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clinical neurology

Luiz Carlos Boaventura, Heloise Cazangi Borges, Armando Hitoshi Ozaki
The scope of this study was to evaluate factors that influence the burden of adult wheelchair-bound patients with neurological alterations on informal caregivers. Sixteen informal caregivers of adult wheelchair-bound patients with neurological alterations were evaluated, using the Zarit Burden Interview (ZBI) scale to evaluate the burden on caregivers, as well as gather data on the care and socio-demographic profile of the caregivers, on the socio-economic data and the degree of functional independence of adult wheelchair-bound patients with neurological alterations...
October 2016: Ciência & Saúde Coletiva
Koray Akkan, Erhan Ilgit, Baran Onal, Emetullah Cindil, Evsen Polattas Solak, Fatih Oncu, Dilan Ece Geylan
BACKGROUND: The treatment strategy and the correct incidence of near occlusion (NO) of the internal carotid artery (ICA) is still controversial. In routine radiological imaging NO can easily be misdiagnosed as complete occlusion and there is no consensus on the standard treatment strategy. PURPOSE: To present our perioperative and long-term follow-up results of ICA NO patients treated with carotid artery stenting (CAS). MATERIAL AND METHODS: Between 2004-2014 a total of 182 patients with ICA NO were evaluated for CAS...
October 25, 2016: Clinical Neuroradiology
Parth Makker, Yuichi J Shimada, Deepika Misra, Yumiko Kanei
Therapeutic hypothermia is used in select patients after out-of-hospital cardiac arrest (OHCA) to improve neurologic outcome. Rebound hyperthermia (RH) is commonly observed post-treatment. Previous studies analyzing the association of RH with clinical outcome have reported conflicting results. The purpose of this study is to examine the impact of RH after completion of therapeutic hypothermia in patients postcardiac arrest. We analyzed a retrospective cohort from our institution. All adults who underwent therapeutic hypothermia post-OHCA were divided into two cohorts depending on the presence/absence of fever (T > 38°C) within 24 hours of completing hypothermia protocol...
October 26, 2016: Therapeutic Hypothermia and Temperature Management
Bharat Bhusan Subudhi, Pratap Kumar Sahu
Oxidative stress in brain underlies the major neurological disorders including Alzheimer's disease (AD) and Parkinson's disease (PD). Peripherally, Angiotensin-II is a major effector of inflammation. Identification of its capacity to access brain during hypertension, as well as location of central rennin angiotensin system have led to its recognition as the major effector of oxidative stress in brain. Clinical uses of antioxidants to antagonize this oxidative stress have mostly failed. In this scenario, AT1 blockers have been investigated to prevent neurodegeneration...
October 24, 2016: Mini Reviews in Medicinal Chemistry
Eyal Behrbalk, Ofir Uri, Yoram Folman, Marcus Rickert, Radek Kaiser, Bronek Maximilian Boszczyk
Study Design Technical report. Objective Multilevel osteoporotic vertebral compression fractures may lead to considerable thoracic deformity and sagittal imbalance, which may necessitate surgical intervention. Correction of advanced thoracic kyphosis in patients with severe osteoporosis remains challenging, with a high rate of failure. This study describes a surgical technique of staged vertebral augmentation with osteotomies for the treatment of advanced thoracic kyphosis in patients with osteoporotic multilevel vertebral compression fractures...
November 2016: Global Spine Journal
Gregory D Schroeder, Mark F Kurd, Christopher K Kepler, James C Krieg, Jefferson R Wilson, Conor P Kleweno, Reza Firoozabadi, Carlo Bellabarba, Frank Kandizoria, Klause J Schnake, S Rajesekaran, Marcel F Dvorak, Jens R Chapman, Luiz R Vialle, F C Oner, Alexander R Vaccaro
Study Design Survey study. Objective To determine the global perspective on controversial aspects of sacral fracture classifications. Methods While developing the AOSpine Sacral Injury Classification System, a survey was sent to all members of AOSpine and AOTrauma. The survey asked four yes-or-no questions to help determine the best way to handle controversial aspects of sacral fractures in future classifications. Chi-square tests were initially used to compare surgeons' answers to the four key questions of the survey, and then the data was modeled through multivariable logistic regression analysis...
November 2016: Global Spine Journal
Hua Liu, Yong Liu, Jinbing Zhao, Hongyi Liu, Shengxue He
BACKGROUND: Inflammatory responses are correlated with secondary brain injury after aneurysmal subarachnoid hemorrhage (aSAH). Galectin-3 (Gal-3) is a novel biomarker reflecting inflammation status, and its elevated circulating levels are associated with poor prognosis of some inflammatory diseases. The aim of this study was to evaluate the relationship between Gal-3 plasma levels and prognosis in a group of aSAH patients. MATERIALS AND METHODS: We assessed plasma Gal-3 levels in 120 patients and 120 healthy individuals...
