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https://www.readbyqxmd.com/read/29032021/clinical-characteristics-and-survival-outcomes-of-terminally-ill-patients-undergoing-withdrawal-of-mechanical-ventilation
#1
Yu-Shin Hung, Shu-Hui Lee, Chia-Yen Hung, Chao-Hui Wang, Chen-Yi Kao, Hung-Ming Wang, Wen-Chi Chou
BACKGROUND: Withdrawal of mechanical ventilation is an important, but rarely explored issue in Asia during end-of-life care. This study aimed to describe the clinical characteristics and survival outcomes of terminally ill patients undergoing withdrawal of mechanical ventilation in Taiwan. METHODS: One-hundred-thirty-five terminally ill patients who had mechanical ventilation withdrawn between 2013 and 2016, from a medical center in Taiwan, were enrolled. Patients' clinical characteristics and survival outcomes after withdrawal of mechanical ventilation were analyzed...
October 11, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29026570/calypso-s-spell-accidental-near-fatal-thiacloprid-intoxication
#2
Patrick Zuercher, Daniel Gerber, Nadia Schai, Matthias Nebiker, Stefan König, Joerg C Schefold
Acute life-threatening intoxications with insecticides are rare. We report a case of accidental near-fatal thiacloprid intoxication with mass spectrometry-based analytical confirmation. The initial clinical presentation resembled imminent brain death and/or severe postanoxic encephalopathy. Prolonged supportive treatment resulted in full recovery underlining intoxication as an important differential diagnosis in unclear coma.
October 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29023643/improved-survival-of-patients-with-melanoma-brain-metastases-in-the-era-of-targeted-braf-and-immune-checkpoint-therapies
#3
Sarah Sloot, Yian A Chen, Xiuhua Zhao, Jamie L Weber, Jacob J Benedict, James J Mulé, Keiran S Smalley, Jeffrey S Weber, Jonathan S Zager, Peter A Forsyth, Vernon K Sondak, Geoffrey T Gibney
BACKGROUND: The development of brain metastases is common for systemic treatment failure in patients with melanoma and has been associated with a poor prognosis. Recent advances with BRAF and immune checkpoint therapies have led to improved patient survival. Herein, the authors evaluated the risk of de novo brain metastases and survival among patients with melanoma brain metastases (MBM) since the introduction of more effective therapies. METHODS: Patients with unresectable AJCC stage III/IV melanoma who received first-line systemic therapy at Moffitt Cancer Center between 2000 and 2012 were identified...
October 12, 2017: Cancer
https://www.readbyqxmd.com/read/29018323/cerebrospinal-fluid-amino-acid-profiling-of-pediatric-cases-with-tuberculous-meningitis
#4
Shayne Mason, Carolus J Reinecke, Regan Solomons
Background: In Africa, tuberculosis is generally regarded as persisting as one of the most devastating infectious diseases. The pediatric population is particularly vulnerable, with infection of the brain in the form of tuberculous meningitis (TBM) being the most severe manifestation. TBM is often difficult to diagnose in its early stages because of its non-specific clinical presentation. Of particular concern is that late diagnosis, and subsequent delayed treatment, leads to high risk of long-term neurological sequelae, and even death...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28986666/primary-central-nervous-system-malignant-melanoma-with-leptomeningeal-melanomatosis-a-case-report-and-review-of-the-literature
#5
Kentaro Fujimori, Keiichi Sakai, Fumiko Higashiyama, Fusakazu Oya, Toshitaka Maejima, Tomomi Miyake
Leptomeningeal melanomatosis is an extremely rare variant of primary central nervous system (CNS) melanoma and has a poor prognosis and no standard treatment. Primary CNS melanoma is derived from the melanocytes of the leptomeninges. Here, we describe a case of a 37-year-old male who visited our hospital due to worsening headaches. Characteristic imaging findings of this tumor type include hyper-dense lesions that are enhanced by contrast medium on computed tomography and hyper-intensity on T1-weighted magnetic resonance images and iso- to hypo-intensity on T2-weighted magnetic resonance images...
