13,691 results match your criteria Lumbar Puncture


Parechovirus infection causing sepsis-like illness in newborns: a NICU approach.

New Microbiol 2020 Jun 13;43(3). Epub 2020 Jun 13.

Neonatal Intensive Care Unit, St. Orsola-Malpighi Hospital, University of Bologna, Italy.

Human parechovirus (HpeV) is an important emerging infection in young infants, able to cause sepsis-like disease and meningoencephalitis, especially in newborns. Among the 19 identified genotypes, HPeV1, 3 and 6 are the most common types involved in human infections; HPeV3 is the type mainly responsible for neonatal infections and for infections involving the central nervous system. Signs and symptoms overlap with those of a bacterial infection and patients are usually treated with broad spectrum antibiotics. Read More

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Procedure Training Workshop for Internal Medicine Residents that Emphasizes Procedural Ultrasound: Logistics and Teaching Materials.

MedEdPORTAL 2020 May 15;16:10897. Epub 2020 May 15.

Associate Professor, Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington.

Introduction: Early formal instruction in procedural skills may increase the frequency with which residents perform procedures in the clinical setting. This workshop trained internal medicine residents in ultrasound skills and manual skills required to perform procedures common on medicine wards and required for board eligibility.

Methods: Since 2016, our internal medicine residency program has executed three annual half-day workshops for interns during orientation, before clinical duties began. Read More

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http://dx.doi.org/10.15766/mep_2374-8265.10897DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7331964PMC

Meningoencephalitis and Cerebral Abscess in a Heart Transplant Recipient.

Authors:
Paul C Adjei

Case Rep Infect Dis 2020 21;2020:8498216. Epub 2020 Jun 21.

Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Tufts University School of Medicine Clinical and Translational Science Institute, Boston, MA, USA.

A 54-year-old male, five months postorthotopic heart transplantation, presented with intermittent fevers, headaches, and "soupy" stools. Prior to presentation, he had low-level cytomegalovirus (CMV) viremia for two straight weeks. Given his immunosuppression, diarrhea, and low-level CMV viremia, he was presumed to have cytomegalovirus and/or colitis and treated empirically for both on hospital day one. Read More

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http://dx.doi.org/10.1155/2020/8498216DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327578PMC

Cerebrospinal Fluid Hypovolemia and Posterior Reversible Encephalopathy Syndrome.

Front Neurol 2020 23;11:591. Epub 2020 Jun 23.

Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.

Posterior reversible encephalopathy syndrome (PRES) is a reversible neuroradiological syndrome characterized by reversible vasogenic edema. The pathophysiological mechanism is still unclear, but PRES may be triggered by various etiologies. To date, only a few PRES cases linked to cerebrospinal fluid (CSF) hypovolemia were reported. Read More

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http://dx.doi.org/10.3389/fneur.2020.00591DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7324723PMC

Coexistence of idiopathic intracranial hypertension and optic disc drusen in a latin american patient: case report.

Arch Soc Esp Oftalmol 2020 Jul 8. Epub 2020 Jul 8.

Departamento de salud pública, Universidad de Caldas, Manizales, Colombia.

Optic nerve drusen are acellular concretions of calcium located in the parenchyma of the optic nerve head described as the most common cause of pseudo-papilloedema, which makes it difficult to differentiate from a true optical disc oedema. Despite it being rare optic nerve drusen and the papilloedema secondary to idiopathic intracranial hypertension can coexist in the same patient. We present a case of a 34-year-old woman referred to the Ophthalmology Department with visual discomfort, headaches, and pulsatile tinnitus of two months onset. Read More

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http://dx.doi.org/10.1016/j.oftal.2020.06.017DOI Listing

Post dural puncture headache evolving to a subdural hematoma: A case report.

Pain Pract 2020 Jul 11. Epub 2020 Jul 11.

Department of Anesthesiology, Emergency Medicine and Multidisciplinary Pain Center, Ziekenhuis Oost-Limburg, Genk, Belgium.

Introduction: Cervical epidural corticosteroid injections are frequently used for the treatment of subacute cervicobrachial pain. This therapy isconsidered safe with the vast majority of the complications being minor and transient.

Case Report: We present a case of a woman in her fifties who suffered from cervicobrachialgia and received 2 cervical epidural corticosteroid infiltrations. Read More

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http://dx.doi.org/10.1111/papr.12937DOI Listing

Excluding subarachnoid haemorrhage within 24 hours: to LP or not to LP?

Br J Neurosurg 2020 Jul 10:1-6. Epub 2020 Jul 10.

Nottingham University Hospitals NHS Trust, City Campus, Nottingham, UK.

