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Hypertensive encephalopathy

Ching-Yi Tsai, Yan-Yuen Poon, Julie Y H Chan, Samuel H H Chan
By application of diffusion tensor imaging (DTI) as a physiological tool to evaluate changes in functional connectivity between key brain stem nuclei in the baroreflex neural circuits of mice and rats, recent work revealed several hitherto unidentified phenomena regarding baroreflex functionality. (1) The presence of robust functional connectivity between nucleus tractus solitarii (NTS) and nucleus ambiguus (NA) or rostral ventrolateral medulla (RVLM) offers a holistic view on the moment-to-moment modus operandi of the cardiac vagal baroreflex or baroreflex-mediated sympathetic vasomotor tone...
October 16, 2018: Journal of Physiology
M H Liu, F Zhou, X B Wang, L P Chen, G Z Li, Q Zhao
Objective: To investigate the incidence rate of transjugular intrahepatic portosystemic shunt (TIPS) complications in the treatment of cirrhotic portal hypertension, and analyze the cause of complication to management methods. Methods: Data of 116 patients obtained from Zhongnan Hospital of Wuhan University were retrospectively analyzed. Portal venous pressure, routine blood test, coagulation test, liver and kidney function test, ammonia blood test, imaging and endoscopy reports were collected before and after procedure...
August 20, 2018: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
Carlos Ferre Aracil, Laura Núñez Gómez, Luis Téllez Villajos, Agustín Albillos Martínez
INTRODUCTION: Epistaxis in cirrhotic patients is a common issue. However, the literature published to date is very scarce. MATERIAL AND METHODS: Retrospective case series of patients with cirrhosis who presented with a significant epistaxis, between 2006 and 2016. RESULTS: Data were collected from 39 cirrhotic patients with a mean age of 61.4 (±14) years, 75% of which were males. The main comorbidities were hypertension (33%) and diabetes mellitus (26%)...
October 9, 2018: Gastroenterología y Hepatología
Junying Yuan, Jun Wang, Jieqiong Ma, Dengna Zhu, Zhenhuan Zhang, Jianan Li
OBJECTIVE: To evaluate the prevalence of, and risk factors for, cerebral palsy in Henan province, China. METHODS: The prevalence of cerebral palsy in children aged 0-6 years between September 2011 and September 2012 was investigated using a stratified-clustered-random sampling method. An age-, sex- , and residence-matched control group of typically developing children was recruited. Univariate analysis and multinomial logistic regression analysis were used to identify risk factors associated with cerebral palsy...
October 9, 2018: Journal of Rehabilitation Medicine
Nicholas Nacca, Rachel Schult, Robert Loflin, Adam Weltler, Rachel Gorodetsky, Sherri Kacinko, Jeffery Moran, Alex Krotulski, Timothy Wiegand
BACKGROUND: Synthetic cannabinoid intoxication has become difficult to diagnose and manage in the United States, in part due to varying clinical effects within this heterogeneous group of compounds. CASE REPORT: A 38-year-old man was admitted with altered mental status and bradycardia. He demonstrated progressive encephalopathy, seizure activity, second-degree atrioventricular block type I, respiratory failure, hypotension, hypothermia, and hypoglycemia. A computed tomography scan of the abdomen and pelvis revealed multiple packages in the patient's stomach and rectum...
October 5, 2018: Journal of Emergency Medicine
Lara Camilleri
A 69-year-old man developed reduced consciousness of sudden onset. Examination and parameters were normal, except for a Glasgow Coma Scale (GCS) score of six. Brain imaging and blood tests were also normal, except for high plasma ammonia. His past medical history included epilepsy, hypertension and colitis. He was taking multiple antiepileptic medications, including sodium valproate, with no recent dose alterations. Medical intervention led to the sodium valproate being stopped and naloxone being administered...
October 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
Dengke Teng, Hao Zuo, Lin Liu, Jinghui Dong, Lei Ding
BACKGROUND: Transjugular intrahepatic portosystemic shunt (TIPS) procedure has played a vital role in management of portal hypertension. Thus, we aimed to investigate the natural history, long-term clinical outcome, predictors of survival in viral hepatitis related cirrhotic patients post-TIPS. METHOD: A total of 704 patients with complete followed-up data were enrolled, and clinical characteristics of patients were collected and analyzed. Kaplan-Meier method was used to calculate survival, and comparisons were made by log rank test...
