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https://www.readbyqxmd.com/read/28453910/central-nervous-system-disease-in-pediatric-acute-myeloid-leukemia-a-report-from-the-children-s-oncology-group
#1
Donna L Johnston, Todd A Alonzo, Robert B Gerbing, Richard Aplenc, William G Woods, Soheil Meshinchi, Alan S Gamis
BACKGROUND: The prognostic impact of central nervous system (CNS) involvement in children with acute myeloid leukemia (AML) has varied in past trials, and controversy exists over the degree of involvement requiring intensified CNS therapy. Two recent Children's Oncology Group protocols, AAML03P1 and AAML0531, directed additional intrathecal (IT) therapy to patients with CNS2 (≤5 white blood cell [WBC] with blasts) or CNS3 (>5 WBC with blasts or CNS symptoms) disease at diagnosis...
April 28, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28453773/increased-cerebrospinal-fluid-levels-of-gaba-testosterone-and-estradiol-in-women-with-polycystic-ovary-syndrome
#2
Jennifer F Kawwass, Kristen M Sanders, Tammy L Loucks, Lisa Cencia Rohan, Sarah L Berga
STUDY QUESTION: Do cerebrospinal fluid (CSF) concentrations of gamma-aminobutyric acid (GABA), testosterone (T) and estradiol (E2) differ in women with polycystic ovary syndrome (PCOS) as compared to eumenorrheic, ovulatory women (EW)? SUMMARY ANSWER: Women with PCOS displayed higher CSF levels of GABA and E2, and possibly T, than EW. WHAT IS KNOWN ALREADY: The chronic anovulation characteristic of PCOS has been attributed to increased central GnRH drive and resulting gonadotropin aberrations...
April 27, 2017: Human Reproduction
https://www.readbyqxmd.com/read/28446129/novel-predictors-of-neurosyphilis-among-hiv-negative-syphilis-patients-with-neurological-symptoms-an-observational-study
#3
Yao Xiao, Man-Li Tong, Li-Li Liu, Li-Rong Lin, Mei-Jun Chen, Hui-Lin Zhang, Wei-Hong Zheng, Shu-Lian Li, Hui-Ling Lin, Zhi-Feng Lin, Hui-Qin Xing, Jian-Jun Niu, Tian-Ci Yang
BACKGROUND: Known predictors of neurosyphilis were mainly drawn from human immunodeficiency virus (HIV)-infected syphilis patients, which may not be applicable to HIV-negative populations as they have different characteristics, particularly those with neurological symptoms. This study aimed to identify novel predictors of HIV-negative symptomatic neurosyphilis (S-NS). METHODS: From June 2005 to June 2015, 370 HIV-negative syphilis patients with neurological symptoms were recruited, consisting of 191 S-NS patients (including 123 confirmed neurosyphilis and 68 probable neurosyphilis patients) and 179 syphilis/non-neurosyphilis (N-NS) patients...
April 26, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28444683/-atypical-guillain-barre-syndrome-clustering-is-it-necessary-to-reconsider-the-diagnostic-criteria-and-microbiological-protocol
#4
A Dominguez-Mayoral, C Gutierrez, J M Lopez-Dominguez, S Eichau, J Abril, G Navarro-Mascarell, M A Quesada-Garcia, M Ramos, M Alvarez-Lopez, C Menendez-De Leon, G Izquierdo
INTRODUCTION: Guillain-Barre syndrome is classically defined as a symmetrical ascending acute polyradiculoneuropathy, although there are atypical variants that make diagnosis difficult. CASE REPORTS: The medical data of six patients in our hospital area are collected during the first quarter of 2013. Lumbar punctures, imaging, neurophysiological studies, ganglioside antibodies and serologies have been proposed in all cases. We focus on the atypical features as late hyporeflexia, increased frequency of asymmetry and distal paresis and initial fever...
May 1, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28442089/x-marks-the-spot-or-does-it-ultrasonography-assisted-site-marking-for-lumbar-puncture-in-children-may-2017-annals-of-emergency-medicine-journal-club
#5
David O Kessler, Lise E Nigrovic
No abstract text is available yet for this article.
May 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28439354/residents-procedural-experience-does-not-ensure-competence-a-research-synthesis
#6
Jeffrey H Barsuk, Elaine R Cohen, Joe Feinglass, William C McGaghie, Diane B Wayne
BACKGROUND: Many medical certifying bodies require that a minimum number of clinical procedures be completed during residency training to obtain board eligibility. However, little is known about the relationship between the number of procedures residents perform and their clinical competence. OBJECTIVE: This study evaluated associations between residents' medical procedure skills measured in a simulation laboratory and self-reported procedure experience and year of training...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28439219/the-utility-of-csf-for-the-diagnosis-of-primary-and-secondary-monoamine-neurotransmitter-deficiencies
#7
A B Burlina, A Celato, G Polo, C Edini, A P Burlina
Biogenic amine defects constitute a complex and expanding group of neurotransmitter disorders affecting cognitive, motor and autonomic system development, mostly in the pediatric age. In recent years different enzymatic defects have been identified impairing the tetrahydrobiopterin cofactor pathway and/or biogenic amine synthesis, catabolism and transport, with subsequent new disease entities described. The lumbar puncture, with subsequent withdrawal of cerebrospinal fluid (CSF), remains a key step in the diagnostic procedure...
