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Neurological Illness

Jasper Fuk-Woo Chan, Zheng Zhu, Hin Chu, Shuofeng Yuan, Kenn Ka-Heng Chik, Chris Chung-Sing Chan, Vincent Kwok-Man Poon, Cyril Chik-Yan Yip, Xi Zhang, Jessica Oi-Ling Tsang, Zijou Zou, Kah-Meng Tee, Huiping Shuai, Gang Lu, Kwok-Yung Yuen
Zika virus (ZIKV) is a human-pathogenic flavivirus that has recently emerged as a global public health threat. ZIKV infection may be associated with congenital malformations in infected fetuses and severe neurological and systemic complications in infected adults. There are currently limited treatment options for ZIKV infection. AR-12 (OSU-03012) is a celecoxib derivative cellular kinase inhibitor that has broad-spectrum antiviral activities. In this study, we investigated the antiviral activity and mechanism of AR-12 against ZIKV...
October 13, 2018: Antiviral Research
Juliana Durack, Susan V Lynch
Over the past decade, our view of human-associated microbes has expanded beyond that of a few species toward an appreciation of the diverse and niche-specialized microbial communities that develop in the human host with chronological age. The largest reservoir of microbes exists in the distal gastrointestinal tract, both in the lumen, where microbes facilitate primary and secondary metabolism, and on mucosal surfaces, where they interact with host immune cell populations. While local microbial-driven immunomodulation in the gut is well described, more recent studies have demonstrated a role for the gut microbiome in influencing remote organs and mucosal and hematopoietic immune function...
October 15, 2018: Journal of Experimental Medicine
Matthew P Kirschen, Josh Blinder, Aaron Dewitt, Megan Snyder, Rebecca Ichord, Robert A Berg, Vinay Nadkarni, Alexis Topjian
IntroductionNeurodevelopmental disabilities in children with CHD can result from neurologic injury sustained in the cardiac ICU when children are at high risk of acute neurologic injury. Physicians typically order and specify frequency for serial bedside nursing clinical neurologic assessments to evaluate patients' neurologic status.Materials and methodsWe surveyed cardiac ICU physicians to understand how these assessments are performed, and the attitudes of physicians on the utility of these assessments. The survey contained questions regarding assessment elements, assessment frequency, communication of neurologic status changes, and optimisation of assessments...
October 16, 2018: Cardiology in the Young
Lisa Kearns, Alison Bateman-House, Arthur Caplan
Patients who suffer from life-threatening illnesses or are stricken with conditions that could result in serious morbidity who have exhausted all appropriate treatments may choose to try, through the Food and Drug Administration's expanded access program, an investigational drug or device in development. The program has succeeded for decades in allowing patients to access potentially helpful but still experimental agents. Nevertheless, the administration of investigational drugs outside of clinical trials raises several ethical issues...
October 2018: Seminars in Neurology
K Brizzi, C J Creutzfeldt
Neuropalliative care is a new and growing field within neurology that focuses on improving the quality of life of patients with serious neurologic illnesses. While specialty-level palliative care training is available to interested neurologists, all neurologists can strive to provide primary palliative care for their patients. In this review, we will describe the scope of neuropalliative care, define patient populations who may benefit from palliative care, and explore the communication and symptom management skills essential to palliative care delivery...
October 2018: Seminars in Neurology
Michael J Falvo, Jacob B Lindheimer, Jorge M Serrador
Neurological dysfunction has been reported in Gulf War Illness (GWI), including abnormal cerebral blood flow (CBF) responses to physostigmine challenge. However, it is unclear whether the CBF response to normal physiological challenges and regulation is similarly dysfunctional. The goal of the present study was to evaluate the CBF velocity response to orthostatic stress (i.e., sit-to-stand maneuver) and increased fractional concentration of carbon dioxide. 23 cases of GWI (GWI+) and 9 controls (GWI) volunteered for this study...
