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clinical examination neurology

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https://www.readbyqxmd.com/read/27932751/-a-case-of-subacute-combined-degeneration-caused-by-vitamin-b-sub-12-sub-deficiency-in-a-cervical-spondylosis-surgery-referral
#1
Kunio Yokoyama, Masahiro Kawanishi, Akira Sugie, Makoto Yamada, Hidekazu Tanaka, Yutaka Ito, Toshihiko Kuroiwa
A 62-year-old man with a 1-year history of numbness of the extremities, clumsiness, and gait disorder was diagnosed with cervical spondylotic myelopathy at a neighboring clinic and referred to our institution for surgery. The patient had undergone a total gastrectomy 6 years previously. Flattening of the cervical cord, associated with diffuse cervical spondylosis and intramedullary intensity change, was observed on magnetic resonance imaging of the cervical spine. Neurological examination revealed decreased vibratory and position sense in all limbs, with posterior funiculus-based neurological symptoms...
December 2016: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/27932197/crucial-role-of-carotid-ultrasound-for-the-rapid-diagnosis-of-hyperacute-aortic-dissection-complicated-by-cerebral-infarction-a-case-report-and-literature-review
#2
Eglė Sukockienė, Kristina Laučkaitė, Antanas Jankauskas, Dalia Mickevičienė, Giedrė Jurkevičienė, Antanas Vaitkus, Edgaras Stankevičius, Kęstutis Petrikonis, Daiva Rastenytė
Aortic dissection is a life-threatening rare condition that may virtually present by any organ system dysfunction, the nervous system included. Acute cerebral infarction among multiple other neurological and non-neurological presentations is part of this acute aortic syndrome. Rapid and correct diagnosis is of extreme importance keeping in mind the possibility of thrombolytic treatment if a patient with a suspected ischemic stroke arrives to the Emergency Department within a 4.5-h window after symptom onset...
November 19, 2016: Medicina
https://www.readbyqxmd.com/read/27930661/chronic-diseases-health-behaviors-and-demographic-characteristics-as-predictors-of-ill-health-retirement-findings-from-the-korea-health-panel-survey-2008-2012
#3
Young Joong Kang, Mo-Yeol Kang
PURPOSE: The research aim was to identify demographic characteristics, chronic diseases, and unhealthy behaviors predicting ill health retirement in South Korea. METHODS: Data were collected from 15,407 individuals enrolled in the first through the fifth phases of the Korea Health Panel Survey (2008-2012) using structured questionnaires examining retirement, morbidities, and health-related behaviors. The Cox proportional hazard model was used to examine demographic and clinical characteristics' effects on ill health retirement...
2016: PloS One
https://www.readbyqxmd.com/read/27930565/a-case-report-with-the-peculiar-concomitance-of-2-different-genetic-syndromes
#4
Alberto Lerario, Irene Colombo, Donatella Milani, Lorenzo Peverelli, Luisa Villa, Roberto Del Bo, Monica Sciacco, Giacomo Pietro Comi, Susanna Esposito, Maurizio Moggio
RATIONALE: Down syndrome (DS) is the most common chromosome disorder in live born infants, affecting several body systems, but usually sparing skeletal muscles. We present the case of a child with coexistence of DS and dystrophinopathy. Only 1 similar case has been reported so far. PATIENT CONCERNS: An 8-year-old boy with DS had a history of incidental finding of increased serum creatine kinase levels up to 1775 U/L (normal values 38-174 U/L). He presented no delay in motor development; at the neurological examination, no muscle weakness or fatigability was detected in 2 different evaluations performed over a 6-month period...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27929803/an-autopsy-verified-case-of-ftld-tdp-type-a-with-upper-motor-neuron-predominant-motor-neuron-disease-mimicking-mm2-thalamic-type-sporadic-creutzfeldt-jakob-disease
#5
Yuichi Hayashi, Yasushi Iwasaki, Akira Takekoshi, Nobuaki Yoshikura, Takahiko Asano, Maya Mimuro, Akio Kimura, Katsuya Satoh, Tetsuyuki Kitamoto, Mari Yoshida, Takashi Inuzuka
Here we report an autopsy-verified case of frontotemporal lobar degeneration (FTLD)-transactivation responsive region (TAR) DNA binding protein (TDP) type A with upper motor neuron-predominant motor neuron disease mimicking MM2-thalamic-type sporadic Creutzfeldt-Jakob disease (sCJD). A 69-year-old woman presented with an 11-month history of progressive dementia, irritability, insomnia, and gait disturbance without a family history of dementia or prion disease. Neurological examination revealed severe dementia, frontal signs, and exaggerated bilateral tendon reflexes...
