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https://www.readbyqxmd.com/read/28205009/mixed-pathologies-including-chronic-traumatic-encephalopathy-account-for-dementia-in-retired-association-football-soccer-players
#1
Helen Ling, Huw R Morris, James W Neal, Andrew J Lees, John Hardy, Janice L Holton, Tamas Revesz, David D R Williams
In retired professional association football (soccer) players with a past history of repetitive head impacts, chronic traumatic encephalopathy (CTE) is a potential neurodegenerative cause of dementia and motor impairments. From 1980 to 2010, 14 retired footballers with dementia were followed up regularly until death. Their clinical data, playing career, and concussion history were prospectively collected. Next-of-kin provided consent for six to have post-mortem brain examination. Of the 14 male participants, 13 were professional and 1 was a committed amateur...
February 15, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28199174/role-of-troponins-i-and-t-and-n-terminal-prohormone-of-brain-natriuretic-peptide-in-monitoring-cardiac-safety-of-patients-with-early-stage-human-epidermal-growth-factor-receptor-2-positive-breast-cancer-receiving-trastuzumab-a-herceptin-adjuvant-study-cardiac
#2
Dimitrios Zardavas, Thomas M Suter, Dirk J Van Veldhuisen, Jutta Steinseifer, Johannes Noe, Sabine Lauer, Nedal Al-Sakaff, Martine J Piccart-Gebhart, Evandro de Azambuja
Purpose Women receiving trastuzumab with chemotherapy are at risk for trastuzumab-related cardiac dysfunction (TRCD). We explored the prognostic value of cardiac markers (troponins I and T, N-terminal prohormone of brain natriuretic peptide [NT-proBNP]) to predict baseline susceptibility to develop TRCD. We examined whether development of cardiac end points or significant left ventricular ejection fraction (LVEF) drop was associated with markers' increases. Patients and Methods Cardiac marker assessments were coupled with LVEF measurements at different time points for 533 patients from the Herceptin Adjuvant (HERA) study who agreed to participate in this study...
October 23, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28182114/evolution-of-cerebral-atrophy-in-a-patient-with-super-refractory-status-epilepticus-treated-with-barbiturate-coma
#3
Christopher R Newey, Pravin George, Premkumar Nattanmai, Christine Ahrens, Stephen Hantus, Aarti Sarwal
Introduction. Status epilepticus is associated with neuronal breakdown. Radiological sequelae of status epilepticus include diffusion weighted abnormalities and T2/FLAIR cortical hyperintensities corresponding to the epileptogenic cortex. However, progressive generalized cerebral atrophy from status epilepticus is underrecognized and may be related to neuronal death. We present here a case of diffuse cerebral atrophy that developed during the course of super refractory status epilepticus management despite prolonged barbiturate coma...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28169857/intersection-of-prognosis-and-palliation-in-neurocritical-care
#4
Michael Rubin, Jordan Bonomo, J Claude Hemphill
PURPOSE OF REVIEW: Difficult discussions regarding end-of-life care are common in neurocritical care. Because of a patient's neurological impairment, decisions regarding continuing or limiting aggressive care must often be made by patients' families in conjunction with medical providers. This review provides perspective on three major aspects of this circumstance: prognostication, family-physician discussions, and determination of death (specifically as it impacts on organ donation). RECENT FINDINGS: Numerous studies have now demonstrated that prediction models developed from populations of brain-injured patients may be misleading when applied to individual patients...
February 4, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28087824/neuropathology-of-sudep-role-of-inflammation-blood-brain-barrier-impairment-and-hypoxia
#5
Zuzanna Michalak, Dima Obari, Matthew Ellis, Maria Thom, Sanjay M Sisodiya
OBJECTIVE: To seek a neuropathologic signature of sudden unexpected death in epilepsy (SUDEP) in a postmortem cohort by use of immunohistochemistry for specific markers of inflammation, gliosis, acute neuronal injury due to hypoxia, and blood-brain barrier (BBB) disruption, enabling the generation of hypotheses about potential mechanisms of death in SUDEP. METHODS: Using immunohistochemistry, we investigated the expression of 6 markers (CD163, human leukocyte antigen-antigen D related, glial fibrillary acid protein, hypoxia-inducible factor-1α [HIF-1α], immunoglobulin G, and albumin) in the hippocampus, amygdala, and medulla in 58 postmortem cases: 28 SUDEP (definite and probable), 12 epilepsy controls, and 18 nonepileptic sudden death controls...
