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Emergency neurology

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https://www.readbyqxmd.com/read/29053903/galectin-3-an-emerging-biomarker-in-stroke-and-cerebrovascular-diseases
#1
Anand Venkatraman, Shalaka Hardas, Nirav Patel, Navkaranbir Singh Bajaj, Garima Arora, Pankaj Arora
BACKGROUND: The carbohydrate-binding molecule Galectin-3 has garnered significant attention recently as a biomarker for various conditions ranging from cardiac disease to obesity. Though there have been several recent studies investigating its role in stroke and other cerebrovascular diseases, awareness of this emerging biomarker in the wider neurology community is limited. METHODS: We performed a systematic search in PubMed, EMBASE, Scopus, CINAHL, Clinicaltrials...
October 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29053777/movement-disorders-with-neuronal-antibodies-syndromic-approach-genetic-parallels-and-pathophysiology
#2
Bettina Balint, Angela Vincent, Hans-Michael Meinck, Sarosh R Irani, Kailash P Bhatia
Movement disorders are a prominent and common feature in many autoantibody-associated neurological diseases, a group of potentially treatable conditions that can mimic infectious, metabolic or neurodegenerative disease. Certain movement disorders are likely to associate with certain autoantibodies; for example, the characteristic dyskinesias, chorea and dystonia associated with NMDAR antibodies, stiff person spectrum disorders with GAD, glycine receptor, amphiphysin or DPPX antibodies, specific paroxysmal dystonias with LGI1 antibodies, and cerebellar ataxia with various anti-neuronal antibodies...
September 25, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29050752/maternal-substance-use-disorders-and-infant-outcomes-in-the-first-year-of-life-among-massachusetts-singletons-2003-2010
#3
Sunah S Hwang, Hafsatou Diop, Chia-Ling Liu, Qi Yu, Hermik Babakhanlou-Chase, Xiaohui Cui, Milton Kotelchuck
OBJECTIVE: To determine the association of maternal substance use disorders (SUDs) during pregnancy with adverse neonatal outcomes and infant hospital re-admissions, observational stays, and emergency department utilization in the first year of life. STUDY DESIGN: We analyzed 2 linked statewide datasets from 2002 to 2010: the Massachusetts Pregnancy to Early Life Longitudinal data system and the Massachusetts Bureau of Substance Abuse Services Management Information System...
October 16, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29050380/inflammasomes-in-neurological-diseases-emerging-pathogenic-and-therapeutic-concepts
#4
Manmeet K Mamik, Christopher Power
Inflammasome activation in the central nervous system occurs in both health and disease. Inflammasomes are cytosolic protein complexes that sense specific infectious or host stimuli and initiate inflammatory responses through caspase activation. Assembly of inflammasomes results in caspase-1-mediated proteolytic cleavage and release of the pro-inflammatory cytokines, interleukin-1β and interleukin-18, with initiation of pyroptosis, an inflammatory programmed cell death. Recent developments in the inflammasome field have uncovered novel molecular mechanisms that contribute to a broad range of neurological disorders including those associated with specific mutations in inflammasome genes as well as diseases modulated by inflammasome activation...
September 1, 2017: Brain: a Journal of Neurology
https://www.readbyqxmd.com/read/29049132/one-year-survival-after-in-hospital-cardiac-arrest-does-pre-arrest-sepsis-matter
#5
Pia Koivikko, Olli Arola, Outi Inkinen, Minna Tallgren
AIM: Cardiac arrest is not a common complication of sepsis, although sepsis has been recognized as one condition behind cardiac arrest. Our aim was to evaluate the prevalence of sepsis among patients with in-hospital cardiac arrest (IHCA), and to determine if sepsis is associated with inferior outcome after IHCA. METHODS: All consecutive emergency team dispatches in Turku University Hospital in 2011-2014 (n = 607) were reviewed retrospectively to identify the patients undergoing cardiopulmonary resuscitation (CPR) for IHCA (n = 301)...
