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Sample records for neurological emergency requiring

  1. Neurologic emergencies in sports.

    Science.gov (United States)

    Williams, Vernon B

    2014-12-01

    Sports neurology is an emerging area of subspecialty. Neurologists and non-neurologists evaluating and managing individuals participating in sports will encounter emergencies that directly or indirectly involve the nervous system. Since the primary specialty of sports medicine physicians and other practitioners involved in the delivery of medical care to athletes in emergency situations varies significantly, experience in recognition and management of neurologic emergencies in sports will vary as well. This article provides a review of information and elements essential to neurologic emergencies in sports for the practicing neurologist, although content may be of benefit to readers of varying background and expertise. Both common neurologic emergencies and less common but noteworthy neurologic emergencies are reviewed in this article. Issues that are fairly unique to sports participation are highlighted in this review. General concepts and principles related to treatment of neurologic emergencies that are often encountered unrelated to sports (eg, recognition and treatment of status epilepticus, increased intracranial pressure) are discussed but are not the focus of this article. Neurologic emergencies can involve any region of the nervous system (eg, brain, spine/spinal cord, peripheral nerves, muscles). In addition to neurologic emergencies that represent direct sports-related neurologic complications, indirect (systemic and generalized) sports-related emergencies with significant neurologic consequences can occur and are also discussed in this article. Neurologists and others involved in the care of athletes should consider neurologic emergencies in sports when planning and providing medical care.

  2. A hyperacute neurology team - transforming emergency neurological care.

    Science.gov (United States)

    Nitkunan, Arani; MacDonald, Bridget K; Boodhoo, Ajay; Tomkins, Andrew; Smyth, Caitlin; Southam, Medina; Schon, Fred

    2017-07-01

    We present the results of an 18-month study of a new model of how to care for emergency neurological admissions. We have established a hyperacute neurology team at a single district general hospital. Key features are a senior acute neurology nurse coordinator, an exclusively consultant-delivered service, acute epilepsy nurses, an acute neurophysiology service supported by neuroradiology and acute physicians and based within the acute medical admissions unit. Key improvements are a major increase in the number of patients seen, the speed with which they are seen and the percentage seen on acute medical unit before going to the general wards. We have shown a reduced length of stay and readmission rates for patients with epilepsy. Epilepsy accounted for 30% of all referrals. The cost implications of running this service are modest. We feel that this model is worthy of widespread consideration. © Royal College of Physicians 2017. All rights reserved.

  3. The Profile of Neurology Patients Evaluated in the Emergency Department

    OpenAIRE

    Ufuk Emre; Ayşe Semra Demir; Esra Acıman; Nejla Çabuk; Sibel Kıran; Aysun Ünal

    2009-01-01

    OBJECTIVE: Early, rapid, and multidisciplinary approaches are very important in the diagnosis of neurological disorders in emergency departments. The present study aimed to investigate the features of patients that presented for neurology consultation in the emergency department. METHODS: The present study included 780 patients. Patient demographic features, reasons for emergent treatment and neurological consultation, neurological diagnosis by the neurologist, and laboratory (total blood...

  4. Emergency Neurological Life Support: Intracerebral Hemorrhage.

    Science.gov (United States)

    Jauch, Edward C; Pineda, Jose A; Hemphill, J Claude

    2015-12-01

    Intracerebral hemorrhage (ICH) is a subset of stroke due to bleeding within the parenchyma of the brain. It is potentially lethal, and survival depends on ensuring an adequate airway, reversal of coagulopathy, and proper diagnosis. ICH was chosen as an Emergency Neurological Life Support protocol because intervention within the first critical hour may improve outcome, and it is critical to have site-specific protocols to drive care quickly and efficiently.

  5. Neurologic emergencies in HIV-negative immunosuppressed patients.

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    Guzmán-De-Villoria, J A; Fernández-García, P; Borrego-Ruiz, P J

    HIV-negative immunosuppressed patients comprise a heterogeneous group including transplant patients, patients undergoing treatment with immunosuppressors, uremic patients, alcoholics, undernourished patients, diabetics, patients on dialysis, elderly patients, and those diagnosed with severe or neoplastic processes. Epileptic seizures, focal neurologic signs, and meningoencephalitis are neurologic syndromes that require urgent action. In most of these situations, neuroimaging tests are necessary, but the findings can be different from those observed in immunocompetent patients in function of the inflammatory response. Infectious disease is the first diagnostic suspicion, and the identification of an opportunistic pathogen should be oriented in function of the type and degree of immunosuppression. Other neurologic emergencies include ischemic stroke, cerebral hemorrhage, neoplastic processes, and pharmacological neurotoxicity. This article reviews the role of neuroimaging in HIV-negative immunodepressed patients with a neurologic complication that requires urgent management. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. [Current emergency medicine for neurological disorders in children].

    Science.gov (United States)

    Osamura, Toshio

    2010-01-01

    In 2006, the number of pediatric outpatients consulting our hospital during non-practice hours increased by 218.1% of that in 1996. The number of pediatric inpatients during non-practice hours in 2006 increased by 71.3% of that in 1996. In 2006, the number of patients who were admitted with neurological disorders in children during non-practice hours increased to 213.3% of that in 1996. The proportion of these pediatric patients among those who were admitted during non-practice hours was 16.6% in our hospital, suggesting the importance of neurological disorders in pediatric emergency medicine. More than 60% of inpatients with neurological disorders in children were 3 years old or younger. The most common neurological symptoms observed at admission included convulsion (81.6%) and disturbance of consciousness (8.5%). The disorders were mainly febrile seizure (41.4%) and epilepsy (29.0%). Most patients with severe disorders requiring emergency medicine, such as head bruise, acute encephalitis/encephalopathy, purulent meningitis, and head trauma, were admitted during non-practice hours. The prognoses of most neurological disorders in children were favorable. However, patients with sequelae (especially, hypoxic encephalopathy, acute encephalitis/encephalopathy) showed an unfavorable neurological prognosis. Early rehabilitation during admission was useful as a support method for their families. In the future, a comprehensive rehabilitation program for children with acquired brain injury should be established and laws to promote home care must be passed.

  7. Blog and Podcast Watch: Neurologic Emergencies

    Directory of Open Access Journals (Sweden)

    Andrew Grock

    2016-11-01

    Full Text Available Introduction: The WestJEM Blog and Podcast Watch presents high quality open-access educational blogs and podcasts in emergency medicine (EM based on the ongoing ALiEM Approved Instructional Resources (AIR and AIR-Professional series. Both series critically appraise resources using an objective scoring rubric. This installment of the Blog and Podcast Watch highlights the topic of neurologic emergencies from the AIR series. Methods: The AIR series is a continuously building curriculum that follows the Council of Emergency Medicine Residency Director’s (CORD annual testing schedule. For each module, relevant content is collected from the top 50 Social Media Index sites published within the previous 12 months, and scored by eight board members using five equally weighted measurement outcomes: Best Evidence in Emergency Medicine (BEEM score, accuracy, educational utility, evidence based, and references. Resources scoring ≥30 out of 35 available points receive an AIR label. Resources scoring 27-29 receive an honorable mention label, if the executive board agrees that the post is accurate and educationally valuable. Results: A total of 125 blog posts and podcasts were evaluated. Key educational pearls from the 14 AIR posts are summarized, and the 20 honorable mentions are listed. Conclusion: The WestJEM Blog and Podcast Watch series is based on the AIR and AIR-Pro series, which attempts to identify high quality educational content on open-access blogs and podcasts. This series provides an expert-based, post-publication curation of educational social media content for EM clinicians with this installment focusing on neurologic emergencies.

  8. Conversion disorder in a neurological emergency department: Restrospective series

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    Alejandro Cardozo

    2017-01-01

    Full Text Available Objective: To observe the conversion disorder in a neurological emergency department. Methods: It is common that the initial approach to this patients include the use of various diagnostic exams. In this series we reviewed 94 patients that arrived a neurological emergency room in a 3 year period.Results: 72 patients were females (76%, and the initial presumptive diagnosis were: neurovascular syndrome in 36 patients (38.3%, convulsive disorder in 20 patients (21.28%, and conversive disorder in 8 patients (8.51%. 82 patients had motor symptoms and 61 sensitive symptoms. 88 patients (93% required neuroimaging studies, 77 (81% patients underwent through basic biochemical panels. Other tests performed were: electroencephalogram in 12 patients (12.77%, electromyography in 11 patients (11.7%, lumbar punction in 8 patients (8.04% and regarding the medical consult in the care of these patients 11 were evaluated by 1 specialists, 35 (37.2% by 2 different specialties, 42 (44.63% patients required evaluation by 3, and 6 patients (6.38% required evaluation by 4 different specialties.Conclusions: Based on this data, we conclude that conversion disorders require a lot of resources in the emergency room and that the similarities with neurological diseases demands a complete workup including expensive diagnostic tools. However, this patients can be discharged safely without requiring hospitalization.

  9. Neurologic emergencies and multislice computed tomography

    International Nuclear Information System (INIS)

    Eftimov, L.; Morhard, D.; Reiser, M.; Ertl-Wagner, B.

    2009-01-01

    Modern MSCT with its broad availability and rapid examination times is the preferred modality in the initial evaluation of neurologic emergencies and by its continual development has become more important within recent years. With increased spatial resolution and new post-processing techniques, non-invasive MSCT angiography is seen to increasingly replace diagnostic DSA. Multidetector CTA is a suitable method for the evaluation of intracranial aneurysms, carotid artery stenoses, arterial dissections, as well as cerebral venous and basilar artery thromboses. Multimodal CT (non-enhanced CCT, CTA and perfusion CT) is used more frequently in the assessment of acute stroke patients, it increases the detection rate of early ischemia and is likely to improve the treatment of acute stroke. (orig.) [de

  10. The Profile of Neurology Patients Evaluated in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Ufuk Emre

    2009-09-01

    Full Text Available OBJECTIVE: Early, rapid, and multidisciplinary approaches are very important in the diagnosis of neurological disorders in emergency departments. The present study aimed to investigate the features of patients that presented for neurology consultation in the emergency department. METHODS: The present study included 780 patients. Patient demographic features, reasons for emergent treatment and neurological consultation, neurological diagnosis by the neurologist, and laboratory (total blood count, serum glucose level, urea, creatine, erythrocyte sedimentation rate, and D-dimer levels and imaging findings were retrospectively evaluated based on patient charts. RESULTS: Impaired consciousness was the most frequent reason for neurological consultation (19.7%. Among these patients, ischemic stroke was diagnosed in 27.9%, hypoxic encephalopathy in 18.2%, cerebral hemorrhage in 9.1%, and 11% had no neurological diagnosis. Other common reasons for neurological consultation were vertigo, headache, seizure, and stroke. Clinical findings were related to other systemic causes in 43.7% of the study group. Focal neurological findings were present, especially in patients that presented with ischemic and hemorrhagic stroke, epilepsy, and hypoxic encephalopathy. CONCLUSION: In emergency departments, metabolic causes should be ruled out in patients with impaired consciousness and the absence of focal neurological signs. Intracranial structural disorders must be evaluated when focal neurological signs are present. Cautiously prepared algorithms and neurological examination training will help improve the accuracy of emergency department diagnoses

  11. [Online survey of the organizational structures of emergency neurology in Germany].

    Science.gov (United States)

    Topka, H; Pfefferkorn, T; Andres, F; Kastrup, A; Klein, M; Niesen, W; Poppert, H

    2017-06-01

    In 2007, the first poll among neurologists provided some insight into the organizational structures of emergency neurology in Germany. Given that emergency neurology as well as emergency medicine in general have undergone substantial changes during the last decade, the subcommittee Neurological Emergency Medicine of the German Neurological Society conducted a follow-up study to explore current structures supporting neurological emergency medicine in German neurological hospitals. Between July and September 2016, an online questionnaire was e‑mailed to 675 neurologists in institutions participating in in-patient neurological care. Of these, some 32% (university hospitals 49%) answered. Neurological patients represent 12-16% and hence a significant proportion of emergency patients. The fraction of in-patients admitted to hospitals via emergency departments amounted to 78% (median) in general hospitals and 52% in university hospitals. Most emergency departments are organized as an interdisciplinary structure combining conservative with surgical disciplines frequently led by an independent department head. Neurology departments employ rather diverse strategies to organize neurological emergency care. Also, the way emergency patients are assigned to different disciplines varied largely. Currently, neurological patients represent a rather growing fraction of patients in emergency departments. An increasing proportion of neurology in-patients enter the hospital via emergency departments. Neurology departments in Germany face increasing challenges to cope with large numbers of neurological emergency patients. While most of the participating neurologists indicated suffering predominantly from scarce personal resources both in neurology and neuroradiology, an independent neurological emergency department was not considered an option.

  12. Non-traumatic neurological emergencies: emergency neuroradiological interventions

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    Schroth, Gerhard; Loevblad, Karl-Olof; Ozdoba, Christoph; Remonda, Luca [Department of Neuroradiology, University of Bern, Inselspital (Switzerland)

    2002-07-01

    This article summarizes recent developments in the growing field of interventional neuroradiology for the treatment of acute cerebrovascular disease. We describe the possibilities in endovascular therapy of acute cerebral aneurysms using electrolytically detachable coils combined with trispan neck bridging devices and stent implantation to occlude acute wide neck aneurysms. Techniques and results of local intra-arterial thrombolytic therapy in acute stroke and central retinal artery occlusion are described and we discuss the potential for rapid, large-burden thrombus removal in cases of internal carotid artery thrombosis by rheolytic thrombectomy, percutaneous transluminal angioplasty and stent implantation. Emergency endovascular therapy using the transvenous approach to treat severe intracranial or intraocular hypertension and multifocal haemorrhagic venous infarction due to cerebral sinus thrombosis or dural fistulas is also described. In cases of acute bleeding of head and neck lesions following trauma, tumours after radiotherapy, arteriovenous malformations, epistaxis or from iatrogenic origin, angiography plays a major role in localizing the source of bleeding and occluding the damaged vessel during the same session using the same endovascular approach. (orig.)

  13. Non-traumatic neurological emergencies: emergency neuroradiological interventions

    International Nuclear Information System (INIS)

    Schroth, Gerhard; Loevblad, Karl-Olof; Ozdoba, Christoph; Remonda, Luca

    2002-01-01

    This article summarizes recent developments in the growing field of interventional neuroradiology for the treatment of acute cerebrovascular disease. We describe the possibilities in endovascular therapy of acute cerebral aneurysms using electrolytically detachable coils combined with trispan neck bridging devices and stent implantation to occlude acute wide neck aneurysms. Techniques and results of local intra-arterial thrombolytic therapy in acute stroke and central retinal artery occlusion are described and we discuss the potential for rapid, large-burden thrombus removal in cases of internal carotid artery thrombosis by rheolytic thrombectomy, percutaneous transluminal angioplasty and stent implantation. Emergency endovascular therapy using the transvenous approach to treat severe intracranial or intraocular hypertension and multifocal haemorrhagic venous infarction due to cerebral sinus thrombosis or dural fistulas is also described. In cases of acute bleeding of head and neck lesions following trauma, tumours after radiotherapy, arteriovenous malformations, epistaxis or from iatrogenic origin, angiography plays a major role in localizing the source of bleeding and occluding the damaged vessel during the same session using the same endovascular approach. (orig.)

  14. Development of Pediatric Neurologic Emergency Life Support Course: A Preliminary Report.

    Science.gov (United States)

    Haque, Anwarul; Arif, Fehmina; Abass, Qalab; Ahmed, Khalid

    2017-11-01

    Acute neurological emergencies (ANEs) in children are common life-threatening illnesses and are associated with high mortality and severe neurological disability in survivors, if not recognized early and treated appropriately. We describe our experience of teaching a short, novel course "Pediatric Neurologic Emergency Life Support" to pediatricians and trainees in a resource-limited country. This course was conducted at 5 academic hospitals from November 2013 to December 2014. It is a hybrid of pediatric advance life support and emergency neurologic life support. This course is designed to increase knowledge and impart practical training on early recognition and timely appropriate treatment in the first hour of children with ANEs. Neuroresuscitation and neuroprotective strategies are key components of this course to prevent and treat secondary injuries. Four cases of ANEs (status epilepticus, nontraumatic coma, raised intracranial pressure, and severe traumatic brain injury) were taught as a case simulation in a stepped-care, protocolized approach based on best clinical practices with emphasis on key points of managements in the first hour. Eleven courses were conducted during the study period. One hundred ninety-six physicians including 19 consultants and 171 residents participated in these courses. The mean (SD) score was 65.15 (13.87%). Seventy percent (132) of participants were passed (passing score > 60%). The overall satisfaction rate was 85%. Pediatric Neurologic Emergency Life Support was the first-time delivered educational tool to improve outcome of children with ANEs with good achievement and high satisfaction rate of participants. Large number courses are required for future validation.

  15. The role of emergency neurology in Italy: outcome of a consensus meeting for a Intersociety position.

    Science.gov (United States)

    Micieli, Giuseppe; De Falco, Fabrizio A; Consoli, Domenico; Inzitari, Domenico; Sterzi, Roberto; Tedeschi, Gioacchino; Toni, Danilo

    2012-04-01

    A possible definition of clinical, educational and organizing aspects of emergency neurology in Italy is reported in this position paper of Emergency Neurology Intersociety Group, created in 2008 among the two neurological Societies in Italy: Società Italiana di Neurologia and Società di Neuroscienze Ospedaliere. The aim of this Group has been the evaluation of the role of neurologist in the emergency setting of Italian hospitals, as well as of the description of different scenarios in which a ward dedicated to a semi-intensive care of neurological emergencies could have a role in the actual organization of academic or general hospitals in our Country. The actual great relevance of neurologist activity in the inpatients treatment, in fact, is actually misleaded as it is the considerable significance of neurological expertise, techniques and support in hospital care pathways also involving neurological manifestations throughout the course of other diseases. Finally, the possible contents of educational programs orienting neurological specialty towards a better comprehension and management of emergency neurological problems either in terms of specific formation or of techniques to be learned by emergency neurologist, are reported as a results of the Consensus Workshop hold in Castiglioncello (LI) in September 12th, 2009.

  16. A "Neurological Emergency Trolley" reduces turnaround time for high-risk medications in a general intensive care unit.

    Science.gov (United States)

    Ajzenberg, Henry; Newman, Paula; Harris, Gail-Anne; Cranston, Marnie; Boyd, J Gordon

    2018-02-01

    To reduce medication turnaround times during neurological emergencies, a multidisciplinary team developed a neurological emergency crash trolley in our intensive care unit. This trolley includes phenytoin, hypertonic saline and mannitol, as well as other equipment. The aim of this study was to assess whether the cart reduced turnaround times for these medications. In this retrospective cohort study, medication delivery times for two year epochs before and after its implementation were compared. Eligible patients were identified from our intensive care unit screening log. Adults who required emergent use of phenytoin, hypertonic saline or mannitol while in the intensive care unit were included. Groups were compared with nonparametric analyses. 33-bed general medical-surgical intensive care unit in an academic teaching hospital. Time to medication administration. In the pre-intervention group, there were 43 patients with 66 events. In the post-intervention group, there were 45 patients with 80 events. The median medication turnaround time was significantly reduced after implementation of the neurological emergency trolley (25 vs. 10minutes, p=0.003). There was no statistically significant difference in intensive care or 30-day survival between the two cohorts. The implementation of a novel neurological emergency crash trolley in our intensive care unit reduced medication turnaround times. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Emerging Links between Homeostatic Synaptic Plasticity and Neurological Disease

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    Dion eDickman

    2013-11-01

    Full Text Available Homeostatic signaling systems are ubiquitous forms of biological regulation, having been studied for hundreds of years in the context of diverse physiological processes including body temperature and osmotic balance. However, only recently has this concept been brought to the study of excitatory and inhibitory electrical activity that the nervous system uses to establish and maintain stable communication. Synapses are a primary target of neuronal regulation with a variety of studies over the past 15 years demonstrating that these cellular junctions are under bidirectional homeostatic control. Recent work from an array of diverse systems and approaches has revealed exciting new links between homeostatic synaptic plasticity and a variety of seemingly disparate neurological and psychiatric diseases. These include autism spectrum disorders, intellectual disabilities, schizophrenia, and Fragile X Syndrome. Although the molecular mechanisms through which defective homeostatic signaling may lead to disease pathogenesis remain unclear, rapid progress is likely to be made in the coming years using a powerful combination of genetic, imaging, electrophysiological, and next generation sequencing approaches. Importantly, understanding homeostatic synaptic plasticity at a cellular and molecular level may lead to developments in new therapeutic innovations to treat these diseases. In this review we will examine recent studies that demonstrate homeostatic control of postsynaptic protein translation, retrograde signaling, and presynaptic function that may contribute to the etiology of complex neurological and psychiatric diseases.

  18. Imaging aspects of neurologic emergencies in children treated for non-CNS malignancies

    International Nuclear Information System (INIS)

    Kaste, S.C.; Langston, J.; Rodriguez-Galindo, C.; Furman, W.L.; Thompson, S.J.

    2000-01-01

    There is a paucity of radiologic literature addressing neurologic emergencies in children receiving therapy for non-CNS primary malignancies. In the acute setting, many of these children present to local community hospitals. This pictorial is from a single institutional experience describing the spectrum of neurologic emergencies seen in children with non-CNS cancers. We hope to familiarize pediatric radiologists with these entities in order to expedite diagnosis, facilitate treatment, and minimize morbity and mortality that may be associated with these complications. (orig.)

  19. Non-traumatic neurological emergencies: imaging of cerebral ischemia

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    Grunwald, Iris; Reith, Wolfgang [Department of Neuroradiology, Saarland University Clinic, Homburg/Saar (Germany)

    2002-07-01

    , the occlusion of a large sinus or a widespread vein obstruction will eventually lead to venous infarction. Thus, optimal stroke care requires not only early and exact identification of ischemia, but also a close collaboration between the clinician and radiologist. (orig.)

  20. Non-traumatic neurological emergencies: imaging of cerebral ischemia

    International Nuclear Information System (INIS)

    Grunwald, Iris; Reith, Wolfgang

    2002-01-01

    , the occlusion of a large sinus or a widespread vein obstruction will eventually lead to venous infarction. Thus, optimal stroke care requires not only early and exact identification of ischemia, but also a close collaboration between the clinician and radiologist. (orig.)

  1. NIH Roundtable on Opportunities to Advance Research on Neurologic and Psychiatric Emergencies.

    Science.gov (United States)

    D'Onofrio, Gail; Jauch, Edward; Jagoda, Andrew; Allen, Michael H; Anglin, Deirdre; Barsan, William G; Berger, Rachel P; Bobrow, Bentley J; Boudreaux, Edwin D; Bushnell, Cheryl; Chan, Yu-Feng; Currier, Glenn; Eggly, Susan; Ichord, Rebecca; Larkin, Gregory L; Laskowitz, Daniel; Neumar, Robert W; Newman-Toker, David E; Quinn, James; Shear, Katherine; Todd, Knox H; Zatzick, Douglas

    2010-11-01

    The Institute of Medicine Committee on the Future of Emergency Care in the United States Health System (2003) identified a need to enhance the research base for emergency care. As a result, a National Institutes of Health (NIH) Task Force on Research in Emergency Medicine was formed to enhance NIH support for emergency care research. Members of the NIH Task Force and academic leaders in emergency care participated in 3 Roundtable discussions to prioritize current opportunities for enhancing and conducting emergency care research. We identify key research questions essential to advancing the science of emergency care and discuss the barriers and strategies to advance research by exploring the collaboration between NIH and the emergency care community. Experts from emergency medicine, neurology, psychiatry, and public health assembled to review critical areas in need of investigation, current gaps in knowledge, barriers, and opportunities. Neurologic emergencies included cerebral resuscitation, pain, stroke, syncope, traumatic brain injury, and pregnancy. Mental health topics included suicide, agitation and delirium, substances, posttraumatic stress, violence, and bereavement. Presentations and group discussion firmly established the need for translational research to bring basic science concepts into the clinical arena. A coordinated continuum of the health care system that ensures rapid identification and stabilization and extends through discharge is necessary to maximize overall patient outcomes. There is a paucity of well-designed, focused research on diagnostic testing, clinical decisionmaking, and treatments in the emergency setting. Barriers include the limited number of experienced researchers in emergency medicine, limited dedicated research funding, and difficulties of conducting research in chaotic emergency environments stressed by crowding and limited resources. Several themes emerged during the course of the roundtable discussion, including the need

  2. Fellowship Training in the Emerging Fields of Fetal-Neonatal Neurology and Neonatal Neurocritical Care.

    Science.gov (United States)

    Smyser, Christopher D; Tam, Emily W Y; Chang, Taeun; Soul, Janet S; Miller, Steven P; Glass, Hannah C

    2016-10-01

    Neonatal neurocritical care is a growing and rapidly evolving medical subspecialty, with increasing numbers of dedicated multidisciplinary clinical, educational, and research programs established at academic institutions. The growth of these programs has provided trainees in neurology, neonatology, and pediatrics with increased exposure to the field, sparking interest in dedicated fellowship training in fetal-neonatal neurology. To meet this rising demand, increasing numbers of training programs are being established to provide trainees with the requisite knowledge and skills to independently deliver care for infants with neurological injury or impairment from the fetal care center and neonatal intensive care unit to the outpatient clinic. This article provides an initial framework for standardization of training across these programs. Recommendations include goals and objectives for training in the field; core areas where clinical competency must be demonstrated; training activities and neuroimaging and neurodiagnostic modalities which require proficiency; and programmatic requirements necessary to support a comprehensive and well-rounded training program. With consistent implementation, the proposed model has the potential to establish recognized standards of professional excellence for training in the field, provide a pathway toward Accreditation Council for Graduate Medical Education certification for program graduates, and lead to continued improvements in medical and neurological care provided to patients in the neonatal intensive care unit. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. An Emerging Role for Long Non-Coding RNA Dysregulation in Neurological Disorders

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    Elio Scarpini

    2013-10-01

    Full Text Available A novel class of transcripts, long non coding RNAs (lncRNAs, has recently emerged as key players in several biological processes, including dosage compensation, genomic imprinting, chromatin regulation, embryonic development and segmentation, stem cell pluripotency, cell fate determination and potentially many other biological processes, which still are to be elucidated. LncRNAs are pervasively transcribed in the genome and several lines of evidence correlate dysregulation of different lncRNAs to human diseases including neurological disorders. Although their mechanisms of action are yet to be fully elucidated, evidence suggests lncRNA contributions to the pathogenesis of a number of diseases. In this review, the current state of knowledge linking lncRNAs to different neurological disorders is discussed and potential future directions are considered.

  4. An Emerging Role for Long Non-Coding RNA Dysregulation in Neurological Disorders

    Science.gov (United States)

    Fenoglio, Chiara; Ridolfi, Elisa; Galimberti, Daniela; Scarpini, Elio

    2013-01-01

    A novel class of transcripts, long non coding RNAs (lncRNAs), has recently emerged as key players in several biological processes, including dosage compensation, genomic imprinting, chromatin regulation, embryonic development and segmentation, stem cell pluripotency, cell fate determination and potentially many other biological processes, which still are to be elucidated. LncRNAs are pervasively transcribed in the genome and several lines of evidence correlate dysregulation of different lncRNAs to human diseases including neurological disorders. Although their mechanisms of action are yet to be fully elucidated, evidence suggests lncRNA contributions to the pathogenesis of a number of diseases. In this review, the current state of knowledge linking lncRNAs to different neurological disorders is discussed and potential future directions are considered. PMID:24129177

  5. [Ideal subspecialty training in the field of neurology - competence required for the experts: neurophysiology].

    Science.gov (United States)

    Kohara, Nobuo

    2012-01-01

    All neurologists have to make a differential diagnosis of consciousness loss by EEG. The judgment of epilepsy is especially important. Experts of neurology were also required to determine the level and etiology of the acute or chronic weakness or numbness by EMG with nerve conduction study. Hands on seminar and e-learning would be useful to acquire these tools.

  6. Adult neurology training during child neurology residency.

    Science.gov (United States)

    Schor, Nina F

    2012-08-21

    As it is currently configured, completion of child neurology residency requires performance of 12 months of training in adult neurology. Exploration of whether or not this duration of training in adult neurology is appropriate for what child neurology is today must take into account the initial reasons for this requirement and the goals of adult neurology training during child neurology residency.

  7. Rate and predictors of serious neurologic causes of dizziness in the emergency department.

    Science.gov (United States)

    Navi, Babak B; Kamel, Hooman; Shah, Maulik P; Grossman, Aaron W; Wong, Christine; Poisson, Sharon N; Whetstone, William D; Josephson, S Andrew; Johnston, S Claiborne; Kim, Anthony S

    2012-11-01

    To describe the rate and predictors of central nervous system (CNS) disease in emergency department (ED) patients with dizziness in the modern era of neuroimaging. We retrospectively reviewed the medical records of all adults presenting between January 1, 2007, and December 31, 2009, to an academic ED for a primary triage complaint of dizziness, vertigo, or imbalance. The final diagnosis for the cause of dizziness was independently assigned by 2 neurologists, with a third neurologist resolving any disagreements. The primary outcome was a composite of ischemic stroke, intracranial hemorrhage, transient ischemic attack, seizure, brain tumor, demyelinating disease, and CNS infection. Univariate and multivariate logistic regression were used to assess the association between clinical variables and serious CNS causes of dizziness. Of 907 patients experiencing dizziness (mean age, 59 years; 58% women [n=529]), 49 (5%) had a serious neurologic diagnosis, including 37 cerebrovascular events. Dizziness was often caused by benign conditions, such as peripheral vertigo (294 patients [32%]) or orthostatic hypotension (121 patients [13%]). Age 60 years or older (odds ratio [OR], 5.7; 95% confidence interval [CI], 2.5-11.2), a chief complaint of imbalance (OR, 5.9; 95% CI, 2.3-15.2), and any focal examination abnormality (OR, 5.9; 95% CI, 3.1-11.2) were independently associated with serious neurologic diagnoses, whereas isolated dizziness symptoms were inversely associated (OR, 0.2; 95% CI, 0.0-0.7). Dizziness in the ED is generally benign, although a substantial fraction of patients harbor serious neurologic disease. Clinical suspicion should be heightened for patients with advanced age, imbalance, or focal deficits. Copyright © 2012 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  8. Neurological outcome after emergency radiotherapy in MSCC of patients with non-small cell lung cancer - a prospective trial

    International Nuclear Information System (INIS)

    Rief, Harald; Heinhold, Rita C; Petersen, Lina C; Rieken, Stefan; Bruckner, Thomas; Moghaddam-Alvandi, Arash; Debus, Jürgen; Sterzing, Florian

    2013-01-01

    The aim of this trial was to investigate neurological outcome after emergency RT in MSCC of NSCLC patients with acute neurological deficit. This pilot trial was prospective, non-randomized, and monocentre, ten patients were treated from July 2012 until June 2013. After onset of neurological symptoms RT was started within 12 hours. The neurological outcome was assessed at baseline, and six weeks after RT using the ASIA Impairment Scale (AIS). The results showed an improved neurological outcome in one patient (10%), one patient (10%) had a decreased, and five patients (50%) a constant outcome after six weeks. Three patients (30%) died within the first six weeks following RT, additional 4 patients (40%) died within 4 month due to tumor progression. In this group of NSCLC patients we were able to show that emergency RT in MSCC with acute neurological deficit had no considerable benefit in neurological outcome. Therefore, short-course regime or best supportive care due to poor survival should be considered for these patients with additional distant metastases. Patients with favorable prognosis may be candidates for long-course RT

  9. A prospective emergency department-based study of pattern and outcome of neurologic and neurosurgical diseases in Haiti.

    Science.gov (United States)

    Barthélemy, Ernest Joseph; Benjamin, Ernest; Edouard Jean-Pierre, Marie Yolaine; Poitevien, Geneviève; Ernst, Silvia; Osborn, Irene; Germano, Isabelle M

    2014-12-01

    To perform the first prospective survey of neurologic and neurosurgical emergency department (ED) admissions in Haiti. Data of all ED admissions at 3 Haitian hospitals for 90 consecutive days per site were collected prospectively. Patients who were given a diagnosis of a neurologic or neurosurgical disorder by the ED physician were entered in a deidentified database including demographics, presenting symptoms, brain imaging (when available), requests for neurosurgical consultation, and outcome. Of the 7628 patients admitted to the ED during this study, 1243 patients had a neurologic disorder, yielding an ED-based neurologic disease prevalence of 16%. The 3 most common neurologic diseases were cerebrovascular disease (31%), neurotrauma (28%), and altered mental status (12%). Neurosurgical pathologies represented 19% of all neurologic admissions with a combined ED-based disease prevalence of 3%. Mortality rate was 9%. The most common neurosurgical disease was neurotrauma (87%), caused by motor vehicle accidents (59%), falls (20%), and assault (17%). Neurosurgical procedures were performed in 14 of 208 patients with a mortality rate of 33%. This prospective survey represents the first study of neurosurgical or neurologic disease patterns in Haiti. The results suggest specific disease priorities for this population that can guide efforts to improve Haitian health care and conduct more comprehensive epidemiologic studies in Haiti. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. REQUIREMENTS FOR IMAGE QUALITY OF EMERGENCY SPACECRAFTS

    Directory of Open Access Journals (Sweden)

    A. I. Altukhov

    2015-05-01

    Full Text Available The paper deals with the method for formation of quality requirements to the images of emergency spacecrafts. The images are obtained by means of remote sensing of near-earth space orbital deployment in the visible range. of electromagnetic radiation. The method is based on a joint taking into account conditions of space survey, characteristics of surveillance equipment, main design features of the observed spacecrafts and orbital inspection tasks. Method. Quality score is the predicted linear resolution image that gives the possibility to create a complete view of pictorial properties of the space image obtained by electro-optical system from the observing satellite. Formulation of requirements to the numerical value of this indicator is proposed to perform based on the properties of remote sensing system, forming images in the conditions of outer space, and the properties of the observed emergency spacecraft: dimensions, platform construction of the satellite, on-board equipment placement. For method implementation the authors have developed a predictive model of requirements to a linear resolution for images of emergency spacecrafts, making it possible to select the intervals of space shooting and get the satellite images required for quality interpretation. Main results. To verify the proposed model functionality we have carried out calculations of the numerical values for the linear resolution of the image, ensuring the successful task of determining the gross structural damage of the spacecrafts and identifying changes in their spatial orientation. As input data were used with dimensions and geometric primitives corresponding to the shape of deemed inspected spacecrafts: Resurs-P", "Canopus-B", "Electro-L". Numerical values of the linear resolution images have been obtained, ensuring the successful task solution for determining the gross structural damage of spacecrafts.

  11. Education requirements for nurses working with people with complex neurological conditions: nurses' perceptions.

    Science.gov (United States)

    Baker, Mark

    2012-01-01

    Following a service evaluation methodology, this paper reports on registered nurses' (RNs) and healthcare assistants' (HCAs) perceptions about education and training requirements in order to work with people with complex neurological disabilities. A service evaluation was undertaken to meet the study aim using a non-probability, convenience method of sampling 368 nurses (n=110 RNs, n=258 HCAs) employed between October and November 2008 at one specialist hospital in south-west London in the U.K. The main results show that respondents were clear about the need to develop an education and training programme for RNs and HCAs working in this speciality area (91% of RNs and 94% of HCAs). A variety of topics were identified to be included within a work-based education and training programme, such as positively managing challenging behaviour, moving and handling, working with families. Adults with complex neurological needs have diverse needs and thus nurses working with this patient group require diverse education and training in order to deliver quality patient-focused nursing care. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Neurological Soft Signs, Spontaneous and Treatment Emergent Extrapyramidal Syndromes in Black Africans With First Episode Schizophrenia

    Directory of Open Access Journals (Sweden)

    Akin Ojagbemi

    2018-05-01

    Full Text Available Background: Very little is known about the relationship between spontaneous and treatment-induced motor syndromes in Africans with first episode schizophrenia.Objective: We investigated the association between spontaneous NSS and EPS, with treatment-induced EPS in a homogenous sample of Black Africans with first episode schizophrenia.Methods: We examined Xhosa (South Africa and Yoruba (Nigeria patients, using the Neurological Evaluation Scale and extrapyramidal symptoms scale before and at 3 months after exposure to low dose flupenthixol decanoate. Pearson's correlations and Linear regression models, controlling for duration of untreated psychosis (D.U.P and premorbid adjustments, were used in examining associations.Results: Among 99 participants in the baseline sample, 91 (91.8% and 20 (20.2% had at least one definite NSS and EPS, respectively, before exposure to antipsychotics. Treatment-induced EPS were recorded in 34 (38.6%. Spontaneous EPS was associated with treatment-emergent Akathisia in participants with a longer D.U.P (r = 0.75, β = 0.70, p = 0.008. This association was specific for Parkinsonism (r = 0.75, β = 0.85, p = 0.008 and dyskinesia (r = 0.75, β = 1.70, p = 0.008.Conclusion: Similar to previous findings for tardive dyskinesia in studies implementing longer-term follow-up, spontaneous EPS may also predict short-term antipsychotic-induced EPS such as akathisia. These results may be important for early identification of patients at risk of treatment-induced Akathisia-linked psychomotor agitation in first episode schizophrenia.

  13. Some Qualitative Requirements for Testing of Nuclear Emergency Response Robots

    International Nuclear Information System (INIS)

    Eom, Heungseop; Cho, Jai Wan; Choi, Youngsoo; Jeong, Kyungmin

    2014-01-01

    Korea Atomic Energy Research Institute (KAERI) is carrying out the project 'Development of Core Technology for Remote Response in Nuclear Emergency Situation', and as a part of the project, we are studying the reliability and performance requirements of nuclear emergency response robots. In this paper, we described some qualitative requirements for testing of nuclear emergency response robots which are different to general emergency response robots. We briefly introduced test requirements of general emergency response robots and described some qualitative aspects of test requirements for nuclear emergency response robots. When considering an immature field-robot technology and variety of nuclear emergency situations, it seems hard to establish quantitative test requirements of these robots at this time. However, based on studies of nuclear severe accidents and the experience of Fukushima NPP accident, we can expect some test requirements including quantitative ones for nuclear emergency response robots

  14. PRACTICAL RECOMMENDATIONS OF DATA PREPROCESSING AND GEOSPATIAL MEASURES FOR OPTIMIZING THE NEUROLOGICAL AND OTHER PEDIATRIC EMERGENCIES MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Ionela MANIU

    2017-08-01

    Full Text Available Time management, optimal and timed determination of emergency severity as well as optimizing the use of available human and material resources are crucial areas of emergency services. A starting point for achieving these optimizations can be considered the analysis and preprocess of real data from the emergency services. The benefits of performing this method consist in exposing more useful structures to data modelling algorithms which consequently will reduce overfitting and improves accuracy. This paper aims to offer practical recommendations for data preprocessing measures including feature selection and discretization of numeric attributes regarding age, duration of the case, season, period, week period (workday, weekend and geospatial location of neurological and other pediatric emergencies. An analytical, retrospective study was conducted on a sample consisting of 933 pediatric cases, from UPU-SMURD Sibiu, 01.01.2014 – 27.02.2017 period.

  15. 12 CFR 204.9 - Emergency reserve requirement.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 2 2010-01-01 2010-01-01 false Emergency reserve requirement. 204.9 Section... RESERVE REQUIREMENTS OF DEPOSITORY INSTITUTIONS (REGULATION D) § 204.9 Emergency reserve requirement. (a..., additional reserve requirements on depository institutions at any ratio on any liability upon a finding by at...

  16. 32 CFR 732.16 - Emergency care requirements.

    Science.gov (United States)

    2010-07-01

    ... sepsis. (9) Any other obstetrical condition that, by definition, constitutes an emergency circumstance. ... 32 National Defense 5 2010-07-01 2010-07-01 false Emergency care requirements. 732.16 Section 732... MEDICAL AND DENTAL CARE Medical and Dental Care From Nonnaval Sources § 732.16 Emergency care requirements...

  17. The emerging link between O-GlcNAcylation and neurological disorders.

    Science.gov (United States)

    Ma, Xiaofeng; Li, He; He, Yating; Hao, Junwei

    2017-10-01

    O-linked β-N-acetylglucosaminylation (O-GlcNAcylation) is involved in the regulation of many cellular cascades and neurological diseases such as Alzheimer's disease (AD), Parkinson's disease (PD), and stroke. In the brain, the expression of O-GlcNAcylation is notably heightened, as is that of O-linked N-acetylglucosaminyltransferase (OGT) and β-N-acetylglucosaminidase (OGA), the presence of which is prominent in many regions of neurological importance. Most importantly, O-GlcNAcylation is believed to contribute to the normal functioning of neurons; conversely, its dysregulation participates in the pathogenesis of neurological disorders. In neurodegenerative diseases, O-GlcNAcylation of the brain's key proteins, such as tau and amyloid-β, interacts with their phosphorylation, thereby triggering the formation of neurofibrillary tangles and amyloid plaques. An increase of O-GlcNAcylation by pharmacological intervention prevents neuronal loss. Additionally, O-GlcNAcylation is stress sensitive, and its elevation is cytoprotective. Increased O-GlcNAcylation ameliorated brain damage in victims of both trauma-hemorrhage and stroke. In this review, we summarize the current understanding of O-GlcNAcylation's physiological and pathological roles in the nervous system and provide a foundation for development of a therapeutic strategy for neurological disorders.

  18. Department of Energy Emergency Management Functional Requirements Study

    International Nuclear Information System (INIS)

    1987-05-01

    This Study, the Emergency Management Functional Requirements Study (EMFRS), identifies the physical environment, information resources, and equipment required in the DOE Headquarters Emergency Operations Center (EOC) to support the DOE staff in managing an emergency. It is the first step toward converting the present Forrestal EOC into a practical facility that will function well in each of the highly diverse types of emergencies in which the Department could be involved. 2 figs

  19. Emergency Evacuation Management Requirements and Concepts

    Science.gov (United States)

    1981-05-01

    state government would assert positive leadership , motivate the public, and issue emergency directives. In other words, local officials assume...feasible way to implement such a program is for FEMA to assume leadership through subordinate units considered relevant and prestigous. Active...Supply and Organizations and recruits Organizations control per- D&C and organizatins ronitor Distribution control operations. ations. and reallocate

  20. Causal inference as an emerging statistical approach in neurology: an example for epilepsy in the elderly

    Directory of Open Access Journals (Sweden)

    Moura LMVR

    2016-12-01

    Full Text Available Lidia MVR Moura,1,2 M Brandon Westover,1,2 David Kwasnik,1 Andrew J Cole,1,2 John Hsu3–5 1Massachusetts General Hospital, Department of Neurology, Epilepsy Service, Boston, MA, USA; 2Harvard Medical School, Boston, MA, USA; 3Massachusetts General Hospital, Mongan Institute, Boston, MA, USA; 4Harvard Medical School, Department of Medicine, Boston, MA, USA; 5Harvard Medical School, Department of Health Care Policy, Boston, MA, USA Abstract: The elderly population faces an increasing number of cases of chronic neurological conditions, such as epilepsy and Alzheimer’s disease. Because the elderly with epilepsy are commonly excluded from randomized controlled clinical trials, there are few rigorous studies to guide clinical practice. When the elderly are eligible for trials, they either rarely participate or frequently have poor adherence to therapy, thus limiting both generalizability and validity. In contrast, large observational data sets are increasingly available, but are susceptible to bias when using common analytic approaches. Recent developments in causal inference-analytic approaches also introduce the possibility of emulating randomized controlled trials to yield valid estimates. We provide a practical example of the application of the principles of causal inference to a large observational data set of patients with epilepsy. This review also provides a framework for comparative-effectiveness research in chronic neurological conditions. Keywords: epilepsy, epidemiology, neurostatistics, causal inference

  1. CK2—An Emerging Target for Neurological and Psychiatric Disorders

    Directory of Open Access Journals (Sweden)

    Julia Castello

    2017-01-01

    Full Text Available Protein kinase CK2 has received a surge of attention in recent years due to the evidence of its overexpression in a variety of solid tumors and multiple myelomas as well as its participation in cell survival pathways. CK2 is also upregulated in the most prevalent and aggressive cancer of brain tissue, glioblastoma multiforme, and in preclinical models, pharmacological inhibition of the kinase has proven successful in reducing tumor size and animal mortality. CK2 is highly expressed in the mammalian brain and has many bona fide substrates that are crucial in neuronal or glial homeostasis and signaling processes across synapses. Full and conditional CK2 knockout mice have further elucidated the importance of CK2 in brain development, neuronal activity, and behavior. This review will discuss recent advances in the field that point to CK2 as a regulator of neuronal functions and as a potential novel target to treat neurological and psychiatric disorders.

  2. [Regression trends of neurologic damage in the surgical emergency management of patients with injuries of the cervical vertebrae with spinal cord involvement].

    Science.gov (United States)

    Kortmann, H R; Wolter, D; Meinecke, F W; Eggers, C

    1986-11-01

    Sixty-five patients with cervical spine injuries and varied neurological deficits were treated operatively. Evaluation revealed an improvement in neurological findings dependent upon the promptness of anatomical reduction in patients with incomplete lesions. The more frequent neurological improvement seen with open reduction and internal fixation as compared with closed reduction was not statistically significant but was felt to justify the additional resources required for internal fixation. In complete lesions, there was no evidence that the time of anatomical reduction was related to improvement in neurological findings.

  3. Spatial data requirements for emergency response

    International Nuclear Information System (INIS)

    Walker, H.

    1985-01-01

    The Atmospheric Release Advisory Capability (ARAC) provides real-time assessments of the consequences resulting from an atmospheric radioactive material. In support of this operation, a system has been created which integrates numerical models, data acquisition systems, data analysis techniques, and professional staff. Components of this system rely to large degree on spatial data of various kinds. Of particular importance is the rapid generation of digital terrain models for any area in the continental U.S. The digital terrain models are used as input to atmospheric models and serve to familiarize assessors to new areas by presenting the terrain surface as a graphical image. In addition, base map data (roads, rivers, political boundaries) must also be supplied as an overlay to ARAC graphical products. A terrain data base and an associated acquisition system have been developed that provide the required terrain data within ten minutes. This terrain data base was derived from the Defense Mapping Ageny's planar data. A digital base map data base is currently being developed from the U.S. Geographical Survey's 1:2,000,000 Digital Line Graph data as well as their Geographic Names Information System. This base map data base improves ARAC's response to its mapping needs anywhere in the continental U.S

  4. Paraneoplastic limbic encephalitis presenting as a neurological emergency: a case report

    Directory of Open Access Journals (Sweden)

    Mehta Brijesh P

    2010-03-01

    Full Text Available Abstract Introduction Paraneoplastic limbic encephalitis remains a challenging clinical diagnosis with poor outcome if it is not recognized and treated early in the course of the disease. Case Presentation A 65-year-old Caucasian woman presented with generalized tonic-clonic seizures and increasing confusion shortly after a lung biopsy that led to the diagnosis of small-cell lung cancer. She had a complicated hospital course, and had recurrent respiratory distress due to aspiration pneumonia, and fluctuating mental status and seizures that were refractory to anti-epileptic drug treatment. Routine laboratory testing, magnetic resonance imaging of the brain, electroencephalogram, lumbar puncture, serum and cerebrospinal fluid tests for paraneoplastic antibodies, and chest computed tomography were performed on our patient. The diagnosis was paraneoplastic limbic encephalitis in the setting of small-cell lung cancer with positive N-type voltage-gated calcium channel antibody titer. Anti-epileptic drugs for seizures, chemotherapy for small-cell lung cancer, and intravenous immunoglobulin and steroids for paraneoplastic limbic encephalitis led to a resolution of her seizures and improved her mental status. Conclusion Early recognition of paraneoplastic limbic encephalitis and prompt intervention with immune therapies at the onset of presentation will probably translate into more favorable neurological outcomes.

  5. Emergency Closed Reduction of a C4/5 Fracture Dislocation with Complete Paraplegia Resulting in Profound Neurologic Recovery

    Directory of Open Access Journals (Sweden)

    Christian W. Müller

    2013-01-01

    Full Text Available Introduction. Cervical spinal cord injuries due to traumatic fractures are associated with persistent neurological deficits. Although clinical evidence is weak, early decompression, defined as <24–72 h, has been frequently proposed. Animal studies show better outcomes after early decompression within one hour or less, which can hardly ever be achieved in clinical practice. Case Presentation. A 37-year-old patient was hospitalized after being hit by a shying horse. After diagnosis of C4/5 fracture dislocation and complete paraplegia, she was intubated and sedated with deep relaxation. Emergency reduction was performed at approximately 120 minutes after trauma. Subsequently, a standard anterior decompression, discectomy, and fusion were carried out. She was then transferred to a specialized rehabilitation hospital. Her neurologic function improved from AIS grade A on admission to grade B postoperatively and grade D after four months of rehabilitation. One year after the accident, she was ambulatory without walking aids and restarted horse riding. Discussion and Conclusion. Rarely in clinical practice, decompression of the spine canal can be performed as early as in this case. This case highlights the potential benefit of utmost early reduction in cervical fracture dislocations with compression of the spinal cord.

  6. ALWR utility requirements - A technical basis for updated emergency planning

    International Nuclear Information System (INIS)

    Leaver, David E.W.; DeVine, John C. Jr.; Santucci, Joseph

    2004-01-01

    U.S. utilities, with substantial support from international utilities, are developing a comprehensive set of design requirements in the form of a Utility Requirements Document (URD) as part of an industry wide effort to establish a technical foundation for the next generation of light water reactors. A key aspect of the URD is a set of severe accident-related design requirements which have been developed to provide a technical basis for updated emergency planning for the ALWR. The technical basis includes design criteria for containment performance and offsite dose during severe accident conditions. An ALWR emergency planning concept is being developed which reflects this severe accident capability. The main conclusion from this work is that the likelihood and consequences of a severe accident for an ALWR are fundamentally different from that assumed in the technical basis for existing emergency planning requirements, at least in the U.S. The current technical understanding of severe accident risk is greatly improved compared to that available when the existing U.S. emergency planning requirements were established nearly 15 years ago, and the emerging ALWR designs have superior core damage prevention and severe accident mitigation capability. Thus, it is reasonable and prudent to reflect this design capability in the emergency planning requirements for the ALWR. (author)

  7. Establishing functional requirements for emergency management information systems

    Energy Technology Data Exchange (ETDEWEB)

    Reed, J.H.; Rogers, G.O.; Sorensen, J.H.