Subarachnoid haemorrhage (SAH) is a potentially life-threatening cause of acute headache. Current conventional practice in the United Kingdom (UK) is for head computed tomography (CT) followed by cerebrospinal fluid (CSF) xanthochromia analysis if the head CT is normal. However, with increasing radiological accuracy, head CT alone may be sufficient to exclude SAH without requiring CSF xanthochromia for confirmation. Read More

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http://dx.doi.org/10.1080/02688697.2020.1781055DOI Listing

Development of an App to Facilitate Communication and Shared Decision-Making with Parents of Febrile Infants ≤60 Days Old.

Acad Emerg Med 2020 Jul 9. Epub 2020 Jul 9.

Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.

Objectives: We aimed to develop and test a tool to engage parents of febrile infants ≤60 days of age evaluated in the emergency department (ED). The tool was designed to improve communication for all parents and to support shared decision-making (SDM) about whether to perform a lumbar puncture (LP) for infants 29 to 60 days of age.

Methods: We conducted a multi-phase development and testing process: 1) individual, semi-structured interviews with parents and clinicians (pediatric and general emergency medicine (EM) physicians, and pediatric EM nurses) to learn their preferences for a communication and SDM tool; 2) design of a "storyboard" of the tool with design impression testing; 3) development of a software application (i. Read More

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http://dx.doi.org/10.1111/acem.14082DOI Listing

Measurement of Choroid Thickness Using Optical Coherence Tomography to Monitor Intracranial Pressure in an Idiopathic Cranial Hypertension Model.

Neurol India 2020 May-Jun;68(3):636-639

Department of Neurosurgery, Memorial Sisli Hospital, Istanbul, Turkey.

Background: Idiopathic intracranial hypertension (IIH) is a condition with increased intracranial pressure (ICP) without mass lesion or a known etiology with normal cerebrospinal fluid (CSF) composition. With optical coherence tomography (OCT), which is a noninvasive imaging technique, cross-sectional scans of the retina, choroid, and optic nerve head can be obtained with a resolution that is close to histological resolution.

Aim: The study aimed to evaluate the efficacy of OCT in providing practical and sensitive measurements to follow-up patients with IIH. Read More

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http://dx.doi.org/10.4103/0028-3886.288980DOI Listing

A case of herpes simplex 2 encephalitis with an unusual radiographic manifestation.

IDCases 2020 22;21:e00884. Epub 2020 Jun 22.

Department of Medicine, St. Elizabeth's Medical Center, Boston, MA, USA.

Herpes Simplex Virus (HSV) continues to be an important pathogen inflicting encephalitis in adults and children globally that entails high morbidity and mortality. Prompt diagnosis and treatment are the keys to minimize potential sequelae of the disease. Although HSV encephalitis-1(HSVE-1) is well recognized for its radiographic manifestation of temporal lobe involvement owing to its pathogenesis, radiographic features of HSVE-2 are less uniform. Read More

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http://dx.doi.org/10.1016/j.idcr.2020.e00884DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7334455PMC

Stress and Perception of Procedural Pain Management in Chinese Parents of Children with Cancer.

J Pain Symptom Manage 2020 Jul 5. Epub 2020 Jul 5.

The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR. Electronic address:

Objectives: Children with cancer are exposed to repeated painful and invasive procedures. This study examines Chinese parents' stress and perception towards their children's procedural pain-control.

Methods: We recruited 265 parents of children (aged <18 years) diagnosed with hematological cancer (74. Read More

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http://dx.doi.org/10.1016/j.jpainsymman.2020.06.028DOI Listing

Phase 1-2 Trial of Antisense Oligonucleotide Tofersen for ALS.

N Engl J Med 2020 07;383(2):109-119

From the Washington University School of Medicine, St. Louis (T.M., R.C.B., A.P.); the Healey Center for ALS, Massachusetts General Hospital, Harvard Medical School, Boston (M.C., N.A.), and Biogen, Cambridge (A.S., H.R., D.G., H.H., A.M., I.N., I.C., L.F., S.F., T.A.F.) - both in Massachusetts; the Sheffield Institute for Translational Neuroscience, University of Sheffield, and NIHR Sheffield Biomedical Research Centre and Clinical Research Facility, University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield (P.J.S., C.J.M.), and Biogen, Maidenhead (M.M.) - both in the United Kingdom; the Department of Clinical Science, Neurosciences, Umeå University, Umea, Sweden (P.M.A.); Montreal Neurological Institute and Hospital, Montreal (A.G.), and Sunnybrook Research Institute, Toronto (L.Z.); Emory University, Atlanta (J.G.); Barrow Neurological Institute, Phoenix, AZ (S.L.); the University of Ulm, Ulm, Germany (A.L.L.); Johns Hopkins University School of Medicine, Baltimore (N.J.M.); the University of California San Diego, La Jolla (J.R.), and Ionis Pharmaceuticals, Carlsbad (C.F.B., R.L.) - both in California; Paris ALS Centre, Hôpital de la Salpêtrière, Paris (F.S.); the University of Tennessee Medical Center, Knoxville (R.T.); and KU Leuven, VIB Center for Brain and Disease Research, University Hospitals Leuven, Leuven, Belgium (P.V.D.).