October 2016: Brain and Behavior
Yogi Chang-Yo Hsuan, Cheng-Hsien Lin, Ching-Ping Chang, Mao-Tsun Lin
BACKGROUND: Mesenchymal stem cell (MSC) transplantation has been reported to improve neurological function following neural injury. Many physiological and molecular mechanisms involving MSC therapy-related neuroprotection have been identified. METHODS: A review is presented of articles that pertain to MSC therapy and diverse brain injuries including stroke, neural trauma, and heat stroke, which were identified using an electronic search (e.g., PubMed), emphasize mechanisms of MSC therapy-related neuroprotection...
October 2016: Brain and Behavior
Wayne B Dyer, Joanne C G Tan, Timothy Day, Lynette Kiers, Matthew C Kiernan, Con Yiannikas, Stephen Reddel, Karl Ng, Phillip Mondy, Peta M Dennington, Melinda M Dean, Halina M Trist, Cristobal Dos Remedios, P Mark Hogarth, Steve Vucic, David O Irving
OBJECTIVE: The objective of the study was to profile leukocyte markers modulated during intravenous immunoglobulin (IVIg) treatment, and to identify markers and immune pathways associated with clinical efficacy of IVIg for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with potential for monitoring treatment efficacy. METHODS: Response to IVIg treatment in newly diagnosed IVIg-naïve and established IVIg-experienced patients was assessed by changes in expression of inflammatory leukocyte markers by flow cytometry...
October 2016: Brain and Behavior
Jeymohan Joseph, Paola Cinque, Deborah Colosi, Ameet Dravid, Luminita Ene, Howard Fox, Dana Gabuzda, Magnus Gisslen, Sarah Beth Joseph, Scott Letendre, Shibani S Mukerji, Avindra Nath, Ignacio Perez-Valero, Deborah Persaud, Richard W Price, Vasudev R Rao, Ned Sacktor, Ronald Swanstrom, Alan Winston, Valerie Wojna, Edwina Wright, Serena Spudich
CSF HIV escape is a recently recognised phenomenon that suggests that despite suppressive treatment, HIV RNA may be detected in the CNS compartment in some individuals. In rare cases this is associated with clinical neurological disease, while in most cases, neurological consequences are not apparent. Attempts at characterising the biological substrates of CSF escape and further investigating the neurological consequences need to be made to better understand the implications of this condition for the HIV cure agenda as well as for clinical outcomes...
October 5, 2016: Journal of Virus Eradication
Randall C Edgell, Ahmed E Sarhan, Jazba Soomro, Collin Einertson, Joanna Kemp, Peyman Shirani, Theodore K Malmstrom, Jeroen Coppens
BACKGROUND: Central nervous system vasculitis (CNSV) is a rare disorder, the pathophysiology of which is not fully understood. It involves a combination of inflammation and thrombosis. CNSV is most commonly associated with headache, gradual changes in mental status, and focal neurological symptoms. Diagnosis requires the effective use of history, laboratory testing, imaging, and biopsy. Catheter angiography can be a powerful tool in the diagnosis when common and low-frequency angiographic manifestations of CNSV are considered...
September 2016: Interventional Neurology
Ingo Helbig, Abou Ahmad N Tayoun
Epileptic encephalopathies are severe often intractable seizure disorders where epileptiform abnormalities contribute to a progressive disturbance in brain function. Often, epileptic encephalopathies start in childhood and are accompanied by developmental delay and various neurological and non-neurological comorbidities. In recent years, this concept has become virtually synonymous with a group of severe childhood epilepsies including West syndrome, Lennox-Gastaut syndrome, Dravet syndrome, and several other severe childhood epilepsies for which genetic factors are increasingly recognized...
September 2016: Molecular Syndromology
Navneet Singla, Ashish Aggarwal, Sameer Vyas, Ankur Sanghvi, Pravin Salunke, Ravi Garg
BACKGROUND: A sudden onset of neurological symptoms in patients is conventionally thought to be due to vascular phenomenon, with one common differential diagnosis being subarachnoid hemorrhage. Another important differential diagnosis is ischemic stroke. An uncommon cause of such acute symptoms can be hemorrhage in a pre-existing tumor, that is, intratumoral hemorrhage (ITH). PURPOSE: ITH is an important, though uncommon differential diagnosis in cases of sudden onset of neurological deterioration...