November 2016: Prion
https://www.readbyqxmd.com/read/27929229/the-mental-status-examination
#6
David Norris, Molly S Clark, Sonya Shipley
The mental status examination includes general observations made during the clinical encounter, as well as specific testing based on the needs of the patient and physician. Multiple cognitive functions may be tested, including attention, executive functioning, gnosia, language, memory, orientation, praxis, prosody, thought content, thought processes, and visuospatial proficiency. Proprietary and open-source clinical examination tools are available, such as the Mini-Mental State Examination and the Mini-Cog...
October 15, 2016: American Family Physician
https://www.readbyqxmd.com/read/27928411/visual-impairment-due-to-lissencephaly
#7
V E Marqués-Fernández, H Sánchez-Tocino, M T Escudero-Caro, R Cancho-Candela, M García-Zamora
Lissencephaly is a rare disorder due to abnormal neural migration, causing neurological impairment and clinically characterised by mental retardation and epilepsy. Any disturbance of the visual pathway can cause loss of vision. The authors describe a case of a 6-year-old boy referred to the ophthalmologist presenting poor bilateral vision. This child had no other known medical conditions, and neurological examination was completely normal. Only when a magnetic resonance imaging was made that a lissencephaly-pachygyria with band heterotopia mostly occipital was noted...
October 2016: Neuro-ophthalmology
https://www.readbyqxmd.com/read/27926973/neurologic-injury-in-acidemic-term-infants
#8
Alison G Cahill, Amit M Mathur, Christopher D Smyser, Robert C Mckinstry, Kimberly A Roehl, Julia D López, Terrie E Inder, George A Macones
Objective To determine whether arterial umbilical cord gas (aUCG) pH, in anatomically normal-term infants, could select infants at risk for brain injury identified on magnetic resonance imaging (MRI). Study Design We performed a nested case-control within a prospective cohort of 8,580 women. Cases, with an aUCG pH < 7.10, were temporally, age, and sex matched to controls with an aUCG pH ≥ 7.20. Bi- and multivariable analyses compared the presence and severity of brain injury. Secondary analyses estimated whether elevated arterial base excess or lactate were associated with brain injury...
December 7, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27926758/association-between-surgeon-scorecard-use-and-operating-room-costs
#9
Corinna C Zygourakis, Victoria Valencia, Christopher Moriates, Christy K Boscardin, Sereina Catschegn, Alvin Rajkomar, Kevin J Bozic, Kent Soo Hoo, Andrew N Goldberg, Lawrence Pitts, Michael T Lawton, R Adams Dudley, Ralph Gonzales
Importance: Despite the significant contribution of surgical spending to health care costs, most surgeons are unaware of their operating room costs. Objective: To examine the association between providing surgeons with individualized cost feedback and surgical supply costs in the operating room. Design, Setting, and Participants: The OR Surgical Cost Reduction (OR SCORE) project was a single-health system, multihospital, multidepartmental prospective controlled study in an urban academic setting...
December 7, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27926447/motivation-and-attention-following-hemispheric-stroke
#10
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/27925608/active-music-therapy-and-physical-improvements-from-rehabilitation-for-neurological-conditions
#11
Demian Leandro Kogutek, Jeffrey David Holmes, Jessica Adrienne Grahn, Sara G Lutz, Emily Ready
Context • A variety of rehabilitation-based interventions are currently available for individuals with physical impairments resulting from neurological conditions, including physiotherapy, occupational therapy, and speech language pathology. Many individuals find participation in those therapies to be challenging. Alternative therapies have emerged as beneficial adjunctive treatments for individuals undergoing neurological rehabilitation, including music therapy (MT). Objective • The study intended to identify and collate systematically the evidence on MT interventions that address physical improvements in a rehabilitative setting...
October 2016: Advances in Mind-body Medicine
https://www.readbyqxmd.com/read/27925332/left-atrial-appendage-closure-with-the-new-occlutech%C3%A2-device-first-in-man-experience-and-neurological-outcome
#12
Barbara Bellmann, Steffen Schnupp, Peter Kühnlein, Christian Javernik, Caroline Kleinecke, Andreas Rillig, Ulf Landmesser, Johannes Brachmann, Jai-Wun Park
AIMS: Percutaneous left atrial appendage closure (LAAC) is a valuable treatment option for stroke prevention in patients with atrial fibrillation and a HAS-BLED-Score ≥ 3. Determinants of procedural safety events and neurological outcome of the patients with the Occlutech Device (OD) are not established yet. METHODS AND RESULTS: Between 2012 and 2016, 30 patients underwent LAAC using the OD. This is a prospective, study. Neurological examination and transesophageal echocardiography was performed directly before and after the procedure and after 1, 3 and 12 months...
