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https://www.readbyqxmd.com/read/28538388/myxedema-coma-a-case-report-of-pediatric-emergency-care
#1
Yueniu Zhu, Wenjuan Qiu, Mengyan Deng, Xiaodong Zhu
RAIONALE: Myxedema coma (MC) is extremely rare but lethal in pediatric patients with hypothyroidism leading to altered mental status and hypothermia. But there is no clinical guideline for such cases. PATIENT CONCERNS: A 6-year-old Chinese girl presented with coma and hypothermia preceded by pneumonia. Her lab results were: free thyroxin (T4) 4.18 pmol/L and thyroid-stimulating hormone (TSH) > 150 μIU/mL with extremely elevated anti-thyroid peroxidase (TPO-Ab) and anti-thyroglobulin...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28515709/effects-of-10-hz-repetitive-transcranial-magnetic-stimulation-of-the-left-dorsolateral-prefrontal-cortex-in-disorders-of-consciousness
#2
Xiaoyu Xia, Yang Bai, Yangzhong Zhou, Yi Yang, Ruxiang Xu, Xiaorong Gao, Xiaoli Li, Jianghong He
BACKGROUND: While repetitive transcranial magnetic stimulation (rTMS) has been applied in treatment of patients with disorders of consciousness (DOC), a standardized stimulation protocol has not been proposed, and its therapeutic effects are inconsistently documented. OBJECTIVES: To assess the efficacy of rTMS in improving consciousness in patients with persistent minimally conscious state (MCS) or unresponsive wakefulness syndrome (UWS), previously known as vegetative state (VS)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28497927/the-potential-role-of-pain-related-sseps-in-the-early-prognostication-of-long-term-functional-outcome-in-post-anoxic-coma
#3
Alessandra Del Felice, Stefano Bargellesi, Federico Linassi, Bruno Scarpa, Emanuela Formaggio, Paolo Boldrini, Stefano Masiero, Paolo Zanatta
BACKGROUND: Cardiac arrest (CA) is a common cause of disability. Multimodal evaluation has improved prognosis but precocious biomarkers are not appropriate in determining long-term functional outcome. AIM: to identify early prognostication markers of long-term functional outcome in post-anoxic coma. DESIGN: retrospective assessment of outcomes. POPULATION: Individuals older than 18 years with post-anoxic coma hospitalized in intensive care units after cardiac arrest (CA) regardless of cause (cardiac or non-cardiac) and location of event (in or out-of-hospital)...
May 12, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28489640/little-black-boxes-noncardiac-implantable-electronic-medical-devices-and-their-anesthetic-and-surgical-implications
#4
Una Srejic, Paul Larson, Philip E Bickler
Implanted electronic medical devices. or stimulators such as pacemakers and nerve stimulators have grown enormously in diversity and complexity over recent decades. The function and potential interaction of these devices with the perioperative environment is of increasing concern for anesthesiologists and surgeons. Because of the innate electromagnetic environment of the hospital (operating room, gastrointestinal procedure suite, and imaging suite), implanted device malfunction, reprogramming, or destruction may occur and cause physical harm (including nerve injury, blindness, deafness, burn, stroke, paralysis, or coma) to the patient...
May 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28484399/biochemical-benefits-diagnosis-and-clinical-risks-evaluation-of-kratom
#5
REVIEW
Dimy Fluyau, Neelambika Revadigar
BACKGROUND: Kratom (Mitragyna speciosa) is a tropical tree with a long history of traditional use in parts of Africa and Southeast Asia. Kratom is also known as Thom, Thang, and Biak. Its leaves and the teas brewed from them have long been used by people in that region to manage pain and opioid withdrawal and to stave off fatigue. Kratom is actually consumed throughout the world for its stimulant effects and as an opioid substitute (in form of tea, chewed, smoked, or ingested in capsules)...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28424270/significance-of-circadian-rhythms-in-severely-brain-injured-patients-a-clue-to-consciousness
#6
Christine Blume, Julia Lechinger, Nayantara Santhi, Renata Del Giudice, Maria-Teresa Gnjezda, Gerald Pichler, Monika Scarpatetti, Johann Donis, Gabriele Michitsch, Manuel Schabus
OBJECTIVE: To investigate the relationship between the presence of a circadian body temperature rhythm and behaviorally assessed consciousness levels in patients with disorders of consciousness (DOC; i.e., vegetative state/unresponsive wakefulness syndrome or minimally conscious state). METHODS: In a cross-sectional study, we investigated the presence of circadian temperature rhythms across 6 to 7 days using external skin temperature sensors in 18 patients with DOC...
