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https://www.readbyqxmd.com/read/28929294/neurologic-complications-of-infective-endocarditis-recent-findings
#1
REVIEW
Marie Cantier, Mikael Mazighi, Isabelle Klein, J P Desilles, Michel Wolff, J F Timsit, Romain Sonneville
PURPOSE OF REVIEW: The purpose of this paper is to provide recent insights in management of neurologic complications of left-sided infective endocarditis (IE). RECENT FINDINGS: Cerebral lesions observed in IE patients are thought to involve synergistic pathophysiological mechanisms including thromboembolism, sepsis, meningitis, and small-vessel cerebral vasculitis. Brain MRI represents a major tool for the detection of asymptomatic events occurring in the majority of patients...
September 19, 2017: Current Infectious Disease Reports
https://www.readbyqxmd.com/read/28927320/stress-and-cortisol-responses-in-men-differences-according-to-facial-symmetry
#2
Javier I Borráz-León, Ana Lilia Cerda-Molina, Lilian Mayagoitia-Novales
Stress response is associated with increased activity in the hypothalamic-pituitary-adrenocortical axis. Chronic stress-induced elevation in cortisol may alter its own negative regulation with multiple long-term consequences for physical and psychological health. One of the most reliable physical traits associated with mental, apparent physical health, and competitiveness is the degree of facial fluctuating asymmetry. However, to our knowledge there are no studies regarding the relationship between cortisol levels, facial symmetry and male competitiveness, and how cortisol changes after a stressful test depending on these traits...
September 19, 2017: Stress: the International Journal on the Biology of Stress
https://www.readbyqxmd.com/read/28927291/differentially-conserved-transcriptomic-response-to-adversity-related-to-self-rated-health-in-the-multi-ethnic-study-of-atherosclerosis
#3
Pia Riestra, Samson Y Gebreab, Yongmei Liu, Ana V Diez Roux, Rumana R Khan, Amadou Gaye, Ruihua Xu, S K Davis
Self-rated health (SRH) is considered a strong indicator of well-being and clinical health status and has been linked to inflammatory markers. The objective of this work was to examine how self-rated physical health (SRPH) and mental health (SRMH) influence the immune system through the regulation of a stress-related gene expression profile known as the 'conserved transcriptional response to adversity' (CTRA), which involves the up-regulation of pro-inflammatory genes and down-regulation of genes involved in type I interferon (IFN) response and antibody synthesis...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28926420/seronegative-paraneoplastic-limbic-encephalitis-associated-with-thymoma
#4
Jaime Toro, David Cuellar-Giraldo, Alejandra Duque, Karla Minota, Jorge Patiño, Manuel García
Paraneoplastic limbic encephalitis is an autoimmune syndrome characterized by the acute or subacute onset of encephalopathy, memory loss, confusion, temporal lobe seizures, and behavioral and mood changes. Although most patients with paraneoplastic limbic encephalitis have antineuronal antibodies, advances in the field now permit the diagnosis without autoantibody test results. In this case illustrating the new diagnostic criteria, we report a 70-year-old woman who was brought to the emergency room after the acute onset of cognitive impairment, altered mental status, and choreoathetoid movements...
September 2017: Cognitive and Behavioral Neurology: Official Journal of the Society for Behavioral and Cognitive Neurology
https://www.readbyqxmd.com/read/28922287/pregabalin-toxicity-manifesting-as-reversible-encephalopathy-with-continuous-triphasic-waves-in-electroencephalogram
#5
Mihir Parekh, Gopal Krishna Dash, Isthiaque Ahamed
A 74-year-old man with peripheral neuropathy due to diabetes presented with deliberate ingestion of 450 mg of pregabalin (PBG) over a period of 8 hours followed by altered mental status. A bedside electroencephalogram was performed to rule out nonconvulsive status epilepticus, which showed continuous triphasic waves (TWs) with slow background activity. He recovered after 48 hours of stopping PBG, and his repeat electroencephalogram after 72 hours did not show any TWs. We present a rare case of PBG-induced TWs thereby highlighting the extent of the etiologic spectrum of TWs and discussing the literature related to this association...
September 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28921731/inter-observer-agreement-in-pediatric-cervical-spine-injury-assessment-between-prehospital-and-emergency-department-providers
#6
Lorin R Browne, Hamilton Schwartz, Fahd A Ahmad, Michael Wallendorf, Nathan Kuppermann, E Brooke Lerner, Julie C Leonard
BACKGROUND: Investigators have derived cervical spine injury (CSI) decision support tools from physician observations. There is a need to demonstrate that prehospital emergency medical services (EMS) providers can use these tools to appropriately determine the need for spinal motion restrictions and make field disposition decisions. OBJECTIVE: To determine the inter-observer agreement between EMS and emergency department (ED) providers for CSI risk assessment variables and overall gestalt for CSI in children after blunt trauma...
