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Acute neurology

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https://www.readbyqxmd.com/read/28453871/elevated-cerebrospinal-fluid-tumor-necrosis-factor-is-associated-with-acute-and-long-term-neurocognitive-impairment-in-cerebral-malaria
#1
Estela Shabani, Benson J Ouma, Richard Idro, Paul Bangirana, Robert O Opoka, Gregory S Park, Andrea L Conroy, Chandy C John
Systemic tumor necrosis factor-α (TNF-α) may contribute to the pathogenesis of cerebral malaria (CM) by promoting endothelial activation and parasite sequestration. However less is known about the role of central nervous system (CNS) TNF-α in CM. We assessed plasma (n=249) and cerebrospinal fluid (CSF) (n=167) TNF-α levels in Ugandan children with CM, plasma TNF-α in Ugandan community control children (n=198), and CSF TNF-α in North American control children who had recovered from leukemia (n=13). Plasma and CSF TNF-α were measured by magnetic bead assay...
April 28, 2017: Parasite Immunology
https://www.readbyqxmd.com/read/28453793/impact-of-gender-on-long-term-outcomes-after-surgical-repair-for-acute-stanford-a-aortic-dissection-a-propensity-score-matched-analysis%C3%A2
#2
Anton Sabashnikov, Stephanie Heinen, Antje Christin Deppe, Mohamed Zeriouh, Alexander Weymann, Ingo Slottosch, Kaveh Eghbalzadeh, Aron-Frederik Popov, Oliver Liakopoulos, Parwis B Rahmanian, Navid Madershahian, Axel Kroener, Yeong-Hoon Choi, Ferdinand Kuhn-Régnier, André R Simon, Thorsten Wahlers, Jens Wippermann
OBJECTIVES: Previous research suggests that female gender is associated with increased mortality rates after surgery for Stanford A acute aortic dissection (AAD). However, women with AAD usually present with different clinical symptoms that may bias outcomes. Moreover, there is a lack of long-term results regarding overall mortality and freedom from major cerebrovascular events. We analysed the impact of gender on long-term outcomes after surgery for Stanford A AAD by comparing genders with similar risk profiles using propensity score matching...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28447870/does-specialized-inpatient-rehabilitation-affect-whether-or-not-people-with-traumatic-spinal-cord-injury-return-home
#3
Christiana L Cheng, Tova Plashkes, Tian Shen, Nader Fallah, Suzanne Humphreys, Colleen O'Connell, A Gary Linassi, Chester Ho, Christine Short, Karen Ethans, Rebecca Charbonneau, Jérôme Paquet, Vanessa K Noonan
Return to living at home is an important patient-reported outcome following traumatic spinal cord injury (tSCI). Specialized inpatient rehabilitation assists such patients in maximizing function and independence. Our project aim was to describe those patients receiving specialized rehabilitation after tSCI in Canada, and to determine if such rehabilitation improved the likelihood of returning home. This cohort study utilized data from RHSCIR to identify patients with tSCI discharged from 1 of 18 participating acute specialized spine facilities between 2011-2015 to either 1 of 13 participating specialized rehabilitation facilities, or another discharge destination...
April 27, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28446490/complicated-acute-cerebellitis-with-obstructive-hydrocephalus-and-tonsillar-herniation-in-a-child
#4
Manchikanti Venkatesh, Sunitha Vellathussery Chakkalakkoombil, Manju Bashini Duraipandi, Reena Gulati
Acute cerebellitis (AC) is a rare inflammatory syndrome presenting as cerebellar dysfunction, seen more frequently in children. AC can have a variable course with features of cerebellar dysfunction, raised intracranial pressure and neurological deficits, and can sometimes even be potentially fatal due to complications such as obstructive hydrocephalus and brainstem compression, warranting surgical intervention. We report a case of a 12-year-old boy who presented with raised intracranial pressure and ataxia...
April 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28445240/evaluation-of-a-pediatric-early-warning-score-across-different-subspecialty-patients
#5
Nathan P Dean, J B Fenix, Michael Spaeder, Amanda Levin
OBJECTIVE: To evaluate the ability of a Pediatric Early Warning Score to predict deterioration in different subspecialty patient populations. DESIGN: Single center, retrospective cohort study. Patients were classified into five groups: 1) cardiac; 2) hematology/oncology/bone marrow transplant; 3) surgical; 4) neurologic; and 5) general medical. The relationship between the Pediatric Early Warning Score and unplanned ICU transfer requiring initiation of specific ICU therapies (intubation, high-flow nasal cannula, noninvasive ventilation, inotropes, or aggressive fluid hydration within 12 hr of transfer) was evaluated...