April 19, 2017: Neurology
https://www.readbyqxmd.com/read/28399715/prevalence-of-coma-recovery-scale-revised-signs-of-consciousness-in-patients-in-minimally-conscious-state
#7
Sarah Wannez, Olivia Gosseries, Deborah Azzolini, Charlotte Martial, Helena Cassol, Charlène Aubinet, Jitka Annen, Géraldine Martens, Olivier Bodart, Lizette Heine, Vanessa Charland-Verville, Aurore Thibaut, Camille Chatelle, Audrey Vanhaudenhuyse, Athena Demertzi, Caroline Schnakers, Anne-Françoise Donneau, Steven Laureys
Different behavioural signs of consciousness can distinguish patients with an unresponsive wakefulness syndrome from patients in minimally conscious state (MCS). The Coma Recovery Scale-Revised (CRS-R) is the most sensitive scale to differentiate the different altered states of consciousness and eleven items detect the MCS. The aim of this study is to document the prevalence of these items. We analysed behavioural assessments of 282 patients diagnosed in MCS based on the CRS-R. Results showed that some items are particularly frequent among patients in MCS, namely fixation, visual pursuit, and reproducible movement to command, which were observed in more than 50% of patients...
April 11, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28323659/stimulus-induced-rhythmic-periodic-or-ictal-discharges-in-coma-incidence-and-interrater-reliability-of-continuous-eeg-after-a-standard-stimulation-protocol-a-prospective-study
#8
Khalid A Alsherbini, Joao Mc-OʼNeil Plancher, David M Ficker, Brandon P Foreman, Opeolu M Adeoye, Jun Ying, Michael D Privitera
PURPOSE: Stimulus-induced rhythmic, periodic, or ictal discharges (SIRPIDs) are often seen during continuous electroencephalographic (cEEG) monitoring in coma. Given their uncertain clinical significance, our prospective study evaluated incidence of SIRPIDs in comatose patients in the neuroscience intensive care unit (NSICU) who underwent a standard stimulation protocol and defined interreader reliability for cEEG. METHODS: Of 146 patients prospectively screened who underwent cEEG during a 6-month period, 53 patients were included and 93 patients were excluded...
March 17, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28281845/controlled-clinical-trial-of-repeated-prefrontal-tdcs-in-patients-with-chronic-minimally-conscious-state
#9
Aurore Thibaut, Sarah Wannez, Anne-Francoise Donneau, Camille Chatelle, Olivia Gosseries, Marie-Aurélie Bruno, Steven Laureys
OBJECTIVES: To assess the effects of repeated transcranial direct current stimulation (tDCS) sessions on the level of consciousness in chronic patients in minimally conscious state (MCS). METHODS: In this randomized double-blind sham-controlled crossover study, we enrolled 16 patients in chronic MCS. For 5 consecutive days, each patient received active or sham tDCS over the left prefrontal cortex (2 mA during 20 min). Consciousness was assessed with the Coma Recovery Scale-Revised (CRS-R) before the first stimulation (baseline), after each stimulation (day 1-day 5) and 1 week after the end of each session (day 12)...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28239544/measures-of-metabolism-and-complexity-in-the-brain-of-patients-with-disorders-of-consciousness
#10
Olivier Bodart, Olivia Gosseries, Sarah Wannez, Aurore Thibaut, Jitka Annen, Melanie Boly, Mario Rosanova, Adenauer G Casali, Silvia Casarotto, Giulio Tononi, Marcello Massimini, Steven Laureys
BACKGROUND: Making an accurate diagnosis in patients with disorders of consciousness remains challenging. (18)F-fluorodeoxyglucose (FDG)-PET has been validated as a diagnostic tool in this population, and allows identifying unresponsive patients with a capacity for consciousness. In parallel, the perturbational complexity index (PCI), a new measure based on the analysis of the electroencephalographic response to transcranial magnetic stimulation, has also been suggested as a tool to distinguish between unconscious and conscious states...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28222692/hashimoto-s-encephalitis-associated-with-ampar2-antibodies-a-case-report
#11
Mingqin Zhu, Xuefan Yu, Caiyun Liu, Chenchen Duan, Chunxiao Li, Jie Zhu, Ying Zhang
BACKGROUND: Hashimoto's encephalitis (HE) is a rare neurological complication of Hashimoto's thyroiditis (HT), while limbic encephalitis (LE) is an autoimmune inflammatory disorder frequently associated with anti-neuronal antibodies. The glutamate receptor α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptor (AMPAR) is important for synaptic transmission, memory, and learning. The etiology of HE remains unclear. We present a case of HE with antibodies to AMPAR2 both in the serum and cerebrospinal fluid...
