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    Evaluating the Impact of Implementing a Clinical Practice Guideline for Febrile Infants With Positive Respiratory Syncytial Virus or Enterovirus Testing.
    Hosp Pediatr 2017 Sep 21. Epub 2017 Sep 21.
    Department of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine, Kansas City, Missouri; and.
    Objectives: To evaluate clinical practice patterns and patient outcomes among febrile low-risk infants with respiratory syncytial virus (RSV) infection or enterovirus (EV) meningitis after implementing a clinical practice guideline (CPG) that provides recommendations for managing febrile infants with RSV infection and EV meningitis.

    Methods: Our institution implemented a CPG for febrile infants, which gives explicit recommendations for managing both RSV-positive and EV-positive infants in 2011. We retrospectively analyzed medical records of febrile infants ≤60 days old from June 2008 to January 2013. Read More

    Laparoscopic Cholecystectomy under Segmental Thoracic Spinal Anesthesia: A Feasible Economical Alternative.
    Anesth Essays Res 2017 Jul-Sep;11(3):781-783
    Department of Anesthesiology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India.
    Laparoscopic surgery is normally performed under general anesthesia, but regional techniques like thoracic epidural and lumbar spinal have been emerging and found beneficial. We performed a clinical case study of segmental thoracic spinal anaesthesia in a healthy patient. We selected an ASA grade I patient undergoing elective laparoscopic cholecystectomy and gave spinal anesthetic in T10-11 interspace using 1 ml of bupivacaine 5 mg ml(-1) mixed with 0. Read More

    Treatment of Autoimmune Glial Fibrillary Acidic Protein Astrocytopathy: Follow-Up in 7 Cases.
    Neuroimmunomodulation 2017 Sep 19. Epub 2017 Sep 19.
    Department of Neurology, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Collaborative Innovation Center for Neurogenetics and Channelopathies, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
    Objective: The aim of this work was to report an autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy with long-term follow-up in 7 patients.

    Methods: Antibodies were detected by indirect immunofluorescence assay and patient data were analyzed retrospectively.

    Results: Seven patients (4 female, 3 male) with ≥1 year follow-up were included. Read More

    [Rare and severe complication of spinal anesthesia: bacterial meningitis (about a case and literature review)].
    Pan Afr Med J 2017 30;27:158. Epub 2017 Jun 30.
    Service des Urgences Médico-Chirurgicales, Hôpital Militaire Mohamed V, Faculté de Médecine et de Pharmacie, Rabat, Maroc.
    Spinal anesthesia (SA) is the first locoregional anesthesia. It can cause side effects and carry risks that need to be avoided, prevented or treated early. We here report the case of a female patient operated under spinal anesthesia who had intense headache associated with nausea and vomiting evolving in the context of fever within a few days after surgeryLumbar puncture showed cloudy liquid revealing Gram + cocci on direct examination. Read More

    Factors Influencing Successful Lumbar Puncture in Alzheimer Research.
    Alzheimer Dis Assoc Disord 2017 Sep 7. Epub 2017 Sep 7.
    *Department of Neurology, Knight Alzheimer Disease Research Center, Washington University, St. Louis, MO †National Alzheimer's Coordinating Center, University of Washington, Seattle, WA ‡Department of Neuroscience and Physiology, Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, University of Gothenburg, Mölndal, Sweden.
    Objective: Lumbar puncture (LP) is increasingly common in Alzheimer disease research; however, agreement to undergo LP varies. We sought to determine factors influencing LP consent at Alzheimer's Disease Centers (ADCs) in the United States.

    Methods: A 3-part survey was distributed to each ADC: (1) ADC LP Experience; (2) LP Requestor Experience; and (3) Patient LP Experience (both Initial and Follow-up). Read More

    Adult Spinal Deformity: National Trends in the Presentation, Treatment, and Perioperative Outcomes From 2003 to 2010.
    Spine Deform 2017 Sep;5(5):342-350
    Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, 301 E 17th St, New York, NY 10003, USA.
    Study Design: Retrospective review of a prospective database.

    Objectives: To investigate adult spinal deformity (ASD) surgery outcome trends on a nationwide scale using the Nationwide Inpatient Sample (NIS) from 2003 to 2010.