October 6, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28984519/surgical-management-of-incidentally-discovered-diffusely-infiltrating-low-grade-glioma
#6
Michael Opoku-Darko, Stefan T Lang, James Artindale, J Gregory Cairncross, Robert J Sevick, John J P Kelly
OBJECTIVE Occasionally, diffusely infiltrating low-grade gliomas (LGGs) are identified as incidental findings in patients who have no signs or symptoms that can be ascribed to the tumors. The diagnosis of incidental, asymptomatic LGGs has become more frequent due to the vast increase in access to medical imaging technology. While management of these lesions remains controversial, early surgery has been suggested to improve outcome. The authors set out to identify and review the characteristics and surgical outcomes of patients who underwent surgical intervention for incidental LGG...
October 6, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28980384/noncompaction-cardiomyopathy-in-an-infant-with-walker-warburg-syndrome
#7
Sarah Abdullah, Cynthia Hawkins, Gregory Wilson, Grace Yoon, Luc Mertens, Melissa T Carter, Andrea Guerin
Walker-Warburg syndrome (WWS) is a rare autosomal recessive, congenital muscular dystrophy that is associated with brain and eye anomalies. Several genes encoding proteins involved in α-dystroglycan glycosylation have been implicated in the aetiology of WWS. We describe a patient with nonclassical features of WWS presenting with heart failure related to noncompaction cardiomyopathy resulting in death at 4 months of age. Muscle biopsy revealed absent α-dystroglycan on immunostaining and genetic testing confirmed the diagnosis with two previously described POMT2 mutations...
October 5, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28980090/isolated-sulfite-oxidase-deficiency
#8
Helena Claerhout, Peter Witters, Luc Régal, Katrien Jansen, Marie-Rose Van Hoestenberghe, Jeroen Breckpot, Pieter Vermeersch
Isolated sulfite oxidase deficiency (ISOD) is a life-threatening, autosomal recessive disease characterized by severe neurological impairment. As no long-term effective treatment is available, distinction from other treatable diseases, such as molybdenum cofactor deficiency (MoCD) type A, should be made. We reviewed 47 patients (45 previously reported in the literature). Cases were reviewed for consanguinity, sex, age at onset, death, clinical findings (including spasticity, seizures, psychomotor retardation, feeding difficulties, ectopia lentis, microcephaly), laboratory findings [urinary sulfite, S-sulfocysteine (in plasma and urine), plasma cystine, total homocysteine, uric acid, and oxypurines in urine] and radiological findings (including cerebral/cerebellar atrophy, cystic white matter changes, ventriculomegaly)...
October 4, 2017: Journal of Inherited Metabolic Disease
https://www.readbyqxmd.com/read/28973174/low-dose-vs-standard-dose-alteplase-for-patients-with-acute-ischemic-stroke-secondary-analysis-of-the-enchanted-randomized-clinical-trial
#9
Xia Wang, Thompson G Robinson, Tsong-Hai Lee, Qiang Li, Hisatomi Arima, Philip M Bath, Laurent Billot, Joseph Broderick, Andrew M Demchuk, Geoffrey Donnan, Jong S Kim, Pablo Lavados, Richard I Lindley, Sheila O Martins, Veronica V Olavarria, Jeyaraj D Pandian, Mark W Parsons, Octavio M Pontes-Neto, Stefano Ricci, Vijay K Sharma, Nguyen H Thang, Ji-Guang Wang, Mark Woodward, Craig S Anderson, John Chalmers
Importance: A lower dose of intravenous alteplase appears to be a safer treatment option than the standard dose, reducing the risk of symptomatic intracerebral hemorrhage. There is uncertainty, however, over how this effect translates into an overall clinical benefit for patients with acute ischemic stroke (AIS). Objective: To assess whether older, Asian, or severely affected patients with AIS who are considered at high risk of thrombolysis may benefit more from low-dose rather than standard-dose alteplase treatment...
October 2, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28973155/high-throughput-screening-uncovers-mirnas-enhancing-glioblastoma-cell-susceptibility-to-tyrosine-kinase-inhibitors
#10
Pedro P Cunha, Pedro M Costa, Catarina M Morais, Inês R Lopes, Ana M Cardoso, Ana L Cardoso, Miguel Mano, Amália S Jurado, Maria C Pedroso de Lima
Glioblastoma (GBM) is a deadly and therapy resistant malignant brain tumour, characterized by an aggressive and diffuse growth pattern, which prevents complete surgical resection. Despite advances in the identification of genomic and molecular alterations that fuel the tumour, average patient survival post-diagnosis remains very low (∼14.6-months). In addition to being highly heterogeneous, GBM tumour cells exhibit high adaptive capacity to targeted molecular therapies owing to an established network of signalling cascades with functional redundancy, which provides them with robust compensatory survival mechanisms...
