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practical examination neurology

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https://www.readbyqxmd.com/read/28088349/stroke-biomarkers-in-clinical-practice-a-critical-appraisal
#1
REVIEW
Geelyn J L Ng, Amy M L Quek, Christine Cheung, Thiruma V Arumugam, Raymond C S Seet
Biomarkers provide critical mechanistic insights to key biologic processes that occur during cerebral ischemia which, when carefully applied, can improve clinical decision-making in acute stroke management. The translation of a blood-based biomarker in ischemic stroke to clinical practice is challenging, in part, due to the complexity of ischemic stroke pathogenesis and the presence of a blood-brain barrier that restricts the release of brain-specific markers into the circulation. The pathologic and clinical aspects of ischemic stroke are described in this review, where a non-exhaustive list of biomarkers that interrogate different aspects of ischemic stroke such as oxidative damage, inflammation, thrombus formation, cardiac function and brain injury are described...
January 11, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28039618/birth-settings-and-the-validation-of-neonatal-seizures-recorded-in-birth-certificates-compared-to-medicaid-claims-and-hospital-discharge-abstracts-among-live-births-in-south-carolina-1996-2013
#2
Qing Li, Dorothea D Jenkins, Stephen L Kinsman
Objective Neonatal seizures in the first 28 days of life often reflect underlying brain injury or abnormalities, and measure the quality of perinatal care in out-of-hospital births. Using the 2003 revision of birth certificates only, three studies reported more neonatal seizures recorded among home births ​or planned out-of-hospital births compared to hospital births. However, the validity of recording neonatal seizures or serious neurologic dysfunction across birth settings in birth certificates has not been evaluated...
December 30, 2016: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28031256/organ-donation-after-medical-assistance-in-dying-or-cessation-of-life-sustaining-treatment-requested-by-conscious-patients-the-canadian-context
#3
Julie Allard, Marie-Chantal Fortin
In June 2016, following the decision of the Supreme Court of Canada to decriminalise assistance in dying, the Canadian government enacted Bill C-14, legalising medical assistance in dying (MAID). In 2014, the province of Quebec had passed end-of-life care legislation making MAID available as of December 2015. The availability of MAID has many implications, including the possibility of combining this practice with organ donation through the controlled donation after cardiac death (cDCD) protocol. cDCD most often occurs in cases where the patient has a severe neurological injury but does not meet all the criteria for brain death...
December 28, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27993546/post-resuscitation-management-of-cardiac-arrest-patients-in-the-critical-care-environment-a-retrospective-audit-of-compliance-with-evidence-based-guidelines
#4
REVIEW
A Milonas, A Hutchinson, D Charlesworth, A Doric, J Green, J Considine
BACKGROUND: There is a clear relationship between evidence-based post resuscitation care and survival and functional status at hospital discharge. The Australian Resuscitation Council (ARC) recommends protocol driven care to enhance chance of survival following cardiac arrest. Healthcare providers have an obligation to ensure protocol driven post resuscitation care is timely and evidence based. OBJECTIVES: The aim of this study was to examine adherence to best practice guidelines for post resuscitation care in the first 24h from Return of Spontaneous Circulation for patients admitted to the intensive care unit from the emergency department having suffered out of hospital or emergency department cardiac arrest and survived initial resuscitation...
December 16, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27990473/a-station-based-concept-for-teaching-the-neurological-examination-a-prospective-quasi-experimental-study
#5
Jochen Brich, Michael Rijntjes
Background: The neurological examination is considered to be complex and contributes to the phenomenon of "neurophobia". It is traditionally taught in small groups by residents ("traditional concept"), making the learning success partially dependent on the resident's level of clinical training, didactic education and personal motivation. Aim of this study was to examine the effects of a newly developed concept ("station concept") for teaching the neurological examination on achieving an improved and more equal transfer of knowledge and practical skills...
2016: GMS Journal for Medical Education
https://www.readbyqxmd.com/read/27984401/who-orders-a-head-ct-perceptions-of-the-cirrhotic-bleeding-risk-in-an-international-multispecialty-survey-study
#6
Laura M Mazer, Marie Méan, Elliot B Tapper
OBJECTIVE: Traditional coagulopathic indices, including elevated international normalized ratio, do not correlate with bleeding risk in patients with cirrhosis. For this reason, head computed tomography (CT) has a low yield in cirrhotic patients with altered mental status and no trauma history. The initial diagnostic evaluation, however, is often made by nongastroenterologists influenced by the so-called "coagulopathy of cirrhosis." We sought to examine the prevalence, impact, and malleability of this perception in an international, multispecialty cohort...
December 14, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27978593/fetal-neurosonogaphy-ultrasound-and-magnetic-resonance-imaging-in-competition
#7
S Tercanli, F Prüfer
Both in routine diagnostics and detailed, highly specialized workups, major advances have been observed in many areas of ultrasound due to an increase in expertise and improved technology in recent years. This is particularly true in the case of fetal neurosonography 1 2 3 4. Malformations of the CNS together with fetal heart defects are among the most common congenital anomalies. From the embryonic phase to the late third trimester, the CNS undergoes extensive development and maturation processes. The diagnosis of CNS anomalies is therefore primarily dependent on the time at which the examination is performed and the experience of the examiner...
