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https://www.readbyqxmd.com/read/29780579/managing-portal-hypertension-in-patients-with-liver-cirrhosis
#1
REVIEW
Tilman Sauerbruch, Robert Schierwagen, Jonel Trebicka
Portal hypertension is one cause and a part of a dynamic process triggered by chronic liver disease, mostly induced by alcohol or incorrect nutrition and less often by viral infections and autoimmune or genetic disease. Adequate staging - continuously modified by current knowledge - should guide the prevention and treatment of portal hypertension with defined endpoints. The main goals are interruption of etiology and prevention of complications followed, if necessary, by treatment of these. For the past few decades, shunts, mostly as intrahepatic stent bypass between portal and hepatic vein branches, have played an important role in the prevention of recurrent bleeding and ascites formation, although their impact on survival remains ambiguous...
2018: F1000Research
https://www.readbyqxmd.com/read/29774193/predictable-values-of-decompressive-craniectomy-in-patients-with-acute-subdural-hematoma-comparison-between-decompressive-craniectomy-after-craniotomy-group-and-craniotomy-only-group
#2
Hyunjun Kim, Sang-Jun Suh, Ho-Jun Kang, Min-Seok Lee, Yoon-Soo Lee, Jeong-Ho Lee, Dong-Gee Kang
Objective: Patients with traumatic acute subdural hematoma (ASDH) often require surgical treatment. Among patients who primarily underwent craniotomy for the removal of hematoma, some consequently developed aggressive intracranial hypertension and brain edema, and required secondary decompressive craniectomy (DC). To avoid reoperation, we investigated factors which predict the requirement of DC by comparing groups of ASDH patients who did and did not require DC after craniotomy. Methods: The 129 patients with ASDH who underwent craniotomy from September 2007 to September 2017 were reviewed...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29771445/tirofiban-combined-with-rt-pa-intraarterial-thrombolysis-improves-the-recanalization-rate-of-acute-middle-cerebral-artery-occlusion-in-rabbits
#3
Y-J Yu, W Xiong
OBJECTIVE: To investigate the curative effect of tirofiban combined with recombinant tissue-plasminogen activator (rt-PA) selective intra-arterial thrombolysis on acute middle cerebral artery occlusion (MCAO). MATERIALS AND METHODS: A total of 60 adult male Japanese white rabbits weighing 2.5-3.0 kg were selected, and the acute cerebral infarction model was established via autologous thromboembolism of middle cerebral artery. Rabbits were randomly divided into 4 groups: tirofiban group (Ti group, 5 μg/kg, n=15), rt-PA group (rt-PA group, 2 mg/kg, n=15), tirofiban + rt-PA group (Ti + rt-PA group, 3 μg/kg Ti + 1 mg/kg rt-PA, n=15), and control group (Co group, n=15)...
May 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29758369/intraoperative-active-bleeding-in-endoscopic-surgery-for-spontaneous-intracerebral-hemorrhage-is-predicted-by-the-spot-sign
#4
Koichi Miki, Kenji Yagi, Masani Nonaka, Mitsutoshi Iwaasa, Hiroshi Abe, Takashi Morishita, Hisatomi Arima, Tooru Inoue
BACKGROUND: Endoscopic evacuation of hematoma (EEH) has recently been applied to treat patients with spontaneous intracerebral hemorrhage (sICH). Intraoperative active bleeding (IAB), which is occasionally observed in EEH, might lead to greater blood loss, further brain damage, and more postoperative recurrent hemorrhage. However, no definite predictor of IAB has been established. Because the spot sign is associated with other hemorrhagic complications, we aimed to evaluate whether it predicts IAB...
May 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29754158/-a-phd-completed-midfacial-trauma-patients-in-amsterdam-an-epidemiological-survey
#5
E G Salentijn
A population of patients in Amsterdam with midfacial fractures was studied. Traffic accidents were found to be the most common cause, followed by violence and falls. The zygomatic complex was the most common fracture site. The majority of surgically treated patients consisted of men between 20 and 29 years of age. In addition to fracture displacement, indicative factors for surgery appear to be age, comorbidity and the presence or absence of functional problems. 8.1% of the surgically treated patients appear to have suffered brain damage...