August 16, 2017: Human Molecular Genetics
https://www.readbyqxmd.com/read/28965318/the-drd2-taq1a-a1-allele-may-magnify-the-risk-of-alzheimer-s-in-aging-african-americans
#11
REVIEW
Kenneth Blum, Rajendra D Badgaiyan, Georgia M Dunston, David Baron, Edward J Modestino, Thomas McLaughlin, Bruce Steinberg, Mark S Gold, Marjorie C Gondré-Lewis
Alzheimer's disease is an irreversible, progressive brain disorder that slowly destroys cognitive skills and the ability to perform the simplest tasks. More than 5 million Americans are afflicted with Alzheimer's; a disorder which ranks third, just behind heart disease and cancer, as a cause of death for older people. With no real cure and in spite of enormous efforts worldwide, the disease remains a mystery in terms of treatment. Importantly, African-Americans are two times as likely as Whites to develop late-onset Alzheimer's disease and less likely to receive timely diagnosis and treatment...
September 30, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28961826/whole-brain-radiotherapy-after-stereotactic-radiosurgery-or-surgical-resection-among-patients-with-one-to-three-brain-metastases-and-favorable-prognoses-a-secondary-analysis-of-eortc-22952-26001
#12
T M Churilla, E Handorf, S Collette, L Collette, Y Dong, A A Aizer, M Kocher, R Soffietti, B M Alexander, S E Weiss
Background: The absence of a survival benefit for whole brain radiotherapy (WBRT) among randomized trials has been attributed to a competing risk of death from extracranial disease. We re-analyzed EORTC 22952 to assess the impact of WBRT on survival for patients with controlled extracranial disease or favorable prognoses. Patients and methods: We utilized Cox regression, landmark analysis, and the Kaplan-Meier method to evaluate the impact of WBRT on survival accounting for (i) extracranial progression as a time-dependent covariate in all patients and (ii) diagnosis-specific graded prognostic assessment (GPA) score in patients with primary non-small-cell lung cancer (NSCLC)...
October 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28961316/reduced-infancy-and-childhood-epilepsy-following-hypothermia-treated-neonatal-encephalopathy
#13
Xun Liu, Sally Jary, Frances Cowan, Marianne Thoresen
OBJECTIVE: To investigate what proportion of a regional cohort of cooled infants with neonatal encephalopathy develop epilepsy (determined by the International League Against Epilepsy [ILAE] definition and the number of antiepileptic drugs [AEDs]) up to 8 years of age. METHODS: From 2006-2013, 151 infants with perinatal asphyxia underwent 72 h cooling. Clinical and amplitude-integrated electroencepalography (aEEG) with single-channel EEG-verified neonatal seizures were treated with AEDs...
September 29, 2017: Epilepsia
https://www.readbyqxmd.com/read/28960284/potential-years-lost-and-life-expectancy-in-adults-with-newly-diagnosed-epilepsy
#14
Claudia A Granbichler, Georg Zimmermann, Willi Oberaigner, Giorgi Kuchukhidze, Jean-Pierre Ndayisaba, Alexandra Taylor, Gerhard Luef, Arne C Bathke, Eugen Trinka
OBJECTIVE: Studies using relative measures, such as standardized mortality ratios, have shown that patients with epilepsy have an increased mortality. Reports on more direct and absolute measure such as life expectancy are sparse. We report potential years lost and how life expectancy has changed over 40 years in a cohort of patients with newly diagnosed epilepsy. METHODS: We analyzed life expectancy in a cohort of adult patients diagnosed with definite epilepsy between 1970 and 2010...
September 28, 2017: Epilepsia
https://www.readbyqxmd.com/read/28949872/online-public-reactions-to-fmri-communication-with-patients-with-disorders-of-consciousness-quality-of-life-end-of-life-decision-making-and-concerns-with-misdiagnosis
#15
Jennifer A Chandler, Jeffrey A Sun, Eric Racine
BACKGROUND: Recently, the news media have reported on the discovery of covert awareness and the establishment of limited communication using a functional magnetic resonance imaging (fMRI) neuroimaging technique with several brain-injured patients thought to have been in a vegetative state. This discovery has raised many ethical, legal, and social questions related to quality of life, end-of-life decision making, diagnostic and prognostic accuracy in disorders of consciousness, resource allocation, and other issues...