April 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28445083/fatigue-and-physical-functioning-in-children-with-multiple-sclerosis-and-acute-disseminated-encephalomyelitis
#6
Leontien Cc Toussaint-Duyster, Yu Yi M Wong, Monique Hm Van der Cammen-van Zijp, Daniëlle Van Pelt-Gravesteijn, Coriene E Catsman-Berrevoets, Rogier Q Hintzen, Rinze F Neuteboom
BACKGROUND AND OBJECTIVE: Fatigue and physical impairments are a major concern in children with multiple sclerosis (MS) and after acute disseminated encephalomyelitis (post-ADEM). We here aimed to evaluate the interaction between fatigue, exercise capacity, motor performance, neurological status, and quality of life (HRQoL). METHODS: In this cross-sectional study, data of 38 children (MS n = 22, post-ADEM n = 16), aged 4-17 years attending our national pediatric MS center, were studied...
April 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28443389/neuroscience-intermediate-level-care-units-staffed-by-intensivists-clinical-outcomes-and-cost-analysis
#7
Kwadwo Kyeremanteng, Ariel Hendin, Kalpana Bhardwaj, Kednapa Thavorn, Dave Neilipovitz, Dalibour Kubelik, Gianni D'Egidio, Grant Stotts, Erin Rosenberg
INTRODUCTION: With an aging population and increasing numbers of intensive care unit admissions, novel ways of providing quality care at reduced cost are required. Closed neurointensive care units improve outcomes for patients with critical neurological conditions, including decreased mortality and length of stay (LOS). Small studies have demonstrated the safety of intermediate-level units for selected patient populations. However, few studies analyze both cost and safety outcomes of these units...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28443386/association-of-renal-function-and-symptoms-with-mortality-in-star-fruit-averrhoa-carambola-intoxication
#8
Choon-Bing Chua, Cheuk-Kwan Sun, Huan-Wen Tsui, Po-Jen Yang, Kuo-Hsin Lee, Chih-Wei Hsu, I-Ting Tsai
BACKGROUND: Star fruit (SF) is a commonly available fruit produced and eaten in tropical and subtropical countries. Since 1993, various reports have described neurotoxicity after eating SF, but this clinical condition remains unfamiliar. We aimed to describe this clinical entity, the role of renal dysfunction in this disorder, treatment strategies, and prognosis of patients with SF intoxication. METHODS: We conducted a search of PubMed and Google Scholar databases from 1993 to 2016...
April 26, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28441824/-clinical-and-neuroimaging-features-of-acute-encephalopathy-after-status-epilepticus-in-dravet-syndrome
#9
X J Tian, Y H Zhang, A J Liu, X L Yang, Q Zeng, Z X Yang, J T Ye, X Y Liu, Y W Jiang, X R Wu
Objective: To investigate the clinical and neuroimaging characteristics of acute encephalopathy (AE) after status epilepticus (SE) of patients with Dravet syndrome (DS). Method: The clinical data of DS patients who had AE (coma ≥24 h) after SE were retrospectively collected from February 2005 to August 2016 in Peking University First Hospital and SCN1A gene tests were performed.The clinical and neuroimaging features were summarized. Result: Twenty-two patients (9 males and 13 females) with AE were collected among 412 DS patients during follow-up...
April 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28441453/brainstem-response-patterns-in-deeply-sedated-critically-ill-patients-predict-28-day-mortality
#10
Benjamin Rohaut, Raphael Porcher, Tarik Hissem, Nicholas Heming, Patrick Chillet, Kamel Djedaini, Guy Moneger, Stanislas Kandelman, Jeremy Allary, Alain Cariou, Romain Sonneville, Andréa Polito, Marion Antona, Eric Azabou, Djillali Annane, Shidasp Siami, Fabrice Chrétien, Jean Mantz, Tarek Sharshar
BACKGROUND AND PURPOSE: Deep sedation is associated with acute brain dysfunction and increased mortality. We had previously shown that early-assessed brainstem reflexes may predict outcome in deeply sedated patients. The primary objective was to determine whether patterns of brainstem reflexes might predict mortality in deeply sedated patients. The secondary objective was to generate a score predicting mortality in these patients. METHODS: Observational prospective multicenter cohort study of 148 non-brain injured deeply sedated patients, defined by a Richmond Assessment sedation Scale (RASS) <-3...
