easily accessible biomarker for amyloid beta (Aβ) accumulation. We performed the T1w/T2w analysis in cognitively normal elderly individuals. We applied [(11)C] Pittsburgh Compound B (PiB)-PET to the same individuals, and Aβ deposition was quantified by its binding potential (PiB-BPND)...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/27998453/-clinical-features-of-neurosyphilis-with-optic-neuritis-as-an-initial-finding
#17
S S Cao, H Y Li, Q G Xu, S Y Tan, S H Wei
Objective: To study the characteristics of neurosyphilis with optic neuritis as an initial finding. Methods: Retrospective analysis of clinical data and laboratory testing results of 16 cases (27 eyes) with optic neuritis as an initial finding of neurosyphilis from October 2010 to March 2015 in General Hospital of People's Liberation Army was made. Results: Six-teen patients (12 males, 4 females) were collected, the median age of patients was 47 (range 33 to 65) years ,the mean age was (49.63±9.05) years. Treponema pallidum particle agglutination assay (TPPA) analysis was positive in all of the patients and rapid plasma reagin (RPR) test was positive in 14 patients (2 patients did not test)...
December 11, 2016: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/27994840/intraspinal-lumbar-juxtaarticular-cyst-treatment-through-ct-guided-percutaneus-induced-rupture-results-in-a-favorable-patient-outcome
#18
Adisa Kursumovic, Richard Bostelmann, Maria Gollwitzer, Stefan Rath, Hans Jakob Steiger, Athanasios K Petridis
Juxta-articular cysts are synovial cysts originating from the facet joints or the flava ligaments. If they grow intra-spinally they can compress nervous structures and cause a variety of symptoms. Micro-neurosurgery is usually the treatment of choice. Alternatively to surgical treatment the cyst can be approached and treated with a CT guided percutaneous injection inducing rupture. After fulfilling strict selection criteria twenty patients (25% of all treated lumbar synovial cyst patients), were treated minimally invasive by this method from 2010-2016...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27994549/research-lumbar-punctures-among-african-americans-and-caucasians-perception-predicts-experience
#19
Jennifer C Howell, Monica W Parker, Kelly D Watts, Alexander Kollhoff, Dobromira Z Tsvetkova, William T Hu
African Americans are under-represented in Alzheimer's disease (AD)-related biomarker studies, and it has been speculated that mistrust plays a major factor in the recruitment of African Americans for studies involving invasive procedures such as the lumbar puncture (LP). We set out to determine factors associated with non-participation in a biomarker study aiming to explore cerebrospinal fluid (CSF) AD biomarker differences between older African Americans and Caucasians. We also surveyed participants' procedure-related perception (a standard medical procedure vs...
2016: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/27987228/pharmacokinetics-and-pharmacodynamics-of-intrathecally-administered-xen2174-a-synthetic-conopeptide-with-norepinephrine-reuptake-inhibitor-and-analgesic-properties
#20
Pieter Okkerse, Justin L Hay, Elske Sitsen, Albert Dahan, Erica Klaassen, William Houghton, Geert Jan Groeneveld
AIM: Xen2174 is a synthetic 13-amino acid peptide that binds specifically to the norepinephrine transporter, which results in inhibition of norepinephrine uptake. It is being developed as a possible treatment for moderate to severe pain and is delivered intrathecally. The current study was performed to assess the pharmacodynamics (PD) and the cerebrospinal fluid (CSF) pharmacokinetics (PK) of Xen2174 in healthy subjects. METHODS: This was a randomized, blinded, placebo-controlled study in healthy subjects...
November 2, 2016: British Journal of Clinical Pharmacology
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