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Neurological Illness

Preethi Pansari Agarwal, Narayana Manjunatha, Guru S Gowda, M N Girish Kumar, Neelaveni Shanthaveeranna, Channaveerachari Naveen Kumar, Suresh Bada Math
Background: Tele-medicine helps to provide clinical care comparable to in-person treatment in various clinical settings. It is a novel system of healthcare delivery in both low-resource settings and sites where adequate medical care continues to pose greatest challenge like in prison's in India and worldwide. Aim: To study the sociodemographic and clinical profile of patients from Central Prisons, having received collaborative Tele-Neuropsychiatric Care. Methodology: Psychiatry, neurology, and neurosurgery specialists provided tele-neuropsychiatry consultation through Specialist-Doctor-Patient model as part of the state-run program for the two central prisons from July 1, 2014, to June 30, 2016...
January 2019: Journal of Neurosciences in Rural Practice
Anil C Anand, Pankaj Singh
Neurologic dysfunction characterised by Hepatic Encephalopathy (HE) and cerebral oedema are the most dramatic presentations of Acute Liver Failure (ALF) and signify poor outcome. Improved critical care and wider availability of emergency Liver Transplantation (LT) has improved survivability in ALF. In most cases absence of clinically overt encephalopathy after spontaneous recovery from ALF or after LT is thought to indicate complete neurologic recovery. Recent data suggests that neurologic recovery may not always be complete...
January 2019: Journal of Clinical and Experimental Hepatology
John Titus George, Mohammad Sadiq, Elanthenral Sigamani, Alice Joan Mathuram
A 27-year-old man presented with high-grade intermittent fever for 4 months, generalised fatigue for 2 months, intermittent gum bleeds for 1 month and loss of weight of 15 kg. He appeared cachectic with generalised wasting, had pallor and features of reticuloendothelial system proliferation. His liver span was 17 cm. He had massive splenomegaly. His cardiovascular, respiratory and neurological examination were normal. He was diagnosed to have visceral leishmaniasis (VL) based on bone marrow (BM) examination that showed Leishmania donovani (LD) bodies and was treated with liposomal amphotericin (LA)...
February 13, 2019: BMJ Case Reports
Giri Shan Rajahram, Gillian Hale, Julu Bhatnagar, Jessie Hiu, Ravindran Thayan, Timothy William, Kum Thong Wong, Paul Anantharajah Tambyah, Tsin Wen Yeo
Zika virus infections in immunocompetent adults typically are asymptomatic or cause mild symptoms, but have also been associated with neurological complications including Guillain-Barre Syndrome. Zika virusassociated non-neurological fatalities in adults are rare. Herein, we describe a decedent with multiple commodities who developed an acute febrile illness with rash days prior to death. A post-mortem evaluation detected molecular evidence of disseminated Zika virus. Further testing by Zika virus in-situ hybridization identified genomic and replicative Zika viral RNA in renal tubular epithelial cells, and cardiomyocytes, providing insights into organ-specific viral reservoirs...
February 11, 2019: International Journal of Infectious Diseases: IJID
Mark J D Jordans, Nagendra P Luitel, Brandon A Kohrt, Sujit D Rathod, Emily C Garman, Mary De Silva, Ivan H Komproe, Vikram Patel, Crick Lund
BACKGROUND: In low-income countries, care for people with mental, neurological, and substance use (MNS) disorders is largely absent, especially in rural settings. To increase treatment coverage, integration of mental health services into community and primary healthcare settings is recommended. While this strategy is being rolled out globally, rigorous evaluation of outcomes at each stage of the service delivery pathway from detection to treatment initiation to individual outcomes of care has been missing...
February 2019: PLoS Medicine
DaMarcus E Baymon, Edward W Boyer
PURPOSE OF REVIEW: Chimeric antigen receptor -(CAR) T-cell therapy has become a commonly used immunotherapy originally used in the treatment of B-cell leukemias but which are now applied broadly across tumor classes. Although high rates of remission are associated with CAR T-cell therapy, toxicities associated with these novel treatment regimens can be lethal if not recognized in a timely manner. RECENT FINDINGS: Cytokine release syndrome and neurotoxicity are the two most common toxicities associated with CAR T-cell therapy...
