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Diagnosis of brain death

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https://www.readbyqxmd.com/read/29673325/incidence-pattern-and-prognosis-of-brain-metastases-in-patients-with-metastatic-triple-negative-breast-cancer
#1
Jia Jin, Yu Gao, Jian Zhang, Leiping Wang, Biyun Wang, Jun Cao, Zhimin Shao, Zhonghua Wang
BACKGROUND: To identify the incidence, recurrence pattern and prognosis of brain metastases (BM) among women with metastatic triple negative breast cancer (mTNBC) treated consecutively at a single institution during a 7-year period. METHODS: Patients with histologically confirmed mTNBC were retrospectively identified. The incidence of BM as first site of recurrence and the cumulative BM incidence were computed. We used the Cox proportional hazards model to identify the univariate and multivariate factors associated with survival...
April 19, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29667443/implications-of-structural-and-functional-brain-changes-in-amyotrophic-lateral-sclerosis
#2
Thanuja Dharmadasa, William Huynh, Jun Tsugawa, Yoshimitsu Shimatani, Yan Ma, Matthew C Kiernan
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that causes progressive muscle weakness and disability, eventually leading to death. Heterogeneity of disease has become a major barrier to understanding key clinical questions such as prognosis and disease spread, and has disadvantaged clinical trials in search of therapeutic intervention. Patterns of disease have been explored through recent advances in neuroimaging, elucidating structural, molecular and functional changes. Unique brain signatures have emerged that have lent a greater understanding of critical disease mechanisms, offering opportunities to improve diagnosis, guide prognosis, and establish candidate biomarkers to direct future therapeutic strategies...
April 19, 2018: Expert Review of Neurotherapeutics
https://www.readbyqxmd.com/read/29663994/-predictive-value-of-early-phrase-echocardiography-and-cardiac-biological-markers-in-patients-with-severe-sepsis-a-five-year-single-center-retrospective-study
#3
Xuefeng Zang, Wei Chen, Bo Sheng, Lei Zhao, Xuyun Gu, Jie Zhen, Ping Liu
OBJECTIVE: To assess the predictive value of early phrase echocardiography and cardiac biomarkers in patients with severe sepsis. METHODS: A retrospective analysis of severe septic patients (patients with acute coronary syndrome and end stage renal disease were excluded) in department of intensive care unit of Capital Medical University Affiliated Beijing Shijitan Hospital from January 2013 to December 2017 was conducted. The acute physiology and chronic health evaluation II (APACHE II) score, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI), myoglobin (MYO), creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB) within 6 hours after admission, and bedside echocardiography indexes [left ventricular ejection fraction (LVEF), the ratio of the peak blood flow velocity in the early stage of the mitral valve and the peak blood flow rate of the mitral valve (E/A ratio)] within 6 hours after diagnosis were recorded...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29627628/early-administration-of-hypertonic-hyperoncotic-hydroxyethyl-starch-hyperhes-improves-cerebral-blood-flow-and-outcome-after-experimental-subarachnoid-hemorrhage-in-rats
#4
Nadine Lilla, Christoph Rinne, Judith Weiland, Thomas Linsenmann, Thomas Westermaier
OBJECTIVE: Early cytotoxic brain edema may be one decisive factor which maintains a vicious of cerebral malperfusion after subarachnoid hemorrhage (SAH). In addition, endothelial cell swelling may be an independent factor restricting cerebral blood flow (CBF) in a very early stage after SAH. Immediate and aggressive treatment may be able to restore CBF in this critical period. MATERIALS AND METHODS: Male Sprague-Dawley rats were subjected to SAH by the endovascular filament model and treated by a bolus of hyperoncotic-hypertonic hydroxyethyl starch (HyperHES 4 ml/kg body weight) immediately after vessel perforation and 150 min later (n = 12) or by the same amount of normal saline (n = 9)...
April 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29625762/effectiveness-of-preventive-cognitive-therapy-while-tapering-antidepressants-versus-maintenance-antidepressant-treatment-versus-their-combination-in-prevention-of-depressive-relapse-or-recurrence-drd-study-a-three-group-multicentre-randomised-controlled-trial
#5
Claudi L H Bockting, Nicola S Klein, Hermien J Elgersma, Gerard D van Rijsbergen, Christien Slofstra, Johan Ormel, Erik Buskens, Jack Dekker, Peter J de Jong, Willem A Nolen, Aart H Schene, Steven D Hollon, Huibert Burger
BACKGROUND: Keeping individuals on antidepressants after remission or recovery of major depressive disorder is a common strategy to prevent relapse or recurrence. Preventive cognitive therapy (PCT) has been proposed as an alternative to maintenance antidepressant treatment, but whether its addition would allow tapering of antidepressants or enhance the efficacy of maintenance antidepressant treatment is unclear. We aimed to compare the effectiveness of antidepressants alone, with PCT while tapering off antidepressants, or PCT added to antidepressants in the prevention of relapse and recurrence...