February 21, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28180120/effects-of-a-sensory-stimulation-by-nurses-and-families-on-level-of-cognitive-function-and-basic-cognitive-sensory-recovery-of-comatose-patients-with-severe-traumatic-brain-injury-a-randomized-control-trial
#12
Marzieh Moattari, Fatemeh Alizadeh Shirazi, Nasrin Sharifi, Najaf Zareh
BACKGROUND: Several lines of evidence suggest that early sensory stimulation and regular family visiting programs are potential nursing interventions to improve the outcomes of head injured comatose patients. However, little is known about the impacts of family involvement in providing sensory stimulation. OBJECTIVES: To determine the effects of a sensory stimulation program conducted by nurses and families on the consciousness, level of cognitive function, and basic cognitive sensory recovery of head injury comatose patients...
September 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28152637/l-arginine-in-the-treatment-of-valproate-overdose-five-clinical-cases
#13
Verena Schrettl, Norbert Felgenhauer, Christian Rabe, Malkanthi Fernando, Florian Eyer
BACKGROUND: Valproic acid and its metabolites - particularly valproyl-CoA - are inhibitors of the enzyme N-acetylglutamate synthetase. The amino acid l-arginine can stimulate N-acetylglutamate synthetase activity and could be potentially used therapeutically to correct hyperammonemia caused by valproate therapy or overdose. Severely valproic-acid-poisoned patients are usually treated with l-carnitine or hemodialysis in order to decrease hyperammonemia. We herein report of five cases, in which l-arginine was administered...
April 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28102097/familiar-auditory-sensory-training-in-chronic-traumatic-brain-injury-a-case-study
#14
Emily Galassi Sullivan, Ann Guernon, Brett Blabas, Amy A Herrold, Theresa L-B Pape
PURPOSE: The evaluation and treatment for patients with prolonged periods of seriously impaired consciousness following traumatic brain injury (TBI), such as a vegetative or minimally conscious state, poses considerable challenges, particularly in the chronic phases of recovery. METHOD: This blinded crossover study explored the effects of familiar auditory sensory training (FAST) compared with a sham stimulation in a patient seven years post severe TBI. Baseline data were collected over 4 weeks to account for variability in status with neurobehavioral measures, including the Disorders of Consciousness scale (DOCS), Coma Near Coma scale (CNC), and Consciousness Screening Algorithm...
January 19, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28087785/thermolytic-degradation-of-synthetic-cannabinoids-chemical-exposures-and-pharmacological-consequences
#15
Brian F Thomas, Timothy W Lefever, Ricardo A Cortes, Megan Grabenauer, Alexander L Kovach, Anderson O Cox, Purvi R Patel, Gerald T Pollard, Julie A Marusich, Richard C Kevin, Thomas F Gamage, Jenny L Wiley
Synthetic cannabinoids are manufactured clandestinely with little quality control and are distributed as herbal "spice" for smoking or as bulk compound for mixing with a solvent and inhalation via electronic vaporizers. Intoxication with synthetic cannabinoids has been associated with seizure, excited delirium, coma, kidney damage, and other disorders. The chemical alterations produced by heating these structurally novel compounds for consumption are largely unknown. Here, we show that heating synthetic cannabinoids containing tetramethylcyclopropyl-ring substituents produced thermal degradants with pharmacological activity that varied considerably from their parent compounds...