Background: Tofersen is an antisense oligonucleotide that mediates the degradation of superoxide dismutase 1 (SOD1) messenger RNA to reduce SOD1 protein synthesis. Intrathecal administration of tofersen is being studied for the treatment of amyotrophic lateral sclerosis (ALS) due to mutations.

Methods: We conducted a phase 1-2 ascending-dose trial evaluating tofersen in adults with ALS due to mutations. Read More

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http://dx.doi.org/10.1056/NEJMoa2003715DOI Listing

Body Mass Index Correlates with Skin to Spinal Canal Distance: A Large Retrospective Single-Center Study.

J Neuroimaging 2020 Jul 8. Epub 2020 Jul 8.

Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY.

Background And Purpose: Despite increasing demand for fluoroscopy-guided lumbar puncture (FG-LP), there is limited quantitative and epidemiological data on patients undergoing this procedure. Additionally, data are scarce on the correlation of iliac crest landmarks to the actual anatomical lumbar level (intercristal line). The aim of this study is to determine if (1) body mass index (BMI) correlates with skin to spinal canal distance (SCD) and (2) the iliac crest landmark correlates with the presumed anatomical landmark on cross-sectional imaging. Read More

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http://dx.doi.org/10.1111/jon.12760DOI Listing

Report of intradural aneurysm in the cavernous segment of the internal carotid artery presented with subarachnoid hemorrhage and oculomotor palsy.

Surg Neurol Int 2020 13;11:149. Epub 2020 Jun 13.

Department of Neurosurgery, Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil.

Background: Aneurysms of the cavernous segment of the internal carotid artery (ICA) do not usually cause subarachnoid hemorrhage (SAH). We report a patient who presented with this condition due to a ruptured aneurysm located on the posterior genu of the cavernous segment, raising the question of what factors could have led to such evolution.

Case Description: A 55-year-old male patient presented with sudden, intense thunderstorm headache, associated with complete palsy of the left oculomotor nerve and neck stiffness. Read More

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http://dx.doi.org/10.25259/SNI_105_2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7332490PMC

Acquired Chiari malformation following spinal cord injury-a case series.

Spinal Cord Ser Cases 2019 Jul 9;5(1):65. Epub 2019 Jul 9.

Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK.

Introduction: Chiari malformation is characterized by caudal descent of the cerebellar tonsils through the foramen magnum. Acquired Chiari malformations (ACM) have previously been described after a variety of pathologies including lumbar puncture, cerebrospinal fluid (CSF) drainage, lumboperitoneal shunts, and conditions causing craniocephalic disproportion.

Case Presentation: We present four cases of ACM following spinal cord injury (SCI), which has not previously been described in the literature. Read More

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http://dx.doi.org/10.1038/s41394-019-0211-yDOI Listing

Paraplegia Caused by Spontaneous Spinal Hemorrhage in a Patient Undergoing Rivaroxaban Therapy.

Am J Case Rep 2020 Jul 7;21:e923607. Epub 2020 Jul 7.

Department of Nephrology, Transplantology and Internal Medicine, Independent Public Clinical Hospital No. 2, Szczecin, Poland.

BACKGROUND Spinal hematomas can be post-traumatic, iatrogenic, or spontaneous. A spontaneous spinal hematoma is a rare finding, but one with very serious clinical implications. There are some risk factors linked to its occurrence, e. Read More

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http://dx.doi.org/10.12659/AJCR.923607DOI Listing

Environmental exposure to phthalates and dementia with Lewy bodies: contribution of metabolomics.

J Neurol Neurosurg Psychiatry 2020 Jul 7. Epub 2020 Jul 7.

Institut de Biologie Moléculaire des Plantes, Plant Imaging and Mass Spectrometry (PIMS), CNRS, University of Strasbourg, Strasbourg, France.

Background: In neurodegenerative diseases, alongside genetic factors, the possible intervention of environmental factors in the pathogenesis is increasingly being considered. In particular, recent evidence suggests the intervention of a pesticide-like xenobiotic in the initiation of disease with Lewy bodies (DLB).

Objectives: To test for the presence of pesticides or other xenobiotics in the cerebrospinal fluid (CSF) of patients with DLB. Read More

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http://dx.doi.org/10.1136/jnnp-2020-322815DOI Listing

Tackling cryptococcal meningitis in Nigeria, one-step at a time; the impact of training.

PLoS One 2020 6;15(7):e0235577. Epub 2020 Jul 6.

Mycotic Diseases Branch, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.