April 3, 2018: Lancet Psychiatry
https://www.readbyqxmd.com/read/29625312/strokectomy-and-extensive-cerebro-spinal-fluid-drainage-for-the-treatment-of-space-occupying-cerebellar-ischemic-strokes
#6
Fulvio Tartara, Daniele Bongetta, Elena Virginia Colombo, Carlo Bortolotti, Marco Cenzato, Ermanno Giombelli, Paolo Gaetani, Francesco Zenga, Giulia Pilloni, Alfonso Ciccone, Maria Sessa
BACKGROUND: and Purpose: Cerebellar ischemia may lead to space-occupying edema, resulting in potentially fatal complications. Different surgical procedures have been reported to create space for the swollen ischemic brain; still, both the type and timing of surgical treatments are debated in literature. We present here a case series of patients treated with a unilateral craniotomy to perform a cerebellar strokectomy and extensive cerebro-spinal fluid drainage without osteo-dural posterior fossa decompression...
April 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29607780/brain-death-in-intensive-care-units-problems-differences-in-methods-of-diagnosis-and-donor-care
#7
Aykut Sarıtaş, Burcu Acar Çinleti, Çiler Zincircioğlu, Uğur Uzun, Işıl Köse, Nimet Şenoğlu
OBJECTIVES: Our aim was to investigate the most common problems in diagnosing brain death, the care of the organ donor, and organ donation after death. MATERIALS AND METHODS: A survey was sent randomly to clinicians working in national intensive care units in Turkey. The survey, which consisted of 17 questions for clinicians, had 163 responders. RESULTS: The most common cause of brain death was traumatic brain injury. Although 22% of clinicians found the apnea test necessary for brain death diagnosis, 78% stated that it could be used as an optional confirmatory test...
April 2, 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29605023/a-subgroup-analysis-of-penetrating-injuries-to-the-pancreas-777-patients-from-the-national-trauma-data-bank-2010-2014
#8
Bradley Phillips, Lauren Turco, Dan McDonald, Elizabeth Mause, Ryan W Walters
BACKGROUND: This study is the first to analyze penetrating injuries to the pancreas within subgroups of severe traumatic brain injury (TBI), early deaths, and potential survivors. Our objectives were to identify national patterns of injury, predictors of mortality, and to validate the American Association for Surgery of Trauma Organ Injury Scale (AAST-OIS) pancreas injury grades by mortality. Secondary outcomes included hospital and intensive care unit length of stay and days on mechanical ventilation...
May 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29604436/investigational-chemotherapy-and-novel-pharmacokinetic-mechanisms-for-the-treatment-of-breast-cancer-brain-metastases
#9
REVIEW
Neal Shah, Afroz S Mohammad, Pushkar Saralkar, Samuel A Sprowls, Schuyler D Vickers, Devin John, Rachel M Tallman, Brandon Lucke-Wold, Katherine E Jarrell, Mark Pinti, Richard L Nolan, Paul R Lockman
In women, breast cancer is the most common cancer diagnosis and second most common cause of cancer death. More than half of breast cancer patients will develop metastases to the bone, liver, lung, or brain. Breast cancer brain metastases (BCBM) confers a poor prognosis, as current therapeutic options of surgery, radiation, and chemotherapy rarely significantly extend life and are considered palliative. Within the realm of chemotherapy, the last decade has seen an explosion of novel chemotherapeutics involving targeting agents and unique dosage forms...