2017: PloS One
https://www.readbyqxmd.com/read/28440586/comparison-of-preoperative-quantitative-magnetic-resonance-imaging-and-clinical-assessment-of-deep-pain-perception-as-prognostic-tools-for-early-recovery-of-motor-function-in-paraplegic-dogs-with-intervertebral-disk-herniations
#11
A Wang-Leandro, J S Siedenburg, M K Hobert, P Dziallas, K Rohn, V M Stein, A Tipold
BACKGROUND: Prognostic tools to predict early postoperative motor function recovery (MFR) after thoracolumbar intervertebral disk herniation (IVDH) in paraplegic dogs represent an opportunity to timely implement novel therapies that could shorten recovery times and diminish permanent neurological dysfunctions. HYPOTHESIS: Fractional anisotropy (FA) values obtained using diffusion tensor imaging have a higher prognostic value than a lesion extension ratio in T2-weighted images (T2W-LER) and clinical assessment of deep pain perception (DPP) for MFR...
April 25, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28439892/cerebrospinal-fluid-cyto-chemokine-profile-during-acute-herpes-simplex-virus-induced-anti-n-methyl-d-aspartate-receptor-encephalitis-and-in-chronic-neurological-sequelae
#12
Kavitha Kothur, Deepak Gill, Melanie Wong, Shekeeb S Mohammad, Sushil Bandodkar, Susan Arbunckle, Louise Wienholt, Russell C Dale
AIM: To examine the cytokine/chemokine profile of cerebrospinal fluid (CSF) during acute herpes simplex virus-induced N-methyl-d-aspartate receptor (NMDAR) autoimmunity and in chronic/relapsing post-herpes simplex virus encephalitis (HSE) neurological syndromes. METHOD: We measured longitudinal serial CSF cyto-/chemokines (n=34) and a glial marker (calcium-binding astroglial protein, S100B) in one patient during acute HSE and subsequent anti-NMDAR encephalitis, and compared the results with those from two patients with anti-NMDAR encephalitis without preceding HSE...
April 25, 2017: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/28439774/albumin-induced-neuroprotection-in-focal-cerebral-ischemia-in-the-alias-trial-does-severity-mechanism-and-time-of-infusion-matter
#13
Rakesh Khatri, Mohammad Rauf Afzal, Gustavo J Rodriguez, Alberto Maud, Muhammad Shah Miran, Mohtashim Arbaab Qureshi, Salvador Cruz-Flores, Adnan I Qureshi
OBJECTIVE: To determine whether there is any differential benefit of albumin administration within 2 h of onset of ischemia and in settings (severe ischemia with reperfusion in cardioembolic strokes with National Institutes of Health Stroke Scale [NIHSS] ≥15), most representative of experimental models of cerebral ischemia in which albumin was effective in reducing neurological injury. BACKGROUND: High-dose intravenous (IV) albumin treatment for acute ischemic stroke (ALIAS) trial did not show overall clinical benefit in ischemic stroke patients in contrast to preclinical studies; however, models of preclinical studies were not completely followed...
April 24, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28439773/parsonage-turner-syndrome-due-to-autochthonous-acute-genotype-3f-hepatitis-e-virus-infection-in-a-nonimmunocompromised-55-year-old-patient
#14
A Velay, W Kack-Kack, F Abravanel, S Lhomme, P Leyendecker, L Kremer, P Chamouard, J Izopet, S Fafi-Kremer, H Barth
Hepatitis E virus (HEV) infection is an emerging autochthonous disease in industrialized countries. Extra-hepatic manifestations, in particular neurologic manifestations, have been reported in HEV infection. Only a few cases of hepatitis E-associated Parsonage-Turner syndrome have been reported, and HEV genotypes were rarely determined. Here, we report the case of a Parsonage-Turner syndrome associated with an acute autochthonous HEV infection in a 55-year-old immunocompetent patient. HEV genomic RNA was detected in serum and cerebrospinal fluid samples (CSF), and molecular phylogenetic analysis of HEV was performed...
April 24, 2017: Journal of Neurovirology
https://www.readbyqxmd.com/read/28439196/clinical-differences-of-influenza-subspecies-among-hospitalized-children
#15
Manolya Acar, Murat Sütçü, Hacer Aktürk, Selda Hançerli Törün, Metin Uysalol, Sevim Meşe, Nuran Salman, Ayper Somer
AIM: Clinical findings, mortality, and morbidity rates differ among influenza subspecies. Awareness of these differences will lead physicians to choose the proper diagnostic and therapeutic strategies and to foresee possible complications. The aim of this study was to evaluate the clinical differences of influenza subspecies among hospitalized children. MATERIAL AND METHODS: Hospitalized children with proven influenza infection by polymerase chain reaction on nasopharyngeal swab specimens in our clinic, between December 2013 and March 2016, were enrolled...
