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Definition of brain death

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https://www.readbyqxmd.com/read/27876002/sporadic-creutzfeldt-jakob-disease-with-unusual-initial-presentation-as-posterior-reversible-encephalopathy-syndrome-a-case-report
#1
Edgaras Dirzius, Renata Balnyte, Vesta Steibliene, Rymante Gleizniene, Inga Gudinaviciene, Andrius Radziunas, Kestutis Petrikonis
BACKGROUND: Creutzfeldt - Jakob disease (CJD) is a rapidly progressive and fatal neurodegenerative prion disease. MRI findings are included in diagnostic criteria for probable CJD, giving a sensitivity and specificity more than 90%, but the atypical radiological presentations in the early stage of the disease could cause the diagnostic difficulties. CJD can be definitively diagnosed by histopathological confirmation, brain biopsy or at autopsy. CASE PRESENTATION: We present a case of 53-year-old woman with a history of a rapidly progressive dementia with symptoms of visual impairment, increased extrapyramidal type muscle tonus, stereotypical movements and ataxic gait resulting in the patient's death after13 months...
November 22, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27870453/do-microglia-play-a-role-in-sex-differences-in-tbi
#2
REVIEW
Henry W Caplan, Charles S Cox, Supinder S Bedi
Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality for both males and females and is, thus, a major focus of current study. Although the overall death rate of TBI for males is roughly three times higher than that for females, males have been disproportionately represented in clinical and preclinical studies. Gender differences are known to exist in many neurologic disorders, such as multiple sclerosis and stroke, and differences appear to exist in TBI. Furthermore, it is known that microglia have sexually dimorphic roles in CNS development and other neurologic conditions; however, most animal studies of microglia and TBI have focused on male subjects...
January 2, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/27853394/long-term-impact-after-fulminant-guillain-barr%C3%A3-syndrome-case-report-and-literature-review
#3
Alain Rougé, Jérémie Lemarié, Sébastien Gibot, Pierre Edouard Bollaert
A 47-year-old man was admitted to the intensive care unit a few hours after presenting to emergency department with acute diplopia and dysphonia. Swallowing disorders and respiratory muscular weakness quickly required invasive ventilation. On day 3, the patient was in a "brain-death"-like state with deep coma and absent brainstem reflexes. Electroencephalogram ruled out brain death diagnosis as a paradoxical sleep trace was recorded. Cerebrospinal fluid analysis, electrophysiologic studies, and a recent history of diarrhea led to the diagnosis of Campylobacter jejuni-related fulminant Guillain-Barré syndrome (GBS) mimicking brain death...
2016: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/27833198/a-philosophical-assessment-of-tk-s-autopsy-report-implications-for-the-debate-over-the-brain-death-criteria
#4
Nicanor Pier Giorgio Austriaco
: In recent years, there has been increasing evidence that the totally brain-dead patient is able to continue to live and to maintain some integrated functions, albeit with the necessary assistance of mechanical ventilation. Several years ago, the autopsy report of a totally brain-dead patient named TK who was kept on life support for nearly twenty years was published in the Journal of Child Neurology. He remains the individual kept on life support the longest after suffering total brain failure...
May 2016: Linacre Quarterly
https://www.readbyqxmd.com/read/27803917/long-term-stabilization-of-stage-4-colon-cancer-using-sodium-dichloroacetate-therapy
#5
Akbar Khan, Douglas Andrews, Anneke C Blackburn
Oral dichloroacetate sodium (DCA) has been investigated as a novel metabolic therapy for various cancers since 2007, based on data from Bonnet et al that DCA can trigger apoptosis of human lung, breast and brain cancer cells. Response to therapy in human studies is measured by standard RECIST definitions, which define "response" by the degree of tumour reduction, or tumour disappearance on imaging. However, Blackburn et al have demonstrated that DCA can also act as a cytostatic agent in vitro and in vivo, without causing apoptosis (programmed cell death)...
October 16, 2016: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/27803368/death-by-neurological-criteria-expert-definitions-and-lay-misgivings
#6
REVIEW
L Syd M Johnson
For decades, there has been persistent controversy concerning brain death, or the determination of death by neurological criteria, among physicians, philosophers, and the lay public. This article examines the various ways that brain death is conceptualized and justified, as well as the persistent questions and controversies related to brain death, particularly within pluralistic, multicultural societies. A culturally sensitive and practical way forward is proposed.