    Methods: ASD patients ≥25 years from 2003 to 2010 in the NIS undergoing anterior, posterior, or combined surgical approaches were included. Read More

    Cerebrospinal Fluid Apolipoprotein E Levels in Delirium.
    Dement Geriatr Cogn Dis Extra 2017 May-Aug;7(2):240-248. Epub 2017 Jul 11.
    School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia.
    Background/aims: Delirium and the apolipoprotein E ε4 allele are risk factors for late-onset Alzheimer disease (LOAD), but the connection is unclear. We looked for an association.

    Methods: Inpatients with delirium (n = 18) were compared with LOAD outpatients (n = 19), assaying blood and cerebrospinal fluid (CSF) using multiplex ELISA. Read More

    Continuous Spinal Anesthesia for Obstetric Anesthesia and Analgesia.
    Front Med (Lausanne) 2017 15;4:133. Epub 2017 Aug 15.
    Division of Obstetric Anesthesia, Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, TN, United States.
    The widespread use of continuous spinal anesthesia (CSA) in obstetrics has been slow because of the high risk for post-dural puncture headache (PDPH) associated with epidural needles and catheters. New advances in equipment and technique have not significantly overcome this disadvantage. However, CSA offers an alternative to epidural anesthesia in morbidly obese women, women with severe cardiac disease, and patients with prior spinal surgery. Read More

    Thoracic intradural-extramedullary epidermoid tumor: the relevance for resection of "classical" subarachnoid space microsurgical anatomy in "modern" spinal surgery. Technical note and review of the literature.
    World Neurosurg 2017 Aug 23. Epub 2017 Aug 23.
    Department of Neurological Surgery, Policlinico "G. Rodolico" University Hospital, Via Santa Sofia 86, 95123 - Catania, Italy.
    Background: Intradural epidermoid tumors of the spinal cord are commonly associated with spinal cord dysraphism or invasive procedures. We report the particular relationships between spinal subarachnoid compartments and a thoracic intradural-extramedullary epidermoid tumor, highlighting the relevant anatomical changes, which may influence microsurgery.

    Methods: A 40 year old woman suffering from compressive myelopathy due to a thoracic epidermoid tumor extending from T3 to T4, and not associated with spina bifida, trauma, previous surgery or lumbar spinal puncture, underwent microsurgical excision. Read More

    A case of symptomatic spinal dural arteriovenous fistula after high-volume lumbar puncture.
    Surg Neurol Int 2017 1;8:164. Epub 2017 Aug 1.
    Department of Neurological Surgery, Henry Ford Hospital, Detroit, Michigan, USA.
    Background: Spinal dural arteriovenous fistulas (DAVFs) are rare lesions that lead to venous congestion and ischemic injury resulting in neurologic deterioration. Here we present a patient diagnosed with glioblastoma multiforme (GBM) who became symptomatic from a spinal DAVF after a diagnostic high-volume lumbar puncture (LP).

    Case Description: When a 72-year-old female developed partial seizures in her left upper extremity without other focal neurological deficits, she underwent a magnetic resonance imaging (MRI) scan of the brain. Read More

    Pediatric idiopathic intracranial hypertension - Is the fixed threshold value of elevated LP opening pressure set too high?
    Eur J Paediatr Neurol 2017 Aug 12. Epub 2017 Aug 12.
    Department of Pediatric Neurology, Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
    Background: Idiopathic intracranial hypertension (IIH) in children is a rare condition of unknown etiology and various clinical presentations. The primary aim of this study was to evaluate if our pediatric IIH study group fulfilled the revised diagnostic criteria for IIH published in 2013, particularly with regard to clinical presentation and threshold value of an elevated lumbar puncture opening pressure. Additionally we investigated the potential utilization of MR-based and fundoscopic methods of estimating intracranial pressure for improved diagnosis. Read More

    A dedicated lumbar puncture clinic: performance and short-term patient outcomes.
    J Neurol 2017 Aug 23. Epub 2017 Aug 23.
    Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
    The purpose of the study was to evaluate patient outcomes, including success rates, factors associated with unsuccessful procedures and frequency of post-lumbar puncture headaches (PLPH), at a dedicated academic outpatient lumbar puncture (LP) clinic. All patients referred to our LP clinic between June 1, 2014 and May 31, 2015 were included in this consecutive observational series. We collected information about patient characteristics, operational parameters of the procedure, and complications. Read More