March 2017: Türk Pediatri Arşivi
https://www.readbyqxmd.com/read/28438894/flow-diverter-treatment-of-intracranial-vertebral-artery-dissecting-pseudoaneurysms
#16
REVIEW
Russell Cerejo, Mark Bain, Nina Moore, Julian Hardman, Andrew Bauer, M Shazam Hussain, Thomas Masaryk, Peter Rasmussen, Gabor Toth
INTRODUCTION: Intracranial vertebral dissecting pseudoaneurysms are a rare, but increasingly recognized, cause of subarachnoid hemorrhage and ischemic stroke. The risks of aneurysm re-rupture and associated morbidity are high. The use of flow diverter stents for the treatment of these aneurysms has not been well studied. OBJECTIVE: To report our data and provide a summarized review of literature using flow diverter stents for the treatment of intracranial vertebral artery dissecting pseudoaneurysms...
April 24, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28438705/tigr4-strain-causes-more-severe-disease-than-wu2-strain-in-a-mouse-model-of-streptococcus-pneumoniae-meningitis-a-common-pathogenic-role-for-interferon-%C3%AE
#17
Belinda Yau, Lay Khoon Too, Helen J Ball, Nicholas H Hunt
Streptococcus pneumoniae (S. pneumoniae) meningitis causes debilitating neurological symptoms and acute fatalities in patients, and long-term neurological sequelae in some survivors. Current vaccines do not protect against all 94 known S. pneumoniae capsular serotypes, many of which are capable of causing pneumococcal meningitis (PM). We here compare the pathogenic outcomes of two clinically virulent isolates of S. pneumoniae, serotype 3 strain WU2 and serotype 4 strain TIGR4, in a murine model of PM. At an identical infectious dosage of 10(3) CFU administered via the intracerebroventricular route, significantly greater mortality, interleukin (IL)1β and IL6 production, and blood-brain barrier dysfunction occurred in TIGR4-induced PM compared to PM caused by WU2...
April 21, 2017: Microbes and Infection
https://www.readbyqxmd.com/read/28438223/extrastriatal-changes-in-patients-with-late-onset-glutaric-aciduria-type-i-highlight-the-risk-of-long-term-neurotoxicity
#18
Nikolas Boy, Jana Heringer, Renate Brackmann, Olaf Bodamer, Angelika Seitz, Stefan Kölker, Inga Harting
BACKGROUND: Without neonatal initiation of treatment, 80-90% of patients with glutaric aciduria type 1 (GA1) develop striatal injury during the first six years of life resulting in a complex, predominantly dystonic movement disorder. Onset of motor symptoms may be acute following encephalopathic crisis or insidious without apparent crisis. Additionally, so-called late-onset GA1 has been described in single patients diagnosed after the age of 6 years. With the aim of better characterizing and understanding late-onset GA1 we analyzed clinical findings, biochemical phenotype, and MRI changes of eight late-onset patients and compared these to eight control patients over the age of 6 years with early diagnosis and start of treatment...
April 24, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28437378/risk-factors-for-pediatric-extubation-failure-the-importance-of-respiratory-muscle-strength
#19
Robinder G Khemani, Tro Sekayan, Justin Hotz, Rutger C Flink, Gerrard F Rafferty, Narayan Iyer, Christopher J L Newth
OBJECTIVE: Respiratory muscle weakness frequently develops during mechanical ventilation, although in children there are limited data about its prevalence and whether it is associated with extubation outcomes. We sought to identify risk factors for pediatric extubation failure, with specific attention to respiratory muscle strength. DESIGN: Secondary analysis of prospectively collected data. SETTING: Tertiary care PICU. PATIENTS: Four hundred nine mechanically ventilated children...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437329/metastatic-spinal-cord-compression-and-steroid-treatment-a-systematic-review
#20
Abhishek Kumar, Michael H Weber, Ziya Gokaslan, Jean-Paul Wolinsky, Meic Schmidt, Laurence Rhines, Michael G Fehlings, Ilya Laufer, Daniel M Sciubba, Michelle J Clarke, Narayan Sundaresan, Jorrit-Jan Verlaan, Arjun Sahgal, Dean Chou, Charles G Fisher
STUDY DESIGN: Systematic review. OBJECTIVES: We conducted a systematic review of the literature to answer the following questions regarding the use of steroid therapy in metastatic spinal cord compression (MSCC): 1. In cases of MSCC, what is the effect of steroid administration before definitive radiotherapy or surgery on ambulatory status, bowel and bladder function and survival? 2. What steroid dosing regimens are associated with the best outcomes concerning neurological symptoms and complication prevention in cases of MSCC? SUMMARY OF BACKGROUND DATA: Currently, there is significant variation in the initial bolus dose, daily maintenance dose and duration of treatment when steroids are used as a bridge to definitive therapy for MSCC...
May 2017: Clinical Spine Surgery
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