September 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28919568/robotic-stereotactic-assistance-rosa-utilization-for-minimally-invasive-placement-of-intraparenchymal-hematoma-and-intraventricular-catheters-case-report
#7
Nima Alan, Phillip Lee, Alp Ozpinar, Bradley A Gross, Brian T Jankowitz
BACKGROUND: In patients with supratentorial spontaneous intracerebral hemorrhage, intrahematomal catheter placement may allow for intra-clot thrombolysis and drainage. Robotic assistance may be used for the stereotactic placement of catheters. CASE DESCRIPTION: A 76-year-old male presented with altered mental status and left-sided weakness. Non-contrast CT head showed a right ganglionic intraparenchymal hemorrhage with resultant entrapment of the temporal horn. Using Robotic Stereotactic Assistance (ROSA), an intrahematomal and an intraventricular catheter were placed...
September 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28919338/diagnostic-accuracy-of-xpert-mtb-rif-ultra-for-tuberculous-meningitis-in-hiv-infected-adults-a-prospective-cohort-study
#8
Nathan C Bahr, Edwin Nuwagira, Emily E Evans, Fiona V Cresswell, Philip V Bystrom, Adolf Byamukama, Sarah C Bridge, Ananta S Bangdiwala, David B Meya, Claudia M Denkinger, Conrad Muzoora, David R Boulware
BACKGROUND: WHO recommends Xpert MTB/RIF as initial diagnostic testing for tuberculous meningitis. However, diagnosis remains difficult, with Xpert sensitivity of about 50-70% and culture sensitivity of about 60%. We evaluated the diagnostic performance of the new Xpert MTB/RIF Ultra (Xpert Ultra) for tuberculous meningitis. METHODS: We prospectively obtained diagnostic cerebrospinal fluid (CSF) specimens during screening for a trial on the treatment of HIV-associated cryptococcal meningitis in Mbarara, Uganda...
September 14, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28915823/patients-with-acute-poisoning-presenting-to-an-urban-emergency-department-of-a-tertiary-hospital-in-tanzania
#9
Ghaniya S Mbarouk, Hendry R Sawe, Juma A Mfinanga, John Stein, Shankar Levin, Victor Mwafongo, Michael S Runyon, Teri A Reynolds, Kent R Olson
BACKGROUND: Poisoning is a major public health concern in sub-Saharan Africa, affecting patients of all age groups. Poisoned patients often present to the emergency department (ED) and prompt evaluation and appropriate management are imperative to ensure optimal outcomes. Unfortunately, little is known about the specific presentations of poisoned patients in East Africa. We describe the clinical and epidemiological features of patients presenting to the Muhimbili National Hospital (MNH) ED with suspected toxicological syndromes...
September 16, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28912126/atypical-altered-mental-status-in-a-toddler
#10
Kimberly M Dickinson, Brandon Smith, Madiha Raees, Sheila Hofert
No abstract text is available yet for this article.
September 14, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28910681/the-imaging-spectrum-of-posterior-reversible-encephalopathy-syndrome-a-pictorial-review
#11
REVIEW
Emily Brady, Neal S Parikh, Babak B Navi, Ajay Gupta, Andrew D Schweitzer
Posterior reversible encephalopathy syndrome (PRES) is characterized by the acute onset of neurologic symptoms (headache, altered mental status, visual changes, seizures) with accompanying vasogenic edema on brain imaging. Risk factors for PRES include infection, uremia, malignancy, autoimmune disorders, the peripartum state and hypertension. PRES is classically described as being posterior (i.e. parieto-occipital) but radiologic variants are increasingly recognized. This pictorial review demonstrates the heterogeneity of the different radiologic presentations of PRES in reference to lesion distribution, hemorrhage, diffusion restriction, contrast enhancement, and other associated findings...
August 30, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28898743/qsofa-score-predictive-validity-in-enterobacteriaceae-bloodstream-infections
#12
Jason P Burnham, Marin H Kollef
PURPOSE: To determine whether the quick Sequential Organ Failure Assessment (qSOFA) retains predictive validity in patients with Enterobacteriaceae sepsis that all received appropriate initial antimicrobial therapy. MATERIALS AND METHODS: Retrospective cohort at Barnes-Jewish Hospital including individuals with Enterobacteriaceae sepsis receiving appropriate initial antimicrobial therapy between 6/2009-12/2013. Outcomes were compared according to qSOFA score and sepsis classification...
September 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28898135/understanding-adolescent-low-back-pain-from-a-multidimensional-perspective-implications-for-management
#13
Peter O'Sullivan, Anne Smith, Darren Beales, Leon Straker
Synopsis Low back pain (LBP) is the leading cause of disability worldwide. It often begins in adolescence, setting a course for later life. We have tracked the time course of LBP in the Raine Study cohort from the age of 14 years into early adulthood. Our work highlights that LBP is already prevalent at 14 years increasing across adolescence and into early adulthood. It is often co-morbid with other musculoskeletal pain. For some adolescents LBP has little impact - while for others its impact includes care seeking, taking medication, taking time off school and work, as well as modifying physical and functional activity...
