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Lumbar puncture

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https://www.readbyqxmd.com/read/28527079/endolymphatic-hydrops-in-idiopathic-intracranial-hypertension-prevalence-and-clinical-outcome-after-lumbar-puncture-preliminary-data
#1
Angelo Ranieri, Michele Cavaliere, Stefania Sicignano, Pietro Falco, Federico Cautiero, Roberto De Simone
Idiopathic intracranial hypertension is characterized by raised intracranial pressure (ICP) without any underlying pathology, presenting with (IIH) or without papilledema (IIHWOP). Headache, often on daily basis, is the most frequent symptom. Among audiovestibular symptoms, tinnitus and dizziness are commonly reported, while vertigo and hearing impairment are infrequent reports. Endolymphatic hydrops (ELH) is the typical histopathologic feature of Ménière disease, a condition featured by episodes of vertigo, dizziness, fluctuating hearing loss, tinnitus, and aural fullness...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28526220/lumbar-puncture-for-all-febrile-infants-29-56-days-old-a-retrospective-cohort-reassessment-study
#2
Richard Scarfone, Ashlee Murray, Payal Gala, Fran Balamuth
OBJECTIVES: To determine the incidence of bacterial meningitis (BM) among all febrile infants 29-56 days old undergoing a lumbar puncture (LP) in the emergency department of a tertiary care children's hospital and the number of low-risk febrile infants with BM to reassess the need for routine LP in these infants. STUDY DESIGN: Retrospective cohort study using a quality improvement registry from July 2007-April 2014. Infants included were 29-56 days old with fever and who had an LP in the emergency department...
May 16, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28525592/neurosyphilis-increases-hiv-associated-central-nervous-system-inflammation-but-does-not-explain-cognitive-impairment-in-hiv-infected-individuals-with-syphilis
#3
Emily L Ho, Clare L Maxwell, Shelia B Dunaway, Sharon K Sahi, Lauren C Tantalo, Sheila A Lukehart, Christina M Marra
Background: HIV-infected individuals with previous syphilis have cognitive impairment. We tested the hypothesis that neurosyphilis causes cognitive impairment in HIV by amplifying HIV-related CNS inflammation. Methods: 132 HIV-infected participants enrolled in a study of CSF abnormalities in syphilis underwent the mental alternation test (MAT), venipuncture and lumbar puncture. CSF concentrations of chemokine (C-X-C motif) ligand 10 (CXCL10), chemokine (C-C motif) ligand 2 (CCL2) and neurofilament light (NFL) were determined by commercial assays...
May 19, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28514889/pain-perception-in-nicu-a-pilot-questionnaire
#4
C V Bellieni, M Tei, S Cornacchione, S Di Lucia, V Nardi, A Verrotti, G Buonocore
PURPOSE: Neonatal pain management has made a great step forward over the last several years. Despite the drafting of International guidelines, an under-treatment of neonatal pain is still reported. MATERIALS AND METHODS: Medical and paramedical personnel working in 5 Italian NICUs were asked to complete a questionnaire about pain management. The questionnaire was comprised of three sections: (i) brief explanation of the purpose; (ii) demographic information, including age, profession, religious beliefs, and hospital level; (iii) questionnaire about pain management and prevention...
May 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28512589/a-case-of-early-disseminated-neurological-lyme-disease-followed-by-atypical-cutaneous-manifestations
#5
Vamsi Kantamaneni, Vikas Sunder, Mohammad Bilal, Scott Vargo
Lyme disease (LD) is a tick-borne illness caused by Borrelia burgdorferi sensu stricto. An 80-year-old female from Pennsylvania, USA, presented to an outside hospital with fever, confusion, lower extremity weakness, and stool incontinence. CT head and MRI spine were unremarkable. An infectious work-up including lumbar puncture was negative. She was transferred to our tertiary care hospital. Patient was noted to have mild unilateral right-sided facial droop and a diffuse macular rash throughout the body. She denied any outdoor activities, tick bites, or previous rash...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28512047/preoperative-planning-of-lateral-entry-point-is-necessary-in-percutaneous-lumbar-5th-vertebroplasty
#6
Hsi-Hsien Lin, Ming-Chau Chang, Po-Hsin Chou, Pei-I Hung, Shih-Tien Wang, Chien-Lin Liu
BACKGROUND: To compare treatment outcomes and complications between the computer-assisted preoperative planning of lateral entry approach and the traditional approach for L5 percutaneous vertebroplasty. METHODS: This prospective randomized clinical study was performed from January 2008 to December 2014, wherein 68 patients who received L5 percutaneous vertebroplasty were randomly divided into either group A, for which the traditional trans-pedicle approach was used, or group B, for which the computer-assisted lateral entry point approach was used for L5 percutaneous vertebroplasty...
May 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28507634/multi-system-complications-after-intravenous-cocaine-abuse
#7
Lidija Petkovska, Andon Chibishev, Aleksandra Stevcevska, Ivica Smokovski, Dusan Petkovski, Emilija Antova
BACKGROUND: Use and abuse of cocaine are associated with numerous adverse effects, independent of the route of administration. More severe conditions of poisoning, however, are observed after cocaine intravenous administration. AIM: We present a case of severe poisoning after violent intravenous injection of cocaine, but with a good outcome. CASE PRESENTATION: Cocaine was intravenously (i.v.) administered in 16-years old female patient as a homicide attempt...
