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https://www.readbyqxmd.com/read/27913910/a-randomized-trial-of-displaying-paid-price-information-on-imaging-study-and-procedure-ordering-rates
#1
Alyna T Chien, Lisa Soleymani Lehmann, Laura A Hatfield, Kate E Koplan, Carter R Petty, Anna D Sinaiko, Meredith B Rosenthal, Thomas D Sequist
BACKGROUND: Prior studies have demonstrated how price transparency lowers the test-ordering rates of trainees in hospitals, and physician-targeted price transparency efforts have been viewed as a promising cost-controlling strategy. OBJECTIVE: To examine the effect of displaying paid-price information on test-ordering rates for common imaging studies and procedures within an accountable care organization (ACO). DESIGN: Block randomized controlled trial for 1 year...
December 2, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27913745/the-association-of-uric-acid-with-leukoaraiosis
#2
Jun-Jing Li, Yin-Hui Huang, You-Yu Lin, Mi-Mi Li, Ya-Fang Chen, Ruo-Wei Cai
OBJECTIVE: To explore the possible correlation between uric acid levels and leukoaraiosis (LA). METHODS: This cross-sectional study enrolled patients who presented with some neurological discomfort (e.g. dizziness, headache, mild cognitive impairment). Potential demographic and clinical risk factors associated with LA, including sex, age, hypertension, diabetes mellitus, smoking, alcohol consumption, dyslipidaemia, plasma fibrinogen, D-dimer, uric acid, and homocysteine, were investigated using univariate and multivariate logistic regression analyses...
December 2, 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/27913505/management-of-primary-central-nervous-system-lymphoma-in-children
#3
Lisa Giulino-Roth, Oussama Abla, Tracy T Batchelor
A 14-year-old boy with no significant past medical history presents with headaches and vomiting and is found to have a 2 × 3-cm left parietal lobe mass. A stereotactic biopsy reveals diffuse large B-cell lymphoma (DLBCL). Cerebrospinal fluid cytology, as well as bone marrow biopsies are negative, and a whole-body positron emission tomography/computed tomography scan does not demonstrate other areas of disease. The primary medical team asks how you would treat this patient.
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913261/typical-symptoms-of-normal-pressure-hydrocephalus-caused-by-choroid-plexus-papilloma-in-the-cerebellopontine-angle-a-case-report
#4
Hiroshi Ito, Yukiko Nakahara, Masatou Kawashima, Jun Masuoka, Tatsuya Abe, Toshio Matsushima
BACKGROUND: Choroid plexus papillomas (CPPs) are rare benign intracranial tumors. Here, we report a rare case of CPP presenting with typical symptoms of normal-pressure hydrocephalus not with obstructive hydrocephalus. CASE DESCRIPTION: A 45-year-old female presented with a 6-year history of headache and typical symptoms of normal-pressure hydrocephalus (NPH) such as gait disturbance, urinary incontinence, and cognitive dysfunction in addition to the more common symptoms of choroid plexus papillomas (CPP), such as lower cranial nerve dysfunctions and ataxia...
November 29, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27913087/a-case-of-multiple-empyema-caused-by-streptococcus-intermedius
#5
Akihito Kaga, Ryuzaburo Higo, Hiroshi Yoshikawa, Naoko Yokoi, Takuo Haruyama, Hiroaki Komatsu, Ayumi Yabe, Takeshi Kusunoki, Katsuhisa Ikeda
We report the case of a patient with multiple empyema present throughout his body, including chronic sinusitis and chronic suppurative otitis media, as well as subsequent epidural empyema, all caused by Streptococcus intermedius. A 38-year-old man presented with chief complaints of headache, left ear discharge, and nasal congestion. Imaging studies revealed pansinusitis, soft tissue signs in the mastoid cells, and otitis media. The patient was treated with meropenem hydrate, 6g/day. While clinical findings indicated improvement of the sinusitis, his headache did not improve...