September 12, 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28895468/prevalence-of-ideal-cardiovascular-health-and-its-association-with-cognitive-function-in-older-adults-the-chilean-national-health-survey-2009-2010
#14
Antonio García-Hermoso, Robison Ramírez-Vélez, Rodrigo Ramirez-Campillo, Mikel Izquierdo
BACKGROUND: Health behaviors and risk factors are independently related with cognitive function in older adults. This study aimed to examine the prevalence and relationship between cognitive function and a number of ideal cardiovascular health metrics in older adults from the 2009-2010 Chilean National Health Survey. BASIC PROCEDURES: Data from 460 older adults (mean age 73.5 years old, 59.3% women) from the 2009-2010 Chilean Health Survey were analyzed. Ideal cardiovascular health was defined as meeting the ideal levels of the following components: four behaviors (smoking, body mass index, physical activity and diet adherence) and three factors (total cholesterol, blood pressure and fasting glucose)...
September 12, 2017: Rejuvenation Research
https://www.readbyqxmd.com/read/28893576/isolated-internal-carotid-artery-thrombus-and-cerebral-infarction-in-a-patient-with-necrotizing-pancreatitis-case-report
#15
Daniel R Ludwig, Matthew J Austin, Adam N Wallace, Mudassar Kamran, Akash P Kansagra, Joshua W Osbun, DeWitte T Cross, Christopher J Moran
Isolated internal carotid artery (ICA) thrombus in the absence of underlying atherosclerotic disease is a rare entity. We report a case of a patient presenting with right arm weakness, slurred speech, and altered mental status in the setting of acute on chronic pancreatitis. The patient was found to have scattered left cerebral hemisphere cortical infarctions, and catheter angiography confirmed the presence of intraluminal left ICA thrombus, with no evidence of atherosclerotic disease in the cervical or intracranial vasculature...
September 8, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28890836/new-diagnosis-of-aids-based-on-salmonella-enterica-subsp-i-enterica-enteritidis-a-meningitis-in-a-previously-immunocompetent-adult-in-the-united-states
#16
Andrew C Elton, James Levin, Matthew P Lazio
Salmonella meningitis is a rare manifestation of meningitis typically presenting in neonates and the elderly. This infection typically associates with foodborne outbreaks in developing nations and AIDS-endemic regions. We report a case of a 19-year-old male presenting with altered mental status after 3-day absence from work at a Wisconsin tourist area. He was febrile, tachycardic, and tachypneic with a GCS of 8. The patient was intubated and a presumptive diagnosis of meningitis was made. Treatment was initiated with ceftriaxone, vancomycin, acyclovir, dexamethasone, and fluid resuscitation...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28886979/development-of-a-prediction-model-for-diagnosis-of-acute-poisoning-in-patients-with-altered-mental-status-and-absent-history-of-alcohol-drug-ingestion
#17
Robert Camilleri
BACKGROUND: Diagnosis of acute poisoning in patients with altered mental status and absent history is a challenging diagnostic problem in clinical practice. OBJECTIVE: The aims of the study were to develop a simple clinical tool to stratify risk of acute poisoning in patients with altered mental states and no history of alcohol/drug ingestion, and develop a prediction model using initial observations from which a simple risk score could be derived. METHODS: The study was carried out on non-trauma patients aged 15 years and older admitted with altered mental states and no history of alcohol or drug ingestion...
September 5, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28881419/a-55-year-old-male-presenting-with-altered-mental-status-a-complicated-case-of-intracranial-aneurysm
#18
Shivani Garg, Arezou Khosroshahi
A 55-year-old African American male was in good health 5 months back when he underwent colonoscopy as part of a routine colon cancer screening. After the procedure, he developed colitis and was treated with antibiotics for 5 days with resolution of his symptoms. 1 month after this episode he was admitted at an outside hospital for constellation of fever, bilateral ankle swelling and petechial pruritic rash on his lower extremities. This article is protected by copyright. All rights reserved.
September 7, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28878103/multimodality-imaging-of-anomalous-origin-of-right-coronary-artery-from-pulmonary-artery-arcapa
#19
Sanjay S Mehta, Srinivasan Sattiraju
Computed tomography angiogram confirmed the anomalous right coronary artery from pulmonary artery (ARCAPA) in a patient who presented with altered mental status and hypoxia due to opiate drug abuse. ARCAPA is exceedingly rare, with reported incidence of 0.002% in the literature. We present clinical images and describe the case management.
September 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28874952/duration-of-mechanical-ventilation-in-the-emergency-department
#20
Lauren B Angotti, Jeremy B Richards, Daniel F Fisher, Jeffrey D Sankoff, Todd A Seigel, Haitham S Al Ashry, Susan R Wilcox
INTRODUCTION: Due to hospital crowding, mechanically ventilated patients are increasingly spending hours boarding in emergency departments (ED) before intensive care unit (ICU) admission. This study aims to evaluate the association between time ventilated in the ED and in-hospital mortality, duration of mechanical ventilation, ICU and hospital length of stay (LOS). METHODS: This was a multi-center, prospective, observational study of patients ventilated in the ED, conducted at three academic Level I Trauma Centers from July 2011 to March 2013...
August 2017: Western Journal of Emergency Medicine
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