    1991-01-01

    The advancement of computer technologies has led to the development of a number of emergency management information systems (e.g., EIS, CAMEO, IEMIS). The design of these systems has tended to be technologically driven rather than oriented to meeting information management needs during an emergency. Of course, emergency management needs vary depending on the characteristics of the emergency. For example, in hurricanes, onset is typically slow enough to allow emergency managers to simulate evacuations dynamically while in chemical disasters onset may be sufficiently rapid to preclude such simulation(s). This paper describes a system design process in which the analysis of widely recognized emergency management functions was used to identify information requirements and the requisite software and hardware capabilities to deal with rapid onset, low probability, high consequence events. These requirements were then implemented as a prototype emergency management system using existing hardware and software to assure feasibility. Data, hardware, and software requirements were further developed, refined, and made more concrete through an iterative prototyping effort. This approach focuses attention directly on meeting emergency management information needs while avoiding unneeded technological innovations. 10 refs., 4 figs., 1 tab.

  8. Neurology Concepts: Young Women and Ischemic Stroke-Evaluation and Management in the Emergency Department.

    Science.gov (United States)

    Chang, Bernard P; Wira, Charles; Miller, Joseph; Akhter, Murtaza; Barth, Bradley E; Willey, Joshua; Nentwich, Lauren; Madsen, Tracy

    2018-01-01

    Ischemic stroke is a leading cause of morbidity and mortality worldwide. While the incidence of ischemic stroke is highest in older populations, incidence of ischemic stroke in adults has been rising particularly rapidly among young (e.g., premenopausal) women. The evaluation and timely diagnosis of ischemic stroke in young women presents a challenging situation in the emergency department, due to a range of sex-specific risk factors and to broad differentials. The goals of this concepts paper are to summarize existing knowledge regarding the evaluation and management of young women with ischemic stroke in the acute setting. A panel of six board-certified emergency physicians, one with fellowship training in stroke and one with training in sex- and sex-based medicine, along with one vascular neurologist were coauthors involved in the paper. Each author used various search strategies (e.g., PubMed, PsycINFO, and Google Scholar) for primary research and reviewed articles related to their section. The references were reviewed and evaluated for relevancy and included based on review by the lead authors. Estimates on the incidence of ischemic stroke in premenopausal women range from 3.65 to 8.9 per 100,000 in the United States. Several risk factors for ischemic stroke exist for young women including oral contraceptive (OCP) use and migraine with aura. Pregnancy and the postpartum period (up to 12 weeks) is also an important transient state during which risks for both ischemic stroke and cerebral hemorrhage are elevated, accounting for 18% of strokes in women under 35. Current evidence regarding the management of acute ischemic stroke in young women is also summarized including use of thrombolytic agents (e.g., tissue plasminogen activator) in both pregnant and nonpregnant individuals. Unique challenges exist in the evaluation and diagnosis of ischemic stroke in young women. There are still many opportunities for future research aimed at improving detection and treatment

  9. Pictures as a neurological tool: lessons from enhanced and emergent artistry in brain disease.

    Science.gov (United States)

    Schott, G D

    2012-06-01

    Pictures created spontaneously by patients with brain disease often display impaired or diminished artistry, reflecting the patient's cerebral damage. This article explores the opposite: those pictures created in the face of brain disease that show enhanced or enduring artistry, and those that emerge for the first time in artistically naïve patients. After comments on background issues relating to the patient and the viewer, the paintings and drawings are considered in relation to the heterogeneous conditions in which this artistic creativity is seen. These conditions include various dementias-most notably frontotemporal lobar dementia, stroke, Parkinson's disease, autism and related disorders and psychiatric disease, epilepsy, migraine and trauma. In the discussion, it is argued that evidence of underlying brain dysfunction revealed by these pictures often rests on the abnormal context in which the pictures are created, or on changes in artistry demonstrated by a sequence of pictures. In the former, the compulsive element and sensory and emotional accompaniments are often important features; in the latter, evolving changes are evident, and have included depiction of increasing menace in portrayal of faces. The occurrence of synaesthesia, and its relation to creativity, are briefly discussed in respect of two unusual patients, followed by considering the role of the anterior and frontal lobes, mesolimbic connections and the right hemisphere. In at least some patients, impaired inhibition leading to paradoxical functional facilitation, with compensatory changes particularly in the right posterior hemisphere, is likely to be pivotal in enabling unusual artistry to emerge; preservation of language, however, is not a prerequisite. Many patients studied have been artists, and it appears possible that some of those with an artistic predisposition may be more likely to experience pathologically obsessive creativity. The discussion concludes that occasionally pictures

  10. Identifying and Managing Engineering Design Requirements for Emerging Markets

    DEFF Research Database (Denmark)

    Li, Xuemeng

    , especially for those companies originally from developed markets, to acquire an in-depth understanding of particular design requirements in emerging markets in order to adapt both company products and approaches in such contexts. Prior studies on the identification and management of design requirements have...... predominantly been conducted in the context of developed countries and relatively affluent markets. Emerging markets are distinct from developed markets in terms of numerous contextual factors, e.g., regulatory environments and competitive landscapes. These factors influence the requirement identification...... attention. There is a need for an overview of different perspectives in requirement identification for manufacturing companies and their corresponding assessments in the context of emerging markets. Therefore, this research project is motivated to 1) investigate the process of identifying and managing...

  11. Zika Virus-associated Ocular and Neurologic Disorders: The Emergence of New Evidence.

    Science.gov (United States)

    Şahiner, Fatih; Siğ, Ali Korhan; Savaşçi, Ümit; Tekin, Kemal; Akay, Fahrettin

    2017-12-01

    It has been approximately 70 years since the discovery of the Zika virus (ZIKV). It had been established that the virus causes mild infections and is confined to Africa and Asia; however, major changes in the clinical and epidemiologic patterns of ZIKV infection have occurred in recent years. The virus has attracted intense interest because of the possible association of several autoimmune and neurodevelopmental disorders. We present a summary of the articles that attempt to explain the ZIKV unknowns and strengthen the association with some disorders that are thought to be related to ZIKV, by describing the discovery milestones from the initial identification of the virus to the present day. New evidence strengthens the association between ZIKV infections and Guillain-Barré syndrome (GBS), microcephaly and various neurodevelopmental and ophthalmologic disorders as a result of numerous new clinical and experimental studies. The World Health Organization declared the end of the "Public Health Emergency of International Concern" in December 2016, but ZIKV and associated consequences remain a significant enduring public health challenge.

  12. Dimensioning of emergency condensers in accordance with safety requirements

    Energy Technology Data Exchange (ETDEWEB)

    Palavecino, C [SIEMENS, Energieerzeugung, Offenbach (Germany)

    1996-12-01

    The emergency condensers are heat exchangers consisting of a parallel arrangement of horizontal U-tubes between two common heads. The tope header is connected via piping to the reactor vessel steam space, while the lower header is connected to the reactor vessel below the reactor vessel water level. The heat exchangers are located in a pool filled with cold water. The emergency condensers and the reactor vessel thus form a system of communicating pipes. At normal reactor water level, the emergency condensers are flooded with cold, non-flowing water. No heat transfer takes place in this condition. If there is a drop in the reactor water level, the heat exchanging surfaces are gradually uncovered and the incoming steam condenses on the cold surfaces. The cold condensate in returned to the reactor vessel. In this way, heat is removed from the reactor vessel and water simultaneously supplied to the reactor vessel. This means that the emergency condensers function as a heat removal system while at the same time serving as HP and LP coolant injection systems. The emergency condensers operate with the highest possible degree of passivity imaginable, namely through a drop in the reactor vessel water level alone, requiring neither control systems nor power supply. The design of the emergency condensers must meet the requirements dictated by the thermal and the hydraulic conditions. Taking into consideration a redundancy degree of N + 2, a specific thermal rating of 63 MW per emergency condenser results for a reactor with an output of 2778 MW. The total performance of the emergency condenser system in thus 252 MW, or 9.1% of reactor output. The probability of failure of the emergency condenser of Siemens SWR 1000 is approximately 10{sup -4} per demand, while that of the older emergency condenser designs is approximately 2 to 3 x 10{sup -3} per demand. (author). 7 figs, 2 tabs.

  13. 41 CFR 101-26.607-3 - Emergency requirements.

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Emergency requirements. 101-26.607-3 Section 101-26.607-3 Public Contracts and Property Management Federal Property Management Regulations System FEDERAL PROPERTY MANAGEMENT REGULATIONS SUPPLY AND PROCUREMENT 26-PROCUREMENT SOURCES AND...

  14. Employer Requirements to Work during Emergency Responses: Key Ethics Considerations.

    Science.gov (United States)

    Rutkow, Lainie; Taylor, Holly A; Powell, Tia

    2017-03-01

    Local health departments and their employees are at the forefront of emergency preparedness and response. Yet, recent studies have found that some local public health workers are unwilling to report to work in a variety of disaster scenarios. This can greatly compromise a response, as many local health departments need "all hands on deck" to effectively meet increased demands. To address these concerns, local health departments have employed varied policy strategies to ensure that employees do report to work. After describing different approaches taken by local health departments throughout the United States, we briefly identify and explore key ethics considerations that arise for local health departments when employees are required to report to work for emergency responses. We then discuss how these ethics considerations may inform local health department practices intended to promote a robust emergency response.

  15. Mesenteric panniculitis patients requiring emergency surgery: report of three cases.

    Science.gov (United States)

    Duman, Mustafa; Koçak, Osman; Fazli, Olgaç; Koçak, Cengiz; Atici, Ali Emre; Duman, Uğur

    2012-04-01

    Mesenteric panniculitis is a rare, benign disease characterized by a chronic non-specific inflammatory process of mesenteric fat tissue with unknown etiology. The small bowel mesentery is affected mostly. This process rarely involves the large intestine mesentery. Mesenteric panniculitis includes symptoms as abdominal pain, nausea and vomiting, diarrhea, constipation, and fever. In our cases, we had difficulty in the preoperative diagnosis as the clinical changes imitated an obstruction or ischemia of the small bowel. All the cases required emergency abdominal surgery and partial jejunal resection. The aim of this article was to present three cases of mesenteric panniculitis of the small bowel mesentery requiring emergency surgery together with a short review of the literature.

  16. 78 FR 31769 - Accessible Emergency Information; Apparatus Requirements for Emergency Information and Video...

    Science.gov (United States)

    2013-05-24

    ... and equipment and better access video programming.'' \\7\\ \\7\\ H.R. Rep. No. 111-563, 111th Cong., 2d... Video Accessibility Act of 2010 (``CVAA''), the Commission adopts rules requiring video programming distributors and video programming providers (including program owners) to make televised emergency information...

  17. Definition of areas requiring criticality alarm annunciation and emergency control

    International Nuclear Information System (INIS)

    Hobson, J.M.

    1988-01-01

    The design of fissile material handling at British Nuclear Fuels plc requires the provision of a criticality incident detection system unless a specific case for omission can be formally made. Where such systems are provided, the 100 mSv contour resulting from a reference criticality incident must be restricted to an area of administrative control within which it is reasonably practicable to provide alarm annunciation and for which emergency arrangements can be defined. For typical reprocessing plant applications, the definition of these areas, and their restriction by provision of shielding where necessary, potentially requires a very large number of three dimensional neutron transport calculations in complex geometries. However, by considering the requirements and nature of this assessment, simple generic methods have been developed and justified. Consequently, rapid and inexpensive assessments of control areas can be carried out

  18. Tumefactive multiple sclerosis requiring emergency craniotomy: case report and literature review.

    Science.gov (United States)

    Munarriz, Pablo M; Castaño-Leon, Ana M; Martinez-Perez, Rafael; Hernandez-Lain, Aurelio; Ramos, Ana; Lagares, Alfonso

    2013-01-01

    Multiple sclerosis (MS) is a demyelinating disease of the central nervous system, characterized by focal neurological dysfunction with a relapsing and remitting course. Tumor-like presentation of MS (or "tumefactive"/"pseudotumoral" presentation) has been described before with a certain frequency; it consists of a large single plaque (>2cm) with presence of edema and mass effect and it is hard to distinguish from a brain tumor. However, we present a very rare case of a 53-year-old woman with a right temporal mass that turned out to be a MS plaque, who deteriorated within hours (brain herniation with loss of consciousness and unilateral mydriasis) and required an emergency craniotomy. We also present a review of the literature. It appears that only 4 cases of emergency craniotomy/craniectomy required in a patient with a tumor-like MS plaque have been reported before. Copyright © 2012 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  19. Clarification of TMI action plan requirements. Requirements for emergency response capability

    International Nuclear Information System (INIS)

    1983-01-01

    This document, Supplement 1 to NUREG-0737, is a letter from D. G. Eisenhut, Director of the Division of Licensing, NRR, to licensees of operating power reactors, applicants for operating licenses, and holders of construction permits forwarding post-TMI requirements for emergency response capability which have been approved for implementation. On October 30, 1980, the NRC staff issued NUREG-0737, which incorporated into one document all TMI-related items approved for implementation by the Commission at that time. In this NRC report, additional clarification is provided regarding Safety Parameter Display Systems, Detailed Control Room Design Reviews, Regulatory Guide 1.97 (Revision 2) - Application to Emergency Response Facilities, Upgrade of Emergency Operating Procedures, Emergency Response Facilities, and Meteorological Data

  20. Neurology and neurologic practice in China.

    Science.gov (United States)

    Shi, Fu-Dong; Jia, Jian-Ping

    2011-11-29

    In the wake of dramatic economic success during the past 2 decades, the specialized field of neurology has undergone a significant transformation in China. With an increase in life expectancy, the problems of aging and cognition have grown. Lifestyle alterations have been associated with an epidemiologic transition both in the incidence and etiology of stroke. These changes, together with an array of social issues and institution of health care reform, are creating challenges for practicing neurologists throughout China. Notable problems include overcrowded, decrepit facilities, overloaded physician schedules, deteriorating physician-patient relationships, and an insufficient infrastructure to accommodate patients who need specialized neurologic care. Conversely, with the creation of large and sophisticated neurology centers in many cities across the country, tremendous opportunities exist. Developments in neurologic subspecialties enable delivery of high-quality care. Clinical and translational research based on large patient populations as well as highly sophisticated technologies are emerging in many neurologic centers and pharmaceutical companies. Child neurology and neurorehabilitation will be fast-developing subdisciplines. Given China's extensive population, the growth and progress of its neurology complex, and its ever-improving quality control, it is reasonable to anticipate that Chinese neurologists will contribute notably to unraveling the pathogenic factors causing neurologic diseases and to providing new therapeutic solutions.

  1. Impact of a Revised Curriculum Focusing on Clinical Neurology and Musculoskeletal Care on a Required Fourth-Year Medical Student Physical Medicine and Rehabilitation Clerkship

    Directory of Open Access Journals (Sweden)

    John W. Norbury

    2016-01-01

    Full Text Available Background. A Required Fourth-Year Medical Student Physical Medicine and Rehabilitation (PM&R Clerkship was found to increase students’ knowledge of PM&R; however the students’ overall rotation evaluations were consistently lower than the other 8 required clerkships at the medical school. Objective. To describe the impact of a revised curriculum based upon Entrustable Professional Activities and focusing on basic pain management, musculoskeletal care, and neurology. Setting. Academic Medical Center. Participants. 73 fourth-year medical students. Methods. The curriculum changes included a shift in the required readings from rehabilitation specific topics toward more general content in the areas of clinical neurology and musculoskeletal care. Hands-on workshops on neurological and musculoskeletal physical examination techniques, small group case-based learning, an anatomy clinical correlation lecture, and a lecture on pain management were integrated into the curriculum. Main Outcome Measurements. Student evaluations of the clerkship. Results. Statistically significant improvements were found in the students’ evaluations of usefulness of lecturers, development of patient interviewing skills, and diagnostic and patient management skills (p≤0.05. Conclusions. This study suggests that students have a greater satisfaction with a required PM&R clerkship when lecturers utilize a variety of pedagogic methods to teach basic pain, neurology and musculoskeletal care skills in the rehabilitation setting rather than rehabilitation specific content.

  2. Composition and fundamental requirements of nuclear emergency response monitoring equipment

    International Nuclear Information System (INIS)

    Lai Yongfang; Huang Weiqi; Wang Yonghong

    2009-01-01

    Nuclear emergency monitoring equipment is concrete foundation for accomplishing radiation monitoring in nuclear or radiation accidents. Based on technical report: Generic procedures for monitoring in a nuclear or radiological emergency published by IAEA in 1999, this paper presents the main task and composition of nuclear emergency monitoring briefly, and then the basic equipment and trends of nuclear emergency monitoring equipment is put forward in detail, which is useful to construction and reinforcement of our nuclear emergency monitoring. (authors)

  3. [Neurology! Adieau? (Part 2)].

    Science.gov (United States)

    Szirmai, Imre

    2010-05-30

    The education of neurologists is debilitated worldwide. University professors are engaged in teaching, research and patient-care. This triple challenge is very demanding, and results in permanent insecurity of University employees. To compensate for the insufficient clinical training, some institutes in the USA employ academic staff members exclusively for teaching. The formation of new subspecialties hinders the education and training of general neurologists. At present, four generations of medical doctors are working together in hospitals. The two older generations educate the younger neurologists who have been brought up in the world of limitless network of sterile information. Therefore their manual skills at the bedside and their knowledge of emergency treatment are deficient. Demographics of medical doctors changed drastically. Twice as many women are working in neurology and psychiatry than men. Integrity of neurology is threatened by: (1) Separation of the cerebrovascular diseases from general neurology. Development of "stroke units" was facilitated by the better reimbursement for treatment and by the interest of the pharmaceutical companies. Healthcare politics promoted the split of neurology into two parts. The independent status of "stroke departments" will reduce the rest of clinical neurology to outpatient service. (2) The main argumentation to segregate the rare neurological diseases was that their research will provide benefit for the diseases with high prevalence. This argumentation serves territorial ambitions. The separation of rare diseases interferes with the teaching of differential diagnostics in neurological training. The traditional pragmatic neurology can not be retrieved. The faculty of neurology could retain its integrity by the improvement of diagnostic methods and the ever more effective drugs. Nevertheless, even the progression of neurological sciences induces dissociation of clinical neurology. Neurology shall suffer fragmentation if

  4. Gender differences in neurological emergencies part II: a consensus summary and research agenda on traumatic brain injury.

    Science.gov (United States)

    Wright, David W; Espinoza, Tamara R; Merck, Lisa H; Ratcliff, Jonathan J; Backster, Anika; Stein, Donald G

    2014-12-01

    Traumatic brain injury (TBI) is a major cause of death and disability worldwide. There is strong evidence that gender and sex play an important role across the spectrum of TBI, from pathophysiology to clinical care. In May 2014, Academic Emergency Medicine held a consensus conference "Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes." A TBI working group was formed to explore what was known about the influence of sex and gender on TBI and to identify gaps for future research. The findings resulted in four major recommendations to guide the TBI research agenda. © 2014 by the Society for Academic Emergency Medicine.

  5. Nurse management skills required at an emergency care unit

    OpenAIRE

    Montezeli, Juliana Helena; Peres, Aida Maris; Bernardino, Elizabeth

    2013-01-01

    Objective: To identify the management skills needed for this professional at an emergency care unit. Method: An exploratory descriptive qualitative study conducted with eight nurses in which semi-structured interviews with nonparticipating systematic observation were conducted; the data was processed by content analysis. Results: The categories which emerged from the content analysis served as a list of management skills necessary to their work at the emergency care unit: leadership, decision...

  6. Current neurology

    International Nuclear Information System (INIS)

    Appel, S.H.

    1988-01-01

    The topics covered in this book include: Duchenne muscular dystrophy: DNA diagnosis in practice; Central nervous system magnetic resonance imaging; and Magnetic resonance spectroscopy of neurologic diseases

  7. Critical Infrastructure Awareness Required by Civil Emergency Planning

    NARCIS (Netherlands)

    Luiijf, H.A.M.; Klaver, M.H.A.

    2005-01-01

    Modern societies are increasingly dependent on a set of critical products and services which comprise the Critical Infrastructure (CI). This makes Critical infrastructures increasingly important as a planning factor in case of emergencies. For that reason, we studied a number of emergencies and a

  8. Emergency Response Capability Baseline Needs Assessment - Requirements Document

    Energy Technology Data Exchange (ETDEWEB)

    Sharry, J A

    2016-10-04

    This document was prepared by John A. Sharry, LLNL Fire Marshal and LLNL Division Leader for Fire Protection and reviewed by LLNL Emergency Management Department Head James Colson. The document follows and expands upon the format and contents of the DOE Model Fire Protection Baseline Capabilities Assessment document contained on the DOE Fire Protection Web Site, but only addresses emergency response.

  9. Cardiomyopathy in neurological disorders.

    Science.gov (United States)

    Finsterer, Josef; Stöllberger, Claudia; Wahbi, Karim

    2013-01-01

    According to the American Heart Association, cardiomyopathies are classified as primary (solely or predominantly confined to heart muscle), secondary (those showing pathological myocardial involvement as part of a neuromuscular disorder) and those in which cardiomyopathy is the first/predominant manifestation of a neuromuscular disorder. Cardiomyopathies may be further classified as hypertrophic cardiomyopathy, dilated cardiomyopathy, restrictive cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, or unclassified cardiomyopathy (noncompaction, Takotsubo-cardiomyopathy). This review focuses on secondary cardiomyopathies and those in which cardiomyopathy is the predominant manifestation of a myopathy. Any of them may cause neurological disease, and any of them may be a manifestation of a neurological disorder. Neurological disease most frequently caused by cardiomyopathies is ischemic stroke, followed by transitory ischemic attack, syncope, or vertigo. Neurological disease, which most frequently manifests with cardiomyopathies are the neuromuscular disorders. Most commonly associated with cardiomyopathies are muscular dystrophies, myofibrillar myopathies, congenital myopathies and metabolic myopathies. Management of neurological disease caused by cardiomyopathies is not at variance from the same neurological disorders due to other causes. Management of secondary cardiomyopathies is not different from that of cardiomyopathies due to other causes either. Patients with neuromuscular disorders require early cardiologic investigations and close follow-ups, patients with cardiomyopathies require neurological investigation and avoidance of muscle toxic medication if a neuromuscular disorder is diagnosed. Which patients with cardiomyopathy profit most from primary stroke prevention is unsolved and requires further investigations. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. American Academy of Neurology

    Science.gov (United States)

    ... on draft guideline manuscript on autism and sleep problems. Capitol Hill Report: Opioid Epidemic Declared Public Health Emergency Read the latest news on how the AAN is fighting for neurology in Washington DC. New Study: Virtual Reality Training May Be as Effective as Regular Therapy ...

  11. Neurologic complications in oncology

    Directory of Open Access Journals (Sweden)

    Andrea Pace

    2010-06-01

    Full Text Available Neurologic side effects related to cancer therapy are a common problem in oncology practice. These complications can negatively affect the management of the patient, because they can inhibit treatment and diminish quality of life. Therefore specific skills are required to recognise symptoms and clinical manifestations. This review focuses on the most common neurologic complications to improve physician’s familiarity in determining the aetiology of these symptoms.

  12. Quantification In Neurology

    Directory of Open Access Journals (Sweden)

    Netravati M

    2005-01-01

    Full Text Available There is a distinct shift of emphasis in clinical neurology in the last few decades. A few years ago, it was just sufficient for a clinician to precisely record history, document signs, establish diagnosis and write prescription. In the present context, there has been a significant intrusion of scientific culture in clinical practice. Several criteria have been proposed, refined and redefined to ascertain accurate diagnosis for many neurological disorders. Introduction of the concept of impairment, disability, handicap and quality of life has added new dimension to the measurement of health and disease and neurological disorders are no exception. "Best guess" treatment modalities are no more accepted and evidence based medicine has become an integral component of medical care. Traditional treatments need validation and new therapies require vigorous trials. Thus, proper quantification in neurology has become essential, both in practice and research methodology in neurology. While this aspect is widely acknowledged, there is a limited access to a comprehensive document pertaining to measurements in neurology. This following description is a critical appraisal of various measurements and also provides certain commonly used rating scales/scores in neurological practice.

  13. 40 CFR 355.12 - What quantities of extremely hazardous substances trigger emergency planning requirements?

    Science.gov (United States)

    2010-07-01

    ... EMERGENCY PLANNING AND NOTIFICATION Emergency Planning Who Must Comply § 355.12 What quantities of extremely... 40 Protection of Environment 27 2010-07-01 2010-07-01 false What quantities of extremely hazardous substances trigger emergency planning requirements? 355.12 Section 355.12 Protection of Environment...

  14. 75 FR 52753 - Agency Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management...

    Science.gov (United States)

    2010-08-27

    ... therefore submitting a revised data collection form for emergency clearance. The definition of subsidized... Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management and Budget (OMB) Title: TANF Emergency Fund Subsidized Employment Report, Form OFA- 200. OMB No.: New Collection. Description...

  15. 75 FR 32473 - Agency Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management...

    Science.gov (United States)

    2010-06-08

    ... a TANF Emergency Fund award. The definition of subsidized employment used for this collection is the... Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management and Budget (OMB) Title: TANF Emergency Fund Subsidized Employment Report, Form OFA 200. OMB No.: New Collection. Description...

  16. Development of CSA N1600-14: general requirements for nuclear emergency management programs

    Energy Technology Data Exchange (ETDEWEB)

    Sellar, C. [Canadian Standards Association Group, Mississauga, ON (Canada); Coles, J. [Ontario Power Generation, Darlington, ON (Canada)

    2014-07-01

    CSA Group has published a new standard on General requirements for nuclear emergency management programs (CSA N1600-14). The standard establishes criteria for the emergency management programs of on- and off-site organizations to address nuclear emergencies at Canadian nuclear power plants (NPPs). It provides the requirements to develop, implement, evaluate, maintain, and continuously improve a nuclear emergency management program for prevention and mitigation, preparedness, response, and recovery from a nuclear emergency at a NPP. This paper discusses the development of the standard, and provides the key drivers, structure, scope, and outline of the standard, while highlighting key features, impacts, and benefits. (author)

  17. Neurologic disorders

    International Nuclear Information System (INIS)

    Chakeres, D.W.

    1987-01-01

    There is a wide range of indications for radiographic evaluation of possible cerebrovascular disease, since a wide range of neurologic symptoms can be encountered secondary to ischemia. Frequently the diagnosis of cerebrovascular disease is clear on clinical grounds, but radiographic evaluation is essential both to quantify the extent of disease and establish the underlying cause (e.g., vasculitis, embolus) while excluding other causes so that the proper therapy can follow

  18. Emergency department CT screening of patients with nontraumatic neurological symptoms referred to the posterior fossa: comparison of thin versus thick slice images.

    Science.gov (United States)

    Kamalian, Shervin; Atkinson, Wendy L; Florin, Lauren A; Pomerantz, Stuart R; Lev, Michael H; Romero, Javier M

    2014-06-01

    Evaluation of the posterior fossa (PF) on 5-mm-thick helical CT images (current default) has improved diagnostic accuracy compared to 5-mm sequential CT images; however, 5-mm-thick images may not be ideal for PF pathology due to volume averaging of rapid changes in anatomy in the Z-direction. Therefore, we sought to determine if routine review of 1.25-mm-thin helical CT images has superior accuracy in screening for nontraumatic PF pathology. MRI proof of diagnosis was obtained within 6 h of helical CT acquisition for 90 consecutive ED patients with, and 88 without, posterior fossa lesions. Helical CT images were post-processed at 1.25 and 5-mm-axial slice thickness. Two neuroradiologists blinded to the clinical/MRI findings reviewed both image sets. Interobserver agreement and accuracy were rated using Kappa statistics and ROC analysis, respectively. Of the 90/178 (51 %) who were MR positive, 60/90 (66 %) had stroke and 30/90 (33 %) had other etiologies. There was excellent interobserver agreement (κ > 0.97) for both thick and thin slice assessments. The accuracy, sensitivity, and specificity for 1.25-mm images were 65, 44, and 84 %, respectively, and for 5-mm images were 67, 45, and 85 %, respectively. The diagnostic accuracy was not significantly different (p > 0.5). In this cohort of patients with nontraumatic neurological symptoms referred to the posterior fossa, 1.25-mm-thin slice CT reformatted images do not have superior accuracy compared to 5-mm-thick images. This information has implications on optimizing resource utilizations and efficiency in a busy emergency room. Review of 1.25-mm-thin images may help diagnostic accuracy only when review of 5-mm-thick images as current default is inconclusive.

  19. Multiattribute selection of acute stroke imaging software platform for Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) clinical trial.

    Science.gov (United States)

    Churilov, Leonid; Liu, Daniel; Ma, Henry; Christensen, Soren; Nagakane, Yoshinari; Campbell, Bruce; Parsons, Mark W; Levi, Christopher R; Davis, Stephen M; Donnan, Geoffrey A

    2013-04-01

    The appropriateness of a software platform for rapid MRI assessment of the amount of salvageable brain tissue after stroke is critical for both the validity of the Extending the Time for Thrombolysis in Emergency Neurological Deficits (EXTEND) Clinical Trial of stroke thrombolysis beyond 4.5 hours and for stroke patient care outcomes. The objective of this research is to develop and implement a methodology for selecting the acute stroke imaging software platform most appropriate for the setting of a multi-centre clinical trial. A multi-disciplinary decision making panel formulated the set of preferentially independent evaluation attributes. Alternative Multi-Attribute Value Measurement methods were used to identify the best imaging software platform followed by sensitivity analysis to ensure the validity and robustness of the proposed solution. Four alternative imaging software platforms were identified. RApid processing of PerfusIon and Diffusion (RAPID) software was selected as the most appropriate for the needs of the EXTEND trial. A theoretically grounded generic multi-attribute selection methodology for imaging software was developed and implemented. The developed methodology assured both a high quality decision outcome and a rational and transparent decision process. This development contributes to stroke literature in the area of comprehensive evaluation of MRI clinical software. At the time of evaluation, RAPID software presented the most appropriate imaging software platform for use in the EXTEND clinical trial. The proposed multi-attribute imaging software evaluation methodology is based on sound theoretical foundations of multiple criteria decision analysis and can be successfully used for choosing the most appropriate imaging software while ensuring both robust decision process and outcomes. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke Organization.

  20. Preparedness and Response for a Nuclear or Radiological Emergency. General Safety Requirements (Chinese Edition)

    International Nuclear Information System (INIS)

    2016-01-01

    This publication, jointly sponsored by the FAO, IAEA, ICAO, ILO, IMO, INTERPOL, OECD/NEA, PAHO, CTBTO, UNEP, OCHA, WHO and WMO, is the new edition establishing the requirements for preparedness and response for a nuclear or radiological emergency which takes into account the latest experience and developments in the area. It supersedes the previous edition of the Safety Requirements for emergency preparedness and response, Safety Standards Series No. GS-R-2, which was published in 2002. This publication establishes the requirements for ensuring an adequate level of preparedness and response for a nuclear or radiological emergency, irrespective of its cause. These Safety Requirements are intended to be used by governments, emergency response organizations, other authorities at the local, regional and national levels, operating organizations and the regulatory body as well as by relevant international organizations at the international level.

  1. Preparedness and Response for a Nuclear or Radiological Emergency. General Safety Requirements (Arabic Edition)

    International Nuclear Information System (INIS)

    2016-01-01

    This publication, jointly sponsored by the FAO, IAEA, ICAO, ILO, IMO, INTERPOL, OECD/NEA, PAHO, CTBTO, UNEP, OCHA, WHO and WMO, is the new edition establishing the requirements for preparedness and response for a nuclear or radiological emergency which takes into account the latest experience and developments in the area. It supersedes the previous edition of the Safety Requirements for emergency preparedness and response, Safety Standards Series No. GS-R-2, which was published in 2002. This publication establishes the requirements for ensuring an adequate level of preparedness and response for a nuclear or radiological emergency, irrespective of its cause. These Safety Requirements are intended to be used by governments, emergency response organizations, other authorities at the local, regional and national levels, operating organizations and the regulatory body as well as by relevant international organizations at the international level.

  2. Preparedness and Response for a Nuclear or Radiological Emergency. General Safety Requirements (Russian Edition)

    International Nuclear Information System (INIS)

    2016-01-01

    This publication, jointly sponsored by the FAO, IAEA, ICAO, ILO, IMO, INTERPOL, OECD/NEA, PAHO, CTBTO, UNEP, OCHA, WHO and WMO, is the new edition establishing the requirements for preparedness and response for a nuclear or radiological emergency which takes into account the latest experience and developments in the area. It supersedes the previous edition of the Safety Requirements for emergency preparedness and response, Safety Standards Series No. GS-R-2, which was published in 2002. This publication establishes the requirements for ensuring an adequate level of preparedness and response for a nuclear or radiological emergency, irrespective of its cause. These Safety Requirements are intended to be used by governments, emergency response organizations, other authorities at the local, regional and national levels, operating organizations and the regulatory body as well as by relevant international organizations at the international level.

  3. 33 CFR 157.410 - Emergency lightering requirements for oil tankers.

    Science.gov (United States)

    2010-07-01

    ... HOMELAND SECURITY (CONTINUED) POLLUTION RULES FOR THE PROTECTION OF THE MARINE ENVIRONMENT RELATING TO TANK... Petroleum Oils § 157.410 Emergency lightering requirements for oil tankers. Each oil tanker, to which this...

  4. [Emergency transcranial doppler ultrasound: predictive value for the development of symptomatic vasospasm in spontaneous subarachnoid hemorrhage in patients in good neurological condition].

    Science.gov (United States)

    Muñoz-Sanchez, M A; Murillo-Cabezas, F; Egea-Guerrero, J J; Gascón-Castillo, M L; Cancela, P; Amaya-Villar, R; Rincón-Ferrari, M D; Flores-Cordero, J M; Cayuela, A; García-Alfaro, C

    2012-12-01

    To examine the predictive value of an early transcranial Doppler ultrasound (TCD) study performed in the emergency department in patients with spontaneous subarachoniod hemorrhage (SAH) in good neurological condition, in order to know which patients are at high risk of developing delayed cerebral ischemia (DCI). A descriptive observational study was carried out involving a period of 3 years. Critical Care and Emergency Department. The study consecutively included patients with SAH of grade I-III on the Hunt and Hess scale. DCI (decrease of 2 points in GCS or focal deficit), Mean Velocity (MV) of middle cerebral arteries (MCA), Lindegaard Index (IL). Sonographic vasospasm pattern (SVP) was considered if MCA-MV>120cm/sc and IL>3. The mean age of the 122 patients was 54.1±13.7 years; 57.3% were women. SVP was detected in 24 patients (19.7%), although high velocities patterns (HVP) were present in 38 patients (31.1%). DCI developed in 21 patients (MV183+/-49cm/sc), all with previous SVP. In this group MV increased 22+/-5cm/sc/day during the first 3 days. The group without HVP (84 patients/MV of 67+/-16.6cm/sc), compared with DCI group, showed differences in highest MV (p<0.001), and also ΔMV/day (8.30+/-4,5cm/sc Vs 22+/-5cm/sc) during the first 3 days (p=0.009). In our series, ROC analysis selected the best cut-off value for ΔMV/day as 21cm/sc (p<0.001). During the first 3 days, an increase of 21cm/s/24h in MCA-MV was associated with the development of symptomatic vasospasm. TCD is a useful tool for the early detection of patients at risk of DCI after SAH. Copyright © 2011 Elsevier España, S.L. and SEMICYUC. All rights reserved.

  5. A study on the establishment of habitability requirement for enviromental laboratory in nuclear emergency

    International Nuclear Information System (INIS)

    Khang, Byung Oui

    2003-01-01

    The Establishment of the habitability requirement for Environmental Laboratory (EL) was required to decide the time of movement to a backup EL. The habitability criteria of the EL located inside plum pathway emergency planning zone was established including the alarm setpoint of the area radiation monitor based on the operational intervention level recommended by IAEA. The MDA of analysis equipments were established based on the generic action level recommended by IAEA. The countermeasures for the loss of habitability of EL was established by defined the emergency response activity at EL in nuclear emergency

  6. 78 FR 51729 - Emergency Clearance: Public Information Collection Requirements Submitted to the Office of...

    Science.gov (United States)

    2013-08-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare and Medicaid Services [Document Identifier: CMS-10496 Emergency Clearance: Public Information Collection Requirements Submitted to the Office of Management and Budget (OMB) AGENCY: Center for Medicare and Medicaid Services. In compliance with the requirement of section 3506(c)(2)(A) of...

  7. 78 FR 56898 - Emergency Clearance: Public Information Collection Requirements Submitted to the Office of...

    Science.gov (United States)

    2013-09-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare and Medicaid Services [Document Identifier: CMS-10371] Emergency Clearance: Public Information Collection Requirements Submitted to the Office of Management and Budget (OMB) AGENCY: Center for Medicare and Medicaid Services, HHS. In compliance with the requirement of section 3506(c)(2)...

  8. Prototyping and validating requirements of radiation and nuclear emergency plan simulator

    Energy Technology Data Exchange (ETDEWEB)

    Hamid, AHA., E-mail: amyhamijah@nm.gov.my [Malaysian Nuclear Agency (NM), Bangi, 43000 Kajang, Selangor (Malaysia); Faculty of Computing, Universiti Teknologi Malaysia (UTM), Skudai, 81310 Johor Bahru, Johor (Malaysia); Rozan, MZA.; Ibrahim, R.; Deris, S.; Selamat, A. [Faculty of Computing, Universiti Teknologi Malaysia (UTM), Skudai, 81310 Johor Bahru, Johor (Malaysia)

    2015-04-29

    Organizational incapability in developing unrealistic, impractical, inadequate and ambiguous mechanisms of radiological and nuclear emergency preparedness and response plan (EPR) causing emergency plan disorder and severe disasters. These situations resulting from 65.6% of poor definition and unidentified roles and duties of the disaster coordinator. Those unexpected conditions brought huge aftermath to the first responders, operators, workers, patients and community at large. Hence, in this report, we discuss prototyping and validating of Malaysia radiation and nuclear emergency preparedness and response plan simulation model (EPRM). A prototyping technique was required to formalize the simulation model requirements. Prototyping as systems requirements validation was carried on to endorse the correctness of the model itself against the stakeholder’s intensions in resolving those organizational incapability. We have made assumptions for the proposed emergency preparedness and response model (EPRM) through the simulation software. Those assumptions provided a twofold of expected mechanisms, planning and handling of the respective emergency plan as well as in bringing off the hazard involved. This model called RANEPF (Radiation and Nuclear Emergency Planning Framework) simulator demonstrated the training emergency response perquisites rather than the intervention principles alone. The demonstrations involved the determination of the casualties’ absorbed dose range screening and the coordination of the capacity planning of the expected trauma triage. Through user-centred design and sociotechnical approach, RANEPF simulator was strategized and simplified, though certainly it is equally complex.

  9. Prototyping and validating requirements of radiation and nuclear emergency plan simulator

    International Nuclear Information System (INIS)

    Hamid, AHA.; Rozan, MZA.; Ibrahim, R.; Deris, S.; Selamat, A.

    2015-01-01

    Organizational incapability in developing unrealistic, impractical, inadequate and ambiguous mechanisms of radiological and nuclear emergency preparedness and response plan (EPR) causing emergency plan disorder and severe disasters. These situations resulting from 65.6% of poor definition and unidentified roles and duties of the disaster coordinator. Those unexpected conditions brought huge aftermath to the first responders, operators, workers, patients and community at large. Hence, in this report, we discuss prototyping and validating of Malaysia radiation and nuclear emergency preparedness and response plan simulation model (EPRM). A prototyping technique was required to formalize the simulation model requirements. Prototyping as systems requirements validation was carried on to endorse the correctness of the model itself against the stakeholder’s intensions in resolving those organizational incapability. We have made assumptions for the proposed emergency preparedness and response model (EPRM) through the simulation software. Those assumptions provided a twofold of expected mechanisms, planning and handling of the respective emergency plan as well as in bringing off the hazard involved. This model called RANEPF (Radiation and Nuclear Emergency Planning Framework) simulator demonstrated the training emergency response perquisites rather than the intervention principles alone. The demonstrations involved the determination of the casualties’ absorbed dose range screening and the coordination of the capacity planning of the expected trauma triage. Through user-centred design and sociotechnical approach, RANEPF simulator was strategized and simplified, though certainly it is equally complex

  10. Prototyping and validating requirements of radiation and nuclear emergency plan simulator

    Science.gov (United States)

    Hamid, AHA.; Rozan, MZA.; Ibrahim, R.; Deris, S.; Selamat, A.

    2015-04-01

    Organizational incapability in developing unrealistic, impractical, inadequate and ambiguous mechanisms of radiological and nuclear emergency preparedness and response plan (EPR) causing emergency plan disorder and severe disasters. These situations resulting from 65.6% of poor definition and unidentified roles and duties of the disaster coordinator. Those unexpected conditions brought huge aftermath to the first responders, operators, workers, patients and community at large. Hence, in this report, we discuss prototyping and validating of Malaysia radiation and nuclear emergency preparedness and response plan simulation model (EPRM). A prototyping technique was required to formalize the simulation model requirements. Prototyping as systems requirements validation was carried on to endorse the correctness of the model itself against the stakeholder's intensions in resolving those organizational incapability. We have made assumptions for the proposed emergency preparedness and response model (EPRM) through the simulation software. Those assumptions provided a twofold of expected mechanisms, planning and handling of the respective emergency plan as well as in bringing off the hazard involved. This model called RANEPF (Radiation and Nuclear Emergency Planning Framework) simulator demonstrated the training emergency response perquisites rather than the intervention principles alone. The demonstrations involved the determination of the casualties' absorbed dose range screening and the coordination of the capacity planning of the expected trauma triage. Through user-centred design and sociotechnical approach, RANEPF simulator was strategized and simplified, though certainly it is equally complex.

  11. Preparedness and response for a nuclear or radiological emergency. Safety requirements

    International Nuclear Information System (INIS)

    2004-01-01

    This Safety Requirements publication establishes the requirements for an adequate level of preparedness and response for a nuclear or radiological emergency in any State. Their implementation is intended to minimize the consequences for people, property and the environment of any nuclear or radiological emergency. The fulfilment of these requirements will also contribute to the harmonization of arrangements in the event of a transnational emergency. These requirements are intended to be applied by authorities at the national level by means of adopting legislation, establishing regulations and assigning responsibilities. The requirements apply to all those practices and sources that have the potential for causing radiation exposure or environmental radioactive contamination warranting an emergency intervention and that are: (a) Used in a State that chooses to adopt the requirements or that requests any of the sponsoring organizations to provide for the application of the requirements. (B) Used by States with the assistance of the FAO, IAEA, ILO, PAHO, OCHA or WHO in compliance with applicable national rules and regulations. (C) Used by the IAEA or which involve the use of materials, services, equipment, facilities and non-published information made available by the IAEA or at its request or under its control or supervision. Or (d) Used under any bilateral or multilateral arrangement whereby the parties request the IAEA to provide for the application of the requirements. The requirements also apply to the off-site jurisdictions that may need to make an emergency intervention in a State that adopts the requirements. The types of practices and sources covered by these requirements include: fixed and mobile nuclear reactors. Facilities for the mining and processing of radioactive ores. Facilities for fuel reprocessing and other fuel cycle facilities. Facilities for the management of radioactive waste. The transport of radioactive material. Sources of radiation used in

  12. Severe hypoglycaemia requiring the assistance of emergency medical services - frequency, causes and symptoms

    Czech Academy of Sciences Publication Activity Database

    Krnačová, V.; Kuběna, Aleš Antonín; Macek, K.; Bezděk, M.; Šmahelová, A.; Vlček, J.

    2012-01-01

    Roč. 156, č. 3 (2012), s. 271-277 ISSN 1213-8118 Grant - others:GA UK(CZ) SVV-2010-261-004 Keywords : regression trees * causes * symptoms * incidence * emergency medical service * severe hypoglycaemia Subject RIV: EI - Biotechnology ; Bionics Impact factor: 0.990, year: 2012 http://library.utia.cas.cz/separaty/2013/E/kubena-severe hypoglycaemia requiring the assistance of emergency medical services - frequency causes and symptoms.pdf

  13. Emerging Requirements for Technology Management: A Sector-based Scenario Planning Approach

    Directory of Open Access Journals (Sweden)

    Simon Patrick Philbin

    2013-09-01

    Full Text Available Identifying the emerging requirements for technology management will help organisations to prepare for the future and remain competitive. Indeed technology management as a discipline needs to develop and respond to societal and industrial needs as well as the corresponding technology challenges. Therefore, following a review of technology forecasting methodologies, a sector-based scenario planning approach has been used to derive the emerging requirements for technology management. This structured framework provided an analytical lens to focus on the requirements for managing technology in the healthcare, energy and higher education sectors over the next 5-10 years. These requirements include the need for new business models to support the adoption of technologies; integration of new technologies with existing delivery channels; management of technology options including R&D project management; technology standards, validation and interoperability; and decision-making tools to support technology investment.

  14. 78 FR 77469 - Emergency Clearance: Public Information Collection Requirements Submitted to the Office of...

    Science.gov (United States)

    2013-12-23

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document Identifier: CMS-10510] Emergency Clearance: Public Information Collection Requirements Submitted to the Office of Management and Budget (OMB) AGENCY: Centers for Medicare & Medicaid Services, HHS. In compliance with section 3506(c)(2)(A) of the Paperwork...

  15. 78 FR 62638 - Agency Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management...

    Science.gov (United States)

    2013-10-22

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Agency Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management and Budget (OMB) Title: Low Income Home Energy Assistance Program (LIHEAP) Grantee Needs Assessment. OMB No.: New Collection. Description: This information collection is a...

  16. Emergency surgery and Limitation of therapeutic effort in relation to neurologic deterioration in elderly patients – a survey of European surgeons

    Directory of Open Access Journals (Sweden)

    Mihai Păduraru

    2017-10-01

    Full Text Available Background. In emergency surgery, a very heterogeneous approach is required in the decision making process, especially when considering the patient’s postoperative quality of life as well as medical, ethical, and legal factors. In some cases, the presence of an Advance Directive (AD form may potentially help resolve the surgeon’s dilemma. Objectives. The primary objective of this survey was to investigate the opinions of surgeons across a representative cross-section of European countries regarding the decision making process using a specific case scenario so as to identify similarities and differences in practice. A secondary objective was to identify the possibility of establishing a more uniform approach and best practice. Method. A survey was conducted of surgeons from a range of European countries. Questionnaires were designed to obtain an overview of decision making in relation to the Limitation of Therapeutic Effort (LTE using a specific case study and the level of awareness and practical use of ADs. Surveys were distributed via email to the members of the ESTES (European Society for Trauma and Emergency Surgery and AEC (Association of Spanish surgeons, with voluntary, anonymous participation. Conclusions. Clear and additional support in the form of legal and ethical guidance with clinical protocols for surgical practice in such case scenarios is necessary. Wider use of ADs, together with education about their role and support for patients and relatives, would benefit the type of patient described in our scenario. A multidisciplinary team should play a more active role in decision making in order to avoid surgical procedures that are potentially futile. The concepts of LTE and Quality of life need a broader understanding among surgeons as well as more consistent application.

  17. Lawrence Livermore National Laboratory Emergency Response Capability Baseline Needs Assessment Requirement Document

    Energy Technology Data Exchange (ETDEWEB)

    Sharry, J A

    2009-12-30

    This revision of the LLNL Fire Protection Baseline Needs Assessment (BNA) was prepared by John A. Sharry, LLNL Fire Marshal and LLNL Division Leader for Fire Protection and reviewed by Martin Gresho, Sandia/CA Fire Marshal. The document follows and expands upon the format and contents of the DOE Model Fire Protection Baseline Capabilities Assessment document contained on the DOE Fire Protection Web Site, but only address emergency response. The original LLNL BNA was created on April 23, 1997 as a means of collecting all requirements concerning emergency response capabilities at LLNL (including response to emergencies at Sandia/CA) into one BNA document. The original BNA documented the basis for emergency response, emergency personnel staffing, and emergency response equipment over the years. The BNA has been updated and reissued five times since in 1998, 1999, 2000, 2002, and 2004. A significant format change was performed in the 2004 update of the BNA in that it was 'zero based.' Starting with the requirement documents, the 2004 BNA evaluated the requirements, and determined minimum needs without regard to previous evaluations. This 2010 update maintains the same basic format and requirements as the 2004 BNA. In this 2010 BNA, as in the previous BNA, the document has been intentionally divided into two separate documents - the needs assessment (1) and the compliance assessment (2). The needs assessment will be referred to as the BNA and the compliance assessment will be referred to as the BNA Compliance Assessment. The primary driver for separation is that the needs assessment identifies the detailed applicable regulations (primarily NFPA Standards) for emergency response capabilities based on the hazards present at LLNL and Sandia/CA and the geographical location of the facilities. The needs assessment also identifies areas where the modification of the requirements in the applicable NFPA standards is appropriate, due to the improved fire protection

  18. Verification of voltage/ frequency requirement for emergency diesel generator in nuclear power plant using dynamic modeling

    International Nuclear Information System (INIS)

    Hur, J.S.; Roh, M.S.

    2013-01-01

    Full-text: One major cause of the plant shutdown is the loss of electrical power. The study is to comprehend the coping action against station blackout including emergency diesel generator, sequential loading of safety system and to ensure that the emergency diesel generator should meet requirements, especially voltage and frequency criteria using modeling tool. This paper also considered the change of the sequencing time and load capacity only for finding electrical design margin. However, the revision of load list must be verified with safety analysis. From this study, it is discovered that new load calculation is a key factor in EDG localization and in-house capability increase. (author)

  19. Neurologic disorder and criminal responsibility.

    Science.gov (United States)

    Yaffe, Gideon

    2013-01-01

    Sufferers from neurologic and psychiatric disorders are not uncommonly defendants in criminal trials. This chapter surveys a variety of different ways in which neurologic disorder bears on criminal responsibility. It discusses the way in which a neurologic disorder might bear on the questions of whether or not the defendant acted voluntarily; whether or not he or she was in the mental state that is required for guilt for the crime; and whether or not he or she is deserving of an insanity defense. The discussion demonstrates that a just determination of whether a sufferer from a neurologic disorder is diminished in his or her criminal responsibility for harmful conduct requires equal appreciation of the nature of the relevant disorder and its impact on behavior, on the one hand, and of the legal import of facts about the psychologic mechanisms through which behavior is generated, on the other. © 2013 Elsevier B.V. All rights reserved.