May 2018: Nederlands Tijdschrift Voor Tandheelkunde
https://www.readbyqxmd.com/read/29731328/intracranial-hemorrhage-in-neonates-a-review-of-etiologies-patterns-and-predicted-clinical-outcomes
#6
REVIEW
Ai Peng Tan, Patricia Svrckova, Frances Cowan, Wui Khean Chong, Kshitij Mankad
Intracranial hemorrhage (ICH) in neonates often results in devastating neurodevelopmental outcomes as the neonatal period is a critical window for brain development. The neurodevelopmental outcomes in neonates with ICH are determined by the maturity of the brain, the location and extent of the hemorrhage, the specific underlying etiology and the presence of other concomitant disorders. Neonatal ICH may result from various inherited and acquired disorders. We classify the etiologies of neonatal ICH into eight main categories: (1) Hemorrhagic stroke including large focal hematoma, (2) Prematurity-related hemorrhage, (3) Bleeding diathesis, (4) Genetic causes, (5) Infection, (6) Trauma-related hemorrhage, (7) Tumor-related hemorrhage and (8) Vascular malformations...
April 24, 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29730103/value-of-routine-preoperative-tests-for-coagulation-before-elective-cranial-surgery-results-of-an-institutional-audit-and-a-nationwide-survey-of-neurosurgical-centers-in-pakistan
#7
Naveed Zaman Akhunzada, Muhammad Bilal Tariq, Saad Akhtar Khan, Sidra Sattar, Wajeeha Tariq, Muhammad Shahzad Shamim, Samie Asghar Dogar
Routine preoperative blood testing has become a dogma. The general practice is to order preoperative work up as a knee jerk response rather than individualize it for each patient. The fact that the bleeding brain tends to swell, which coupled with limited options for proximal control, packing and overall hemostasis, leads to an over emphasis on preoperative coagulation profile. MATERIAL AND METHODS: This is a retrospective review of the medical records of patients admitted at Aga Khan University Hospital from January 2010 to December 2015 for an elective craniotomy...
May 3, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29729844/acute-intracranial-and-spinal-subdural-hematoma-associated-with-vardenafil
#8
Takaaki Nakamura, Genya Watanabe, Ryuhei Harada, Emiko Kawasaki, Kenichi Tsukita, Yasushi Suzuki
A 28-year-old healthy man was admitted to our hospital because of right-sided headache, vomiting, and lower back pain after the administration of vardenafil. Computed tomography and magnetic resonance imaging of the brain showed a small, right-sided, subdural hematoma. A lumbar magnetic resonance imaging showed a longitudinally extended subdural hematoma. He had no history of trauma. We speculated that vardenafil might have had an association with the bleeding. Several reports have suggested a relationship between phosphodiesterase-5 inhibitors and intracerebral or subarachnoid hemorrhage...
May 2, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29717401/modelling-mortality-and-discharge-of-hospitalized-stroke-patients-using-a-phase-type-recovery-model
#9
Bruce Jones, Sally McClean, David Stanford
We model the length of in-patient hospital stays due to stroke and the mode of discharge using a phase-type stroke recovery model. The model allows for three different types of stroke: haemorrhagic (the most severe, caused by ruptured blood vessels that cause brain bleeding), cerebral infarction (less severe, caused by blood clots) and transient ischemic attack or TIA (the least severe, a mini-stroke caused by a temporary blood clot). A four-phase recovery process is used, where the initial phase depends on the type of stroke, and transition from one phase to the next depends on the age of the patient...
May 1, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/29713501/management-of-recurrent-or-metastatic-thyroid-cancer
#10
Makoto Tahara
Recently, vascular endothelial growth factor receptor (VEGFR)-targeted tyrosine kinase inhibitors (TKIs) have become available for the treatment of recurrent or metastatic thyroid cancer. However, a number of clinical challenges that impact the use of VEGFR-targeted TKI in daily clinical practice have arisen. Toxicity is considerable, to the extent that most physicians hesitate to start VEGFR-targeted TKI and prefer to continue a watch-and-wait approach until the patient's disease markedly worsens. This delayed use of VEGFR-targeted TKI leads to a higher incidence of serious adverse events than was reported in clinical trials...