February 11, 2019: Current Opinion in Pediatrics
Evgeni Brotfain, Yoram Klein, Ronen Toledano, Micha Yitzhak Shamir, Leonid Koyfman, Uri Barak, Tamar Guttmann, Alexander Zlotnik, Moti Klein
PURPOSE: Dynamic changes in urine output and neurological status are the recognized clinical signs of hemodynamically significant hemorrhage. In the present study, we analyzed the dynamic minute-to-minute changes in the UFR and also the changes in its minute-to-minute variability in a group of critically ill multiple trauma patients whose blood pressures were normal on admission to the ICU but who subsequently developed hypotension within the first few hours of their ICU admission. PATIENTS AND METHODS: The study was retrospective and observational...
February 13, 2019: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Sarah M Schlein, Paul G Marcolini, Evie G Marcolini
The study of wilderness medicine is within the scope of medical care in the austere environment and addresses medicine as practiced in the setting of delayed access to definitive medical care, hostile environment, limited equipment, and inherent risks to the patient and/or rescuers. Part of this topic includes the care of patients with neurologic illness and/or injury.We will address the five most important skills of a wilderness medicine professional: decision making, prevention, preparation, protocol development, and education by applying the principles to select common neurologic problems that occur in the extended environment: traumatic brain injury, dehydration, hyponatremia, heat illness, hypothermia, spine injury, and lightning injury...
February 2019: Seminars in Neurology
Austin T Smith, Jin H Han
Altered mental status is an umbrella term that covers a broad spectrum of disease processes that vary greatly in chronicity and severity. Causes can be a primary neurologic insult or a result of a systemic illness resulting in end-organ dysfunction of the brain. Acute changes in mental status are more likely than chronic changes to be immediately life-threatening and are therefore the focus of this review. Given the potential time-sensitive nature, acute changes in mental status must be addressed immediately and with urgency...
February 2019: Seminars in Neurology
Hannah Lamont, Alexander Ille, Stacy A Amico-Ruvio
The myelin basic protein (MBP) gene is a complex gene which codes for several distinct forms of MBP. The various forms of MBP are functionally involved in the development of the nervous system, T-cell regulation, and myelination. Several neurological disorders have been linked to MBP abnormality, further demonstrating its functional significance in the nervous system. The white-footed mouse (Peromyscus leucopus) exhibits profound neuroprotective characteristics, is asymptomatic to various disease-states, and has a lifespan twice that of the house mouse (Mus musculus)...
February 8, 2019: Neuroscience Letters
Fiona M Thompson, James W Ferguson, Deirdre A Kelly, Gideon M Hirschfield
Increasing numbers of children are surviving into adulthood with a diagnosis of liver disease or having undergone liver transplantation. This population presents some challenges for the adult hepatologist, and a formal transition service clearly improves outcomes for patients in this group. Evidence of ongoing neurological development in young people up to the age of 25 years exists, and understanding these physiological processes is important in overcoming some of the challenges that caring for this population presents...
March 2019: Lancet. Gastroenterology & Hepatology
Gerard M Moloney, Wesley E P A van Oeffelen, Feargal J Ryan, Marcel van de Wouw, Caitlin Cowan, Marcus J Claesson, Harriet Schellekens, Timothy G Dinan, John F Cryan
Impulsivity is an important component of many psychiatric illnesses and has been associated with a number of psychiatric disorders such as bipolar disorder and attention deficit / hyperactivity disorder (ADHD). Exploring the different aspects of impulsive behaviour and assigning these to specific neurobiological pathways would advance our interpretation of disorders for which impulsivity is key. Pharmacological studies have implicated a number of neurotransmitters in impulsivity, which in turn have been shown to be affected by several genes in both rodent and human studies of impulsivity...
February 6, 2019: Behavioural Brain Research
Alvaro J Idrovo, Gabriel D Pinilla-Monsalve, Edgar F Manrique-Hernández
The interesting article by Simas et. al. describes an outbreak case with over 600 individuals who exhibited neurological symptoms and which occurred in a town located at the northern region of Colombia in 2014. The community associated this event to the second-dose vaccination campaign against the Human Papillomavirus (HPV) and scientists defined it as a mass psychogenic illness.1,2 Unfortunately, the authors did not include in their article important findings related to a case-control study (with n = 137 and n = 437, respectively), conducted by the Colombian government...