  20. [Compliance with the requirements of paediatric emergency departments in Spain: a self-assessment survey].

    Science.gov (United States)

    Sánchez Etxaniz, J; Luaces I Cubells, C; Benito Fernández, J

    2011-08-01

    Paediatric emergency medicine in Spain is practiced in differently configured departments, staffing and organisation. Our goal was to determine the situation in Paediatric Emergency Departments (PED) and their adaptation to the quality standards proposed by the Spanish Society of Paediatric Emergencies. A self-assessment questionnaire on standards performance was sent to 47 PED directors by e-mail. It consisted of 101 items, 69 considered mandatory. According to the fulfilment of these 69 items 4 PED groups were selected: group I: in the best position (met 69), group II: requiring minimal changes (meeting 62-68), group III: requiring major changes (meeting 41-61); group IV: requiring a lot of major changes (meeting less than 41). Thirty nine questionnaires were completed in full. The PED included in the study tended to an average of 35310 annual emergencies (5000-115000). No PED was included in group I, 6 in II 27 in III and 6 in IV. There was a tendency towards higher compliance with standards in larger PED, but there was no significant relationship between the number of emergencies and the number of items fulfilled. 1. Staffing and architectural and organizational aspects may not be adequate to achieve optimal patient outcome in many PED in Spain. This fact does not appear to be related to the annual patient census. 2. The areas for improvement mainly affect functional issues that must be undertaken by those responsible. 3. A significant number of PED have serious architectural and staffing deficiencies, which would require economic measures by their managers. 4. Our self-assessment questionnaire identifies improvement actions. Copyright © 2010 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  1. Neurological examination in small animals

    Directory of Open Access Journals (Sweden)

    Viktor Paluš

    2014-03-01

    Full Text Available This clinical review about the neurological examination in small animals describes the basics about the first steps of investigation when dealing with neurological patients. The knowledge of how to perform the neurological examination is important however more important is how to correctly interpret these performed tests. A step-by-step approach is mandatory and examiners should master the order and the style of performing these tests. Neurological conditions can be sometimes very distressing for owners and for pets that might not be the most cooperating. The role of a veterinary surgeon, as a professional, is therefore to collect the most relevant history, to examine a patient in a professional manner and to give to owners an educated opinion about the further treatment and prognosis. However neurological examinations might look challenging for many. But it is only the clinical application of neuroanatomy and neurophysiology to an every-day situation for practicing veterinarians and it does not require any specific in-to-depth knowledge. This clinical review is aimed not only to provide the information on how to perform the neurological examination but it is also aimed to appeal on veterinarians to challenge their daily routine and to start practicing on neurologically normal patients. This is the best and only way to differentiate between the normal and abnormal in a real situation.

  2. What is 5G? Emerging 5G Mobile Services and Network Requirements

    OpenAIRE

    Heejung Yu; Howon Lee; Hongbeom Jeon

    2017-01-01

    In this paper, emerging 5G mobile services are investigated and categorized from the perspective of not service providers, but end-users. The development of 5G mobile services is based on an intensive analysis of the global trends in mobile services. Additionally, several indispensable service requirements, essential for realizing service scenarios presented, are described. To illustrate the changes in societies and in daily life in the 5G era, five megatrends, including the explosion of mobi...

  3. Identification of emergent off-nominal operational requirements during conceptual architecting of the more electric aircraft

    Science.gov (United States)

    Armstrong, Michael James

    Increases in power demands and changes in the design practices of overall equipment manufacturers has led to a new paradigm in vehicle systems definition. The development of unique power systems architectures is of increasing importance to overall platform feasibility and must be pursued early in the aircraft design process. Many vehicle systems architecture trades must be conducted concurrent to platform definition. With an increased complexity introduced during conceptual design, accurate predictions of unit level sizing requirements must be made. Architecture specific emergent requirements must be identified which arise due to the complex integrated effect of unit behaviors. Off-nominal operating scenarios present sizing critical requirements to the aircraft vehicle systems. These requirements are architecture specific and emergent. Standard heuristically defined failure mitigation is sufficient for sizing traditional and evolutionary architectures. However, architecture concepts which vary significantly in terms of structure and composition require that unique failure mitigation strategies be defined for accurate estimations of unit level requirements. Identifying of these off-nominal emergent operational requirements require extensions to traditional safety and reliability tools and the systematic identification of optimal performance degradation strategies. Discrete operational constraints posed by traditional Functional Hazard Assessment (FHA) are replaced by continuous relationships between function loss and operational hazard. These relationships pose the objective function for hazard minimization. Load shedding optimization is performed for all statistically significant failures by varying the allocation of functional capability throughout the vehicle systems architecture. Expressing hazards, and thereby, reliability requirements as continuous relationships with the magnitude and duration of functional failure requires augmentations to the traditional

  4. Compatibility of DOE energy data bases with EEMIS data requirements. [Energy Emergency Management Information Systems

    Energy Technology Data Exchange (ETDEWEB)

    D& #x27; Acierno, J; Hermelee, A

    1979-12-01

    Object of this report is to present the data from EIA data bases which are compatible with the requirements of the data structure for the Energy Emergency Management Information System (EEMIS). An overview of data availability is briefly described and presented in the EEMIS petroleum and natural gas flow diagrams as well as in a more detailed review with each data element in the EEMIS data requirements. This information is presented with the intent that it be used as an overall system guide during the data transfer task as well as in future operation of EEMIS and in the interpretation of EEMIS data.

  5. 40 CFR 355.11 - To what substances do the emergency planning requirements of this subpart apply?

    Science.gov (United States)

    2010-07-01

    ... PLANNING AND NOTIFICATION Emergency Planning Who Must Comply § 355.11 To what substances do the emergency... 40 Protection of Environment 27 2010-07-01 2010-07-01 false To what substances do the emergency planning requirements of this subpart apply? 355.11 Section 355.11 Protection of Environment ENVIRONMENTAL...

  6. Requirements for radiation emergency urine bioassay techniques for the public and first responders.

    Science.gov (United States)

    Li, Chunsheng; Vlahovich, Slavica; Dai, Xiongxin; Richardson, Richard B; Daka, Joseph N; Kramer, Gary H

    2010-11-01

    Following a radiation emergency, the affected public and the first responders may need to be quickly assessed for internal contamination by the radionuclides involved. Urine bioassay is one of the most commonly used methods for assessing radionuclide intake and radiation dose. This paper attempts to derive the sensitivity requirements (from inhalation exposure) for the urine bioassay techniques for the top 10 high-risk radionuclides that might be used in a terrorist attack. The requirements are based on a proposed reference dose to adults of 0.1 Sv (CED, committed effective dose). In addition, requirements related to sample turnaround time and field deployability of the assay techniques are also discussed. A review of currently available assay techniques summarized in this paper reveals that method development for ²⁴¹Am, ²²⁶Ra, ²³⁸Pu, and ⁹⁰Sr urine bioassay is needed.

  7. 3D GEO-INFORMATION REQUIREMENTS FOR DISASTER AND EMERGENCY MANAGEMENT

    Directory of Open Access Journals (Sweden)

    E. Demir Ozbek

    2016-06-01

    Full Text Available A conceptual approach is proposed to define 3D geo-information requirement for different types of disasters. This approach includes components such as Disaster Type-Sector-Actor-Process-Activity-Task-Data. According to disaster types processes, activities, tasks, sectors, and responsible and operational actors are derived. Based on the tasks, the needed level of detail for 3D geo-information model is determined. The levels of detail are compliant with the 3D international standard CityGML. After a brief introduction on the disaster phases and geo-information requirement for actors to perform the tasks, the paper discusses the current situation of disaster and emergency management in Turkey and elaborates on components of conceptual approach. This paper discusses the 3D geo-information requirements for the tasks to be used in the framework of 3D geo-information model for Disaster and Emergency Management System in Turkey. The framework is demonstrated for an industrial fire case in Turkey.

  8. A comparison of alcohol positive and alcohol negative trauma patients requiring an emergency laparotomy.

    Science.gov (United States)

    Benson, Cedric; Weinberg, Janice; Narsule, Chaitan K; Brahmbhatt, Tejal S

    2018-07-01

    The effect of alcohol exposure on patients undergoing a laparotomy for trauma is unknown. The purpose of this study was to compare outcomes of morbidity and mortality between alcohol positive and alcohol negative trauma patients who required emergent laparotomies using the National Trauma Data Bank (NTDB). A retrospective database analysis was performed using 28,354 NTDB incident trauma cases, from 2007 through 2012, who had been tested for alcohol and who required abdominal operations (using ICD-9-CM procedure codes) within 24h of presentation. Variables used: age, gender, admission year, alcohol presence, ISS, GCS, injury type & mechanism, discharge status, hospital LOS, ICU stay, ventilator use, and hospital complications. In adjusted analyses, there were no statistically significant differences between the alcohol positive and alcohol negative cohorts when evaluating in-hospital mortality (OR, 0.93; 95% CI: 0.84-1.03), likelihood of earlier hospital discharge (HR, 1.02; 95% CI: 0.99-1.05), and the all-inclusive category of in-hospital complications (OR, 1.04; 95% CI: 0.97-1.12). After adjusting for age, gender, admission year, ISS, GCS, and injury mechanism, there were no major differences between the alcohol positive and alcohol negative cohorts when it came to in-hospital mortality, likelihood of earlier hospital discharge, and most of the in-hospital complications measured among adult trauma patients requiring emergency laparotomies. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. [Difficult Ventilation Requiring Emergency Endotracheal Intubation during Awake Craniotomy Managed by Laryngeal Mask Airway].

    Science.gov (United States)

    Matsuda, Asako; Mizota, Toshiyuki; Tanaka, Tomoharu; Segawa, Hajime; Fukuda, Kazuhiko

    2016-04-01

    We report a case of difficult ventilation requiring emergency endotracheal intubation during awake craniotomy managed by laryngeal mask airway (LMA). A 45-year-old woman was scheduled to receive awake craniotomy for brain tumor in the frontal lobe. After anesthetic induction, airway was secured using ProSeal LMA and patient was mechanically ventilated in pressure-control mode. Patient's head was fixed with head-pins at anteflex position, and the operation started. About one hour after the start of the operation, tidal volume suddenly decreased. We immediately started manual ventilation, but the airway resistance was extremely high and we could not adequately ventilate the patient. We administered muscle relaxant for suspected laryngospasm, but ventilatory status did not improve; so we decided to conduct emergency endotracheal intubation. We tried to intubate using Airwayscope or LMA-Fastrach, but they were not effective in our case. Finally trachea was intubated using transnasal fiberoptic bronchoscopy. We discuss airway management during awake craniotomy, focusing on emergency endotracheal intubation during surgery.

  10. Users’ Participation in Requirements Gathering for Smart Phones Applications in Emerging Markets

    DEFF Research Database (Denmark)

    Aryana, Bijan; Clemmensen, Torkil; Boks, Casper

    2015-01-01

    This study presents insights from using requirements gathering techniques for country-specific customization of smart phones in two emerging markets, Iran and Turkey. In each country, a group of users participated in requirements gathering sessions that were aimed at developing design ideas...... for overcoming country-specific usability problems. Using qualitative content analysis, it was found that in each country some specific interaction activities were considered more when participants generated design ideas for country-specific usability problems. It was also found that even for similar usability...... problems, participants suggested country-specific solutions. Therefore, it is suggested that participation of local users in the design process should not be limited to identification of usability problems, but should also include the problem-solving phase that is usually a phase in design and development...

  11. Overlapping Requirements for Tet2 and Tet3 in Normal Development and Hematopoietic Stem Cell Emergence

    Directory of Open Access Journals (Sweden)

    Cheng Li

    2015-08-01

    Full Text Available The Tet family of methylcytosine dioxygenases (Tet1, Tet2, and Tet3 convert 5-methylcytosine to 5-hydroxymethylcytosine. To date, functional overlap among Tet family members has not been examined systematically in the context of embryonic development. To clarify the potential for overlap among Tet enzymes during development, we mutated the zebrafish orthologs of Tet1, Tet2, and Tet3 and examined single-, double-, and triple-mutant genotypes. Here, we identify Tet2 and Tet3 as the major 5-methylcytosine dioxygenases in the zebrafish embryo and uncover a combined requirement for Tet2 and Tet3 in hematopoietic stem cell (HSC emergence. We demonstrate that Notch signaling in the hemogenic endothelium is regulated by Tet2/3 prior to HSC emergence and show that restoring expression of the downstream gata2b/scl/runx1 transcriptional network can rescue HSCs in tet2/3 double mutant larvae. Our results reveal essential, overlapping functions for tet genes during embryonic development and uncover a requirement for 5hmC in regulating HSC production.

  12. Employment of telemedicine in emergency medicine. Clinical requirement analysis, system development and first test results.

    Science.gov (United States)

    Czaplik, M; Bergrath, S; Rossaint, R; Thelen, S; Brodziak, T; Valentin, B; Hirsch, F; Beckers, S K; Brokmann, J C

    2014-01-01

    Demographic change, rising co-morbidity and an increasing number of emergencies are the main challenges that emergency medical services (EMS) in several countries worldwide are facing. In order to improve quality in EMS, highly trained personnel and well-equipped ambulances are essential. However several studies have shown a deficiency in qualified EMS physicians. Telemedicine emerges as a complementary system in EMS that may provide expertise and improve quality of medical treatment on the scene. Hence our aim is to develop and test a specific teleconsultation system. During the development process several use cases were defined and technically specified by medical experts and engineers in the areas of: system administration, start-up of EMS assistance systems, audio communication, data transfer, routine tele-EMS physician activities and research capabilities. Upon completion, technical field tests were performed under realistic conditions to test system properties such as robustness, feasibility and usability, providing end-to-end measurements. Six ambulances were equipped with telemedical facilities based on the results of the requirement analysis and 55 scenarios were tested under realistic conditions in one month. The results indicate that the developed system performed well in terms of usability and robustness. The major challenges were, as expected, mobile communication and data network availability. Third generation networks were only available in 76.4% of the cases. Although 3G (third generation), such as Universal Mobile Telecommunications System (UMTS), provides beneficial conditions for higher bandwidth, system performance for most features was also acceptable under adequate 2G (second generation) test conditions. An innovative concept for the use of telemedicine for medical consultations in EMS was developed. Organisational and technical aspects were considered and practical requirements specified. Since technical feasibility was demonstrated in these

  13. The ED-inpatient dashboard: Uniting emergency and inpatient clinicians to improve the efficiency and quality of care for patients requiring emergency admission to hospital.

    Science.gov (United States)

    Staib, Andrew; Sullivan, Clair; Jones, Matt; Griffin, Bronwyn; Bell, Anthony; Scott, Ian

    2017-06-01

    Patients who require emergency admission to hospital require complex care that can be fragmented, occurring in the ED, across the ED-inpatient interface (EDii) and subsequently, in their destination inpatient ward. Our hospital had poor process efficiency with slow transit times for patients requiring emergency care. ED clinicians alone were able to improve the processes and length of stay for the patients discharged directly from the ED. However, improving the efficiency of care for patients requiring emergency admission to true inpatient wards required collaboration with reluctant inpatient clinicians. The inpatient teams were uninterested in improving time-based measures of care in isolation, but they were motivated by improving patient outcomes. We developed a dashboard showing process measures such as 4 h rule compliance rate coupled with clinically important outcome measures such as inpatient mortality. The EDii dashboard helped unite both ED and inpatient teams in clinical redesign to improve both efficiencies of care and patient outcomes. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  14. Neurology at the bedside

    DEFF Research Database (Denmark)

    Kondziella, Daniel; Waldemar, Gunhild

    This updated and expanded new edition takes neurology trainees by the hand and guides them through the whole patient encounter - from an efficient neurological history and bedside examination through to differential diagnosis, diagnostic procedures and treatment. At each step the expert authors......, as have new chapters including neurogenetics, neurorehabilitation, neurocritical care and heuristic neurological reasoning. In addition, this second edition now includes more than 100 unique case histories. Neurology at the Bedside, Second Edition is written for neurologists in all stages of training....... Medical students, general practitioners and others with an interest in neurology will also find invaluable information here....

  15. Patients with worsening chronic heart failure who present to a hospital emergency department require hospital care

    Directory of Open Access Journals (Sweden)

    Shafazand Masoud

    2012-03-01

    Full Text Available Abstract Background Chronic heart failure (CHF is a major public health problem characterised by progressive deterioration with disabling symptoms and frequent hospital admissions. To influence hospitalisation rates it is crucial to identify precipitating factors. To characterise patients with CHF who seek an emergency department (ED because of worsening symptoms and signs and to explore the reasons why they are admitted to hospital. Method Patients (n = 2,648 seeking care for dyspnoea were identified at the ED, Sahlgrenska University Hospital/Östra. Out of 2,648 patients, 1,127 had a previous diagnosis of CHF, and of these, 786 were included in the present study with at least one sign and one symptom of worsening CHF. Results Although several of the patients wanted to go home after acute treatment in the ED, only 2% could be sent home. These patients were enrolled in an interventional study, which evaluated the acute care at home compared to the conventional, in hospital care. The remaining patients were admitted to hospital because of serious condition, including pneumonia/respiratory disease, myocardial infarction, pulmonary oedema, anaemia, the need to monitor cardiac rhythm, pathological blood chemistry and difficulties to communicate. Conclusion The vast majority of patients with worsening CHF seeking the ED required hospital care, predominantly because of co-morbidities. Patients with CHF with symptomatic deterioration may be admitted to hospital without additional emergency room investigations.

  16. The determination of nutritional requirements for Safe Haven Food Supply System (emergency/survival foods)

    Science.gov (United States)

    Ahmed, Selina

    1987-01-01

    The Space Station Safe Haven Food System must sustain 8 crew members under emergency conditions for 45 days. Emergency Survival Foods are defined as a nutritionally balanced collection of high density food and beverages selected to provide for the survival of Space Station flight crews in contingency situations. Since storage volume is limited, the foods should be highly concentrated. A careful study of different research findings regarding starvation and calorie restricted diets indicates that a minimum nutritional need close to RDA is an important factor for sustaining an individual's life in a stressful environment. Fat, protein, and carbohydrates are 3 energy producing nutrients which play a vital role in the growth and maintenance process of human life. A lower intake of protein can minimize the water intake, but it causes a negative nitrogen balance and a lower performance level. Other macro and micro nutrients are also required for nutritional interrelationships to metabolize the other 3 nutrients to their optimum level. The various options for longer duration than 45 days are under investigation.

  17. Converging requirements and emerging challenges to public health diseases surveillance and bio surveillance

    International Nuclear Information System (INIS)

    Rao, V.; Abel, T.

    2009-01-01

    Disease surveillance systems are a critical component of an early warning system for public health agencies to prepare and respond to major public health catastrophes. With a growing emphasis for more robust early indicator and warning systems to track emerging and dangerous diseases of suspicious nature, considerable emphasis is now placed on deployment of more expanded electronic disease surveillance systems. The architectural considerations for bio surveillance information system are based on collection, analysis and dissemination of human, veterinary and agricultural related disease surveillance to broader regional areas likely to be affected in the event of an emerging disease, or due to bioterrorism and better coordinate plans, preparations and response by governmental agencies and multilateral forums. The diseases surveillance systems architectures by intent and design could as well support biological threat monitoring and threat reduction initiatives. As an illustrative sample set, this paper will describe the comparative informatics requirements for a disease surveillance systems developed by CSC for the US Centers for Diseases Control and Prevention (CDC) currently operational nationwide, and biological weapons threat assessment developed as part of the Threat Agent Detection and Response (TADR) Network under the US Biological Threat Reduction Program and deployed at Uzbekistan, Kazakhstan, Georgia, and Azerbaijan.(author)

  18. Oil spill emergency response: Fulfilling regulatory requirements on the Grand Banks

    International Nuclear Information System (INIS)

    Horvath, C.L.

    1991-01-01

    Offshore well licensing under Canadian regulations requires the operator to conduct a practice exercise of oil spill countermeasures and emergency response procedures at least yearly, once the drilling program starts. The relevant parts of the Newfoundland Offshore Petroleum Drilling Regulations are summarized and the objectives and benefits of the practice exercises are reviewed. In addition to ensuring regulatory compliance, the exercises also provide the opportunity to test operational procedures, to provide in-house training, and improve response efficiency by regular repetition of the exercise. Exercises in communications during a spill incident in the offshore and in deployment of offshore spill response equipment conducted by Petro-Canada in Newfoundland are described. Problems identified during the exercises are noted

  19. Bleeding prevalence and transfusion requirement in patients with thrombocytopenia in the emergency department.

    Science.gov (United States)

    Turvani, Fabrizio; Pigozzi, Luca; Barutta, Letizia; Pivetta, Emanuele; Pizzolato, Elisa; Morello, Fulvio; Battista, Stefania; Moiraghi, Corrado; Montrucchio, Giuseppe; Lupia, Enrico

    2014-10-01

    Thrombocytopenia is the most common coagulation disorder in critically ill patients. No studies have investigated the epidemiology and clinical impact of this condition in emergency department (ED) patients. We aimed to investigate epidemiological features, incidence of bleeding, and diagnostic and therapeutic requirements of patients with thrombocytopenia admitted to the ED. We performed a retrospective observational study enrolling all patients admitted to the medical-surgical ED of the "Città della Salute e della Scienza di Torino" Hospital with a platelet count <150×10(9) PLTs/L, during four non-consecutive months. There were no exclusion criteria. The study included 1218 patients. The percentage of patients with severe (<50×10(9) PLTs/L) or very severe (<20×10(9) PLTs/L) thrombocytopenia was about 12%. Thrombocytopenia associated with liver cirrhosis was the most represented etiology. On the contrary, the most frequent cause in patients with newly recognized low platelet count was disseminated intravascular coagulation/sepsis. The incidence of bleeding and hypovolemia, as well as the need of transfusional support and mechanical, surgical or endoscopic hemostasis progressively increased with the severity of thrombocytopenia. Our results suggest that the detection of a platelet count lower than 50×10(9) PLTs/L may help to identify patients with higher bleeding risk in the ED setting. Additional studies are required to evaluate whether, in this setting, thrombocytopenia may represent an independent risk factor for bleeding episodes and increased mortality.

  20. What is 5G? Emerging 5G Mobile Services and Network Requirements

    Directory of Open Access Journals (Sweden)

    Heejung Yu

    2017-10-01

    Full Text Available In this paper, emerging 5G mobile services are investigated and categorized from the perspective of not service providers, but end-users. The development of 5G mobile services is based on an intensive analysis of the global trends in mobile services. Additionally, several indispensable service requirements, essential for realizing service scenarios presented, are described. To illustrate the changes in societies and in daily life in the 5G era, five megatrends, including the explosion of mobile data traffic, the rapid increase in connected devices, everything on the cloud, hyper-realistic media for convergence services and knowledge as a service enabled by big-data analysis, are examined. Based on such trends, we classify the new 5G services into five categories in terms of the end-users’ experience as follows: immersive 5G services, intelligent 5G services, omnipresent 5G services, autonomous 5G services and public 5G services. Moreover, several 5G service scenarios in each service category are presented, and essential technical requirements for realizing the aforementioned 5G services are suggested, along with a competitiveness analysis on 5G services/devices/network industries and the current condition of 5G technologies.

  1. Differences in nutrient requirements imply a non-linear emergence of leaders in animal groups.

    Directory of Open Access Journals (Sweden)

    Cédric Sueur

    Full Text Available Collective decision making and especially leadership in groups are among the most studied topics in natural, social, and political sciences. Previous studies have shown that some individuals are more likely to be leaders because of their social power or the pertinent information they possess. One challenge for all group members, however, is to satisfy their needs. In many situations, we do not yet know how individuals within groups distribute leadership decisions between themselves in order to satisfy time-varying individual requirements. To gain insight into this problem, we build a dynamic model where group members have to satisfy different needs but are not aware of each other's needs. Data about needs of animals come from real data observed in macaques. Several studies showed that a collective movement may be initiated by a single individual. This individual may be the dominant one, the oldest one, but also the one having the highest physiological needs. In our model, the individual with the lowest reserve initiates movements and decides for all its conspecifics. This simple rule leads to a viable decision-making system where all individuals may lead the group at one moment and thus suit their requirements. However, a single individual becomes the leader in 38% to 95% of cases and the leadership is unequally (according to an exponential law distributed according to the heterogeneity of needs in the group. The results showed that this non-linearity emerges when one group member reaches physiological requirements, mainly the nutrient ones - protein, energy and water depending on weight - superior to those of its conspecifics. This amplification may explain why some leaders could appear in animal groups without any despotism, complex signalling, or developed cognitive ability.

  2. Neurology at the bedside

    DEFF Research Database (Denmark)

    Kondziella, Daniel; Waldemar, Gunhild

    , as have new chapters including neurogenetics, neurorehabilitation, neurocritical care and heuristic neurological reasoning. In addition, this second edition now includes more than 100 unique case histories. Neurology at the Bedside, Second Edition is written for neurologists in all stages of training...

  3. The menagerie of neurology

    Science.gov (United States)

    Beh, Shin C.; Frohman, Teresa; Frohman, Elliot M.

    2014-01-01

    Summary Neurology is a field known for “eponymophilia.” While eponym use has been a controversial issue in medicine, animal-related metaphoric descriptions continue to flourish in neurologic practice, particularly with the advent of neuroimaging. To provide practicing and trainee neurologists with a useful reference for all these colorful eponyms, we performed a literature review and summarized the various animal eponyms in the practice of neurology (and their etiologic implications) to date. We believe that the ability to recognize animal-like attributes in clinical neurology and neuroradiology may be attributed to a visual phenomenon known as pareidolia. We propose that animal eponyms are a useful method of recognizing clinical and radiologic patterns that aid in the diagnostic process and therefore are effective aidesmémoire and communicative tools that enliven and improve the practice of neurology. PMID:29473555

  4. Child Neurology Education for Pediatric Residents.

    Science.gov (United States)

    Albert, Dara V F; Patel, Anup D; Behnam-Terneus, Maria; Sautu, Beatriz Cunill-De; Verbeck, Nicole; McQueen, Alisa; Fromme, H Barrett; Mahan, John D

    2017-03-01

    The aim of this study was to evaluate whether the current state of child neurology education during pediatric residency provides adequate preparation for pediatric practice. A survey was sent to recent graduates from 3 pediatric residency programs to assess graduate experience, perceived level of competence, and desire for further education in child neurology. Responses from generalists versus subspecialists were compared. The response rate was 32%, half in general pediatric practice. Only 22% feel very confident in approaching patients with neurologic problems. This may represent the best-case scenario as graduates from these programs had required neurology experiences, whereas review of Accreditation Council of Graduate Medical Education-accredited residency curricula revealed that the majority of residencies do not. Pediatric neurologic problems are common, and pediatric residency graduates do encounter such problems in practice. The majority of pediatricians report some degree of confidence; however, some clear areas for improvement are apparent.

  5. Neurologic complications of vaccinations.

    Science.gov (United States)

    Miravalle, Augusto A; Schreiner, Teri

    2014-01-01

    This chapter reviews the most common neurologic disorders associated with common vaccines, evaluates the data linking the disorder with the vaccine, and discusses the potential mechanism of disease. A literature search was conducted in PubMed using a combination of the following terms: vaccines, vaccination, immunization, and neurologic complications. Data were also gathered from publications of the American Academy of Pediatrics Committee on Infectious Diseases, the World Health Organization, the US Centers for Disease Control and Prevention, and the Vaccine Adverse Event Reporting System. Neurologic complications of vaccination are rare. Many associations have been asserted without objective data to support a causal relationship. Rarely, patients with a neurologic complication will have a poor outcome. However, most patients recover fully from the neurologic complication. Vaccinations have altered the landscape of infectious disease. However, perception of risk associated with vaccinations has limited the success of disease eradication measures. Neurologic complications can be severe, and can provoke fear in potential vaccines. Evaluating whether there is causal link between neurologic disorders and vaccinations, not just temporal association, is critical to addressing public misperception of risk of vaccination. Among the vaccines available today, the cost-benefit analysis of vaccinations and complications strongly argues in favor of vaccination. © 2014 Elsevier B.V. All rights reserved.

  6. Neurology in Asia.

    Science.gov (United States)

    Tan, Chong-Tin

    2015-02-10

    Asia is important as it accounts for more than half of the world population. The majority of Asian countries fall into the middle income category. As for cultural traditions, Asia is highly varied, with many languages spoken. The pattern of neurologic diseases in Asia is largely similar to the West, with some disease features being specific to Asia. Whereas Asia constitutes 60% of the world's population, it contains only 20% of the world's neurologists. This disparity is particularly evident in South and South East Asia. As for neurologic care, it is highly variable depending on whether it is an urban or rural setting, the level of economic development, and the system of health care financing. To help remedy the shortage of neurologists, most counties with larger populations have established training programs in neurology. These programs are diverse, with many areas of concern. There are regional organizations serving as a vehicle for networking in neurology and various subspecialties, as well as an official journal (Neurology Asia). The Asian Epilepsy Academy, with its emphasis on workshops in various locations, EEG certification examination, and fellowships, may provide a template of effective regional networking for improving neurology care in the region. © 2015 American Academy of Neurology.

  7. Profile of Neurological admissions at the University of Nigeria ...

    African Journals Online (AJOL)

    Background: The burden of Neurological diseases may be on the increase especially in developing countries. Improved outcome in these settings may require appreciation of the spectrum of Neurological diseases and the impediments to their management. We aim to determine the profile of neurological admissions and ...

  8. [Rocuronium and sugammadex in emergency medicine: requirements of a muscle relaxant for rapid sequence induction].

    Science.gov (United States)

    Luxen, J; Trentzsch, H; Urban, B

    2014-04-01

    The required characteristics of neuromuscular blockers for rapid sequence induction (RSI) are clearly defined: nearly immediate effectiveness and short duration of effect. These demands are not only necessary for ideal conditions of quick endotracheal intubation without mask-bag intermediate ventilation but are also essential to enable a quick return to sufficient spontaneous breathing in case of a cannot intubate cannot ventilate situation. Until recently only succinylcholine had these characteristics; however, a considerable number of dangerous side effects and contraindications had to be accepted. In 1996, rocuronium was introduced, which was capable of immediately establishing good intubation conditions similar to succinylcholine. However, the median duration of effect is 45-60 min and it therefore contains a risk if the patient cannot be ventilated and oxygenated. Therefore, rocuronium is considered a good alternative but not a complete substitute for succinylcholine. The introduction of sugammadex in 2008 for quick reversal of rocuronium changed matters. Comparative studies from the past 4 years dealing with rocuronium/sugammadex versus uccinylcholine in RSI showed that rocuronium and sugammadex combined enabled a significantly faster return to sufficient spontaneous ventilation in emergency situations and also proved that the use of rocuronium significantly reduced the degree of desaturation during the interval between injection and ventilation postintubation. rocuronium used in hospital is a very good substitute for succinylcholine as a neuromuscular blocker during RSI as long as sugammadex is at hand for reversal. It remains to be considered that in a situation with severe problems of the airway and breathing, which are the main preclinical indications for intubation, a forward strategy for ventilation of the patient is the only acceptable way in most cases and the return to spontaneous breathing is not an alternative. Therefore, the value of sugammadex

  9. Neurology and international organizations.

    Science.gov (United States)

    Mateen, Farrah J

    2013-07-23

    A growing number of international stakeholders are engaged with neurologic diseases. This article provides a brief overview of important international stakeholders in the practice of neurology, including global disease-specific programs, United Nations agencies, governmental agencies with international influence, nongovernmental organizations, international professional organizations, large private donors, private-public partnerships, commercial interests, armed forces, and universities and colleges. The continued engagement of neurologists is essential for the growing number of international organizations that can and should incorporate neurologic disease into their global agendas.

  10. William Shakespeare's neurology.

    Science.gov (United States)

    Paciaroni, Maurizio; Bogousslavsky, Julien

    2013-01-01

    Many of Shakespeare's plays contain characters who appear to be afflicted by neurological or psychiatric disorders. Shakespeare, in his descriptive analysis of his protagonists, was contributing to the understanding of these disorders. In fact, Charcot frequently used Shakespearean references in his neurological teaching sessions, stressing how acute objective insight is essential to achieving expert clinical diagnosis. Charcot found in Shakespeare the same rigorous observational techniques for which he himself became famous. This chapter describes many of Shakespearean characters suffering from varied neurological disorders, including Parkinsonism, epilepsy, sleeping disturbances, dementia, headache, prion disease, and paralyses. © 2013 Elsevier B.V. All rights reserved.

  11. Standard operating procedures improve acute neurologic care in a sub-Saharan African setting.

    Science.gov (United States)

    Jaiteh, Lamin E S; Helwig, Stefan A; Jagne, Abubacarr; Ragoschke-Schumm, Andreas; Sarr, Catherine; Walter, Silke; Lesmeister, Martin; Manitz, Matthias; Blaß, Sebastian; Weis, Sarah; Schlund, Verena; Bah, Neneh; Kauffmann, Jil; Fousse, Mathias; Kangankan, Sabina; Ramos Cabrera, Asmell; Kronfeld, Kai; Ruckes, Christian; Liu, Yang; Nyan, Ousman; Fassbender, Klaus

    2017-07-11

    Quality of neurologic emergency management in an under-resourced country may be improved by standard operating procedures (SOPs). Neurologic SOPs were implemented in a large urban (Banjul) and a small rural (Brikama) hospital in the Gambia. As quality indicators of neurologic emergency management, performance of key procedures was assessed at baseline and in the first and second implementation years. At Banjul, 100 patients of the first-year intervention group exhibited higher rates of general procedures of emergency management than 105 control patients, such as neurologic examination (99.0% vs 91.4%; p process quality of neurologic emergency management in under-resourced settings. This study provides Class IV evidence that, for patients with suspected neurologic emergencies in sub-Saharan Africa, neurologic SOPs increase the rate of performance of guideline-recommended procedures. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  12. Neurological sequelae of bacterial meningitis

    NARCIS (Netherlands)

    Lucas, Marjolein J.; Brouwer, Matthijs C.; van de Beek, Diederik

    2016-01-01

    We reported on occurrence and impact of neurological sequelae after bacterial meningitis. We reviewed occurrence of neurological sequelae in children and adults after pneumococcal and meningococcal meningitis. Most frequently reported sequelae are focal neurological deficits, hearing loss, cognitive

  13. Neurological abnormalities predict disability

    DEFF Research Database (Denmark)

    Poggesi, Anna; Gouw, Alida; van der Flier, Wiesje

    2014-01-01

    To investigate the role of neurological abnormalities and magnetic resonance imaging (MRI) lesions in predicting global functional decline in a cohort of initially independent-living elderly subjects. The Leukoaraiosis And DISability (LADIS) Study, involving 11 European centres, was primarily aimed...... at evaluating age-related white matter changes (ARWMC) as an independent predictor of the transition to disability (according to Instrumental Activities of Daily Living scale) or death in independent elderly subjects that were followed up for 3 years. At baseline, a standardized neurological examination.......0 years, 45 % males), 327 (51.7 %) presented at the initial visit with ≥1 neurological abnormality and 242 (38 %) reached the main study outcome. Cox regression analyses, adjusting for MRI features and other determinants of functional decline, showed that the baseline presence of any neurological...

  14. Wikipedia and neurological disorders.

    Science.gov (United States)

    Brigo, Francesco; Igwe, Stanley C; Nardone, Raffaele; Lochner, Piergiorgio; Tezzon, Frediano; Otte, Willem M

    2015-07-01

    Our aim was to evaluate Wikipedia page visits in relation to the most common neurological disorders by determining which factors are related to peaks in Wikipedia searches for these conditions. Millions of people worldwide use the internet daily as a source of health information. Wikipedia is a popular free online encyclopedia used by patients and physicians to search for health-related information. The following Wikipedia articles were considered: Alzheimer's disease; Amyotrophic lateral sclerosis; Dementia; Epilepsy; Epileptic seizure; Migraine; Multiple sclerosis; Parkinson's disease; Stroke; Traumatic brain injury. We analyzed information regarding the total article views for 90 days and the rank of these articles among all those available in Wikipedia. We determined the highest search volume peaks to identify possible relation with online news headlines. No relation between incidence or prevalence of neurological disorders and the search volume for the related articles was found. Seven out of 10 neurological conditions showed relations in search volume peaks and news headlines. Six out of these seven peaks were related to news about famous people suffering from neurological disorders, especially those from showbusiness. Identification of discrepancies between disease burden and health seeking behavior on Wikipedia is useful in the planning of public health campaigns. Celebrities who publicly announce their neurological diagnosis might effectively promote awareness programs, increase public knowledge and reduce stigma related to diagnoses of neurological disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. 18 CFR 376.209 - Procedures during periods of emergency requiring activation of the Continuity of Operations Plan.

    Science.gov (United States)

    2010-04-01

    ... periods of emergency requiring activation of the Continuity of Operations Plan. 376.209 Section 376.209... of the Continuity of Operations Plan. (a)(1) The Commission's Continuity of Operations Plan is...) During periods when the Continuity of Operations Plan is activated, the Commission will continue to act...

  16. The Role of Magnesium in Neurological Disorders

    Directory of Open Access Journals (Sweden)

    Anna E. Kirkland

    2018-06-01

    Full Text Available Magnesium is well known for its diverse actions within the human body. From a neurological standpoint, magnesium plays an essential role in nerve transmission and neuromuscular conduction. It also functions in a protective role against excessive excitation that can lead to neuronal cell death (excitotoxicity, and has been implicated in multiple neurological disorders. Due to these important functions within the nervous system, magnesium is a mineral of intense interest for the potential prevention and treatment of neurological disorders. Current literature is reviewed for migraine, chronic pain, epilepsy, Alzheimer’s, Parkinson’s, and stroke, as well as the commonly comorbid conditions of anxiety and depression. Previous reviews and meta-analyses are used to set the scene for magnesium research across neurological conditions, while current research is reviewed in greater detail to update the literature and demonstrate the progress (or lack thereof in the field. There is strong data to suggest a role for magnesium in migraine and depression, and emerging data to suggest a protective effect of magnesium for chronic pain, anxiety, and stroke. More research is needed on magnesium as an adjunct treatment in epilepsy, and to further clarify its role in Alzheimer’s and Parkinson’s. Overall, the mechanistic attributes of magnesium in neurological diseases connote the macromineral as a potential target for neurological disease prevention and treatment.

  17. Program Director Survey: Attitudes Regarding Child Neurology Training and Testing.

    Science.gov (United States)

    Valencia, Ignacio; Feist, Terri B; Gilbert, Donald L

    2016-04-01

    As a result of major clinical and scientific advances and changes in clinical practice, the role of adult neurology training for Child Neurology and Neurodevelopmental Disability (NDD) certification has become controversial. The most recently approved requirements for board eligibility for child neurology and neurodevelopmental disability residents still include 12 months in adult neurology rotations. The objective of this study was to assess United States child neurology and neurodevelopmental disability residency program directors' opinions regarding optimal residency training. The authors developed an 18-item questionnaire and contacted all 80 child neurology and neurodevelopmental disability program directors via e-mail, using SurveyMonkey. A total of 44 program directors responded (55%), representing programs that train 78 categorical and 94 total resident positions, approximately 70% of those filled in the match. Respondents identified multiple areas where child neurology residents need more training, including genetics and neuromuscular disease. A substantial majority (73%) believed child neurology and neurodevelopmental disability residents need less than 12 adult neurology training months; however, most (75%) also believed adult hospital service and man-power needs (55%) and finances (34%) would pose barriers to reducing adult neurology. Most (70%) believed reductions in adult neurology training should be program flexible. A majority believed the written initial certification examination should be modified with more child neurology and fewer basic neuroscience questions. Nearly all (91%) felt the views of child neurology and neurodevelopmental disability program directors are under-represented within the Accreditation Council for Graduate Medical Education Residency Review Committee. The requirement for 12 adult neurology months for Child Neurology and Neurodevelopmental Disability certification is not consistent with the views of the majority of program

  18. Neurologic manifestations of achondroplasia.

    Science.gov (United States)

    Hecht, Jacqueline T; Bodensteiner, John B; Butler, Ian J

    2014-01-01

    Achondroplasia is the best described and most common form of the congenital short-limbed dwarfing conditions. Achondroplasia is apparent at birth and has a birth prevalence of 1 in 20000-30000 live-born infants. Achondroplasia is inherited as an autosomal dominant condition, although 80% of cases occur sporadically as new events in their families. Achondroplasia is caused, in virtually all of the cases, by a G380R mutation in fibroblast growth factor receptor 3 (FGFR3). Patients with achondroplasia should be evaluated by a multidisciplinary team of clinicians including geneticists, neurologists, and orthopedists, since there are numerous bony and neurological complications. The most severe complication results from craniocervical stenosis and medullary and upper spinal cord compression, which can have devastating and even lethal sequelae during early childhood. In subsequent decades, including adolescence, spinal cord and nerve compression are more prominent. The neurological complications of achondroplasia have been recognized in adults for more than a century and are attributed to bony defects, connective tissue structures, or both. Similar neurological complications are now appreciated in infants, young children, and teenagers with achondroplasia. Defective connective tissue elements in achondroplasia frequently lead to ligamentous laxity, which can aggravate the complications associated with bony stenosis. Bony abnormalities are known to cause neurological morbidity and lead to a shortened lifespan. Neurological complications associated with achondroplasia are reviewed, including recommendations for the evaluation and management of these clinical problems. © 2014 Elsevier B.V. All rights reserved.

  19. [Neurology and literature].

    Science.gov (United States)

    Iniesta, I

    2010-10-01

    Literature complements medical literature in the academic and clinical development of neurologists. The present article explores the contributions of writers of fiction on neurology. Literary works of fiction with particular reference to neurology. A symbiosis between writers of fiction and doctors has been well recognised. From Shakespeare to Cervantes by way of Dickens and Cela to writer - physicians such as Anton Chekhov or António Lobo Antunes have contributed through their medically informed literature to the better understanding of neurology. Some writers like Dostoevsky, Machado de Assis and Margiad Evans have written about their own experiences with disease thus bringing new insights to medicine. Furthermore, some neurological disorders have been largely based on literary descriptions. For instance, Dostoevsky's epilepsy has been retrospectively analysed by famous neurologists including Freud, Alajouanine or Gastaut, whilst his writings and biography have prompted others like Waxman and Geschwind to describe typical behavioural changes in temporal lobe epilepsy, finding their source of inspiration in Dostoevsky. Likewise, Cirignotta et al have named an unusual type of seizure after the Russian novelist. Inspired by Lewis Carroll, Todd introduced the term Alice in Wonderland Syndrome to refer to visual distortions generally associated with migraine. Writers of fiction offer a humanised perception of disease by contributing new insights into the clinical history, informing about the subjective experience of the illness and helping to eradicate the stigma associated to neurological disorders.

  20. Severe neurological complication following adjustable gastric banding.

    Science.gov (United States)

    Martines, G; Musa, N; Aquilino, F; Capuano, P

    2018-01-01

    In the last years with the increase of bariatric surgery, first of all as a result of new indications, a rise in the incidence of nutrient-related complications has been observed. Currently little is known about the impact of post-bariatric malnutrition and neurological complications. Wernicke's encephalopathy is a severe neurological syndrome which occurs as a result of thiamine deficiency. Wernicke-Korsakoff syndrome must be considered a serious neurological complication of bariatric surgery with significant morbidity and mortality, with rapidly progressing neurological symptoms, and must be treated immediately. We report the case of a 35 years-old male patient, affected by morbid obesity, anxious-depressive syndrome and alcohol use disorder, who after adjustable gastric banding implanted in another hospital developed a severe malnutrition and neurological syndrome. The patient showed poor adherence to the follow-up and to the dietary indications and after all, we needed to place a PEG for enteral nutrition in order to resolve the malnutrition condition and the neurological syndrome. Our experience emphasizes that preoperative selection and assessment of a patient's nutritional status according to guidelines, is required to identify potential problems, and that bariatric surgeons or physicians caring for patient who have undergone bariatric surgery should be familiar with the constellation of nutritional and neurological disorder that may occur after surgery. We want to remark the importance of preoperative selection of the patients, the follow-up and the cooperation between patient and physician in order to obtain the best result and avoid severe complications.

  1. Neurocritical care education during neurology residency

    Science.gov (United States)

    Drogan, O.; Manno, E.; Geocadin, R.G.; Ziai, W.

    2012-01-01

    Objective: Limited information is available regarding the current state of neurocritical care education for neurology residents. The goal of our survey was to assess the need and current state of neurocritical care training for neurology residents. Methods: A survey instrument was developed and, with the support of the American Academy of Neurology, distributed to residency program directors of 132 accredited neurology programs in the United States in 2011. Results: A response rate of 74% (98 of 132) was achieved. A dedicated neuroscience intensive care unit (neuro-ICU) existed in 64%. Fifty-six percent of residency programs offer a dedicated rotation in the neuro-ICU, lasting 4 weeks on average. Where available, the neuro-ICU rotation was required in the vast majority (91%) of programs. Neurology residents' exposure to the fundamental principles of neurocritical care was obtained through a variety of mechanisms. Of program directors, 37% indicated that residents would be interested in performing away rotations in a neuro-ICU. From 2005 to 2010, the number of programs sending at least one resident into a neuro-ICU fellowship increased from 14% to 35%. Conclusions: Despite the expansion of neurocritical care, large proportions of US neurology residents have limited exposure to a neuro-ICU and neurointensivists. Formal training in the principles of neurocritical care may be highly variable. The results of this survey suggest a charge to address the variability of resident education and to develop standardized curricula in neurocritical care for neurology residents. PMID:22573636

  2. 78 FR 79081 - Medicare and Medicaid Programs; Emergency Preparedness Requirements for Medicare and Medicaid...

    Science.gov (United States)

    2013-12-27

    ... Conditions for Coverage CHAP Community Health Accreditation Program CMHC Community Mental Health Center COI... Pathology Services (Sec. 485.727) N. Emergency Preparedness Regulations for Community Mental Health Centers... Preparedness for Community Mental Health Centers (CMHCs)--Training and Testing (Sec. 485.920(d)) R. Conditions...

  3. Neurologic Complications of Transplantation.

    Science.gov (United States)

    Dhar, Rajat

    2018-02-01

    Neurologic disturbances including encephalopathy, seizures, and focal deficits complicate the course 10-30% of patients undergoing organ or stem cell transplantation. While much or this morbidity is multifactorial and often associated with extra-cerebral dysfunction (e.g., graft dysfunction, metabolic derangements), immunosuppressive drugs also contribute significantly. This can either be through direct toxicity (e.g., posterior reversible encephalopathy syndrome from calcineurin inhibitors such as tacrolimus in the acute postoperative period) or by facilitating opportunistic infections in the months after transplantation. Other neurologic syndromes such as akinetic mutism and osmotic demyelination may also occur. While much of this neurologic dysfunction may be reversible if related to metabolic factors or drug toxicity (and the etiology is recognized and reversed), cases of multifocal cerebral infarction, hemorrhage, or infection may have poor outcomes. As transplant patients survive longer, delayed infections (such as progressive multifocal leukoencephalopathy) and post-transplant malignancies are increasingly reported.

  4. Effects of seasonal smog on asthma and COPD exacerbations requiring emergency visits in Chiang Mai, Thailand.

    Science.gov (United States)

    Pothirat, Chaicharn; Tosukhowong, Apiwat; Chaiwong, Warawut; Liwsrisakun, Chalerm; Inchai, Juthamas

    2016-12-01

    Seasonal smog produces particulate matters that are less than 10 microns in diameter (PM₁₀), which are known to have several impacts on the respiratory system. This study was to determine the association of an increased PM10 level due to seasonal smog in Chiang Mai and emergency visits for asthma and chronic obstructive pulmonary disease (COPD) exacerbations. A retrospective cross-sectional study was conducted between the months of January and March from 2006 until 2009. The association of an increased PM₁₀ level and the daily number of asthma and COPD exacerbations were analyzed using a generalized linear model; a Poisson regression model was fit to the number of daily emergency visits using predictor variables: lags of PM10, day of the week, and time. There were a total of 917 emergency visits for acute exacerbations of asthma and COPD, with a median of 2 visits per day (range 0-10). The median PM₁₀ level during the same interval was 64.5 microgram per cubic meter (μg/m3) (16-304). For every 10 μg/m3 rise in PM10 concentration, there was a lag time of 6 days for asthma exacerbations [Adjusted relative risk (RR)=1.020; 95% confident interval (CI), 1.001-1.040; (p=0.014)], 7 days for COPD exacerbations [RR=1.030; 95%CI, 1.010-1.050 (p=0.024)] and 7 days for all exacerbations [RR=1.030 95%CI, 1.010-1.040 (p<0.001)]. This study confirms the effect of increasing PM₁₀ concentrations from seasonal smog on asthma and COPD exacerbations. However, there was an approximately 1 week lag time between the elevated PM₁₀ levels and time to emergency visits due to disease exacerbation.

  5. Review and assessment of package requirements (yellowcake) and emergency response to transportation accidents

    International Nuclear Information System (INIS)

    1978-10-01

    As a consequence of an accident involving a truck shipment of yellowcake, a joint NRC--DOT study was undertaken to review and assess the regulations and practices related to package integrity and to emergency response to transportation accidents involving low specific activity radioactive materials. Recommendations are made regarding the responsibilities of state and local agencies, carriers, and shippers, and the DOT and NRC regulations

  6. Requirements and Challenges of Location-Based Access Control in Healthcare Emergency Response

    DEFF Research Database (Denmark)

    Vicente, Carmen Ruiz; Kirkpatrick, Michael; Ghinita, Gabriel

    2009-01-01

    Recent advances in positioning and tracking technologies have led to the emergence of novel location-based applications that allow participants to access information relevant to their spatio-temporal context. Traditional access control models, such as role-based access control (RBAC), are not suf...... to such settings. We overview the main technical issues to be addressed, and we describe the architecture for policy decision and enforcement points....