November 29, 2016: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/27910226/successful-treatment-of-post-dural-puncture-headache-using-epidural-fibrin-glue-patch-after-persistent-failure-of-epidural-blood-patches
#6
Kevin Wong, Brian R Monroe
OBJECTIVES: Epidural blood patch is the gold standard for the treatment of post-dural puncture headache (PDPH) when conservative treatments have failed to provide any relief. However, alternative therapies are lacking when epidural blood patch persistently fails to improve symptoms. Failure to treat PDPH may lead to significant functional impairment of daily living. Alternative therapies should be sought to accelerate recovery from PDPH. CASE REPORT: This case describes a woman who developed PDPH secondary to accidental dural puncture during a spinal cord stimulator trial...
December 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27910213/dedifferentiated-chordoid-meningioma-with-rhabdomyosarcomatous-differentiation-on-the-middle-cranial-fossa
#7
Hirotaka Fudaba, Tatsuya Abe, Masaki Morishige, Yasutomo Momii, Kenji Kashima, Akira Yamada, Hirofumi Nagatomi, Atsushi Natsume, Junko Hirato, Yoichi Nakazato, Minoru Fujiki
A 46-year-old woman presented with headache and right hemiparesis. MRI demonstrated a mass in the left middle fossa. Total resection was performed. A histological examination of the tumor specimen showed several characteristic morphological features. A chordoid meningioma showing an epithelial-like palisade arrangement was observed. An anaplastic short spindle cell tumor exhibiting a fascicular pattern was considered to be a rhabdomyosarcoma. After conventional radiotherapy, the tumor was well controlled without any neurological deficit for 20 months...
December 2016: Neuropathology: Official Journal of the Japanese Society of Neuropathology
https://www.readbyqxmd.com/read/27910097/chronic-migraine-an-update-on-physiology-imaging-and-the-mechanism-of-action-of-two-available-pharmacologic-therapies
#8
Sheena K Aurora, Mitchell F Brin
Several lines of research support the hypothesis that migraine is a spectrum of illness, with clinical symptoms that vary along a continuum from episodic migraine to chronic migraine. Physiologic changes may result in episodic migraine evolving into chronic migraine over months to years in susceptible individuals. With chronification, headache frequency increases, becoming more disabling and less responsive to therapy. Neurophysiologic and functional imaging research has reported that chronic migraine may be associated with severity-specific metabolic, functional, and structural abnormalities in the brainstem...
December 2, 2016: Headache
https://www.readbyqxmd.com/read/27910093/headache-attributed-to-craniocervical-dystonia-a-little-known-headache
#9
Marcos Eugenio Ramalho Bezerra, Pedro Augusto Sampaio Rocha-Filho
BACKGROUND: Craniocervical dystonia is a focal or segmental dystonia in its distribution, classically known as spasmodic torticollis when in its pure cervical presentation. Although craniocervical dystonia has been recognized as a possible cause of headache since the publication of the second version of International Classification of Headache Disorders, there are few studies about this entity. METHOD: This was a narrative review. RESULTS: Craniocervical dystonia was associated with muscle pain in 67-89% of the cases...
December 2, 2016: Headache
https://www.readbyqxmd.com/read/27910089/bilateral-endolymphatic-hydrops-in-a-patient-with-migraine-variant-without-vertigo-a-case-report
#10
Isabelle Y Liu, Akira Ishiyama, Ali R Sepahdari, Kevin Johnson, Gail Ishiyama
OBJECTIVE: To use modern high-resolution inner ear imaging modalities to evaluate for endolymphatic hydrops (EH) in a patient with migraine-associated fluctuating hearing loss without vertigo spells or dizziness. BACKGROUND: EH has been well described in patients with Meniere's disease on both human temporal bone studies and modern high-resolution imaging; however, there is no study to date, to our knowledge, that examines the presence of EH in a patient with migraine and bilateral hearing loss...
December 2, 2016: Headache
https://www.readbyqxmd.com/read/27910088/the-efficacy-of-greater-occipital-nerve-blockade-in-chronic-migraine-a-placebo-controlled-study
#11
H L Gul, A O Ozon, O Karadas, G Koc, L E Inan
OBJECTIVE: GON blockade with local anesthetics is an effective treatment for a group of headaches, such as cervicogenic headache, cluster headache, occipital neuralgia, migraine. Our aim was to evaluate the efficacy of greater occipital nerve (GON) blockade in patients with chronic migraine (CM) by using a control group. MATERIALS AND METHODS: We included 44 CM patients and randomly divide the patients into two groups, as group A (bupivacaine) and group B (placebo) to our study...