March 28, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29580900/deletion-of-the-endogenous-trkb-t1-receptor-isoform-restores-the-number-of-hippocampal-ca1-parvalbumin-positive-neurons-and-rescues-long-term-potentiation-in-pre-symptomatic-msod1-g93a-als-mice
#10
Eros Quarta, Gianluca Fulgenzi, Riccardo Bravi, Erez James Cohen, Sudhirkumar Yanpallewar, Lino Tessarollo, Diego Minciacchi
Amyotrophic lateral sclerosis (ALS) causes rapidly progressive paralysis and death within 5 years from diagnosis due to degeneration of the motor circuits. However, a significant population of ALS patients also shows cognitive impairments and progressive hippocampal pathology. Likewise, the mutant SOD1(G93A) mouse model of ALS (mSOD1), in addition to loss of spinal motor neurons, displays altered spatial behavior and hippocampal abnormalities including loss of parvalbumin-positive interneurons (PVi) and enhanced long-term potentiation (LTP)...
March 23, 2018: Molecular and Cellular Neurosciences
https://www.readbyqxmd.com/read/29579816/systodiastolic-separation-expresses-cerebral-circulatory-arrest
#11
A Cacciatori, M Godino, R Mizraji
There is a situation before the cerebral circulatory cessation phase, the systodiastolic separation in transcranial Doppler (TCD), which may raise doubts to the operator technician who performs it. A total of 266 studies were performed in 188 neurocritical patients over a 9-year period: 88 cases (77%) corresponded to cerebral circulatory arrest (CCA) which accompanies brain death (BD); 9 (5%) presented the systodiastolic separation pattern. In 1 of those 9 there was persistence of cough reflex and spontaneous breathing; in 5, CCA was not reached; only 3 evolved to CCA...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29579812/neurocritical-patient-characteristics-related-to-brain-death
#12
M C Bacqué, M E Barone, A Yankowski, A Antik, L Trunzo, S Fioretti, P Penone
BACKGROUND: The lack of viable organs for transplantation led to the creation in Argentina of the Glasgow 7 Program based on the detection and follow-up of acute neurologic patients admitted with Glasgow scores ≤7 in selected hospitals. The objective of this study was to determine the likelihood of hospitalized acute neurologic patients progressing to brain death (BD) based on several variables, including age, sex, and admission diagnosis. METHODS: This study was a retrospective cohort analysis of data obtained from the SINTRA (Procurement and Transplantation National Information System) database between 2006 and 2015...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29575593/utility-of-autopsy-brain-imprint-and-squash-cytology-for-detection-of-lymphoma-leukemia-emboli-in-select-patients-presenting-with-rapid-decline-in-mental-status
#13
Asangi R Kumarapeli, Murat Gokden
Central nervous system (CNS) hematologic malignancies, whether primary or secondary, are uncommon and their clinical presentations vary. Intravascular lymphoma (IVL) is a very rare, aggressive systemic malignancy that is often difficult to diagnose and susceptible to early CNS involvement. Blast crisis in myeloid leukemias can cause widespread neoplastic emboli. Here, we report two adult patients (72 years and 22 years of age) who presented with altered mental status followed by rapid decline in their conditions leading to death...
March 25, 2018: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/29574625/the-cluster-re-6-se-8-i-6-3-penetrates-biological-membranes-drug-like-properties-for-cns-tumor-treatment-and-diagnosis
#14
Lisbell D Estrada, Elizabeth Duran, Matias Cisterna, Cesar Echeverria, Zhiping Zheng, Vincenzo Borgna, Nicolas Arancibia-Miranda, Rodrigo Ramírez-Tagle
Tumorigenic cell lines are more susceptible to [Re6 Se8 I6 ]3- cluster-induced death than normal cells, becoming a novel candidate for cancer treatment. Still, the feasibility of using this type of molecules in human patients remains unclear and further pharmacokinetics analysis is needed. Using coupled plasma optical emission spectroscopy, we determined the Re-cluster tissue content in injected mice, as a biodistribution measurement. Our results show that the Re-cluster successfully reaches different tissues, accumulating mainly in heart and liver...
March 24, 2018: Biometals: An International Journal on the Role of Metal Ions in Biology, Biochemistry, and Medicine
https://www.readbyqxmd.com/read/29568659/primary-nocardia-infection-causing-a-fluorodeoxyglucose-avid-right-renal-mass-in-a-redo-lung-transplant-recipient
#15
Sreeja Biswas Roy, Mitchell D Ross, Pradnya D Patil, Richard Trepeta, Ross M Bremner, Tanmay S Panchabhai
Immunosuppression after lung transplantation may increase susceptibility to opportunistic infection and is associated with early and delayed deaths in lung transplant recipients. Factors that may predispose lung transplant recipients to opportunistic bacterial and fungal infections include prolonged corticosteroid use, renal impairment, treatment of acute rejection, and post-transplant diabetes mellitus. We present a unique case of a 63-year-old woman with diabetes mellitus who underwent redo lung transplantation...