December 2016: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/27978485/nocebo-effect-in-refractory-partial-epilepsy-during-pre-surgical-monitoring-systematic-review-and-meta-analysis-of-placebo-controlled-clinical-trials
#8
Panagiotis Zis, Faiza Shafiq, Dimos-Dimitrios Mitsikostas
PURPOSE: Nocebo is very prevalent among neurological diseases resulting in low adherence and treatment outcome. We sought to examine the AEs following placebo administration in Randomized Controlled Studies (RCTs) for Epilepsy. METHOD: After a systematic Medline search for RCTs for Epilepsy pharmacological treatments, we assessed the number of discontinuations because of placebo intolerance. RESULTS: Data were extracted from 4 RCTs fulfilling our search criteria...
December 7, 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27974938/spontaneous-vertebral-artery-dissection-with-multiple-supratentorial-and-infratentorial-acute-infarcts-in-the-posterior-circulation-case-report
#9
Cristea I, Popa C
The article represents a case of a young patient with atypical clinical and paraclinical presentation of vertebral artery dissection by multiple cerebral infarcts, localized at the supratentorial and infratentorial levels in the posterior circulation. A case of a 21-year-old man, without a history of trauma in the cervical area or at the cranial level, without recent chiropractic maneuvers or practicing a sport, which required rapid, extreme, rotational movements of the neck, was examined. He presented to the emergency room with nausea, numbness of the left limbs, dysarthria, and incoordination of walking, with multiple objective signs at the neurological examination, which revealed right vertebral artery subacute dissection after the paraclinical investigations...
July 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27964735/strength-in-numbers-patient-experiences-of-group-exercise-within-hospice-palliative-care
#10
Lorna Malcolm, Gill Mein, Alison Jones, Helena Talbot-Rice, Matthew Maddocks, Katherine Bristowe
BACKGROUND: Exercise is increasingly recognized as a core component of palliative rehabilitation. The group exercise model is often adopted as a means of reaching more patients with limited resource. Despite the growth of quantitative research examining this area of practice, few qualitative studies have looked at the patient experience of participating in group exercise in a palliative setting, and most exclude patients with a non-cancer diagnosis. METHODS: The aim of this study was to explore patients' experiences of participating in group exercise classes in a hospice setting...
December 13, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/27959885/potassium-aspartate-attenuates-brain-injury-induced-by-controlled-cortical-impact-in-rats-through-increasing-adenosine-triphosphate-atp-levels-na-k-atpase-activity-and-reducing-brain-edema
#11
Yi Gu, Jie Zhang, Yumei Zhao, Yujin Su, Yazhuo Zhang
BACKGROUND Potassium aspartate (PA), as an electrolyte supplement, is widely used in clinical practice. In our previous study, we found PA had neuroprotective effects against apoptosis after cerebral ischemia/reperfusion in rats. In this study, we examine whether PA has protective effects on traumatic brain injury (TBI). MATERIAL AND METHODS TBI was induced by controlled cortical impact (CCI) in rats. Vehicle treatment (control) or PA treatment was administered intraperitoneally at 30 minutes after CCI. The modified neurological severity score (mNSS) and cortical lesion volume were examined...
December 13, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27926447/motivation-and-attention-following-hemispheric-stroke
#12
E Olgiati, C Russell, D Soto, P Malhotra
Spatial neglect (SN) is an extremely common disorder of attention; it is most frequently a consequence of stroke, especially to the right cerebral hemisphere. The current view of SN is that it is not a unitary deficit but a multicomponent syndrome. Crucially, it has been repeatedly shown that it has a considerable negative impact on rehabilitation outcome. Although a number of behavioral and pharmacological therapies have been developed, none of these appears to be applicable to all patients with SN or has proved unequivocally successful in clinical trials...
2016: Progress in Brain Research
https://www.readbyqxmd.com/read/27923300/the-glasgow-coma-scale-in-adults-doing-it-right
#13
Ismalia de Sousa, Sue Woodward
After 40 years, the Glasgow Coma Scale (GCS) is the resource of choice for assessing the level of consciousness in patients with neurological conditions. Clinicians' ability to monitor patients' conditions, identify deterioration and make clinical decisions depends on their ability to carry out GCS assessments, so it is vital that they understand it. This article explores how best to use the GCS in clinical practice and examines some of the factors that can affect the accuracy of assessments. The article also explains the difference between peripheral and central stimuli...