Background: Nigeria is estimated to have 25,000 cases of cryptococcal antigenemia (CrAg) annually. CrAg screening with pre-emptive fluconazole treatment is recommended but not yet implemented in Nigeria. Trainings were conducted to improve health-care provider (HCP) awareness and clinical skills in the management and prevention of cryptococcal meningitis (CM). Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235577PLOS

Cerebrospinal Fluid Leaks and Pseudomeningocele after Posterior Fossa Surgery: Effect of an Autospray Dural Sealant.

Cureus 2020 May 31;12(5):e8379. Epub 2020 May 31.

Neurological Surgery, University of California, San Francisco, USA.

Background Posterior fossa craniotomies can be complicated by cerebrospinal fluid (CSF) leaks, infection, meningitis, neurologic deficits, and intracranial hypotension caused by defective closure of the dura. Secondary dural closures such as pericranial graft, muscle graft, glue, sealants, or fat graft are used. However, there have been few studies examining the use of sealants with a polyethylene glycol and polyethylenimine component. Read More

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http://dx.doi.org/10.7759/cureus.8379DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328695PMC

A Case of Reversible Cerebral Vasoconstriction Syndrome in a Healthy Adult Male.

Cureus 2020 May 31;12(5):e8374. Epub 2020 May 31.

Emergency Medicine, Queen Elizabeth II Health Science Center, Halifax, CAN.

Reversible cerebral vasoconstriction syndrome (RCVS) represents a potentially under-recognized cause of thunderclap headache in patients presenting to the ED. While a rarely made diagnosis in emergency medicine practice, RCVS may be as common as subarachnoid hemorrhage (SAH). RCVS typically presents as a sudden onset, excruciating headache that may be associated with nausea, vomiting, photophobia, or other features with overlap in the clinical presentation of both SAH and migraine headaches. Read More

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http://dx.doi.org/10.7759/cureus.8374DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328700PMC

Endothelial Activation, Acute Kidney Injury, and Cognitive Impairment in Pediatric Severe Malaria.

Crit Care Med 2020 Jun 30. Epub 2020 Jun 30.

1Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda. 2Department of Epidemiology and Biostatistics, College of Health Sciences, Makerere University, Kampala, Uganda. 3Department of Pediatrics, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine, Indianapolis, IN. 4Department of Pediatrics, University of Minnesota, Minneapolis, MN. 5Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda. 6Nuffield Department of Medicine, Centre of Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom. 7Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda. 8Department of Medicine, University of Toronto and University Health Network, Toronto, ON, Canada.

Objectives: Evaluate the relationship between endothelial activation, malaria complications, and long-term cognitive outcomes in severe malaria survivors.

Design: Prospectively cohort study of children with cerebral malaria, severe malarial anemia, or community children.

Setting: Mulago National Referral Hospital in Kampala, Uganda. Read More

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http://dx.doi.org/10.1097/CCM.0000000000004469DOI Listing

Evaluation of low cryptococcal antigen titer as determined by the lateral flow assay in serum and cerebrospinal fluid among HIV-negative patients: a retrospective diagnostic accuracy study.

IMA Fungus 2020 10;11. Epub 2020 Mar 10.

Department of Infectious Diseases, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Central Urumqi Road, Shanghai, 200040 China.

Cryptococcosis is one of the most common opportunistic infections in both immunocompetent and immunocompromised hosts. Although the cryptococcal antigen (CrAg) lateral flow assay (LFA) has been widely used in clinical settings due to its high sensitivity and specificity, the diagnostic value of a low CrAg LFA titers remains unclear. In this study, we performed a retrospective analysis of 149 HIV-negative patients with low CrAg LFA titers (≤1:10) in a Chinese tertiary hospital from January 2013 to December 2017, to evaluate the diagnostic value of low CrAg LFA titers in serum and cerebrospinal fluid (CSF) at different thresholds. Read More

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http://dx.doi.org/10.1186/s43008-020-00028-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325107PMC

Modified paramedian versus conventional paramedian technique in the residency training: an observational study.

BMC Med Educ 2020 Jul 2;20(1):211. Epub 2020 Jul 2.

Biotechology R&D Center, National Taiwan University Hospital Hsin-Chu, Hsin-Chu, Taiwan.

Background: Residency training includes positive and negative aspects. Well-trained doctors must be educated, but the process may bring additional risks to patients. Anesthesiologists' performance when conducting neuraxial anesthesia is related to their experience. Read More

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http://dx.doi.org/10.1186/s12909-020-02118-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330994PMC

Optimization of a rat lumbar IVD degeneration model for low back pain.

JOR Spine 2020 Jun 22;3(2):e1092. Epub 2020 Jun 22.

Orthopaedic Stem Cell Research Laboratory Cedars-Sinai Medical Center Los Angeles California USA.