March 2017: EJIFCC
https://www.readbyqxmd.com/read/28437262/loss-of-resistance-a-randomised-controlled-trial-assessing-four-low-fidelity-epidural-puncture-simulators
#8
Tina H Pedersen, Jonas Meuli, Eike J Plazikowski, Maximilian Buttenberg, Maren Kleine-Brueggeney, Christian Seidl, Lorenz Theiler, Robert Greif
BACKGROUND: Detecting loss of resistance (LOR) can either be taught with dedicated simulators, with a cost ranging from &OV0556;1500 to 3000, or with the 'Greengrocer's Model', requiring simply a banana. OBJECTIVES: The purpose of this study was to compare three dedicated epidural puncture training simulators and a banana in their ability to simulate LOR. Our hypothesis was that there was a difference between the four simulators when comparing the detection of LOR...
April 21, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28435899/hematologic-parameters-to-predict-negative-cerebrospinal-fluid-examination-results-among-neurologically-intact-patients-who-underwent-lumbar-puncture-on-suspicion-of-central-nervous-system-infection
#9
Ji Hwan Kim, Hong-Jik Kim, Ji Ung Na, Sang Kuk Han, Pil Cho Choi, Dong Hyuk Shin
OBJECTIVE: Cerebrospinal fluid (CSF) examination is mandatory whenever central nervous system (CNS) infection is suspected. However, pleocytosis is not detected in a substantial number of suspected patients who undergo CSF examination. This study aimed to identify parameters that can aid in predicting negative CSF examination results (defined as a white blood cell count of <5 cells/high-power field). METHODS: The study included 101 neurologically intact patients who underwent lumbar puncture because of suspicion of CNS infection...
March 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28435117/use-of-intracranial-pressure-monitoring-frequently-refutes-diagnosis-of-idiopathic-intracranial-hypertension
#10
David S Xu, Randall J Hlubek, Celene B Mulholland, Kerry L Knievel, Kris A Smith, Peter Nakaji
OBJECTIVE: The diagnosis and management of patients with idiopathic intracranial hypertension (IIH) frequently relies on lumbar puncture to ascertain intracranial pressures. However, pressures derived this way may be spurious due to patient body habitus and behavior. We recently incorporated direct continuous intracranial pressure (ICP) monitoring into the work-up for IIH and review our experience and outcomes. METHODS: Through billing records, we identified all patients during a 3-year period who had a diagnosis of idiopathic intracranial hypertension and who underwent ICP monitoring prior to shunt placement or revision...
April 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28434576/can-lumbar-puncture-be-deferred-in-febrile-neonates-with-suspected-uti
#11
Sarah S Long
No abstract text is available yet for this article.
May 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28434571/ultrasound-skin-marking-increases-lumbar-puncture-success-in-infants
#12
Michael Gorn
No abstract text is available yet for this article.
May 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28434443/aneurysmal-subarachnoid-hemorrhage
#13
Athanasios K Petridis, Marcel A Kamp, Jan F Cornelius, Thomas Beez, Kerim Beseoglu, Bernd Turowski, Hans-Jakob Steiger
BACKGROUND: Aneurysmal subarachnoid hemorrhage (SAH) is associated with a mortality of more than 30%. Only about 30% of patients with SAB recover sufficiently to return to independent living. METHODS: This article is based on a selective review of pertinent literature retrieved by a PubMed search. RESULTS: Acute, severe headache, typically described as the worst headache of the patient's life, and meningismus are the characteristic manifestations of SAH...
March 31, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28434131/knowing-how-and-knowing-why-testing-the-effect-of-instruction-designed-for-cognitive-integration-on-procedural-skills-transfer
#14
Jeffrey J H Cheung, Kulamakan M Kulasegaram, Nicole N Woods, Carol-Anne Moulton, Charlotte V Ringsted, Ryan Brydges
Transfer is a desired outcome of simulation-based training, yet evidence for how instructional design features promote transfer is lacking. In clinical reasoning, transfer is improved when trainees experience instruction integrating basic science explanations with clinical signs and symptoms. To test whether integrated instruction has similar effects in procedural skills (i.e., psychomotor skills) training, we studied the impact of instruction that integrates conceptual (why) and procedural (how) knowledge on the retention and transfer of simulation-based lumbar puncture (LP) skill...
