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https://www.readbyqxmd.com/read/28736097/alcoholic-pellagra-as-a-cause-of-altered-mental-status-in-the-emergency-department
#1
Sarah Luthe Kyuragi, Ryota Sato
BACKGROUND: Pellagra, which is caused by a deficiency of niacin and tryptophan, the precursor of niacin, is a rare disease in developed countries where alcoholism is a major risk factor due to malnutrition and lack of B vitamins. Although pellagra involves treatable dementia and psychosis, it is often underdiagnosed, especially in developed countries. CASE REPORT: In Japan, a 37-year-old man presented to the emergency department with altered mental status and seizures...
July 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28729382/recommended-clinical-trial-end-points-for-dialysis-catheters
#2
Michael Allon, Deborah J Brouwer-Maier, Kenneth Abreo, Kevin M Baskin, Kay Bregel, Deepa H Chand, Andrea M Easom, Leonard Mermel, Michele H Mokrzycki, Priti R Patel, Prabir Roy-Chaudhury, Surendra Shenoy, Rudolph P Valentini, Haimanot Wasse
Central venous catheters are used frequently in patients on hemodialysis as a bridge to a permanent vascular access. They are prone to frequent complications, including catheter-related bloodstream infection, catheter dysfunction, and central vein obstruction. There is a compelling need to develop new drugs or devices to prevent central venous catheter complications. We convened a multidisciplinary panel of experts to propose standardized definitions of catheter end points to guide the design of future clinical trials seeking approval from the Food and Drug Administration...
July 20, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28714083/acute-liver-failure-with-amiodarone-infusion-a-case-report-and-systematic-review
#3
P Jaiswal, B M Attar, J E Yap, K Devani, R Jaiswal, Y Wang, R Szynkarek, D Patel, M Demetria
WHAT IS KNOWN AND OBJECTIVE: Amiodarone, a commonly used class III antiarrhythmic agent notable for a relatively long half-life of up to 6 months and its pronounced adverse effect profile, is used for both acute and chronic management of cardiac arrhythmias. Chronic use of amiodarone has been associated with asymptomatic hepatotoxicity; however, acute toxicity is thought to be uncommon. There are only six reported cases of acute liver failure (ALF) secondary to amiodarone. In all these cases the outcome of death during the same hospitalization resulted...
July 16, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28704898/a-case-of-auditory-neuropathy-caused-by-pontine-hemorrhage-in-an-adult
#4
Seung-Hyun Chung, Sung Wook Jeong, Lee-Suk Kim
A pontine hemorrhage can evoke several neurological symptoms because the pons contains various nuclei and nerve fibers. Hearing loss can develop as a result of a pontine hemorrhage because there is an auditory conduction pathway in the cochlear nucleus of the pons. However, very few cases of hearing loss caused by pontine lesions have been reported, and there have been no reports of auditory neuropathy that developed following a pontine hemorrhage. Recently we had a patient who experienced a nontraumatic pontine hemorrhage who was diagnosed with auditory neuropathy...
July 2017: Journal of Audiology & Otology
https://www.readbyqxmd.com/read/28701497/teaching-neurology-to-medical-students-with-a-simplified-version-of-team-based-learning
#5
Jochen Brich, Meike Jost, Peter Brüstle, Marianne Giesler, Michel Rijntjes
OBJECTIVE: To compare the effect of a simplified version of team-based learning (sTBL), an active learning/small group instructional strategy, with that of the traditionally used small group interactive seminars on the acquisition of knowledge and clinical reasoning (CR) skills. METHODS: Third- and fourth-year medical students (n = 122) were randomly distributed into 2 groups. A crossover design was used in which 2 neurologic topics were taught by sTBL and 2 by small group interactive seminars...
July 12, 2017: Neurology
https://www.readbyqxmd.com/read/28701428/a-mercury-toxicity-case-complicated-by-hyponatremia-and-abnormal-endocrinological-test-results
#6
Matthew Carter, Abdul Abdi, Fareeha Naz, Farouq Thabet, Arpita Vyas
Mercury (Hg) poisoning is considered a rare disease by the National Institutes of Health and the diagnosis can present great challenges to clinicians. Children who are exposed to Hg can present with a wide variety of symptoms, including acrodynia, tremor, excessive salivation, and psychiatric symptoms, including insomnia. However, endocrinologic manifestations from Hg exposure are less well known. This is a case report of a 12-year-old boy who presented with body rash, irritability, insomnia, and profuse sweating after returning from a summer camp...