2018: ESMO Open
https://www.readbyqxmd.com/read/29710367/spontaneous-intraventricular-hemorrhage-caused-by-sphenoid-meningioma
#11
Cherkaoui Mandour, Jawad Laaguili, Miloudi Gazzaz, Brahim El Mostarchid
INTRODUCTION:  Benign sphenoid meningioma presenting with an acute intraventricular hemorrhage is extremely uncommon. CASE REPORT:  We report a case of a 61-year-old man who was admitted after sudden onset of a severe headache. Brain computed tomography revealed a sphenoid meningioma with acute intraventricular hemorrhage. DISCUSSION:  Intraventricular hemorrhage caused by Meningiomas is infrequent. Several hypotheses have been proposed to explain the cause of hemorrhage...
April 30, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/29695464/distribution-of-lacunar-infarcts-in-asians-with-intracerebral-hemorrhage-a-magnetic-resonance-imaging-and-amyloid-positron-emission-tomography-study
#12
Hsin-Hsi Tsai, Marco Pasi, Li-Kai Tsai, Ya-Fang Chen, Bo-Ching Lee, Sung-Chun Tang, Panagiotis Fotiadis, Chen-Yu Huang, Ruoh-Fang Yen, M Edip Gurol, Jiann-Shing Jeng
BACKGROUND AND PURPOSE: We evaluated whether lacunes in centrum semiovale (lobar lacunes) were associated with cerebral amyloid angiopathy (CAA) markers in an Asian intracerebral hemorrhage (ICH) population. METHODS: One hundred ten patients with primary ICH were classified as CAA-ICH (n=24; mean age, 70.9±13.9) or hypertensive ICH (n=86; mean age, 59.3±13.0) according to the presence of strictly lobar (per modified Boston criteria) or strictly deep bleeds (both ICH and cerebral microbleeds), respectively...
April 25, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29689120/acute-on-chronic-liver-failure-getting-ready-for-prime-time
#13
Jasmohan S Bajaj, Richard Moreau, Patrick S Kamath, Hugo E Vargas, Vicente Arroyo, K Rajender Reddy, Gyongyi Szabo, Puneeta Tandon, Jody Olson, Constantine Karvellas, Thierry Gustot, Jennifer C Lai, Florence Wong
Acute on chronic liver failure (ACLF) is a culmination of chronic liver disease and extra-hepatic organ failures, which is associated with a high short-term mortality and immense healthcare expenditure. There are varying definitions for organ failures and ACLF in Europe, North America and Asia. These differing definitions need to be reconciled to enhance progress in the field. The pathogenesis of ACLF is multi-factorial and related to interactions between the immuno-inflammatory system, microbiota and the precipitating factors...
April 24, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29685415/preoperative-assessment-of-haemostasis-in-patients-undergoing-stereotactic-brain-biopsy
#14
Christopher Beynon, Shilai Wei, Alexander Radbruch, David Capper, Andreas W Unterberg, Karl L Kiening
Parenchymal hemorrhage is considered a major risk factor for perioperative morbidity in patients undergoing stereotactic brain biopsy. Studies on patients undergoing surgical procedures have suggested that evaluation of prothrombin time (PT) and activated partial thromboplastin time (aPTT) is of limited value with regard to prevention of haemorrhagic complications. However, this issue has not yet been addressed in patients undergoing stereotactic biopsy of intracranial lesions. We retrospectively analysed the medical records of 159 consecutive patients undergoing stereotactic biopsy of supratentorial intracranial lesions during a three-year period...
April 20, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29685176/atr-kinase-inhibitors-nvp-bez235-and-azd6738-effectively-penetrate-the-brain-after-systemic-administration
#15
Guido Fròsina, Aldo Profumo, Daniela Marubbi, Diana Marcello, Jean Louis Ravetti, Antonio Daga
Ataxia Telangiectasia and Rad3 related protein (ATR) is a central mediator of the response to DNA damage that may cause the quiescent resistance of cancer initiating cells to genotoxic radiotherapy. NVP-BEZ235 is a dual PI3K/mTOR inhibitor that also effectively targets ATR with IC50  = 21 × 10- 9  M in cells. AZD6738 does not target significantly PI3K/mTOR-related kinases but specifically inhibits ATR with IC50  = 74 × 10- 9  M in cells. Both drugs have been proposed as radiosensitizers of different tumors including glioblastoma (GB), the most malignant brain tumor...
