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Emergency neurology

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https://www.readbyqxmd.com/read/28102882/factors-associated-with-significant-mri-findings-in-medical-walk-in-patients-with-acute-headache
#1
Joris Budweg, Till Sprenger, Anthony De Vere-Tyndall, Anne Hagenkord, Christoph Stippich, Christoph T Berger
QUESTION: Acute headache is a main reason for emergency consultations and can be a symptom of dangerous neurological conditions. We hypothesised that in medical walk-in headache patients with low suspicion of intracranial bleeding significant findings in brain magnetic resonance imaging (MRI) are associated with clinical features. METHODS: Retrospective chart review on medical outpatient referrals for brain MRI (2010-2014) with the chief complaint "acute headache" (duration <4 weeks)...
January 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28102171/lumbar-disc-herniation-causing-cauda-equina-syndrome-in-a-paediatric-patient-a-case-report
#2
Mohamad Irshad, Khurshid Ahmad, Hilal Ahmad Malla
Lumbar disc disease occurs mainly in the adult population. A disc prolapse in the paediatric population is very rare. Cauda equine syndrome resulting from compression of the cauda equina is a rare syndrome and is one of the few spinal surgical emergencies. Here we present a 13-year-old boy with pain in the lumbar region radiating bilaterally to the lower limbs, with asymmetrical weakness of lower the limbs, perianal hypoaesthesia and urinary retention. MRI of lumbar spine confirmed disc protrusion at the L3-L4 level with severe spinal canal stenosis...
August 30, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28102150/ultra-rare-genetic-variation-in-common-epilepsies-a-case-control-sequencing-study
#3
(no author information available yet)
BACKGROUND: Despite progress in understanding the genetics of rare epilepsies, the more common epilepsies have proven less amenable to traditional gene-discovery analyses. We aimed to assess the contribution of ultra-rare genetic variation to common epilepsies. METHODS: We did a case-control sequencing study with exome sequence data from unrelated individuals clinically evaluated for one of the two most common epilepsy syndromes: familial genetic generalised epilepsy, or familial or sporadic non-acquired focal epilepsy...
February 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28101763/mir-126-affects-brain-heart-interaction-after-cerebral-ischemic-stroke
#4
Jieli Chen, Chengcheng Cui, Xiaoping Yang, Jiang Xu, Poornima Venkat, Alex Zacharek, Peng Yu, Michael Chopp
Cardiovascular diseases are approximately three times higher in patients with neurological deficits than in patients without neurological deficits. MicroRNA-126 (MiR-126) facilitates vascular remodeling and decreases fibrosis and is emerging as an important factor in the pathogenesis of cardiovascular diseases and cerebral stroke. In this study, we tested the hypothesis that decreased miR-126 after ischemic stroke may play an important role in regulating cardiac function. Wild-type (WT), specific conditional-knockout endothelial cell miR-126 (miR-126(EC-/-)), and miR-126 knockout control (miR-126(fl/fl)) mice were subjected to distal middle cerebral artery occlusion (dMCAo) (n = 10/group)...
January 19, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28101311/a-hospital-based-retrospective-comparative-study-of-complications-outcomes-clinical-and-laboratory-parameters-of-malaria-with-and-without-neurological-involvement
#5
Sohaib Ahmad, Nadia Shirazi, Nowneet K Bhat, Minakshi Dhar, Garima Mittal, Manish Mittal, Nidhi Kaeley, Manoj Kumar
BACKGROUND & OBJECTIVES: Classically associated with Plasmodium (P.) falciparum, neurological complications in severe malaria is associated with increased morbidity and mortality. However, reports implicate the long considered benign P. vivax for causing severe malaria as well. We aimed to analyse the cerebral complications in malaria, and study if there is a species-related difference in the presentation and outcomes. METHODS: We retrospectively compared patients with malaria hospitalised from 2009-15, with (n=105) and without (n=1155) neurological involvement regarding outcomes, complications, demographic attributes, clinical features, and laboratory parameters...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/28100765/acute-transient-vestibular-syndrome-prevalence-of-stroke-and-efficacy-of-bedside-evaluation
#6
Jae-Hwan Choi, Min-Gyu Park, Seo Young Choi, Kyung-Pil Park, Seung Kug Baik, Ji-Soo Kim, Kwang-Dong Choi
BACKGROUND AND PURPOSE: The aim of this study was to determine the prevalence of stroke and efficacy of bedside evaluation in diagnosing stroke in acute transient vestibular syndrome (ATVS). METHODS: We performed a prospective, single-center, observational study that had consecutively recruited 86 patients presenting with ATVS to the emergency department of Pusan National University Yangsan Hospital from January to December 2014. All patients received a constructed evaluation, including HINTS plus (head impulse, nystagmus patterns, test of skew, and finger rubbing) and brain magnetic resonance imagings...