July 13, 2017: Pediatrics
https://www.readbyqxmd.com/read/28694775/yoga-meditation-and-mind-body-health-increased-bdnf-cortisol-awakening-response-and-altered-inflammatory-marker-expression-after-a-3-month-yoga-and-meditation-retreat
#7
B Rael Cahn, Matthew S Goodman, Christine T Peterson, Raj Maturi, Paul J Mills
Thirty-eight individuals (mean age: 34.8 years old) participating in a 3-month yoga and meditation retreat were assessed before and after the intervention for psychometric measures, brain derived neurotrophic factor (BDNF), circadian salivary cortisol levels, and pro- and anti-inflammatory cytokines. Participation in the retreat was found to be associated with decreases in self-reported anxiety and depression as well as increases in mindfulness. As hypothesized, increases in the plasma levels of BDNF and increases in the magnitude of the cortisol awakening response (CAR) were also observed...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28686543/a-physician-s-attempt-to-self-medicate-bipolar-depression-with-n-n-dimethyltryptamine-dmt
#8
Tanida Brown, Wanda Shao, Shehzad Ayub, David Chong, Christian Cornelius
N,N-dimethyltryptamine (DMT) is a psychoactive substance that has been gaining popularity in therapeutic and recreational use. This is a case of a physician who chronically took DMT augmented with phenelzine in an attempt to self-medicate refractory bipolar depression. His presentation of altered mental status, mania, and psychosis is examined in regards to his DMT use. This case discusses DMT, the possible uses of DMT, and the theorized mechanism of DMT in psychosis and treatment of depression, particularly involving its agonist activity at 5-HT1A, 5-HT2A, and 5-HT2C...
July 7, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28682904/sudden-bilateral-vision-loss-as-the-sole-manifestation-of-posterior-reversible-encephalopathy-syndrome-from-acute-uremia-clinical-case-report
#9
Hye-Young Shin, So Hee Kim, Mee Yon Lee, Sun Ae Yoon, Su Young Kim, Young Chun Lee
RATIONALE: Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological entity associated with vasogenic edema. Symptoms may include headache, seizures, altered mental status, and visual impairment. Patients with PRES generally present with neurological deficits. PATIENT CONCERNS: Here, we report an unusual case of a 42-year-old man who presented with sudden bilateral vision loss without any other neurologic symptoms. DIAGNOSES: He was diagnosed with PRES secondary to acute uremia...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28681577/tuberculous-meningitis-mimicking-varicella-zoster-meningitis
#10
Sun In Hong, Taeeun Kim, Jiwon Jung, Se Yoon Park, Yong Pil Chong, Sang Oh Lee, Sang Ho Choi, Yang Soo Kim, Jun Hee Woo, Sang Ahm Lee, Sung Han Kim
BACKGROUND: Varicella-zoster virus (VZV) is one of the most common etiologies of aseptic meningitis. The severest manifestation of VZV meningitis is occasionally confused with tuberculous meningitis (TBM). Thus, we investigated the clinical manifestations of VZV meningitis as compared with those of TBM. MATERIALS AND METHODS: All adult patients who were diagnosed with VZV meningitis or TBM were enrolled at a tertiary hospital in Seoul, South Korea, during an 8-year period...
June 2017: Infection & Chemotherapy
https://www.readbyqxmd.com/read/28680515/can-patients-with-non-convulsive-seizure-be-identified-in-the-emergency-department
#11
Gholamreza Sadeghipoor Roodsari, Geetha Chari, Bryan Mera, Shahriar Zehtabchi
BACKGROUND: Non-convulsive seizure (NCS) is an underdiagnosed, potentially treatable emergency with significant mortality and morbidity. The objective of this study is to examine the characteristics of patients with NCS presenting with altered mental status (AMS) and diagnosed with electroencephalography (EEG), to identify the factors that could increase the pre-test probability of NCS. METHODS: Retrospective study using the data collected prospectively. Inclusion criteria: patients older than 13 years with AMS...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28672712/in-reply-to-the-letter-to-the-editor-regarding-risk-factors-and-independent-predictors-of-30-day-readmission-for-altered-mental-status-after-elective-spine-surgery-for-spine-deformity-a-single-institutional-study-of-1090-patients
#12
https://www.readbyqxmd.com/read/28672711/letter-to-the-editor-regarding-risk-factors-and-independent-predictors-of-30-day-readmission-for-altered-mental-status-after-elective-spine-surgery-for-spine-deformity-a-single-institutional-study-of-1090-patients
#13
https://www.readbyqxmd.com/read/28660239/factors-influencing-diabetes-self-management-among-medically-underserved-patients-with-type-ii-diabetes
#14
Jimmy Reyes, Toni Tripp-Reimer, Edith Parker, Brandi Muller, Helena Laroche
In this study, researchers compare and contrast issues regarding diabetes self-management between persons in good versus poor glycemic control. The sample comprises low-income racially diverse adults with diabetes from four mid-western community health centers; 44 patients participated in eight focus groups divided by control status (HbA1c of > 9 [uncontrolled] or < 7 [controlled]). Themes common to both groups included the impact of dietary restrictions on social interactions, food cravings, the impact of mental health on self-management, and the importance of formal and informal (friends and family) support...