November 1, 2016: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/27798860/histone-deacetylase-inhibitors-a-novel-therapeutic-weapon-against-medullary-thyroid-cancer
#7
REVIEW
Christos Damaskos, Serena Valsami, Eleftherios Spartalis, Efstathios A Antoniou, Periklis Tomos, Stefanos Karamaroudis, Theofano Zoumpou, Vasilios Pergialiotis, Konstantinos Stergios, Constantinos Michaelides, Konstantinos Kontzoglou, Despina Perrea, Nikolaos Nikiteas, Dimitrios Dimitroulis
BACKGROUND/AIM: Medullary thyroid cancer (MTC) is highly malignant, metastatic and recurrent, remaining generally incurable, and responsible for approximately 14% of all thyroid carcinoma-related deaths. MTC can metastasize to lymph nodes, trachea and distant organs, such as brain, lungs, liver and bones. MTC cells are resistant to chemotherapy and traditional external therapies are not showing definite clinical benefits. Scientists are trying to understand the molecular background of carcinogenesis and histone deacetylase (HDAC) seems to play a potential role to gene transcription...
October 2016: Anticancer Research
https://www.readbyqxmd.com/read/27765556/impact-of-the-new-american-heart-association-american-stroke-association-definition-of-stroke-on-the-results-of-the-stenting-and-aggressive-medical-management-for-preventing-recurrent-stroke-in-intracranial-stenosis-trial
#8
Sami Al Kasab, Michael J Lynn, Tanya N Turan, Colin P Derdeyn, David Fiorella, Bethany F Lane, L Scott Janis, Marc I Chimowitz
BACKGROUND: An American Heart Association/American Stroke Association (AHA/ASA) writing committee has recently recommended that tissue evidence of cerebral infarction associated with temporary symptoms (CITS) lasting <24 hours should be considered a stroke. We analyzed the impact of considering CITS as equivalent to stroke on the results of the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial. METHODS: We compared outcomes in the medical (n = 227) and stenting (n = 224) groups in SAMMPRIS using the following primary end point (new components in bold): any stroke, CITS, or death within 30 days after enrollment or within 30 days after a revascularization procedure for the qualifying lesion during follow-up; or ischemic stroke or CITS in the territory of the qualifying artery beyond 30 days...
October 17, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27754167/sy-12-3-are-ras-inhibitors-necessary-for-all-patients-with-diabetes-and-chronic-kidney-disease
#9
Shokei Kim-Mitsuyama
There is accumulating evidence that RAS inhibitors not only reduce blood pressure, but also exert pleiotropic effects, including a renoprotective effect, amelioration of insulin resistance, reduction in onset of diabetes, and suppression of cardiovascular remodelling,. However, the definite benefit of RAS inhibition in treatment of hypertension with CKD or DM is not conclusive. We previously performed the OlmeSartan and Calcium Antagonists Randomized (OSCAR) study comparing the preventive effect of high-dose ARB therapy versus ARB plus CCB combination therapy on cardiovascular morbidity and mortality in 1164 Japanese elderly hypertensive patients with baseline type 2 diabetes and/or CVD (Am J Med (2012))...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27742419/complex-i-deficiency-related-to-t10158c-mutation-nd3-gene-a-further-definition-of-the-clinical-spectrum
#10
Salvatore Grosso, Maria Alessandra Carluccio, Elena Cardaioli, Alfonso Cerase, Alessandro Malandrini, Chiara Romano, Antonio Federico, Maria Teresa Dotti
BACKGROUND: Complex I deficiency is the most common energy generation disorder which may clinically present at any age with a wide spectrum of symptoms and signs. The T10158C mutation ND3 gene is rare and occurs in patients showing an early rapid neurological deterioration invariably leading to death after a few months. CASE PRESENTATION: We report a 9year-old boy with a mtDNA T10158C mutation showing a mild MELAS-like phenotype and brain MRI features congruent with both MELAS and Leigh syndrome...