January 18, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28099107/case-238-spontaneous-pneumothorax-secondary-to-intrapulmonary-necrobiotic-rheumatoid-nodule
#7
Ammar A Chaudhry, Maryam Gul, Abbas A Chaudhry, William Moore
History A 54-year-old white woman with a history of rheumatoid arthritis who was taking glucocorticoids and methotrexate presented to the emergency department in December with worsening shortness of breath and chest heaviness for 1 week. She reported additional symptoms of weakness, headache, and arthralgia primarily involving her bilateral hands, wrist, ankles, and feet. She denied experiencing fevers, syncope or presyncope, focal neurologic deficits, chest pain, nausea, vomiting, unintentional weight loss, or recent trauma...
February 2017: Radiology
https://www.readbyqxmd.com/read/28095468/evaluating-hospital-based-surveillance-for-outbreak-detection-in-bangladesh-analysis-of-healthcare-utilization-data
#8
Birgit Nikolay, Henrik Salje, Katharine Sturm-Ramirez, Eduardo Azziz-Baumgartner, Nusrat Homaira, Makhdum Ahmed, A Danielle Iuliano, Repon C Paul, Mahmudur Rahman, M Jahangir Hossain, Stephen P Luby, Simon Cauchemez, Emily S Gurley
BACKGROUND: The International Health Regulations outline core requirements to ensure the detection of public health threats of international concern. Assessing the capacity of surveillance systems to detect these threats is crucial for evaluating a country's ability to meet these requirements. METHODS AND FINDINGS: We propose a framework to evaluate the sensitivity and representativeness of hospital-based surveillance and apply it to severe neurological infectious diseases and fatal respiratory infectious diseases in Bangladesh...
January 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28095299/african-and-asian-zika-virus-strains-differentially-induce-early-antiviral-responses-in-primary-human-astrocytes
#9
Rodolphe Hamel, Pauline Ferraris, Sineewanlaya Wichit, Fodé Diop, Loïc Talignani, Julien Pompon, Déborah Garcia, Florian Liegeois, Amadou A Sall, Hans Yssel, Dorothée Missé
ZIKA virus (ZIKV) is a newly emerging arbovirus. Since its discovery 60years ago in Uganda, it has spread throughout the Pacific, Latin America and the Caribbean, emphasizing the capacity of ZIKV to spread to non-endemic regions worldwide. Although infection with ZIKV often leads to mild disease, its recent emergence in the Americas has coincided with an increase in adults developing Guillain-Barré syndrome and neurological complications in new-borns, such as congenital microcephaly. Many questions remain unanswered regarding the complications caused by different primary isolates of ZIKV...
January 14, 2017: Infection, Genetics and Evolution
https://www.readbyqxmd.com/read/28095198/effects-of-small-world-rewiring-probability-and-noisy-synaptic-conductivity-on-slow-waves-cortical-network
#10
Ramazan Tekin, Mehmet Emin Tagluk
Physiological rhythms play a critical role in the functional development of living beings. Many biological functions are executed with an interaction of rhythms produced by internal characteristics of scores of cells. While synchronized oscillations may be associated with normal brain functions, anomalies in these oscillations may cause or relate the emergence of some neurological or neuropsychological pathologies. This study was designed to investigate the effects of topological structure and synaptic conductivity noise on the spatial synchronization and temporal rhythmicity of the waves generated by cells in the network...
