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https://www.readbyqxmd.com/read/28228434/sagittal-sinus-thrombosis-in-jak2-v617f-mutation-without-overt-myeloproliferative-disorder
#1
Prashant Ramesh Bhand, Supriya Ramesh Karde, Nagabathula Ramesh
We describe a case of a man aged 41 years who presented with a history of generalised headaches for 1 week and an acute episode of tonic-clonic seizures. He had no history of medical illness, was non-smoker, with an extensive family history of haematological disorders. Initial CT brain with contrast did not show any abnormalities in brain parenchyma. X-ray and CT right shoulder showed shoulder dislocation secondary to trauma associated with seizure prior to hospital admission. Subsequently, MRA and MRV brain was arranged, which revealed extensive expansible occlusive filling defect dominating the middle of superior sagittal sinus with left frontal cortical and subcortical acute oedema...
February 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28227101/high-density-penetrating-electrode-arrays-for-autonomic-nerves
#2
John Burns, Yee-Hsee Hsieh, Andrew Mueller, Juliette Chevallier, T S Sriram, Stephen J Lewis, Daniel Chew, Anil Achyuta, Jason Fiering, John Burns, Yee-Hsee Hsieh, Andrew Mueller, Juliette Chevallier, T S Sriram, Stephen J Lewis, Daniel Chew, Anil Achyuta, Jason Fiering, Daniel Chew, Yee-Hsee Hsieh, Andrew Mueller, Jason Fiering, T S Sriram, Juliette Chevallier, Stephen J Lewis, Anil Achyuta
Electrode arrays for recording and stimulation in the central nervous system have enabled numerous advances in basic science and therapeutic strategies. In particular, micro-fabricated arrays with precision size and spacing offer the benefit of accessing single neurons and permit mapping of neuronal function. Similar advances are envisioned toward understanding the autonomic nervous system and developing therapies based on its modulation, but appropriate electrode arrays are lacking. Here, we present for the first time, a multi-channel electrode array suitable for penetration of peripheral nerves having diameters as small as 0...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28224128/upregulation-of-th-il-17-pathway-related-genes-in-human-coronary-endothelial-cells-stimulated-with-serum-of-patients-with-acute-coronary-syndromes
#3
Giovanni Cimmino, Loreta Pia Ciuffreda, Giovanni Ciccarelli, Paolo Calabrò, Fiorella Angelica Valeria Ferraiolo, Alessia Rivellino, Raffaele De Palma, Paolo Golino, Francesco Rossi, Plinio Cirillo, Liberato Berrino
BACKGROUND: Inflammation plays an essential role in the development and complications of atherosclerosis plaques, including acute coronary syndromes (ACS). Indeed, previous reports have shown that within the coronary circulation of ACS patients, several soluble mediators are released. Moreover, it has been demonstrated that endothelial dysfunction might play an important role in atherosclerosis as well as ACS pathophysiology. However, the mechanisms by which these soluble mediators might affect endothelial functions are still largely unknown...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28222415/young-adult-patient-with-headache-fever-and-blurred-vision
#4
Stavroula A Paschou, Konstantinos Tzioras, Vasiliki Trianti, Stavroula Lyra, Vasileios-Arsenios Lioutas, Andreas Seretis, Andromachi Vryonidou
BACKGROUND AND IMPORTANCE: This case highlights the fact that acute pituitary apoplexy may be misdiagnosed due to being confused with other entities exhibiting similar symptoms, such as meningitis or subarachnoid hemorrhage. CLINICAL PRESENTATION: A patient in his late 30s presented with sudden and severe frontal headache, fever, blurred vision, nausea, confusion, as well as oculomotor palsy (CN III) with partial ptosis of the left eyelid, dilated left pupil and left eye globe deviation inferiorly and laterally...