  7. New source terms and the implications for emergency planning requirements at nuclear power plants in the United State

    International Nuclear Information System (INIS)

    Kaiser, G.D.; Cheok, M.C.

    1987-01-01

    This paper begins with a brief review of current approaches to source term driven changes to NRC emergency planning requirements and addresses significant differences between them. Approaches by IDCOR and EPRI, industry submittals to NRC and alternative risk-based evaluations have been considered. Important issues are discussed, such as the role of Protective Action Guides in determining the radius of the emergency planning zone (EPZ). The significance of current trends towards the prediction of longer warning times and longer durations of release in new source terms is assessed. These trends may help to relax the current notification time requirements. Finally, the implications of apparent support in the regulations for a threshold in warning time beyond which ad hoc protective measures are adequate is discussed

  8. African Journal of Neurological Sciences - 2009 Vol. 28 No 1

    African Journals Online (AJOL)

    Department of Medicine, Makerere University College of Health Sciences, Kampala, ... and emergency unit, and general neurology unit by a neurologist, internal medicine physicians, nurses and ... deep vein thrombosis and pressure sores.

  9. Computational neurology and psychiatry

    CERN Document Server

    Bhattacharya, Basabdatta; Cochran, Amy

    2017-01-01

    This book presents the latest research in computational methods for modeling and simulating brain disorders. In particular, it shows how mathematical models can be used to study the relationship between a given disorder and the specific brain structure associated with that disorder. It also describes the emerging field of computational psychiatry, including the study of pathological behavior due to impaired functional connectivity, pathophysiological activity, and/or aberrant decision-making. Further, it discusses the data analysis techniques that will be required to analyze the increasing amount of data being generated about the brain. Lastly, the book offers some tips on the application of computational models in the field of quantitative systems pharmacology. Mainly written for computational scientists eager to discover new application fields for their model, this book also benefits neurologists and psychiatrists wanting to learn about new methods.

  10. Wikipedia and neurological disorders

    NARCIS (Netherlands)

    Brigo, Francesco; Igwe, Stanley C.; Nardone, Raffaele; Lochner, Piergiorgio; Tezzon, Frediano; Otte, WM

    2015-01-01

    Our aim was to evaluate Wikipedia page visits in relation to the most common neurological disorders by determining which factors are related to peaks in Wikipedia searches for these conditions. Millions of people worldwide use the internet daily as a source of health information. Wikipedia is a

  11. Neurological aspects of eclampsia

    Directory of Open Access Journals (Sweden)

    Jovanović Dejana

    2003-01-01

    Full Text Available The difficult types of preeclampsia and eclampsia are presented with the neurological symptoms. The break of cerebral autoregulation mechanism plays the most important role in pathogenesis of cerebral vasospasm. Nevertheless eclampsia isn’t just an ordinary hypertensive encephalopathy because other pathogenic mechanisms are involved in its appearance. The main neuropathologic changes are multifocal vasogenic edema, perivascular multiple microinfarctions and petechial hemorrhages. Neurological clinical manifestations are convulsions, headache, visual disturbances and rarely other discrete focal neurological symptoms. Eclampsia is a high-risk factor for onset of hemorrhagic or ischemic stroke. This is a reason why neurological diagnostic tests are sometimes needed. The method of choice for evaluation of complicated eclampsia is computerized brain topography that shows multiple areas of hypodensity in occipitoparietal regions. These changes are focal vasogenic cerebral edema. For differential diagnosis of eclampsia and stroke other diagnostic methods can be used - fundoscopic exam, magnetic resonance brain imaging, cerebral angiography and cerebrospinal fluid exam. The therapy of eclampsia considers using of magnesium sulfate, antihypertensive, anticonvulsive and antiedematous drugs.

  12. Astroglia in neurological diseases

    Czech Academy of Sciences Publication Activity Database

    Verkhratsky, Alexei; Rodríguez Arellano, Jose Julio; Parpura, V.

    2013-01-01

    Roč. 8, č. 2 (2013), s. 149-158 ISSN 1479-6708 R&D Projects: GA ČR(CZ) GAP304/11/0184; GA ČR GA309/09/1696 Institutional support: RVO:68378041 Keywords : amyotrophic lateral sclerosis * Alzheimer's disease * Alexander disease Subject RIV: FH - Neurology

  13. Neurology of cardiopulmonary resuscitation.

    Science.gov (United States)

    Mulder, M; Geocadin, R G

    2017-01-01

    This chapter aims to provide an up-to-date review of the science and clinical practice pertaining to neurologic injury after successful cardiopulmonary resuscitation. The past two decades have seen a major shift in the science and practice of cardiopulmonary resuscitation, with a major emphasis on postresuscitation neurologic care. This chapter provides a nuanced and thoughtful historic and bench-to-bedside overview of the neurologic aspects of cardiopulmonary resuscitation. A particular emphasis is made on the anatomy and pathophysiology of hypoxic-ischemic encephalopathy, up-to-date management of survivors of cardiopulmonary resuscitation, and a careful discussion on neurologic outcome prediction. Guidance to practice evidence-based clinical care when able and thoughtful, pragmatic suggestions for care where evidence is lacking are also provided. This chapter serves as both a useful clinical guide and an updated, thorough, and state-of-the-art reference on the topic for advanced students and experienced practitioners in the field. © 2017 Elsevier B.V. All rights reserved.

  14. Neurologic abnormalities in murderers.

    Science.gov (United States)

    Blake, P Y; Pincus, J H; Buckner, C

    1995-09-01

    Thirty-one individuals awaiting trial or sentencing for murder or undergoing an appeal process requested a neurologic examination through legal counsel. We attempted in each instance to obtain EEG, MRI or CT, and neuropsychological testing. Neurologic examination revealed evidence of "frontal" dysfunction in 20 (64.5%). There were symptoms or some other evidence of temporal lobe abnormality in nine (29%). We made a specific neurologic diagnosis in 20 individuals (64.5%), including borderline or full mental retardation (9) and cerebral palsy (2), among others. Neuropsychological testing revealed abnormalities in all subjects tested. There were EEG abnormalities in eight of the 20 subjects tested, consisting mainly of bilateral sharp waves with slowing. There were MRI or CT abnormalities in nine of the 19 subjects tested, consisting primarily of atrophy and white matter changes. Psychiatric diagnoses included paranoid schizophrenia (8), dissociative disorder (4), and depression (9). Virtually all subjects had paranoid ideas and misunderstood social situations. There was a documented history of profound, protracted physical abuse in 26 (83.8%) and of sexual abuse in 10 (32.3%). It is likely that prolonged, severe physical abuse, paranoia, and neurologic brain dysfunction interact to form the matrix of violent behavior.

  15. Emergence of a phase transition for the required amount of storage in highly renewable electricity systems

    DEFF Research Database (Denmark)

    Jensen, Tue Vissing; Greiner, Martin

    2014-01-01

    -up of the required amount of storage, with renewable penetration being the control parameter and average relative storage filling level being the order parameter. A singularity appears for the required storage energy capacity at a renewable penetration determined by the parameters of the storage. For an ideal...... storage with no roundtrip losses the transition occurs at 100% renewable penetration. Moreover, the required storage energy capacity is strongly enhanced by temporal correlations on the synoptic weather time scale. A Markov process is proposed, which reproduces these findings....

  16. Definition of Specific Functions and Procedural Skills Required by Cuban Specialists in Intensive Care and Emergency Medicine.

    Science.gov (United States)

    Véliz, Pedro L; Berra, Esperanza M; Jorna, Ana R

    2015-07-01

    INTRODUCTION Medical specialties' core curricula should take into account functions to be carried out, positions to be filled and populations to be served. The functions in the professional profile for specialty training of Cuban intensive care and emergency medicine specialists do not include all the activities that they actually perform in professional practice. OBJECTIVE Define the specific functions and procedural skills required of Cuban specialists in intensive care and emergency medicine. METHODS The study was conducted from April 2011 to September 2013. A three-stage methodological strategy was designed using qualitative techniques. By purposive maximum variation sampling, 82 professionals were selected. Documentary analysis and key informant criteria were used in the first stage. Two expert groups were formed in the second stage: one used various group techniques (focus group, oral and written brainstorming) and the second used a three-round Delphi method. In the final stage, a third group of experts was questioned in semistructured in-depth interviews, and a two-round Delphi method was employed to assess priorities. RESULTS Ultimately, 78 specific functions were defined: 47 (60.3%) patient care, 16 (20.5%) managerial, 6 (7.7%) teaching, and 9 (11.5%) research. Thirty-one procedural skills were identified. The specific functions and procedural skills defined relate to the profession's requirements in clinical care of the critically ill, management of patient services, teaching and research at the specialist's different occupational levels. CONCLUSIONS The specific functions and procedural skills required of intensive care and emergency medicine specialists were precisely identified by a scientific method. This product is key to improving the quality of teaching, research, administration and patient care in this specialty in Cuba. The specific functions and procedural skills identified are theoretical, practical, methodological and social contributions to

  17. Decision Making Processes for a Pregnant Woman Admitted to the Accident and Emergency Department Requiring Emergency Diagnostic X-ray – A Case Study

    Directory of Open Access Journals (Sweden)

    S. Ismanto

    2017-07-01

    Full Text Available The objective of this study is to apply the decision-making processes for a pregnant woman who was involved in a motor vehicle accident and admitted to a private middle-class hospital in the capital of Indonesia requiring radiologic X-ray examination.  It also aims to examine and evaluate the patient who was in her 20th week of gestation in order to provide her with the best emergency care, diagnostic investigations and treatments.The descriptive, normative and prescriptive models of decision-making are demonstrated. The descriptive model used intuition, while the normative model used decision trees as decision options and lastly the prescriptive decision used the information processing theory (IPT to decide on the best emergency care, diagnostic investigations and treatments for the patient. The IPT dominated the decision-making process; hence an X-ray examination was done that was safe for the fetus and the childbearing mother. Decision option was not used since the patient was in pain and could not understand much of the procedure that was explained.  Intuition helped in the decision-making in order to ensure safe and effective practice.

  18. The Journey to Meet Emerging Community Benefit Requirements in a Rural Hospital: A Case Study

    Science.gov (United States)

    Sabin, Allison V; Levin, Pamela F

    2015-10-22

    The Affordable Care Act requires nonprofit hospitals to collaborate with public health agencies and community stakeholders to identify and address community health needs. As a rural organization, Wabash County (Indiana) Hospital pursued new approaches to achieve these revised requirements of the community benefit mandate. Using a case study approach, the authors provide a historical review of governmental relationships with nonprofit community hospitals, offer a case study application for implementing legislative mandates and community benefit requirements, share the insights they garnered on their journey to meet the mandates, and conclude that drawing upon the existing resources in the community and using current community assets in novel ways can help conserve time, and also financial, material, and human resources in meeting legislative mandates.

  19. The Effectiveness of Ultrasonography in Detecting Emergent Pediatric Pathologies and Requirement for Additional Imaging Techniques: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Betül Tiryaki Baştuğ

    2018-04-01

    Full Text Available Introduction: In emergency cases, ultrasonography is used in guiding resuscitation, to provide procedural guidance, and confirm a clinical diagnosis. In addition, it may prevent unnecessary exposure of the patient to ionizing radiation and risks caused by transporting the patient away from monitoring. This paper aimed to evaluate the effectiveness of ultrasonography in detecting emergent pediatric pathologies in a state hospital radiology unit, and to identify whether additional imaging techniques, such as computed tomography, were required. Methods: This study was designed as a retrospective investigation. A group of 536 patients were randomly selected from 1.401 pediatric patients who underwent ultrasonography for non-traumatic emergent pathologies between 2015 and 2016. Results: Of the 536 patients, 46 were diagnosed with appendicitis, 14 with pathologies of the urinary system, 1 with ileus, 29 with mesenteric lymphadenitis, 4 with intussusception, 3 with ovarian cyst rupture, 1 with ovarian torsion, and 32 with scrotal pathologies. Computed tomography was performed for 20 patients. Ureteral calculi and appendicitis were confirmed by computed tomography in 5 and 14 patients, respectively, after being identified as secondary findings by ultrasonography. In 1 patient, ileus was verified by computed tomography. The sensitivity of ultrasonography was determined to be 85.7%. Only 14% of patients were not given definite pathological diagnoses by ultrasonography alone. Subsequent computed tomography for verifying secondary findings detected by ultrasonography was essential in only 20 patients. Conclusion: Our results promote the use of ultrasonography as the initial imaging test for evaluating pediatric patients with suspected emergency pathologies.

  20. 3D Geo-Information requirements for disaster and emergency management

    NARCIS (Netherlands)

    Demir Ozbek, E.; Zlatanova, S.; Ates Aydar, S.; Yomralioglu, T

    2016-01-01

    A conceptual approach is proposed to define 3D geo-information requirement for different types of disasters. This approach includes components such as Disaster Type-Sector-Actor-Process-Activity-Task-Data. According to disaster types processes, activities, tasks, sectors, and responsible and

  1. Post dengue neurological complication

    Directory of Open Access Journals (Sweden)

    Hizlinda Tohid

    2015-12-01

    Full Text Available Dengue infection is highly endemic in many tropical countries including Malaysia. However, neurological complications arising from dengue infection is not common; Gullain–Barre syndrome (GBS is one of these infrequent complications. In this paper, we have reported a case in which a 39-year-old woman presented with a neurological complication of dengue infection without typical symptoms and signs of dengue fever. She had a history of acute gastroenteritis (AGE followed by an upper respiratory tract infection (URTI weeks prior to her presentation rendering GBS secondary to the post viral URTI and AGE as the most likely diagnosis. Presence of thrombocytopenia was the only clue for dengue in this case.

  2. Neurological legal disability

    Directory of Open Access Journals (Sweden)

    Radhakrishna H

    2006-01-01

    Full Text Available Neurological disorders with a prolonged course, either remediable or otherwise are being seen increasingly in clinical practice and many such patients are young and are part of some organization or other wherein their services are needed if they were healthy and fit. The neurologists who are on the panel of these organizations are asked to certify whether these subjects are fit to work or how long they should be given leave. These certificates may be produced in the court of law and may be subjected to verification by another neurologist or a medical board. At present there are no standard guidelines in our country to effect such certification unlike in orthopedic specialty or in ophthalmology. The following is a beginning, based on which the neurologist can certify the neurological disability of such subjects and convey the same meaning to all neurologists across the country.

  3. Vaccination and neurological disorders

    Directory of Open Access Journals (Sweden)

    Anastasia Gkampeta

    2015-12-01

    Full Text Available Active immunization of children has been proven very effective in elimination of life threatening complications of many infectious diseases in developed countries. However, as vaccination-preventable infectious diseases and their complications have become rare, the interest focuses on immunization-related adverse reactions. Unfortunately, fear of vaccination-related adverse effects can led to decreased vaccination coverage and subsequent epidemics of infectious diseases. This review includes reports about possible side effects following vaccinations in children with neurological disorders and also published recommendations about vaccinating children with neurological disorders. From all international published data anyone can conclude that vaccines are safer than ever before, but the challenge remains to convey this message to society.

  4. The Neurology of Proverbs

    Directory of Open Access Journals (Sweden)

    Diana Van Lancker

    1990-01-01

    Full Text Available Although proverb tests are commonly used in the mental status examination surprisingly little is known about either normal comprehension or the interpretation of proverbial expressions. Current proverbs tests have conceptual and linguistic shortcomings, and few studies have been done to investigate the specific effects of neurological and psychiatric disorders on the interpretation of proverbs. Although frontal lobes have traditionally been impugned in patients who are “concrete”, recent studies targeting deficient comprehension of non literal language (e.g. proverbs, idioms, speech formulas, and indirect requests point to an important role of the right hemisphere (RH. Research describing responses of psychiatrically and neurologically classified groups to tests of proverb and idiom usage is needed to clarify details of aberrant processing of nonliteral meanings. Meanwhile, the proverb test, drawing on diverse cognitive skills, is a nonspecific but sensitive probe of mental status.

  5. Prevalence and Distribution of Neurological Disease in a Neurology ...

    African Journals Online (AJOL)

    Uche

    Annals of Medical and Health Sciences Research – January 2011 – Vol. 1 N0.1. >>>63<<<. Prevalence and Distribution of Neurological Disease in a. Neurology Clinic in Enugu, Nigeria. Onwuekwe IO* and Ezeala-Adikaibe B*. *Neurology Unit, Department of Medicine,. University of Nigeria Teaching Hospital, Enugu, ...

  6. Survey of the professors of child neurology: neurology versus pediatrics home for child neurology.

    Science.gov (United States)

    Pearl, Phillip L; McConnell, Emily R; Fernandez, Rosamary; Brooks-Kayal, Amy

    2014-09-01

    The optimal academic home for child neurology programs between adult neurology versus pediatric departments remains an open question. The Professors of Child Neurology, the national organization of child neurology department chairs, division chiefs, and training program directors, was surveyed to evaluate the placement of child neurology programs. Professors of Child Neurology members were surveyed regarding the placement of child neurology programs within adult neurology versus pediatric departments. Questions explored academic versus clinical lines of reporting and factors that may be advantages and disadvantages of these affiliations. Issues also addressed were the current status of board certification and number of clinics expected in academic child neurology departments. Of 120 surveys sent, 95 responses were received (79% response rate). The primary academic affiliation is in neurology in 54% of programs versus 46% in pediatrics, and the primary clinical affiliation is 45% neurology and 55% pediatrics. Advantages versus disadvantages of one's primary affiliation were similar whether the primary affiliation was in neurology or pediatrics. While 61% of respondents are presently board certified in pediatrics, only 2% of those with time-limited certification in general pediatrics plan to be recertified going forward. Typically six to eight half-day clinics per week are anticipated for child neurologists in academic departments without additional funding sources. Overall, leaders of child neurology departments and training programs would not change their affiliation if given the opportunity. Advantages and disadvantages associated with current affiliations did not change whether child neurology was located in neurology or pediatrics. Board certification by the American Board of Psychiatry and Neurology in child neurology is virtually universal, whereas pediatric board certification by the American Board of Pediatrics is being maintained by very few. Most academic

  7. Palliative care and neurology

    Science.gov (United States)

    Boersma, Isabel; Miyasaki, Janis; Kutner, Jean

    2014-01-01

    Palliative care is an approach to the care of patients and families facing progressive and chronic illnesses that focuses on the relief of suffering due to physical symptoms, psychosocial issues, and spiritual distress. As neurologists care for patients with chronic, progressive, life-limiting, and disabling conditions, it is important that they understand and learn to apply the principles of palliative medicine. In this article, we aim to provide a practical starting point in palliative medicine for neurologists by answering the following questions: (1) What is palliative care and what is hospice care? (2) What are the palliative care needs of neurology patients? (3) Do neurology patients have unique palliative care needs? and (4) How can palliative care be integrated into neurology practice? We cover several fundamental palliative care skills relevant to neurologists, including communication of bad news, symptom assessment and management, advance care planning, caregiver assessment, and appropriate referral to hospice and other palliative care services. We conclude by suggesting areas for future educational efforts and research. PMID:24991027

  8. Entrepreneurship management skills requirements in an emerging economy: A South African outlook

    Directory of Open Access Journals (Sweden)

    M. Anastacia Mamabolo

    2017-05-01

    Aim: This study’s aim was to determine skills required by South African entrepreneurs to run their businesses. Setting: Entrepreneurs who own and run businesses in South Africa. Method: A sequential exploratory mixed method research design was applied in the study. Phase I, which consisted of qualitative interviews with 15 entrepreneurs and 6 national experts, resulted in skills that were used to develop a survey instrument. A survey was conducted in Phase II on 235 entrepreneurs to confirm the skills to a larger population. Results: Confirmatory factor analysis results showed that entrepreneurs require financial management, human resource management, start-up, social and interpersonal, leadership, personality, marketing, technical and business management skills. Conclusion: The identified skills through empirical research will be instrumental in the training of entrepreneurs and as a tool to measure skills in future entrepreneurship skills research.

  9. Documenting the emergence of bio-ontologies: or, why researching bioinformatics requires HPSSB.

    Science.gov (United States)

    Leonelli, Sabina

    2010-01-01

    This paper reflects on the analytic challenges emerging from the study of bioinformatic tools recently created to store and disseminate biological data, such as databases, repositories, and bio-ontologies. I focus my discussion on the Gene Ontology, a term that defines three entities at once: a classification system facilitating the distribution and use of genomic data as evidence towards new insights; an expert community specialised in the curation of those data; and a scientific institution promoting the use of this tool among experimental biologists. These three dimensions of the Gene Ontology can be clearly distinguished analytically, but are tightly intertwined in practice. I suggest that this is true of all bioinformatic tools: they need to be understood simultaneously as epistemic, social, and institutional entities, since they shape the knowledge extracted from data and at the same time regulate the organisation, development, and communication of research. This viewpoint has one important implication for the methodologies used to study these tools; that is, the need to integrate historical, philosophical, and sociological approaches. I illustrate this claim through examples of misunderstandings that may result from a narrowly disciplinary study of the Gene Ontology, as I experienced them in my own research.

  10. Cognitive and motivational requirements for the emergence of cooperation in a rat social game.

    Science.gov (United States)

    Viana, Duarte S; Gordo, Isabel; Sucena, Elio; Moita, Marta A P

    2010-01-13

    Game theory and the Prisoner's Dilemma (PD) game in particular, which captures the paradox of cooperative interactions that lead to benefits but entail costs to the interacting individuals, have constituted a powerful tool in the study of the mechanisms of reciprocity. However, in non-human animals most tests of reciprocity in PD games have resulted in sustained defection strategies. As a consequence, it has been suggested that under such stringent conditions as the PD game humans alone have evolved the necessary cognitive abilities to engage in reciprocity, namely, numerical discrimination, memory and control of temporal discounting. We use an iterated PD game to test rats (Rattus norvegicus) for the presence of such cognitive abilities by manipulating the strategy of the opponent, Tit-for-Tat and Pseudo-Random, or the relative size of the temptation to defect. We found that rats shape their behaviour according to the opponent's strategy and the relative outcome resulting from cooperative or defective moves. Finally, we show that the behaviour of rats is contingent upon their motivational state (hungry versus sated). Here we show that rats understand the payoff matrix of the PD game and the strategy of the opponent. Importantly, our findings reveal that rats possess the necessary cognitive capacities for reciprocity-based cooperation to emerge in the context of a prisoner's dilemma. Finally, the validation of the rat as a model to study reciprocity-based cooperation during the PD game opens new avenues of research in experimental neuroscience.

  11. Problem neurology residents: a national survey.

    Science.gov (United States)

    Tabby, David S; Majeed, Muhammed H; Schwartzman, Robert J

    2011-06-14

    Problem residents are found across most medical specialties at a prevalence of about 10%. This study was designed to explore the prevalence and causes of problem neurology residents and to compare neurology programs' responses and outcomes. Directors of 126 US neurology residency programs were sent an electronic survey. We collected data on demographics, first and all "identifiers" of problem residents, and year of training in which the problem was found. We asked about observable signs, etiology, and who performed remediation. We asked what resources were used and what outcomes occurred. Ninety-five program directors completed surveys (75% response rate). Almost all neurology programs have problem residents (81%). Age, sex, marital status, being a US native, or attending a US medical school had no effect on problem status. Being a parent carried a lower likelihood of problems (32%). Most commonly the problem is acted on during the first year of training. Faculty members without defined educational roles were the most frequent first identifiers. Program directors were the most common remediators. The most common remediation techniques were increasing supervision and assigning a faculty mentor. Graduate medical education office and psychiatric or psychological counseling services were most often used. Eleven percent of problem residents required a program for impaired physicians and 14% required a leave of absence. Sixteen percent were dismissed from their programs. The prevalence of problem residents in neurology is similar to other disciplines, and various resources are available to remediate them.

  12. Microgrids: An emerging paradigm for meeting building electricityand heat requirements efficiently and with appropriate energyquality

    Energy Technology Data Exchange (ETDEWEB)

    Marnay, Chris; Firestone, Ryan

    2007-04-10

    The first major paradigm shift in electricity generation,delivery, and control is emerging in the developed world, notably Europe,North America, and Japan. This shift will move electricity supply awayfrom the highly centralised universal service quality model with which weare familiar today towards a more dispersed system with heterogeneousqualities of service. One element of dispersed control is the clusteringof sources and sinks into semi-autonomous mu grids (microgrids).Research, development, demonstration, and deployment (RD3) of mu gridsare advancing rapidly on at least three continents, and significantdemonstrations are currently in progress. This paradigm shift will resultin more electricity generation close to end-uses, often involvingcombined heat and power application for building heating and cooling,increased local integration of renewables, and the possible provision ofheterogeneous qualities of electrical service to match the requirementsof various end-uses. In Europe, mu grid RD3 is entering its third majorround under the 7th European Commission Framework Programme; in the U.S.,one specific mu grid concept is undergoing rigorous laboratory testing,and in Japan, where the most activity exists, four major publiclysponsored and two privately sponsored demonstrations are in progress.This evolution poses new challenges to the way buildings are designed,built, and operated. Traditional building energy supply systems willbecome much more complex in at least three ways: 1. one cannot simplyassume gas arrives at the gas meter, electricity at its meter, and thetwo systems are virtually independent of one another; rather, energyconversion, heat recovery and use, and renewable energy harvesting mayall be taking place simultaneously within the building energy system; 2.the structure of energy flows in the building must accommodate multipleenergy processes in a manner that permits high overall efficiency; and 3.multiple qualities of electricity may be supplied to

  13. Increase in pediatric magnet-related foreign bodies requiring emergency care.

    Science.gov (United States)

    Silverman, Jonathan A; Brown, Julie C; Willis, Margaret M; Ebel, Beth E

    2013-12-01

    We describe magnetic foreign body injuries among children and obtain national estimates of magnetic foreign body injury incidence over time. We searched the National Electronic Injury Surveillance System for cases of magnetic foreign bodies in children younger than 21 years in the United States, from 2002 to 2011. Cases were analyzed by location: alimentary or respiratory tract, nasal cavity, ear canal, or genital area. We identified 893 cases of magnetic foreign bodies, corresponding to 22,581 magnetic foreign body cases during a 10-year period (95% confidence interval [CI] 17,694 to 27,469). Most magnetic foreign bodies were ingested (74%) or intranasal (21%). Mean age was 5.2 years for ingested magnetic foreign bodies and 10.1 years for nasal magnetic foreign bodies (difference 4.9; 95% CI 4.1 to 5.6), suggesting different circumstances of injury. The incidence of pediatric magnet ingestions increased from 2002 to 2003 from 0.57 cases per 100,000 children per year (95% CI 0.22 to 0.92) to a peak in 2010 to 2011 of 3.06 cases per 100,000 children per year (95% CI 2.16 to 3.96). Most ingested magnetic foreign bodies (73%) and multiple magnet ingestions (91%) occurred in 2007 or later. Patients were admitted in 15.7% of multiple magnet ingestions versus 2.3% of single magnet ingestions (difference 13.4%; 95% CI 2.8% to 24.0%). Magnet-related injuries are an increasing public health problem for young children, as well for older children who may use magnets for play or to imitate piercings. Education and improved magnet safety standards may decrease the risk small magnets pose to children. Copyright © 2013 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

  14. African Journal of Neurological Sciences

    African Journals Online (AJOL)

    African Journal of Neurological Sciences (AJNS) is owned and controlled by the Pan African Association of Neurological Sciences (PAANS). The AJNS's aim is to publish scientific papers of any aspects of Neurological Sciences. AJNS is published quarterly. Articles submitted exclusively to the AJNS are accepted if neither ...

  15. Vitamins K1 and K2: The Emerging Group of Vitamins Required for Human Health.

    Science.gov (United States)

    Schwalfenberg, Gerry Kurt

    2017-01-01

    To review the evidence for the use of vitamin K supplementation in clinical conditions such as osteoporosis, vascular calcification, arthritis, cancer, renal calculi, diabetes, and warfarin therapy. PubMed was searched for articles on vitamin K (K1 and K2) along with books and conference proceedings and health conditions listed above. Level I and II evidence supports the use of vitamins K1 and K2 in osteoporosis and Level II evidence supports vitamin K2 in prevention of coronary calcification and cardiovascular disease. Evidence is insufficient for use in diabetes, arthritis, renal calculi, and cancer. Vitamin K2 may be a useful adjunct for the treatment of osteoporosis, along with vitamin D and calcium, rivaling bisphosphonate therapy without toxicity. It may also significantly reduce morbidity and mortality in cardiovascular health by reducing vascular calcification. Vitamin K2 appears promising in the areas of diabetes, cancer, and osteoarthritis. Vitamin K use in warfarin therapy is safe and may improve INR control, although a dosage adjustment is required. Vitamin K supplementation may be useful for a number of chronic conditions that are afflicting North Americans as the population ages. Supplementation may be required for bone and cardiovascular health.

  16. Vitamins K1 and K2: The Emerging Group of Vitamins Required for Human Health

    Directory of Open Access Journals (Sweden)

    Gerry Kurt Schwalfenberg

    2017-01-01

    Full Text Available Objective. To review the evidence for the use of vitamin K supplementation in clinical conditions such as osteoporosis, vascular calcification, arthritis, cancer, renal calculi, diabetes, and warfarin therapy. Quality of Evidence. PubMed was searched for articles on vitamin K (K1 and K2 along with books and conference proceedings and health conditions listed above. Level I and II evidence supports the use of vitamins K1 and K2 in osteoporosis and Level II evidence supports vitamin K2 in prevention of coronary calcification and cardiovascular disease. Evidence is insufficient for use in diabetes, arthritis, renal calculi, and cancer. Main Message. Vitamin K2 may be a useful adjunct for the treatment of osteoporosis, along with vitamin D and calcium, rivaling bisphosphonate therapy without toxicity. It may also significantly reduce morbidity and mortality in cardiovascular health by reducing vascular calcification. Vitamin K2 appears promising in the areas of diabetes, cancer, and osteoarthritis. Vitamin K use in warfarin therapy is safe and may improve INR control, although a dosage adjustment is required. Conclusion. Vitamin K supplementation may be useful for a number of chronic conditions that are afflicting North Americans as the population ages. Supplementation may be required for bone and cardiovascular health.

  17. Pre-operative risk scores for the prediction of outcome in elderly people who require emergency surgery

    Directory of Open Access Journals (Sweden)

    Bates Tom

    2007-06-01

    Full Text Available Abstract Background The decision on whether to operate on a sick elderly person with an intra-abdominal emergency is one of the most difficult in general surgery. A predictive risk-score would be of great value in this situation. Methods A Medline search was performed to identify those predictive risk-scores relevant to sick elderly patients in whom emergency surgery might be life-saving. Results Many of the risk scores for surgical patients include the operative findings or require tests which are not available in the acute situation. Most of the relevant studies include younger patients and elective surgery. The Glasgow Aneurysm Score and Hardman Index are specific to ruptured aortic aneurysm while the Boey Score and the Hacetteppe Score are specific to perforated peptic ulcer. The Reiss Index and Fitness Score can be used pre-operatively if the elements of the score can be completed in time. The ASA score, which includes a significant element of subjective clinical judgement, can be augmented with factors such as age and urgency of surgery but no test has a negative predictive value sufficient to recommend against surgical intervention without clinical input. Conclusion Risk scores may be helpful in sick elderly patients needing emergency abdominal surgery but an experienced clinical opinion is still essential.

  18. Prehospital neurological deterioration in stroke.

    Science.gov (United States)

    Slavin, Sabreena J; Sucharew, Heidi; Alwell, Kathleen; Moomaw, Charles J; Woo, Daniel; Adeoye, Opeolu; Flaherty, Matthew L; Ferioli, Simona; McMullan, Jason; Mackey, Jason; De Los Rios La Rosa, Felipe; Martini, Sharyl; Kissela, Brett M; Kleindorfer, Dawn O

    2018-04-27

    Patients with stroke can experience neurological deterioration in the prehospital setting. We evaluated patients with stroke to determine factors associated with prehospital neurological deterioration (PND). Among the Greater Cincinnati/Northern Kentucky region (population ~1.3 million), we screened all 15 local hospitals' admissions from 2010 for acute stroke and included patients aged ≥20. The GCS was compared between emergency medical services (EMS) arrival and hospital arrival, with decrease ≥2 points considered PND. Data obtained retrospectively included demographics, medical history and medication use, stroke subtype (eg, ischaemic stroke (IS), intracerebral haemorrhage (ICH), subarachnoid haemorrhage (SAH)) and IS subtype (eg, small vessel, large vessel, cardioembolic), seizure at onset, time intervals between symptom onset, EMS arrival and hospital arrival, EMS level of training, and blood pressure and serum glucose on EMS arrival. Of 2708 total patients who had a stroke, 1092 patients (median (IQR) age 74 (61-83) years; 56% women; 21% black) were analysed. PND occurred in 129 cases (12%), including 9% of IS, 24% of ICH and 16% of SAH. In multivariable analysis, black race, atrial fibrillation, haemorrhagic subtype and ALS level of transport were associated with PND. Haemorrhage and atrial fibrillation is associated with PND in stroke, and further investigation is needed to establish whether PND can be predicted. Further studies are also needed to assess whether preferential transport of patients with deterioration to hospitals equipped with higher levels of care is beneficial, identify why race is associated with deterioration and to test therapies targeting PND. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Neurology and literature 2.

    Science.gov (United States)

    Iniesta, I

    2014-05-01

    Good literary fiction has the potential to move us, extend our sense of life, transform our prospective views and help us in the face of adversity. A neurological disorder is likely to be the most challenging experience a human being may have to confront in a lifetime. As such, literary recreations of illnesses have a doubly powerful effect. Study the synergies between neurology and fictional literature with particular reference to narrative based medicine (NBM). Doctors establish boundaries between the normal and the abnormal. Taking a clinical history is an act of interpretation in which the doctor integrates the science of objective signs and measurable quantities with the art of subjective clinical judgment. The more discrepancy there is between the patient's experience with the illness and the doctor's interpretation of that disease, the less likely the doctor-patient interaction is to succeed. NBM contributes to a better discernment of the meanings, thus considering disease as a biographical event rather than just a natural fact. Drawing from their own experience with disease, writers of fiction provide universal insights through their narratives, whilst neuroscientists, like Cajal, have occasionally devoted their scientific knowledge to literary narratives. Furthermore, neurologists from Alzheimer to Oliver Sacks remind us of the essential value of NBM in the clinic. Integrating NBM (the narrative of patients) and the classic holistic approach to patients with our current paradigm of evidence based medicine represents a challenge as relevant to neurologists as keeping up with technological and scientific advances. Copyright © 2011 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  20. Neurological Consequences of Obesity

    Science.gov (United States)

    O’Brien, Phillipe D.; Hinder, Lucy M.; Callaghan, Brian C.; Feldman, Eva L.

    2017-01-01

    Obesity, primarily a consequence of poor dietary choices and an increased sedentary lifestyle, has become a global pandemic that brings with it enormous medical, social, and economic challenges. Not only does obesity increase the risk of cardiovascular disease and certain cancers, but it is also recognized as a key driver of other metabolic syndrome (MetS) components. These components include insulin resistance, hyperglycemia with prediabetes or type 2 diabetes, dyslipidemia, and hypertension, and are underlying contributors to systemic metabolic dysfunction. More recently, obesity and diet-induced metabolic dysfunction have been identified as risk factors for the development of a wide variety of neurological disorders in both the central and peripheral nervous systems. An abundance of literature has shown that obesity is associated with mild cognitive impairment and altered hippocampal structure and function, and there is a robust correlation between obesity and Alzheimer’s type dementia. Similarly, many reports show that both the autonomic and somatic components of the peripheral nervous system are impacted by obesity. The autonomic nervous system, under control of the hypothalamus, displays altered catabolic and anabolic processes in obese individuals attributed to sympathetic-parasympathetic imbalances. A close association also exists between obesity and polyneuropathy, a complication most commonly found in prediabetic and diabetic patients, and is likely secondary to a combination of obesity-induced dyslipidemia with hyperglycemia. This review will outline the pathophysiological development of obesity and dyslipidemia, discuss the adverse impact of these conditions on the nervous system, and provide evidence for lipotoxicity and metabolic inflammation as the drivers underlying the neurological consequences of obesity. In addition, this review will examine the benefits of lifestyle and surgical interventions in obesity-induced neurological disorders. PMID

  1. Neurological Respiratory Failure

    Directory of Open Access Journals (Sweden)

    Mohan Rudrappa

    2018-01-01

    Full Text Available West Nile virus infection in humans is mostly asymptomatic. Less than 1% of neuro-invasive cases show a fatality rate of around 10%. Acute flaccid paralysis of respiratory muscles leading to respiratory failure is the most common cause of death. Although the peripheral nervous system can be involved, isolated phrenic nerve palsy leading to respiratory failure is rare and described in only two cases in the English literature. We present another case of neurological respiratory failure due to West Nile virus-induced phrenic nerve palsy. Our case reiterates the rare, but lethal, consequences of West Nile virus infection, and the increase of its awareness among physicians.

  2. Status of neurology medical school education

    Science.gov (United States)

    Ali, Imran I.; Isaacson, Richard S.; Safdieh, Joseph E.; Finney, Glen R.; Sowell, Michael K.; Sam, Maria C.; Anderson, Heather S.; Shin, Robert K.; Kraakevik, Jeff A.; Coleman, Mary; Drogan, Oksana

    2014-01-01

    Objective: To survey all US medical school clerkship directors (CDs) in neurology and to compare results from a similar survey in 2005. Methods: A survey was developed by a work group of the American Academy of Neurology Undergraduate Education Subcommittee, and sent to all neurology CDs listed in the American Academy of Neurology database. Comparisons were made to a similar 2005 survey. Results: Survey response rate was 73%. Neurology was required in 93% of responding schools. Duration of clerkships was 4 weeks in 74% and 3 weeks in 11%. Clerkships were taken in the third year in 56%, third or fourth year in 19%, and fourth year in 12%. Clerkship duration in 2012 was slightly shorter than in 2005 (fewer clerkships of ≥4 weeks, p = 0.125), but more clerkships have moved into the third year (fewer neurology clerkships during the fourth year, p = 0.051). Simulation training in lumbar punctures was available at 44% of schools, but only 2% of students attempted lumbar punctures on patients. CDs averaged 20% protected time, but reported that they needed at least 32%. Secretarial full-time equivalent was 0.50 or less in 71% of clerkships. Eighty-five percent of CDs were “very satisfied” or “somewhat satisfied,” but more than half experienced “burnout” and 35% had considered relinquishing their role. Conclusion: Trends in neurology undergraduate education since 2005 include shorter clerkships, migration into the third year, and increasing use of technology. CDs are generally satisfied, but report stressors, including inadequate protected time and departmental support. PMID:25305155

  3. Education Research: Neurology resident education

    Science.gov (United States)

    Mayans, David; Schneider, Logan; Adams, Nellie; Khawaja, Ayaz M.; Engstrom, John

    2016-01-01

    Objective: To survey US-trained graduating neurology residents who are American Academy of Neurology members, in an effort to trend perceived quality and completeness of graduate neurology education. Methods: An electronic survey was sent to all American Academy of Neurology members graduating from US neurology residency programs in the Spring of 2014. Results: Of 805 eligible respondents, 24% completed the survey. Ninety-three percent of adult neurology residents and 56% of child neurology residents reported plans to pursue fellowship training after residency. Respondents reported a desire for additional training in neurocritical care, neuro-oncology, neuromuscular diseases, botulinum toxin injection, and nerve blocks. There remains a clear deficit in business training of neurology residents, although there was notable improvement in knowledge of coding and office management compared to previous surveys. Discussion: Although there are still areas of perceived weakness in neurology training, graduating neurology residents feel generally well prepared for their chosen careers. However, most still pursue fellowship training for reasons that are little understood. In addition to certain subspecialties and procedures, practice management remains deficient in neurology training and is a point of future insecurity for most residents. Future curriculum changes should consider resident-reported gaps in knowledge, with careful consideration of improving business training. PMID:26976522

  4. Psychiatric emergency "surge capacity" following acts of terrorism and mass violence with high media impact: what is required?

    Science.gov (United States)

    Claassen, Cindy; Kashner, T Michael; Kashner, Tetyana K; Xuan, Lei; Larkin, Gregory L

    2011-01-01

    Adequate preparedness for acts of terrorism and mass violence requires a thorough understanding of the postdisaster mental health needs of all exposed groups, including those watching such events from a distance. This study examined emergency psychiatric treatment-seeking patterns following media exposure to four national terrorist or mass casualty events. An event was selected for study if (a) it precipitated local front-page headlines for >5 consecutive days and (b) emergency service psychiatrists identified it as specifically precipitating help-seeking in the study hospital. Four events qualified: the Oklahoma City bombing (1995), the Columbine High School (1999) and Wedgewood Baptist Church (1999) shootings and the terrorist attacks of September 11, 2001. Time-series analyses were used to correct for autocorrelation in visit patterns during the postdisaster week, and equivalent time periods from years before and after each event were used as control years. Overall, disaster week census did not differ significantly from predisaster weeks, although 3-day nonsignificant decreases in visit rate were observed following each disaster. Treatment-seeking for anxiety-related issues showed a nonsignificant increase following each disaster, which became significant in the "all disaster" model (t=5.17; P=.006). Intensity of media coverage did not impact rate of help-seeking in any analysis. Although these sentinel US disasters varied in scope, method, geographic proximity to the study site, perpetrator characteristics, public response, sequelae and degree of media coverage, the extent to which they impacted emergency department treatment-seeking was minimal. Geographically distant mass violence and disaster events of the type and scope studied here may require only minimal mental health "surge capacity" in the days following the event. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. Standards in Neurological Rehabilitation, June 1997

    Directory of Open Access Journals (Sweden)

    Michael P. Barnes

    1997-01-01

    Full Text Available The European Federation of Neurological Societies (EFNS Scientific Panel on Neurorehabilitation established a Task Force on standards in neurological rehabilitation in June 1996. The remit for the Task Force was to: (1 produce a report on the state of neurological rehabilitation across Europe; and (2 recommend standards for the provision of neurological services for disabled people. The main conclusions of the Task Force were as follows: (1 A questionnaire circulated to each European member country has indicated a significant lack of adequate neurological rehabilitation facilities across Europe. Very few countries have any established network of neurological rehabilitation centres. Few countries have adequately trained neurological rehabilitation physicians, therapists or nurses. Such poor facilities should be seen in the context of the large numbers and increasing prevalence of people with neurological disabilities. (2 The Task Force has summarized the significant benefits that can follow from the establishment of a dedicated and cost effective neurological rehabilitation service including functional improvement, reduction of unnecessary complications, better coordination and use of limited resources, improved opportunities for education, training and research and a clear point of contact for the disabled person. (3 The Task Force recommends minimum standards for the prevention of neurological disability including access to health education, genetic counselling and emergency resources. The Task Force also encourages governments to invest in improved legislation for accident prevention. (4 The Task Force has outlined some minimum standards for the staffing of a neurological rehabilitation service including improved training both for neurologists and rehabilitation physicians. Such training could include a cross-national training programme both for physicians and other health care staff. (5 The Task Force supports a two-tier system of

  6. History of Neurology in China

    Institute of Scientific and Technical Information of China (English)

    Wang Xinde

    2000-01-01

    @@In 1921, the first independent department of neurology was established in Beijing. Before 1949, all over China only 12 professional doctors lectured neurology in medical colleges. Only 30 medically trained personnel were engaged in the neurological departments. The neurological departments contained roughly 200 beds. The thesis on stroke was written by Zhang Shanlei and published in 1922. Author discussed the cerebral stroke on basis of Chinese traditional medicine and European medicine. The first Textbook of Neurology in China was written by Professor Cheng Yu-lin and was published in 1939. In 1952, the Chinese Society of Neurology and Psychiatry of Chinese Medical Association was established. In 1955, the first issue of the Chinese Journal of Neurology and Psychiatry was published.

  7. Cotard syndrome in neurological and psychiatric patients.

    Science.gov (United States)

    Ramirez-Bermudez, Jesus; Aguilar-Venegas, Luis C; Crail-Melendez, Daniel; Espinola-Nadurille, Mariana; Nente, Francisco; Mendez, Mario F

    2010-01-01

    The authors describe the frequency and characteristics of Cotard syndrome among neurological and psychiatric inpatients at a tertiary referral center. All inpatients from the National Institute of Neurology of Mexico (March 2007-May 2009) requiring neuropsychiatric consultation were reviewed. Among 1,321 inpatient consultations, 63.7% had neurological disease and one (0.11%) had viral encephalitis and Cotard syndrome. Of inpatients, 36.2% had pure psychiatric disorders and three (0.62%) had Cotard syndrome, associated with psychotic depression, depersonalization, and penile retraction (koro syndrome). This review discusses potential mechanisms for Cotard syndrome, including the role of a perceptual-emotional dissociation in self-misattribution in the deliré des negations.

  8. Aphasia, Just a Neurological Disorder?

    Directory of Open Access Journals (Sweden)

    Mehmet Ozdemir

    2016-02-01

    Full Text Available Hashimoto%u2019s encephalopathy (HE is a rare disorder associated with autoimmune thyroiditis. Etiology of HE is not completely understood. High levels of serum antithyroid antibodies are seen in HE. Presentation with otoimmune thyroiditis, cognitive impairment, psychiatric and neurologic symptoms and absence of bacterial or viral enfections are characteristics of HE. HE is a steroid responsive encephalopathy. 60 years old male patient admitted to hospital with forget fulness continuing for 9 months and speech loss starting 2 days ago. Strong positivity of antithyroid antibodies increases the odds for HE. Thyroid function tests showed severe hypothyroidism. Electroencephalography and magnetic resonance imaging results were compatible with HE. HE is diagnosed with differantial diagnosis and exclusion of other reasons. This uncommon disorder is not recognised enough. High titres of serum antithyroid antiboides are always needed for diagnosis. Correct diagnosis requires awareness of wide range of cognitive and clinical presentations of HE.

  9. Are the French neurology residents satisfied with their training?

    Science.gov (United States)

    Codron, P; Roux, T; Le Guennec, L; Zuber, M

    2015-11-01

    There have been dramatic changes in neurology over the past decade; these advances require a constant adaptation of residents' theoretical and practical training. The French Association of Neurology Residents and the College of Neurology Teachers conducted a national survey to assess the French neurology residents' satisfaction about their training. A 16-item questionnaire was sent via e-mail to French neurology residents completing training in 2014. Data were collected and processed anonymously. Of eligible respondents, 126 returned the survey, representing approximately 40% of all the French neurology residents. Most residents (78%) rated their clinical training favorably. Seventy-two percent reported good to excellent quality teaching of neurology courses from their faculty. However, many residents (40%) felt insufficient their doctoral thesis supervision. All residents intended to enter fellowship training after their residency, and most of them (68%) planned to practice in a medical center. French neurology residents seemed satisfied with the structure and quality of their training program. However, efforts are required to improve management of the doctoral thesis and make private practice more attractive and accessible during the residency. In the future, similar surveys should be scheduled to regularly assess neurology residents' satisfaction and the impact of the forthcoming national and European reforms. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  10. Primary care perceptions of neurology and neurology services.

    Science.gov (United States)

    Loftus, Angela M; Wade, Carrie; McCarron, Mark O

    2016-06-01

    Neurophobia (fear of neural sciences) and evaluation of independent sector contracts in neurology have seldom been examined among general practitioners (GPs). A questionnaire determined GPs' perceptions of neurology compared with other medical specialties. GP experiences of neurology services with independent sector companies and the local National Health Service (NHS) were compared. Areas of potential improvement in NHS neurology services were recorded from thematic analyses. Among 76 GPs neurology was perceived to be as interesting as other medical specialties. GPs reported less knowledge, more difficulty and less confidence in neurology compared with other medical specialties. There was a preference for a local NHS neurology service (pneurology services provided better patient satisfaction. GPs prefer local NHS neurology services to independent sector contracts. GPs' evaluations should inform commissioning of neurology services. Combating neurophobia should be an integral part of responsive commissioning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  11. Congress of Neurological Surgeons

    Science.gov (United States)

    ... Newsletter Antitrust Drugs & Devices Emergency - Trauma Care & Stroke Fraud & Abuse Graduate Medical Education Guidelines MACRA Medical Liability ... Service Connect With Us Connect with us on Facebook Connect with us on Twitter Connect with us ...

  12. Molecular genetics in neurology.

    Science.gov (United States)

    Martin, J B

    1993-12-01

    There has been remarkable progress in the identification of mutations in genes that cause inherited neurological disorders. Abnormalities in the genes for Huntington disease, neurofibromatosis types 1 and 2, one form of familial amyotrophic lateral sclerosis, fragile X syndrome, myotonic dystrophy, Kennedy syndrome, Menkes disease, and several forms of retinitis pigmentosa have been elucidated. Rare disorders of neuronal migration such as Kallmann syndrome, Miller-Dieker syndrome, and Norrie disease have been shown to be due to specific gene defects. Several muscle disorders characterized by abnormal membrane excitability have been defined as mutations of the muscle sodium or chloride channels. These advances provide opportunity for accurate molecular diagnosis of at-risk individuals and are the harbinger of new approaches to therapy of these diseases.

  13. Neurological complications of alcoholism

    Directory of Open Access Journals (Sweden)

    I. I. Nikiforov

    2017-01-01

    Full Text Available Nervous system lesions associated with chronic alcohol intoxication are common in clinical practice. They lead to aggravated alcoholic disease, its more frequent recurrences, and intensified pathological craving for alcohol. Neurological pathology in turn occurs with frequent exacerbations. The interaction of diseases, age, and medical  pathomorphism modifies the clinical presentation and course of the  major pathology, as well as comorbidity, the nature and severity of  complications, worsens quality of life in a patient, and makes the  diagnostic and treatment process difficult. The paper discusses the  classification, clinical variants, biochemical and molecular biological  aspects of various complications of alcoholic disease. It considers its  most common form, in particular alcoholic polyneuropathy, as well as its rarer variants, such as hemorrhagic encephalopathy with a subacute course (Gayet–Wernicke encephalopathy.