October 11, 2016: Brain & Development
https://www.readbyqxmd.com/read/27742317/transplant-procurement-management-model-training-marked-improvement-in-the-mindset-of-in-hospital-procurement-coordinators-at-hyogo-prefecture-japan
#11
M Yoshikawa, K Yoshinaga, Y Imamura, T Hayashi, T Osako, K Takahashi, M Kaneko, M Fujisawa, S Kamidono
BACKGROUND: The organ donation rate in Japan is much lower than that in other developed countries for several reasons. An advanced educational program for in-hospital procurement coordinators is a possible solution for this. We introduced a Transplant Procurement Management (TPM) educational program at Hyogo Prefecture, Japan. METHODS: Ten healthcare professionals at Hyogo Prefecture participated in the Advanced International TPM course to educate themselves on TPM and held 2 TPM Model Organ Procurement Training Workshops at Hyogo Prefecture for in-hospital procurement coordinators...
September 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27737717/informed-consent-for-the-diagnosis-of-brain-death-a-conceptual-argument
#12
Osamu Muramoto
BACKGROUND: This essay provides an ethical and conceptual argument for the use of informed consent prior to the diagnosis of brain death. It is meant to enable the family to make critical end-of-life decisions, particularly withdrawal of life support system and organ donation, before brain death is diagnosed, as opposed to the current practice of making such decisions after the diagnosis of death. The recent tragic case of a 13-year-old brain-dead patient in California who was maintained on a ventilator for over 2 years illustrates how such a consent would have made a crucial difference...
October 13, 2016: Philosophy, Ethics, and Humanities in Medicine: PEHM
https://www.readbyqxmd.com/read/27664944/microinfarcts-in-an-older-population-representative-brain-donor-cohort-mrc-cfas-prevalence-relation-to-dementia-and-mobility-and-implications-for-the-evaluation-of-cerebral-small-vessel-disease
#13
Paul G Ince, Thais Minett, Gill Forster, Carol Brayne, Stephen B Wharton
INTRODUCTION: Microinfarcts, small ischaemic foci common in ageing brain, are associated with dementia and gait dysfunction. We determined their relationship to dementia, mobility and cerebrovascular disease in an older population-representative brain donor cohort. These data on microinfarcts were evaluated in relation to pathological assessments of clinically significant cerebral small vessel disease (SVD). METHODS: Microinfarcts were assessed in the MRC Cognitive Function and Ageing Study (n=331)...
September 24, 2016: Neuropathology and Applied Neurobiology
https://www.readbyqxmd.com/read/27643122/sy-12-3-are-ras-inhibitors-necessary-for-all-patients-with-diabetes-and-chronic-kidney-disease
#14
Shokei Kim-Mitsuyama
There is accumulating evidence that RAS inhibitors not only reduce blood pressure, but also exert pleiotropic effects, including a renoprotective effect, amelioration of insulin resistance, reduction in onset of diabetes, and suppression of cardiovascular remodelling,. However, the definite benefit of RAS inhibition in treatment of hypertension with CKD or DM is not conclusive. We previously performed the OlmeSartan and Calcium Antagonists Randomized (OSCAR) study comparing the preventive effect of high-dose ARB therapy versus ARB plus CCB combination therapy on cardiovascular morbidity and mortality in 1164 Japanese elderly hypertensive patients with baseline type 2 diabetes and/or CVD (Am J Med (2012))...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27637961/the-epidemiology-of-amyotrophic-lateral-sclerosis
#15
E O Talbott, A M Malek, D Lacomis
Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease in adults and is characterized by neurodegeneration of motor neurons in the brain and spinal cord. The incidence of ALS is approximately 1-2.6 cases per 100 000 persons annually, whereas the prevalence is approximately 6 cases per 100 000. The average age of onset of ALS is currently 58-60 years and the average survival from onset to death is 3-4 years. Between October 19, 2010 and December 31, 2011, there were an estimated 12 187 prevalent cases diagnosed with definite ALS in the USA alone...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27623840/prevalence-of-microcephaly-in-europe-population-based-study
#16
Joan K Morris, Judith Rankin, Ester Garne, Maria Loane, Ruth Greenlees, Marie-Claude Addor, Larraitz Arriola, Ingeborg Barisic, Jorieke E H Bergman, Melinda Csaky-Szunyogh, Carlos Dias, Elizabeth S Draper, Miriam Gatt, Babak Khoshnood, Kari Klungsoyr, Jennifer J Kurinczuk, Catherine Lynch, Robert McDonnell, Vera Nelen, Amanda J Neville, Mary T O'Mahony, Anna Pierini, Hanitra Randrianaivo, Anke Rissmann, David Tucker, Christine Verellen-Dumoulin, Hermien E K de Walle, Diana Wellesley, Awi Wiesel, Helen Dolk
OBJECTIVES:  To provide contemporary estimates of the prevalence of microcephaly in Europe, determine if the diagnosis of microcephaly is consistent across Europe, and evaluate whether changes in prevalence would be detected using the current European surveillance performed by EUROCAT (the European Surveillance of Congenital Anomalies). DESIGN:  Questionnaire and population based observational study. SETTING:  24 EUROCAT registries covering 570 000 births annually in 15 countries...