October 1, 2018: Virology Journal
Wen Xu, Ping Liu, Yong-Ping Mu
Portal hypertension (PHT) is an important consequence of liver cirrhosis, which can lead to complications that adversely affect a patient's quality of life and survival, such as upper gastrointestinal bleeding, ascites, and portosystemic encephalopathy. In recent years, advances in molecular biology have led to major discoveries in the pathological processes of PHT, including the signaling pathways that may be involved: PI3K-AKT-mTOR, RhoA/Rho-kinase, JAK2/STAT3, and farnesoid X receptor. However, the pathogenesis of PHT is complex and there are numerous pathways involved...
September 26, 2018: World Journal of Clinical Cases
Eve Grillo Carvalho, Henrique Guarino Colli Peluso, Lorena Luana Batista, Cissa Santos Moreira, Juliana Suzano Moraes Protti, Maria Cristina Bento Soares, Aline de Freitas Suassuna Autran, Amanda Rocha Soares Almeida, Denise Cristina Rodrigues, Lívia Verônica Grillo Romano Bernardes, Luciana Pimenta de Paula
INTRODUCTION: The posterior reversible encephalopathy (PRES) syndrome encompasses a set of clinical-radiological findings associated with severe systemic arterial hypertension. This case report proposes to discuss the identification, diagnosis, and management of PRES in the pediatric population. CASE PRESENTATION: Female patient, 10 years old, admitted to the emergency room with complaint of oliguria and generalized edema. At the initial physical exam, the only alteration present was anasarca...
September 21, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Cristian Eduardo Navarro, Paula Juliana Rodríguez, Oscar Mauricio Espitia
Posterior reversible encephalopathy syndrome is a disorder of reversible subcortical vasogenic brain edema in the context of different diseases or exposure to cytotoxic drugs such as fludarabine. We present the case of a pediatric patient with β-thalassemia who develops a fludarabine-induced posterior reversible encephalopathy while he received an induction regimen to achieve an allogenic hematopoietic cell transplantation. The clinical presentation consists in altered mental state, headache, status epilepticus, visual disturbance, and hypertension...
September 28, 2018: Clinical Neuropharmacology
L M Antonenko, V A Parfenov
AIM: To study the efficacy of various methods of non-drug therapy of diseases manifested by vertigo and dizziness in neurological practice. MATERIAL AND METHODS: Referral and final diagnoses were compared after neurovestibular examination of 599 patients (177 men and 422 women), aged 25 to 79 years (mean age 55 years), with various causes of vertigo. Patients underwent vestibular rehabilitation, trainings on the stabiloplatform with biological feedback (biofeedback), repositioning maneuvers in patients with benign paroxysmal positional vertigo (BPPV)...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Daisuke Katsura, Yuichiro Takahashi, Shigenori Iwagaki, Rika Chiaki, Kazuhiko Asai, Masako Koike, Ryuhei Nagai, Shunsuke Yasumi, Madoka Furuhashi
We report prophylactic amnioinfusion (AI) for variable decelerations in umbilical cord compression without oligohydramnios as an early sign of deterioration. We performed a transabdominal AI in cases without oligohydramnios using the ultrasonography findings of umbilical cord compression (i.e. sandwich sign [SWS]) and variable decelerations (VD) in a foetal heart rate. Thirteen cases and 21 AIs were analysed. Nine (69%) cases were of a foetal growth restriction and 4 (31%) had umbilical hyper-coiled cords. VD frequency (p < ...
September 22, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Saadiya Javed Khan, Arjumand Ali Arshad, Mohammad Bilal Fayyaz, Islah Ud Din Mirza
PURPOSE: Posterior reversible encephalopathy syndrome (PRES) is associated with a range of medical conditions and medications. In this retrospective analysis, we present 19 pediatric patients with PRES who had undergone chemotherapy. METHODS: We identified four female and 15 male patients diagnosed with PRES on the basis of clinical and radiologic features. Patient charts were reviewed from January 2013 to June 2016 after authorization from the institutional review board...
September 2018: Journal of Global Oncology
Brigida E Annicchiarico, Concetta Santonocito, Massimo Siciliano, Margherita Scapaticci, Donatella Guarino, Carmine Di Stasi, Maria E Riccioni, Enrico Di Stasio, Ettore Capoluongo, Antonio Gasbarrini
BACKGROUND: In liver cirrhosis, the renin-angiotensin-aldosterone system is involved in the pathogenesis of portal hypertension. Its effector, angiotensin II, is generated by angiotensin-converting enzyme (ACE). Serum ACE levels are affected by I/D polymorphism of its gene, with alleles I and D being associated, respectively, with lesser and greater activity of the enzyme. In cirrhotic patients carrying the ACE I allele, an increased risk for gastro-oesophageal varices was observed. AIM: The aim of our study was to evaluate whether ACE I/D polymorphism influenced portal pressure...
