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Guangming Wang, Jinlu Yu
INTRODUCTION: Chronic subdural hematoma(CSDH) can be treated by a relatively simple burr hole surgery. Acute subarachnoid hemorrhage (SAH) occurring after surgery for CSDH has been reported as a rare but severe complication. CASE REPORT: An 88-year-old female complained of progressive headache and dizziness for one month. A right fronto-temporo-parietal CSDH with a shift in the midline structures and lateral ventricle compression was shown by computed tomography (CT) scans...
March 3, 2018: International Journal of Surgery Case Reports
Fawaz Al-Mufti, Kalina Anna Misiolek, David Roh, Aws Alawi, Andrew Bauerschmidt, Soojin Park, Sachin Agarwal, Philip M Meyers, E Sander Connolly, Jan Claassen, J Michael Schmidt
BACKGROUND: Immune dysregulation has long been implicated in the development of delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH). OBJECTIVE: To determine the relationship of inflammatory cell biomarkers with DCI. METHODS: We evaluated 849 aSAH patients who were enrolled into a prospective observational cohort study and had a white blood cell (WBC) differential obtained within 72 h of bleed onset. RESULTS: WBC count > 12...
March 8, 2018: Neurosurgery
Morten Würtz, Morten Schmidt, Erik Lerkevang Grove, Erzsébet Horváth-Puhó, Victor W Henderson, Christian Fynbo Christiansen, Henrik Toft Sørensen
Aims: The impact of preadmission antiplatelet treatment on prognosis after stroke is poorly understood. We therefore investigated whether preadmission use of aspirin and clopidogrel was associated with mortality in patients hospitalized with ischemic stroke, intracerebral hemorrhage (ICH), or subarachnoid hemorrhage (SAH). Methods and Results: We used nationwide population-based registries to identify all first-time hospitalizations for stroke and subsequent mortality in patients treated with aspirin and clopidogrel in Denmark during 2004-2012...
March 8, 2018: European Heart Journal. Cardiovascular Pharmacotherapy
Shraddha Siwakoti, Rinku Sah, Rupa Singh Rajbhandari, Basudha Khanal
Introduction: Pantoea agglomerans, primarily an environmental and agricultural organism has been reported as both commensal and pathogen of humans. We present two case reports of P. agglomerans infections in children that involved the meninges and bloodstream. Case Presentations: A 6-month-old female baby, diagnosed as congenital hydrocephalus secondary to aqueduct stenosis with ventriculoperitoneal shunt in situ, operated 14 days back was brought to the pediatric emergency with a two-day history of high fever associated with vomiting, irritability, excessive crying, and decreased feeding...
2018: Case Reports in Pediatrics
Jiuxing Liang, Xiangmin Zhang, Yuxi Luo, Tingting Wang, Lin Sun, Shaoxiong Huang
Sleep apnea hypopnea syndrome (SAHS) is an independent risk factor for cardiovascular diseases. However, the pathophysiology between them is not yet clear. This paper seeks to understand how respiratory events impact the cardiovascular system by heart rate variability. We compared the differences between successional pathological respiratory events (PR) and pure normal respiration (NR) during sleep. The transitions between normal and pathological respiration (TR) were also analyzed. Thirteen patients who suffered moderate or severe SAHS were enrolled in this study...
March 12, 2018: International Heart Journal
Thomas Sersté, Alexia Cornillie, Hassane Njimi, Marco Pavesi, Vicente Arroyo, Antonella Putignano, Laura Weichselbaum, Pierre Deltenre, Delphine Degré, Eric Trépo, Christophe Moreno, Thierry Gustot
BACKGROUND & AIMS: A better identification of factors predicting death is needed in alcoholic hepatitis. Acute-on-chronic liver failure (ACLF) occurs during the course of liver disease and can be identified when AH is diagnosed (prevalent ACLF, pACLF) or during follow-up (incidental ACLF, iACLF). This study analyzed the impact of ACLF on outcomes in AH and the role of infection in the onset of ACLF and death. METHODS: Patients admitted from July, 2006 to July, 2015 suffering from biopsy-proven severe (s)AH with a Maddrey discriminant function (mDF) ≥32 were included...
March 7, 2018: Journal of Hepatology
Isabel Fragata, Nuno Canto-Moreira, Patrícia Canhão
PURPOSE: Perimesencephalic hemorrhage (PMH) is a benign subtype of nonaneurysmal subarachnoid hemorrhage (SAH). We aimed to investigate if cerebral perfusion in PMH is less affected than in aneurysmal SAH (aSAH). METHODS: From a prospective cohort of 80 patients with spontaneous SAH, we included PMH patients (n = 15) and selected aSAH patients (n = 39) with similar clinical grade at admission (World Federation of Neurosurgeons Scale-WFNS I/II). Computed tomography (CT) perfusion was performed at < 72 h and/or at 8-10 days...