2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27613662/deformable-image-registration-between-pathological-images-and-mr-image-via-an-optical-macro-image
#17
Takashi Ohnishi, Yuka Nakamura, Toru Tanaka, Takuya Tanaka, Noriaki Hashimoto, Hideaki Haneishi, Tracy T Batchelor, Elizabeth R Gerstner, Jennie W Taylor, Matija Snuderl, Yukako Yagi
Computed tomography (CT) and magnetic resonance (MR) imaging have been widely used for visualizing the inside of the human body. However, in many cases, pathological diagnosis is conducted through a biopsy or resection of an organ to evaluate the condition of tissues as definitive diagnosis. To provide more advanced information onto CT or MR image, it is necessary to reveal the relationship between tissue information and image signals. We propose a registration scheme for a set of PT images of divided specimens and a 3D-MR image by reference to an optical macro image (OM image) captured by an optical camera...
October 2016: Pathology, Research and Practice
https://www.readbyqxmd.com/read/27564556/molecular-mechanisms-of-anesthetic-neurotoxicity-a-review-of-the-current-literature
#18
William M Jackson, Christy D B Gray, Danye Jiang, Michele L Schaefer, Caroline Connor, Cyrus D Mintz
Data from epidemiologic studies and animal models have raised a concern that exposure to anesthetic agents during early postnatal life may cause lasting impairments in cognitive function. It is hypothesized that this is due to disruptions in brain development, but the mechanism underlying this toxic effect remains unknown. Ongoing research, particularly in rodents, has begun to address this question. In this review we examine currently postulated molecular mechanisms of anesthetic toxicity in the developing brain, including effects on cell death pathways, growth factor signaling systems, NMDA and GABA receptors, mitochondria, and epigenetic factors...
October 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27548625/update-on-the-effects-of-treatment-with-recombinant-tissue-type-plasminogen-activator-rt-pa-in-acute-ischemic-stroke
#19
Aldo Bonaventura, Fabrizio Montecucco, Franco Dallegri
INTRODUCTION: Acute ischemic stroke (AIS) represents a major cause of death and disability all over the world. The recommended therapy aims at dissolving the clot to re-establish quickly the blood flow to the brain and reduce neuronal injury. Intravenous administration of recombinant tissue-type plasminogen activator (rt-PA) is clinically used with this goal. AREAS COVERED: A description of beneficial and detrimental effects of rt-PA treatment is addressed. An overview of new therapies against AIS, such as new thrombolytics, sonolysis and sonothrombolysis, endovascular procedures, and association therapies is provided...
November 2016: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/27543840/prediction-prevention-and-management-of-delayed-graft-function-where-are-we-now
#20
Björn Nashan, Mario Abbud-Filho, Franco Citterio
Delayed graft function (DGF) remains a major barrier to improved outcomes after kidney transplantation. High-risk transplant recipients can be identified, but no definitive prediction model exists. Novel biomarkers to predict DGF in the first hours post-transplant, such as neutrophil gelatinase-associated lipocalin (NGAL), are under investigation. Donor management to minimize the profound physiological consequences of brain death is highly complex. A hormonal resuscitation package to manage the catecholamine "storm" that follows brain death is recommended...
October 2016: Clinical Transplantation
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