January 17, 2017: Neural Computation
https://www.readbyqxmd.com/read/28094484/a-simplified-screening-tool-to-identify-seriously-ill-patients-in-the-emergency-department-for-referral-to-a-palliative-care-team
#11
Paolo Cotogni, Anna DE Luca, Andrea Evangelista, Claudia Filippini, Renata Gili, Antonio Scarmozzino, Giovannino Ciccone, Luca Brazzi
BACKGROUND: The aims of this study were to evaluate the feasibility of an Emergency Department (ED)-initiated screening to identify seriously ill patients in need of palliative care (PC) and to develop a simplified screening tool (SST). METHODS: Eligible patients with known diagnosis of chronic heart, lung, liver, and kidney failures, progressive neurological diseases or advanced cancer, awaiting to be hospitalized after an ED-visit, were assessed with the screening tool from the Italian Society Anaesthesia Analgesia Resuscitation Intensive Care (SIAARTI)...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28094079/a-stroke-mimic-methotrexate-induced-neurotoxicity-in-the-emergency-department
#12
Patrick Rogers, Wilbur J Pan, Richard A Drachtman, Christopher Haines
BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common form of childhood leukemia. The treatment of ALL involves multimodality therapy, and methotrexate (MTX) remains a mainstay of treatment. A complication of MTX therapy includes acute, subacute, and chronic neurotoxocity. Signs and symptoms may range from headaches, dizziness, and mood disorders to seizures and stroke-like symptoms. CASE REPORT: An 18-year-old woman with a history of ALL presented to the emergency department with acute onset of right-sided facial paralysis, right upper extremity flaccid paralysis, and right lower extremity weakness after receiving MTX therapy 3 days earlier...
January 13, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28092986/a-review-of-the-treatment-of-primary-orthostatic-hypotension
#13
Genevieve M Hale, Jose Valdes, Michael Brenner
OBJECTIVE: To review the efficacy and safety of pharmacological and nonpharmacological strategies used to treat primary orthostatic hypotension (OH). DATA SOURCES: A literature review using PubMed and MEDLINE databases searching hypotension, non-pharmacological therapy, midodrine, droxidopa, pyridostigmine, fludrocortisone, atomoxetine, pseudoephedrine, and octreotide was performed. STUDY SELECTION AND DATA EXTRACTION: Randomized or observational studies, cohorts, case series, or case reports written in English between January 1970 and November 2016 that assessed primary OH treatment in adult patients were evaluated...
January 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28092859/n-2-arylmethylimino-ethyl-7-chloroquinolin-4-amine-derivatives-synthesized-by-thermal-and-ultrasonic-means-are-endowed-with-anti-zika-virus-activity
#14
Giselle Barbosa-Lima, Ligia S da Silveira Pinto, Carlos R Kaiser, James L Wardell, Caroline S De Freitas, Yasmine R Vieira, Andressa Marttorelli, José Cerbino Neto, Patrícia T Bozza, Solange M S V Wardell, Marcus V N de Souza, Thiago M L Souza
Zika virus (ZIKV), an emerging Flavivirus, was recently associated with severe neurological complications and congenital diseases. Therefore, development of antiviral agents capable of inhibiting ZIKV replication is urgent. Chloroquine is a molecule with a confirmed safety history for use with pregnant women, and has been found to exhibit anti-ZIKV activity at concentrations around 10 μM. This suggests that modifications to the chloroquine structure could be promising for obtaining more effective anti-ZIKV agents...
January 6, 2017: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28092661/interactions-between-the-microbiota-immune-and-nervous-systems-in-health-and-disease
#15
REVIEW
Thomas C Fung, Christine A Olson, Elaine Y Hsiao
The diverse collection of microorganisms that inhabit the gastrointestinal tract, collectively called the gut microbiota, profoundly influences many aspects of host physiology, including nutrient metabolism, resistance to infection and immune system development. Studies investigating the gut-brain axis demonstrate a critical role for the gut microbiota in orchestrating brain development and behavior, and the immune system is emerging as an important regulator of these interactions. Intestinal microbes modulate the maturation and function of tissue-resident immune cells in the CNS...