March 9, 2018: Neuroradiology
Diane C McLaughlin, Margaret M Margretta, William D Freeman
INTRODUCTION: We hypothesized that a nocturnist advanced practice provider (APP) model compared with overnight neurocritical care coverage with general critical care physicians and neurology residents would provide similar patient outcomes, as measured by patient mortality. METHODS: This study is a retrospective review of healthcare outcomes of aneurysmal subarachnoid hemorrhage (aSAH) patients from 2013 and 2016, after implementation of specialty-trained neurocritical care nocturnist APPs...
April 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Masaomi Koyanagi, Hitoshi Fukuda, Masaaki Saiki, Yoshihito Tsuji, Benjamin Lo, Toshinari Kawasaki, Yoshihiko Ioroi, Ryu Fukumitsu, Ryota Ishibashi, Masashi Oda, Osamu Narumi, Masaki Chin, Sen Yamagata, Susumu Miyamoto
OBJECTIVE Shunt-dependent hydrocephalus (SDHC) may arise after aneurysmal subarachnoid hemorrhage (aSAH) as CSF resorptive mechanisms are disrupted. Using propensity score analysis, the authors aimed to investigate which treatment modality, surgical clipping or endovascular treatment, is superior in reducing rates of SDHC after aSAH. METHODS The authors' multicenter SAH database, comprising 3 stroke centers affiliated with Kyoto University, Japan, was used to identify patients treated between January 2009 and July 2016...
March 9, 2018: Journal of Neurosurgery
Mio Takayama, Brian Waters, Hiroshi Fujii, Kenji Hara, Masayuki Kashiwagi, Aya Matsusue, Natsuki Ikematsu, Shin-Ichi Kubo
Based on a prospective case-control study of forensic autopsies, the causes of cocaine (COC)-related sudden death (SD) are cardiovascular events in 62.0% of cases, cerebrovascular events in 14.0%, and others. A forensic autopsy of a male in his early forties revealed subarachnoid hemorrhage (SAH) at the base of the brain. A cerebral arterial aneurysm was not detected even though hemorrhage was clearly observed in the anterior cerebral artery (ACA) bifurcation area. The brain weighed 1488 g and was edematous...
March 2, 2018: Legal Medicine
Eiichiro Amano, Kokoro Ozaki, Satoru Egawa, Motohiro Suzuki, Takashi Hirai, Satoru Ishibashi, Takuya Ohkubo, Toshitaka Yoshii, Atsushi Okawa, Takanori Yokota
RATIONALE: OSAM is a rare ventriculoperitoneal (VP) shunt complication where cervical spinal cord compression by epidural venous plexus engorgement is caused by cerebrospinal fluid (CSF) overdrainage. Symmetrically indented deformity of the upper cervical spinal cord and surrounding epidural venous engorgement are characteristic radiological findings. Both of them are typically detected on magnetic resonance imaging (MRI) and enhanced computed tomography (CT). PATIENT CONCERNS: The 77-year-old man who underwent the placement of a VP shunt without an antisiphon device to treat post-subarachnoid hemorrhage (SAH) hydrocephalus presented with progressive quadriplegia 10 years postoperatively...
March 2018: Medicine (Baltimore)
Saggere Muralikrishna Shasthry, Archana Rastogi, Chhagan Bihari, Rajan Vijayaraghavan, Vinod Arora, Manoj Kumar Sharma, Shiv Kumar Sarin
Baseline clinical and biochemical parameters fail to predict non-response to steroids in severe alcoholic hepatitis patients. Liver biopsy features have not been adequately assessed for predicting response to steroid therapy in severe alcoholic hepatitis. We aimed to identify histological parameters, which can predict steroid response in severe alcoholic hepatitis (SAH). We analyzed histological data of 107 SAH patients (71 in a derivative and 36 in a validation cohort) who presented within 4 weeks after inset of jaundice and were prospectively treated with steroids (40 mg/day)...
March 7, 2018: Virchows Archiv: An International Journal of Pathology
Maurílio de Souza Cazarim, Leonardo Régis Leira Pereira
INTRODUCTION: Only 20% of patients with systemic arterial hypertension (SAH) have blood pressure within recommended parameters. SAH has been the main risk factor for morbidity and mortality of cardiovascular diseases, which affects the burden of the Public Health System (PHS). Some studies have shown the effectiveness of Pharmaceutical Care (PC) in the care of hypertensive patients. OBJECTIVE: To perform a cost-effectiveness analysis to compare SAH treatment with PC management and conventional treatment for hypertensive patients offered by the PHS...