    Impact of intrathecal morphine analgesia on the incidence of pulmonary complications after cardiac surgery: a single center propensity-matched cohort study.
    BMC Anesthesiol 2017 Aug 22;17(1):109. Epub 2017 Aug 22.
    Department of Anesthesiology, Pharmacology and Intensive Care, University Hospital of Geneva, Rue Gabrielle-Perret-Gentil 4, -1211, Geneva, CH, Switzerland.
    Background: Acute pain and systemic opioids may both negatively impact respiratory function after cardiac surgery. This study analyzes the local practice of using intrathecal morphine analgesia (ITMA) with minimal parenteral opioid administration in cardiac surgery, specifically the impact on postoperative pulmonary complications (PPCs).

    Methods: Data from adult patients who underwent elective cardiac surgery between January 2002, and December 2013 in a single center were analyzed. Read More

    Finger tapping and verbal fluency post-tap test improvement in INPH: its value in differential diagnosis and shunt-treatment outcomes prognosis.
    Acta Neurochir (Wien) 2017 Aug 21. Epub 2017 Aug 21.
    Department of Neurosurgery, University of Athens, Evangelismos Hospital, EKNE Ploutarchou 3 str. Kolonaki, TK. 10675, Athens, Greece.
    Background: Idiopathic normal pressure hydrocephalus (INPH) diagnosis is challenging as it can be mimicked by other neurological conditions, such as neurodegenerative dementia and motor syndromes. Additionally, outcomes after lumbar puncture (LP) tap test and shunt treatment may vary due to the lack of a common protocol in INPH assessment. The present study aimed to assess whether a post-LP test amelioration of frontal cognitive dysfunctions, characterizing this syndrome, can differentiate INPH from similar neurological conditions and whether this improvement can predict INPH post-shunt outcomes. Read More

    Remote Cerebellar Hemorrhage Following Lumboperitoneal Shunt Insertion: A Rare Case Report.
    Surg J (N Y) 2016 Oct 1;2(4):e139-e142. Epub 2016 Dec 1.
    Clinic of Neurosurgery, Ministry of Health Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
    Idiopathic intracranial hypertension is characterized by high intracranial pressure without hydrocephalus or intracranial mass. Surgical treatment includes optic nerve fenestration and insertion of ventriculoperitoneal and lumboperitoneal (LP) shunts. For decreasing intracranial pressure, cerebrospinal fluid (CSF) LP shunt is widely used for the surgical management; it also carries complications such as shunt migration, venous sinus thrombosis, subarachnoid hemorrhage, and subdural and intracerebral hematoma. Read More

    Comparison Between Pendant Position and Traditional Sitting Position for Successful Spinal Puncture in Spinal Anesthesia for Cesarean Section.
    Anesth Pain Med 2017 Jun 21;7(3):e14300. Epub 2017 Jun 21.
    Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
    Background: Success of spinal anesthesia in pregnant females is strongly influenced by the position of the patient at the time of spinal insertion. Pendant position is a new position introduced to increase the intervertebral spaces. The current study aimed at comparing successful spinal puncture among the patients with pendant position in comparison with the ones with traditional sitting position for the elective caesarean section. Read More

    Spinal anesthesia for pediatric urological surgery: Reducing the theoretic neurotoxic effects of general anesthesia.
    J Pediatr Urol 2017 Jul 14. Epub 2017 Jul 14.
    Division of Pediatric Urology, Nationwide Children's Hospital, Columbus, OH 43205, USA; Department of Urology, The Ohio State University College of Medicine, Columbus, OH 43212, USA.
    Background: Spinal anesthesia (SA) is an effective technique that has been used in children for years. With growing concern with regard to the risks of general anesthesia (GA), we developed a SA program to provide an alternative option. We present our initial experience with this program. Read More

    [Construction and improvement of animal models with different positional osseous metastasis of prostate cancer in vivo].
    Beijing Da Xue Xue Bao 2017 Aug;49(4):590-596
    Department of Urology, the First People's Hospital of Yunnan Province, the Affiliated Hospital of Kunming University of Science and Technology, Kunming 650032, China.
    Objective: To provide an important tool for the study of diagnose and treatment of prostate cancer (PCa) osseous metastasis and change of bone stress force on prostate cancer (PCa) osseous metastasis and a platform, which is more congruous to clinical process, for prevention and cure of neoplastic bone metastases, and to carry out the construction and improvement of animal models of PCa with different positional osseous metastasis in vivo.