2018: PloS One
Charlotte Cordonnier, Andrew Demchuk, Wendy Ziai, Craig S Anderson
Acute spontaneous intracerebral haemorrhage is a life-threatening illness of global importance, with a poor prognosis and few proven treatments. As a heterogeneous disease, certain clinical and imaging features help identify the cause, prognosis, and how to manage the disease. Survival and recovery from intracerebral haemorrhage are related to the site, mass effect, and intracranial pressure from the underlying haematoma, and by subsequent cerebral oedema from perihaematomal neurotoxicity or inflammation and complications from prolonged neurological dysfunction...
October 6, 2018: Lancet
Emma Macdonald-Laurs, Archana Koirala, Philip N Britton, William Rawlinson, Chee Chung Hiew, Jocelynne Mcrae, Russell C Dale, Cheryl Jones, Kristine Macartney, Brendan McMullan, Sekhar Pillai
PURPOSE: Neurological complications of influenza cause significant disease in children. Central nervous system inflammation, the presumed mechanism of influenza-associated encephalopathy, is difficult to detect. Characteristics of children presenting with severe neurological complications of influenza, and potential biomarkers of influenza-associated encephalopathy are described. METHODS: A multi-center, retrospective case-series of children with influenza and neurological complications during 2017 was performed...
September 28, 2018: European Journal of Paediatric Neurology: EJPN
Teppo Särkämö, Aleksi J Sihvonen
During the last decades, there have been major advances in mapping the brain regions that underlie our ability to perceive, experience, and produce music and how musical training can shape the structure and function of the brain. This progress has fueled and renewed clinical interest towards uncovering the neural basis for the impaired or preserved processing of music in different neurological disorders and how music-based interventions can be used in their rehabilitation and care. This article reviews our contribution to and the state-of-the-art of this field...
September 19, 2018: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
Amy Calandriello, Joanna C Tylka, Pallavi P Patwari
With growing recognition of pediatric delirium in pediatric critical illness there has also been increased investigation into improving recognition and determining potential risk factors. Disturbed sleep has been assumed to be one of the key risk factors leading to delirium and is commonplace in the pediatric critical care setting as the nature of intensive care requires frequent and invasive monitoring and interventions. However, this relationship between sleep and delirium in pediatric critical illness has not been definitively established and may, instead, reflect significant overlap in risk factors and consequences of underlying neurologic dysfunction...
October 10, 2018: Medical Sciences: Open Access Journal
Samuel Natzeder, David J Mack, Gabriela Maissen, Christian Strässle, Emanuela Keller, Carl Muroi
BACKGROUND: Portable automated infrared pupillometry is becoming increasingly popular. To generate an objective reference base, the Neurological Pupil index (NPi) which combines different values of the pupillary light reflex is being introduced into clinical practice. In this explorative study, we examined different aspects of the NPi in relation to clinical severity and outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). MATERIALS AND METHODS: Patients with serial assessment of the NPi (NeurOptics pupillometer NPi-200, Irvine, CA) starting no later than day 2 after aSAH onset were included in the study...
October 9, 2018: Journal of Neurosurgical Anesthesiology
Sam C Tyagi, Keith D Calligaro, Shinichi Fukuhara, Jacques Greenberg, Danielle M Pineda, Hong Zheng, Matthew J Dougherty, Douglas A Troutman
OBJECTIVE: Although lifelong surveillance is recommended by the Society for Vascular Surgery for patients undergoing endovascular aneurysm repair (EVAR) reported that compliance with long-term follow-up has been poor. We sought to identify factors that predict compliance with EVAR surveillance through analysis of patient variables and post-EVAR questionnaire results. METHODS: We analyzed 28 patient variables gathered from our computerized registry, patient charts, and phone questionnaires of patients who underwent EVAR between January 1, 2010, and December 31, 2014...
October 6, 2018: Journal of Vascular Surgery
C Ong, M Hutch, M Barra, A Kim, S Zafar, S Smirnakis
BACKGROUND: Osmotic therapy is a critical component of medical management for cerebral edema. While up to 90% of neurointensivists report using these treatments, few quantitative clinical measurements guide optimal timing, dose, or administration frequency. Its use is frequently triggered by a qualitative assessment of neurologic deterioration and/or pupil size, and anecdotally appears to improve pupil asymmetry suggestive of uncal herniation. However, subjective pupil assessment has poor reliability, making it difficult to detect or track subtle changes...