April 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28503848/in-response-ultrasound-assisted-lumbar-puncture-on-infants-in-the-pediatric-emergency-department
#8
Samuel H F Lam
I read with interest the recently published article on ultrasound assisted pediatric lumbar puncture (UALP) by Gorn and colleagues(1) . As an advocate of point-of-care ultrasound in the pediatric emergency department setting, I am greatly encouraged by the study results. However, I would suggest clarification on several details of the study, some of which could potentially lead to biased outcomes. This article is protected by copyright. All rights reserved.
May 15, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28499451/effects-of-annulus-defects-and-implantation-of-poly-lactic-co-glycolic-acid-plga-fibrin-gel-scaffolds-on-nerves-ingrowth-in-a-rabbit-model-of-annular-injury-disc-degeneration
#9
Long Xin, Weixing Xu, Leijun Yu, Shunwu Fan, Wei Wang, Fang Yu, Zhenbin Wang
BACKGROUND: Growth of nerve fibers has been shown to occur in a rabbit model of intravertebral disc degeneration (IVD) induced by needle puncture. As nerve growth may underlie the process of chronic pain in humans affected by disc degeneration, we sought to investigate the factors underlying nerve ingrowth in a minimally invasive annulotomy rabbit model of IVD by comparing the effects of empty disc defects with those of defects filled with poly(lactic-co-glycolic acid)/fibrin gel (PLGA) plugs...
May 12, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28495841/lower-body-negative-pressure-decreases-non-invasively-measured-intracranial-pressure-and-internal-jugular-vein-cross-sectional-area-during-head-down-tilt
#10
William Watkins, Alan R Hargens, Shannon Baird, Erika Marie Clary, Brandon R Macias
INTRODUCTION: Long-term space flight induces a near visual acuity change in approximately 50% of astronauts. In some crew members, postflight cerebrospinal fluid (CSF) opening pressures by lumbar puncture are as high as 20.9 mmHg who demonstrated optic disc edema. CSF communicates through the cochlear aqueduct to affect perilymphatic pressure and tympanic membrane motion. We hypothesized that 50 mmHg of lower-body negative pressure (LBNP) during 15° head-down tilt (HDT) would mitigate elevations in internal jugular vein cross-sectional area (IJV CSA) and intracranial pressure (ICP)...
May 11, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28491166/toothpick-meningitis
#11
Qiao Zhou, Neera Singh, Bradley Monteforte
A 66-year-old male with a history of hypertension, back pain, diverticulosis and anal fistula presents with acute onset syncopal episodes, worsening back pain, and altered mental status. The patient exhibited considerable leukocytosis but was hemodynamically stable. CT imaging of the head revealed a gas pattern in the posterior fossa and velum interpositum. CT imaging of the abdomen and pelvis revealed a needle-like foreign body traversing the left sacrum to the sigmoid colon. A lumbar puncture revealed meningitis...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28489779/epidural-hematoma-after-total-hip-arthroplasty-in-ankylosing-spondylitis-patient-a-case-report-and-review-of-the-literature
#12
Jia Li, Ke Qi, Yongjin Zhang, Chenchen Xue, Weidong Xu
RATIONALE: Ankylosing spondylitis (AS) can affect the hip joint, causing deformity and disability. Total hip arthroplasty can obviously relieve the pain of the hip joint, and reconstruct the function of hip joint. Epidural anesthesia in this patient population has high risk of epidural hematoma, but the reason is unclear. PATIENT CONCERNS: A 44-year-old man diagnosed with AS underwent total hip arthroplasty. DIAGNOSES: Six days after operation, he was diagnosed epidural hematoma...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28489618/core-competencies-or-a-competent-core-a-scoping-review-and-realist-synthesis-of-invasive-bedside-procedural-skills-training-in-internal-medicine
#13
Ryan Brydges, Lynfa Stroud, Brian M Wong, Eric S Holmboe, Kevin Imrie, Rose Hatala
PURPOSE: Invasive bedside procedures are core competencies for internal medicine, yet no formal training guidelines exist. The authors conducted a scoping review and realist synthesis to characterize current training for lumbar puncture, arthrocentesis, paracentesis, thoracentesis, and central venous catheterization. They aimed to collate how educators justify using specific interventions, establish which interventions have the best evidence, and offer directions for future research and training...