August 28, 2018: Digestive and Liver Disease
Christoph Klinger, Bettina Riecken, Johannes Müller, Anja Westphal, Joachim Löffler, Eckhart Froehlich, Karel Caca
PURPOSE:  The purpose of this study was to determine accuracy and necessity of long-term Doppler ultrasound (DU) surveillance of transjugular intrahepatic portosystemic shunt (TIPS) patency after implantation of an ePTFE-covered stent-graft (Viatorr). METHODS:  This single-center retrospective study includes 228 consecutive cirrhotic patients with TIPS implantation due to portal hypertensive complications. Standardized DU surveillance was scheduled 3 - 5 days, 3 months, and 6 months after TIPS implantation and every 6 months thereafter...
September 2018: Zeitschrift Für Gastroenterologie
George Imataka, Takeshi Yamaguchi, Junpei Ishii, Kei Ogino, Kentaro Okamoto, Takashi Tsuchioka, Shigemi Yoshihara
A case of mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) in a female child who developed bacterial translocation from a congenital portal vein hypoplasia is reported. The patient was diagnosed as having portal hypertension after examinations and laboratory results showing splenomegaly and thrombocytopenia at the age of 1 year. The patient required three endoscopic variceal ligation (EVL) surgeries before the age of 9 due to development of multiple esophageal varices. After the second and third EVL procedures, she developed septicemia, possibly due to bacterial translocation associated with the administration of general anesthesia...
October 2018: Experimental and Therapeutic Medicine
K Xu, X Y Mao, Y Yao, H Cheng, X J Zhang
Objective: To explore the clinical and genetic characteristics of infantile nephrotic syndrome caused by COQ2 variants. Methods: The clinical and genetic data of a patient with nephrotic syndrome caused by COQ2 variants diagnosed at pediatric department of Peking University First Hospital from February 2018 to March 2018 were retrospectively analyzed. Related literature retrieved from PubMed, CNKI and Wanfang databases were searched to date (up to July 2018) with "COQ2 gene" or "primary coenzyme Q10 deficiency" and "nephrotic syndrome" or "nephropathy" as key words...
September 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
H Y Geng, L N Ji, C Y Chen, J Tu, H R Li, R Bao, Y Lin
Objective: To compare the efficacy and safety of mycophenolate mofetil versus cyclosporine A in treating children with primary refractory nephrotic syndrome. Methods: Conducted a prospective randomized controlled clinical trial in 62 pediatric patients (including 44 boys and 18 girls), age ranged from 2.1 to 17.0 years; 32 cases presented with frequently relapsing nephrotic syndrome (FRNS) and 30 cases presented with steroid-resistant nephrotic syndrome (SRNS), who were admitted to department of Nephrology, Children's Hospital Affiliated to Capital Institute of Pediatrics from October 2013 to October 2015...
September 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
William Ryan, Farouk Dako, Gary Cohen, David Pryluck, Joseph Panaro, Emily Cuthbertson, Dmitry Niman
Patients with liver disease and portal hypertension who have had surgical formation of an abdominal stoma are at risk of developing peristomal varices. These varices have a predilection for bleeding. Ideally, portal decompression via TIPS procedure is performed, with or without direct embolization of the bleeding varix. When TIPS is not an appropriate option due to significant liver disease and hepatic encephalopathy there are other approaches to treat peristomal variceal hemorrhage. We report the embolization of such a varix via direct percutaneous puncture under ultrasound guidance when portal decompression was not an appropriate option...
2018: Case Reports in Radiology
Bogdan Procopet, Petra Fischer, Adelina Horhat, Emil Mois, Horia Stefanescu, Mihai Comsa, Florin Graur, Adrian Bartos, Monica Lupsor-Platon, Radu Badea, Mircea Grigorescu, Marcel Tantau, Zeno Sparchez, Nadim Al Hajjar
The evaluation of patients with early hepatocellular carcinoma (HCC) referred for liver resection is still a matter of debate. Aims: 1) to compare liver stiffness measurement (LSM) by transient elastography with hepatic venous pressure gradient (HVPG) in the prediction of decompensation after liver resection in patients with cirrhosis and early HCC; 2) to identify which definition for posthepatectomy liver failure is better associated with survival. MATERIAL AND METHODS: Fifty-one patients (MELD score of 10±3) were included...
August 30, 2018: Medical Ultrasonography
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