Introduction: Intervertebral disc (IVD) degeneration is often associated with low back pain and radiating leg pain. The purpose of this study is to develop a reproducible and standardized preclinical model of painful lumbar IVD degeneration by evaluation of structural and behavioral changes in response to IVD injury with increasing needle sizes. This model can be used to develop new therapies for IVD degeneration. Read More

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http://dx.doi.org/10.1002/jsp2.1092DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323460PMC

Increased Noradrenaline as an Additional Cerebrospinal Fluid Biomarker in PSP-Like Parkinsonism.

Front Aging Neurosci 2020 16;12:126. Epub 2020 Jun 16.

Department of Experimental Medicine and Surgery, Faculty of Medicine and Surgery, University Tor Vergata, Rome, Italy.

Academic centers utilize sequential clinical and neuroimaging assessments, including morphometric ratios, to obtain an unequivocal diagnosis of the non-synucleinopathic forms of Parkinsonism, such as progressive supranuclear palsy (PSP), however, a 1-2 year follow-up is required. The on-going long-lasting trials using anti-tau antibodies for PSP patients might therefore be biased by the incorrect enrollment of Parkinson's disease (PD) patients manifesting early axial signs. This perspective study aimed at achieving two major goals: first, to summarize the established biomarker candidates found in cerebrospinal fluid (CSF) in probable PSP patients, including low p-tau and altered neurofilaments. Read More

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http://dx.doi.org/10.3389/fnagi.2020.00126DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308889PMC

Quality of life, need for retreatment, and the re-equilibration phenomenon after venous sinus stenting for idiopathic intracranial hypertension.

J Neurointerv Surg 2020 Jul 1. Epub 2020 Jul 1.

Neurological Surgery, Wake Forest University, Winston-Salem, North Carolina, United States

Background: Long term failure rates after venous sinus stenting (VSS) for idiopathic intracranial hypertension (IIH) are poorly understood.

Methods: Retrospective analysis was performed on a prospectively-maintained single center database to identify patients with medically refractory IIH who underwent VSS. Patients with persistent or severe recurrent symptoms after VSS undergo lumbar puncture (LP), therefore LP serves as a marker for treatment failure. Read More

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http://dx.doi.org/10.1136/neurintsurg-2020-016124DOI Listing

Bilateral thalamic lesions in a patient with probable acute disseminating encephalomyelitis: a case report.

BMC Neurol 2020 Jul 1;20(1):265. Epub 2020 Jul 1.

Department of Neurology, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China.

Background: Bilateral thalamic lesions are rare. Here, we describe a case of probable acute disseminating encephalomyelitis (ADEM) with symmetrical bilateral thalamic lesions.

Case Presentation: An 85-year-old man presented with weakness of the lower limbs and urinary retention for 1 day, soon followed by coma. Read More

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http://dx.doi.org/10.1186/s12883-020-01834-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7328267PMC

Community memory screening as a strategy for recruiting older adults into Alzheimer's disease research.

Alzheimers Res Ther 2020 Jun 30;12(1):78. Epub 2020 Jun 30.

Department of Neurosciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0948, USA.

Background: Growing awareness of Alzheimer's disease (AD) has prompted a demand for quick and effective ways to screen for memory loss and cognitive decline in large numbers of individuals in the community. Periodic Memory Screening Day events provide free, brief cognitive screening aimed at those 65 years and older, and can serve as an opportunity to gauge participants' attitudes towards AD research and recruit them into ongoing research projects.

Methods: Over 6 single-day events in 2 years, more than 574 individuals were individually screened using the MoCA and a story recall task (immediate and delayed), given feedback about their performance, and introduced to AD research and opportunities to participate. Read More

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http://dx.doi.org/10.1186/s13195-020-00643-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7325657PMC

Can incoming United States pediatric interns be entrusted with the essential communication skills of informed consent?

J Educ Eval Health Prof 2020 29;17:18. Epub 2020 Jun 29.

Department of Pediatrics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA.

Purpose: According to the Entrustable Professional Activities (EPA) for Entering Residency by the Association of American Medical Colleges, incoming residents are expected to independently obtain informed consent for procedures they are likely to perform. This requires residents to not only inform their patients but to ensure comprehension of that information. We assessed the communication skills demonstrated by 372 incoming pediatric interns between 2007 and 2018 at the University of Texas Health Science Center at Houston, obtaining informed consent for a lumbar puncture. Read More

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http://dx.doi.org/10.3352/jeehp.2020.17.18DOI Listing

Saliva immunoglobulin free light chain analysis for monitoring disease activity and response to treatment in multiple sclerosis.

Mult Scler Relat Disord 2020 Jun 24;44:102339. Epub 2020 Jun 24.

Heller Institute of Medical Research, Sheba Medical Center, Tel-Hashomer, Israel.

