- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Traumatic brain injury (TBI) occurs in patients of all age groups and is a significant public health issue. In the United States, 1.5 million TBIs occur annually, 75% of TBIs are classified as mild, ...
Traumatic brain injury (TBI) occurs in patients of all age groups and is a significant public health issue. In the United States, 1.5 million TBIs occur annually, 75% of TBIs are classified as mild, and costs are generated of $17 billion each year. Most patients that suffer from TBI will have spontaneous resolution of symptoms, but for some patients, symptoms may linger and negatively affect daily cognitive function. Post-concussive syndrome (PCS) demarcates the constellation of symptoms seen most often in prolonged mild TBI. Clinical criteria for PCS is outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). PCS is a constellation of physical, cognitive, behavioral, and emotional symptoms occurring after TBI. These symptoms include a headache, fatigue, vision changes, disturbances in balance, confusion, dizziness, insomnia, and difficulty with concentration. Approximately 90% of concussion symptoms are transient, with symptoms resolving within 10 to 14 days but may linger for weeks. Persistent PCS occurs when symptoms persist past 3 months. Fifteen percent of mild TBI patients will suffer from PCS, and a small minority of those patients will experience persistent PCS requiring further evaluation and treatment. Research has shown that mild TBI resulting in persistent PCS has lasting effects on cognition, memory, learning, and executive function. Patients who suffer more than one brain injury are at increased risk for PCS. Due to limited diagnostic tools, those permanent changes in executive function can go undocumented. Thus, the 15% incidence of PCS is an underestimation of the true incidence.
- Baroreflex function, haemodynamic responses to an orthostatic challenge, and falls in haemodialysis patients. [Journal Article]
- PlosPLoS One 2018; 13(12):e0208127
- CONCLUSIONS: This cross-sectional comparison indicates that, at rest, HD patients with a positive history of falls present with a lower count of baroreceptor sequences and BEI. Short-term BP regulation warrants further investigation as BP drops during a passive orthostatic challenge may be implicated in the aetiology of falls in HD.
- [Foodbourne Botulism: A Forgotten Disease]. [Case Reports]
- AMActa Med Port 2018 Nov 30; 31(11):691-693
- Botulism is a serious illness caused by exposure to botulinum toxin. It is manifested by flaccid, paralysis, symmetric and in descending pattern affecting cranial and peripheral nerves. Given the fre...
Botulism is a serious illness caused by exposure to botulinum toxin. It is manifested by flaccid, paralysis, symmetric and in descending pattern affecting cranial and peripheral nerves. Given the frequent need for invasive mechanical ventilation, these patients should be approached in an intensive care setting. Treatment with anti-botulinum toxin is the only effective treatment. The authors present the case of a 64-year-old patient, with vomiting and vertigo, evolution to diplopia, dysphagia and flaccid, muscle paralysis, installation after ingestion of canning homemade. From the etiologica, we highlight the electroneuromyogram study with a pre-synaptic lesion compatible with the botulism hypothesis. Progressive improvement of the deficits after administration of anti-botulinum toxin. A brief theoretical review is made of a serious, potentially fatal and infrequent pathology in our country.
- Apixaban-Associated Spontaneous Splenic Rupture-A Case Report. [Journal Article]
- IMIr Med J 2018 08 13; 111(7):792
- IntroductionA 62-year-old lady presented to The Emergency Department (ED) with one-day history of dizziness, vomiting and feeling weak. ECG showed new onset Atrial Fibrillation. Four days ago, she wa...
IntroductionA 62-year-old lady presented to The Emergency Department (ED) with one-day history of dizziness, vomiting and feeling weak. ECG showed new onset Atrial Fibrillation. Four days ago, she was referred to the Cardiology team where she underwent PCI and was discharged on Apixaban and Plavix. Two days later she represented to the ED pale and hypotensive with BP 70/50. CT-Abdomen showed a large splenic hematoma and thickening of the inferior wall of the stomach. Treatment She was then taken for an emergency laparotomy with splenectomy and partial gastrectomy. She became septic post-operative, responded well to antibiotics and was discharged after 18 days on lifelong prophylactic oral antibiotics. Conclusion Spontaneous splenic rupture in a patient on Direct Oral Anticoagulants (DOAC) presented with abdominal pain could be even with no history of trauma.