January 16, 2017: Nature Neuroscience
https://www.readbyqxmd.com/read/28092376/infectious-immunity-in-the-central-nervous-system-and-brain-function
#16
REVIEW
Robyn S Klein, Charise Garber, Nicole Howard
Inflammation is emerging as a critical mechanism underlying neurological disorders of various etiologies, yet its role in altering brain function as a consequence of neuroinfectious disease remains unclear. Although acute alterations in mental status due to inflammation are a hallmark of central nervous system (CNS) infections with neurotropic pathogens, post-infectious neurologic dysfunction has traditionally been attributed to irreversible damage caused by the pathogens themselves. More recently, studies indicate that pathogen eradication within the CNS may require immune responses that interfere with neural cell function and communication without affecting their survival...
February 2017: Nature Immunology
https://www.readbyqxmd.com/read/28088691/stability-effect-of-cholesterol-poly-acrylic-acid-in-a-stimuli-responsive-polymer-liposome-complex-obtained-from-soybean-lecithin-for-controlled-drug-delivery
#17
M G Simões, P Alves, Manuela Carvalheiro, P N Simões
The development of polymer-liposome complexes (PLCs), in particular for biomedical applications, has grown significantly in the last decades. The importance of these studies comes from the emerging need in finding intelligent controlled release systems, more predictable, effective and selective, for applications in several areas, such as treatment and/or diagnosis of cancer, neurological, dermatological, ophthalmic and orthopedic diseases, gene therapy, cosmetic treatments, and food engineering. This work reports the development and characterization of a pH sensitive system for controlled release based on PLCs...
January 4, 2017: Colloids and Surfaces. B, Biointerfaces
https://www.readbyqxmd.com/read/28088067/tuning-neural-circuits-by-turning-the-interneuron-knob
#18
REVIEW
Nathalie Dehorter, Nicolás Marichal, Oscar Marín, Benedikt Berninger
Interneurons play a critical role in sculpting neuronal circuit activity and their dysfunction can result in neurological and neuropsychiatric disorders. To temporally structure and balance neuronal activity in the adult brain interneurons display a remarkable degree of subclass-specific plasticity, of which the underlying molecular mechanisms have recently begun to be elucidated. Grafting new interneurons to pre-existing neuronal networks allows for amelioration of circuit dysfunction in rodent models of neurological disease and can reopen critical windows for circuit plasticity...
January 11, 2017: Current Opinion in Neurobiology
https://www.readbyqxmd.com/read/28087097/quick-epinephrine-administration-induces-favorable-neurological-outcomes-in-out-of-hospital-cardiac-arrest-patients
#19
H Ueta, H Tanaka, S Tanaka, R Sagisaka, H Takyu
OBJECTIVE: This research is to study if quick administration of adrenaline on OHCA prior to hospitalization has an effect on improving CPC1-2 at one month. METHODOLOGY: A total 13,326 cases were extracted from 2011 to 2014 Utstein data for this retrospective cohort study, also, EMT reached the patients within 16min after 119 called and adrenaline was then administered within 22min of after contact. PATIENTS DIVIDED INTO TWO GROUPS: Patients were contacted within 8min of the 119 call (n=6956), and were contacted between 8 and 16min after the call (n=6370)...
January 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28081529/zika-virus-induced-microcephaly-and-its-possible-molecular-mechanism
#20
Md Imam Faizan, Mohd Abdullah, Sher Ali, Irshad H Naqvi, Anwar Ahmed, Shama Parveen
Zika virus is an arthropod-borne re-emerging pathogen associated with the global pandemic of 2015-2016. The devastating effect of Zika viral infection is reflected by its neurological manifestations such as microcephaly in newborns. This scenario evoked our interest to uncover the neurotropic localization, multiplication of the virus, and the mechanism of microcephaly. The present report provides an overview of a possible molecular mechanism of Zika virus-induced microcephaly based on recent publications. Transplacental transmission of Zika viral infection from mother to foetus during the first trimester of pregnancy results in propagation of the virus in human neural progenitor cells (hNPCs), where entry is facilitated by the receptor (AXL protein) leading to the alteration of signalling and immune pathways in host cells...
January 13, 2017: Intervirology
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