  14. Deja vu in neurology.

    Science.gov (United States)

    Wild, Edward

    2005-01-01

    The significance of deja vu is widely recognised in the context of temporal lobe epilepsy, and enquiry about deja vu is frequently made in the clinical assessment of patients with possible epilepsy. Deja vu has also been associated with several psychiatric disorders. The historical context of current understanding of deja vu is discussed. The literature reveals deja vu to be a common phenomenon consistent with normality. Several authors have suggested the existence of a "pathological" form of deja vu that differs, qualitatively or quantitatively, from "non-pathological" deja vu. The features of deja vu suggesting neurological or psychiatric pathology are discussed. Several neuroanatomical and psychological models of the deja vu experience are highlighted, implicating the perceptual, mnemonic and affective regions of the lateral temporal cortex, hippocampus and amygdala in the genesis of deja vu. A possible genetic basis for a neurochemical model of deja vu is discussed. Clinical approaches to the patient presenting with possible deja vu are proposed.

  15. Neurology of ciguatera

    Science.gov (United States)

    Pearn, J

    2001-01-01

    Ciguatera is a widespread ichthyosarcotoxaemia with dramatic and clinically important neurological features. This severe form of fish poisoning may present with either acute or chronic intoxication syndromes and constitutes a global health problem. Ciguatera poisoning is little known in temperate countries as a potentially global problem associated with human ingestion of large carnivorous fish that harbour the bioaccumulated ciguatoxins of the photosynthetic dinoflagellate Gambierdiscus toxicus. This neurotoxin is stored in the viscera of fish that have eaten the dinoflagellate and concentrated it upwards throughout the food chain towards progressively larger species, including humans. Ciguatoxin accumulates in all fish tissues, especially the liver and viscera, of "at risk" species. Both Pacific (P-CTX-1) and Caribbean (C-CTX-1) ciguatoxins are heat stable polyether toxins and pose a health risk at concentrations above 0.1 ppb. The presenting signs of ciguatera are primarily neurotoxic in more than 80% of cases. Such include the pathognomonic features of postingestion paraesthesiae, dysaesthesiae, and heightened nociperception. Other sensory abnormalities include the subjective features of metallic taste, pruritis, arthralgia, myalgia, and dental pain. Cerebellar dysfunction, sometimes diphasic, and weakness due to both neuropathy and polymyositis may be encountered. Autonomic dysfunction leads to hypotension, bradycardia, and hypersalivation in severe cases. Ciguatoxins are potent, lipophilic sodium channel activator toxins which bind to the voltage sensitive (site 5) sodium channel on the cell membranes of all excitable tissues. Treatment depends on early diagnosis and the early administration of intravenous mannitol. The early identification of the neurological features in sentinel patients has the potential to reduce the number of secondary cases in cluster outbreaks.

 PMID:11118239

  16. Human endogenous retroviruses in neurologic disease.

    Science.gov (United States)

    Christensen, Tove

    2016-01-01

    Endogenous retroviruses are pathogenic - in other species than the human. Disease associations for Human Endogenous RetroViruses (HERVs) are emerging, but so far an unequivocal pathogenetic cause-effect relationship has not been established. A role for HERVs has been proposed in neurological and neuropsychiatric diseases as diverse as multiple sclerosis (MS) and schizophrenia (SCZ). Particularly for MS, many aspects of the activation and involvement of specific HERV families (HERV-H/F and HERV-W/MSRV) have been reported, both for cells in the circulation and in the central nervous system. Notably envelope genes and their gene products (Envs) appear strongly associated with the disease. For SCZ, for ALS, and for HIV-associated dementia (HAD), indications are accumulating for involvement of the HERV-K family, and also HERV-H/F and/or HERV-W. Activation is reasonably a prerequisite for causality as most HERV sequences remain quiescent in non-pathological conditions, so the importance of regulatory pathways and epigenetics involved in regulating HERV activation, derepression, and also involvement of retroviral restriction factors, is emerging. HERV-directed antiretrovirals have potential as novel therapeutic paradigms in neurologic disease, particularly in MS. The possible protective or ameliorative effects of antiretroviral therapy in MS are substantiated by reports that treatment of HIV infection may be associated with a significantly decreased risk of MS. Further studies of HERVs, their role in neurologic diseases, and their potential as therapeutic targets are essential. © 2016 APMIS. Published by John Wiley & Sons Ltd.

  17. Child Neurology Services in Africa

    Science.gov (United States)

    Wilmshurst, Jo M.; Badoe, Eben; Wammanda, Robinson D.; Mallewa, Macpherson; Kakooza-Mwesige, Angelina; Venter, Andre; Newton, Charles R.

    2013-01-01

    The first African Child Neurology Association meeting identified key challenges that the continent faces to improve the health of children with neurology disorders. The capacity to diagnose common neurologic conditions and rare disorders is lacking. The burden of neurologic disease on the continent is not known, and this lack of knowledge limits the ability to lobby for better health care provision. Inability to practice in resource-limited settings has led to the migration of skilled professionals away from Africa. Referral systems from primary to tertiary are often unpredictable and chaotic. There is a lack of access to reliable supplies of basic neurology treatments such as antiepileptic drugs. Few countries have nationally accepted guidelines either for the management of epilepsy or status epilepticus. There is a great need to develop better training capacity across Africa in the recognition and management of neurologic conditions in children, from primary health care to the subspecialist level. PMID:22019842

  18. Do instability markers predict satisfactory reduction and requirement for later surgery in emergency department patients with wrist fracture?

    Science.gov (United States)

    Winayak, Amar; Gossat, Alyza; Cooper, Jenny; Ritchie, Peter; Lim, Wei; Klim, Sharon; Kelly, Anne-Maree

    2018-02-01

    Research suggests that the presence of instability markers in patients with displaced distal radial fractures is associated with poorer outcome. Our aims were to determine whether the presence of previously defined instability markers could predict the likelihood of successful ED reduction and requirement for a secondary procedure after ED reduction. Retrospective cohort study performed by medical record review. Adult ED patients coded as having an isolated wrist fracture and having fracture reduction in ED were eligible for inclusion. Data collected included demographics, history of osteoporosis, mechanism of injury, radiological features on X-rays and performance of a secondary procedure. Outcomes of interest were the rate of successful fracture reduction in ED (against defined radiological criteria), the rate of secondary procedures and the association between the number of defined instability risk factors and successful reduction and performance of a secondary surgical procedure. Analysis was by χ 2 test, receiver operating characteristic curve, logistic regression analyses. Three hundred and nineteen patients were studied; median age 62 years, 77% female. Sixty-five per cent of patients had satisfactory fracture reduction in ED (95% CI 59%-70%). Eighty-six patients underwent a secondary procedure to reduce/stabilise their fracture (28%, 95% CI 23%-33%). Younger age, lack of satisfactory ED reduction and increased number of instability factors were independently predictive of the performance of a secondary procedure. Instability risk factors are common in patients with wrist fractures requiring reduction in ED. The number of instability factors is not a strong predictor of the performance of secondary procedures. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  19. Affective disorders in neurological diseases

    DEFF Research Database (Denmark)

    Nilsson, F M; Kessing, L V; Sørensen, T M

    2003-01-01

    OBJECTIVE: To investigate the temporal relationships between a range of neurological diseases and affective disorders. METHOD: Data derived from linkage of the Danish Psychiatric Central Register and the Danish National Hospital Register. Seven cohorts with neurological index diagnoses and two...... of affective disorder was lower than the incidence in the control groups. CONCLUSION: In neurological diseases there seems to be an increased incidence of affective disorders. The elevated incidence was found to be particularly high for dementia and Parkinson's disease (neurodegenerative diseases)....

  20. An Examination of Women Experiencing Obstetric Complications Requiring Emergency Care: Perceptions and Sociocultural Consequences of Caesarean Sections in Bangladesh

    Science.gov (United States)

    Khan, Rasheda; Sultana, Marzia; Bilkis, Sayeda; Koblinsky, Marge

    2012-01-01

    Little is known about the physical and socioeconomic postpartum consequences of women who experience obstetric complications and require emergency obstetric care (EmOC), particularly in resource-poor countries such as Bangladesh where historically there has been a strong cultural preference for births at home. Recent increases in the use of skilled birth attendants show socioeconomic disparities in access to emergency obstetric services, highlighting the need to examine birthing preparation and perceptions of EmOC, including caesarean sections. Twenty women who delivered at a hospital and were identified by physicians as having severe obstetric complications during delivery or immediately thereafter were selected to participate in this qualitative study. Purposive sampling was used for selecting the women. The study was carried out in Matlab, Bangladesh, during March 2008–August 2009. Data-collection methods included in-depth interviews with women and, whenever possible, their family members. The results showed that the women were poorly informed before delivery about pregnancy-related complications and medical indications for emergency care. Barriers to care-seeking at emergency obstetric facilities and acceptance of lifesaving care were related to apprehensions about the physical consequences and social stigma, resulting from hospital procedures and financial concerns. The respondents held many misconceptions about caesarean sections and distrust regarding the reason for recommending the procedure by the healthcare providers. Women who had caesarean sections incurred high costs that led to economic burdens on family members, and the blame was attributed to the woman. The postpartum health consequences reported by the women were generally left untreated. The data underscore the importance of educating women and their families about pregnancy-related complications and preparing families for the possibility of caesarean section. At the same time, the health

  1. Perioperative Management of Neurological Conditions

    Directory of Open Access Journals (Sweden)

    Manjeet Singh Dhallu

    2017-06-01

    Full Text Available Perioperative care of the patients with neurological diseases can be challenging. Most important consideration is the management and understanding of pathophysiology of these disorders and evaluation of new neurological changes that occur perioperatively. Perioperative generally refers to 3 phases of surgery: preoperative, intraoperative, and postoperative. We have tried to address few commonly encountered neurological conditions in clinical practice, such as delirium, stroke, epilepsy, myasthenia gravis, and Parkinson disease. In this article, we emphasize on early diagnosis and management strategies of neurological disorders in the perioperative period to minimize morbidity and mortality of patients.

  2. Challenges for the registration of vaccines in emerging countries: Differences in dossier requirements, application and evaluation processes.

    Science.gov (United States)

    Dellepiane, Nora; Pagliusi, Sonia

    2018-06-07

    The divergence of regulatory requirements and processes in developing and emerging countries contributes to hamper vaccines' registration, and therefore delay access to high-quality, safe and efficacious vaccines for their respective populations. This report focuses on providing insights on the heterogeneity of registration requirements in terms of numbering structure and overall content of dossiers for marketing authorisation applications for vaccines in different areas of the world. While it also illustrates the divergence of regulatory processes in general, as well as the need to avoid redundant reviews, it does not claim to provide a comprehensive view of all processes nor existing facilitating mechanisms, nor is it intended to touch upon the differences in assessments made by different regulatory authorities. This report describes the work analysed by regulatory experts from vaccine manufacturing companies during a meeting held in Geneva in May 2017, in identifying and quantifying differences in the requirements for vaccine registration in three aspects for comparison: the dossier numbering structure and contents, the application forms, and the evaluation procedures, in different countries and regions. The Module 1 of the Common Technical Document (CTD) of 10 countries were compared. Modules 2-5 of the CTDs of two regions and three countries were compared to the CTD of the US FDA. The application forms of eight countries were compared and the registration procedures of 134 importing countries were compared as well. The analysis indicates a high degree of divergence in numbering structure and content requirements. Possible interventions that would lead to significant improvements in registration efficiency include alignment in CTD numbering structure, a standardised model-application form, and better convergence of evaluation procedures. Copyright © 2018.

  3. Music-based interventions in neurological rehabilitation.

    Science.gov (United States)

    Sihvonen, Aleksi J; Särkämö, Teppo; Leo, Vera; Tervaniemi, Mari; Altenmüller, Eckart; Soinila, Seppo

    2017-08-01

    During the past ten years, an increasing number of controlled studies have assessed the potential rehabilitative effects of music-based interventions, such as music listening, singing, or playing an instrument, in several neurological diseases. Although the number of studies and extent of available evidence is greatest in stroke and dementia, there is also evidence for the effects of music-based interventions on supporting cognition, motor function, or emotional wellbeing in people with Parkinson's disease, epilepsy, or multiple sclerosis. Music-based interventions can affect divergent functions such as motor performance, speech, or cognition in these patient groups. However, the psychological effects and neurobiological mechanisms underlying the effects of music interventions are likely to share common neural systems for reward, arousal, affect regulation, learning, and activity-driven plasticity. Although further controlled studies are needed to establish the efficacy of music in neurological recovery, music-based interventions are emerging as promising rehabilitation strategies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Report on the costs of domestic and international emergencies and on the threats posed by the Kuwaiti oil fires as required by P. L. 102-55

    Energy Technology Data Exchange (ETDEWEB)

    1991-06-01

    The report fulfills the requirements of Public Law 12-55, the FY 1992 dire emergency supplemental appropriations bill, signed by the President on June 13, 1991. This law required the Director of the Office of Management and Budget to prepare and submit to the appropriate committees of Congress a report on: unfunded costs of dire emergencies because of floods, droughts, tornadoes, unemployment, and other disasters in the United States; unfunded costs, including food assistance, of international disaster emergencies existing because of floods, droughts, tornadoes, and other disasters; and the threats to oil supply, human health, and the environment that the Kuwaiti oil fires might pose.

  5. A focus on adolescence to reduce neurological, mental health and substance-use disability.

    Science.gov (United States)

    Davidson, Leslie L; Grigorenko, Elena L; Boivin, Michael J; Rapa, Elizabeth; Stein, Alan

    2015-11-19

    Globally, there is a crucial need to prioritize research directed at reducing neurological, mental health and substance-use disorders in adolescence, which is a pivotal age for the development of self-control and regulation. In adolescence, behaviour optimally advances towards adaptive long-term goals and suppresses conflicting maladaptive short-lived urges to balance impulsivity, exploration and defiance, while establishing effective societal participation. When self-control fails to develop, violence, injury and neurological, mental health and substance-use disorders can result, further challenging the development of self-regulation and impeding the transition to a productive adulthood. Adolescent outcomes, positive and negative, arise from both a life-course perspective and within a socioecological framework. Little is known about the emergence of self-control and regulation in adolescents in low- and middle-income countries where enormous environmental threats are more common (for example, poverty, war, local conflicts, sex trafficking and slavery, early marriage and/or pregnancy, and the absence of adequate access to education) than in high-income countries and can threaten optimal neurodevelopment. Research must develop or adapt appropriate assessments of adolescent ability and disability, social inclusion and exclusion, normative development, and neurological, mental health and substance-use disorders. Socioecological challenges in low- and middle-income countries require innovative strategies to prevent mental health, neurological and substance-use disorders and develop effective interventions for adolescents at risk, especially those already living with these disorders and the consequent disability.

  6. Neurological sequelae from brachiocephalic vein stenosis.

    Science.gov (United States)

    Herzig, David W; Stemer, Andrew B; Bell, Randy S; Liu, Ai-Hsi; Armonda, Rocco A; Bank, William O

    2013-05-01

    Stenosis of central veins (brachiocephalic vein [BCV] and superior vena cava) occurs in 30% of hemodialysis patients, rarely producing intracranial pathology. The authors present the first cases of BCV stenosis causing perimesencephalic subarachnoid hemorrhage and myoclonic epilepsy. In the first case, a 73-year-old man on hemodialysis presented with headache and blurry vision, and was admitted with presumed idiopathic intracranial hypertension after negative CT studies and confirmatory lumbar puncture. The patient mildly improved until hospital Day 3, when he experienced a seizure; emergency CT scans showed perimesencephalic subarachnoid hemorrhage. Cerebral angiography failed to find any vascular abnormality, but demonstrated venous congestion. A fistulogram found left BCV occlusion with jugular reflux. The occlusion could not be reopened percutaneously and required open fistula ligation. Postoperatively, symptoms resolved and the patient remained intact at 7-month follow-up. In the second case, a 67-year-old woman on hemodialysis presented with right arm weakness and myoclonic jerks. Admission MRI revealed subcortical edema and a possible dural arteriovenous fistula. Cerebral angiography showed venous engorgement, but no vascular malformation. A fistulogram found left BCV stenosis with jugular reflux, which was immediately reversed with angioplasty and stent placement. Postprocedure the patient was seizure free, and her strength improved. Seven months later the patient presented in myoclonic status epilepticus, and a fistulogram revealed stent occlusion. Angioplasty successfully reopened the stent and she returned to baseline; she was seizure free at 4-month follow-up. Central venous stenosis is common with hemodialysis, but rarely presents with neurological findings. Prompt recognition and endovascular intervention can restore normal venous drainage and resolve symptoms.

  7. A burn center paradigm to fulfill deferred consent public disclosure and community consultation requirements for emergency care research.

    Science.gov (United States)

    Blackford, Martha G; Falletta, Lynn; Andrews, David A; Reed, Michael D

    2012-09-01

    To fulfill Food and Drug Administration and Department of Health and Human Services emergency care research informed consent requirements, our burn center planned and executed a deferred consent strategy gaining Institutional Review Board (IRB) approval to proceed with the clinical study. These federal regulations dictate public disclosure and community consultation unique to acute care research. Our regional burn center developed and implemented a deferred consent public notification and community consultation paradigm appropriate for a burn study. Published accounts of deferred consent strategies focus on acute care resuscitation practices. We adapted those strategies to design and conduct a comprehensive public notification/community consultation plan to satisfy deferred consent requirements for burn center research. To implement a robust media campaign we engaged the hospital's public relations department, distributed media materials, recruited hospital staff for speaking engagements, enlisted community volunteers, and developed initiatives to inform "hard-to-reach" populations. The hospital's IRB determined we fulfilled our obligation to notify the defined community. Our communication strategy should provide a paradigm other burn centers may appropriate and adapt when planning and executing a deferred consent initiative. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  8. Trends in neurology fellowship training

    Institute of Scientific and Technical Information of China (English)

    Jordan S.A. Williams; Trent S. Hodgson; Fernando D. Goldenberg; Rimas V. Lukas

    2017-01-01

    Aim:Aneed for Neurologists exists in the USA.The majority of Neurology residency graduates go on to additional subspecialty training. Methods: Data from the Accreditation Council for Graduate Medical Education from 2001-2014 and the United Council for Neurologic Subspecialties from was analyzed for trends in the number of Neurology subspecialty training programs and their composition. Results: There has been an overall trend of growth in the number of accredited Neurology subspecialty training programs and fellows. These trends vary between specific subspecialties. Conclusion: The authors provide an overview of the contemporary state of Neurology subspecialty training in the USA. A clearer understanding of subspecialty training allows for anticipation of workforce surpluses and deficits.

  9. Need for palliative care for neurological diseases.

    Science.gov (United States)

    Provinciali, Leandro; Carlini, Giulia; Tarquini, Daniela; Defanti, Carlo Alberto; Veronese, Simone; Pucci, Eugenio

    2016-10-01

    The new concept of palliative care supports the idea of palliation as an early approach to patients affected by disabling and life-limiting disease which focuses on the patient's quality of life along the entire course of disease. This model moves beyond the traditional concept of palliation as an approach restricted to the final stage of disease and widens the fields of intervention. There is a growing awareness of the importance of palliative care not only in oncological diseases but also in many other branches of medicine, and it appears particularly evident in the approach to many of the most frequent neurological diseases that are chronic, incurable and autonomy-impairing illnesses. The definition and implementation of palliative goals and procedures in neurology must take into account the specific features of these conditions in terms of the complexity and variability of symptoms, clinical course, disability and prognosis. The realization of an effective palliative approach to neurological diseases requires specific skills and expertise to adapt the concept of palliation to the peculiarities of these diseases; this approach should be realized through the cooperation of different services and the action of a multidisciplinary team in which the neurologist should play a central role to identify and face the patient's needs. In this view, it is paramount for the neurologist to be trained in these issues to promote the integration of palliative care in the care of neurological patients.

  10. Moving beyond too little, too late: managing emerging infectious diseases in wild populations requires international policy and partnerships

    Science.gov (United States)

    Voyles, Jamie; Kilpatrick, A. Marm; Collins, James P.; Fisher, Matthew C.; Frick, Winifred F.; McCallum, Hamish I.; Willis, Craig K.R.; Blehert, David S.; Murray, Kris A.; Puschendorf, Robert; Rosenblum, Erica Bree; Bolker, Benjamin M.; Cheng, Tina L.; Langwig, Kate E.; Linder, Daniel L.; Toothman, Mary; Wilber, Mark Q.; Briggs, Cheryl J.

    2015-01-01

    Emerging infectious diseases (EIDs) are on the rise due to multiple factors, including human facilitated movement of pathogens, broad-scale landscape changes, and perturbations to ecological systems (Jones et al. 2008; Fisher et al. 2012). Epidemics in wildlife are problematic because they can lead to pathogen spillover to new host organisms, erode biodiversity and threaten ecosystems that sustain human societies (Fisher et al. 2012; Kilpatrick 2011). There have been recent calls for large-scale research approaches to combat threats EIDs pose to wildlife (Sleeman 2013). While it is true that developing new analytical models, diagnostic assays and molecular tools will significantly avance outr abilities to respond to disease threats, we also propose that addressing difficult problems in EIDs will require considerable shofts in international health policy and infrastructure. While there are currently international organizations responsbile for rapidly initiating and coordinating preventative measures to control infectious diseases in human, livestock, and arable systems, there are few comparable instiutions that have the authority to implement transnational responses to EIDs in wildlife. This absence of well-developed infastructure hampers the rapid responses necessary to mitigate international spread of EIDs.

  11. Mentha spicata L. infusions as sources of antioxidant phenolic compounds: emerging reserve lots with special harvest requirements.

    Science.gov (United States)

    Rita, Ingride; Pereira, Carla; Barros, Lillian; Santos-Buelga, Celestino; Ferreira, Isabel C F R

    2016-10-12

    Mentha spicata L., commonly known as spearmint, is widely used in both fresh and dry forms, for infusion preparation or in European and Indian cuisines. Recently, with the evolution of the tea market, several novel products with added value are emerging, and the standard lots have evolved to reserve lots, with special harvest requirements that confer them with enhanced organoleptic and sensorial characteristics. The apical leaves of these batches are collected in specific conditions having, then, a different chemical profile. In the present study, standard and reserve lots of M. spicata were assessed in terms of the antioxidants present in infusions prepared from the different lots. The reserve lots presented the highest concentration in all the compounds identified in relation to the standard lots, with 326 and 188 μg mL -1 of total phenolic compounds, respectively. Both types of samples presented rosmarinic acid as the most abundant phenolic compound, at concentrations of 169 and 101 μg mL -1 for reserve and standard lots, respectively. The antioxidant activity was higher in the reserve lots which had the highest total phenolic compounds content, with EC 50 values ranging from 152 to 336 μg mL -1 . The obtained results provide scientific information that may allow the consumer to make a conscientious choice.

  12. Neurological Manifestations of Dengue Infection

    Directory of Open Access Journals (Sweden)

    Guo-Hong Li

    2017-10-01

    Full Text Available Dengue counts among the most commonly encountered arboviral diseases, representing the fastest spreading tropical illness in the world. It is prevalent in 128 countries, and each year >2.5 billion people are at risk of dengue virus infection worldwide. Neurological signs of dengue infection are increasingly reported. In this review, the main neurological complications of dengue virus infection, such as central nervous system (CNS, peripheral nervous system, and ophthalmic complications were discussed according to clinical features, treatment and possible pathogenesis. In addition, neurological complications in children were assessed due to their atypical clinical features. Finally, dengue infection and Japanese encephalitis were compared for pathogenesis and main clinical manifestations.

  13. A century of Dutch neurology.

    Science.gov (United States)

    Koehler, P J; Bruyn, G W; Moffie, D

    1998-12-01

    The Netherlands Society of Neurology evolved from the Society of Psychiatry founded in 1871. The name was changed into Netherlands Society of Psychiatry and Neurology (NSPN) in 1897. In the same year, the word neurology was also added to the name of the journal. The Society steadily blossomed, but in 1909 the first signs of dissatisfaction occurred: the Amsterdam Neurologists Society was founded. A few split-offs would follow. The number of members of the NSPN increased from 205 in 1920 to 585 in 1960. In the early 1960s, the Society was reorganised and would consist of two sections, one for psychiatry and one for neurology. However, this would not last, as a full separation was established in 1974. For several reasons, the name of the journal was changed four times until it assumed its present name in 1974. The 100th volume of CNN was not published, as expected. in 1996, but in 1998, because of two skipped publication years, one during WWII and another in the 1970s. During the last decades of the nineteenth century, teaching of neurology was mostly given within the frame of psychiatry, following the German tradition of 'brainpsychiatry' (organic or biologic psychiatry). The first official chair of psychiatry was founded at Utrecht, 1893 (Winkler). In Amsterdam, private teachers such as Delprat taught 'electro-therapy and nervous diseases' since the 1880s. The first extraordinary chair of neurology and electrotherapy was founded for his successor, Wertheim Salomonson in 1899. The first university clinic for psychiatry and neurology started at the Amsterdam Municipal University, when Winkler became professor of psychiatry and neurology in Amsterdam in 1896. Around the turn of the century, chairs of psychiatry and neurology were also founded in Groningen and Leiden. Separate chairs for neurology and psychiatry appeared in Amsterdam in 1923 and in Utrecht in 1936. Following an initiative of Brouwer, the first neurological university clinic opened its doors in

  14. Why neurology? Factors which influence career choice in neurology.

    Science.gov (United States)

    Albert, Dara V; Hoyle, Chad; Yin, Han; McCoyd, Matthew; Lukas, Rimas V

    2016-01-01

    To evaluate the factors which influence the decision to pursue a career in neurology. An anonymous survey was developed using a Likert scale to rate responses. The survey was sent to adult and child neurology faculty, residents and fellows, as well as medical students applying for neurology. Descriptive statistics were used to analyse the factors of influence. Respondents were subsequently categorized into pre-neurology trainees, neurology trainees, child neurologists and adult neurologists, and differences between the groups were analysed using Pearson's chi-square test. One hundred and thirty-three anonymous responses were received. The respondents were neurologists across all levels of training and practice. Across all respondents, the most common factor of high importance was intellectual content of specialty, challenging diagnostic problems, type of patient encountered and interest in helping people. Responses were similar across the groups; however, the earliest trainees cited interest in helping people as most important, while those in neurology training and beyond cite intellectual content of the specialty as most important. As trainees transition from their earliest levels of clinical experience into working as residents and faculty, there is a shift in the cited important factors. Lifestyle and financial factors seem to be the least motivating across all groups. Encouragement from peers, mentors, faculty and practicing physicians is considered high influences in a smaller number of neurologists. This may present an opportunity for practicing neurologists to make connections with medical students early in their education in an effort to encourage and mentor candidates.

  15. Emergency planning requirements and short-term countermeasures for commercial nuclear power plants in the United States

    International Nuclear Information System (INIS)

    Kantor, F.; Hogan, R.; Mohseni, A.

    1995-01-01

    Since the accident at the Three Mile Island Unit, the United States Nuclear Regulatory's Commission (NRC's) emergency planning regulations are now considered and an important part of the regulatory framework for protecting the public health and safety. Many aspects of the countermeasures are presented: Emergency Planning Zones (EPZ), off-Site emergency planning and preparedness, responsibilities of nuclear power plants operators and states and local government. Finally, protective action recommendations are given as well as the federal response to an emergency. The authors noted that the use of potassium iodide is not considered as an effective countermeasure for the public protection in the US. (TEC). 1 fig

  16. Neurologic Complications of Smallpox Vaccination

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2003-06-01

    Full Text Available Smallpox and smallpox vaccination is reviewed from the Departments of Neurology, Yale University School of Medicine, New Haven, CT, and University of New Mexico School of Medicine, Albuquerque.

  17. Neurological complication in HIV patients

    Science.gov (United States)

    Ritarwan, K.

    2018-03-01

    Human Immunodeficiency Virus (HIV) is neurotropic and immunotropic, making themassive destruction of both systems. Although their amount has been reduced, there is still neurological presentations and complications of HIV remain common in the era of combination antiretroviral therapy (cART). Neurological opportunistic infections (OI) occur in advanced HIV diseases such as primary cerebral lymphoma, cryptococcal meningitis, cerebral toxoplasmosis, and progressive multifocal encephalopathy. Neurological problem directly related to HIV appear at any stage in the progress of HIV disease, from AIDS-associated dementia to the aseptic meningitis of primary HIV infection observed in subjects with an immune deficiency. The replication of peripheral HIV viral is able to be controlled in the era of effective antiretroviral therapy. Non-HIV-related neurological disease such as stroke increased important as the HIV population ages.

  18. Neurological complications following bariatric surgery

    Directory of Open Access Journals (Sweden)

    Yara Dadalti Fragoso

    2012-09-01

    Full Text Available OBJECTIVE: It was to report on Brazilian cases of neurological complications from bariatric surgery. The literature on the subject is scarce. METHOD: Cases attended by neurologists in eight different Brazilian cities were collected and described in the present study. RESULTS: Twenty-six cases were collected in this study. Axonal polyneuropathy was the most frequent neurological complication, but cases of central demyelination, Wernicke syndrome, optical neuritis, radiculits, meralgia paresthetica and compressive neuropathies were also identified. Twenty-one patients (80% had partial or no recovery from the neurological signs and symptoms. CONCLUSION: Bariatric surgery, a procedure that is continuously increasing in popularity, is not free of potential neurological complications that should be clearly presented to the individual undergoing this type of surgery. Although a clear cause-effect relation cannot be established for the present cases, the cumulative literature on the subject makes it important to warn the patient of the potential risks of this procedure.

  19. African Journal of Neurological Sciences

    African Journals Online (AJOL)

    African Journal of Neurological Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 28, No 1 (2009) >. Log in or Register to get access to full text downloads.

  20. African Journal of Neurological Sciences

    African Journals Online (AJOL)

    African Journal of Neurological Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 31, No 2 (2012) >. Log in or Register to get access to full text downloads.

  1. African Journal of Neurological Sciences

    African Journals Online (AJOL)

    African Journal of Neurological Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 29, No 2 (2010) >. Log in or Register to get access to full text downloads.

  2. African Journal of Neurological Sciences

    African Journals Online (AJOL)

    African Journal of Neurological Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 31, No 1 (2012) >. Log in or Register to get access to full text downloads.

  3. African Journal of Neurological Sciences

    African Journals Online (AJOL)

    African Journal of Neurological Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 30, No 1 (2011) >. Log in or Register to get access to full text downloads.

  4. Neurological manifestations of influenza infection in children and adults: results of a National British Surveillance Study.

    Science.gov (United States)

    Goenka, Anu; Michael, Benedict D; Ledger, Elizabeth; Hart, Ian J; Absoud, Michael; Chow, Gabriel; Lilleker, James; Lunn, Michael; McKee, David; Peake, Deirdre; Pysden, Karen; Roberts, Mark; Carrol, Enitan D; Lim, Ming; Avula, Shivaram; Solomon, Tom; Kneen, Rachel

    2014-03-01

    The emergence of influenza A(H1N1) 2009 was met with increased reports of associated neurological manifestations. We aimed to describe neurological manifestations of influenza in adults and children in the United Kingdom that presented at this time. A 2-year surveillance study was undertaken through the British adult and pediatric neurological surveillance units from February 2011. Patients were included if they met clinical case definitions within 1 month of proven influenza infection. Twenty-five cases were identified: 21 (84%) in children and 4 (16%) in adults. Six (29%) children had preexisting neurological disorders. Polymerase chain reaction of respiratory secretions identified influenza A in 21 (81%; 20 of which [95%] were H1N1) and influenza B in 4 (15%). Twelve children had encephalopathy (1 with movement disorder), 8 had encephalitis, and 1 had meningoencephalitis. Two adults had encephalopathy with movement disorder, 1 had encephalitis, and 1 had Guillain-Barré syndrome. Seven individuals (6 children) had specific acute encephalopathy syndromes (4 acute necrotizing encephalopathy, 1 acute infantile encephalopathy predominantly affecting the frontal lobes, 1 hemorrhagic shock and encephalopathy, 1 acute hemorrhagic leukoencephalopathy). Twenty (80%) required intensive care, 17 (68%) had poor outcome, and 4 (16%) died. This surveillance study described a cohort of adults and children with neurological manifestations of influenza. The majority were due to H1N1. More children than adults were identified; many children had specific encephalopathy syndromes with poor outcomes. None had been vaccinated, although 8 (32%) had indications for this. A modified classification system is proposed based on our data and the increasing spectrum of recognized acute encephalopathy syndromes.

  5. Historical perspective of Indian neurology.

    Science.gov (United States)

    Mishra, Shrikant; Trikamji, Bhavesh; Singh, Sandeep; Singh, Parampreet; Nair, Rajasekharan

    2013-10-01

    To chronicle the history of medicine and neurology in India with a focus on its establishment and evolution. THE HISTORY OF NEUROLOGY IN INDIA IS DIVIDED INTO TWO PERIODS: ancient and modern. The ancient period dates back to the mid-second millennium Before Christ (B.C.) during the creation of the Ayurvedic Indian system of Medicine, which detailed descriptions of neurological disorders called Vata Vyadhi. The early 20(th) century witnessed the birth of modern Indian medicine with the onset of formal physician training at the nation's first allopathic medical colleges located in Madras (1835), Calcutta (1835) and Mumbai (1848). Prior to India's independence from Britain in 1947, only 25 medical schools existed in the entire country. Today, there are over 355. In 1951, physicians across the field of neurology and neurosurgery united to create the Neurological Society of India (NSI). Four decades later in 1991, neurologists branched out to establish a separate organization called the Indian Academy of Neurology (IAN). Information was gathered through literature review using PubMed, MD Consult, OVID, primary texts and research at various academic institutions in India. Neurological disorders were first described in ancient India under Ayurveda. The transition to modern medicine occurred more recently through formal training at medical schools beginning in the 1930's. Early pioneers and founders of the NSI (1951) include Dr. Jacob Chandy, Dr. B Ramamurthi, Dr. S. T. Narasimhan and Dr. Baldev Singh. Later, Dr. J. S. Chopra, a prominent neurologist and visionary, recognized the need for primary centers of collaboration and subsequently established the IAN (1991). The future of Neurology in India is growing rapidly. Currently, there are 1100 practicing neurologists and more than 150 post-graduate trainees who join the ranks every year. As the number of neurologists rises across India, there is an increase in the amount of basic, clinical and epidemiological research being

  6. Historical perspective of Indian neurology

    Directory of Open Access Journals (Sweden)

    Shrikant Mishra

    2013-01-01

    Full Text Available Objective: To chronicle the history of medicine and neurology in India with a focus on its establishment and evolution. Background: The history of neurology in India is divided into two periods: ancient and modern. The ancient period dates back to the mid-second millennium Before Christ (B.C. during the creation of the Ayurvedic Indian system of Medicine, which detailed descriptions of neurological disorders called Vata Vyadhi. The early 20 th century witnessed the birth of modern Indian medicine with the onset of formal physician training at the nation′s first allopathic medical colleges located in Madras (1835, Calcutta (1835 and Mumbai (1848. Prior to India′s independence from Britain in 1947, only 25 medical schools existed in the entire country. Today, there are over 355. In 1951, physicians across the field of neurology and neurosurgery united to create the Neurological Society of India (NSI. Four decades later in 1991, neurologists branched out to establish a separate organization called the Indian Academy of Neurology (IAN. Design/Methods: Information was gathered through literature review using PubMed, MD Consult, OVID, primary texts and research at various academic institutions in India. Results: Neurological disorders were first described in ancient India under Ayurveda. The transition to modern medicine occurred more recently through formal training at medical schools beginning in the 1930′s. Early pioneers and founders of the NSI (1951 include Dr. Jacob Chandy, Dr. B Ramamurthi, Dr. S. T. Narasimhan and Dr. Baldev Singh. Later, Dr. J. S. Chopra, a prominent neurologist and visionary, recognized the need for primary centers of collaboration and subsequently established the IAN (1991. The future of Neurology in India is growing rapidly. Currently, there are 1100 practicing neurologists and more than 150 post-graduate trainees who join the ranks every year. As the number of neurologists rises across India, there is an increase in

  7. Microgrids: An emerging paradigm for meeting building electricity and heat requirements efficiently and with appropriate energy quality

    Energy Technology Data Exchange (ETDEWEB)

    Marnay, Chris; Firestone, Ryan [Berkeley Lab MS 90R4000 (United States)

    2007-07-01

    The first major paradigm shift in electricity generation, delivery, and control is emerging in the developed world, notably Europe, North America, and Japan. This shift will move electricity supply away from the highly centralised universal service quality model with which we are familiar today towards a more dispersed system with heterogeneous qualities of service. One element of dispersed control is the clustering of sources and sinks into semi-autonomous {mu}grids (microgrids). Research, development, demonstration, and deployment (RD3) of {mu}grids are advancing rapidly on at least three continents, and significant demonstrations are currently in progress. This paradigm shift will result in more electricity generation close to end-uses, often involving combined heat and power application for building heating and cooling, increased local integration of renewables, and the possible provision of heterogeneous qualities of electrical service to match the requirements of various end-uses. In Europe, microgrid RD3 is entering its third major round under the 7th European Commission Framework Programme; in the U.S., one specific microgrid concept is undergoing rigorous laboratory testing, and in Japan, where the most activity exists, four major publicly sponsored and two privately sponsored demonstrations are in progress. This evolution poses new challenges to the way buildings are designed, built, and operated. Traditional building energy supply systems will become much more complex in at least three ways: 1. one cannot simply assume gas arrives at the gas meter, electricity at its meter, and the two systems are virtually independent of one another; rather, energy conversion, heat recovery and use, and renewable energy harvesting may all be taking place simultaneously within the building energy system; 2. the structure of energy flows in the building must accommodate multiple energy processes in a manner that permits high overall efficiency; and 3. multiple qualities

  8. Hippocrates: the forefather of neurology.

    Science.gov (United States)

    Breitenfeld, T; Jurasic, M J; Breitenfeld, D

    2014-09-01

    Hippocrates is one of the most influential medical doctors of all times. He started observing and experimenting in times of mysticism and magic. He carried a holistic and humanitarian approach to the patient with examination as the principal approach-inspection, palpation and auscultation are still the most important tools in diagnosing algorithms of today. He had immense experience with the human body most likely due to numerous wound treatments he had performed; some even believe he performed autopsies despite the negative trend at the time. Hippocrates identified the brain as the analyst of the outside world, the interpreter of consciousness and the center of intelligence and willpower. Interestingly, Hippocrates was aware of many valid concepts in neurology; his treatise On the Sacred Disease was the most important for understanding neurology and epilepsy. His other ideas pioneered modern day neurology mentioning neurological diseases like apoplexy, spondylitis, hemiplegia, and paraplegia. Today, 10 % of neurological Pubmed and 7 % of neuroscience Scopus reviews mention Corpus Hippocraticum as one of the sources. Therefore, Hippocrates may be considered as the forefather of neurology.

  9. Procalcitonin and C-reactive protein cannot differentiate bacterial or viral infection in COPD exacerbation requiring emergency department visits

    Directory of Open Access Journals (Sweden)

    Chang CH

    2015-04-01

    Full Text Available Chih-Hao Chang,1 Kuo-Chien Tsao,2,3 Han-Chung Hu,1,4 Chung-Chi Huang,1,4 Kuo-Chin Kao,1,4 Ning-Hung Chen,1,4 Cheng-Ta Yang,1,4 Ying-Huang Tsai,4,5 Meng-Jer Hsieh4,51Department of Pulmonary and Critical Care Medicine, Linkou Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Chang-Gung University College of Medicine, Taoyuan, Taiwan; 2Department of Laboratory Medicine, Linkou Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation; 3Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan; 4Department of Respiratory Therapy, Chang-Gung University, Taoyuan, Taiwan; 5Department of Pulmonary and Critical Care Medicine, Chiayi Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Puzi City, TaiwanBackground: Viral and bacterial infections are the most common causes of chronic obstructive pulmonary disease (COPD exacerbations. Whether serum inflammatory markers can differentiate bacterial from virus infection in patients with COPD exacerbation requiring emergency department (ED visits remains controversial.Methods: Viral culture and polymerase chain reaction (PCR were used to identify the viruses in the oropharynx of patients with COPD exacerbations. The bacteria were identified by the semiquantitative culture of the expectorated sputum. The peripheral blood white blood cell (WBC counts, serum C-reactive protein (CRP, procalcitonin (PCT, and clinical symptoms were compared among patients with different types of infections.Results: Viruses were isolated from 16 (22.2% of the 72 patients enrolled. The most commonly identified viruses were parainfluenza type 3, influenza A, and rhinovirus. A total of 30 (41.7% patients had positive bacterial cultures, with the most commonly found bacteria being Haemophilus influenzae and Haemophilus parainfluenzae. Five patients (6.9% had both positive sputum cultures and virus identification. The WBC, CRP, and PCT levels of the bacteria-positive and bacteria

  10. An analysis of the macroeconomic conditions required for SME lending: Evidence from Turkey and other emerging market countries

    OpenAIRE

    Jenkins Hatice; Hossain Monir

    2017-01-01

    Providing small and medium enterprises (SMEs) with access to external finance has been a major concern for many governments and international organizations for three decades. In recent years the experiences of emerging market countries suggest that a paradigm shift is taking place in SME finance. Particularly in fast-growing emerging market countries such as Turkey, banks are increasingly targeting SMEs as a new line of banking business. This research analy...

  11. Neurological and ocular fascioliasis in humans.

    Science.gov (United States)

    Mas-Coma, Santiago; Agramunt, Verónica H; Valero, María Adela

    2014-01-01

    Fascioliasis is a food-borne parasitic disease caused by the trematode species Fasciola hepatica, distributed worldwide, and Fasciola gigantica, restricted to given regions of Africa and Asia. This disease in humans shows an increasing importance, which relies on its recent widespread emergence related to climate and global changes and also on its pathogenicity in the invasive, biliary, and advanced chronic phases in the human endemic areas, mainly of developing countries. In spite of the large neurological affection capacity of Fasciola, this important pathogenic aspect of the disease has been pronouncedly overlooked in the past decades and has not even appear within the numerous reviews on the parasitic diseases of the central nervous system. The aim of this wide retrospective review is an in-depth analysis of the characteristics of neurological and ocular fascioliasis caused by these two fasciolid species. The terms of neurofascioliasis and ophthalmofascioliasis are restricted to cases in which the direct affection of the central nervous system or the eye by a migrant ectopic fasciolid fluke is demonstrated by an aetiological diagnosis of recovered flukes after surgery or spontaneous moving-out of the fluke through the orbit. Cases in which the ectopic fluke is not recovered and the symptoms cannot be explained by an indirect affection at distance may also be included in these terms. Neurofascioliasis and ophthalmofascioliasis cases are reviewed and discussed. With regard to fascioliasis infection giving an indirect rise to neurological affection, the distribution and frequency of cases are analysed according to geography, sex, and age. Minor symptoms and major manifestations are discussed. Three main types of cases are distinguished depending on the characteristics of their manifestations: genuine neurological, meningeal, and psychiatric or neuropsychic. The impressive symptoms and signs appearing in each type of these cases are included. Brain examination

  12. Emergency neuroradiology

    International Nuclear Information System (INIS)

    Scarabino, T.; Hospital of Andria; Salvolini, U.; Jinkins, J.R.

    2006-01-01

    The book is directed at emergency radiologists and neuroradiologists. It aims at providing exhaustive information that will help the reader understand the clinical problems in the full range of neurological emergencies and to select the methodological and technical options that will ensure prompt and effective response and correct interpretation of the clinical findings. The various chapters address the most common neuroradiological emergencies, summarize their fundamental physiopathological features, describe the main semiological and differential diagnostic features, and provide operative suggestions for the selection of the appropriate techniques to be applied in a sequential order. The book addresses the application of state-of-the-art techniques and their implications for clinical practice (particularly the contributions of standard and functional MRI and of spiral and multislice CT). The illustrations provide not only training but also reference material for routine clinical work. (orig.)

  13. Neurology in the Vietnam War.

    Science.gov (United States)

    Gunderson, Carl H; Daroff, Robert B

    2016-01-01

    Between December 1965 and December 1971, the United States maintained armed forces in Vietnam never less than 180,000 men and women in support of the war. At one time, this commitment exceeded half a million soldiers, sailors, and airmen from both the United States and its allies. Such forces required an extensive medical presence, including 19 neurologists. All but two of the neurologists had been drafted for a 2-year tour of duty after deferment for residency training. They were assigned to Vietnam for one of those 2 years in two Army Medical Units and one Air Force facility providing neurological care for American and allied forces, as well as many civilians. Their practice included exposure to unfamiliar disorders including cerebral malaria, Japanese B encephalitis, sleep deprivation seizures, and toxic encephalitis caused by injection or inhalation of C-4 explosive. They and neurologists at facilities in the United States published studies on all of these entities both during and after the war. These publications spawned the Defense and Veterans Head Injury Study, which was conceived during the Korean War and continues today as the Defense and Veterans Head Injury Center. It initially focused on post-traumatic epilepsy and later on all effects of brain injury. The Agent Orange controversy arose after the war; during the war, it was not perceived as a threat by medical personnel. Although soldiers in previous wars had developed serious psychological impairments, post-traumatic stress disorder was formally recognized in the servicemen returning from Vietnam. © 2016 S. Karger AG, Basel.

  14. Breadth versus volume: Neurology outpatient clinic cases in medical education.

    Science.gov (United States)

    Albert, Dara V; Blood, Angela D; Park, Yoon Soo; Brorson, James R; Lukas, Rimas V

    2016-06-01

    This study examined how volume in certain patient case types and breadth across patient case types in the outpatient clinic setting are related to Neurology Clerkship student performance. Case logs from the outpatient clinic experience of 486 students from The University of Chicago Pritzker School of Medicine, USA, participating in the 4week Neurology Clerkship from July 2008 to June 2013 were reviewed. A total of 12,381 patient encounters were logged and then classified into 13 diagnostic categories. How volume of cases within categories and the breadth of cases across categories relate to the National Board of Medical Examiners Clinical Subject Examination for Neurology and a Neurology Clerkship Objective Structured Clinical Examination was analyzed. Volume of cases was significantly correlated with the National Board of Medical Examiners Clinical Subject Examination for Neurology (r=.290, pNeurology (r=.231, p=.017), however was not significantly correlated with any component of the Objective Structured Clinical Examination. Volume of cases correlated with higher performance on measures of specialty knowledge and clinical skill. Fewer relationships emerged correlating breadth of cases and performance on the same measures. This study provides guidance to educators who must decide how much emphasis to place on volume versus breadth of cases in outpatient clinic learning experiences. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Milestone-compatible neurology resident assessments: A role for observable practice activities.

    Science.gov (United States)

    Jones, Lyell K; Dimberg, Elliot L; Boes, Christopher J; Eggers, Scott D Z; Dodick, David W; Cutsforth-Gregory, Jeremy K; Leep Hunderfund, Andrea N; Capobianco, David J

    2015-06-02

    Beginning in 2014, US neurology residency programs were required to report each trainee's educational progression within 29 neurology Milestone competency domains. Trainee assessment systems will need to be adapted to inform these requirements. The primary aims of this study were to validate neurology resident assessment content using observable practice activities (OPAs) and to develop assessment formats easily translated to the Neurology Milestones. A modified Delphi technique was used to establish consensus perceptions of importance of 73 neurology OPAs among neurology educators and trainees at 3 neurology residency programs. A content validity score (CVS) was derived for each neurology OPA, with scores ≥4.0 determined in advance to indicate sufficient content validity. The mean CVS for all OPAs was 4.4 (range 3.5-5.0). Fifty-seven (78%) OPAs had a CVS ≥4.0, leaving 16 (22%) below the pre-established threshold for content validity. Trainees assigned a higher importance to individual OPAs (mean CVS 4.6) compared to faculty (mean 4.4, p = 0.016), but the effect size was small (η(2) = 0.10). There was no demonstrated effect of length of education experience on perceived importance of neurology OPAs (p = 0.23). Two sample resident assessment formats were developed, one using neurology OPAs alone and another using a combination of neurology OPAs and the Neurology Milestones. This study provides neurology training programs with content validity evidence for items to include in resident assessments, and sample assessment formats that directly translate to the Neurology Milestones. Length of education experience has little effect on perceptions of neurology OPA importance. © 2015 American Academy of Neurology.

  16. Therapeutic approaches to disease modifying therapy for multiple sclerosis in adults: an Australian and New Zealand perspective: part 2 new and emerging therapies and their efficacy. MS Neurology Group of the Australian and New Zealand Association of Neurologists.

    Science.gov (United States)

    Broadley, Simon A; Barnett, Michael H; Boggild, Mike; Brew, Bruce J; Butzkueven, Helmut; Heard, Robert; Hodgkinson, Suzanne; Kermode, Allan G; Lechner-Scott, Jeannette; Macdonell, Richard A L; Marriott, Mark; Mason, Deborah F; Parratt, John; Reddel, Stephen W; Shaw, Cameron P; Slee, Mark; Spies, Judith; Taylor, Bruce V; Carroll, William M; Kilpatrick, Trevor J; King, John; McCombe, Pamela A; Pollard, John D; Willoughby, Ernest

    2014-11-01

    In Part 2 of this three part review of multiple sclerosis (MS) treatment with a particular focus on the Australian and New Zealand perspective, we review the newer therapies that have recently become available and emerging therapies that have now completed phase III clinical trial programs. We go on to compare the relative efficacies of these newer and emerging therapies alongside the existing therapies. The effectiveness of β-interferon in the treatment of different stages and the different disease courses of MS is critically reviewed with the conclusion that the absolute level of response in term of annualised relapse rates (where relapses occur) and MRI activity are similar, but are disappointing in terms of sustained disability progression for progressive forms of the disease. Finally we review the controversial area of combination therapy for MS. Whilst it remains the case that we have no cure or means of preventing MS, we do have a range of effective therapies that when used appropriately and early in the disease course can have a significant impact on short term and longer term outcomes. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  17. Opinion and Special Articles: Neurology education at US osteopathic medical schools.