October 18, 2017: Shock
https://www.readbyqxmd.com/read/29047014/a-callosal-catastrophe-toxic-leukoencephalopathy-associated-with-thermogenic-weight-loss-supplement-use
#6
Zakraus K Mahdavi, Ram Narayan, Shraddha Mainali, Benjamin M Greenberg, Venkatesh Aiyagari, David L McDonagh
BACKGROUND: The use of weight loss drugs and dietary supplements is common, but safety profiles for these drugs are largely unknown. Reports of toxicity have been published, and the use of these agents should be considered in clinical differential diagnoses. METHODS: We report the case of a patient with toxic leukoencephalopathy and hyponatremia associated with oral consumption of a thermogenic dietary supplement and essential oils. RESULTS: A 30-year-old woman presented after 2 days of headache, blurred vision, photophobia, vomiting, and hand spasms...
October 18, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29046467/-clinical-characteristics-of-craniocervical-junction-arteriovenous-fistulas
#7
Michio Nakamura, Tadashi Miyazaki, Natsuki Shinozaki, Masaki Izumi, Takashi Itabashi
OBJECTIVE: Craniocervical junction arteriovenous fistulas(CCJ-AVFs)are extremely rare lesions that may result in both subarachnoid hemorrhage(SAH)and myelopathy. Diagnosis of CCJ-AVF is difficult and may be delayed due to variable clinical features and a spectrum of neuroradiological findings. To elucidate the clinical characteristics of CCJ-AVF, we analyzed the clinical symptoms, neuroimaging findings, and the results of surgical treatment in five patients. RESULTS: Among the five patients, four were diagnosed with dural AVFs, and the remaining patient was diagnosed with radicular AVF...
October 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29040883/veno-arterial-extracorporeal-membrane-oxygenation-va-ecmo-for-emergency-cardiac-support
#8
Terri Sun, Andrew Guy, Amandeep Sidhu, Gordon Finlayson, Brian Grunau, Lillian Ding, Saida Harle, Leith Dewar, Richard Cook, Hussein D Kanji
PURPOSE: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) may provide benefit to patients in refractory cardiac arrest and cardiogenic shock. We aim to summarize our center's 6-year experience with resuscitative VA-ECMO. MATERIALS AND METHODS: A retrospective medical record review (April 2009 to 2015) was performed on consecutive non-cardiotomy patients who were managed with VA-ECMO due to refractory in- or out-of-hospital cardiac (IHCA/OHCA) arrest (E-CPR) or refractory cardiogenic shock (E-CS) with or without preceding cardiac arrest...
October 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29040867/long-term-follow-up-of-anterior-thalamic-deep-brain-stimulation-in-epilepsy-a-11-year-single-center-experience
#9
Seong Hoon Kim, Sung Chul Lim, Jiyeon Kim, Byung-Chul Son, Kyung Jin Lee, Young-Min Shon
PURPOSE: Anterior thalamic deep brain stimulation (ATN DBS) is an emerging, effective treatment for patients with drug-resistant epilepsy, but long-term results on its efficacy and safety are lacking. To evaluate the long-term efficacy and safety of ATN DBS treatment, as well as predictors of its success, in patients with drug-refractory epilepsy (DRE). METHOD: We retrospectively studied clinical outcomes in 29 consecutive refractory epilepsy patients treated by a single DBS team (two neurosurgeons, four neurologists) over an 11-year period, for whom follow-up was performed for up to 137 months (mean, 74...
October 14, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29040696/the-effect-of-surgical-start-time-on-complications-associated-with-neurological-surgeries
#10
Joseph R Linzey, James F Burke, M Amr Sabbagh, Stephen Sullivan, B Gregory Thompson, Karin M Muraszko, Aditya S Pandey
BACKGROUND: Neurosurgical procedures are necessary at all times of day. Other surgical specialties have examined the effect of surgical start time (SST) on morbidity and mortality; however, a similar study has not been performed for neurosurgical procedures. OBJECTIVE: To perform a retrospective cohort study describing the association between SST and operative morbidity. METHODS: We analyzed all patients undergoing neurological surgery between January 1, 2007 and August 1, 2014 at our institution...