December 7, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27924713/acetylcholinesterase-and-neuropathy-target-esterase-activities-in-11-cases-of-symptomatic-flight-crew-members-after-fume-events
#13
Astrid R R Heutelbeck, Catherine Bornemann, Martina Lange, Anke Seeckts, Michael M Müller
In modern aviation, so-called fume events such as exposure to an unknown mixture of chemicals introduced into the aircraft cabin with bleed air drawn off at the engines may occur. Human exposure may result in (neuro)toxic symptoms described as so-called "aerotoxic syndrome." Currently, among other agents organophosphates (OP) are regarded as a likely cause of the observed adverse effects. After fume events 11 flight crew members (9 female/2 male; ages 23-58 yr) were admitted for a medical examination within 5 d post exposure...
2016: Journal of Toxicology and Environmental Health. Part A
https://www.readbyqxmd.com/read/27923300/the-glasgow-coma-scale-in-adults-doing-it-right
#14
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/27923113/characteristics-and-outcomes-of-young-adults-who-suffered-an-out-of-hospital-cardiac-arrest-ohca
#15
Michael Yih-Chong Chia, Qing Shu Lu, Nik Hisamuddin Rahman, Nausheen Edwin Doctor, Tatsuya Nishiuchi, Benjamin Sieu-Hon Leong, Lai Peng Tham, E-Shaun Goh, Ling Tiah, Apichaya Monsomboon, Marcus Eng Hock Ong
BACKGROUND: There is paucity of data examining the incidence and outcomes of young OHCA adults. The aim of this study is to determine the outcomes and characteristics of young adults who suffered an OHCA and identify factors that are associated with favourable neurologic outcomes. METHODS: All EMS-attended OHCA adults between the ages of 16 and 35 years in the Pan-Asian Resuscitation Outcomes Study (PAROS) registry were analysed. The primary outcome was favourable neurologic outcome (Cerebral Performance Category 1 or 2) at hospital discharge or at 30th day post OHCA if not discharged...
December 3, 2016: Resuscitation
https://www.readbyqxmd.com/read/27922494/approach-to-the-patient-with-hyperckemia
#16
Shannon L Venance
PURPOSE OF REVIEW: Neurologists commonly receive consultation requests regarding the evaluation of patients with an elevated serum creatine kinase (CK), a condition known as hyperCKemia. This article outlines an approach to the history and examination of patients with hyperCKemia in order to narrow the localization and differential of an elevated CK and guide possible next steps. This article aims to help clinicians identify treatable or reversible etiologies as well as those that will change management...
December 2016: Continuum: Lifelong Learning in Neurology
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
#17
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/27920793/cognitive-decline-in-patients-with-chronic-hydrocephalus-and-normal-aging-growing-into-deficits
#18
Marlijn H de Beer, Philip Scheltens
BACKGROUND/AIM: To explore the theory of 'growing into deficits', a concept known from developmental neurology, in a series of cases with chronic hydrocephalus (CH). METHODS: Patients were selected from the Amsterdam Dementia Cohort and underwent extensive dementia screening. RESULTS: Twelve patients with CH were selected, in whom Alzheimer's disease was considered unlikely, based on biomarker information and follow-up. Mean Mini-Mental State Examination score was 24 (range 7-30)...
September 2016: Dementia and Geriatric Cognitive Disorders Extra
https://www.readbyqxmd.com/read/27919116/stylohyoid-complex-eagle-syndrome-starting-in-a-9-year-old-boy
#19
Maite Gárriz-Luis, Pablo Irimia, Juan M Alcalde, Pablo Domínguez, Juan Narbona
Background There are only four previous pediatric reports of the glossopharyngeal neuralgic form of the stylohyoid complex syndrome. Stylohyoid complex has merely been described as cases of glossopharyngeal neuralgia in children. Case Report A 12-year-old boy came to our hospital because of recurrent episodes of severe cranial pain (9/10) lasting for 5 to 15 minutes. Pain affected the right tonsillar fossa, ear, and mastoid region. Since the start at the age of 9 years, the frequency of painful episodes has progressively increased: when admitted to our clinics 3 years later, the child was having up to five episodes daily in spite of analgesic, antiepileptic, and antidepressant drugs; he had abandoned school and leisure...
December 5, 2016: Neuropediatrics
https://www.readbyqxmd.com/read/27918194/first-report-of-tumor-treating-fields-use-in-combination-with-bevacizumab-in-a-pediatric-patient-a-case-report
#20
Daniel O'Connell, Violet Shen, William Loudon, Daniela A Bota
We report the first case of a pediatric patient with glioblastoma (GBM; WHO grade IV astrocytoma) successfully treated with tumor treating fields (TTF). The patient was diagnosed with GBM when 13 years of age and progressed through surgical resection, radiotherapy and chemotherapy. Discrete tumor growth visualized on MRI with stable neurological examination was monitored for 6 months with subsequent stable disease observed radiographically and clinically for 7 months while adherent to Optune(®) (TTF). TTF thereby played a role in forestalling recurrent GBM growth in this young woman for 7 months without significant adverse effects...
December 5, 2016: CNS Oncology
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