October 8, 2018: Neurocritical Care
Christopher M Pruitt, Mark I Neuman, Samir S Shah, Veronika Shabanova, Christopher Woll, Marie E Wang, Elizabeth R Alpern, Derek J Williams, Laura Sartori, Sanyukta Desai, Rianna C Leazer, Richard D Marble, Russell J McCulloh, Adrienne G DePorre, Sahar N Rooholamini, Catherine E Lumb, Fran Balamuth, Sarah Shin, Paul L Aronson
OBJECTIVE: To determine factors associated with adverse outcomes among febrile young infants with invasive bacterial infections (IBIs) (ie, bacteremia and/or bacterial meningitis). STUDY DESIGN: Multicenter, retrospective cohort study (July 2011-June 2016) of febrile infants ≤60 days of age with pathogenic bacterial growth in blood and/or cerebrospinal fluid. Subjects were identified by query of local microbiology laboratory and/or electronic medical record systems, and clinical data were extracted by medical record review...
October 5, 2018: Journal of Pediatrics
Marlène Guillon, Lise Rochaix, Jean-Claude K Dupont
OBJECTIVES: The aim of this study is to review evidence on the cost-effectiveness of exercise-based interventions in the treatment of chronic conditions a decade after the publication of Roine et al. in 2009 (Roine E, Roine RP, Räsänen P, et al. Int J Technol Assess Health Care. 2009;25:427-454). METHODS: We carried out a review of published articles in PUBMED and JSTOR between January 1, 2008, and December 31, 2016. Full economic evaluations of exercise programs targeting patients with a chronic condition were eligible for inclusion...
October 9, 2018: International Journal of Technology Assessment in Health Care
Minesh P Mehta, Rupesh Kotecha
The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors' suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice...
October 8, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
K M Sauro, A Soo, A Kramer, P Couillard, J Kromm, D Zygun, D J Niven, S M Bagshaw, H T Stelfox
BACKGROUND/OBJECTIVES: Venous thromboembolism (VTE) is a leading cause of preventable, in-hospital deaths; critically ill patients have a higher risk. Effective and efficient strategies to prevent VTE exist; however, neurocritical care patients present unique challenges due to competing risk of bleeding. The objective of this study was to examine current VTE prophylaxis practices among neurocritical care patients, concordance with guideline-recommended care, and the association with clinical outcomes...
October 1, 2018: Neurocritical Care
S P Panda, R C Das, Kalpana Srivastava, Ashutosh Ratnam, Neha Sharma
AIM: To study the prevalence of psychiatric comorbidities in patients of multiple sclerosis and their association to the degree of disability. METHOD: Psychiatric symptoms were assessed in 90 patients of multiple sclerosis using GHQ-12, MMSE, HADS, Beck Depression Inventory and AUDIT. Neurological disability was assessed using Expanded Disability Status Scale. Correlations were determined between EDSS scores and psychiatric scale scores. RESULT: 61% of patients had significant psychological distress...
September 22, 2018: Neurologia i Neurochirurgia Polska
James J Sejvar
PURPOSE OF REVIEW: In recent years, we have observed the emergence and reemergence of a number of arthropod-borne viruses (arboviruses). Zika virus is the most recent addition to this group, first causing sporadic cases of uncomplicated febrile illness followed by sizeable outbreaks in the Pacific. However, the epidemiology and clinical features of Zika virus infection have changed rapidly and dramatically; it is now recognized as causing Guillain-Barré syndrome (GBS) in children and adults and congenital abnormalities in infected fetuses...
October 2018: Continuum: Lifelong Learning in Neurology
Mary Warrell, David A Warrell, Arnaud Tarantola
The aim of this review is to guide clinicians in the practical management of patients suffering from rabies encephalomyelitis. This condition is eminently preventable by modern post-exposure vaccination, but is virtually always fatal in unvaccinated people. In the absence of any proven effective antiviral or other treatment, palliative care is an imperative to minimise suffering. Suspicion of rabies encephalomyelitis depends on recognising the classic symptomatology and eliciting a history of exposure to a possibly rabid mammal...
October 4, 2017: Tropical Medicine and Infectious Disease
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