    Science.gov (United States)

    Freedman, Daniel A; Albert, Dara V F

    2017-12-12

    Osteopathic medical schools have a longstanding tradition of training primary care physicians (PCP). Neurologic symptoms are common in the PCP's office and there is an undersupply of neurologists in the United States. It is therefore crucial for osteopathic medical students to have a strong foundation in clinical neurology. Despite the importance, a mere 6% of osteopathic medical schools have required neurology clerkships. Furthermore, exposure to neurology in medical school through required clerkships has been correlated with matching into neurology residency. As osteopathic medical schools continue to expand, it will become increasingly important to emphasize the American Academy Neurology's published guidelines for a core clerkship curriculum. Practicing neurologists should take an active role in encouraging osteopathic medical schools to adopt these guidelines. © 2017 American Academy of Neurology.

  18. The neurological basis of occupation.

    Science.gov (United States)

    Gutman, Sharon A; Schindler, Victoria P

    2007-01-01

    The purpose of the present paper was to survey the literature about the neurological basis of human activity and its relationship to occupation and health. Activities related to neurological function were organized into three categories: those that activate the brain's reward system; those that promote the relaxation response; and those that preserve cognitive function into old age. The results from the literature review correlating neurological evidence and activities showed that purposeful and meaningful activities could counter the effects of stress-related diseases and reduce the risk for dementia. Specifically, it was found that music, drawing, meditation, reading, arts and crafts, and home repairs, for example, can stimulate the neurogical system and enhance health and well-being, Prospective research studies are needed to examine the effects of purposeful activities on reducing stress and slowing the rate of cognitive decline.

  19. An analysis of the macroeconomic conditions required for SME lending: Evidence from Turkey and other emerging market countries

    Directory of Open Access Journals (Sweden)

    Jenkins Hatice

    2017-01-01

    Full Text Available Providing small and medium enterprises (SMEs with access to external finance has been a major concern for many governments and international organizations for three decades. In recent years the experiences of emerging market countries suggest that a paradigm shift is taking place in SME finance. Particularly in fast-growing emerging market countries such as Turkey, banks are increasingly targeting SMEs as a new line of banking business. This research analyzes how macroeconomic factors have contributed to increased commercial bank lending to SMEs in six emerging market countries: Turkey, Argentina, Brazil, Mexico, Chile, and Poland. Based on time series and panel data analysis, we find that a high GDP growth rate and increased competition in the banking sector have contributed to increased banking sector credit to SMEs. The findings also reveal that curbing the high inflation rate and reducing government domestic borrowing have significantly encouraged bank lending to the SME segment.

  20. [Neurologic aspects of vibration syndrome].

    Science.gov (United States)

    Langauer-Lewowicka, H; Zajac-Nedza, M

    1997-01-01

    The authors present divergent opinions on the pathogenesis of vibratory syndrome, and primarily on its angio-neurological form, i.e. vascular, neurogenic and immunological theory. In the light of these concepts the clinical manifestations of vibratory syndrome are discussed in view of both systemic and local developments. The issues concerning neurological diagnostics with reference to the usefulness of electrophysiological methods are thoroughly analysed. Difficulties in early diagnosis and identification of symptoms that distinguish vibratory syndrome from other syndromes with similar manifestations are highlighted.

  1. Neurological manifestations in Fabry's disease

    DEFF Research Database (Denmark)

    Møller, Anette Torvin; Jensen, Troels Staehelin

    2007-01-01

    . Neurological symptoms, such as burning sensations (occasionally accompanied by acroparesthesia) and stroke, are among the first to appear, and occur in both male and female patients. A delay in establishing the diagnosis of Fabry's disease can cause unnecessary problems, especially now that enzyme replacement...... treatment is available to prevent irreversible organ damage. Females with Fabry's disease who present with pain have often been ignored and misdiagnosed because of the disorder's X-linked inheritance. This Review will stress the importance of recognizing neurological symptoms for the diagnosis of Fabry...

  2. Neurological manifestation of colonic adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Uzair Chaudhary

    2012-04-01

    Full Text Available Paraneoplastic neurologic disorders are extremely rare in cancer patients and are most commonly associated with certain tumors, such as ovarian cancer, small cell lung cancer, and breast cancer. We report here a paraneoplastic neurological syndrome in a 53-year-old man with colonic adenocarcinoma with a solitary liver metastasis. His paraneoplastic syndrome was successfully treated by methylprednisolone and primary oncologic therapies including neoadjuvant chemotherapy and definitive surgery. This is also the first documented case of simultaneous manifestation of a sensory neuropathy and limbic encephalitis with colon cancer.

  3. [Variation in the pathology attended in out-patient Neurology Clinics: a demented future].

    Science.gov (United States)

    Morera-Guitart, J; Pedro Cano, M J

    2003-10-01

    We analyze the changes observed between 1996 and 2001 in the distribution of the pathology attended and the follow up model used by the out-patient Neurology Clinic in the Marina Alta area, in order to confirm possible variations that may have repercussions for Human Resource needs in the provision of adequate neurological care. We prospectively registered the attendance records for visits made to the Out-patient Neurology Clinic of Marina Alta in 1996. The variation coefficients between both series were calculated and compared. The average age of patients increased in 5 years. The number of patients attended increased 42.3%, new patients 40%, visits 13%, the "Review visit/First Visit" ratio reduced 29%. The attendance of patients with Cognitive Impairment (Cog. Imp.) doubled. There were no changes in the origins of the patients. Requests due to Cog. Imp. and parkinsonism increased significantly from Primary Care and Emergency Department. The delay to be attended increased 23%. Discharges increased 43.9%, highlighting an increase of 144% observed in the Cog. Imp. group. Changes have been observed in: the age of the population studied; the follow up of patients; the delay in attending them; and the pathology attended, with a significant increase in demand due to neurodegenerative pathology (especially Cog. Imp.). All this requires an increase in care needs that the Health Service has not been able to assume, creating an incongruous care model: we suggest a direct follow up model and offer a consultancy model.

  4. Revisiting the Molecular Mechanism of Neurological Manifestations in Antiphospholipid Syndrome: Beyond Vascular Damage

    Science.gov (United States)

    Carecchio, M.; Cantello, R.; Comi, C.

    2014-01-01

    Antiphospholipid syndrome (APS) is a multiorgan disease often affecting the central nervous system (CNS). Typically, neurological manifestations of APS include thrombosis of cerebral vessels leading to stroke and requiring prompt initiation of treatment with antiplatelet drugs or anticoagulant therapy. In these cases, alterations of the coagulation system at various levels caused by multiple effects of antiphospholipid antibodies (aPL) have been postulated to explain the vascular damage to the CNS in APS. However, several nonvascular neurological manifestations of APS have progressively emerged over the past years. Nonthrombotic, immune-mediated mechanisms altering physiological basal ganglia function have been recently suggested to play a central role in the pathogenesis of these manifestations that include, among others, movement disorders such as chorea and behavioral and cognitive alterations. Similar clinical manifestations have been described in other autoimmune CNS diseases such as anti-NMDAR and anti-VGCK encephalitis, suggesting that the spectrum of immune-mediated basal ganglia disorders is expanding, possibly sharing some pathophysiological mechanisms. In this review, we will focus on thrombotic and nonthrombotic neurological manifestations of APS with particular attention to immune-mediated actions of aPL on the vascular system and the basal ganglia. PMID:24741580

  5. Neurologic disorders associated with weight lifting and bodybuilding.

    Science.gov (United States)

    Busche, Kevin

    2009-02-01

    Weight lifting and other forms of strength training are becoming more common because of an increased awareness of the need to maintain individual physical fitness. Emergency room data indicate that injuries caused by weight training have become more universal over time, likely because of increased participation rates. Neurologic injuries can result from weight lifting and related practices. Although predominantly peripheral nervous system injuries have been described, central nervous system disease may also occur. This article illustrates the types of neurologic disorders associated with weight lifting.

  6. Outline of metabolic diseases in adult neurology.

    Science.gov (United States)

    Mochel, F

    2015-01-01

    Inborn errors of metabolism (IEM) are traditionally defined by enzymatic deficiencies or defects in proteins involved in cellular metabolism. Historically discovered and characterized in children, a growing number of IEM are described in adults, and especially in the field of neurology. In daily practice, it is important to recognize emergency situations as well as neurodegenerative diseases for which a metabolic disease is likely, especially when therapeutic interventions are available. Here, the goal is to provide simple clinical, imaging and biochemical tools that can first orientate towards and then confirm the diagnosis of IEM. General guidelines are presented to treat the most common IEM during metabolic crises - acute encephalopathies with increased plasma ammonia, lactate or homocystein, as well as rhabdomyolysis. Examples of therapeutic strategies currently applied to chronic neurometabolic diseases are also provided - GLUT1 deficiency, adrenoleukodystrophy, cerebrotendinous xanthomatosis, Niemann-Pick type C and Wilson disease. Genetic counseling is mandatory in some X-linked diseases - ornithine transcarbamylase deficiency and adrenoleukodystrophy - and recommended in maternally inherited mitochondrial diseases - mutations of mitochondrial DNA. Besides these practical considerations, the contribution of metabolism to the field of adult neurology and neurosciences is much greater: first, with the identification of blood biomarkers that are progressively changing our diagnostic strategies thanks to lipidomic approaches, as illustrated in the field of spastic paraplegia and atypical psychiatric presentations; and second, through the understanding of pathophysiological mechanisms involved in common neurological diseases thanks to the study of these rare diseases. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. 40 CFR 355.31 - What types of releases are exempt from the emergency release notification requirements of this...

    Science.gov (United States)

    2010-07-01

    ... Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO... combustion related activities. (g) Any release to the air of a hazardous substance from animal waste at farms that stable or confine fewer than the numbers of animal specified in any of the following categories...

  8. Moving Beyond Too Little, Too Late: Managing Emerging Infectious Diseases in Wild Populations Requires International Policy and Partnerships

    Science.gov (United States)

    Jamie Voyles; A. Marm Kilpatrick; James P. Collins; Matthew C. Fisher; Winifred F. Frick; Hamish McCallum; Craig K. R. Willis; David S. Blehert; Kris A. Murray; Robert Puschendorf; Erica Bree Rosenblum; Benjamin M. Bolker; Tina L. Cheng; Kate E. Langwig; Daniel L. Lindner; Mary Toothman; Mark Q. Wilber; Cheryl J. Briggs

    2015-01-01

    Emerging infectious diseases (EIDs) are on the rise due to multiple factors, including human facilitated movement of pathogens, broad-scale landscape changes, and perturbations to ecological systems (Jones et al. 2008; Fisher et al. 2012). Epidemics in wildlife are problematic because they can lead to pathogen spillover to new host organisms, erode biodiversity and...

  9. Energy information needs for U. S. state-level policy making: Minimal data requirements during normal and emergency periods

    Energy Technology Data Exchange (ETDEWEB)

    Barkenbus, J.N.; Leff, H.S.

    1983-01-01

    Since the oil embargo of 1973, state governments have increased their efforts to track and understand energy flows within their boundaries. There is a commonly perceived need to comprehend the status of present and expected future energy availability, demand, and price and to be prepared to exercise responsible and effective management during energy emergencies. This responsibility has brought with it new needs for accurate and timely state-level information on energy transactions and the external parameters that effect energy availability and disposition. What energy data are needed by a state, regardless of its idiosyncracies, during both normal and energy emergency periods, and to what extent are these data available now. The authors find that needed ongoing (core) data are only partially available at present, and that emergency data can be obtained only with a carefully planned monitoring program that can be fitted to specific emergency conditions. Overall, this paper provides a realistic assessment of the state-level energy data needed to provide state policy makers with sufficient information to make considered judgments.

  10. Energy-information needs for US state-level policy making: minimal data requirements during normal and emergency periods

    Energy Technology Data Exchange (ETDEWEB)

    Barkenbus, J.N.; Leff, H.S.

    1983-01-01

    Since the oil embargo of 1973, state governments have increased their efforts to track and understand energy flows within their boundaries. There is a commonly perceived need to comprehend the status of present and expected future energy availability, demand, and price and to be prepared to exercise responsible and effective management during energy emergencies. This responsibility has brought with it new needs for accurate and timely state-level information on energy transactions and the external parameters that effect energy availability and disposition. Hence, we ask: what energy data are needed by a state, regardless of its idiosyncracies, during both normal and energy emergency periods, and to what extent are these data available now. We find that needed ongoing (core) data are only partially available at present, and that emergency data can be obtained only with a carefully planned monitoring program that can be fitted to specific emergency conditions. Overall, this paper provides a realistic assessment of the state-level energy data needed to provide state policy makers with sufficient information to make considered judgments. 7 references, 6 tables.

  11. Education Research: Neurology training reassessed

    Science.gov (United States)

    Maas, Matthew B.; Coleman, Mary; Jozefowicz, Ralph; Engstrom, John

    2012-01-01

    Objective: To assess the strengths and weaknesses of neurology resident education using survey methodology. Methods: A 27-question survey was sent to all neurology residents completing residency training in the United States in 2011. Results: Of eligible respondents, 49.8% of residents returned the survey. Most residents believed previously instituted duty hour restrictions had a positive impact on resident quality of life without impacting patient care. Most residents rated their faculty and clinical didactics favorably. However, many residents reported suboptimal preparation in basic neuroscience and practice management issues. Most residents (71%) noted that the Residency In-service Training Examination (RITE) assisted in self-study. A minority of residents (14%) reported that the RITE scores were used for reasons other than self-study. The vast majority (86%) of residents will enter fellowship training following residency and were satisfied with the fellowship offers they received. Conclusions: Graduating residents had largely favorable neurology training experiences. Several common deficiencies include education in basic neuroscience and clinical practice management. Importantly, prior changes to duty hours did not negatively affect the resident perception of neurology residency training. PMID:23091077

  12. Edgar Allan Poe and neurology

    Directory of Open Access Journals (Sweden)

    Hélio Afonso Ghizoni Teive

    2014-06-01

    Full Text Available Edgar Allan Poe was one of the most celebrated writers of all time. He published several masterpieces, some of which include references to neurological diseases. Poe suffered from recurrent depression, suggesting a bipolar disorder, as well as alcohol and drug abuse, which in fact led to his death from complications related to alcoholism. Various hypotheses were put forward, including Wernicke's encephalopathy.

  13. [Neurology in medieval regimina sanitatis].

    Science.gov (United States)

    de Frutos González, V; Guerrero Peral, A L

    2011-09-01

    In medical medieval literature some works about dietetics stand out. Dietetics, as a separate branch of medicine, includes not only food or drinks, but other environmental factors influencing on health. They are known as regimina sanitatis or salutis, and specially developed in the Christian west. They generally consisted of a balance between the Galenic "six non-natural things"; factors regulating health and its protection: environment, exercise, food, sleep, bowel movements and emotions. After reviewing the sources and defining the different stages of this genre, we have considered three of the most out-standing medieval regimina, the anonymous Regimen sanitatis salernitanum, Arnaldo de Vilanova's Regimen sanitatis ad regem aragonum and Bernardo de Gordon's Tractatus of conservatione vite humane. In them we review references to neurological disease. Though not independently considered, there is a significant presence of neurological diseases in the regimina. Dietetics measures are proposed to preserve memory, nerves, or hearing, as well as for the treatment of migraine, epilepsy, stroke or dizziness. Regimina are quiet representative among medical medieval literature, and they show medieval physicians vision of neurological diseases. Dietetics was considered useful to preserve health, and therapeutics was based on natural remedies. 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  14. [Neurology of hysteria (conversion disorder)].

    Science.gov (United States)

    Sonoo, Masahiro

    2014-07-01

    Hysteria has served as an important driving force in the development of both neurology and psychiatry. Jean Martin Charcot's devotion to mesmerism for treating hysterical patients evoked the invention of psychoanalysis by Sigmund Freud. Meanwhile, Joseph Babinski took over the challenge to discriminate between organic and hysterical patients from Charcot and found Babinski's sign, the greatest milestone in modern neurological symptomatology. Nowadays, the usage of the term hysteria is avoided. However, new terms and new classifications are complicated and inconsistent between the two representative taxonomies, the DSM-IV and ICD-10. In the ICD-10, even the alternative term conversion disorder, which was becoming familiar to neurologists, has also disappeared as a group name. The diagnosis of hysteria remains important in clinical neurology. Extensive exclusive diagnoses and over investigation, including various imaging studies, should be avoided because they may prolong the disease course and fix their symptoms. Psychological reasons that seem to explain the conversion are not considered reliable. Positive neurological signs suggesting nonorganic etiologies are the most reliable measures for diagnosing hysteria, as Babinski first argued. Hysterical paresis has several characteristics, such as giving-way weakness or peculiar distributions of weakness. Signs to uncover nonorganic paresis utilizing synergy include Hoover's test and the Sonoo abductor test.

  15. International electives in neurology training

    Science.gov (United States)

    Lyons, Jennifer L.; Coleman, Mary E.; Engstrom, John W.

    2014-01-01

    Objective: To ascertain the current status of global health training and humanitarian relief opportunities in US and Canadian postgraduate neurology programs. Background: There is a growing interest among North American trainees to pursue medical electives in low- and middle-income countries. Such training opportunities provide many educational and humanitarian benefits but also pose several challenges related to organization, human resources, funding, and trainee and patient safety. The current support and engagement of neurology postgraduate training programs for trainees to pursue international rotations is unknown. Methods: A survey was distributed to all program directors in the United States and Canada (December 2012–February 2013) through the American Academy of Neurology to assess the training opportunities, institutional partnerships, and support available for international neurology electives. Results: Approximately half of responding programs (53%) allow residents to pursue global health–related electives, and 11% reported that at least 1 trainee participated in humanitarian relief during training (survey response rate 61%, 143/234 program directors). Canadian programs were more likely to allow residents to pursue international electives than US programs (10/11, 91% vs 65/129, 50%, p = 0.023). The number of trainees participating in international electives was low: 0%–9% of residents (55% of programs) and 10%–19% of residents (21% of programs). Lack of funding was the most commonly cited reason for residents not participating in global health electives. If funding was available, 93% of program directors stated there would be time for residents to participate. Most program directors (75%) were interested in further information on global health electives. Conclusions: In spite of high perceived interest, only half of US neurology training programs include international electives, mostly due to a reported lack of funding. By contrast, the majority

  16. Challenges to neurology residency education in today's health care environment.

    Science.gov (United States)

    Bega, Danny; Krainc, Dimitri

    2016-09-01

    Residency training has had to adapt to higher patient volumes, increased complexity of medical care, and the commercialized system of health care. These changes have led to a concerning culture shift in neurology. We review the relationship between the emerging health care delivery system and residency training, highlighting issues related to duty hours and work-life balance, the changing technological landscape, high patient volumes, and complex service obligations. We propose that the current challenges in health care delivery offer the opportunity to improve neurology residency through faculty development programs, bringing teaching back to the bedside, increasing resident autonomy, utilizing near-peer teaching, and rewarding educators who facilitate an environment of inquiry and scholarship, with the ultimate goal of better alignment between education and patient care. Ann Neurol 2016;80:315-320. © 2016 American Neurological Association.

  17. Environmental regulation of lateral root emergence in Medicago truncatula requires the HD-Zip I transcription factor HB1.

    Science.gov (United States)

    Ariel, Federico; Diet, Anouck; Verdenaud, Marion; Gruber, Véronique; Frugier, Florian; Chan, Raquel; Crespi, Martin

    2010-07-01

    The adaptation of root architecture to environmental constraints is a major agricultural trait, notably in legumes, the third main crop worldwide. This root developmental plasticity depends on the formation of lateral roots (LRs) emerging from primary roots. In the model legume Medicago truncatula, the HD-Zip I transcription factor HB1 is expressed in primary and lateral root meristems and induced by salt stress. Constitutive expression of HB1 in M. truncatula roots alters their architecture, whereas hb1 TILLING mutants showed increased lateral root emergence. Electrophoretic mobility shift assay, promoter mutagenesis, and chromatin immunoprecipitation-PCR assays revealed that HB1 directly recognizes a CAATAATTG cis-element present in the promoter of a LOB-like (for Lateral Organ Boundaries) gene, LBD1, transcriptionally regulated by auxin. Expression of these genes in response to abscisic acid and auxin and their behavior in hb1 mutants revealed an HB1-mediated repression of LBD1 acting during LR emergence. M. truncatula HB1 regulates an adaptive developmental response to minimize the root surface exposed to adverse environmental stresses.

  18. Emerging concepts and requirements for the long-term management of non-radioactive hazardous wastes - would geological disposal be an appropriate solution for some of these wastes

    International Nuclear Information System (INIS)

    Rein, K. von

    1994-01-01

    This work deals with the emerging concepts and requirements for the long-term management of non-radioactive hazardous wastes. After some generalities on the pollution of natural environment and the legislations taken by the swedish government the author tries to answer to the question : would geological disposal be an appropriate solution for the non-radioactive hazardous wastes? Then is given the general discussion of the last three articles concerning the background to current environmental policies and their implementation and more particularly the evolution and current thoughts about environmental policies, the managing hazardous activities and substances and the emerging concepts and requirements for the long-term management of non-radioactive hazardous wastes. Comments and questions concerning the similarity or otherwise between the present position of radioactive waste disposal and the background to current environmental policies are indicated. (O.L.)

  19. Orphan sources and the challenges: requirement for the prevention of malevolent use of radioactive sources and preparedness for radiological emergencies

    International Nuclear Information System (INIS)

    Pradeepkumar, K.S.; Sharma, D.N.

    2006-01-01

    Challenges from smuggled or illegally transported radioactive sources with intention of causing threats to the society are similar to the radiological emergencies possible from misplaced/lost radioactive sources. While large number of radioactive sources are transported and are in use world over, the emergency preparedness and response system is not adequately developed compared to that for nuclear facilities. After the terrorist attack on W.T.C., there is concern world over about the malicious use of radioactive material calling for improving the emergency response system and international cooperation for preventing illicit trafficking of radioactive sources/material. Extremely sensitive state-of-the art monitoring systems installed at appropriate locations and periodic mobile radiation monitoring around suspected areas can be deterrent and can prevent the illicit trafficking of radioactive sources. Unless every nation ensures strict administrative control over the sources and implement usage of state-of-the art systems and methodology for early detection/prevention of illegal movement of sources within the territory and across its boundaries, the challenges from the orphan sources will remain for ever. The issues and challenges of man made radiological emergencies, remedial measures and the methodology for prevention and management of such emergencies are discussed here. The threat from an orphan source depends on many parameters. The type and quantity of the radionuclide, physical and chemical form influencing dispersion in air, deposition, solubility, migration in soil etc., can vary the radiological consequences when the source gets crushed accidentally along with scrap or is used for malevolent purposes. Depending on the level of environmental contamination, long term effects of the radiological emergency can significantly vary. Development of capability for quick detection, assessment and response are essential if prevention of theft/misuse of such sources

  20. Quantitative Description of Medical Student Interest in Neurology and Psychiatry.

    Science.gov (United States)

    Ramos, Raddy L; Cuoco, Joshua A; Guercio, Erik; Levitan, Thomas

    2016-07-01

    Given the well-documented shortage of physicians in primary care and several other specialties, quantitative understanding of residency application and matching data among osteopathic and allopathic medical students has implications for predicting trends in the physician workforce. To estimate medical student interest in neurology and psychiatry based on numbers of applicants and matches to neurology and psychiatry osteopathic and allopathic residency programs. Also, to gauge students' previous academic experience with brain and cognitive sciences. The number of available postgraduate year 1 positions, applicants, and matches from graduating years 2011 through 2015 were collected from the National Matching Services Inc and the American Association of Colleges of Osteopathic Medicine for osteopathic programs and the National Resident Matching Program and the Association of American Medical Colleges for allopathic programs. To determine and compare osteopathic and allopathic medical students' interest in neurology and psychiatry, the number of positions, applicants, and matches were analyzed considering the number of total osteopathic and allopathic graduates in the given year using 2-tailed χ2 analyses with Yates correction. In addition, osteopathic and allopathic medical schools' websites were reviewed to determine whether neurology and psychiatry rotations were required. Osteopathic medical students' reported undergraduate majors were also gathered. Compared with allopathic medical students, osteopathic medical students had significantly greater interest (as measured by applicants) in neurology (χ21=11.85, Pneurology and psychiatry residency programs. Approximately 6% of osteopathic vs nearly 85% of allopathic medical schools had required neurology rotations. Nearly 10% of osteopathic applicants and matriculants had undergraduate coursework in brain and cognitive sciences. Osteopathic medical students demonstrated greater interest than allopathic medical

  1. Neurologic complications of cerebral angiography in childhood moyamoya syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Robertson, R.L.; Chavali, R.V.; Robson, C.D.; Barnes, P.D.; Burrows, P.E. [Department of Radiology, Children`s Hospital Medical Center, Boston, MA (United States); Eldredge, E.A. [Department of Anesthesia, Children`s Hospital Medical Center and Harvard Medical School, Boston, MA (United States); Scott, R.M. [Department of Neurosurgery, Children`s Hospital Medical Center and Harvard Medical School, Boston, MA (United States)

    1998-11-01

    Purpose. To determine the incidence of neurologic complications of cerebral angiography in children with moyamoya syndrome (MMS) as compared to children without MMS. Materials and methods. One-hundred-ninety consecutive cerebral angiograms obtained in 152 children were evaluated. Sixty of these angiograms were obtained in 40 children with MMS. Patients underwent neurologic evaluation prior to and after the procedure. For this study, a neurologic complication was defined as any new focal neurologic deficit or alteration in mental status occurring during the procedure or within the ensuing 24 hours. Results. There were 2 neurologic complications within 24 hours of angiography, one in the MMS group and one in the non-MMS group. One patient with MMS became mute following angiography. The symptom resolved within 12 hours. One patient without MMS being examined postoperatively for residual arteriovenous malformation developed intracranial hemorrhage requiring reexploration 12 hours after the angiogram. Using a two-tail Fisher`s exact test, there was no significant statistical difference in the ischemic (P = 0.3) or hemorrhagic (P = 1.0) complication rates between the group of patients with MMS and the non-MMS groups. Conclusion. The risk of a neurologic complication from cerebral angiography in children with MMS is low and not statistically different from the risk in children with other cerebrovascular disorders. (orig.) With 8 tabs., 37 refs.

  2. Neurologic complications of cerebral angiography in childhood moyamoya syndrome

    International Nuclear Information System (INIS)

    Robertson, R.L.; Chavali, R.V.; Robson, C.D.; Barnes, P.D.; Burrows, P.E.; Eldredge, E.A.; Scott, R.M.

    1998-01-01

    Purpose. To determine the incidence of neurologic complications of cerebral angiography in children with moyamoya syndrome (MMS) as compared to children without MMS. Materials and methods. One-hundred-ninety consecutive cerebral angiograms obtained in 152 children were evaluated. Sixty of these angiograms were obtained in 40 children with MMS. Patients underwent neurologic evaluation prior to and after the procedure. For this study, a neurologic complication was defined as any new focal neurologic deficit or alteration in mental status occurring during the procedure or within the ensuing 24 hours. Results. There were 2 neurologic complications within 24 hours of angiography, one in the MMS group and one in the non-MMS group. One patient with MMS became mute following angiography. The symptom resolved within 12 hours. One patient without MMS being examined postoperatively for residual arteriovenous malformation developed intracranial hemorrhage requiring reexploration 12 hours after the angiogram. Using a two-tail Fisher's exact test, there was no significant statistical difference in the ischemic (P = 0.3) or hemorrhagic (P = 1.0) complication rates between the group of patients with MMS and the non-MMS groups. Conclusion. The risk of a neurologic complication from cerebral angiography in children with MMS is low and not statistically different from the risk in children with other cerebrovascular disorders. (orig.)

  3. Neurology

    International Nuclear Information System (INIS)

    Lubin, E.; Thom, A.F.

    1976-01-01

    The most used radiopharmaceuticals in encephaloscintigraphy are analysed, such as: sup(99m)Tc-pertechnetate, sup(113m)In- DTPA, 203 Hg-or 197 Hg-clormerodrine and 131 I-albumin. A comparative study is made of scintiscanning of normal brain and that of pathological states. The uses of 131 I-albumin, sup(113m)In-DTPA an 169 Y - DTPA are commented in liquor spaces scintiscanning and clinical indications are given [pt

  4. Neurology clerkship goals and their effect on learning and satisfaction.

    Science.gov (United States)

    Strowd, Roy E; Salas, Rachel Marie E; Cruz, Tiana E; Gamaldo, Charlene E

    2016-02-16

    To define medical student goals in the neurology clerkship and explore the association between goal setting and student performance, clerkship satisfaction, self-directed learning (SDL), and interest in neurology. A 4-year prospective study of consecutive second- to fourth-year medical students rotating through a required 4-week neurology clerkship was conducted. A goal-generating cohort (first 2 years) was enrolled to describe the breadth of student-derived goals. A goal-evaluating cohort (second 2 years) was used to evaluate the frequency of goal achievement and assess associations with performance (e.g., National Board of Medical Examiners [NBME], examination), satisfaction, and SDL behaviors (both based on 5-point Likert scale). Of 440 evaluable students, 201 were goal-generating and 239 goal-evaluating. The top 3 goals were (1) improvement in neurologic examination, (2) understanding neurologic disease, and (3) deriving a differential diagnosis. More than 90% (n = 216/239) of students reported achieving goals. Achievers reported significantly higher clerkship satisfaction (4.2 ± 0.8 vs. 2.8 ± 1.0, p neurology (71% vs. 35%, p = 0.001), and higher observed tendency toward SDL (4.5 ± 0.5 vs. 4.1 ± 0.8, p neurology clerkship. Goal achievers had better adjusted standardized test scores, higher satisfaction, and greater tendency toward SDL. This student-generated, goal-setting program may be particularly appealing to clinicians, educators, and researchers seeking resource-lean mechanisms to improve student experience and performance in the clinical clerkships. © 2015 American Academy of Neurology.

  5. Neurologic Manifestations of Vitamin B Deficiency after Bariatric Surgery.

    Science.gov (United States)

    Punchai, Suriya; Hanipah, Zubaidah Nor; Meister, Katherine M; Schauer, Philip R; Brethauer, Stacy A; Aminian, Ali

    2017-08-01

    The aim of this study was to assess the incidence, clinical presentation, and outcomes of neurologic disorders secondary to vitamin B deficiencies following bariatric surgery. Patients at a single academic institution who underwent bariatric surgery and developed neurologic complications secondary to low levels of vitamins B1, B2, B6, and B12 between the years 2004 and 2015 were studied. In total, 47 (0.7%) bariatric surgical patients (Roux-en-Y gastric bypass n = 36, sleeve gastrectomy n = 9, and duodenal switch n = 2) developed neurologic manifestations secondary to vitamin B deficiencies. Eleven (23%) patients developed postoperative anatomical complications contributed to poor oral intake. Median duration to onset of neurologic manifestation following surgery was 12 months (IQR, 5-32). Vitamin deficiencies reported in the cohort included B1 (n = 30), B2 (n = 1), B6 (n = 12), and B12 (n = 12) deficiency. The most common manifestations were paresthesia (n = 31), muscle weakness (n = 15), abnormal gait (n = 11), and polyneuropathy (n = 7). Four patients were diagnosed with Wernicke-Korsakoff syndrome (WKS) which was developed after gastric bypass (n = 3) and sleeve gastrectomy (n = 1). Seven patients required readmission for management of severe vitamin B deficiencies. Overall, resolution of neurologic symptoms with nutritional interventions and pharmacotherapy was noted in 40 patients (85%). The WKS was not reversible, and all four patients had residual mild ataxia and nystagmus at the last follow-up time. Nutritional neurologic disorders secondary to vitamin B deficiency are relatively uncommon after bariatric surgery. While neurologic disorders are reversible in most patients (85%) with vitamin replacements, persistent residual neurologic symptoms are common in patients with WKS.

  6. Neurological eponyms--who gets the credit? Essay review.

    Science.gov (United States)

    Okun, Michael S

    2003-03-01

    The recent publication of Neurological Eponyms by Peter Koehler and colleagues has revived the interest in neurological eponyms and raised important questions about their use. Many investigators have contributed to the body of knowledge that defines the specialty of neurology. We honor them by associating their names with neurological diseases. The history of neurological eponyms provides us with an opportunity to reexamine the important question of who gets the credit. Additional issues have surfaced including why certain eponyms tend to stick in the literature and others disappear, as well as the important realization that lengthy modern descriptions may require name eponyms for simplification. Eponyms can be confusing as to whether they refer to a disease or a syndrome and this confusion can impact the diagnosis and treatment of patients. There is an inevitable evolution of certain eponyms as our understanding of entities expands. This paper provides an overview of neurological eponyms with the explanation of the potential reasons why names were associated with neurological diseases. These included first case reports, relating isolated cases, years of observation, defining neuroanatomy, physician sufferer, new physical examination maneuvers, academic climate, the advent of a new procedure, fame, and competition amongst investigators. Important issues have surfaced regarding sharing credit amongst investigators, name priority, crediting the wrong investigator, and lack of a defined system to award credit. Since eponym use is based on a peer dependent system, each neurologist must make a more critical appraisal of who gets the credit and understand the differences between diseases and syndromes in order to better preserve neurological history.

  7. Community-Acquired Pneumonia Hospitalization among Children with Neurologic Disorders.

    Science.gov (United States)

    Millman, Alexander J; Finelli, Lyn; Bramley, Anna M; Peacock, Georgina; Williams, Derek J; Arnold, Sandra R; Grijalva, Carlos G; Anderson, Evan J; McCullers, Jonathan A; Ampofo, Krow; Pavia, Andrew T; Edwards, Kathryn M; Jain, Seema

    2016-06-01

    To describe and compare the clinical characteristics, outcomes, and etiology of pneumonia among children hospitalized with community-acquired pneumonia (CAP) with neurologic disorders, non-neurologic underlying conditions, and no underlying conditions. Children children's hospitals. Neurologic disorders included cerebral palsy, developmental delay, Down syndrome, epilepsy, non-Down syndrome chromosomal abnormalities, and spinal cord abnormalities. We compared the epidemiology, etiology, and clinical outcomes of CAP in children with neurologic disorders with those with non-neurologic underlying conditions, and those with no underlying conditions using bivariate, age-stratified, and multivariate logistic regression analyses. From January 2010-June 2012, 2358 children with radiographically confirmed CAP were enrolled; 280 (11.9%) had a neurologic disorder (52.1% of these individuals also had non-neurologic underlying conditions), 934 (39.6%) had non-neurologic underlying conditions only, and 1144 (48.5%) had no underlying conditions. Children with neurologic disorders were older and more likely to require intensive care unit (ICU) admission than children with non-neurologic underlying conditions and children with no underlying conditions; similar proportions were mechanically ventilated. In age-stratified analysis, children with neurologic disorders were less likely to have a pathogen detected than children with non-neurologic underlying conditions. In multivariate analysis, having a neurologic disorder was associated with ICU admission for children ≥2 years of age. Children with neurologic disorders hospitalized with CAP were less likely to have a pathogen detected and more likely to be admitted to the ICU than children without neurologic disorders. Published by Elsevier Inc.

  8. Neurological abnormalities in localized scleroderma of the face and head: a case series study for evaluation of imaging findings and clinical course.

    Science.gov (United States)

    Lis-Święty, Anna; Brzezińska-Wcisło, Ligia; Arasiewicz, Hubert

    2017-09-01

    Localized scleroderma (LoS) of the face and head is often associated with neurological manifestations and/or imaging abnormalities in the central nervous system (CNS). We present an analysis of 20 cases of LoS affecting the face and head. The CNS symptoms and/or abnormalities in high-resolution computed tomography (HRCT) and/or magnetic resonance imaging (MRI) were observed in 12 patients (60%). In addition to the mild and unspecific disorders (e.g. headaches), serious neurological complications probably in the course of vasculitis were revealed: epilepsy (in two patients), epilepsy and pyramidal sings (in one patient). Neurological disorders and LoS occurred at the same time (in three patients) or at the course of the disease (nine patients) and no later than 29 years since the onset of the disease. No link between neurological disorders and the LoS clinical morphology, immunological and other laboratory parameters has been established. CNS involvement is not correlated with the clinical course of the facial and head LoS and may occur years after the disease initial symptomatology. Imaging follow-up is not required if there is not any emerging neurological symptom. In some cases, however, both HRCT and MRI are useful for monitoring disease evolution and addressing therapeutic choices.

  9. 78 FR 12951 - TRICARE; Elimination of the Non-Availability Statement (NAS) Requirement for Non-Emergency...

    Science.gov (United States)

    2013-02-26

    ... an annual effect of $100 million or more on the national economy or which would have other... maternity services, the ASD(HA) may require an NAS prior to TRICARE cost-sharing for additional services...

  10. PET and SPECT in neurology

    Energy Technology Data Exchange (ETDEWEB)

    Dierckx, Rudi A.J.O. [Groningen University Medical Center (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; Ghent Univ. (Belgium). Dept. of Radiology and Nuclear Medicine; Vries, Erik F.J. de; Waarde, Aren van [Groningen University Medical Center (Netherlands). Dept. of Nuclear Medicine and Molecular Imaging; Otte, Andreas (ed.) [Univ. of Applied Sciences Offenburg (Germany). Faculty of Electrical Engineering and Information Technology

    2014-07-01

    PET and SPECT in Neurology highlights the combined expertise of renowned authors whose dedication to the investigation of neurological disorders through nuclear medicine technology has achieved international recognition. Classical neurodegenerative disorders are discussed as well as cerebrovascular disorders, brain tumors, epilepsy, head trauma, coma, sleeping disorders, and inflammatory and infectious diseases of the CNS. The latest results in nuclear brain imaging are detailed. Most chapters are written jointly by a clinical neurologist and a nuclear medicine specialist to ensure a multidisciplinary approach. This state-of-the-art compendium will be valuable to anybody in the field of neuroscience, from the neurologist and the radiologist/nuclear medicine specialist to the interested general practitioner and geriatrician. It is the second volume of a trilogy on PET and SPECT imaging in the neurosciences, the other volumes covering PET and SPECT in psychiatry and in neurobiological systems.

  11. PET and SPECT in neurology

    International Nuclear Information System (INIS)

    Dierckx, Rudi A.J.O.; Ghent Univ.; Vries, Erik F.J. de; Waarde, Aren van; Otte, Andreas

    2014-01-01

    PET and SPECT in Neurology highlights the combined expertise of renowned authors whose dedication to the investigation of neurological disorders through nuclear medicine technology has achieved international recognition. Classical neurodegenerative disorders are discussed as well as cerebrovascular disorders, brain tumors, epilepsy, head trauma, coma, sleeping disorders, and inflammatory and infectious diseases of the CNS. The latest results in nuclear brain imaging are detailed. Most chapters are written jointly by a clinical neurologist and a nuclear medicine specialist to ensure a multidisciplinary approach. This state-of-the-art compendium will be valuable to anybody in the field of neuroscience, from the neurologist and the radiologist/nuclear medicine specialist to the interested general practitioner and geriatrician. It is the second volume of a trilogy on PET and SPECT imaging in the neurosciences, the other volumes covering PET and SPECT in psychiatry and in neurobiological systems.

  12. Neurological complications of infective endocarditis

    International Nuclear Information System (INIS)

    Khan, Sonia A.A.; Yaqub, Basim A.; Al-Deeb, Saleh M.

    1996-01-01

    We reviewed the files of 80 successive patients with native and prosthetic valve endocarditis admitted to Riyadh Armed Forces Hospital. Neurolological complications (NC) occurred in 28 (35%) patients. The valves involved were mitral in 12 (43%), aortic in eight (29%), combined mitral and aortic lesions in six (21%) and others in two (7%). The common causative organisms were Streptococci in 12 (43%), Staphylococcus aureus and Staphylococcus epidermides, both occurring in four (14%). Compared to the 52 infective endocarditis patients with no neurological complications (NNC), the NC occurred more frequently in male patients, those with aortic valve lesion, those with atrial fibrillation, those with delayed therapy and those with causative organisms being Streptococci or Staphylococci. Eleven patients died (39%), 12 (43%) recovered with motor sequelae, six (21%) had seizure disorder and five (18%) had full recovery. The frequency of neurological complications and mortality is comparable to those reported in the literature: however, the frequency was higher in our patients. (author)

  13. Disease mongering in neurological disorders

    OpenAIRE

    Kochen, Sara Silvia; Córdoba, Marta

    2017-01-01

    “Diseases mongering”, than a simple definition would be enforced "to promote or sell disease". The main and common characteristhics of all these "diseases" is that they are amenable to treatment with drugs. So, the pharmaceutical industry redefining the concept of disease, the normal and pathological. In Neurology exploits the deepest atavistic fears of suffering and death. We select some diseases, the choise was based on lack or weak evidence in definition of disease; or cost benefit of trea...

  14. [Deficiency, disability, neurology and cinema].

    Science.gov (United States)

    Collado-Vázquez, Susana; Cano de la Cuerda, Roberto; Jiménez-Antona, Carmen

    2010-12-16

    Cinema has been defined in many different ways, but most of them agree that it should be considered both a technique and an art. Although films often depict fantasy stories, in many cases they also reflect day-to-day realities. In its earliest days cinema was already attracted to the world of health and sickness, and frequently addressed topics like medical practice, how patients lived with their illnesses, bioethical issues, the relationship between physician and patient or research. To review the presence of neurological pathologies in the cinema with a view to identifying the main neurological disorders that have been portrayed in films. Likewise it also intends to describe the medical praxis that is employed, the relationship between physician and patient, how the experiences of the patient and the family are represented, the adaptation to social and occupational situations, and the intervention of other health care professionals related with neurological patients. Some of the most significant films that have addressed these topics were reviewed and it was seen that in some of them the illness is dealt with in a very true-to-life manner, whereas others tend to include a greater number of inaccuracies and a larger degree of fiction. Cinema has helped to shape certain ways of thinking about the health care professionals who work with neurological patients, the importance of support from the family and the social role, among other things. This confirms that resorting to cinematographic productions is a fruitful tool for stimulating a critical interest in the past and present of medical practice.

  15. Neurological Findings in Myeloproliferative Neoplasms

    Directory of Open Access Journals (Sweden)

    Semra Paydas

    2013-04-01

    Full Text Available Myeloproliferative neoplasms (MPN arise from genetic deficiencies at the level of pluripotent stem cells. Each of these neoplasms is a clonal stem cell disorder with specific phenotypic, genetic and clinical properties. Age is one of the most important factors in the development of symptoms and complications associated with MPNs.High white blood cell counts in chronic myelocytic leukemia also known as leukocytosis may lead to central nervous system findings. Tumors developing outside the bone marrow named as extramedullary myeloid tumors (EMMT could be detected at the initial diagnosis or during the prognosis of the disease, which may cause neurological symptoms due to pressure of leukemic cell mass on various tissues along with spinal cord. Central nervous system involvement and thrombocytopenic hemorrhage may lead to diverse neurological symptoms and findings.Transient ischemic attack and thrombotic stroke are the most common symptoms in polycythemia vera. Besides thrombosis and hemorrage, transformation to acute leukemia can cause neurological symptoms and findings. Transient ischemic attack, thrombotic stroke and specifically hemorrage can give rise to neurological symptoms similar to MPN in essential thrombocytosis.Extramedullary hematopoiesis refers to hematopoietic centers arise in organ/tissues other than bone marrow in myelofibrosis. Extramedullar hematopoietic centers may cause intracranial involvement, spinal cord compression, seizures and hydrocephalia. Though rare, extramedullary hematopoiesis can be detected in cranial/spinal meninges, paraspinal tissue and intracerebral regions. Extramedullary hematopoiesis has been reported in peripheral neurons, choroid plexus, pituitary, orbits, orbital and lacrimal fossa and in sphenoidal sinuses. [Cukurova Med J 2013; 38(2.000: 157-169

  16. Aphasia, Just a Neurological Disorder?

    OpenAIRE

    Mehmet Ozdemir

    2016-01-01

    Hashimoto%u2019s encephalopathy (HE) is a rare disorder associated with autoimmune thyroiditis. Etiology of HE is not completely understood. High levels of serum antithyroid antibodies are seen in HE. Presentation with otoimmune thyroiditis, cognitive impairment, psychiatric and neurologic symptoms and absence of bacterial or viral enfections are characteristics of HE. HE is a steroid responsive encephalopathy. 60 years old male patient admitted to hospital with forget fulness continuing for ...

  17. VEGF Signaling in Neurological Disorders

    Directory of Open Access Journals (Sweden)

    Joon W. Shim

    2018-01-01

    Full Text Available Vascular endothelial growth factor (VEGF is a potent growth factor playing diverse roles in vasculogenesis and angiogenesis. In the brain, VEGF mediates angiogenesis, neural migration and neuroprotection. As a permeability factor, excessive VEGF disrupts intracellular barriers, increases leakage of the choroid plexus endothelia, evokes edema, and activates the inflammatory pathway. Recently, we discovered that a heparin binding epidermal growth factor like growth factor (HB-EGF—a class of EGF receptor (EGFR family ligands—contributes to the development of hydrocephalus with subarachnoid hemorrhage through activation of VEGF signaling. The objective of this review is to entail a recent update on causes of death due to neurological disorders involving cerebrovascular and age-related neurological conditions and to understand the mechanism by which angiogenesis-dependent pathological events can be treated with VEGF antagonisms. The Global Burden of Disease study indicates that cancer and cardiovascular disease including ischemic and hemorrhagic stroke are two leading causes of death worldwide. The literature suggests that VEGF signaling in ischemic brains highlights the importance of concentration, timing, and alternate route of modulating VEGF signaling pathway. Molecular targets distinguishing two distinct pathways of VEGF signaling may provide novel therapies for the treatment of neurological disorders and for maintaining lower mortality due to these conditions.

  18. History of pediatric neurology in Poland.

    Science.gov (United States)

    Steinborn, Barbara; Józwiak, Sergiusz

    2010-02-01

    This review presents the past and the present of pediatric neurology in Poland. Pediatric neurology has its roots in Polish general neurology represented by many outstanding scientists. The founder of Polish school of neurology at the end of 19th century was Edward Flatau, known as the author of Flatau's law. The most famous Polish neurologist was Joseph Babiński, recognized for the first description of pathological plantar reflex. First Polish publication related to child neurology was Brudziński's report on a new meningeal symptom (the flexion of lower limbs during passive neck flexion with pain in neck). Contemporary child neurology in Poland was created by Professor Zofia Majewska after the Second World War. Now 10 academic centers of child neurology exist in Poland fulfilling educational, scientific, and therapeutic roles. Polish Society of Child Neurology was established in 1991 and now there are about 580 members, including 300 child neurologists.

  19. African Journal of Neurological Sciences: Journal Sponsorship

    African Journals Online (AJOL)

    African Journal of Neurological Sciences: Journal Sponsorship. Journal Home > About the Journal > African Journal of Neurological Sciences: Journal Sponsorship. Log in or Register to get access to full text downloads.

  20. Clinical trials in neurology: design, conduct, analysis

    National Research Council Canada - National Science Library

    Ravina, Bernard

    2012-01-01

    .... Clinical Trials in Neurology aims to improve the efficiency of clinical trials and the development of interventions in order to enhance the development of new treatments for neurologic diseases...

  1. Lightweight high-performance 1-4 meter class spaceborne mirrors: emerging technology for demanding spaceborne requirements

    Science.gov (United States)

    Hull, Tony; Hartmann, Peter; Clarkson, Andrew R.; Barentine, John M.; Jedamzik, Ralf; Westerhoff, Thomas

    2010-07-01

    Pending critical spaceborne requirements, including coronagraphic detection of exoplanets, require exceptionally smooth mirror surfaces, aggressive lightweighting, and low-risk cost-effective optical manufacturing methods. Simultaneous development at Schott for production of aggressively lightweighted (>90%) Zerodur® mirror blanks, and at L-3 Brashear for producing ultra-smooth surfaces on Zerodur®, will be described. New L-3 techniques for large-mirror optical fabrication include Computer Controlled Optical Surfacing (CCOS) pioneered at L-3 Tinsley, and the world's largest MRF machine in place at L-3 Brashear. We propose that exceptional mirrors for the most critical spaceborne applications can now be produced with the technologies described.

  2. The life cycles of six multi-center adaptive clinical trials focused on neurological emergencies developed for the Advancing Regulatory Science initiative of the National Institutes of Health and US Food and Drug Administration: Case studies from the Adaptive Designs Accelerating Promising Treatments Into Trials Project.

    Science.gov (United States)

    Guetterman, Timothy C; Fetters, Michael D; Mawocha, Samkeliso; Legocki, Laurie J; Barsan, William G; Lewis, Roger J; Berry, Donald A; Meurer, William J

    2017-01-01

    Clinical trials are complicated, expensive, time-consuming, and frequently do not lead to discoveries that improve the health of patients with disease. Adaptive clinical trials have emerged as a methodology to provide more flexibility in design elements to better answer scientific questions regarding whether new treatments are efficacious. Limited observational data exist that describe the complex process of designing adaptive clinical trials. To address these issues, the Adaptive Designs Accelerating Promising Treatments Into Trials project developed six, tailored, flexible, adaptive, phase-III clinical trials for neurological emergencies, and investigators prospectively monitored and observed the processes. The objective of this work is to describe the adaptive design development process, the final design, and the current status of the adaptive trial designs that were developed. To observe and reflect upon the trial development process, we employed a rich, mixed methods evaluation that combined quantitative data from visual analog scale to assess attitudes about adaptive trials, along with in-depth qualitative data about the development process gathered from observations. The Adaptive Designs Accelerating Promising Treatments Into Trials team developed six adaptive clinical trial designs. Across the six designs, 53 attitude surveys were completed at baseline and after the trial planning process completed. Compared to baseline, the participants believed significantly more strongly that the adaptive designs would be accepted by National Institutes of Health review panels and non-researcher clinicians. In addition, after the trial planning process, the participants more strongly believed that the adaptive design would meet the scientific and medical goals of the studies. Introducing the adaptive design at early conceptualization proved critical to successful adoption and implementation of that trial. Involving key stakeholders from several scientific domains early

  3. Efficacy of Various Scoring Systems for Predicting the 28-Day Survival Rate among Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease Requiring Emergency Intensive Care

    Directory of Open Access Journals (Sweden)

    Zhihong Feng

    2017-01-01

    Full Text Available We aimed to investigate the efficacy of four severity-of-disease scoring systems in predicting the 28-day survival rate among patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD requiring emergency care. Clinical data of patients with AECOPD who required emergency care were recorded over 2 years. APACHE II, SAPS II, SOFA, and MEDS scores were calculated from severity-of-disease indicators recorded at admission and compared between patients who died within 28 days of admission (death group; 46 patients and those who did not (survival group; 336 patients. Compared to the survival group, the death group had a significantly higher GCS score, frequency of comorbidities including hypertension and heart failure, and age (P<0.05 for all. With all four systems, scores of age, gender, renal inadequacy, hypertension, coronary heart disease, heart failure, arrhythmia, anemia, fracture leading to bedridden status, tumor, and the GCS were significantly higher in the death group than the survival group. The prediction efficacy of the APACHE II and SAPS II scores was 88.4%. The survival rates did not differ significantly between APACHE II and SAPS II (P=1.519. Our results may guide triage for early identification of critically ill patients with AECOPD in the emergency department.