April 22, 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/28427987/trajectory-planning-and-guided-punctures-with-isocentric-navigation-in-posterolateral-endoscopic-lumbar-discectomy-technical-note
#15
Guoxin Fan, Chuanfeng Wang, Xin Gu, Hailong Zhang, Shisheng He
BACKGROUND: Posterolateral endoscopic trasforaminal discectomy (PELD) requires an ideal percutaneous puncture to place the working channel for endoscopic discectomy. The conventional blinded punctures relies on the surgeons' experience and repeated fluoroscopy, which may increase radiation exposure. The study aimed to introduce isocentric navigation to plan trajectory and guide punctures in PELD. METHODS: Technical note and clinical outcomes of patients undergoing PELD with isocentric navigation were recorded in this report...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28427421/cerebrospinal-fluid-csf-biomarkers-of-iron-status-are-associated-with-csf-viral-load-antiretroviral-therapy-and-demographic-factors-in-hiv-infected-adults
#16
Stephanie M Patton, Quan Wang, Todd Hulgan, James R Connor, Peilin Jia, Zhongming Zhao, Scott L Letendre, Ronald J Ellis, William S Bush, David C Samuels, Donald R Franklin, Harpreet Kaur, Jennifer Iudicello, Igor Grant, Asha R Kallianpur
BACKGROUND: HIV-associated neurocognitive disorder (HAND) remains common, despite antiretroviral therapy (ART). HIV dysregulates iron metabolism, but cerebrospinal fluid (CSF) levels of iron and iron-transport proteins in HIV-infected (HIV+) persons are largely unknown. The objectives of this study were to characterize CSF iron-related biomarkers in HIV+ adults and explore their relationships to known predictors of HAND. METHODS: We quantified total iron, transferrin and heavy-chain (H)-ferritin by immunoassay in CSF sampled by lumbar puncture in 403 HIV+ participants in a multi-center, observational study and evaluated biomarker associations with demographic and HIV-related correlates of HAND [e...
April 21, 2017: Fluids and Barriers of the CNS
https://www.readbyqxmd.com/read/28427368/complications-of-miliary-tuberculosis-low-mortality-and-predictive-biomarkers-from-a-uk-cohort
#17
Jonathan Underwood, Fiona Cresswell, Alex P Salam, Alex J Keeley, Charles Cleland, Laurence John, Robert N Davidson
BACKGROUND: Untreated, miliary tuberculosis (TB) has a mortality approaching 100%. As it is uncommon there is little specific data to guide its management. We report detailed data from a UK cohort of patients with miliary tuberculosis and the associations and predictive ability of admission blood tests with clinical outcomes. METHODS: Routinely collected demographic, clinical, blood, imaging, histopathological and microbiological data were assessed for all patients with miliary TB identified from the London TB register from 2008 to 2012 from Northwest London Hospitals NHS Trust...
April 20, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28422821/how-the-cognitive-reserve-interacts-with-%C3%AE-amyloid-deposition-in-mitigating-fdg-metabolism-an-observational-study
#18
Elena Carapelle, Laura Serra, Sergio Modoni, Michele Falcone, Carlo Caltagirone, Marco Bozzali, Luigi Maria Specchio, Carlo Avolio
This observational study had the aim to assess the interaction between cognitive reserve (CR) and cerebrospinal fluid β-amyloid1-42 (Aβ1-42) in modulating brain [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) metabolism in patients with moderate Alzheimer disease (AD).Twenty-seven patients with probable AD and 25 neurological normal subjects (NNS) entered the study. All participants had an FDG-PET scan, and AD patients also received a lumbar puncture to measure Aβ1-42, 181p-tau, and Tau concentrations...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28420598/1-5-t-augmented-reality-navigated-interventional-mri-paravertebral-sympathetic-plexus-injections
#19
David R Marker, Paweena U Thainual, Tamas Ungi, Aaron J Flammang, Gabor Fichtinger, Iulian I Iordachita, John A Carrino, Jan Fritz
PURPOSE: The high contrast resolution and absent ionizing radiation of interventional magnetic resonance imaging (MRI) can be advantageous for paravertebral sympathetic nerve plexus injections. We assessed the feasibility and technical performance of MRI-guided paravertebral sympathetic injections utilizing augmented reality navigation and 1.5 T MRI scanner. METHODS: A total of 23 bilateral injections of the thoracic (8/23, 35%), lumbar (8/23, 35%) and hypogastric (7/23, 30%) paravertebral sympathetic plexus were prospectively planned in twelve human cadavers using a 1...
April 18, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28419618/correspondence-response-to-letter-to-the-editor-ultrasound-assisted-lumbar-puncture-on-infants-in-the-pediatric-emergency-department
#20
Michael Gorn
We would like to thank our reader for his/her interest in our work and continuing support of point-of-care ultrasound in pediatric emergency medicine. Our study was conducted at a large academic emergency department with pediatrics and emergency medicine residents, nurse practitioners who function at or above the level of a senior resident (PGY-3 and 4), and pediatric emergency fellows who function as attending physicians. As a routine, all initial lumbar puncture (LP) attempts are made by learners. This article is protected by copyright...
April 17, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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