    Methods: Different gradient concentrations of RM-1 cells were inoculated into the cavity of left femoral bone or lumbar vertebra of mice (C57BL/6) respectively. The change of mouse activity, tumor formation, tumor size and survival time were observed respectively. Read More

    Evaluation of intrathecal routes of administration for adeno-associated virus vectors in large animals.
    Hum Gene Ther 2017 Aug 15. Epub 2017 Aug 15.
    University of Pennsylvania, Gene Therapy Program, Department of Medicine, Philadelphia, Pennsylvania, United States ;
    Delivery of adeno-associated virus (AAV) vectors into the cerebrospinal fluid (CSF) can achieve gene transfer to cells throughout the brain and spinal cord, potentially making many neurological diseases tractable gene therapy targets. Identifying the optimal route of CSF access for intrathecal AAV delivery will be a critical step in translating this approach to clinical practice. We previously demonstrated that vector injection into the cisterna magna is a safe and effective method for intrathecal AAV delivery in nonhuman primates; however, this procedure is not commonly used in clinical practice. Read More

    Comprehensive Evaluation of Diagnostic and Treatment Strategies for Idiopathic Spinal Subarachnoid Hemorrhage.
    J Stroke Cerebrovasc Dis 2017 Aug 9. Epub 2017 Aug 9.
    Department of Emergency Medicine, Hiroshima City Hospital, Hiroshima, Japan.
    Background: Idiopathic spinal subarachnoid hemorrhage (IS-SAH), defined as spinal SAH without apparent cause, is extremely rare. The objective of the present study was to establish a consensus on the diagnosis and management of IS-SAH.

    Methods: We enrolled 5 consecutive cases of IS-SAH at our institution, and we enrolled 19 previously published cases as a literature review. Read More

    Optic nerve sheath diameter sonography for the diagnosis of increased intracranial pressure: a systematic review and meta-analysis protocol.
    BMJ Open 2017 Aug 11;7(8):e016194. Epub 2017 Aug 11.
    Division of Neurosurgery, McMaster University, Hamilton, Ontario, Canada.
    Introduction: Increased intracranial pressure (ICP) is a significant neurological issue that may lead to permanent neurological sequelae. When evaluating patients with traumatic brain injury, it is crucial to identify those with high ICP in order to expedite ICP lowering measures and maintain adequate cerebral perfusion. Several measures are used to recognise patients with increased ICP including CT scan, MRI, ICP monitor, and lumbar puncture (LP). Read More

    Ulinastatin inhibited sepsis-induced spinal inflammation to alleviate peripheral neuromuscular dysfunction in an experimental rat model of neuromyopathy.
    J Neurochem 2017 Aug 10. Epub 2017 Aug 10.
    Department of Anesthesiology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
    Sepsis initiates a neuroinflammatory cascade that contributes to spinal cord inflammation and behavioral impairment, and Toll-like receptor 4 (TLR4) is an important mediator of this cascade. In this study, we tested the hypothesis that ulinastatin (ULI) inhibits sepsis-induced spinal inflammation to alleviate peripheral neuromuscular dysfunction through the TLR4/myeloid differentiation factor 88 (MyD88)/NF-κB signaling pathway. Muscular function, spinal cord water content, and cytokine levels of spinal cord were tested in TLR4-inhibited rats subjected to cecal ligation and puncture (CLP). Read More

    Does ultrasound guidance add accuracy to continuous caudal-epidural catheter placements in neonates and infants?
    Paediatr Anaesth 2017 Oct 10;27(10):1010-1014. Epub 2017 Aug 10.
    Children Anaesthesia Services & Surya Children Hospital, Santacruz (West), Mumbai, India.
    Background: Caudo-lumbar and caudo-thoracic epidural anesthesia is an established technique that carries a low risk of dural puncture or spinal cord trauma in infants. Traditionally catheter advancement is based on external measurements. However, malpositioning of catheters are known to occur. Read More

    Targeted epidural blood patch under O-arm-guided stereotactic navigation in patients with intracranial hypotension associated with a spinal CSF leak and ventral dural defect.
    World Neurosurg 2017 Aug 5. Epub 2017 Aug 5.
    Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
    Objective: Targeted epidural blood patch (EBP) at the site of a presumed cerebrospinal fluid leak reportedly has better outcomes than non-targeted EBP; however, it is associated with a higher risk of wrong-site injection such as iatrogenic subarachnoid or intramuscular injections, which lead to reintervention due to the insufficient coverage of injected blood.