January 2017: AJOB Empirical Bioethics
https://www.readbyqxmd.com/read/28945629/critical-care-resource-utilization-and-outcomes-of-children-with-moderate-traumatic-brain-injury
#16
Theerada Chandee, Vivian H Lyons, Monica S Vavilala, Vijay Krishnamoorthy, Nophanan Chaikittisilpa, Arraya Watanitanon, Abhijit V Lele
OBJECTIVES: To characterize admission patterns, critical care resource utilization, and outcomes in moderate pediatric traumatic brain injury. DESIGN: Retrospective cohort study. SETTING: National Trauma Data Bank. PATIENTS: Children under 18 years old with a diagnosis of moderate traumatic brain injury (admission Glasgow Coma Scale score of 9-13) in the National Trauma Data Bank between 2007 and 2014. MEASUREMENT AND MAIN RESULTS: We examined clinical characteristics, critical care resource utilization, and discharge outcomes...
September 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28944130/brain-computed-tomography-angiography-as-an-ancillary-test-in-the-confirmation-of-brain-death
#17
Homa Sadeghian, Mohammad Ali Raeisi, Parviz Dolati, Rouzbeh Motiei-Langroudi
Introduction Brain death (BD) is the irreversible termination of the functioning of the brain. The diagnosis should be first made by clinical criteria and confirmed by using paraclinical confirmatory techniques (ancillary tests). While conventional brain angiography remains the standard method of choice, computed tomography angiography (CTA) has emerged as an alternative method. In this study, we tried to evaluate the accuracy of CTA for the diagnosis of BD. Methods In this study, we included nine patients with a clinical diagnosis of BD, confirmed by electroencephalography (EEG)...
July 19, 2017: Curēus
https://www.readbyqxmd.com/read/28944066/immune-mediated-cerebellar-ataxias-from-bench-to-bedside
#18
REVIEW
Hiroshi Mitoma, Mario Manto, Christiane S Hampe
The cerebellum is a vulnerable target of autoimmunity in the CNS. The category of immune-mediated cerebellar ataxias (IMCAs) was recently established, and includes in particular paraneoplastic cerebellar degenerations (PCDs), gluten ataxia (GA) and anti-GAD65 antibody (Ab) associated-CA, all characterized by the presence of autoantibodies. The significance of onconeuronal autoantibodies remains uncertain in some cases. The pathogenic role of anti-GAD65Ab has been established both in vitro and in vivo, but a consensus has not been reached yet...
2017: Cerebellum & Ataxias
https://www.readbyqxmd.com/read/28930959/outcomes-after-concomitant-traumatic-brain-injury-and-hemorrhagic-shock-a-secondary-analysis-from-the-pragmatic-randomized-optimal-platelets-and-plasma-ratios-trial
#19
RANDOMIZED CONTROLLED TRIAL
Samuel M Galvagno, Erin E Fox, Savitri N Appana, Sarah Baraniuk, Patrick L Bosarge, Eileen M Bulger, Rachel A Callcut, Bryan A Cotton, Michael Goodman, Kenji Inaba, Terence O'Keeffe, Martin A Schreiber, Charles E Wade, Thomas M Scalea, John B Holcomb, Deborah M Stein
BACKGROUND: Often the clinician is faced with a diagnostic and therapeutic dilemma in patients with concomitant traumatic brain injury (TBI) and hemorrhagic shock (HS), as rapid deterioration from either can be fatal. Knowledge about outcomes after concomitant TBI and HS may help prioritize the emergent management of these patients. We hypothesized that patients with concomitant TBI and HS (TBI + HS) had worse outcomes and required more intensive care compared with patients with only one of these injuries...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28923611/cerebral-oximetry-as-an-auxiliary-diagnostic-tool-in-the-diagnosis-of-brain-death
#20
O Tatli, O Bekar, M Imamoglu, O Gonenc Cekic, A Aygun, U Eryigit, Y Karaca, A Sahin, S Turkmen, S Turedi
AIM: To investigate the efficacy of cerebral oximetry (CO) as an auxiliary diagnostic tool in brain death (BD). MATERIALS AND METHODS: This observational case-control study was performed on patients with suspected BD. Patients with diagnosis of BD confirmed by the brain death committee were enrolled as the BD group and other patients as the non-BD group. CO monitoring was performed at least 6 h, and cerebral tissue oxygen saturation (ScO2) parameters were compared...
October 2017: Transplantation Proceedings
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