April 23, 2018: Radiation Oncology
https://www.readbyqxmd.com/read/29671952/in-vivo-study-of-rat-cortical-hemodynamics-using-a-stereotaxic-apparatus-compatible-photoacoustic-microscope
#16
Heng Guo, Qian Chen, Weizhi Qi, Xingxing Chen, Lei Xi
Brain imaging is an important technique in cognitive neuroscience. In this paper, we designed a stereotaxic-apparatus-compatible photoacoustic microscope for studies of rat cortical hemodynamics. Compared with existing OR-PAM systems, the probe owns feature of fast, light, and miniature. In this microscope, we integrated a miniaturized ultrasound transducer with a center frequency of 10 MHz to detect photoacoustic signals and a two-dimensional (2D) micro-electro-mechanical system (MEMS) scanner to achieve raster scanning of the optical focus...
April 19, 2018: Journal of Biophotonics
https://www.readbyqxmd.com/read/29670513/altered-brain-excitability-and-increased-anxiety-in-mice-with-experimental-colitis-consideration-of-hyperalgesia-and-sex-differences
#17
Kewir D Nyuyki, Nina L Cluny, Mark G Swain, Keith A Sharkey, Quentin J Pittman
Crohn's disease (CD) and ulcerative colitis (UC) are incurable lifelong inflammatory bowel diseases (IBD) with a rising worldwide incidence. IBD is characterized by diarrhea, rectal bleeding, severe cramping and weight loss. However, there is a growing evidence that IBD is also associated with anxiety- and depression-related disorders, which further increase the societal burden of these diseases. Given the limited knowledge of central nervous system (CNS) changes in IBD, we investigated CNS-related comorbidities in a mouse model of experimental colitis induced by dextran sulfate sodium (DSS) administration in drinking water for 5 days...
2018: Frontiers in Behavioral Neuroscience
https://www.readbyqxmd.com/read/29668616/lung-metastases-from-intracranial-bleeding-meningioma-a-case-report
#18
Su Hu, Yaqi Zhang, Yue Sun, Yang Yu, Jia Wang, Hui Dai, Feng Sun, Chunhong Hu
RATIONALE: Meningioma is slow-growing benign neoplasm that derived from the meningothelial cells of the arachnoid mater, and it is the most common type of primary brain tumor. Although cases of extracranial metastatic meningioma have been reported previously, few cases have reported the concurrent occurrence of primary meningioma with intratumoral bleeding and lung metastases. Here we report a case of meningioma with concurrent intratumoral bleeding and lung metastases. PATIENT CONCERNS: The patient was admitted to our hospital with sudden left limb paralysis combined with complaints of headache and dizziness...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29668333/blood-biomarkers-in-ischemic-stroke-potential-role-and-challenges-in-clinical-practice-and-research
#19
Konstantinos Makris, Alexander Haliassos, Maria Chondrogianni, Georgios Tsivgoulis
Fast and accurate diagnosis of stroke is crucial for the immediate application of the right therapy to patients. However, rapid diagnosis is still a challenge since an ischemic stroke cannot be identified based only on clinical assessment. CT or MRI imaging is required to rule out hemorrhagic stroke since thrombolytic therapy can lead to increased intracranial bleeding and further aggravation of hemorrhagic stroke. In addition, clinical situations that imitate the signs and symptoms of stroke may also impede the rapid diagnosis and treatment of stroke victims...
April 18, 2018: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/29660554/effect-of-early-brain-infarction-after-subarachnoid-haemorrhage-a-systematic-review-and-meta-analysis
#20
Bruno Gonçalves, Ricardo Turon, Antenor Mendes, Nivea Melo, Paula Lacerda, Pedro Brasil, Fernando Augusto Bozza, Pedro Kurtz, Cassia Righy
OBJECTIVE: Aneurysmal subarachnoid haemorrhage (aSAH) is an acute cerebrovascular event that leads to devastating consequences. Early brain infarction (EBI) develops very early, within the first 72 hours after bleeding, but may have a significant impact on long-term outcomes. The incidence and impact of EBI in the prognosis of aSAH remain uncertain. We performed a systematic review and meta-analysis to evaluate the incidence of EBI in patients with aSAH and determine the effect of EBI on mortality and functional outcomes...
April 13, 2018: World Neurosurgery
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