    Methods: Eight patients with intracranial hypotension due to a CSF leak diagnosed by myelographic CT and thin-cut MRI received an epidural blood patch under O-arm-guided stereotactic navigation.

    Results: The leak site was identified based on myelographic CT findings of a micro-spur and epidural contrast medium extravasations as well as MRI findings of a ventral dural defect. Read More

    Is the Optic Nerve Head Structure Impacted by a Diagnostic Lumbar Puncture in Humans?
    J Glaucoma 2017 Aug 30. Epub 2017 Aug 30.
    *Pôle Vision Val d'Ouest Eye Clinic, Val d'Ouest Private Hospital, Ecully †Department of Ophthalmology, Lyon Sud University Hospital ‡Department of Ophthalmology, Croix-Rousse University Hospital §Centre Ophtalmologique Kleber, Lyon ∥Epidemiology and Infection Control Department ¶Department of Ophthalmology, Dijon University Hospital #Eye and Nutrition Research Group, CSGA, UMR 1324 INRA, 6265 CNRS, Burgundy University, Dijon, France.
    Purpose: The purpose of this study is to assess in vivo whether diagnostic lumbar puncture (LP) is followed by optic nerve head (ONH) and parapapillary anatomic changes in normal human eyes.

    Materials And Methods: Prospective, single-center, observational case series. ONH structures (prelaminar tissue surface, anterior surface of the lamina cribrosa, central retinal vessels) and parapapillary structures (internal limiting membrane, posterior surfaces of retinal nerve fiber layer and Bruch membrane/retinal pigment epithelium complex, Bruch membrane opening, posterior surface of the choroid) were quantitatively evaluated by means of swept-source optical coherence tomography (Triton Ver. Read More

    Lumbar puncture as possible cause of sudden paradoxical herniation in patient with previous decompressive craniectomy: report of two cases.
    BMC Neurol 2017 Aug 2;17(1):147. Epub 2017 Aug 2.
    Department of Neurosurgery, Huzhou Central Hospital, 198 Hongqi Road, Huzhou, Zhejiang, 313000, China.
    Background: Lumbar puncture is often used for the diagnosis and treatment of subarchnoid hemorrhage, infection of Cerebro-spinal Fluid (CSF), hydrocephalus in neurosurgery department patients. It is general that paradoxical herniation followed by lumbar puncture is quite rare in decompressive craniectomy cases; the related reports are very few. Moreover, most of the paradoxical herniation cases are chronic, which often occur weeks or even months after the lumbar puncture, to date, barely no reports on the acute onset paradoxical herniation have been found. Read More

    Feasibility and Complications of Spinal Anaesthesia in Percutaneous Nephrolithotomy: Our Experience.
    J Clin Diagn Res 2017 Jun 1;11(6):UC08-UC11. Epub 2017 Jun 1.
    Consultant, Department of Anaesthesiology, Vinayaka Hospital, Jodhpur, Rajasthan, India.
    Introduction: Percutaneous Nephrolithotomy (PCNL) is the treatment modality used for the extraction of large renal stones, or multiple calculi or stones resistant to shock wave lithotripsy. The General Anaesthesia (GA) is the standard modality for PCNL. However, few studies conclude that Spinal Anaesthesia (SA) can be an alternative method of anaesthesia with similar incidence of complications. Read More

    EAN consensus review on prevention, diagnosis and management of tick-borne encephalitis.
    Eur J Neurol 2017 Oct 1;24(10):1214-e61. Epub 2017 Aug 1.
    Department of Neurology, Rabin Medical Center, Petach Tikva, Israel.
    Background And Purpose: Tick-borne encephalitis (TBE) is an infection of the central nervous system (CNS) caused by tick-borne encephalitis virus (TBEV) and transmitted by ticks, with a variety of clinical manifestations. The incidence of TBE in Europe is increasing due to an extended season of the infection and the enlargement of endemic areas. Our objectives are to provide recommendations on the prevention, diagnosis and management of TBE, based on evidence or consensus decisions. Read More

    A Comparison of the Incidence of Post-Dural Puncture Headache and Backache After Spinal Anesthesia: A Pragmatic Randomized Controlled Trial.
    Worldviews Evid Based Nurs 2017 Jul 29. Epub 2017 Jul 29.
    Assistant Professor, College of Nursing, Seoul National University, Seoul, South Korea.
    Background: Although bed rest is recommended after spinal anesthesia to prevent the occurrence of post-dural puncture headache, current literature suggests that periods of bed rest did not prevent headache as well as increase the risk of other complications such as backache. However, information is scarce regarding an appropriate period of bed rest following a dural puncture.