January 13, 2017: Neurology
https://www.readbyqxmd.com/read/28073578/prophylactic-cranial-irradiation-after-definitive-chemoradiotherapy-for-limited-stage-small-cell-lung-cancer-do-all-patients-benefit
#6
Ahsan S Farooqi, Emma B Holliday, Pamela K Allen, Xiong Wei, James D Cox, Ritsuko Komaki
PURPOSE: Prophylactic cranial irradiation (PCI) can improve overall survival (OS) and suppress brain metastases (BM) in patients with limited-stage small cell lung cancer (LS-SCLC) after complete response to primary therapy. However, PCI can be toxic. We sought to identify characteristics of patients who may not benefit from PCI. METHODS: We identified 658 patients who received chemoradiotherapy at MD Anderson in 1986-2012; 364 received PCI and 294 did not. Median follow-up time was 21...
January 7, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28067742/what-definition-is-used-to-describe-second-impact-syndrome-in-sports-a-systematic-and-critical-review
#7
Steven D Stovitz, Jonathan D Weseman, Matthew C Hooks, Robert J Schmidt, Jonathan B Koffel, Jon S Patricios
Concern about what has been termed, "second impact syndrome" (SIS) is a major factor determining return-to-play decisions after concussion. However, definitions of SIS vary. We used Scopus to conduct a systematic review and categorize the definitions used to describe SIS. Of the 91 sources identified, 79 (87%) clearly specified that SIS involved either cerebral edema or death after a concussion when a prior concussion had not resolved. Twelve articles (13%) could be interpreted as merely the events of two consecutive concussions...
January 2017: Current Sports Medicine Reports
https://www.readbyqxmd.com/read/28018883/determinants-of-alternate-level-of-care-delayed-discharge-among-acute-care-survivors-of-hypoxic-ischemic-brain-injury-a-population-based-cohort-study
#8
David Stock, Cassandra Cowie, Vincy Chan, Angela Colantonio, Walter P Wodchis, David Alter, Nora Cullen
BACKGROUND: Delayed discharge, captured as alternate-level-of-care days, represents inefficient use of high-demand acute care resources and results in potentially poorer patient outcomes. We performed a study to determine the extent of alternate-level-of-care days among patients who survived hypoxic-ischemic brain injury in inpatient hospital care in Ontario and to identify predictors of alternate-level-of-care use in this population. METHODS: A population-based cohort of acute care survivors of hypoxic-ischemic brain injury aged 20 years or more from 2002/03 through 2011/12 was identified...
October 2016: CMAJ Open
https://www.readbyqxmd.com/read/28017304/e-cigarettes-what-a-practicing-cardiologist-needs-to-know
#9
EDITORIAL
Joshua Liberman, Samuel Wann
Cardiologists and other physicians caring for patients who either smoke tobacco or are potential or active users of E-cigarettes have many questions about this increasingly popular method for delivering nicotine to the brain: (1) What are E-cigarettes? (2) What harm do E-cigarettes pose to users and bystanders? (3) Can E-cigarettes help tobacco smokers quit? (4) Are E-cigarettes a gateway to tobacco smoking, addicting new users, particularly the young, to nicotine? and (5) Should E-cigarettes be tolerated, or even favored over tobacco, as a less harmful substitute for those unable to stop smoking tobacco? This editorial summarizes evidence and expert opinion, preparing the physician for informed discussion of this controversial subject with their patients and colleagues...
November 19, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27932184/intrapancreatic-splenule-in-a-pancreas-allograft-case-report
#10
K Yadav, O K Serrano, R Kandaswamy
A 16-year-old white man was involved in a motor vehicle collision and suffered head, chest, and abdominal trauma. Despite initial resuscitative efforts, he progressed to brain death and was designated to be an organ donor by his family. He had no earlier medical or surgical history and no high-risk behaviors. Blood work revealed normal creatinine, liver function tests, lipase, and amylase. Viral serologies were negative except for cytomegalovirus IgG and Epstein-Barr virus nucleic acid. Imaging revealed a right kidney contusion, a manubrial fracture, and fractures of right first rib and bilateral scapulae...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27876002/sporadic-creutzfeldt-jakob-disease-with-unusual-initial-presentation-as-posterior-reversible-encephalopathy-syndrome-a-case-report
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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...
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
#18
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...
January 2017: 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
#19
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
#20
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
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