October 2016: Hormones: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28216472/effects-of-atrial-fibrillation-and-heart-rate-on-percutaneous-mitral-valve-repair-with-mitraclip-results-from-the-transcatheter-mitral-valve-interventions-trami-registry
#5
Alexander Jabs, Ralph S von Bardeleben, Peter Boekstegers, Miriam Puls, Edith Lubos, Raffi Bekeredjian, Taoufik Ouarrak, Björn Plicht, Holger Eggebrecht, Georg Nickenig, Christian Butter, Rainer Hoffmann, Jochen Senges, Ulrich Hink
AIMS: In patients undergoing percutaneous edge-to-edge mitral valve repair for mitral valve regurgitation (MR), our aim was to evaluate acute and follow-up differences with pre-existing sinus rhythm (SR) or atrial fibrillation (AF), as well as comparisons stratified by baseline heart rate. METHODS AND RESULTS: Seven hundred and sixty patients who underwent a MitraClip procedure were prospectively enrolled in the TRAnscatheter Mitral valve Interventions (TRAMI) registry, and stratified according to baseline heart rhythm and heart rate with a cut-off value of 70 beats per minute...
February 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28215570/the-cardiac-electrophysiology-of-patients-with-spinal-cord-injury
#6
Michael Manogue, David S Hirsh, Michael Lloyd
Spinal cord injury (SCI) is a clinical syndrome encountered frequently in trauma centers and is accompanied by both acute and chronic heart rhythm abnormalities. The injury is characterized by sympathetic nervous system (SNS) impairment with preservation of parasympathetic output via the vagus nerve. Severe bradycardia in the form of life-threatening sinus arrest or complete heart block may be observed in the acute recovery phase. Therapy for arrhythmias in the acute phase includes atropine, intravenous chronotropes, methylxanthines for prevention of episodic bradycardia, and pacemaker implantation in severe cases...
February 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28213342/virtual-visits-for-acute-nonurgent-care-a-claims-analysis-of-episode-level-utilization
#7
Aliza S Gordon, Wallace C Adamson, Andrea R DeVries
BACKGROUND: Expansion of virtual health care-real-time video consultation with a physician via the Internet-will continue as use of mobile devices and patient demand for immediate, convenient access to care grow. OBJECTIVE: The objective of the study is to analyze the care provided and the cost of virtual visits over a 3-week episode compared with in-person visits to retail health clinics (RHC), urgent care centers (UCC), emergency departments (ED), or primary care physicians (PCP) for acute, nonurgent conditions...
February 17, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28209460/pharmacologic-cardioversion-with-intravenous-amiodarone-is-likely-safe-in-neurocritically-ill-patients
#8
Michael Su, David Seki, Asma M Moheet
Neurological injury is often associated with cardiac abnormalities, including electrophysiological issues. Cardioversion of acute atrial fibrillation (<48h' duration) without anticoagulation carries about a 0.7% risk of thromboembolism. There is limited data on managing acute atrial fibrillation specifically in the neuroscience intensive care unit (NSICU) setting. We sought to determine the safety of using intravenous (IV) amiodarone for restoring sinus rhythm in patients with presumed new onset atrial or ventricular tachycardia after neurological injury...
February 13, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28208950/cerebral-venous-thrombosis-in-pregnancy-a-poignant-allegory-of-an-unusual-case
#9
Sheeba Marwah, Gaikwad Harsha Shailesh, Sumedha Gupta, Manjula Sharma, Pratima Mittal
Cerebral Venous Thrombosis (CVT), also known as cortical venous, cerebral sinus, cerebral venous sinus, or dural sinus thrombosis, is an infrequent grave condition affecting pregnant females, resulting from clot formation in one of the many outflow tracts of the brain. Although pregnancy-associated stroke or CVT is uncommon, the risk of stroke is greatly increased above the low baseline rate in young patients during late pregnancy and, even more so, during the puerperium. Haemorrhagic infarction can occur in the acute stage of CVT...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208910/anomalous-single-coronary-artery-presenting-with-acute-myocardial-infarction
#10
Vamsi Krishna Kamana, Padmakumar Ramachandran, Anand Muthu Krishnan, Ravella Keerthika Chowdary, Umesh Pai Malpe
The anomalous origin of the entire coronary system from the right coronary sinus is a very rare anomaly. Here a patient with this rare anomaly, who developed acute coronary syndrome, requiring revascularization, is presented and treated successfully. His coronary angiographic findings are also discussed. We would like to highlight the rarity of the origin of all 3 coronary arteries from a single coronary trunk. The case also highlights the importance of using Amplantzer AR1 guiding catheter for such anatomical variations arising in the right coronary cusp...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28195506/the-use-of-diffusion-weighted-imaging-to-evaluate-pathology-outside-the-brain-parenchyma-in-neuroimaging-studies
#11
Philip Benjamin, Faraan Khan, Andrew D MacKinnon
Diffusion weighted imaging (DWI) has transformed the radiological assessment of a variety of cerebral pathologies, in particular acute stroke. In neuroimaging studies, DWI can also be used to evaluate pathology outside the brain parenchyma, although it is sometimes underutilised for this purpose. In this pictorial review, the principles of diffusion-weighted imaging are outlined and thirteen cases of abnormal diffusion outside the brain parenchyma are illustrated in order to show DWI as a useful sequence for the evaluation of the following recommended review areas: the dural venous sinuses, internal carotid arteries, meninges, ventricles, cavernous sinus and orbits, skull base, and lymph nodes...