October 13, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29038738/a-case-of-infective-endocarditis-and-spinal-epidural-abscess-caused-by-streptococcus-mitis-bacteremia
#11
Victoria S Byrd, Attila S Nemeth
A 57-year-old man presented with abdominal pain, hematemesis, and melena. He reported taking high-dose ibuprofen for back pain and drinking several 24-ounce beers daily. Examination was remarkable for icteric sclera, poor dentition, tachycardia, and crescendo-decrescendo murmur at right upper sternal border, radiating to the carotids. Labs revealed leukocytosis, anemia, thrombocytopenia, and elevated liver function tests and INR. Endoscopy demonstrated antral ulcers, duodenitis, and esophagitis. Blood cultures were obtained and broad-spectrum antibiotics started; cultures later grew Streptococcus mitis, and antibiotic coverage was narrowed...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29037228/neuroepigenetic-mechanisms-in-disease
#12
REVIEW
Michael A Christopher, Stephanie M Kyle, David J Katz
Epigenetics allows for the inheritance of information in cellular lineages during differentiation, independent of changes to the underlying genetic sequence. This raises the question of whether epigenetic mechanisms also function in post-mitotic neurons. During the long life of the neuron, fluctuations in gene expression allow the cell to pass through stages of differentiation, modulate synaptic activity in response to environmental cues, and fortify the cell through age-related neuroprotective pathways. Emerging evidence suggests that epigenetic mechanisms such as DNA methylation and histone modification permit these dynamic changes in gene expression throughout the life of a neuron...
October 16, 2017: Epigenetics & Chromatin
https://www.readbyqxmd.com/read/29036580/time-to-epinephrine-and-survival-after-paediatric-out-of-hospital-cardiac-arrest
#13
Tatsuma Fukuda, Yutaka Kondo, Kei Hayashida, Hiroshi Sekiguchi, Ichiro Kukita
Aims: Delay in administration of epinephrine is associated with decreased survival among children with in-hospital cardiac arrest with an initial non-shockable rhythm. Whether this association is applicable to paediatric out-of-hospital cardiac arrest (OHCA) population remains unknown. We aimed to determine whether time to epinephrine administration is associated with outcomes in paediatric OHCA. Methods and results: This was a nation-wide population-based study of paediatric OHCA in Japan from 2005 to 2012 based on data from the All-Japan Utstein Registry...
July 11, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/29034720/investigating-the-neuroanatomical-substrate-of-pathological-laughing-and-crying-in-amyotrophic-lateral-sclerosis-with-multimodal-neuroimaging-techniques
#14
Foteini Christidi, Efstratios Karavasilis, Panagiotis Ferentinos, Sophia Xirou, Georgios Velonakis, Michalis Rentzos, Vasiliki Zouvelou, Ioannis Zalonis, Efstathios Efstathopoulos, Nikolaos Kelekis, Ioannis Evdokimidis
OBJECTIVE: Pathological laughing and crying (PLC) is common in several neurological and psychiatric diseases and is associated with a distributed network involving the frontal cortex, the brainstem and cortico-pontine-cerebellar circuits. By applying multimodal neuroimaging approach, we examined the neuroanatomical substrate of PLC in a sample of patients with amyotrophic lateral sclerosis (ALS). METHODS: We studied 56 non-demented ALS patients and 25 healthy controls (HC)...
October 15, 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/29033792/spontaneous-and-evoked-activity-from-murine-ventral-horn-cultures-on-microelectrode-arrays
#15
Bryan J Black, Rahul Atmaramani, Joseph J Pancrazio
Motor neurons are the site of action for several neurological disorders and paralytic toxins, with cell bodies located in the ventral horn (VH) of the spinal cord along with interneurons and support cells. Microelectrode arrays (MEAs) have emerged as a high content assay platform for mechanistic studies and drug discovery. Here, we explored the spontaneous and evoked electrical activity of VH cultures derived from embryonic mouse spinal cord on multi-well plates of MEAs. Primary VH cultures from embryonic day 15-16 mice were characterized by expression of choline acetyltransferase (ChAT) by immunocytochemistry...