  4. Cervical spinal canal narrowing and cervical neurologi-cal injuries

    Directory of Open Access Journals (Sweden)

    ZHANG Ling

    2012-04-01

    Full Text Available 【Abstract】Cervical spinal canal narrowing can lead to injury of the spinal cord and neurological symptoms in-cluding neck pain, headache, weakness and parasthesisas. According to previous and recent clinical researches, we investigated the geometric parameters of normal cervical spinal canal including the sagittal and transverse diameters as well as Torg ratio. The mean sagittal diameter of cervical spinal canal at C 1 to C 7 ranges from 15.33 mm to 20.46 mm, the mean transverse diameter at the same levels ranges from 24.45 mm to 27.00 mm and the mean value of Torg ratio is 0.96. With respect to narrow cervical spinal canal, the following charaterstics are found: firstly, extension of the cervical spine results in statistically significant stenosis as compared with the flexed or neutral positions; secondly, females sustain cervical spinal canal narrowing more easily than males; finally, the consistent narrowest cervical canal level is at C 4 for all ethnicity, but there is a slight variation in the sagittal diameter of cervical spinal stenosis (≤14 mm in Whites, ≤ 12 mm in Japanese, ≤13.7 mm in Chinese. Narrow sagittal cervical canal diameter brings about an increased risk of neurological injuries in traumatic, degenerative and inflam-matory conditions and is related with extension of cervical spine, gender, as well as ethnicity. It is hoped that this re-view will be helpful in diagnosing spinal cord and neuro-logical injuries with the geometric parameters of cervical spine in the future. Key words: Spinal cord injuries; Spinal stenosis; Trauma, nervous system

  5. Interobserver variability of the neurological optimality score

    NARCIS (Netherlands)

    Monincx, W. M.; Smolders-de Haas, H.; Bonsel, G. J.; Zondervan, H. A.

    1999-01-01

    To assess the interobserver reliability of the neurological optimality score. The neurological optimality score of 21 full term healthy, neurologically normal newborn infants was determined by two well trained observers. The interclass correlation coefficient was 0.31. Kappa for optimality (score of

  6. Paediatric Neurological Conditions Seen at the Physiotherapy ...

    African Journals Online (AJOL)

    Paediatric neurological conditions constitute a major cause of disability in childhood. However there seems to be an apparent dearth of published works on the patterns of neurological conditions seen in Nigerian physiotherapy clinics of rural locations. This study aimed at describing the spectrum of neurological conditions ...

  7. African Journal of Neurological Sciences: Editorial Policies

    African Journals Online (AJOL)

    African Journal of Neurological Sciences (AJNS) is owned and controlled by the Pan African Association of Neurological Sciences (PAANS). The AJNS's aim is to publish scientific papers of any aspects of Neurological Sciences. AJNS is published quarterly. Articles submitted exclusively to the AJNS are accepted if neither ...

  8. The impact of tackle football injuries on the American healthcare system with a neurological focus.

    Directory of Open Access Journals (Sweden)

    Michael J McGinity

    Full Text Available Recent interest in the study of concussion and other neurological injuries has heightened awareness of the medical implications of American tackle football injuries amongst the public.Using the National Emergency Department Sample (NEDS and the National Inpatient Sample (NIS, the largest publicly available all-payer emergency department and inpatient healthcare databases in the United States, we sought to describe the impact of tackle football injuries on the American healthcare system by delineating injuries, specifically neurological in nature, suffered as a consequence of tackle football between 2010 and 2013.The NEDS and NIS databases were queried to collect data on all patients presented to the emergency department (ED and/or were admitted to hospitals with an ICD code for injuries related to American tackle football between the years 2010 and 2013. Subsequently those with football-related neurological injuries were abstracted using ICD codes for concussion, skull/face injury, intracranial injury, spine injury, and spinal cord injury (SCI. Patient demographics, length of hospital stay (LOS, cost and charge data, neurosurgical interventions, hospital type, and disposition were collected and analyzed.A total of 819,000 patients presented to EDs for evaluation of injuries secondary to American tackle football between 2010 and 2013, with 1.13% having injuries requiring inpatient admission (average length of stay 2.4 days. 80.4% of the ED visits were from the pediatric population. Of note, a statistically significant increase in the number of pediatric concussions over time was demonstrated (OR = 1.1, 95% CI 1.1 to 1.2. Patients were more likely to be admitted to trauma centers, teaching hospitals, the south or west regions, or with private insurance. There were 471 spinal cord injuries and 1,908 total spine injuries. Ten patients died during the study time period. The combined ED and inpatient charges were $1.35 billion.Injuries related to

  9. The impact of tackle football injuries on the American healthcare system with a neurological focus.

    Science.gov (United States)

    McGinity, Michael J; Grandhi, Ramesh; Michalek, Joel E; Rodriguez, Jesse S; Trevino, Aron M; McGinity, Ashley C; Seifi, Ali

    2018-01-01

    Recent interest in the study of concussion and other neurological injuries has heightened awareness of the medical implications of American tackle football injuries amongst the public. Using the National Emergency Department Sample (NEDS) and the National Inpatient Sample (NIS), the largest publicly available all-payer emergency department and inpatient healthcare databases in the United States, we sought to describe the impact of tackle football injuries on the American healthcare system by delineating injuries, specifically neurological in nature, suffered as a consequence of tackle football between 2010 and 2013. The NEDS and NIS databases were queried to collect data on all patients presented to the emergency department (ED) and/or were admitted to hospitals with an ICD code for injuries related to American tackle football between the years 2010 and 2013. Subsequently those with football-related neurological injuries were abstracted using ICD codes for concussion, skull/face injury, intracranial injury, spine injury, and spinal cord injury (SCI). Patient demographics, length of hospital stay (LOS), cost and charge data, neurosurgical interventions, hospital type, and disposition were collected and analyzed. A total of 819,000 patients presented to EDs for evaluation of injuries secondary to American tackle football between 2010 and 2013, with 1.13% having injuries requiring inpatient admission (average length of stay 2.4 days). 80.4% of the ED visits were from the pediatric population. Of note, a statistically significant increase in the number of pediatric concussions over time was demonstrated (OR = 1.1, 95% CI 1.1 to 1.2). Patients were more likely to be admitted to trauma centers, teaching hospitals, the south or west regions, or with private insurance. There were 471 spinal cord injuries and 1,908 total spine injuries. Ten patients died during the study time period. The combined ED and inpatient charges were $1.35 billion. Injuries related to tackle

  10. Acute, massive pulmonary embolism with right heart strain and hypoxia requiring emergent tissue plasminogen activator (TPA infusion

    Directory of Open Access Journals (Sweden)

    Jonathan Patane

    2017-04-01

    Full Text Available History of present illness: A 63-year-old male presented to the emergency department with shortness of breath. He had a history of prostate cancer and two previous pulmonary embolisms, but was not currently on blood thinners. He had no associated chest pain at the time of presentation, but endorsed hemoptysis. Vital signs were significant for a heart rate of 88, blood pressure 145/89, oxygen saturation in the mid-70’s on room air which increased to mid-80’s on 15L facemask. His exam was significant for clear lung sounds bilaterally. He immediately underwent chest x-ray which showed no acute abnormalities. A bedside ultrasound was performed which showed evidence of right ventricular and atrial dilation, consistent with right heart strain. Given that the patient’s oxygen saturations improved to 88% on 15L facemask, the patient was felt to be stable enough for CT angiography. Significant findings: CT angiogram showed multiple large acute pulmonary emboli, most significantly in the distal right main pulmonary artery (image 1 and 2. Additional pulmonary emboli were noted in the bilateral lobar, segmental, and subsegmental levels of all lobes. There was a peripheral, wedge-shaped consolidation surrounded by groundglass changes in the posterolateral basal right lower lobe that was consistent with a small lung infarction (image 3. Discussion: The patient underwent in the Emergency Department a tissue plasminogen activator (TPA infusion of alteplase 100 mg over 2 hours for his massive acute pulmonary embolisms. Throughout his TPA infusion his oxygen saturations became improved to mid-90’s and his shortness of breath symptoms began improving. His troponin returned at 0.15 ng/mL, suggesting right heart strain. He was admitted to the ICU for continued monitoring and treatment. An acute, massive pulmonary embolism is described as having more than 50% occlusion of pulmonary blood flow.1 The main causes of hypoxia includes ventilation

  11. Meningitis secondary to Cryptococcus gattii,an emerging pathogen affecting immunocompetent hosts

    Institute of Scientific and Technical Information of China (English)

    Laura Cookman; Maria Hugi

    2013-01-01

    BACKGROUND:Meningitis continues to be one of the most important infections diagnosed and treated by emergency physicians.Despite the advent of anti-infective therapy,meningitis carries a mortality rate of 20%-40%.In this study,we describe the first reported emergency medicine case of meningitis associated with Cryptococcus gattii to alert providers of this insidious,emerging global pathogen infecting immunocompetent individuals.METHODS:We provided a case report and accompanying review of the literature.A MEDLINE search for the term Cryptoccocus gattii was performed to obtain background information on Cryptococcus gattii.RESULTS:After two months of hospitalization,the patient was eventually discharged neurologically intact except for a continued mild bilateral hearing deficit.CONCLUSION:Cryptococcus gattii is an emerging world pathogen,which affects otherwise healthy,immunocompetent patients and requires timely identification and treatment in order to prevent severe neurological sequelae.

  12. Relationships Between Essential Manganese Biology and Manganese Toxicity in Neurological Disease.

    Science.gov (United States)

    Pfalzer, Anna C; Bowman, Aaron B

    2017-06-01

    Manganese (Mn) is critical for neurodevelopment but also has been implicated in the pathophysiology of several neurological diseases. We discuss how Mn requirements intersect with Mn biology and toxicity, and how these requirements may be altered in neurological disease. Furthermore, we discuss the emerging evidence that the level of Mn associated with optimal overall efficiency for Mn biology does not necessarily coincide with optimal cognitive outcomes. Studies have linked Mn exposures with urea cycle metabolism and autophagy, with evidence that exposures typically neurotoxic may be able to correct deficiencies in these processes at least short term. The line between Mn-dependent biology and toxicity is thus blurred. Further, new work suggests that Mn exposures correlating to optimal cognitive scores in children are associated with cognitive decline in adults. This review explores relationships between Mn-dependent neurobiology and Mn-dependent neurotoxicity. We propose the hypothesis that Mn levels/exposures that are toxic to some biological processes are beneficial for other biological processes and influenced by developmental stage and disease state.

  13. Dysfunctional HCN ion channels in neurological diseases

    Directory of Open Access Journals (Sweden)

    Jacopo C. DiFrancesco

    2015-03-01

    Full Text Available Hyperpolarization-activated cyclic nucleotide-gated (HCN channels are expressed as four different isoforms (HCN1-4 in the heart and in the central and peripheral nervous systems. HCN channels are activated by membrane hyperpolarization at voltages close to resting membrane potentials and carry the hyperpolarization-activated current, dubbed If (funny current in heart and Ih in neurons. HCN channels contribute in several ways to neuronal activity and are responsible for many important cellular functions, including cellular excitability, generation and modulation of rhythmic activity, dendritic integration, transmission of synaptic potentials and plasticity phenomena. Because of their role, defective HCN channels are natural candidates in the search for potential causes of neurological disorders in humans. Several data, including growing evidence that some forms of epilepsy are associated with HCN mutations, support the notion of an involvement of dysfunctional HCN channels in different experimental models of the disease. Additionally, some anti-epileptic drugs are known to modify the activity of the Ih current. HCN channels are widely expressed in the peripheral nervous system and recent evidence has highlighted the importance of the HCN2 isoform in the transmission of pain. HCN channels are also present in the midbrain system, where they finely regulate the activity of dopaminergic neurons, and a potential role of these channels in the pathogenesis of Parkinson’s disease has recently emerged. The function of HCN channels is regulated by specific accessory proteins, which control the correct expression and modulation of the neuronal Ih current. Alteration of these proteins can severely interfere with the physiological channel function, potentially predisposing to pathological conditions. In this review we address the present knowledge of the association between HCN dysfunctions and neurological diseases, including clinical, genetic and

  14. Predominance of neurologic diseases in international aeromedical transportation.

    Science.gov (United States)

    Chen, Wan-Lin; Lin, Yu-Ming; Ma, Hong-Ping; Chiu, Wen-Ta; Tsai, Shin-Han

    2009-12-01

    International travel industry in Taiwan is expanding. The number of people traveling abroad was approximately 480,000 people in 1980; 2,940,000 in 1990; 7,320,000 in 2000, and in 2007, it has reached 8,960,000, which was more than one third of total population. Air medical transportation will be necessary when local medical facilities do not approximate the international standards. No previous study on epidemiology in Taiwan on patients received international medical repatriation. This is the first report to discuss the epidemiology of Taiwan's international aeromedical transportation and its focus on neurologic diseases. Retrospective analysis of all international aeromedical transports on Taiwanese patients from October 2005 to September 2007 was performed. All materials were collected from the databank of International SOS, Taipei. The data were analyzed with Microsoft Excel and SPSS v. 11.0 software (SPSS, Chicago, Ill). A total of 416 patients were transported. Excluding expatriates transported outbound and 2-stage inbound transports, the Taiwanese patient number with international aeromedical transport was 379; 51 by air ambulance and 328 commercially. There were 271 male (72%) and 108 female patients (18%). Of the 379 patients, 178 (47%) were neurologic diseases. Two hundred ninety-five (78%) patients were transported from China. Patient transports peaked in autumn by 105 (28%). Of all 33 ventilated patients, 12 (36%) were neurologic diseases. In-flight complications occurred in 10% of neurologic and 2% of nonneurologic cases. No in-flight mortality occurred in both groups. Neurologic diseases comprise most of the Taiwanese patients that requires medical transportation. With relatively suboptimal medical standard and high medical expenses in China, patients with neurologic conditions need timely and safe aeromedical transport than those with other diseases. Transport of patients with neurologic diseases, either by air ambulance or commercial flights, can

  15. Medical emergency aid through telematics: design, implementation guidelines and analysis of user requirements for the MERMAID project.

    Science.gov (United States)

    Anogianakis, G; Maglavera, S; Pomportsis, A; Bountzioukas, S; Beltrame, F; Orsi, G

    1998-01-01

    MERMAID is an EU financed telemedicine project with global reach and 24-h, multilingual capability. It aspires to provide a model for the provision of health care services based on the electronic transmission of medical information, via ISDN based videoconferencing. This model will not be limited to medical diagnostics but it will encompass all cases where the actual delivery of health care services involves a patient who is not located where the provider is. Its implementation requires the commissioning of an expensive telecommunications infrastructure and the exploration of a number of solutions. In fact, all categories of telemedical applications (audio and video conferencing, multimedia communications, flat file and image transfer with low, medium and high bandwidth data requirements) are considered while the full range of network choices (digital land lines, cellular/wireless, satellite and broadband) are being tested in terms of cost/performance tradeoffs that are inherent to them and the developmental stage each of these options occupies in their in its life cycle. Finally, out that MERMAID utilises advanced land based line transmission technologies to aid the remote patient by making available the specialist care that is best suited in the particular case.

  16. Profile of neurological admissions at the University of Nigeria Teaching Hospital Enugu.

    Science.gov (United States)

    Ekenze, O S; Onwuekwe, I O; Ezeala Adikaibe, B A

    2010-01-01

    The burden of Neurological diseases may be on the increase especially in developing countries. Improved outcome in these settings may require appreciation of the spectrum of Neurological diseases and the impediments to their management. We aim to determine the profile of neurological admissions and the challenges of managing these diseases at the University of Nigeria Teaching Hospital Enugu South East Nigeria. Analysis of Neurological admissions into the medical wards of the University of Nigeria Teaching Hospital Enugu from January 2003 to December 2007. Neurological admissions comprise about 14.8% of medical admissions. There were 640 (51%) males and 609 (49%) females. The spectrum of neurological diseases were stroke 64.9%, central nervous system infections (21.8% ), HIV related neurological diseases 3.5%, hypertensive encephalopathy (3.4%), dementia (3%), subarachnoid haemorrhage (2.2%), Guillian Barre syndrome (1.2%), Parkinson's disease (1.1%), myasthenia gravis (1.0%), motor neurone disease and peripheral neuropathy and accounted for 0.8% and 0.6% respectively. Overall, noninfectious disease accounted for 78.2% of neurological admissions while infectious diseases accounted for 11.8%. A wide spectrum of neurological diseases occurs in our setting. The high incidence of CNS infections indicates that efforts should be geared towards preventive measures. A major challenge to be addressed in the management of neurological diseases in our setting is the lack of specialized facilities.

  17. PET molecular imaging in stem cell therapy for neurological diseases

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Jiachuan; Zhang, Hong [Second Affiliated Hospital of Zhejiang University School of Medicine, Department of Nuclear Medicine, Hangzhou, Zhejiang (China); Zhejiang University, Medical PET Center, Hangzhou (China); Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou (China); Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou (China); Tian, Mei [University of Texas, M.D. Anderson Cancer Center, Department of Experimental Diagnostic Imaging, Houston, TX (United States)

    2011-10-15

    Human neurological diseases such as Alzheimer's disease, Parkinson's disease, Huntington's disease, spinal cord injury and multiple sclerosis are caused by loss of different types of neurons and glial cells in the brain and spinal cord. At present, there are no effective therapies against these disorders. Discovery of the therapeutic potential of stem cells offers new strategies for the treatment of neurological diseases. Direct assessment of stem cells' survival, interaction with the host and impact on neuronal functions after transplantation requires advanced in vivo imaging techniques. Positron emission tomography (PET) is a potential molecular imaging modality to evaluate the viability and function of transplanted tissue or stem cells in the nervous system. This review focuses on PET molecular imaging in stem cell therapy for neurological diseases. (orig.)

  18. Adaptive tele-application for remote neurology diagnosis.

    Science.gov (United States)

    Garcia, E; Guyennet, H; Lapayre, J-C; Moulin, T

    2005-12-01

    This paper presents the Collaborative Tele-Neurology (TeNeCi) project which allows practitioners to use telecommunication technologies to provide medical information and services for neurological diseases. Specificities of remote neurology are described and the Cooperative Application Framework (CAliF) multimedia platform on which TeNeCi relies is presented. The technical requirements of such a project in terms of communication and consistency management, audio and video transmissions, and network support, as well as implementation of TeNeCi was evaluated. The software used in this application is composed of several services, such as a Digital Imaging and Communications in Medicine (DICOM) explorer, a DICOM viewer, and a security service. Tests performed on this first TeNeCi release showed good results, and allowed us to explore a larger collaborative experimentation between hospitals in France and Switzerland.

  19. Study on subsequent neurologic complications in children with acute leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Naoaki; Shimazaki, Haruyo; Hoshi, Yasutaka; Akatsuka, Jun-ichi (Jikei Univ., Tokyo (Japan). School of Medicine)

    1989-06-01

    Twenty-seven children with acute leukemia were studied in order to detect the subsequent neurologic complications due to chemotherapy and radiation therapy. Twenty-four patients with ALL received central nervous system prophylaxis including cranial irradiation. The methods of evaluation consisted of electroencephalogram (EEG), computed tomography of the head (CT scan), soft neurological sign, intelligence quotient (IQ) and Bender Gestalt test. The patients with relapse showed severe abnormalities in various kinds of examinations. Younger children at diagnosis were associated with a higher abnormality rate of soft neurological signs and Bender Gestalt test. Factors which were found to be closely associated with a lower IQ score included younger children at diagnosis and longer duration of remission time. These results indicate the need for caution for the dosage of cranial irradiation for younger patients in CNS prophylaxis, and improvement of a lower IQ score in long-term survivors requires further investigation as to the appropriate intellectual environment for their development after remission. (author).

  20. Neurological aspects of lead intoxication

    Energy Technology Data Exchange (ETDEWEB)

    Lehner, H

    1980-05-08

    This study gives a survey over the medical and scientific literature on lead intoxications, which were published until 1979. Neurologic aspects are of particular interest. At present dramatic cases of lead intoxications occur only rarely. However, there are numerous studies about cases of chronical, partly subclinical intoxications. This chronical type of lead intoxication can become manifest clinically as relatively vague symptoms, for example vertigos, insomnia, headaches and weakness. Contrary to this, serious encephalopathies, even with fatal outcome, and polyneuropathies with typical paresis of the radial nerve are preferably observed in acute lead intoxications. Besides the numerous sources of intoxication, also the different opinions found in literature are discussed, concerning the effects of lead on the human body. The fact that there are differing opinions about the limiting value of the blood-lead level at which intoxication symptoms have to be expected, becomes apparent when the determined blood-lead level values are compared and evaluated. Besides the description of general intoxication effects, the discussion of the neurologic aspects found in literature - not only those concerning the central, but also the peripheral system - are preferably concerned. Reports about neuropsychical alterations due to lead exposure, which are mainly found in children, supplement the numerous descriptions of the macroscopic and microscopic alterations of the nervous system provoked by lead. Finally the therapeutic and prophylactic measures given in the literature are discussed.

  1. Neurological disorders in hypertensive patients

    Directory of Open Access Journals (Sweden)

    N. V. Vakhnina

    2015-01-01

    Full Text Available Hypertension is one of the most common vascular diseases. The brain as target organs in hypertension is damaged more often and earlier. Neurological complications due to hypertension are frequently hyperdiagnosed in Russian neurological practice. Thus, headache, dizziness, impaired recall of recent events, nocturnal sleep disorders, and many other complaints in a hypertensive patient are usually regarded as a manifestation of dyscirculatory encephalopathy. At the same time headaches (tension headache and migraine in hypertensive patients are predominantly primary; headache associated with dramatic marked elevations in blood pressure is encountered in only a small number of patients. The role of cerebrovascular diseases in the development of dizziness in hypertensive patients is also overestimated. The vast majority of cases, patients with this complaint are in fact identified to have benign paroxysmal postural vertigo, Mеniеre’s disease, vestibular neuronitis, or vestibular migraine. Psychogenic disorders or multisensory insufficiency are generally responsible for non-systemic vertigo in hypertensive patients. Chronic cerebral circulatory insufficiency may cause non-systemic vertigo as a subjective equivalent of postural instability.Cognitive impairments (CIs are the most common and earliest manifestation of cerebrovascular lesion in hypertension. In most cases, CIs in hypertension were vascular and associated with cerebrovascular lesion due to lacunar infarcts and leukoaraiosis. However, mixed CIs frequently occur when hypertensive patients are also found to have signs of a degenerative disease, most commonly in Alzheimer’s disease.

  2. Neurological complications in hyperemesis gravidarum.

    Science.gov (United States)

    Zara, Gabriella; Codemo, Valentina; Palmieri, Arianna; Schiff, Sami; Cagnin, Annachiara; Citton, Valentina; Manara, Renzo

    2012-02-01

    Hyperemesis gravidarum can impair correct absorption of an adequate amount of thiamine and can cause electrolyte imbalance. This study investigated the neurological complications in a pregnant woman with hyperemesis gravidarum. A 29-year-old pregnant woman was admitted for hyperemesis gravidarum. Besides undernutrition, a neurological examination disclosed weakness with hyporeflexia, ophthalmoparesis, multidirectional nystagmus and optic disks swelling; the patient became rapidly comatose. Brain MRI showed symmetric signal hyperintensity and swelling of periaqueductal area, hypothalamus and mammillary bodies, medial and posterior portions of the thalamus and columns of fornix, consistent with Wernicke encephalopathy (WE). Neurophysiological studies revealed an axonal sensory-motor polyneuropathy, likely due to thiamine deficiency or critical illness polyneuropathy. Sodium and potassium supplementation and parenteral thiamine were administered with improvement of consciousness state in a few days. WE evolved in Korsakoff syndrome. A repeat MRI showed a marked improvement of WE-related alterations and a new hyperintense lesion in the pons, suggestive of central pontine myelinolysis. No sign or symptom due to involvement of the pons was present.

  3. Physicochemical Requirements Inferred for Chemical Self-Organization Hardly Support an Emergence of Life in the Deep Oceans of Icy Moons.

    Science.gov (United States)

    Pascal, Robert

    2016-05-01

    An approach to the origin of life, focused on the property of entities capable of reproducing themselves far from equilibrium, has been developed recently. Independently, the possibility of the emergence of life in the hydrothermal systems possibly present in the deep oceans below the frozen crust of some of the moons of Jupiter and Saturn has been raised. The present report is aimed at investigating the mutual compatibility of these alternative views. In this approach, the habitability concept deduced from the limits of life on Earth is considered to be inappropriate with regard to emerging life due to the requirement for an energy source of sufficient potential (equivalent to the potential of visible light). For these icy moons, no driving force would have been present to assist the process of emergence, which would then have had to rely exclusively on highly improbable events, thereby making the presence of life unlikely on these Solar System bodies, that is, unless additional processes are introduced for feeding chemical systems undergoing a transition toward life and the early living organisms. Icy moon-Bioenergetics-Chemical evolution-Habitability-Origin of life. Astrobiology 16, 328-334.

  4. Physicochemical Requirements Inferred for Chemical Self-Organization Hardly Support an Emergence of Life in the Deep Oceans of Icy Moons

    Science.gov (United States)

    Pascal, Robert

    2016-05-01

    An approach to the origin of life, focused on the property of entities capable of reproducing themselves far from equilibrium, has been developed recently. Independently, the possibility of the emergence of life in the hydrothermal systems possibly present in the deep oceans below the frozen crust of some of the moons of Jupiter and Saturn has been raised. The present report is aimed at investigating the mutual compatibility of these alternative views. In this approach, the habitability concept deduced from the limits of life on Earth is considered to be inappropriate with regard to emerging life due to the requirement for an energy source of sufficient potential (equivalent to the potential of visible light). For these icy moons, no driving force would have been present to assist the process of emergence, which would then have had to rely exclusively on highly improbable events, thereby making the presence of life unlikely on these Solar System bodies, that is, unless additional processes are introduced for feeding chemical systems undergoing a transition toward life and the early living organisms.

  5. Neurologic long term outcome after drowning in children

    Directory of Open Access Journals (Sweden)

    Suominen Pertti K

    2012-08-01

    Full Text Available Abstract Drowning is a major source of mortality and morbidity in children worldwide. Neurocognitive outcome of children after drowning incidents cannot be accurately predicted in the early course of treatment. Therefore, aggressive out-of-hospital and in-hospital treatment is emphasized. There are "miracle" cases after long submersion times that have been reported in the medical literature, which mostly concern small children. However, many of the survivors will remain severely neurologically compromised after remarkably shorter submersion times and will consequently be a great burden to their family and society for the rest of their lives. The duration of submersion, the need of advanced life support at the site of the accident, the duration of cardiopulmonary resuscitation, whether spontaneous breathing and circulation are present on arrival at the emergency room are important factors related to survival with mild neurological deficits or intact function in drowned children. Data on long-term outcome are scarce. The used outcome measurement methods and the duration of follow-up have not been optimal in most of the existing studies. Proper neurological and neurophysiological examinations for drowned children are superior to outcome scales based chart reviews. There is evidence that gross neurological examination at the time of discharge from the hospital in young children does not reveal all the possible sequelae related to hypoxic brain injury and thus long-term follow-up of drowned resuscitated children is strongly recommended.

  6. Regulatory requirements on accident management and emergency preparedness - concept of nuclear and radiation safety during beyond-design-basis accidents

    International Nuclear Information System (INIS)

    Yanke, R.

    2002-01-01

    Actual practice the and proposals for further activities in the field of Accident Management (AM) in the member countries of the Co-operation Forum of WWER regulators and in Western countries have been assessed. Further the results of the last working group on AM , the overview of interactions of severe accident research and the regulatory positions in various countries, IAEA reports, practice in Switzerland and Finland, were taken into consideration. From this information, the working group derived recommendations on Accident Management. The general proposals correspond to the present state of the art on AM. They do not describe the whole spectra of recommendations on AM for NPPs with WWER reactors. A basis for the implementation of an AM program is given, which could be extended in a follow-up working group. The developments and research concerning AM have to be continued. The positions of various countries with regard to the 'Interactions of severe accident research and the regulatory positions' are given. On the basis of the working group proposals, the WWER regulators could set regulatory requirements and support further developments of AM strategies, making use of the benefits of common features of NPPs with WWER reactors. Concerted actions in the field of AM between the WWER regulators would bundle the development of a unified concept of recommendations and speed up the implementation of AM measures in order to minimise the risks involved in nuclear power generation

  7. Hazardous Substance Release Reporting Under CERCLA, EPCR {section}304 and DOE Emergency Management System (EMS) and DOE Occurrence Reporting Requirements. Environmental Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Traceski, T.T.

    1994-06-01

    Releases of various substances from DOE facilities may be subject to reporting requirements under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) and the Emergency Planning and Community Right-to-Know Act (EPCRA), as well as DOE`s internal ``Occurrence Reporting and Processing of Operations Information`` and the ``Emergency Management System`` (EMS). CERCLA and EPCPA are Federal laws that require immediate reporting of a release of a Hazardous Substance (HS) and an Extremely Hazardous Substance (EHS), respectively, in a Reportable Quantity (RQ) or more within a 24-hour period. This guidance uses a flowchart, supplemental information, and tables to provide an overview of the process to be followed, and more detailed explanations of the actions that must be performed, when chemical releases of HSs, EHSs, pollutants, or contaminants occur at DOE facilities. This guidance should be used in conjunction with, rather than in lieu of, applicable laws, regulations, and DOE Orders. Relevant laws, regulations, and DOE Orders are referenced throughout this guidance.

  8. Neurology of foreign language aptitude

    Directory of Open Access Journals (Sweden)

    Adriana Biedroń

    2015-01-01

    Full Text Available This state-of-the art paper focuses on the poorly explored issue of foreign language aptitude, attempting to present the latest developments in this field and reconceptualizations of the construct from the perspective of neuroscience. In accordance with this goal, it first discusses general directions in neurolinguistic research on foreign language aptitude, starting with the earliest attempts to define the neurological substrate for talent, sources of difficulties in the neurolinguistic research on foreign language aptitude and modern research methods. This is followed by the discussion of the research on the phonology of foreign language aptitude with emphasis on functional and structural studies as well as their consequences for the knowledge of the concept. The subsequent section presents the studies which focus on lexical and morphosyntactic aspects of foreign language aptitude. The paper ends with a discussion of the limitations of contemporary research, the future directions of such research and selec ed methodological issues.

  9. Epigenetic mechanisms in neurological disease.

    Science.gov (United States)

    Jakovcevski, Mira; Akbarian, Schahram

    2012-08-01

    The exploration of brain epigenomes, which consist of various types of DNA methylation and covalent histone modifications, is providing new and unprecedented insights into the mechanisms of neural development, neurological disease and aging. Traditionally, chromatin defects in the brain were considered static lesions of early development that occurred in the context of rare genetic syndromes, but it is now clear that mutations and maladaptations of the epigenetic machinery cover a much wider continuum that includes adult-onset neurodegenerative disease. Here, we describe how recent advances in neuroepigenetics have contributed to an improved mechanistic understanding of developmental and degenerative brain disorders, and we discuss how they could influence the development of future therapies for these conditions.

  10. Neurological problems of jazz legends.

    Science.gov (United States)

    Pearl, Phillip L

    2009-08-01

    A variety of neurological problems have affected the lives of giants in the jazz genre. Cole Porter courageously remained prolific after severe leg injuries secondary to an equestrian accident, until he succumbed to osteomyelitis, amputations, depression, and phantom limb pain. George Gershwin resisted explanations for uncinate seizures and personality change and herniated from a right temporal lobe brain tumor, which was a benign cystic glioma. Thelonious Monk had erratic moods, reflected in his pianism, and was ultimately mute and withdrawn, succumbing to cerebrovascular events. Charlie Parker dealt with mood lability and drug dependence, the latter emanating from analgesics following an accident, and ultimately lived as hard as he played his famous bebop saxophone lines and arpeggios. Charles Mingus hummed his last compositions into a tape recorder as he died with motor neuron disease. Bud Powell had severe posttraumatic headaches after being struck by a police stick defending Thelonious Monk during a Harlem club raid.

  11. [Autoantibodies in Paraneoplastic Neurological Syndrome].

    Science.gov (United States)

    Kawachi, Izumi

    2018-04-01

    Paraneoplastic neurological syndromes (PNS) are caused by immune responses against neuronal antigens expressed by the tumor. Based on the immunological pathomechanisms and responsiveness of treatments, onconeuronal antibodies are divided into two categories: 1) antibodies against neural intracellular antigens and 2) antibodies against neuronal surface or synaptic antigens. The recent discovery of onconeuronal antibodies have radically changed concepts of CNS autoimmunity, including PNS. The recognition of PNS provides a foundation for the early detection of underlying tumors and initiations of prompt treatments, which can result in substantial improvement. We here review the characteristic onconeuronal antibodies, including anti-Hu, anti-Ma2, and anti-N-methyl-D-aspartate receptor, and discuss the algorithm for the diagnosis of PNS.

  12. [Neurological disorders in patients with hypoparathyroidism].

    Science.gov (United States)

    Roztoczyńska, Dorota; Kroczka, Sławomir; Kumorowicz-Czoch, Małgorzata; Dolezal-Ołtarzewska, Katarzyna; Kacińsk, Marek; Starzyk, Jerzy

    2010-01-01

    in 9 patients. Five patients of the eight individuals with Albright syndrome showed mild or moderate mental retardation confirmed by psychological testing. 1. Hypoparathyroidism leads to functional and morphological CNS changes. 2. Restoring metabolic balance through administration of calcium and active vitamin D preparations may obliterate the need for anti-epileptic treatment. 3. Calcification foci in the central nervous system seem to be associated with the duration of hypoparathyroidism. 4. No correlation has been observed between the extent and location of calcification foci and neurological abnormalities. 5. Hypoparathyroid patients with calcification foci in CSN require long-term multidisciplinary medical management and neurophysiological, imaging and neuropsychological monitoring.

  13. Neurological Signs and Symptoms in Fibromyalgia

    Science.gov (United States)

    Watson, Nathaniel F.; Buchwald, Dedra; Goldberg, Jack; Noonan, Carolyn; Ellenbogen, Richard G.

    2009-01-01

    Objective To determine the type and frequency of neurological signs and symptoms in individuals with fibromyalgia (FM). Methods Persons with FM (n=166) and pain-free controls (n=66) underwent systematic neurological examination by a neurologist blinded to disease status. Neurological symptoms present over the preceding 3 months were assessed with a standard questionnaire. We used logistic regression to evaluate the association of neurological symptoms and examination findings with FM status. Within the FM group we examined the correlation between self-reported symptoms and physical examination findings. Results Compared to the control group, age and gender adjusted estimates revealed the FM group had significantly more neurological abnormalities in multiple categories including: cranial nerves IX and X (42% vs. 8%), sensory (65% vs. 25%), motor (33% vs. 3%), and gait (28% vs. 7%). Similarly, the FM group endorsed significantly more neurological symptoms than the control group in 27 of 29 categories with the biggest differences observed for photophobia (70% vs. 6%), poor balance (63% vs. 4%), and weakness (58% vs. 2%) and tingling (54% vs. 4%) in the arms and legs. Poor balance, coordination, tingling, weakness in the arms and legs, and numbness in any part of body correlated with appropriate neurological exam findings in the FM group. Conclusions This blinded, controlled study demonstrated neurological physical examination findings in persons with FM. The FM group had more neurological symptoms than controls, with moderate correlation between symptoms and signs. These findings have implications for the medical work-up of patients with FM. PMID:19714636

  14. Nail gun injuries to the head with minimal neurological consequences: a case series.

    Science.gov (United States)

    Makoshi, Ziyad; AlKherayf, Fahad; Da Silva, Vasco; Lesiuk, Howard

    2016-03-16

    An estimated 3700 individuals are seen annually in US emergency departments for nail gun-related injuries. Approximately 45 cases have been reported in the literature concerning nail gun injuries penetrating the cranium. These cases pose a challenge for the neurosurgeon because of the uniqueness of each case, the dynamics of high pressure nail gun injuries, and the surgical planning to remove the foreign body without further vascular injury or uncontrolled intracranial hemorrhage. Here we present four cases of penetrating nail gun injuries with variable presentations. Case 1 is of a 33-year-old white man who sustained 10 nail gunshot injuries to his head. Case 2 is of a 51-year-old white man who sustained bi-temporal nail gun injuries to his head. Cases 3 and 4 are of two white men aged 22 years and 49 years with a single nail gun injury to the head. In the context of these individual cases and a review of similar cases in the literature we present surgical approaches and considerations in the management of nail gun injuries to the cranium. Case 1 presented with cranial nerve deficits, Case 2 required intubation for low Glasgow Coma Scale, while Cases 3 and 4 were neurologically intact on presentation. Three patients underwent angiography for assessment of vascular injury and all patients underwent surgical removal of foreign objects using a vice-grip. No neurological deficits were found in these patients on follow-up. Nail gun injuries can present with variable clinical status; mortality and morbidity is low for surgically managed isolated nail gun-related injuries to the head. The current case series describes the surgical use of a vice-grip for a good grip of the nail head and controlled extraction, and these patients appear to have a good postoperative prognosis with minimal neurological deficits postoperatively and on follow-up.

  15. The use of retinal photography in nonophthalmic settings and its potential for neurology.

    Science.gov (United States)

    Pérez, Mario A; Bruce, Beau B; Newman, Nancy J; Biousse, Valérie

    2012-11-01

    Ocular fundus examination is an important element of the neurological examination. However, direct ophthalmoscopy is difficult to perform without pupillary dilation and requires extensive practice to accurately recognize optic nerve and retinal abnormalities. Recent studies have suggested that digital retinal photography can replace direct ophthalmoscopy in many settings. Ocular fundus imaging is routinely used to document and monitor disease progression in ophthalmology. Advances in optical technology have made it easier to obtain high-quality retinal imaging, even without pupillary dilation. Retinal photography has a high sensitivity, specificity, and interexamination/intraexamination agreement compared with in-person ophthalmologist examination, suggesting that photographs can be used in lieu of ophthalmoscopy in many clinical situations. Nonmydriatic retinal photography has recently gained relevance as a helpful tool for diagnosing neuro-ophthalmologic disorders in the emergency department. In addition, several population-based studies have used retinal imaging to relate ophthalmic abnormalities to the risk of hypertension, renal dysfunction, cardiovascular mortality, subclinical and clinical stroke, and cognitive impairment. The possibility of telemedical consultation offered by digital retinal photography has already increased access to timely and accurate subspecialty care, particularly for underserved areas. Retinal photography (even without pupillary dilation) has become increasingly available to medical fields outside of ophthalmology, allowing for faster and more accurate diagnosis of various ocular, neurological, and systemic disorders. The potential for telemedicine may provide the additional benefits of improving access to appropriate urgent consultation in both clinical and research settings.

  16. The use of retinal photography in non-ophthalmic settings and its potential for neurology

    Science.gov (United States)

    Pérez, Mario A.; Bruce, Beau B.; Newman, Nancy J.; Biousse, Valérie

    2012-01-01

    Background Ocular fundus examination is an important element of the neurological examination. However, direct ophthalmoscopy is difficult to perform without pupillary dilation and requires extensive practice to accurately recognize optic nerve and retinal abnormalities. Recent studies have suggested that digital retinal photography can replace direct ophthalmoscopy in many settings. Review Summary Ocular fundus imaging is routinely used to document and monitor disease progression in ophthalmology. Advances in optical technology have made it easier to obtain high-quality retinal imaging, even without pupillary dilation. Retinal photography has a high sensitivity, specificity, and inter-/intra-examination agreement compared to in-person ophthalmologist examination, suggesting that photographs can be used in lieu of ophthalmoscopy in many clinical situations. Non-mydriatic retinal photography has recently gained relevance as a helpful tool for diagnosing neuro-ophthalmologic disorders in the emergency department. Additionally, several population-based studies have used retinal imaging to relate ophthalmic abnormalities to the risk of hypertension, renal dysfunction, cardiovascular mortality, subclinical and clinical stroke, and cognitive impairment. The possibility of telemedical consultation offered by digital retinal photography has already increased access to timely and accurate subspecialty care, particularly for underserved areas. Conclusion Retinal photography (even without pupillary dilation) has become increasingly available to medical fields outside of ophthalmology, allowing for faster and more accurate diagnosis of various ocular, neurologic and systemic disorders. The potential for telemedicine may provide the additional benefits of improving access to appropriate urgent consultation in both clinical and research settings. PMID:23114666

  17. Pediatric neurology training in Canada: current status and future directions.

    Science.gov (United States)

    Doja, Asif

    2012-05-01

    Child neurology training in Canada has changed considerably over time, with increasing requirements for standardized teaching of the fundamentals of child neurology and the CanMEDS competencies. We sought to determine the current status of child neurology training in Canada as well future directions for training. A web-based survey was sent to program directors (PD's) of active pediatric neurology training programs. General questions about the programs were asked, as well as about success at the Royal College of Physicians and Surgeons of Canada (RCPSC) exam, breakdown of rotations, views on CanMEDS roles and questions on the future of pediatric neurology. 9/9 PD's completed the survey. 96.5% of all trainees successfully passed their RCPSC exam from 2001-2006. Breakdowns of the number and type of rotations for each year of training were provided. All CanMEDS roles were deemed to be important by PD's and programs have developed unique strategies to teach and assess these roles.92.6% of trainees chose to go into academic practice, with the most popular subspecialty being epilepsy. All PD's favour joint training sessions particularly for neurogenetics and neuromuscular disease. Overall, PD's suggest recruitment for future child neurologists at the medical student level but are divided as to whether we are currently training too few or too many child neurologists. This survey provides a view of the current state of pediatric neurology training in Canada and suggestions for further development of post-graduate training. In particular, attention should be given to joint educational programs as well as urgently assessing the manpower needs of child neurologists.

  18. Autoimmune Neurological Conditions Associated With Zika Virus Infection

    Directory of Open Access Journals (Sweden)

    Yeny Acosta-Ampudia

    2018-04-01

    Full Text Available Zika virus (ZIKV is an emerging flavivirus rapidly spreading throughout the tropical Americas. Aedes mosquitoes is the principal way of transmission of the virus to humans. ZIKV can be spread by transplacental, perinatal, and body fluids. ZIKV infection is often asymptomatic and those with symptoms present minor illness after 3 to 12 days of incubation, characterized by a mild and self-limiting disease with low-grade fever, conjunctivitis, widespread pruritic maculopapular rash, arthralgia and myalgia. ZIKV has been linked to a number of central and peripheral nervous system injuries such as Guillain-Barré syndrome (GBS, transverse myelitis (TM, meningoencephalitis, ophthalmological manifestations, and other neurological complications. Nevertheless, mechanisms of host-pathogen neuro-immune interactions remain incompletely elucidated. This review provides a critical discussion about the possible mechanisms underlying the development of autoimmune neurological conditions associated with Zika virus infection.

  19. Dermatologic emergencies

    Directory of Open Access Journals (Sweden)

    M.P. Simón Díaz

    2016-01-01

    Full Text Available Dermatologic emergencies represent about 8–20% of the diseases seen in the Emergency Department of hospitals. It is often a challenge for primary care physicians to differentiate mundane skin ailments from more serious, life threatening conditions that require immediate intervention. In this review we included the following conditions: Stevens-Johnson syndrome/toxic epidermal necrosis, pemphigus vulgaris, toxic shock syndrome, fasciitis necrotising, angioedema/urticaria, meningococcemia, Lyme disease and Rocky Mountain spotted fever.

  20. Alterações transitórias do exame neurológico durante o despertar da anestesia com enflurano, isoflurano ou sevoflurano Alteraciones transitorias del examen neurológico durante el despertar de la anestesia con enflurano, isoflurano o sevoflurano Transient neurological changes during emergence from enflurane, isoflurane or sevoflurane anesthesia

    Directory of Open Access Journals (Sweden)

    Luiz Fernando Soares

    2001-12-01

    comportamiento durante la recuperación de la anestesia con enflurano (Grupo E, isoflurano (Grupo I y sevoflurano (Grupo S. MÉTODO: Fueron estudiados 44 pacientes que recibieron anestesia con enflurano, isoflurano o sevoflurano en N2O a 50%. Fueron anotados antes de la inducción, inmediatamente después de la cesación de la administración del anestésico y 5, 10, 15, 20, 30 e 40 minutos después: temperatura timpánica, nivel de consciencia, tono muscular, reflejos pupilar, ciliar, bicipital, patelar y cutaneo-plantar, bien como la ocurrencia de calofríos. RESULTADOS: Las respuestas de los reflejos pupilar, ciliar, patelar y cutaneo-plantar se correlacionaron con el nivel de consciencia. Los grupos no difirieron cuanto a la prevalencia de hipertonia muscular, hiperreflexia bicipital, clonus plantar y respuesta extensora cutaneo-plantar. Hiperreflexia patelar fue mas frecuente en el grupo del enflurano de que en el grupo del isoflurano. Calofríos fueron mas frecuentes en los grupos E e I de que en el grupo del sevoflurano. La temperatura timpánica no difirió entre los pacientes que presentaron o no calofríos. CONCLUSIONES: Alteraciones reversibles del examen neurológico pueden estar presentes por hasta 40 minutos durante la recuperación de la anestesia con enflurano, isoflurano o sevoflurano.BACKGROUND AND OBJECTIVES: Transient neurological findings are seen during emergence from halothane, enflurane, and isoflurane anesthesia. Little is known about neurological changes during recovery from sevoflurane anesthesia. This study was aimed at comparing the incidence of such findings during recovery from enflurane (Group E, isoflurane (Group I and sevoflurane (Group S anesthesia. METHODS: Forty four patients were assigned to receive enflurane, isoflurane or sevoflurane anesthesia in 50% N2O. Evaluated parameters were: tympanic temperature, consciousness level, muscle tone, pupillary, eyelash, bicipital, patellar and plantar reflexes and shivering, which were recorded before

  1. Teleneurology applications: Report of the Telemedicine Work Group of the American Academy of Neurology.

    Science.gov (United States)

    Wechsler, Lawrence R; Tsao, Jack W; Levine, Steven R; Swain-Eng, Rebecca J; Adams, Robert J; Demaerschalk, Bart M; Hess, David C; Moro, Elena; Schwamm, Lee H; Steffensen, Steve; Stern, Barney J; Zuckerman, Steven J; Bhattacharya, Pratik; Davis, Larry E; Yurkiewicz, Ilana R; Alphonso, Aimee L

    2013-02-12

    To review current literature on neurology telemedicine and to discuss its application to patient care, neurology practice, military medicine, and current federal policy. Review of practice models and published literature on primary studies of the efficacy of neurology telemedicine. Teleneurology is of greatest benefit to populations with restricted access to general and subspecialty neurologic care in rural areas, those with limited mobility, and those deployed by the military. Through the use of real-time audio-visual interaction, imaging, and store-and-forward systems, a greater proportion of neurologists are able to meet the demand for specialty care in underserved communities, decrease the response time for acute stroke assessment, and expand the collaboration between primary care physicians, neurologists, and other disciplines. The American Stroke Association has developed a defined policy on teleneurology, and the American Academy of Neurology and federal health care policy are beginning to follow suit. Teleneurology is an effective tool for the rapid evaluation of patients in remote locations requiring neurologic care. These underserved locations include geographically isolated rural areas as well as urban cores with insufficient available neurology specialists. With this technology, neurologists will be better able to meet the burgeoning demand for access to neurologic care in an era of declining availability. An increase in physician awareness and support at the federal and state level is necessary to facilitate expansion of telemedicine into further areas of neurology.

  2. The relationship between social determinants of health, and rehabilitation of neurological conditions: a systematic literature review.

    Science.gov (United States)

    Frier, Amanda; Barnett, Fiona; Devine, Sue

    2017-05-01

    This systematic literature review aims to explore the relationship between social determinants of health (SDH), and the rehabilitation of neurological conditions. In particular, the review will consider relationships between social determinants and peoples' attendance and sustained adherence to rehabilitation programs, and motivation regarding neurological rehabilitation. A systematic search of peer-reviewed literature from electronic databases; MEDLINE, Scopus, CINAHL and Informit health, was conducted. Papers published between 2004 and 2014 were considered. Eleven quantitative studies met the inclusion criteria. There was a lack of research addressing SDH and neurological rehabilitation simultaneously. Cardiac and cancer rehabilitation studies reported employment and income, social support, transport, housing and food security as the most frequent SDH factors influencing attendance, sustained adherence and motivation. Given this association, a similar relationship between neurological rehabilitation and SDH is plausible. Rehabilitation of neurological conditions can be a long and difficult process. To pursue optimal outcomes, an individual's social circumstances should be considered. Understanding how SDH interact with neurological rehabilitation may enhance service delivery, thus maximizing the possible rehabilitation outcomes for individuals. Future research that considers SDH and rehabilitation of neurological conditions jointly may benefit service providers and those requiring neurological rehabilitation. Implications for Rehabilitation Social determinants of health are important to consider in the rehabilitation of neurological conditions. Understanding the interplay between the social determinants of health and neurological rehabilitation may enhance the possible outcomes for those requiring rehabilitation. Increased awareness and capacity of health care professionals involved in neurological rehabilitation may hasten momentum towards decreased health

  3. Diverse Neurological Manifestations of Lead Encephalopathy ...

    African Journals Online (AJOL)

    Three patients with lead encephalopathy due to industrial poisoning are presented. They all showed a wide spectrum of neurological manifestations, which mimic other neurological presentations. It is emphasised that lead poisoning still occurs in industry, despite efforts at prevention. S. Afr. Med. J., 48, 1721 (1974) ...