February 14, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28194321/extranodal-natural-killer-t-cell-lymphoma-presenting-as-orbital-cellulitis
#12
Hanis Zuhaimy, Hayati Abdul Aziz, Suresh Vasudevan, Siah Hui Hui
Objective: To report an aggressive case of extranodal natural killer/T-cell lymphoma (NKTCL) of the ethmoid sinus presenting as orbital cellulitis Method: Case report Results: A 56-year-old male presented with right eye redness, reduced vision, and periorbital swelling for 5 weeks duration associated with a two-month history of blocked nose. The visual acuity of the right eye was 6/18. The eye was proptosed with periorbital oedema and conjunctival chemosis. The pupil was mid-dilated but there was no relative afferent pupillary defect...
2017: GMS Ophthalmology Cases
https://www.readbyqxmd.com/read/28187920/holter-electrocardiogram-monitoring-in-patients-with-acute-ischaemic-stroke-find-afrandomised-an-open-label-randomised-controlled-trial
#13
Rolf Wachter, Klaus Gröschel, Götz Gelbrich, Gerhard F Hamann, Pawel Kermer, Jan Liman, Joachim Seegers, Katrin Wasser, Anna Schulte, Falko Jürries, Anna Messerschmid, Nico Behnke, Sonja Gröschel, Timo Uphaus, Anne Grings, Tugba Ibis, Sven Klimpe, Michaela Wagner-Heck, Magdalena Arnold, Evgeny Protsenko, Peter U Heuschmann, David Conen, Mark Weber-Krüger
BACKGROUND: Atrial fibrillation is a major risk factor for recurrent ischaemic stroke, but often remains undiagnosed in patients who have had an acute ischaemic stroke. Enhanced and prolonged Holter-electrocardiogram-monitoring might increase detection of atrial fibrillation. We therefore investigated whether enhanced and prolonged rhythm monitoring was better for detection of atrial fibrillation than standard care procedures in patients with acute ischaemic stroke. METHODS: Find-AFRANDOMISED is an open-label randomised study done at four centres in Germany...
February 8, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28187809/management-of-bacterial-central-nervous-system-infections
#14
M C Brouwer, D van de Beek
Bacterial infections of the central nervous system present as a medical emergency, thus requiring rapid diagnosis and immediate treatment. The most prevalent bacterial infections seen in the intensive care unit can be summarized as acute bacterial meningitis, subdural empyema, intracerebral abscess, and ventriculitis, which all commonly involve the brain parenchyma. The infections can either be community-acquired or hospital-acquired, e.g., after neurosurgical intervention, as a complication of severe neurotrauma or related to indwelling cerebrospinal fluid drains...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186496/ecg-derived-respiration-comparison-of-time-domain-approaches-and-application-to-altered-breathing-patterns-of-patients-with-schizophrenia
#15
Marcus Schmidt, Andy Schumann, Jonas Müller, Karl-Jürgen Bär, Georg Rose
In life-threatening diseases and in several clinical interventions, monitoring of vital parameters is essential to guarantee the safety of patients. Besides monitoring the electrocardiogram (ECG), it is helpful to assess respiratory activity. If the respiration signal itself is not recorded, it can be extracted from the ECG (i.e. ECG derived respiration, EDR). In the present paper, we compared six EDR approaches, namely RS-decline quantified by central moments, respiratory sinus arrhythmia (RSA), R-wave amplitude, QRS area, RS-distance and maximum RS-slope...