December 2, 2016: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/27909636/imatinib-induced-ototoxicity-in-a-patient-with-gastrointestinal-stromal-tumor-gist
#12
Komal Wasif, Nawal Wasif, Muhammad W Saif
Imatinib (Gleevec) is a biological agent that is approved for the treatment of chronic myeloid leukemia (CML) as well as gastrointestinal stromal tumor (GIST). The most frequently seen adverse effects in patients treated with imatinib include superficial edema, muscle cramps, musculoskeletal pain, rash, fatigue, headache, abdominal pain, and joint pain. Ototoxicity has rarely been reported except in two cases. We report a case of bilateral irreversible sensorineural hearing loss (SNHL) caused by imatinib in a patient receiving this agent in the adjuvant setting...
October 26, 2016: Curēus
https://www.readbyqxmd.com/read/27909626/metastasis-of-prostate-adenocarcinoma-to-the-frontal-and-ethmoid-sinus
#13
Fatih Akdemir, Mustafa Aldemir, Hasan Çakar, Gülnur Güler
Intracranial metastasis of prostate cancer is rarely seen, and there are few studies in this regard in the literature. Most of these studies in the literature comprise the metastasis of prostate cancer to the sphenoid sinus, and metastasis to the frontal and ethmoid sinus is a much rare entity. Association of visual symptoms, epistaxis, headache, and hematuria may indicate a urologic malignancy in terms of the origin of the primary tumor. This study was aimed to present the prostate cancer case of a 73-year-old patient whose paranasal sinus tomograms revealed the presence of frontal and ethmoid sinus metastasis...
December 2016: Turkish Journal of Urology
https://www.readbyqxmd.com/read/27908761/discovery-of-dual-positive-allosteric-modulators-pams-of-the-metabotropic-glutamate-2-receptor-and-cyslt1-antagonists-for-treating-migraine-headache
#14
Maria-Jesus Blanco, Dana R Benesh, James A Knobelsdorf, Albert Khilevich, Guillermo S Cortez, Fese Mokube, Thomas D Aicher, Todd M Groendyke, Fredrik P Marmsater, Tony P Tang, Kirk W Johnson, Amy Clemens-Smith, Mark A Muhlhauser, Steven Swanson, John Catlow, Renee Emkey, Michael P Johnson, Jeffrey M Schkeryantz
Pyridylmethylsulfonamide series were the first reported example of positive allosteric modulators (PAM) of the mGlu2 receptor. The hydroxyacetophenone scaffold is a second series of mGlu2 PAMs we have identified. This series of molecules are potent mGlu2 potentiators and possess significant CysLT1 (cysteinyl leukotriene receptor 1) antagonist activity, showing in vivo efficacy in a dural plasma protein extravasation (PPE) model of migraine. In this paper, we describe the dual SAR, pharmacokinetics and preclinical in vivo efficacy data for a tetrazole containing hydroxyacetophenone scaffold...
November 18, 2016: Bioorganic & Medicinal Chemistry Letters
https://www.readbyqxmd.com/read/27907970/-epidemiology-etiology-and-clinical-picture-of-enteroviral-meningitis-in-children-in-south-moravia
#15
Adriana Braunová, Petra Rainetová, Lenka Krbková, Iva Čapovová, Lenka Klapačová, Václav Musil, Martin Musílek, Jana Bednářová
OBJECTIVES: Enteroviruses (EVs) are the most common cause of aseptic viral meningitis. In some cases, they can cause severe meningoencephalitis and acute flaccid paralysis - an association with some virulent serotypes. The objectives were to describe the epidemiological situation of EV meningitis in children in South Moravia, to elucidate the etiology including the incidence of virulent serotypes and to evaluate the clinical presentation. MATERIAL AND METHODS: A total of 88 children with EV meningitis were prospectively evaluated...