    Aim: The aim of this study was to compare the incidence of post-dural puncture headache and backache after different periods of bed rest following spinal anesthesia. Read More

    A new method of subarachnoid puncture for clinical diagnosis and treatment: lateral atlanto-occipital space puncture.
    J Neurosurg 2017 Jul 28:1-7. Epub 2017 Jul 28.
    Department of Neurology, Liaocheng People's Hospital, Liaocheng, Shandong, China.
    OBJECTIVE Lumbar puncture may not be suitable for some patients needing subarachnoid puncture, while lateral C1-2 puncture and cisterna magna puncture have safety concerns. This study investigated lateral atlanto-occipital space puncture (also called lateral cisterna magna puncture) in patients who needed subarachnoid puncture for clinical diagnosis or treatment. The purpose of the study was to provide information on the complications and feasibility of this technique and its potential advantages over traditional subarachnoid puncture techniques. Read More

    An [(18)F]-Positron-Emitting, Fluorescent, Cerebrospinal Fluid Probe for Imaging Damage to the Brain and Spine.
    Theranostics 2017 15;7(9):2377-2391. Epub 2017 Jun 15.
    Department of Radiology, Molecular Imaging Innovations Institute (MI3), Weill Cornell Medical College, New York, NY 10065, USA.
    Fluorescein is modified to bear (18)F so that it can act as both a positron emitter, and a fluorophore, allowing detection by positron emission tomography (PET), scintillation, and fluorescent imaging (FL). [(18)F]-2 is injected into the intrathecal space of rats and used to observe the cerebrospinal fluid (CSF) that bathes the brain and spine. Injury in three different applications is visualized with [(18)F]-2: 1) detection of a 0. Read More

    Effect of Head and Neck Immobilization on Postspinal Headache: A Randomized Controlled Trial.
    J Perianesth Nurs 2017 Aug 22;32(4):302-311. Epub 2016 Oct 22.
    Purpose: The purpose of the study was to determine the effect of head and neck immobilization on postdural puncture headache (PDPH) through the use of cervical collars.

    Design: This was a fully randomized controlled trial.

    Method: The sample group of the study consisted of 120 patients. Read More

    Unusual increase of cases of myelitis in a pediatric hospital in Argentina.
    Arch Argent Pediatr 2017 Aug;115(4):364-369
    Servicio de Control Epidemiológico e Infectología. Hospital de Pediatría "Prof. Dr. Juan P. Garrahan".
    Introduction: The association between enterovirus D68 and acute flaccid myelitis was first described in the United States in 2014. Since then, sporadic cases have been reported in Canada and Europe. This study describes a series of cases of acute flaccid myelitis at Hospital de Pediatría "Prof. Read More

    [Fever and Headache after a Vacation in Thailand].
    Dtsch Med Wochenschr 2017 Jul 20;142(14):1063-1066. Epub 2017 Jul 20.
    History 50 year-old man with fever and headache starting one week after returning from his vacation in Thailand. His general practitioner prescribed amoxicillin/clavulanic acid, without further analyses to pinpoint the infection. Examinations The examination of cerebro-spinal fluid was crucial for the final diagnosis. Read More

    Space Flight-Associated Neuro-ocular Syndrome.
    JAMA Ophthalmol 2017 Sep;135(9):992-994
    Space Flight-Associated Neuro-ocular Syndrome (SANS) Clinical Lead, Clinical Services, NASA Johnson Space Center, Houston, Texas.
    New and unique physiologic and pathologic systemic and neuro-ocular responses have been documented in astronauts during and after long-duration space flight. Although the precise cause remains unknown, space flight-associated neuro-ocular syndrome (SANS) has been adopted as an appropriate descriptive term. The Space Medicine Operations Division of the US National Aeronautics and Space Administration (NASA) has documented the variable occurrence of SANS in astronauts returning from long-duration space flight on the International Space Station. Read More