February 10, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28182334/utility-of-intraoperative-frozen-sections-in-surgical-decision-making-for-acute-invasive-fungal-rhinosinusitis
#16
Peter Papagiannopoulos, Diana Murro Lin, Samer Al-Khudari, Kumar Rajan, Swathi Reddy, Paulo Gattuso, Bobby Tajudeen, Pete S Batra
BACKGROUND: Acute invasive fungal rhinosinusitis (AIFRS) represents a fulminant, potentially fatal, disease process in immunocompromised patients. The diagnosis often rests on high index of clinical suspicion, with relative paucity of data on the diagnostic and therapeutic implications of intraoperative frozen sections. METHODS: Retrospective review was performed for 18 cases undergoing endoscopic sinus surgery for AIFRS. Reliability of intraoperative frozen section diagnosis was evaluated for all patients using final pathology as the gold standard...
February 9, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28179971/atypical-double-right-coronary-artery-presenting-with-acute-coronary-syndrome-cardiogenic-shock-and-complete-heart-block
#17
Santosh Kumar Sinha, Shravan Singh, Vikash Chaturvedi, Puneet Agrawal, Mahmadula Razi, Anupam Mahrotra, Vikas Mishra, Mukesh Kumar, Nasar Abdali, Dibbendhu Khanra, Ramesh Thakur, Chandra Mohan Varma, Umeshwar Pandey
Double right coronary artery (RCA) is an extremely rare coronary artery anomaly. We here report an atherosclerotic double RCA which appeared after primary percutaneous intervention performed to treat a 34-year-old male presenting with acute inferior myocardial infarction, cardiogenic shock and complete heart block. This is an unusual case as double RCA had been hidden by total atherosclerotic occlusion of the proximal part of the RCA and complete restoration of patency led complete heart block back to normal sinus rhythm...
March 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28179559/acute-cerebral-venous-thrombosis-three-dimensional-visualization-and-quantification-of-hemodynamic-alterations-using-4-dimensional-flow-magnetic-resonance-imaging
#18
Florian Schuchardt, Anja Hennemuth, Laure Schroeder, Stephan Meckel, Michael Markl, Thomas Wehrum, Andreas Harloff
BACKGROUND AND PURPOSE: Cerebral venous thrombosis (CVT) affects venous hemodynamics and can provoke severe stroke and chronic intracranial hypertension. We sought to comprehensively analyze 3-dimensional blood flow and hemodynamic alterations during acute CVT including collateral recruitment and at follow-up. METHODS: Twenty-two consecutive patients with acute CVT were prospectively included and underwent routine brain magnetic resonance imaging (MRI) and 4-dimensional flow MRI at 3 T for the in vivo assessment of cerebral blood flow...
February 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28166559/should-we-prescribe-antibiotics-to-this-patient-with-persistent-upper-respiratory-symptoms-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#19
Howard Libman, Diane M Brockmeyer, Howard S Gold
The American College of Physicians (ACP) and the Centers for Disease Control and Prevention (CDC) recently published advice for high-value care on the appropriate use of antibiotics for acute respiratory tract infections. They conducted a narrative literature review of evidence for antibiotic use in this setting that included recent clinical guidelines from professional societies supplemented by randomized, controlled trials; meta-analyses; and systematic reviews. They concluded that clinicians should reserve antibiotic treatment for acute rhinosinusitis in patients with persistent symptoms for more than 10 days, high fever and purulent nasal discharge or facial pain lasting for at least 3 consecutive days, or worsening symptoms after a typical viral illness that lasted 5 days and had initially improved ("double-sickening")...
February 7, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28164409/emergency-physician-knowledge-attitudes-and-behavior-regarding-acep-s-choosing-wisely-recommendations-a-survey-study
#20
Michelle P Lin, Thomas Nguyen, Marc A Probst, Lynne D Richardson, Jeremiah D Schuur
OBJECTIVE: In 2013, the American College of Emergency Physicians joined the Choosing Wisely campaign; however, its impact on emergency physician behavior is unknown. We assessed knowledge, attitudes and self-reported behaviors regarding the Choosing Wisely recommendations. METHODS: We performed a cross-sectional survey of emergency physicians at a national meeting. We approached 819 physicians; 765 (93.4%) completed the survey. RESULTS: As a result of the Choosing Wisely campaign, most respondents (64...
February 6, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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