January 2017: Global Qualitative Nursing Research
https://www.readbyqxmd.com/read/28660166/neuroleptic-malignant-syndrome-in-the-trauma-intensive-care-unit-diagnosis-and-management-of-a-rare-disease-in-a-challenging-population
#15
Joseph David Drews, Andrew Christopher, David Clay Evans
Neuroleptic malignant syndrome (NMS) is a life-threatening neurological disorder associated with the use of antipsychotic medications. Many of its classic signs, such as fever and altered mental status, are nonspecific in trauma intensive care unit (ICU) patients, and its rarity makes it a difficult diagnosis in this population. However, delays in treatment can be costly both in terms of hospital resources and patient outcomes. We herein report a case of a 54-year-old trauma patient with NMS precipitated by a combination of cocaine withdrawal and neuroleptic medications...
April 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28653967/exercise-associated-hyponatremia-in-a-lactating-female
#16
Zach Bailowitz, Raymond Grams, David Teeple, Tamara Hew-Butler
A 37-year-old woman presented to the emergency department with severe headache, which quickly progressed to altered mental status and seizure activity in hospital. Her initial serum sodium concentration ([Na]) was 126 mmol/L. In the 24 hours before admission, she exercised vigorously for 120 minutes (interval training plus yoga) and also consumed more than 4 liters of fluid during that time to both stay hydrated and facilitate milk production because she was actively nursing 2 children. Her serum [Na] and altered mental status corrected slowly over the next 48 hours with furosemide, hypertonic saline, and fluid restriction...
July 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28652945/spontaneous-intracranial-hypotension-after-vestibular-schwannoma-resection-due-to-an-unexpected-pathology-tarlov-cysts
#17
Seth E Pross, Jeffrey D Sharon, Michael Lim, Abhay Moghekar, Aruna Rao, John P Carey
While infrequent, cerebrospinal fluid (CSF) leaks are known to occur after surgical resection of vestibular schwannomas. Early signs of CSF leak often include headache and altered mental status. If untreated, life-threatening complications can occur, including brainstem herniation and meningitis. The appropriate surgical treatment for a CSF leak requires accurate localization of the source. While the most likely location of a CSF leak after lateral skull base surgery is through the aerated portions of the temporal bone, we present a unique case of a man with a prolonged CSF leak after an acoustic tumor removal who was ultimately found to have an occult spinal perineural (Tarlov) cyst as the source...
May 19, 2017: Curēus
https://www.readbyqxmd.com/read/28642125/safety-and-efficacy-of-dual-lead-thalamic-deep-brain-stimulation-for-patients-with-treatment-refractory-multiple-sclerosis-tremor-a-single-centre-randomised-single-blind-pilot-trial
#18
Seth F Oliveria, Ramon L Rodriguez, Dawn Bowers, Daniel Kantor, Justin D Hilliard, Erin H Monari, Bonnie M Scott, Michael S Okun, Kelly D Foote
BACKGROUND: Efficacy in previous studies of surgical treatments of refractory multiple sclerosis tremor using lesioning or deep brain stimulation (DBS) has been variable. The aim of this study was to investigate the safety and efficacy of dual-lead thalamic DBS (one targeting the ventralis intermedius-ventralis oralis posterior nucleus border [the VIM lead] and one targeting the ventralis oralis anterior-ventralis oralis posterior border [the VO lead]) for the treatment of multiple sclerosis tremor...
June 19, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28634876/life-expectancy-gain-due-to-employment-status-depends-on-race-gender-education-and-their-intersections
#19
Shervin Assari
PURPOSE: Despite the well-established health effects of socioeconomic status (SES), SES resources such as employment may differently influence health outcomes across sub-populations. This study used a national sample of US adults to test if the effect of baseline employment (in 1986) on all-cause mortality over a 25-year period depends on race, gender, education level, and their intersections. METHODS: Data came from the Americans' Changing Lives (ACL) study, which followed 2025 Whites and 1156 Blacks for 25 years from 1986 to 2011...
June 20, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28632556/watertight-sealing-without-lumbar-drainage-for-incidental-ventral-dural-defect-in-transthoracic-spine-surgery-a-retrospective-review-of-53-cases
#20
Sang-Hyeop Jeon, Sang-Ho Lee, Yi Sheng Tsang, Tag-Geun Jung, Ki-Hyoung Moon, Gun Choi, Ketan D Dilip
STUDY DESIGN: A retrospective review. OBJECTIVES: To evaluate the therapeutic efficacy of the triple layer closure technique to establish watertight sealing without diversion of lumbar drainage, in preventing persistent incidental subarachnoid-pleural fistula and other neurological complications related to excessive drainage of cerebrospinal fluid (CSF) after dural defect in transthoracic ossified posterior longitudinal ligament (OPLL) surgery. SUMMARY OF BACKGROUND DATA: CSF leakage into the pleural cavity leads to unfavorable conditions for natural healing of incidental durotomy due to the negative pressure environment of the pleural space and lack of wound healing around the bony cavity near the decompressed spinal cord...
July 2017: Clinical Spine Surgery
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