February 8, 2019: Human Vaccines & Immunotherapeutics
Sang Hoon Shin, Yong Wook Kim, Na Young Kim
OBJECTIVES: Pathologic laughing is characterized by episodes of uncontrollable laughter caused by underlying neurologic disturbances, such as stroke. Several types of medication, including selective serotonin reuptake inhibitors, have demonstrated only limited success at treating the condition. Duloxetine, a dual serotonin-norepinephrine reuptake inhibitor, is reportedly effective in treating the symptoms of mood disorders. We herein introduce a prospective consecutive sample of stroke patients with pathologic laughing treated with duloxetine...
February 1, 2019: Clinical Neuropharmacology
Aaron M Cook, Jimmi Hatton-Kolpek
Augmented renal clearance (ARC) is a phenomenon in critically ill patients characterized by increased creatinine clearance and elimination of renally-eliminated medications. Patients with severe neurologic injury, sepsis, trauma, and burn have been consistently identified as at risk for ARC, with mean creatinine clearances ranging from 170 ml/min to over 300 ml/min. Several potential mechanisms may contribute to the occurrence of ARC including endogenous responses to increased metabolism and solute production, alterations in neurohormonal balance, and therapeutic maneuvers such as fluid resuscitation...
February 5, 2019: Pharmacotherapy
Eric Racine, Matthew Sample
Common understandings of neuroethics, that is, of its distinctive nature, are premised on two distinct sets of claims: (1) neuroscience can change views about the nature of ethics itself and neuroethics is dedicated to reaping such an understanding of ethics, and (2) neuroscience poses challenges distinct from other areas of medicine and science and neuroethics tackles those issues. Critiques have rightfully challenged both claims, stressing how the first may lead to problematic forms of reductionism whereas the second relies on debatable assumptions about the nature of bioethics specialization and development...
October 2018: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
S Giva, J Finnegan, P Ihidero, G Maguire, B Power, I Knerr, A Monavari
Hyperammonaemia is a metabolic disturbance characterized by accumulation of ammonia in the blood. Entry of ammonia into the brain via the blood-brain barrier leads to hyperammonaemic encephalopathy. The causes of hyperammonaemia in paediatric patients vary. We present 3 cases of hyperammonaemia in critically ill children in whom an inborn metabolic disorder was identified and provide insights into the phenotypes, diagnostic approaches and management. In children with acute overwhelming illness and progressive neurological deterioration plasma ammonia measurement should be included in the urgent diagnostic work-up...
January 15, 2019: Irish Medical Journal
Olivia L Kamensky, Destiny Horton, Donald P Kingsley, Christy C Bridges
BACKGROUND: Mercury poisoning is an uncommon diagnosis in the United States, but it is a differential diagnosis that physicians should consider because it can lead to potentially fatal complications if untreated. Due to the nonspecific presentation of mercury poisoning, which includes symptoms such as fever, nausea, vomiting, and abdominal pain, misdiagnosis may occur unless a proper history is taken. CASE REPORT: In the present case, a white female patient was misdiagnosed repeatedly with a viral illness and sent home from the local hospital...
February 1, 2019: Journal of Emergency Medicine
Laura Finn, Sonia Malhotra
Palliative Care and its medical subspecialty, known as Palliative Medicine, is the care of anyone with a serious illness. This emerging field includes Hospice and comfort care, however, it is not limited to end-of-life care. Examples of the types of serious illness that Palliative Medicine clinicians care for include and are not limited to hematologic and oncologic diseases, such as cancer, advanced heart and lung diseases (e.g., congestive heart failure and chronic obstructive pulmonary disorder), advanced liver and kidney diseases, and advanced neurologic illnesses (e...
February 1, 2019: Healthcare (Basel, Switzerland)
Sara Ibrahim Alshahwan, Ghada Alsowailmi, Afnan Alsahli, Amal Alotaibi, Murtadha Alshaikh, Mohammed Almajed, Aamir Omair, Hind Almodaimegh
BACKGROUND: Pneumonia, the commonest lower respiratory tract infection, can result in respiratory and non-respiratory complications. Few studies have reported on the prevalence of many complications. OBJECTIVES: Identify the prevalence of 18 complications of pneumonia and compare complication rates by age group and type of pneu.monia. Identify most prevalent comorbidities, the effect of the number of comorbidities on the presence of complications, and the association between specific comorbidities and specific complications...
January 2019: Annals of Saudi Medicine
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