    Performing easy prone punction.
    Cent European J Urol 2017 Jun 7;70(2):170-174. Epub 2017 Jun 7.
    Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
    Introduction: Percutaneous renal surgery has been considered one of the most important advances in urology. There are several possibilities to perform a kidney puncture such as using fluoroscopy, ultrasound or both. The aim of this article is to describe our puncture technique. Read More

    Haemodynamic Preservation In Caesarean Sections By Low Dose 0.5% Hyperbaric Bupivacaine.
    J Ayub Med Coll Abbottabad 2017 Apr-Jun;29(2):211-214
    PNS Rahat, Karachi, Pakistan.
    Background: Spinal anaesthesia is technique of choice for caesarean sections and hyperbaric bupivacaine is a recommended drug for this popular block. Although safe but few complications are haemodynamic changes, postdural puncture headache, cauda equina syndrome and radiculopathy. However, hypotension remains the common side effect which is believed to occur in 95% of patients resulting in reduction of uteroplacental perfusion causing foetal acid-base abnormalities. Read More

    A rare case of intradural and extramedullary epidermoid cyst after repetitive epidural anesthesia: case report and review of the literature.
    World J Surg Oncol 2017 Jul 17;15(1):131. Epub 2017 Jul 17.
    Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare Mita Hospital, Minato, Japan.
    Background: Spinal epidermoid cysts are benign tumors, which are rarely seen as an intradural extramedullary spinal cord tumor in the conus medullaris region. Acquired spinal epidermoid cysts are mostly caused by iatrogenic procedures, such as lumbar puncture, and the majority of acquired spinal epidermoid cysts have been reported below the L1 level, because lumbar puncture is usually performed around the iliac crest. Here, we report an extremely rare case of an epidermoid cyst that occurred as an intradural and extramedullary spinal cord tumor attached to the conus medullaris after repetitive epidural anesthesia. Read More

    Intradural Intramedullary Teratoma Presenting in the Lumbar Spine: Report of a Rare Case.
    World Neurosurg 2017 Jul 11. Epub 2017 Jul 11.
    Arak University of Medical Sciences, Arak, Iran.
    Background: Intradural teratomas are an exceedingly unusual phenomenon. They are tumors with the cellular constituent source of all the 3 germ cell layers.

    Case Description: We here report a case of an 18-year-old man with special pathologic features. Read More

    Endoscopic third ventriculostomy and repeat endoscopic third ventriculostomy in pediatric patients: the Dutch experience.
    J Neurosurg Pediatr 2017 Jul 14:1-10. Epub 2017 Jul 14.
    Department of Neurosurgery, University Medical Center Groningen.
    OBJECTIVE After endoscopic third ventriculostomy (ETV), some patients develop recurrent symptoms of hydrocephalus. The optimal treatment for these patients is not clear: repeat ETV (re-ETV) or CSF shunting. The goals of the study were to assess the effectiveness of re-ETV relative to initial ETV in pediatric patients and validate the ETV success score (ETVSS) for re-ETV. Read More

    Analgesic Properties of Opioid/NK1 Multitarget Ligands with Distinct in Vitro Profiles in Naive and Chronic Constriction Injury Mice.
    ACS Chem Neurosci 2017 Jul 26. Epub 2017 Jul 26.
    Institute of Pharmacology, Polish Academy of Sciences, Department of Pain Pharmacology , 31-343 Krakow, Poland.
    The lower efficacy of opioids in neuropathic pain may be due to the increased activity of pronociceptive systems such as substance P. We present evidence to support this hypothesis in this work from the spinal cord in a neuropathic pain model in mice. Biochemical analysis confirmed the elevated mRNA and protein level of pronociceptive substance P, the major endogenous ligand of the neurokinin-1 (NK1) receptor, in the lumbar spinal cord of chronic constriction injury (CCI)-mice. Read More

    Utility of Lumbar Puncture in Children Presenting With Status Epilepticus.
    Pediatr Emerg Care 2017 Aug;33(8):544-547
    From the Division of Emergency Medicine, Boston Children's Hospital Boston, MA.
    Objectives: Because meningitis may trigger seizures, we sought to determine its frequency in children with first-time status epilepticus (SE).