- Transient Anarthria and Quadriplegia in a Patient with Basilar Artery Hypoplasia and Coincidental Intracranial Lipoma: A Case Report. [Journal Article]
- CRCase Rep Neurol 2018 Sep-Dec; 10(3):322-327
- Cerebral ischemia may be rarely associated with a hypoplastic vertebrobasilar system. Intracranial lipoma is also a very rare congenital malformation. We report the case of a 52-year-old woman with v...
Cerebral ischemia may be rarely associated with a hypoplastic vertebrobasilar system. Intracranial lipoma is also a very rare congenital malformation. We report the case of a 52-year-old woman with vertebrobasilar transient ischemic attack associated with basilar artery hypoplasia and coincidental intracranial lipoma. She presented with sudden-onset dizziness, anarthria, and quadriplegia lasting for about 30 min. The patient's initial blood pressure was measured at 200/120 mm Hg. The magnetic resonance and computed tomographic images showed the absence of an acute ischemic lesion in the brain but revealed a hypoplasia of the basilar artery and bilateral V4 vertebral arteries. A lipoma of 11 mm in long diameter was also found in the quadrigeminal cistern and at the superior vermis. The electroencephalography, transthoracic echocardiogram, 24-h Holter monitoring, and transcranial Doppler ultrasonography, including patent foramen ovale study, were all noted as negative. The patient was treated with oral aspirin 100 mg, atorvastatin 10 mg, and antihypertensive medication. She had no symptom recurrence after the treatment. Our case suggests that hypoplasia of the vertebrobasilar arteries can be a predisposing factor for posterior circulation ischemia, especially when additional vascular risk factors coexist.
- Increased Risk of Benign Paroxysmal Positional Vertigo in Patients With Non-Apnea Sleep Disorders: A Nationwide, Population-Based Cohort Study. [Journal Article]
- JCJ Clin Sleep Med 2018 Nov 29
- CONCLUSIONS: We demonstrate that NSD are associated with an increased risk of BPPV. Relative to other types of NSD, patients with chronic insomnia are at the highest risk for development of BPPV.
- Public knowledge of dehydration and fluid intake practices: variation by participants' characteristics. [Journal Article]
- BPBMC Public Health 2018 Dec 05; 18(1):1346
- CONCLUSIONS: The participants displayed good knowledge of dehydration definition, prevention, and water intake recommendation. The participants also displayed good knowledge of the common symptoms, however knowledge was lacking for uncommon symptoms. Moreover, participants had reported adequate water intake, meeting the daily water intake recommendation of ≥3.7 l for men and ≥ 2.7 l for women.
- Recovery Phase Spontaneous Nystagmus, Its Existence and Clinical Implication. [Journal Article]
- JAJ Audiol Otol 2018 Dec 07
- CONCLUSIONS: : In acute vestibulopathy patients, recovery phase nystagmus was observed and on this stage of disease vestibular function tests shows several features that could predict recovery state.
- 2018 Update on Medical Overuse. [Journal Article]
- JIMJAMA Intern Med 2018 Dec 03
- CONCLUSIONS: Many current practices were found to represent overuse, with no benefit and potential harms. Other services were used inappropriately. Reviewing these findings and extrapolating to their patients will enable health care professionals to improve the care they provide.
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- BRIVA-LIFE - a multicentre retrospective study of the long-term use of brivaracetam in clinical practice. [Journal Article]
- ANActa Neurol Scand 2018 Dec 01
- CONCLUSIONS: In a large population of patients with predominantly drug-resistant epilepsy, brivaracetam was effective and well-tolerated; no unexpected AEs occurred over 1 year and the incidence of PAEs was lower compared with levetiracetam. This article is protected by copyright. All rights reserved.