Background: Immunoglobulin free light chains (FLC) have recently gained considerable interest as new promising intrathecal biomarkers of multiple sclerosis (MS). However, lumbar puncture is invasive and not practical for monitoring disease course. This study aimed to assess the utility of saliva FLC as a biomarker of disease activity and response to treatment in MS METHODS: Western blotting was used to study saliva FLC monomers and dimers. Read More

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http://dx.doi.org/10.1016/j.msard.2020.102339DOI Listing

Sexual dimorphism in the cerebrospinal fluid total protein content.

Clin Chem Lab Med 2020 Jun 29. Epub 2020 Jun 29.

Department of Biomedical and Specialist Surgical Sciences, University of Ferrara, Ferrara, Italy.

Objectives Cerebrospinal fluid (CSF) is a clear, colorless body fluid filling the central nervous system. The determination of the CSF total protein (TP) content represents an important screening test of various pathologies. We aimed to address the effect of sex and age on CSF TP content and the use of the current upper reference limits (URLs). Read More

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http://dx.doi.org/10.1515/cclm-2020-0419DOI Listing

Disseminated Cryptococcosis in a Patient With Metastatic Prostate Cancer Who Died in the Coronavirus Disease 2019 (COVID-19) Outbreak.

Cureus 2020 May 23;12(5):e8254. Epub 2020 May 23.

Infectious Disease, Luigi Sacco Hospital, University of Milan, Milan, ITA.

We report the case of a 61-year-old patient with a history of prostate cancer affected by bone metastasis. He presented to our attention for ulcerous and necrotic cutaneous lesions unresponsive to antibiotics. The spread of cutaneous lesions and the onset of neurological symptoms suggested a cryptococcal disease, which was confirmed by lumbar puncture and cutaneous biopsy. Read More

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http://dx.doi.org/10.7759/cureus.8254DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309194PMC

Diagnostic accuracy of VIDISCA-NGS in patients with suspected central nervous system infections.

Clin Microbiol Infect 2020 Jun 24. Epub 2020 Jun 24.

Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. Electronic address:

Objectives: Confirming the diagnosis in viral central nervous system (CNS) infections can be difficult with the currently available diagnostic tools. Virus discovery cDNA-amplified fragment length polymorphism next-generation sequencing (VIDISCA-NGS) is a promising viral metagenomic technique that enables the detection of all viruses in a single assay. We performed a retrospective study on the diagnostic accuracy of VIDISCA-NGS in cerebrospinal fluid (CSF) of individuals with suspected CNS infections. Read More

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http://dx.doi.org/10.1016/j.cmi.2020.06.012DOI Listing

Transverse venous sinus stenosis in idiopathic intracranial hypertension: a prospective pilot study.

Can J Ophthalmol 2020 Jun 23. Epub 2020 Jun 23.

Dalhousie University, Halifax, N.S.; Division of Neuroradiology, Department of Diagnostic Imaging, Nova Scotia Health Authority, Halifax, N.S.; Department of Radiology, University of Manitoba, Winnipeg, MB.. Electronic address:

Objective: Whether transverse venous sinus stenosis (TVSS) causes idiopathic intracranial hypertension (IIH) or is an effect of the increased intracranial pressures is controversial. The purpose of this study was to assess the feasibility of serial imaging in patients with IIH on medical management.

Design And Participants: Patients found to have IIH and TVSS on contrast-enhanced magnetic resonance venography (CEMRV) were recruited in a prospective cohort study. Read More

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http://dx.doi.org/10.1016/j.jcjo.2020.05.008DOI Listing

In vivo delivery of MMP3-shRNA and Sox9 lentivirus cocktail enhances matrix synthesis to prevent lumbar disc degeneration.

Adv Clin Exp Med 2020 Jun;29(6):639-647

Department of Orthopedics, Affiliated Hospital of Qingdao University, China.

Background: Intervertebral disc degeneration (IDD) is characterized by increased proteolytic degradation of the extracellular matrix (ECM), leading to a loss of collagen II and proteoglycan in the nucleus pulposus (NP). Although MMP3 has been reported to play a central role in disc degeneration, it is still unknown whether gene therapy targeting MMP3 can inhibit IDD.

Objectives: To investigate whether lentivirus-mediated MMP3 knockdown is capable of attenuating IDD. Read More

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http://dx.doi.org/10.17219/acem/121509DOI Listing

Leukoencephalopathy Associated with Severe COVID-19 Infection: Sequela of Hypoxemia?

AJNR Am J Neuroradiol 2020 Jun 25. Epub 2020 Jun 25.

From the Departments of Radiology (M.L., K.B., M.D.L., W.A.M., Jr, S.P.R.).