    Methods: We performed a retrospective cross-sectional study of children aged 1 month to 21 years who presented to a single pediatric emergency department between 1995 and 2012 with SE and who had a lumbar puncture (LP) performed as part of the diagnostic evaluation. We defined bacterial meningitis as a cerebrospinal fluid (CSF) culture positive for a bacterial pathogen or CSF pleocytosis (CSF white blood cells ≥10 cells/mm) with a blood culture positive for a bacterial pathogen. Read More

    Post-Dural Puncture Headache is Uncommon in Young Ambulatory Surgery Patients.
    HSS J 2017 Jul 16;13(2):146-151. Epub 2017 Mar 16.
    Department of Anesthesiology, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
    Background: The incidence of post-dural puncture headache (PDPH) arising from spinal anesthesia in the general population is low. However, patients under 45 years have been shown to exhibit a higher incidence of PDPH, even with small needles.

    Questions/purposes: This study aimed to estimate the incidence of PDPH from a 27G pencil-point needle in ambulatory surgery patients between the ages of 15-45 years and compare incidence of PDPH by age group, sex, and history of headache. Read More

    Intrathecal hematoma and arachnoiditis mimicking bacterial meningitis after an epidural blood patch.
    Int J Obstet Anesth 2017 Jun 1. Epub 2017 Jun 1.
    Hôpital Cochin, 27, rue du Faubourg Saint Jacques, 75014 Paris, France.
    We present a case of arachnoiditis and an intrathecal hematoma after an epidural blood patch. A 24-year-old parturient underwent an epidural blood patch three days after an accidental dural puncture during epidural labor analgesia. Four days later, the patient developed severe lower back pain, bilateral leg pain, persistent headache and fever. Read More

    What's new in clinical obstetric anesthesia in 2015?
    Int J Obstet Anesth 2017 Mar 18. Epub 2017 Mar 18.
    Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA. Electronic address:
    Each calendar year the Society for Obstetric Anesthesia and Perinatology invites an individual to conduct a review of the medical literature, identifying clinically relevant publications of interest to the obstetric anesthesia provider. This report of that effort covers the publications from 2015 and includes the categories of anesthesia and analgesia, complications of neuraxial procedures, and the effects of anesthesia on the fetus. Neuraxial procedures represent the foundation of obstetric anesthesia; advances in anesthesia and analgesia include novel modes of administration, and refinements in care of the medically complex patient. Read More

    Initial Experience with the Transapical Access for TEVAR.
    Rofo 2017 Aug 6;189(8):760-764. Epub 2017 Jul 6.
    Cardiac Surgery, Philipps-University Marburg, Germany.
    Background The endovascular approach has become a mainstay in the treatment of aortic aneurysms. While the transfemoral approach is most commonly used, it is often inaccessible due to a vascular pathology, such as occlusion, tortuosity or heavy calcifications. The transapical access provides an alternative approach. Read More

    Insertion of an intrathecal catheter in parturients reduces the risk of post-dural puncture headache: A retrospective study and meta-analysis.
    PLoS One 2017 5;12(7):e0180504. Epub 2017 Jul 5.
    Department of Cardiothoracic Surgery, First Hospital of Jiaxing, School of Medicine, Jiaxing University, Jiaxing, Zhejiang, China.
    This study aimed to determine whether insertion of an intrathecal catheter following accidental dural puncture (ADP) in obstetric patients can reduce the incidence of post-dural puncture headache (PDPH) and the requirement of a therapeutic epidural blood patch (TEBP). This was also compared with relocating the epidural catheter at a different vertebral interspace. A retrospective study was performed, as well as a meta-analysis of the literature to further validate our findings. Read More

    The Postdural Puncture Headache and Back Pain: The Comparison of 26-gauge Atraucan and 26-gauge Quincke Spinal Needles in Obstetric Patients.
    Anesth Essays Res 2017 Apr-Jun;11(2):458-462
    Department of Anaesthesiolgy, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
    Background: The postdural puncture headache (PDPH) and postdural puncture backache (PDPB) are well-known complications of spinal anesthesia. There are some attempts to reduce the frequency of complication such as different design of the spinal needles.

    Aims: The primary outcome of this study is to compare the incidence of PDPH between 26-gauge Atraucan and 26-gauge Quincke spinal needles in elective cesarean operations. Read More

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