May 9, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28487650/neuropsychological-testing-and-machine-learning-distinguish-alzheimer-s-disease-from-other-causes-for-cognitive-impairment
#14
Pavel Gurevich, Hannes Stuke, Andreas Kastrup, Heiner Stuke, Helmut Hildebrandt
With promising results in recent treatment trials for Alzheimer's disease (AD), it becomes increasingly important to distinguish AD at early stages from other causes for cognitive impairment. However, existing diagnostic methods are either invasive (lumbar punctures, PET) or inaccurate Magnetic Resonance Imaging (MRI). This study investigates the potential of neuropsychological testing (NPT) to specifically identify those patients with possible AD among a sample of 158 patients with Mild Cognitive Impairment (MCI) or dementia for various causes...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/28487359/venous-sinus-stenting-shortens-the-duration-of-medical-therapy-for-increased-intracranial-pressure-secondary-to-venous-sinus-stenosis
#15
Tarek A Shazly, Ashutosh P Jadhav, Amin Aghaebrahim, Andrew F Ducruet, Brian T Jankowitz, Tudor G Jovin, Gabrielle R Bonhomme
INTRODUCTION: Medical treatment, cerebrospinal fluid (CSF) shunting, and optic nerve sheath fenestration are standard treatments for increased intracranial pressure (ICP) in patients with idiopathic intracranial hypertension (IIH). Venous sinus stenting provides a novel alternative surgical treatment in cases of venous sinus stenosis with elevated ICP. METHODS: 12 consecutive subjects with papilledema, increased ICP, and radiological signs of dural sinus stenosis underwent cerebral venography and manometry...
May 9, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28486730/die-randunscharfe-papille-eine-diagnostische-herausforderung
#16
Julia Biermann, Wolf Alexander Lagrèze
Correct differential diagnosis in cases of blurred optic disc margins is a challenging task for ophthalmologists. The reliable differentiation of pseudopapilloedema and true papilloedema has significant implications for proper patient management. Conditions that give rise to pseudopapilloedema include small crowded discs, tilted discs and optic nerve head drusen. Conditions that cause bilateral true swelling of the optic nerve head with initially good visual acuity include those that are secondary to raised intracranial pressure (optic disc edema, ODE)...
May 9, 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28484930/heart-shaped-bilateral-medullary-pyramidal-infarction-as-a-pathognomonic-finding-of-anterior-spinal-artery-occlusion
#17
Sammy Searcy, Oluwaseun O Akinduro, Andrew Spector, Jang W Yoon, Benjamin L Brown, William D Freeman
BACKGROUND: Unilateral anterior spinal artery (ASA) occlusion resulting in bilateral medullary pyramidal (BMP) infarction is a rare and devastating stroke subtype. We present two cases highlighting the diagnostic and clinical challenges of BMP infarction. METHODS: Case reports and literature review. RESULTS: A 57-year-old man rapidly had severe vomiting and diarrhea 2 h after a meal. Examination revealed bulbar weakness and areflexic tetraplegia...
May 8, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28482418/-cerebrospinal-fluid-adenosine-deaminase-and-its-dynamic-changes-in-tuberculous-meningitis
#18
X L Li, L P Ma, H M Chen, L Q Zhang, X G Wu, M Q Gao
Objective: To explore the diagnostic value of cerebrospinal fluid (CSF) adenosine deaminase (ADA) level in tuberculous meningitis. Methods: We retrospectively analyzed 139 patients (73 males, 66 females) who visited Beijing Chest Hospital for suspected TBM from January 2010 to June 2015. Of them, 99 patients were diagnosed to have TBM, with 45 males and 54 females, and a mean age of (33±15) years. Forty patients were diagnosed as having Non-TBM, with 28 males and 12 females, and a mean age of (35±18) years...
May 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28480639/pyrimethamine-significantly-lowers-csf-sod1-in-als-patients-with-sod1-mutations
#19
Dale J Lange, Mona Shahbazi, Vincenzo Silani, Albert C Ludolph, Jochen H Weishaupt, Senda Ajroud-Driss, Kara G Fields, Rahul Remanan, Stanley H Appel, Claudia Morelli, Alberto Doretti, Luca Maderna, Stefano Messina, Ulrike Weiland, Stefan L Marklund, Peter M Andersen
BACKGROUND: Cu/Zn superoxide dismutase (SOD1) reduction prolongs survival in SOD1-transgenic animal models. Pyrimethamine produces dose dependent SOD1 reduction in cell culture systems. A previous phase-1 trial showed pyrimethamine lowers SOD1 levels in leucocytes in patients with SOD1 mutations. This study investigated whether pyrimethamine lowered SOD1 levels in the cerebrospinal fluid (CSF) in patients carrying SOD1 mutations linked to ALS (fALS/SOD1). METHODS AND STUDY DESIGN: Multicenter (5 sites), open-label, 9-month duration, dose-ranging, to determine safety and efficacy of pyrimethamine to lower SOD1 levels in the CSF of FALS/SOD1...
May 8, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28480083/optic-nerve-sheath-diameter-as-a-bedside-assessment-for-elevated-intracranial-pressure
#20
Peter Williams
A previously fit and healthy 26-year-old lady with no significant medical history presented with a two-month history of headaches. The headaches were prolonged, generalised, and unusually severe for the patient. Examination revealed papilloedema. The patient's optic nerve sheath diameter was measured 3 mm posterior to the globe and found to be 7.5 mm. The patient subsequently had computed tomography scan of her brain that showed an optic nerve sheath diameter of 7.56 mm as measured 3 mm posterior to the globe...
2017: Case Reports in Critical Care
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