December 7, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/27921161/an-international-urogynecological-association-iuga-international-continence-society-ics-joint-report-on-the-terminology-for-the-conservative-and-nonpharmacological-management-of-female-pelvic-floor-dysfunction
#14
Kari Bo, Helena C Frawley, Bernard T Haylen, Yoram Abramov, Fernando G Almeida, Bary Berghmans, Maria Bortolini, Chantale Dumoulin, Mario Gomes, Doreen McClurg, Jane Meijlink, Elizabeth Shelly, Emanuel Trabuco, Carolina Walker, Amanda Wells
INTRODUCTION AND HYPOTHESIS: There has been an increasing need for the terminology on the conservative management of female pelvic floor dysfunction to be collated in a clinically based consensus report. METHODS: This Report combines the input of members and elected nominees of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted at intervals by many external referees...
December 5, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27918122/an-international-urogynecological-association-iuga-international-continence-society-ics-joint-report-on-the-terminology-for-the-conservative-and-nonpharmacological-management-of-female-pelvic-floor-dysfunction
#15
Kari Bo, Helena C Frawley, Bernard T Haylen, Yoram Abramov, Fernando G Almeida, Bary Berghmans, Maria Bortolini, Chantale Dumoulin, Mario Gomes, Doreen McClurg, Jane Meijlink, Elizabeth Shelly, Emanuel Trabuco, Carolina Walker, Amanda Wells
Introduction and hypothesis There has been an increasing need for the terminology on the conservative management of female pelvic floor dysfunction to be collated in a clinically based consensus report. Methods This Report combines the input of members and elected nominees of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted at intervals by many external referees. An extensive process of nine rounds of internal and external review was developed to exhaustively examine each definition, with decision-making by collective opinion (consensus)...
December 5, 2016: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/27917338/six-different-extremely-calcified-lesions-of-the-brain-brain-stones
#16
Yurdal Gezercan, Vedat Acik, Gökhan Çavuş, Ali Ihsan Ökten, Emre Bilgin, Hakan Millet, Burak Olmaz
BACKGROUND: This study aimed to extend clinical documentation of cerebral calculi by reporting six cases of cerebral calculi with distinct etiologies and localizations. METHODS: We evaluated the age, sex distribution, presenting symptoms, neurological examination findings, pathology results, and location of the calcifications of six patients with intracranial calcifications. RESULTS: Three of the six patients with brain stones were female (50%), and three were male (50%)...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27913700/clinical-decision-making-in-functional-and-hyperkinetic-movement-disorders
#17
Sandra M A van der Salm, Anne-Fleur van Rootselaar, Daniëlle C Cath, Rob J de Haan, Johannes H T M Koelman, Marina A J Tijssen
OBJECTIVE: Functional or psychogenic movement disorders (FMD) present a diagnostic challenge. To diagnose FMD, clinicians must have experience with signs typical of FMD and distinguishing features from other hyperkinetic disorders. The aim of this study was to clarify the decision-making process of expert clinicians while diagnosing FMD, myoclonus, and tics. METHODS: Thirty-nine movement disorders experts rated 60 patients using a standardized web-based survey resembling clinical practice...
December 2, 2016: Neurology
https://www.readbyqxmd.com/read/27897183/sensory-thresholds-at-different-sites-of-the-foot-a-valuable-reference-for-neurologic-examinations
#18
J-W Zhang, Q Wang, X-F Wang, M-M Gao, X-P Yun, H-F Wu, Y Hong
STUDY DESIGN: Prospective healthy volunteer study for sensory thresholds. OBJECTIVES: The aim of this study was to test sensory thresholds at different sites of the foot to provide a reference for diagnosis and neurologic classification. SETTING: A university hospital for the research and clinical practice of rehabilitation. METHODS: Thirty healthy volunteers were recruited, and quantitative sensory testing was performed on three sites of the foot (medial malleolus (for the L4 dermatome), dorsum of the foot at the third metatarsal phalangeal joint (for the L5 dermatome) and lateral heel (for the S1 dermatome))...
November 29, 2016: Spinal Cord
https://www.readbyqxmd.com/read/27894459/dsm-5-somatic-symptom-disorder-in-patients-with-vertigo-and-dizziness-symptoms
#19
Karina Limburg, Heribert Sattel, Katharina Radziej, Claas Lahmann
OBJECTIVE: DSM-5 somatic symptom disorder (SSD) could potentially be a highly relevant diagnosis for patients with vertigo and dizziness. The criteria of SSD, particularly the B-criterion with its three components (cognitive, affective, behavioral), have however not yet been investigated in this patient group. METHODS: We evaluated a large sample (n=399) of outpatients presenting in a neurological setting. Physical examinations and a psychometric assessment (SCID-I) were conducted; patients completed self-report questionnaires...
December 2016: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/27891018/legal-challenges-in-neurological-practice
#20
REVIEW
Sita Jayalakshmi, Sudhindra Vooturi
Clinical neuroscience has made tremendous advances over the last century. Neurology as a discipline is still considered challenging and at times risky due to the natural history and progressive course of few of the neurological diseases. Encouragingly, the patient and their caregivers are now increasingly willing to be actively involved in making decisions. The patients' relationship with the doctor is a reflection of the society. A society that is orienting itself toward "rating" and "feedback" has made this doctor-patient relationship, a consumer-service provider relationship...
October 2016: Annals of Indian Academy of Neurology
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