2018: Case Reports in Transplantation
https://www.readbyqxmd.com/read/29564192/herpes-simplex-virus-encephalitis-atypical-presentation-as-a-right-middle-cerebral-artery-stroke
#16
Maria Shoaib, Jacqueline J Kraus, Muhammad T Khan
Herpes simplex virus encephalitis (HSVE) is a medical emergency associated with high mortality and morbidity. Definitive diagnosis is established by history, clinical examination, neuroimaging studies, supportive electroencephalogram (EEG) findings, and cerebrospinal fluid (CSF) analysis. We report a case of HSVE presenting as a stroke mimic in a 76-year-old female with a history of atrial fibrillation on warfarin. She was admitted to our medical intensive care unit with intermittent fever, lethargy, and new onset left-sided hemiparesis...
January 15, 2018: Curēus
https://www.readbyqxmd.com/read/29560060/reduced-computed-tomography-use-in-the-emergency-department-evaluation-of-headache-was-not-followed-by-increased-death-or-missed-diagnosis
#17
Daniel G Miller, Priyanka Vakkalanka, Mark L Moubarek, Sangil Lee, Nicholas M Mohr
Introduction: This study investigated whether a 9.6% decrease in the use of head computed tomography (HCT) for patients presenting to the emergency department (ED) with a chief complaint of headache was followed by an increase in proportions of death or missed intracranial diagnosis during the 22.5-month period following each index ED visit. Methods: We reviewed the electronic medical records of all patients sampled during a quality improvement effort in which the aforementioned decrease in HCT use had been observed...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29558846/focal-congenital-hyperinsulinism-as-a-cause-for-sudden-infant-death
#18
Amish Chinoy, Indraneel Banerjee, Sarah E Flanagan, Sian Ellard, Bing Han, Zainab Mohamed, Mark J Dunne, Stefania Bitetti
Congenital hyperinsulinism (CHI) is the commonest cause of persistent and severe hypoglycemia in infancy due to unregulated insulin secretion from pancreatic β-cells. Prompt early diagnosis is important, as insulin reduces glucose supply to the brain, resulting in significant brain injury and risk of death. Histologically, CHI has focal and diffuse forms; in focal CHI, an inappropriate level of insulin is secreted from localized β-cell hyperplasia. We report a 4-month-old male infant, who presented with sudden illness and collapse without a recognized cause and died...
January 1, 2018: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/29554185/fatal-powassan-encephalitis-deer-tick-virus-lineage-ii-in-a-patient-with-fever-and-orchitis-receiving-rituximab
#19
Isaac H Solomon, Kristyn M Spera, Sophia L Ryan, Jeffrey Helgager, Juliana Andrici, Sherif R Zaki, Henrikas Vaitkevicius, Kristoffer E Leon, Michael R Wilson, Joseph L DeRisi, Sophia Koo, Stelios M Smirnakis, Umberto De Girolami
Importance: Powassan virus is a rare but increasingly recognized cause of severe neurological disease. Objective: To highlight the diagnostic challenges and neuropathological findings in a fatal case of Powassan encephalitis caused by deer tick virus (lineage II) in a patient with follicular lymphoma receiving rituximab, with nonspecific anti-GAD65 antibodies, who was initially seen with fever and orchiepididymitis. Design, Setting, and Participants: Comparison of clinical, radiological, histological, and laboratory findings, including immunohistochemistry, real-time polymerase chain reaction, antibody detection, and unbiased sequencing assays, in a single case report (first seen in December 2016) at an academic medical center...
March 19, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29549202/can-virtual-autopsy-with-postmortem-ct-improve-clinical-diagnosis-of-cause-of-death-a-retrospective-observational-cohort-study-in-a-dutch-tertiary-referral-centre
#20
Lianne J P Sonnemans, Bela Kubat, Mathias Prokop, Willemijn M Klein
OBJECTIVE: To investigate whether virtual autopsy with postmortem CT (PMCT) improves clinical diagnosis of the immediate cause of death. DESIGN: Retrospective observational cohort study. INCLUSION CRITERIA: inhospital and out-of-hospital deaths over the age of 1 year in whom virtual autopsy with PMCT and conventional autopsy were performed. EXCLUSION CRITERIA: forensic cases, postmortal organ donors and cases with incomplete scanning procedures...
March 16, 2018: BMJ Open
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