2017: Frontiers in Cellular Neuroscience
https://www.readbyqxmd.com/read/29033030/how-to-use-stem-cells-for-repair-in-stroke-patients
#16
REVIEW
O Detante, C Rome, J Papassin
Regenerative cell therapy is a promising therapeutic strategy in neurology, most notably to improve stroke recovery. Although tolerability and feasibility have apparently been validated, many questions remain as to what is the best type of cells to use, the best route and the post-stroke delay for administration. Two main strategies have currently emerged: intravenous injection of mesenchymal stem cells with systemic trophic support; and intracerebral grafting of neural stem cells with brain repair effects at the lesion site...
October 12, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/29032474/discrepancy-between-the-initial-assessment-of-injury-severity-and-post-hoc-determination-of-injury-severity-in-patients-with-apparently-mild-traumatic-brain-injury-a-retrospective-multicenter-cohort-analysis
#17
S M Bossers, K M Pol, E P A Oude Ophuis, B Jacobs, M C Visser, S A Loer, C Boer, J van der Naalt, P Schober
PURPOSE: Traumatic brain injury (TBI) is a major cause of trauma-related visits to emergency departments (ED). Determination of monitoring requirements of patients with apparently mild TBI is challenging. Patients may turn out to be more severely injured than initially assumed, and failure to identify these patients constitutes a serious threat to patient safety. We, therefore, aimed to identify clinical risk factors for more severe injuries in patients with apparently mild TBI. METHODS: In a retrospective cohort analysis performed at two level I trauma centers, 808 patients aged ≥ 16 presenting to the ED with head trauma and a Glasgow Coma Scale (GCS) score 13-15 who received a head CT scan were studied...
October 14, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29031464/moving-concussion-care-to-the-next-level-the-emergence-and-role-of-concussion-clinics-in-the-uk
#18
Osman H Ahmed, Mike Loosemore, Katy Hornby, Bhavesh Kumar, Richard Sylvester, Hegoda Levansri Makalanda, Tim Rogers, David Edwards, Akbar de Medici
Concussion is a worldwide issue in sports medicine at present, and in recent years has evolved into a major consideration for sports in the United Kingdom (UK). Governing bodies, sports clinicians, and indeed athletes themselves are dealing with the implications that this injury brings. In parallel with this, innovative means of managing this condition are emerging. The creation of specialized concussion clinics (which mirror those present in the United States and Canada) is one means of enhancing concussion care in the UK...
2017: Progress in Brain Research
https://www.readbyqxmd.com/read/29029947/a-neurological-emergency-trolley-reduces-turnaround-time-for-high-risk-medications-in-a-general-intensive-care-unit
#19
Henry Ajzenberg, Paula Newman, Gail-Anne Harris, Marnie Cranston, J Gordon Boyd
OBJECTIVES: To reduce medication turnaround times during neurological emergencies, a multidisciplinary team developed a neurological emergency crash trolley in our intensive care unit. This trolley includes phenytoin, hypertonic saline and mannitol, as well as other equipment. The aim of this study was to assess whether the cart reduced turnaround times for these medications. RESEARCH METHODOLOGY/DESIGN: In this retrospective cohort study, medication delivery times for two year epochs before and after its implementation were compared...
October 10, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29028076/intestinal-probiotics-in-relieving-clinical-symptoms-of-severe-hand-foot-and-mouth-disease-and-potential-mechanism-analysis
#20
F Zhu, Z Jiang, H-W Li
OBJECTIVE: In this prospective cohort study, the efficacy and action mechanism of an intestinal probiotic formulation, Golden Bifid, in severe hand, foot, and mouth disease (HFMD) were determined in 63 consecutively admitted patients successfully treated in the Pediatrics Emergency Department of our hospital. PATIENTS AND METHODS: All patients had a persistent fever; 43 patients had rashes on hands, feet, crissum, and hips; and 45 patients had neurological signs and symptoms...
September 2017: European Review for Medical and Pharmacological Sciences
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