There is increasing evidence to suggest that complications of coronavirus disease 2019 (COVID-19) infection are not only limited to the pulmonary system but can also involve the central nervous system. Here, we report 6 critically ill patients with COVID-19 infection and neuroimaging findings of leukoencephalopathy. While these findings are nonspecific, we postulate that they may be a delayed response to the profound hypoxemia the patients experienced due to the infection. Read More

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http://dx.doi.org/10.3174/ajnr.A6671DOI Listing

Analysis of Risk Factors for Prognosis and Infection of Child with Refractory Epilepsy Via Artificial Intelligence Neural Network Image Information.

Neurosci Lett 2020 Jun 22:135198. Epub 2020 Jun 22.

Department of Pediatrics, Affiliated Hospital of Youjiang Medical College for Nationalities, Baise, 533000, Guangxi, China.

In order to analyze the application of artificial intelligence neural network imaging technology in children with refractory epilepsy prognosis infection, the magnetic resonance imaging (MRI), positron emission computed tomography (PET), and MRI/PET fusion technology based on artificial intelligence neural network were adopted to detect the refractory epilepsy of 78 children in this study. The diagnostic sensitivity, specificity, and accuracy of the three imaging methods were calculated. All children were followed up for one year. Read More

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http://dx.doi.org/10.1016/j.neulet.2020.135198DOI Listing

Mild Cognitive Impairment Staging Yields Genetic Susceptibility, Biomarker, and Neuroimaging Differences.

Front Aging Neurosci 2020 5;12:139. Epub 2020 Jun 5.

Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States.

Introduction: While Alzheimer's disease (AD) is divided into severity stages, mild cognitive impairment (MCI) remains a solitary construct despite clinical and prognostic heterogeneity. This study aimed to characterize differences in genetic, cerebrospinal fluid (CSF), neuroimaging, and neuropsychological markers across clinician-derived MCI stages.

Methods: Vanderbilt Memory & Aging Project participants with MCI were categorized into 3 severity subtypes at screening based on neuropsychological assessment, functional assessment, and Clinical Dementia Rating interview, including mild ( = 18, 75 ± 8 years), moderate ( = 89 72 ± 7 years), and severe subtypes ( = 18, 78 ± 8 years). Read More

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http://dx.doi.org/10.3389/fnagi.2020.00139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289958PMC

Multimodal Imaging of Optic Nerve Drusen in a 10-year Hyperopic Child.

J Coll Physicians Surg Pak 2020 May;30(5):541-542

Department of Ophthalmology, University of Health Sciences, Beyoglu Eye Training and Research Hospital Istanbul, Turkey.

Optic nerve drusen (OND) are abnormal calcified acellular deposits located within the prelaminar portion of the optic nerve. They are usually asymptomatic and detected incidentally during fundoscopic examination. They have a clinical significance due to their appearance which mimicks true papilledema, if the drusen are buried. Read More

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http://dx.doi.org/10.29271/jcpsp.2020.05.541DOI Listing

Vogt-Koyanagi-Harada disease-like uveitis following nivolumab administration treated with steroid pulse therapy: a case report.

BMC Ophthalmol 2020 Jun 24;20(1):252. Epub 2020 Jun 24.

Department of Ophthalmology, Kameda Medical Center, Kamogawa, Japan.

Background: Immune checkpoint inhibitors can cause various adverse effects. Recently it has been shown that Vogt-Koyanagi-Harada (VKH) disease-like uveitis can occur in patients treated with nivolumab.

Case Presentation: A 69-year-old man developed bilateral panuveitis after nivolumab treatment for recurrent hypopharyngeal cancer. Read More

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http://dx.doi.org/10.1186/s12886-020-01519-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7313170PMC

Intracranial High-Grade Stenosis and Hyperhomocysteinemia Presenting as Cortical Subarachnoid Hemorrhage Concomitant with Acute Ischemic Stroke in a Young Man.

Am J Case Rep 2020 Jun 24;21:e920606. Epub 2020 Jun 24.

Department of Neurology, Henan Provincial People's Hospital, School of Clinical Medicine, Henan University, Zhengzhou, Henan, China (mainland).

BACKGROUND Cortical subarachnoid hemorrhage (cSAH) is a rare clinical presentation with different causes, but rarely happens along with acute ischemic stroke. Intracranial high-grade stenosis originated from brain has been regarded as an unusual cause of cSAH, especially in young adults. CASE REPORT A case of 33-year-old male presented with mild headache and spontaneous left-sided body weakness. Read More

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http://dx.doi.org/10.12659/AJCR.920606DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327752PMC

Central nervous system candidiasis beyond neonates: Lessons from a nationwide study.

Med Mycol 2020 Jun 23. Epub 2020 Jun 23.

Université de Paris, Service de maladies infectieuses, hôpital Universitaire Necker-Enfants malades, Assistance Publique - Hôpitaux de Paris, IHU Imagine, Paris, France.