April 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28055088/myxedema-psychosis-in-a-patient-with-undiagnosed-hashimoto-thyroiditis
#16
Matthew M Mavroson, Nirav Patel, Eleonora Akker
Myxedema psychosis is uncommon in patients with primary hypothyroidism. Most often, this disease state can be found in patients with Hashimoto thyroiditis or after total thyroidectomy. Chronic hypothyroidism can lead to an insidious onset of psychiatric symptoms in patients, such as dementia, delirium, psychosis, hallucinations, and coma. A 31-year-old man with an unremarkable medical history was brought to the psychiatric emergency department for new-onset aggression, paranoid behavior, and hallucinations for 4 days...
January 1, 2017: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/27812319/evaluating-the-effect-of-repetitive-transcranial-magnetic-stimulation-on-disorders-of-consciousness-by-using-tms-eeg
#17
Yang Bai, Xiaoyu Xia, Jiannan Kang, Xiaoxiao Yin, Yi Yang, Jianghong He, Xiaoli Li
Background: The modulation efficacy of Transcranial magnetic stimulation (TMS) on consciousness improvement of patient with disorder of consciousness (DOC) has not been definitely confirmed. Objective: This study proposes TMS-EEG to assess effects of repetitive TMS (rTMS) on brain modulation of DOC. Methods: Twenty sessions of 10 Hz rTMS were applied over the dorsolateral prefrontal cortex for a patient with DOC. Measures of Coma Recovery Scale-Revised (CRS-R) score, TMS-evoked potential (TEP), perturbation complexity index (PCI), and global mean field power (GMFP) were used to evaluate the consciousness level of the patient at three intervals: before the rTMS protocol (T0), immediately after one session rTMS (T1), and immediately after 20 sessions (T2)...
2016: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/27793075/does-modafinil-improve-the-level-of-consciousness-for-people-with-a-prolonged-disorder-of-consciousness-a-retrospective-pilot-study
#18
Samira Kashinath Dhamapurkar, Barbara A Wilson, Anita Rose, Peter Watson, Agnes Shiel
BACKGROUND AND AIM: Modafinil is best known as a sleep regulator among healthy individuals, but studies suggest that it reduces excessive daytime sleepiness in patients with brain injury. This retrospective pilot study evaluated the effectiveness of Modafinil for people with a prolonged disorder of consciousness and whether those with a traumatic brain injury did better than those with a non-traumatic brain injury. METHOD: Twenty four prolonged disorder of consciousness patients who were prescribed Modafinil, were assessed at least four times both before and during treatment...
October 28, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27773729/do-you-see-me-the-role-of-visual-fixation-in-chronic-disorders-of-consciousness-differential-diagnosis
#19
Antonino Naro, Antonino Leo, Antonio Buda, Alfredo Manuli, Alessia Bramanti, Placido Bramanti, Rocco Salvatore Calabrò
Visual fixation (VF) of a target is a possible, although atypical, feature of the Unresponsive Wakefulness Syndrome (UWS). Whether VF may indicate residual awareness in these patients is debatable, since it may simply subtend a series of reflex processes. Objective tools should therefore be used to identify aware VF, which depends on the integrity of visuomotor networks encompassing frontal-parietal-occipital areas. The aim of our study was to detect residual visuomotor network functionality potentially sustaining aware VF...
October 20, 2016: Brain Research
https://www.readbyqxmd.com/read/27738996/the-neural-correlates-of-lexical-processing-in-disorders-of-consciousness
#20
Anna Nigri, Eleonora Catricalà, Stefania Ferraro, Maria Grazia Bruzzone, Ludovico D'Incerti, Davide Sattin, Davide Rossi Sebastiano, Silvana Franceschetti, Giorgio Marotta, Riccardo Benti, Matilde Leonardi, Stefano F Cappa
There is a growing interest in the use of functional imaging to assess brain activity in the absence of behavioural responses in patients with disorders of consciousness (DOC). In the present study, we applied a hierarchical auditory stimulation paradigm to functional magnetic resonance (fMRI) in a group of long-term DOC adult patients. Brain response to pairs of pseudowords, of unrelated words and of semantically related words, i.e. stimuli differing in lexical status (words vs. pseudowords) and semantic relatedness (related vs...
October 13, 2016: Brain Imaging and Behavior
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