2018: PloS One
Abdullah A Alharbi, Fahad M Alshehri, Abdulrahman A Albatly, Bert-Ram Sah, Christoph Schmid, Gerhard F Huber, Martin W Huellner
PURPOSE: The aim of the study was to investigate the relationship between [18 F]fluoromethyl-dimethyl-2-hydroxyethylammonium ([18 F]FCh) positron emission tomography (PET) parameters, laboratory parameters, and postoperative histopathological results in patients with primary hyperparathyroidism (pHPT) due to parathyroid adenomas. PROCEDURES: This retrospective study was conducted in 52 patients with biochemically proven pHPT. [18 F]FCh-PET parameters (maximum standardized uptake value: SUVmax) in early phase (after 2 min) and late phase (after 50 min), metabolic volume, and adenoma-to-background ratio (ABR), preoperative laboratory results (PTH and serum calcium concentration), and postoperative histopathology (location, size, volume, and weight of adenoma) were assessed...
March 5, 2018: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
Cuong Thach Nguyen, Shyam Kishor Sah, Tae-Yoon Kim
Propionibacterium acnes is a well-known commensal bacterium that plays an important role in the pathogenesis of acne and chronic inflammatory skin disease. In this study, we investigated the effect of superoxide dismutase 3 (SOD3) on P. acnes- or peptidoglycan (PGN)-induced inflammation in vitro and in vivo. Our data demonstrated that SOD3 suppressed toll-like receptor-2 (TLR-2) expression in P. acnes- or PGN-treated keratinocytes and sebocytes. Moreover, we found that SOD3 suppressed the expressions of phosphorylated nuclear factor-κB (NF-κB) and p38 in P...
March 5, 2018: Scientific Reports
M V Lind, L Lauritzen, H Vestergaard, T Hansen, O Pedersen, M Kristensen, A B Ross
BACKGROUND AND AIMS: Alterations to one-carbon metabolism, especially elevated plasma homocysteine (Hcy), have been suggested to be both a cause and a consequence of the metabolic syndrome (MS). A deeper understanding of the role of other one-carbon metabolites in MS, including s-adenosylmethionine (SAM), s-adenosylhomocysteine (SAH), and the methylation capacity index (SAM:SAH ratio) is required. METHODS AND RESULTS: 118 men and women with MS-risk factors were included in this cross-sectional study and cardiometabolic outcomes along with markers of one-carbon metabolism, including fasting plasma SAM, SAH, Hcy and vitamin B12 concentrations, were analysed...
January 31, 2018: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
Avanish Bhardwaj, Hemant Bhagat, Vinod Kumar Grover, Nidhi Bidyut Panda, Kiran Jangra, Seelora Sahu, Navneet Singla
PURPOSE: Surgery for aneurysmal clipping after subarachnoid haemorrhage (SAH) poses a unique anaesthetic challenge. However, data on the influence of anaesthetic agents in these patients are lacking. The study aims to evaluate the superiority of propofol over desflurane for postanaesthetic morbidity in patients undergoing surgery following aneurysmal SAH. METHODS: Seventy World Federation of Neurosurgeons Grade I and II patients were randomized into propofol (n = 35) and desflurane groups (n = 35)...
March 1, 2018: Journal of Anesthesia
Ling Ma, Yong Jiang, Yanan Dong, Jun Gao, Bin Du, Dianwei Liu
Background: Subarachnoid hemorrhage (SAH) can induce apoptosis in many regions of the brain including the cortex and hippocampus. However, few studies have focused on apoptosis in the hypothalamus after SAH. Although some antiapoptotic strategies have been developed for SAH, such as anti-tumor necrosis factor-alpha (TNF-α) antibody, the molecular mechanisms underlying this condition have yet to be elucidated. Therefore, the purpose of this study was to evaluate whether SAH could induce apoptosis in the hypothalamus and identify the potential molecular mechanisms underlying the actions of anti-TNF-α antibody, as a therapeutic regimen, upon apoptosis...
2018: Neuropsychiatric Disease and Treatment
Sophie E Irving, Rebecca M Corrigan
The stringent response is a conserved bacterial stress response mechanism that allows bacteria to respond to nutritional challenges. It is mediated by the alarmones pppGpp and ppGpp, nucleotides that are synthesized and hydrolyzed by members of the RSH superfamily. Whilst there are key differences in the binding targets for (p)ppGpp between Gram-negative and Gram-positive bacterial species, the transient accumulation of (p)ppGpp caused by nutritional stresses results in a global change in gene expression in all species...
March 2018: Microbiology
Francisco Sahli Costabal, Jiang Yao, Ellen Kuhl
A common but serious side effect of many drugs is torsades de pointes, a rhythm disorder that can have fatal consequences. Torsadogenic risk has traditionally been associated with blockage of a specific potassium channel and an increased recovery period in the electrocardiogram. However, the mechanisms that trigger torsades de pointes remain incompletely understood. Here we establish a computational model to explore how drug-induced effects propagate from the single channel, via the single cell, to the whole heart level...
March 1, 2018: Computer Methods in Biomechanics and Biomedical Engineering
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