Though candidiasis is the most frequent invasive fungal infection, Candida spp. central nervous system (CNS) infections are rare but severe. To further describe clinico-patho-radiological presentations of this entity, we report a retrospective study from January 2005 to December 2018 including patients aged ≥ 28 days with proven or probable CNS candidiasis in France. Read More

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http://dx.doi.org/10.1093/mmy/myaa051DOI Listing

Comparison of Ultrasound-Marked Versus Standard Lumbar Puncture Success in Infants.

Pediatr Emerg Care 2020 Jun 22. Epub 2020 Jun 22.

From the Department of Emergency Medicine, Atrium Health's Carolinas Medical Center, Charlotte, NC.

Objectives: The aim of this study was to compare ultrasound (US)-marked versus standard lumbar puncture success in infants.

Methods: This was a prospective cohort study at an academic pediatric emergency department. Standard lumbar puncture success in a retrospective control was compared with success in a US-marked group. Read More

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http://dx.doi.org/10.1097/PEC.0000000000002169DOI Listing

Clinical features of aseptic meningitis with varicella zoster virus infection diagnosed by next-generation sequencing: case reports.

BMC Infect Dis 2020 Jun 22;20(1):435. Epub 2020 Jun 22.

Department of Neurology, Northern Jiangsu People's Hospital, Medical College of Yangzhou University, Yangzhou, 225001, China.

Background: The aseptic meningitis caused by varicella zoster virus (VZV) reactivation was less described in the literature, most of which were detected by means of polymerase chain reaction. The authors presented 4 adult immunocompetent patients with acute aseptic meningitis with VZV infection diagnosed by next-generation sequencing (NGS).

Case Presentation: Four patients were admitted to the hospital with headache and fever between March 2018 and August 2019. Read More

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http://dx.doi.org/10.1186/s12879-020-05155-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309994PMC

Atraumatic Versus Conventional Needles for Lumbar Puncture.

Acad Emerg Med 2020 Jun 22. Epub 2020 Jun 22.

and the, Department of Emergency Medicine, Brooke Army Medical Center, Fort Sam Houston, TX, USA.

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http://dx.doi.org/10.1111/acem.14061DOI Listing

Talaromyces (Penicillium) species infection in the central nervous system.

J R Coll Physicians Edinb 2020 Jun;50(2):138-140

Hospital Pulau Pinang, Ministry of Health Malaysia, Penang, Malaysia.

Talaromycosis typically occurs as an opportunistic infection among immunocompromised individuals. Infection caused by species other than T. marneffei is uncommon. Read More

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http://dx.doi.org/10.4997/JRCPE.2020.211DOI Listing

A case of recurrent trimethoprim-sulfamethoxazole-induced aseptic meningitis and review of literature
.

Int J Clin Pharmacol Ther 2020 Jun 22. Epub 2020 Jun 22.

A 66-year-old male patient presented with fever, headache, mental status changes, and nuchal rigidity with a lumbar puncture revealing neutropenic pleocytosis, and a presumptive diagnosis of bacterial meningitis was made. A careful history revealed that symptoms started within hours of starting oral trimethoprim-sulfamethoxazole. Additional history uncovered a nearly identical episode 1 year earlier after 1 dose of trimethoprim-sulfamethoxazole. Read More

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http://dx.doi.org/10.5414/CP203749DOI Listing

Cryptococcal meningitis: a review of cryptococcal antigen screening programs in Africa.

Expert Rev Anti Infect Ther 2020 Jun 22. Epub 2020 Jun 22.

Department of Clinical Research, Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine , London, United Kingdom.

Introduction: Cryptococcal meningitis remains a significant contributor to AIDS-related mortality despite widened access to antiretroviral therapy. Cryptococcal antigen (CrAg) can be detected in the blood prior to the development of meningitis. The development of highly sensitive and specific rapid diagnostic CrAg tests has helped facilitate the adoption of CrAg screening programs in 19 African countries. Read More

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http://dx.doi.org/10.1080/14787210.2020.1785871DOI Listing

Anti-NMDAR-Positive Small-Cell Lung Cancer Paraneoplastic Limbic Encephalitis: A Case Report and Literature Review.

Case Rep Neurol Med 2020 2;2020:5269352. Epub 2020 Jun 2.

Department of Neurology, SUNY Upstate Medical University Hospital, 750 E Adams St., Syracuse, NY 13210, USA.

Introduction: Paraneoplastic limbic encephalitis (PLE) is a rare disease that presents as rapid onset dementia characterized by short-term memory loss (STM), anxiety, and behavioral changes. Anti-NMDAR antibodies are unfrequently reported in PLE associated with small-cell lung cancer (SCLC). Given that PLE can precede the diagnosis of cancer, it is very important that once infectious, metabolic, nutritional, or structural disorders associated with short-term memory loss are ruled out that vigorous effort must be made to rule out underlying malignancy. Read More

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http://dx.doi.org/10.1155/2020/5269352DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288224PMC