October 2016: Annals of Neurosciences
Brit Long, Alex Koyfman
BACKGROUND: Stroke is a leading cause of death and disability and most commonly presents with focal neurologic deficit within a specific vascular distribution. Several other conditions may present in a similar manner. OBJECTIVES: This review provides emergency providers with an understanding of stroke mimics, use of thrombolytics in these mimics, and keys to differentiate true stroke from mimic. DISCUSSION: Stroke has significant morbidity and mortality, and the American Heart Association emphasizes rapid recognition and aggressive treatment for patients with possible stroke-like symptoms, including thrombolytics...
October 22, 2016: Journal of Emergency Medicine
Yoshimichi Hirayama, Yoshiaki Saito, Yoshihiro Maegaki
BACKGROUND: Development of infection-associated acute encephalopathy (AE) is precipitated by several factors, including viral agents, age, and genetic polymorphisms. In addition, children with prior underlying neurological disorders can also present with AE. METHOD: We reviewed 55 children with AE who were referred to hospitals participating in the Status Epilepticus Study Group from 1988 to 2013. AE was classified into eight subtypes: acute encephalopathy with biphasic seizures and late reduced diffusion (AESD); hemiconvulsion-hemiplegia syndrome (HH); acute necrotizing encephalopathy; hemorrhagic shock and encephalopathy syndrome (HSES); clinically mild encephalitis/encephalopathy with a reversible splenial lesion; acute encephalitis with refractory, repetitive partial seizures; Reye-like syndrome; and unclassified...
October 22, 2016: Brain & Development
Wei Gao, Vincent Crosby, Andrew Wilcock, Rachael Burman, Eli Silber, Nilay Hepgul, K Ray Chaudhuri, Irene J Higginson
BACKGROUND: There is no standard palliative care outcome measure for people with progressive long term neurological conditions (LTNC). This study aims to determine the psychometric properties of a new 8-item palliative care outcome scale of symptom burden (IPOS Neuro-S8) in this population. DATA AND METHODS: Data were merged from a Phase II palliative care intervention study in multiple sclerosis (MS) and a longitudinal observational study in idiopathic Parkinson's disease (IPD), multiple system atrophy (MSA) and progressive supranuclear palsy (PSP)...
2016: PloS One
Ho Yong Choi, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng, Hyun-Jib Kim
STUDY DESIGN: Retrospective case series. OBJECTIVE: To evaluate and compare the surgical, radiographic, and clinical outcomes of pedicle subtraction osteotomy (PSO) according to surgeon's experience. SUMMARY OF BACKGROUND DATA: Although PSO has been widely used to correct spinal deformities, it still remains technically demanding procedure with high complications. METHODS: Comparative analysis of 40 consecutive patients treated with lumbar PSOs was performed...
October 24, 2016: Spine
David James Davies, Michael Clancy, Daniel Lighter, George M Balanos, Samuel John Edwin Lucas, Hamid Dehghani, Zhangjie Su, Mario Forcione, Antonio Belli
The Near-infrared spectroscopy (NIRS) has not been adopted as a mainstream monitoring modality in acute neurosurgical care due to concerns about its reliability and consistency. However, improvements in NIRS parameter recovery techniques are now available that may improve the quantitative accuracy of NIRS for this clinical context. Therefore, the aim of this study was to compare the abilities of a continuous-wave (CW) NIRS device with a similarly clinically viable NIRS device utilising a frequency-domain (FD) parameter recovery technique in detecting changes in cerebral tissue saturation during stepwise increases of experimentally induced hypoxia...
October 24, 2016: Journal of Clinical Monitoring and Computing
Farahnaz Golriz, Lane F Donnelly, Sridevi Devaraj, Raj Krishnamurthy
BACKGROUND: Until recently scurvy has been viewed in developed countries as a disease of the past. More recently there have been reports of case series of children with scurvy who have had a delayed diagnosis after an extensive diagnostic workup that included imaging. Most of these children have had underlying neurologic conditions such as autism. OBJECTIVE: To review the medical records of children diagnosed with vitamin C (ascorbic acid) deficiency based on serum ascorbic acid levels at a large pediatric health care system, to determine imaging findings and utility of imaging in management, and to identify at-risk pediatric populations...
October 24, 2016: Pediatric Radiology
Thomas Flegel, Maria Münch, Karina Held, Florian Salger, Luisa Ziegler, Peter Böttcher
OBJECTIVE: To report feasibility and outcome of multiple thoracolumbar partial lateral corpectomies (TLPLCs) in dogs with predominantly ventral spinal cord compression caused by intervertebral disc disease (IVDD) in the light of reported decreased spinal stability following single TLPLC. Material und methods: In a retrospective study the records of dogs treated by multiple TLPLCs for ventral spinal cord compression caused by Hansen type I or type II IVDD were reviewed. Presurgical spinal cord compression and postsurgical decompression, as well as slot dimensions were determined based on computed tomography (CT)-myelography images...
October 25, 2016: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
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