September 2016: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
https://www.readbyqxmd.com/read/27906948/cervical-interlaminar-epidural-injections-at-high-doses-do-not-increase-optic-nerve-sheath-diameter-on-a-long-term-basis
#16
Hyunzu Kim, Joo Hyeon O, Sung-Jun Hong, Keun Man Shin, JungChan Park, Sang Soo Kang
BACKGROUND: Cervical epidural injection (CEI) is widely performed on patients with pain originating from the cervical spine. Studies have shown a good relationship between the optic nerve sheath diameter (ONSD) and the intracranial pressure (ICP). OBJECTIVE: The aim of this study was to evaluate the changes in the ONSD as a non-invasive surrogate marker of ICP after CEI. STUDY DESIGN: Prospective observational study. SETTING: Hospital and ambulatory pain clinic...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27906941/epidural-blood-patch-for-the-treatment-of-spontaneous-and-iatrogenic-orthostatic-headache
#17
Yun So, Jung Min Park, Pil-Moo Lee, Cho Long Kim, Cheolhan Lee, Jae Hun Kim
BACKGROUND: The cerebrospinal fluid (CSF) leakage could be happened spontaneously or related to the procedures such as spinal anesthesia, epidural anesthesia, CSF tapping, intrathecal chemotherapy or other spinal procedures. The leakage of CSF leads to intracranial hypotension of which distinguishing clinical feature is orthostatic headache. The epidural blood patch is a gold-standard treatment for intracranial hypotension-related orthostatic headaches. OBJECTIVE: We conducted this study to compare the efficacy and number of epidural blood patches for spontaneous and iatrogenic orthostatic headaches...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27905079/the-potential-impact-of-primary-headache-disorders-on-stroke-risk
#18
Chia-Lin Tsai, Chung-Hsing Chou, Pei-Jung Lee, Jiu-Haw Yin, Shao-Yuan Chen, Chun-Chieh Lin, Yueh-Feng Sung, Fu-Chi Yang, Chi-Hsiang Chung, Wu-Chien Chien, Chia-Kuang Tsai, Jiunn-Tay Lee
BACKGROUND: Headache such as migraine is associated with stroke. Studies focused on primary headache disorders (PHDs) as a risk factor for stroke are limited. The purpose of this population-based cohort study was to explore whether patients with PHDs were at a high risk for developing stroke. METHODS: A total of 1346 patients with PHDs were enrolled and compared with 5384 age-, gender- and co-morbidity-matched control cohorts. International Classification of Diseases, Clinical Modification codes were administered for the definition of PHDs, stroke, and stroke risk factors...
December 2016: Journal of Headache and Pain
https://www.readbyqxmd.com/read/27904816/an-unusual-presentation-of-nocardiosis-in-an-allogeneic-transplant-recipient
#19
Uroosa Ibrahim, Amina Saqib, Farhan Mohammad, Terenig Terjanian
Nocardiosis is a rare cause of opportunistic infection post hematopoietic stem cell transplant (HSCT) occurring in about 0.3% of patients. The risk factors include delayed immune reconstitution, prolonged neutropenia, and graft-versus-host disease. The most common site of infection is the lung, followed by the brain and the skin. Concomitant pulmonary and central nervous system (CNS) nocardiosis is an extremely rare entity as presented in our case. We present the case of a 72-year-old male at 137 days post transplant presenting with complaints of headache and slurred speech...
October 17, 2016: Curēus
https://www.readbyqxmd.com/read/27904759/a-review-of-sub-acute-subdural-hematoma-sasdh-with-our-institutional-experience-and-its-management-by-double-barrel-technique-dbt-a-novel-technique
#20
Soubhagya R Tripathy, Pankaj K Swarnakar, Sanjib Mishra, Sudhanshu S Mishra, Manmath K Dhir, Sanjay K Behera, Pratap C Nath, Somnath P Jena, Itibrata Mohanta, Deepak Das, Mani C Satapathy, Sitansu K Rout, Bikash R Behera, Deepak K Parida, Tanushree S Rath
BACKGROUND: Subacute subdural hematoma (SASDH) is an entity which is yet to capture the popular imagination among the neurosurgeons. Its management is often equated clinically to that of the chronic subdural hematoma (CSDH). However, their neurological deterioration is usually rapid, which seems to align them with acute subdural hematoma (ASDH). We proceed for their epidemiological evaluation. The advantages of a novel "double barrel technique (DbT)" over the conventional burrhole drainage are also presented...
2016: Surgical Neurology International
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