  4. [Neurological syndromes associated with homocystein dismetabolism].

    Science.gov (United States)

    Shirokov, E A; Leonova, S F

    2006-01-01

    The article summarizes the results of clinical, neurological, and laboratory examination of patients with hyperhomocysteinemia. The data obtained suggest the existence of common pathobiochemical mechanisms of homocystein, cholesterol, and myelin dysmetabolism. The authors demonstrate that neurological manifestations of hyperhomocysteinemia are associated with the processes of demyelinization in the central and peripheral nervous systems.

  5. Neurological status in severely jaundiced Zimbabwean neonates

    NARCIS (Netherlands)

    Wolf, M. J.; Beunen, G.; Casaer, P.; Wolf, B.

    1998-01-01

    Neurological status was studied in 50 jaundiced infants with a total serum bilirubin of > 400 mumol/l (23.4 mg/dl). Infants were assessed in the neonatal period with the Neonatal Neurological Examination and 4 months of age with the Infant Motor Screen. Twenty-six (52 per cent) infants were

  6. Neurological complications following adult lung transplantation

    NARCIS (Netherlands)

    Mateen, F. J.; Dierkhising, R. A.; Rabinstein, A. A.; van de Beek, D.; Wijdicks, E. F. M.

    2010-01-01

    The full spectrum of neurologic complications and their impact on survival in lung recipients has not been reported. A retrospective cohort review of the Mayo Clinic Lung Transplant Registry (1988-2008) was performed to determine the range of neurologic complications in a cohort of adult lung

  7. Breastfeeding and neurological outcome at 42 months

    NARCIS (Netherlands)

    Patandin, S; Weisglas-Kuperus, N; Touwen, BCL; Boersma, ER

    1998-01-01

    This study investigated the effect of early feeding mode on the neurological condition at 42 months. For this purpose, healthy pregnant women were recruited in Groningen and Rotterdam, The Netherlands. Children were healthy and born at term. At 42 months, the children were neurologically examined by

  8. THE NEUROLOGICAL FACE OF CELIAC DISEASE

    Directory of Open Access Journals (Sweden)

    Sedat IŞIKAY

    2015-09-01

    Full Text Available BackgroundSeveral neurological disorders have also been widely described in celiac disease patients.ObjectiveThe aim of this study was to determine the incidence of accompanying different neurologic manifestations in children with celiac disease at the time of diagnosis and to discuss these manifestations in the light of the recent literature.MethodsThis prospective cross sectional study included 297 children diagnosed with celiac disease. The medical records of all patients were reviewed.ResultsIn neurological evaluation, totally 40 (13. 5% of the 297 celiac patients had a neurological finding including headache, epilepsy, migraine, mental retardation, breath holding spells, ataxia, cerebral palsy, attention deficit hyperactivity disorder, Down syndrome and Turner syndrome in order of frequency. There was not any significant difference between the laboratory data of the patients with and without neurological manifestations. However; type 3a biopsy was statistically significantly more common among patients without neurological manifestations, while type 3b biopsy was statistically significantly more common among patients with neurological manifestations.ConclusionIt is important to keep in mind that in clinical course of celiac disease different neurological manifestations may be reported.

  9. Management of male neurologic patients with infertility

    DEFF Research Database (Denmark)

    Fode, Mikkel; Sønksen, Jens

    2015-01-01

    Many aspects of fertility rely on intact neurologic function and thus neurologic diseases can result in infertility. While research into general female fertility and alterations in male semen quality is limited, we have an abundance of knowledge regarding ejaculatory dysfunction following nerve...

  10. Residual neurologic sequelae after childhood cerebral malaria

    NARCIS (Netherlands)

    van Hensbroek, M. B.; Palmer, A.; Jaffar, S.; Schneider, G.; Kwiatkowski, D.

    1997-01-01

    Cerebral malaria is an important cause of pediatric hospital admissions in the tropics. It commonly leads to neurologic sequelae, but the risk factors for this remain unclear and the long-term outcome unknown. The purpose of this study was to identify the common forms of neurologic sequelae that

  11. Suspecting Neurological Dysfunction From E Mail Messages ...

    African Journals Online (AJOL)

    A non medical person suspected and confirmed neurological dysfunction in an individual, based only on e mail messages sent by the individual. With email communication becoming rampant “peculiar” email messages may raise the suspicion of neurological dysfunction. Organic pathology explaining the abnormal email ...

  12. Task analysis in neurosciences programme design - neurological ...

    African Journals Online (AJOL)

    Defining educational objectives is the key to achieving the goal of professional competence in students. The technique of task analysis was selected to determine components of competence in clinical neurology appropriate to the needs of primary care. A survey of neurological problems in general practice revealed that ...

  13. Diagnostic Exercise: Neurologic Disorder in a Cat

    Science.gov (United States)

    1989-12-21

    IWORK UNIT ELEMENT NO. NO. NO. ACCESSION NO. 11. TITLE (Include Security Classification) Diagnostic Exercise - Neurologic Disorder in a Cat 12...and identify by block number) This report documents the fifth reported occurrance of cerebral phaeophyphomycosis in cats . Because mycotic...Exercise: Neurologic Disorder in a Cat Ronald C. Bell United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick

  14. THE NEUROLOGICAL FACE OF CELIAC DISEASE.

    Science.gov (United States)

    Işikay, Sedat; Kocamaz, Halil

    2015-01-01

    Several neurological disorders have also been widely described in celiac disease patients. The aim of this study was to determine the incidence of accompanying different neurologic manifestations in children with celiac disease at the time of diagnosis and to discuss these manifestations in the light of the recent literature. This prospective cross sectional study included 297 children diagnosed with celiac disease. The medical records of all patients were reviewed. In neurological evaluation, totally 40 (13. 5%) of the 297 celiac patients had a neurological finding including headache, epilepsy, migraine, mental retardation, breath holding spells, ataxia, cerebral palsy, attention deficit hyperactivity disorder, Down syndrome and Turner syndrome in order of frequency. There was not any significant difference between the laboratory data of the patients with and without neurological manifestations. However; type 3a biopsy was statistically significantly more common among patients without neurological manifestations, while type 3b biopsy was statistically significantly more common among patients with neurological manifestations. It is important to keep in mind that in clinical course of celiac disease different neurological manifestations may be reported.

  15. Gluten sensitivity and neurological manifestations

    Directory of Open Access Journals (Sweden)

    Agostino Berio

    2015-12-01

    Full Text Available The authors report on six cases of gluten-sensitivity, also defined non-celiac gluten sensitivity, characterized by abdominal features (diarrhea, bloating, pain, genetic positivity for predisposition to celiac disease (DQB1* 02 in all cases; DQA1*05 in three; DQA1*02 in two, DQB1*03 in two, negative anti-t-Transglutaminase antibodies, normal mucosa on biopsy in four cases, type 1 of Marsh in one case. The subjects presented frequent central nervous system (CNS symptoms: headache in three patients, somnolence in one, electroencephalogram aspecific alterations in three (in two of them with previous seizures, leptomeningeal cyst in one, intracranial calcification in one, cerebral gliosis in two. After a gluten-free diet, all intestinal and clinical CNS features remitted, but re-appeared after gluten reintroduction. On the basis of the neurological signs, the authors stress the relevance of immune innate system in the pathogenesis of these cases with possible subsequent evolution on immune adaptive system involvement.

  16. Emergency procedures

    International Nuclear Information System (INIS)

    Abd Nasir Ibrahim; Azali Muhammad; Ab Razak Hamzah; Abd Aziz Mohamed; Mohammad Pauzi Ismail

    2004-01-01

    The following subjects are discussed - Emergency Procedures: emergency equipment, emergency procedures; emergency procedure involving X-Ray equipment; emergency procedure involving radioactive sources

  17. ESPEN guideline clinical nutrition in neurology.

    Science.gov (United States)

    Burgos, Rosa; Bretón, Irene; Cereda, Emanuele; Desport, Jean Claude; Dziewas, Rainer; Genton, Laurence; Gomes, Filomena; Jésus, Pierre; Leischker, Andreas; Muscaritoli, Maurizio; Poulia, Kalliopi-Anna; Preiser, Jean Charles; Van der Marck, Marjolein; Wirth, Rainer; Singer, Pierre; Bischoff, Stephan C

    2018-02-01

    Neurological diseases are frequently associated with swallowing disorders and malnutrition. Moreover, patients with neurological diseases are at increased risk of micronutrient deficiency and dehydration. On the other hand, nutritional factors may be involved in the pathogenesis of neurological diseases. Multiple causes for the development of malnutrition in patients with neurological diseases are known including oropharyngeal dysphagia, impaired consciousness, perception deficits, cognitive dysfunction, and increased needs. The present evidence- and consensus-based guideline addresses clinical questions on best medical nutrition therapy in patients with neurological diseases. Among them, management of oropharyngeal dysphagia plays a pivotal role. The guideline has been written by a multidisciplinary team and offers 88 recommendations for use in clinical practice for amyotrophic lateral sclerosis, Parkinson's disease, stroke and multiple sclerosis. Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  18. Neurology objective structured clinical examination reliability using generalizability theory.

    Science.gov (United States)

    Blood, Angela D; Park, Yoon Soo; Lukas, Rimas V; Brorson, James R

    2015-11-03

    This study examines factors affecting reliability, or consistency of assessment scores, from an objective structured clinical examination (OSCE) in neurology through generalizability theory (G theory). Data include assessments from a multistation OSCE taken by 194 medical students at the completion of a neurology clerkship. Facets evaluated in this study include cases, domains, and items. Domains refer to areas of skill (or constructs) that the OSCE measures. G theory is used to estimate variance components associated with each facet, derive reliability, and project the number of cases required to obtain a reliable (consistent, precise) score. Reliability using G theory is moderate (Φ coefficient = 0.61, G coefficient = 0.64). Performance is similar across cases but differs by the particular domain, such that the majority of variance is attributed to the domain. Projections in reliability estimates reveal that students need to participate in 3 OSCE cases in order to increase reliability beyond the 0.70 threshold. This novel use of G theory in evaluating an OSCE in neurology provides meaningful measurement characteristics of the assessment. Differing from prior work in other medical specialties, the cases students were randomly assigned did not influence their OSCE score; rather, scores varied in expected fashion by domain assessed. © 2015 American Academy of Neurology.

  19. Biomarker discovery in neurological diseases: a metabolomic approach

    Directory of Open Access Journals (Sweden)

    Afaf El-Ansary

    2009-12-01

    Full Text Available Afaf El-Ansary, Nouf Al-Afaleg, Yousra Al-YafaeeBiochemistry Department, Science College, King Saud University, Riyadh, Saudi ArabiaAbstract: Biomarkers are pharmacological and physiological measurements or specific biochemicals in the body that have a particular molecular feature that makes them useful for measuring the progress of disease or the effects of treatment. Due to the complexity of neurological disorders, it is very difficult to have perfect markers. Brain diseases require plenty of markers to reflect the metabolic impairment of different brain cells. The recent introduction of the metabolomic approach helps the study of neurological diseases based on profiling a multitude of biochemical components related to brain metabolism. This review is a trial to elucidate the possibility to use this approach to identify plasma metabolic markers related to neurological disorders. Previous trials using different metabolomic analyses including nuclear magnetic resonance spectroscopy, gas chromatography combined with mass spectrometry, liquid chromatography combined with mass spectrometry, and capillary electrophoresis will be traced.Keywords: metabolic biomarkers, neurological disorders. metabolome, nuclear magnetic resonance, mass spectrometry, chromatography

  20. What is the Future of Pediatric Neurology in Canada? Resident and Faculty Perceptions of Training and Workforce Issues.

    Science.gov (United States)

    Doja, Asif; Clarkin, Chantalle; Whiting, Sharon; Moharir, Mahendranath

    2016-07-01

    Pediatric neurology trainee numbers have grown considerably in Canada; recent research, however, has shown that the number of pediatric neurology graduates is outpacing the need for future pediatric neurologists. The purpose of this study was to seek the opinion of pediatric neurology program directors and trainees regarding possible solutions for this issue. Two focus groups were convened during the Canadian Neurological Sciences Federation annual congress in June 2012; one consisted of current and former program directors, and the other of current pediatric neurology trainees. Groups were asked for their perceptions regarding child neurology manpower issues in Canada as well as possible solutions. Focus groups were audio-recorded and transcribed for analysis. Theme-based qualitative analysis was used to analyze the transcripts. Major themes emerging from both focus groups included the emphasis on community pediatric neurology as a viable option for trainees, including the need for community mentors; recognizing the needs of underserviced areas; and establishing academic positions for community preceptors. The need for career mentoring and support structures during residency training was another major theme which arose. Program directors and trainees also gave examples of ways to reduce the current oversupply of trainees in Canada, including limiting the number of trainees entering programs, as well as creating a long-term vision of child neurology in Canada. A nationwide dialogue to discuss the supply and demand of manpower in academic and community pediatric neurology is essential. Career guidance options for pediatric neurology trainees across the country merit further strengthening.

  1. Detection of neurological deficits by computed tomography in sacral fracture patients

    International Nuclear Information System (INIS)

    Nakai, Daisuke; Numazaki, Shin; Katsumura, Tetsu; Tamaru, Tomohiko; Sugiyama, Mitsugi; Nakamura, Jun-ichiro; Saitoh, Tomoyuki

    2006-01-01

    The purpose of this study is to evaluate the correlation between sacral fractures and neurological deficits as complications. From November 2002 to February 2005, 12 patients (15 fractures) were found to have sacral fractures without other spinal injuries or brain injuries and were evaluated by plain CT scans immediately after trauma. This group included 6 males and 6 females, whose age ranged from 17 to 67 years with mean of 39.9±17.4. All patients were classified according to AO (Arbeitsgemeinschaft fuer Osteosynthesefragen) classification (pelvic ring fracture) and Denis's classification. Displacements of sacral fractures were evaluated by plain CT scans for all patients. We defined displacements using the key slice in CT scans that included the first foramen in the sacrum. Five cases, including 2 with bi-lateral sacral fractures, were complicated with neurological deficits. There was one case with a neurological deficit of 7 Type B fractures (14%) and 4 cases with neurological deficits of 5 Type C fractures (80%) in the AO classification. There were 6 fractures with neurological deficits of 12 Zone II fractures (50%) and one fracture with neurological deficits of one Zone III fractures (100%) in Denis's classification. There was a significant correlation between the extent in the displacement of the sacral fractures and neurological deficits. For more than 3 mm displacements in the medial or lateral or anterior directions, neurological deficits increased significantly. In emergency medicine, it is difficult to evaluate the neurological findings of patients with impaired consciousness. Our evaluation using CT scan is valuable as a predictor of neurological deficits and for an optimal reduction in sacral fractures in patients with in impaired consciousness. (author)

  2. Anorectal emergencies

    Science.gov (United States)

    Lohsiriwat, Varut

    2016-01-01

    Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis (Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. The last part of this review dedicates to the management of early complications following common anorectal procedures that may present as an emergency including acute urinary retention, bleeding, fecal impaction and anorectal sepsis. Although many of anorectal disorders presenting in an emergency setting are not life-threatening and may be successfully treated in an outpatient clinic, an accurate diagnosis and proper management remains a challenging problem for clinicians. A detailed history taking and a careful physical examination, including digital rectal examination and anoscopy, is essential for correct diagnosis and plan of treatment. In some cases, some imaging examinations, such as endoanal ultrasonography and computerized tomography scan of whole abdomen, are required. If in doubt, the attending physicians should not hesitate to consult an expert e.g., colorectal surgeon about the diagnosis, proper management and appropriate follow-up. PMID:27468181

  3. Does intervention using virtual reality improve upper limb function in children with neurological impairment: a systematic review of the evidence.

    Science.gov (United States)

    Galvin, Jane; McDonald, Rachael; Catroppa, Cathy; Anderson, Vicki

    2011-01-01

    Virtual reality (VR) is an emerging area of paediatric clinical and research practice, however the majority of research to date has focused on outcomes for adults following stroke. This paper appraises and describes current evidence for use of virtual reality interventions to improve upper limb function of children with neurological impairment. A comprehensive database search was undertaken to explore literature on the use of VR systems for rehabilitation of upper limb skills of children with neurological impairment. Studies investigating the use of robotics or other mechanical devices were excluded. Five studies were found and were critiqued using the Downs and Black scale for measuring study quality. One randomized control trial and four case studies were found. No study scored over 50% on the Downs and Black scale, indicating methodological limitations that limit generalizability. Current evidence for the use of VR to improve hand and arm skills is at an emerging stage. Small sample sizes and inconsistencies in outcome measurement limit the ability to generalize findings. Further studies are required to investigate the ability to maintain gains made in VR over time and to determine whether gains transfer from the VR to real life tasks and activities.

  4. [Neurological disease and facial recognition].

    Science.gov (United States)

    Kawamura, Mitsuru; Sugimoto, Azusa; Kobayakawa, Mutsutaka; Tsuruya, Natsuko

    2012-07-01

    To discuss the neurological basis of facial recognition, we present our case reports of impaired recognition and a review of previous literature. First, we present a case of infarction and discuss prosopagnosia, which has had a large impact on face recognition research. From a study of patient symptoms, we assume that prosopagnosia may be caused by unilateral right occipitotemporal lesion and right cerebral dominance of facial recognition. Further, circumscribed lesion and degenerative disease may also cause progressive prosopagnosia. Apperceptive prosopagnosia is observed in patients with posterior cortical atrophy (PCA), pathologically considered as Alzheimer's disease, and associative prosopagnosia in frontotemporal lobar degeneration (FTLD). Second, we discuss face recognition as part of communication. Patients with Parkinson disease show social cognitive impairments, such as difficulty in facial expression recognition and deficits in theory of mind as detected by the reading the mind in the eyes test. Pathological and functional imaging studies indicate that social cognitive impairment in Parkinson disease is possibly related to damages in the amygdalae and surrounding limbic system. The social cognitive deficits can be observed in the early stages of Parkinson disease, and even in the prodromal stage, for example, patients with rapid eye movement (REM) sleep behavior disorder (RBD) show impairment in facial expression recognition. Further, patients with myotonic dystrophy type 1 (DM 1), which is a multisystem disease that mainly affects the muscles, show social cognitive impairment similar to that of Parkinson disease. Our previous study showed that facial expression recognition impairment of DM 1 patients is associated with lesion in the amygdalae and insulae. Our study results indicate that behaviors and personality traits in DM 1 patients, which are revealed by social cognitive impairment, are attributable to dysfunction of the limbic system.

  5. Surgical treatment of neurologic complications of bacterial meningitis in children in Kosovo.

    Science.gov (United States)

    Namani, Sadie A; Koci, Remzie A; Kuchar, Ernest; Dedushi, Kreshnike H

    2012-04-01

    Neurologic complications of bacterial meningitis can occur any time during the course of the disease and some of them need neurosurgical aproach. to determine the incidence of neurologic complications of bacterial meningitis in children requring neurosurgical treatment. a total of 277 children were followed and treated for bacterial meningitis at the Clinic of Infectious Diseases in Prishtina. The authors have analyzed cases who developed acute neurologic complications and treatment procedures. of the 277 children treated for bacterial meningitis, due to the suspicion for neurologic complications, 109 children underwent a head computerized tomography scan. About 47 cases (43%) had evident structural abnormalities while only 15/277 cases (5%) required neurosurgical treatment; 9/38 cases with subdural collections, 5 cases with hydrocephalus and 1 case of spinal abscess. Neurosurgical intervention were not common in pediatric bacterial meningitis cases (5%) but were highly significant in cases complicated with acute neurologic complications (32%).

  6. Opinion and Special Articles: Amateur fundus photography with various new devices: Our experience as neurology residents.

    Science.gov (United States)

    Zafar, Saman; Cardenas, Ylec Mariana; Leishangthem, Lakshmi; Yaddanapudi, Sridhara

    2018-05-08

    Times are changing in the way we secure and share patient fundus photographs to enhance our diagnostic skills in neurology. At the recent American Academy of Neurology meeting, the use of a fundus camera and smartphones to secure good-quality fundus photographs of patients presenting with headache to the emergency department (ED) was presented. We were enthusiastic to replicate the success of the Fundus Photography vs Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) study in our neurology department, but encountered problems in terms of cost, setup, feasibility, and portability of the device. As neurology residents, we came up with 3 easier options. We present these 3 options as our personal experience, and hope to reignite enthusiasm among neurology trainees to find their own means of performing ophthalmoscopy routinely in the hospital, as it appears that the Internet market is now thriving with many other devices to make this examination easier and more rewarding. Of the options explored above, the Handheld Fundus Camera was a clear favorite among the residents, and we have placed one in our call room for routine use. It travels to the clinic, floor, intensive care unit, and ED when needed. It has enhanced the way we approach the fundus examination and been a fun skill to acquire. We look forward to further advances that will make it possible to carry such a device in a physician's pocket. © 2018 American Academy of Neurology.

  7. The Madrid School of Neurology (1885-1939).

    Science.gov (United States)

    Giménez-Roldán, S

    2015-01-01

    The emergence of neurology in Madrid between 1885 and 1939 had well-defined characteristics. On foundations laid by Cajal and Río-Hortega, pioneers combined clinical practice with cutting-edge neurohistology and neuropathology research. Luis Simarro, trained in Paris, taught many talented students including Gayarre, Achúcarro and Lafora. The untimely death of Nicolás Achúcarro curtailed his promising career, but he still completed the clinicopathological study of the first American case of Alzheimer's disease. On returning to Spain, he studied glial cells, including rod cells. Rodríguez Lafora described progressive myoclonus epilepsy and completed experimental studies of corpus callosum lesions and clinical and neuropathology studies of senile dementia. He fled to Mexico at the end of the Spanish Civil War (1936-1939). Sanchís Banús, a sterling clinical neurologist, described the first cluster of Huntington's disease in Spain, and he and Río-Hortega joined efforts to determine that pallidal degeneration underlies rigidity in advanced stages of the disease. Just after the war, Alberca Llorente eruditely described inflammatory diseases of the neuraxis. Manuel Peraita studied "the neurology of hunger" with data collected during the siege of Madrid. Dionisio Nieto, like many exiled intellectuals, settled in Mexico DF, where he taught neurohistological methods and neuropsychiatry in the tradition of the Madrid School of Neurology. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  8. The neurological legacy of John Russell Reynolds (1828-1896).

    Science.gov (United States)

    Eadie, M J

    2007-04-01

    Sir John Russell Reynolds was an eminent and highly influential physician in the Victorian era who held the Presidencies of the Royal College of Physicians of London, and of the British Medical Association. He was the protégée of the great experimental physiologist, Marshall Hall, who discovered the reflex arc, and succeeded to Hall's clinical practice in London. Reynolds' thought and clinical activities linked the emerging British neurology of the first half of the 19th century with its blossoming, particularly in London, from 1860 onwards. In his writings Reynolds was the first English author to apply the approach to classification of neurological disorders that is still often used, though now in modified form. He was also the first to enunciate the notion of positive and negative symptoms arising from neurological disease and to suggest their pathogenesis, and was arguably the originator of the influential concept that an idiopathic disease, epilepsy, existed, one to be distinguished from 'epileptiform' seizures due to brain pathology.

  9. Chapter 44: history of neurology in Italy.

    Science.gov (United States)

    Bentivoglio, Marina; Mazzarello, Paolo

    2010-01-01

    The chapter starts from the Renaissance (although the origins of Italian neurology can be traced back to the Middle Ages), when treatises of nervous system physiopathology still followed Hippocratic and Galenic "humoral" theories. In Italy, as elsewhere in Europe, the concepts of humoral pathology were abandoned in the 18th century, when neurology was influenced by novel trends. Neurology acquired the status of clinical discipline (as "clinic of mental diseases") after national reunification (declared in 1861 but completed much later). At the end of the 19th and first decades of the 20th century, eminent Italian "neuropsychiatrists" (including, among many others, Ugo Cerletti, who introduced electroconvulsive shock therapy in 1938) stimulated novel knowledge and approaches, "centers of excellence" flourished, and "Neurological Institutes" were founded. In the first half of the 20th century, the history of Italian neurology was dominated by World Wars I and II (which stimulated studies on the wounded) and the fascist regime in-between the Wars (when the flow of information was instead very limited). Italy became a republic in 1946, and modern neurology and its distinction from psychiatry were finally promoted. The chapter also provides detailed accounts of scientific societies and journals dedicated to the neurological sciences in Italy.

  10. E-learning in neurology education: Principles, opportunities and challenges in combating neurophobia.

    Science.gov (United States)

    Chhetri, Suresh Kumar

    2017-10-01

    Neurophobia, the fear of clinical neurology, affects not only medical students but also non-career neurologists globally. This can have significant implications on patient care, especially given the increasing burden of chronic neurological disorders. The negative perception and lack of confidence amongst general practitioners and hospital physicians may lead to increased referrals to neurology, thereby increasing waiting times and inpatient stay. The onus, therefore, should be on improving training and stimulating interest in neurology. There is emerging evidence that integrating e-learning to traditional pedagogies can improve delivery of neurology education and help combat neurophobia. However, embracing e-learning may be challenging for contemporary neurologists, mostly 'digital immigrants', involved in the training of tomorrow's doctors who are largely 'digital natives'. This paper reviews the principles, opportunities and challenges of incorporating e-learning in neurology education to help improve learners' perception of clinical neurology, facilitate delivery of self-directed experiential learning and perhaps breed 'neurophilia'. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Neurologic signs and symptoms in fibromyalgia.

    Science.gov (United States)

    Watson, Nathaniel F; Buchwald, Dedra; Goldberg, Jack; Noonan, Carolyn; Ellenbogen, Richard G

    2009-09-01

    To determine the type and frequency of neurologic signs and symptoms in individuals with fibromyalgia (FM). Persons with FM (n = 166) and pain-free controls (n = 66) underwent systematic neurologic examination by a neurologist blinded to disease status. Neurologic symptoms lasting at least 3 months were assessed with a standard questionnaire. We used logistic regression to evaluate the association of neurologic symptoms and examination findings with FM status. Within the FM group we examined the correlation between self-reported symptoms and physical examination findings. Age- and sex-adjusted estimates revealed that compared with the control group, the FM group had significantly more neurologic abnormalities in multiple categories, including greater dysfunction in cranial nerves IX and X (42% versus 8%) and more sensory (65% versus 25%), motor (33% versus 3%), and gait (28% versus 7%) abnormalities. Similarly, the FM group had significantly more neurologic symptoms than the control group in 27 of 29 categories, with the greatest differences observed for photophobia (70% versus 6%), poor balance (63% versus 4%), and weakness (58% versus 2%) and tingling (54% versus 4%) in the arms or legs. Poor balance or coordination, tingling or weakness in the arms or legs, and numbness in any part of the body correlated with appropriate neurologic examination findings in the FM group. This blinded, controlled study demonstrated neurologic physical examination findings in persons with FM. The FM group had more neurologic symptoms than did the controls, with moderate correlation between symptoms and signs. These findings have implications for the medical evaluation of patients with FM.

  12. Molecular imaging in neurology and neuroscience

    International Nuclear Information System (INIS)

    Schreckenberger, M.

    2007-01-01

    Molecular imaging in neurology and neuroscience is a suspenseful and fast developing tool in order to quantitatively image genomics and proteomics by means of direct and indirect markers. Because of its high-sensitive tracer principle, nuclear medicine imaging has the pioneering task for the methodical progression of molecular imaging. The current development of molecular imaging in neurology changes from the use of indirect markers of gene and protein expression to the direct imaging of the molecular mechanisms. It is the aim of this article to give a short review on the status quo of molecular imaging in neurology with emphasis on clinically relevant aspects. (orig.)

  13. Neurological aspects of acute radiation injuries

    International Nuclear Information System (INIS)

    Torubarov, F.S.; Bushmanov, A.Yu.

    1999-01-01

    Results of the most important clinical studies of human nervous system reactions to acute radiation, carried out at Neurology Clinic of the State Research Center of Russia - Institute of Biophysics are presented. Clinical picture of changes in the nervous system in acute radiation disease caused by homologous and heterologous external irradiation is described. Main neurological syndrome of extremely severe acute radiation disease: acute radiation encephalopathy, radiation toxic encephalopathy, and hemorrhagic syndrome of the central nervous system is distinguished. Relationship between neurological disorders and the geometry of exposure are considered [ru

  14. Digital Footprint of Neurological Surgeons.

    Science.gov (United States)

    Kim, Christopher; Gupta, Raghav; Shah, Aakash; Madill, Evan; Prabhu, Arpan V; Agarwal, Nitin

    2018-05-01

    Patients are increasingly turning to online resources to inquire about individual physicians and to gather health information. However, little research exists studying the online presence of neurosurgeons across the country. This study aimed to characterize these online profiles and assess the scope of neurosurgeons' digital identities. Medicare-participating neurologic surgeons from the United States and Puerto Rico were identified using the Centers for Medicare and Medicaid Services (CMS) Physician Comparable Downloadable File. Each physician was characterized by his or her medical education, graduation year, city of practice, gender, and affiliation with an academic institution. Using a Google-based custom search tool, the top 10 search results for each physician were extracted and categorized as 1 of the following: 1) physician, hospital, or healthcare system controlled, 2) third-party or government controlled, 3) social media-based, 4) primary journal article, or 5) other. Among the physicians within the CMS database, 4751 self-identified as being neurosurgeons, yielding a total of 45,875 uniform resource locator search results pertinent to these physicians. Of the 4751 neurosurgeons, 2317 (48.8%) and 2434 (51.2%) were classified as academic and nonacademic neurosurgeons, respectively. At least 1 search result was obtained for every physician. Hospital, healthcare system, or physician-controlled websites (18,206; 39.7%) and third-party websites (17,122; 37.3%) were the 2 most commonly observed domain types. Websites belonging to social media platforms accounted for 4843 (10.6%) search results, and websites belonging to peer-reviewed academic journals accounted for 1888 (4.1%) search results. The frequency with which a third-party domain appeared as the first search result was higher for nonacademic neurosurgeons than for academic neurosurgeons. In general, neurosurgeons lacked a controllable online presence within their first page of Google Search results

  15. Neurologic deficit after resection of the sacrum.

    Science.gov (United States)

    Biagini, R; Ruggieri, P; Mercuri, M; Capanna, R; Briccoli, A; Perin, S; Orsini, U; Demitri, S; Arlecchini, S

    1997-01-01

    The authors describe neurologic deficit (sensory, motor, and sphincteral) resulting from sacrifice of the sacral nerve roots removed during resection of the sacrum. The anatomical and functional bases of sphincteral continence and the amount of neurologic deficit are discussed based on level of sacral resection. A large review of the literature on the subject is reported and discussed. The authors emphasize how the neurophysiological bases of sphincteral continence (rectum and bladder) and of sexual ability are still not well known, and how the literature reveals disagreement on the subject. A score system is proposed to evaluate neurologic deficit. The clinical model of neurologic deficit caused by resection of the sacrum may be extended to an evaluation of post-traumatic deficit.

  16. African Journal of Neurological Sciences: Submissions

    African Journals Online (AJOL)

    African Journal of Neurological Sciences (AJNS) is owned and controlled by ... Decisions about acceptable or rejected manuscripts may take within 8 to 10 weeks. ... The abstract must be clear, precise and concise (no more than 250 words) ...

  17. LEARNERS SATISFACTION FACTORS IN NEUROLOGY RELATED MOOCs

    Directory of Open Access Journals (Sweden)

    Ionela MANIU

    2017-12-01

    Full Text Available The aim of this article is to investigate the factors that are influencing student satisfaction in case of neurology related massive open online courses (MOOCs. We analyzed data collected from learners enrolled in 40 neurology related MOOCs, by manually looking for information in these courses reviews. The main identified satisfaction factors can be grouped into the following categories: content related factors: course content, additional materials, assignments, external research and teaching - learning related factors (teacher presentation techniques / style: engaging, clear, coherent, knowledgeable, sharing / explanation, interactive, excitement, considering student’s needs, inspiring, sense of humor. Competences, skills and objectives pursued by neurology related MOOCs are also discussed. Analyzing these factors can be useful in new courses management (design and implementation and also in understanding the needs (motivation, behaviors, perception of 21st century learners interested in neurology related fields.

  18. Neurological Complications Of Chronic Myeloid Leukaemia: Any ...

    African Journals Online (AJOL)

    , of the neurological deficits complicating chronic myeloid leukaemia. Method: Using patients\\' case folders and haematological malignancy register all cases of chronic myeloid leukaemia seen in Jos University Teaching Hospital between July ...

  19. Editorial | Dechambenoit | African Journal of Neurological Sciences

    African Journals Online (AJOL)

    African Journal of Neurological Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 34, No 2 (2015) >. Log in or Register to get access to full text downloads.

  20. Neurological findings in triosephosphate isomerase deficiency

    NARCIS (Netherlands)

    Poll-The, B. T.; Aicardi, J.; Girot, R.; Rosa, R.

    1985-01-01

    Two siblings with hemolytic anemia caused by triosephosphate isomerase deficiency developed a progressive neurological syndrome featuring dystonic movements, tremor, pyramidal tract signs, and evidence of spinal motor neuron involvement. Intelligence was unaffected. The findings in these patients

  1. Neurologic and neuromuscular functional disorders of the pharynx and esophagus

    International Nuclear Information System (INIS)

    Wuttge-Hannig, A.; Hannig, C.

    2007-01-01

    Neurologic swallowing disorders are an increasing diagnostic problem in our overaged population. Undiagnosed chronic aspiration pneumonia is the cause of death in 20-40% of all inhabitants of nursing homes. In neurologic diseases of the pharynx, the physiologic interaction of pharyngeal contraction, closure of the pharynx, and esophageal motility are frequently disturbed. This may be due to cortical, bulbar, or cerebellar brain damage of ischemic or traumatic origin. Furthermore diseases or peripheral nerves, muscles, and synapses cause disturbances. The most life-threatening complication of these disturbances is tracheal aspiration, which requires an iso-osmolar contrast medium for imaging studies that cause no or minimal pulmonary problems. Utilizing fast dynamic documentation we can analyze the swallowing act in 35 images within the passage time of 0.7 s. This requires digital frame sequences from 15-50 images/s, which can be provided by DSI or videofluoroscopy. Neurologic and neuromuscular patterns are demonstrated with and without tracheal aspiration. The differentiation of aspiration in a so-called pre-, intra-, and postdeglutitive form is possible. We distinguish four grades of severity of aspiration, which is also of great clinical impact for the differential rehabilitation therapy. The efficiency of the rehabilitation protocol can be assessed by the dynamic swallowing studies. (orig.) [de

  2. Functional MRT in psychiatry and neurology

    International Nuclear Information System (INIS)

    Schneider, F.; Fink, G.R.

    2007-01-01

    Almost no other method has reach such an interest as the functional imaging in psychiatric and neurological science; it is fascinating to observe the brain at work. The fundamentals of functional magnetic resonance tomography (fMRT) and the interpretation of MRT images are explained; the state-of-the-art is discussed. The book is focussed on the functional imaging within psychiatry and neurology. The book contains 45 contributions within the following chapters: fundamentals, higher brain accomplishments, disease pattern, examinatory examples, perspectives

  3. Psychiatric and neurologic aspects of war: an overview and perspective.

    Science.gov (United States)

    Difede, JoAnn; Barchas, Jack D

    2010-10-01

    The growing number of soldiers returning home with psychiatric and neurologic disorders, notably posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI), underscores the need for an interdisciplinary framework for understanding the emergent consequences of combat. Among the challenges facing the scientific community is the development of effective treatment strategies for TBI from blast and other injuries, given the confounding effects of comorbid psychological symptoms on accurate diagnoses. At the individual level, emerging technologies-including virtual reality, the use of genetic biomarkers to inform treatment response, and new brain imaging methodology-are playing an important role in the development of differential therapeutics to best address a soldier's particular clinical needs. At the macro level, new approaches toward understanding the political, cultural, and ideological contexts of mass conflict, the decision to join in violence, and ways of preventing genocide are discussed. © 2010 Association for Research in Nervous and Mental Disease.

  4. Emergency radiology

    International Nuclear Information System (INIS)

    Keats, T.E.

    1986-01-01

    This book is the German, translated version of the original published in 1984 in the U.S.A., entitled 'Emergency Radiology'. The publication for the most part is made up as an atlas of the radiological images presenting the findings required for assessment of the emergency cases and their first treatment. The test parts' function is to explain the images and give the necessary information. The material is arranged in seven sections dealing with the skull, the facial part of the skull, the spine, thorax, abdominal region, the pelvis and the hip, and the limbs. With 690 figs [de

  5. Neurological Disorders in Adult Celiac Disease

    Directory of Open Access Journals (Sweden)

    Hugh J Freeman

    2008-01-01

    Full Text Available Celiac disease may initially present as a neurological disorder. Alternatively, celiac disease may be complicated by neurological changes. With impaired nutrient absorption, different deficiency syndromes may occur and these may be manifested clinically with neurological changes. However, in patients with deficiency syndromes, extensive involvement of the small intestine with celiac disease is often evident. There are a number of reports of celiac disease associated with neuropathy, ataxia, dementia and seizure disorder. In these reports, there is no clear relationship with nutrient deficiency and a precise mechanism for the neurological changes has not been defined. A small number of patients have been reported to have responded to vitamin E administration, but most do not. In some, gluten antibodies have also been described, especially in those with ataxia, but a consistent response to a gluten-free diet has not been defined. Screening for celiac disease should be considered in patients with unexplained neurological disorders, including ataxia and dementia. Further studies are needed, however, to determine if a gluten-free diet will lead to improvement in the associated neurological disorder.

  6. Neurological manifestations of dengue viral infection

    Directory of Open Access Journals (Sweden)

    Carod-Artal FJ

    2014-10-01

    Full Text Available Francisco Javier Carod-Artal1,21Neurology Department, Raigmore hospital, Inverness, UK; 2Universitat Internacional de Catalunya (UIC, Barcelona, Spain Abstract: Dengue is the most common mosquito-borne viral infection worldwide. There is increased evidence for dengue virus neurotropism, and neurological manifestations could make part of the clinical picture of dengue virus infection in at least 0.5%–7.4% of symptomatic cases. Neurological complications have been classified into dengue virus encephalopathy, dengue virus encephalitis, immune-mediated syndromes (acute disseminated encephalomyelitis, myelitis, Guillain–Barré syndrome, neuritis brachialis, acute cerebellitis, and others, neuromuscular complications (hypokalemic paralysis, transient benign muscle dysfunction and myositis, and dengue-associated stroke. Common neuro-ophthalmic complications are maculopathy and retinal vasculopathy. Pathogenic mechanisms include systemic complications and metabolic disturbances resulting in encephalopathy, direct effect of the virus provoking encephalitis, and postinfectious immune mechanisms causing immune-mediated syndromes. Dengue viruses should be considered as a cause of neurological disorders in endemic regions. Standardized case definitions for specific neurological complications are still needed. Keywords: encephalitis, encephalopathy, dengue fever, neurological complications

  7. Neurologic sequelae associated with foscarnet therapy.

    Science.gov (United States)

    Lor, E; Liu, Y Q

    1994-09-01

    To report three cases of possible foscarnet-induced neurologic sequelae. We report two cases of seizures and one case of hand cramping and finger paresthesia after starting foscarnet therapy with no evidence of predisposing risk factors, such as serum laboratory abnormalities, renal dysfunction, or known central nervous system (CNS) involvement. All three patients had stable laboratory values during therapy and when the neurologic adverse effects occurred. All patients were receiving appropriate dosages of foscarnet. The incidence of seizures in AIDS patients was reviewed. A history of CNS lesions, infections, and/or AIDS per se may increase the risk of a neurologic adverse effect while receiving foscarnet therapy. Acute ionized hypocalcemia may cause these neurologic adverse effects. Ionized hypocalcemia is transitory, is related to the rate of foscarnet infusion, and may not be reflected as a change in total serum calcium concentration. Foscarnet probably contributed to the neurologic adverse effects reported here. Foscarnet may need to be administered at a slower rate than is recommended by the manufacturer. Electrolytes must be monitored closely; however, a neurologic adverse effect may not be foreseen.

  8. Chapter 50: history of tropical neurology.

    Science.gov (United States)

    Ogunniyi, Adesola

    2010-01-01

    Tropical neurology began less than two centuries ago. Consumption of dietary toxins predominated at the beginning and gave birth to the geographic entity. The story moved from lathyrism through Jamaican neuropathy to cassava-induced epidemic neuropathy, which was contrasted with Konzo, also associated with cassava. Other tropical diseases enumerated with chronological details include: Chaga's diseases, kwashiorkor, Madras type of motor neuron disease, atlanto-axial dislocation, Burkitt's lymphoma and Kuru, associated with cannibalism among the Fore linguistic group in New Guinea. More recent documentation includes the Cuban neuropathy in 1991 with an epidemic of visual loss and neuropathy, Anaphe venata entomophagy in Nigeria presenting as seasonal ataxia, and neurological aspects of the human immunodeficiency virus infection complete the picture. With time, professional associations were formed and the pioneers were given prominence. The World Federation of Neurology featured Geographic Neurology as a theme in 1977 and Tropical Neurology was given prominence at its 1989 meeting in New Delhi, India. The situation remains unchanged with regards to rare diseases like Meniere's, multiple sclerosis, hereditary disorders. However, with westernization and continued urbanization, changing disease patterns are being observed and tropical neurology may depart from dietary toxins to more western world-type disorders.

  9. Clinical neurological examination vs electrophysiological studies: Reflections from experiences in occupational medicine

    DEFF Research Database (Denmark)

    Jepsen, Jørgen Riis

    2015-01-01

    a diagnosis requires the identification of the responsible pathology and the involved tissues and structures. Consequently, improved diagnostic approaches are needed. This editorial discusses the potentials of using the clinical neurologic examination in patients with upper limb complaints related to work....... It is argued that a simple but systematic physical approach permits the examiner to frequently identify patterns of neurological findings that suggest nerve afflictions and their locations, and that electrophysiological studies are less likely to identify pathology. A diagnostic algorithm for the physical...... assessment is provided to assist the clinician. Failure to include representative neurological items in the physical examination may result in patients being misinterpreted, misdiagnosed and mistreated....

  10. The emergency Management Alternative Center (EMAC). Requirements and general considerations; Centro Alternativo de Gestion de la Emergencia (CAGE). Requisitos y consideraciones generales

    Energy Technology Data Exchange (ETDEWEB)

    Turrion, F.; Barrio, M. A. del; Cobos, A.

    2014-10-01

    The Emergency Management Alternative Center (EMAC) will give support to the emergency Organization Response on site, combining the continuity of the accident mitigation actions with the rest and the protection of personnel, adjusting these works to the conditions of the Power Plant and the evolution of the emergency. It must be operational in the Spanish NNPP by December 2015 and the design must be in accordance with the criteria by the Nuclear Safety Council. (Author)

  11. [Action proposals to Japanese Neurological Society from Fukushima Medical University: based on our three years' experiences].

    Science.gov (United States)

    Ugawa, Yoshikazu

    2013-01-01

    In this paper, I make several proposals of what Japanese Neurological Society is able to do or should do in preparing future disaster in Japan. I mention several points separately.Patient education: Patients usually try to visit their hospital as soon as possible for the safety, especially in Japan. Is it true? The traffic jams actually blocked this action in March 11, 2011, which made more serious problems in some patients. We should ask them to prepare matters necessary for staying at home at least for a week when no medical emergency is present.Disaster prevention training: We should make a list of hospitals which accept emergent patients at disaster. We should have some methods of communication still active at disaster (internet, satellite phone) and make society network for communication and patient transportation. How to transfer required drugs to patients is another issue we should consider.Name tag: We sometimes treated unidentified patients in the disaster because the name tag or reference papers was gone or not specified to a certain patient. It is due to great mechanical power of injury or rains. For not detached from the patient and waterproofed, I recommend writing the patient's name on the chest with a permanent marker used in the triathlon when transferring the patients to other hospitals or other places.

  12. Neurology in a globalizing world: World Congress of Neurology, Vienna, 2013.

    Science.gov (United States)

    Hachinski, Vladimir

    2013-06-11

    The World Congress of Neurology (figure 1) theme "Neurology in a Globalizing World" acknowledges that science and increasingly medicine and neurology are becoming globalized. The best way to manage change is to shape it. It is becoming increasingly clear that brain diseases, particularly stroke and dementia, are projected to rise at a rate that could overwhelm our clinics and hospitals. Hence a new emphasis on prevention and the need to work across disciplines beyond our traditional roles. Neurologists are the guardians of the brain and need to take the lead role in advancing new approaches in stemming the tide of neurologic diseases.

  13. Quality improvement in neurology: AAN Parkinson disease quality measures

    Science.gov (United States)

    Cheng, E.M.; Tonn, S.; Swain-Eng, R.; Factor, S.A.; Weiner, W.J.; Bever, C.T.

    2010-01-01

    Background: Measuring the quality of health care is a fundamental step toward improving health care and is increasingly used in pay-for-performance initiatives and maintenance of certification requirements. Measure development to date has focused on primary care and common conditions such as diabetes; thus, the number of measures that apply to neurologic care is limited. The American Academy of Neurology (AAN) identified the need for neurologists to develop measures of neurologic care and to establish a process to accomplish this. Objective: To adapt and test the feasibility of a process for independent development by the AAN of measures for neurologic conditions for national measurement programs. Methods: A process that has been used nationally for measure development was adapted for use by the AAN. Topics for measure development are chosen based upon national priorities, available evidence base from a systematic literature search, gaps in care, and the potential impact for quality improvement. A panel composed of subject matter and measure development methodology experts oversees the development of the measures. Recommendation statements and their corresponding level of evidence are reviewed and considered for development into draft candidate measures. The candidate measures are refined by the expert panel during a 30-day public comment period and by review by the American Medical Association for Current Procedural Terminology (CPT) II codes. All final AAN measures are approved by the AAN Board of Directors. Results: Parkinson disease (PD) was chosen for measure development. A review of the medical literature identified 258 relevant recommendation statements. A 28-member panel approved 10 quality measures for PD that included full specifications and CPT II codes. Conclusion: The AAN has adapted a measure development process that is suitable for national measurement programs and has demonstrated its capability to independently develop quality measures. GLOSSARY

  14. Neurology at Escola Paulista de Medicina (1933-1995). From Fausto Guerner to José Geraldo Camargo Lima.

    Science.gov (United States)

    Ferraz, Henrique Ballalai; Neves, Afonso Carlos

    2015-02-01

    Escola Paulista de Medicina (EPM) was founded in 1933 and the first Professor of Neurology was Fausto Guerner, who could not effectively assume the teaching activities due to his premature death in 1938. Professor Guerner had had his neurological training at Paris. Professor Longo was his successor. Longo was one of the founders of Arquivos de Neuro-Psiquiatria the foremost journal of neurosciences in Latin American. Longo died in 1967 and Professor Paulo Pupo succeeded him. Pupo introduced electroencephalography in Brazil. After his death in 1970, Professor Dante Giorgi succeeded him until 1974. Professor José Geraldo Camargo Lima took over the position after Giorgi's death. He created the Neurological Emergency unit, initiated the Post-Graduation in Neurology and divided the Discipline in specialized units. During the 1980's and until his retirement in 1995, EPM had become one of most important centers of Brazil training neurologists and researchers in neurological sciences.

  15. Emerging Options for Emergency Contraception

    Directory of Open Access Journals (Sweden)

    Atsuko Koyama

    2013-01-01

    Full Text Available Emergency post-coital contraception (EC is an effective method of preventing pregnancy when used appropriately. EC has been available since the 1970s, and its availability and use have become widespread. Options for EC are broad and include the copper intrauterine device (IUD and emergency contraceptive pills such as levonorgestrel, ulipristal acetate, combined oral contraceptive pills (Yuzpe method, and less commonly, mifepristone. Some options are available over-the-counter, while others require provider prescription or placement. There are no absolute contraindications to the use of emergency contraceptive pills, with the exception of ulipristal acetate and mifepristone. This article reviews the mechanisms of action, efficacy, safety, side effects, clinical considerations, and patient preferences with respect to EC usage. The decision of which regimen to use is influenced by local availability, cost, and patient preference.

  16. Emerging Options for Emergency Contraception

    Science.gov (United States)

    Koyama, Atsuko; Hagopian, Laura; Linden, Judith

    2013-01-01

    Emergency post-coital contraception (EC) is an effective method of preventing pregnancy when used appropriately. EC has been available since the 1970s, and its availability and use have become widespread. Options for EC are broad and include the copper intrauterine device (IUD) and emergency contraceptive pills such as levonorgestrel, ulipristal acetate, combined oral contraceptive pills (Yuzpe method), and less commonly, mifepristone. Some options are available over-the-counter, while others require provider prescription or placement. There are no absolute contraindications to the use of emergency contraceptive pills, with the exception of ulipristal acetate and mifepristone. This article reviews the mechanisms of action, efficacy, safety, side effects, clinical considerations, and patient preferences with respect to EC usage. The decision of which regimen to use is influenced by local availability, cost, and patient preference. PMID:24453516

  17. Diabetic Emergencies

    Science.gov (United States)

    ... Campaigns Share this! EmergencyCareForYou » Emergency 101 » Diabetic Emergencies Diabetic Emergencies It is estimated that more than 20 ... they have it. The best way to prevent diabetic emergencies is to effectively manage the disease through ...

  18. Intervertebral Disc Characteristic on Progressive Neurological Deficit

    Directory of Open Access Journals (Sweden)

    Farid Yudoyono

    2017-09-01

    Full Text Available Objective: To examine the intervertebral disc characteristic on magnetic resonance imaging (MRI in lumbar herniated disc (LHD patients with progressive neurological deficit. Methods: Patients were collected retrospectively from Dr. Hasan Sadikin General Hospital Database from 2011–2013 with LHD, had neurological deficit such as radiculopathy and cauda equine syndrome for less than four weeks with a positive sign confirmed by neurological examination and confirmatory with MRI examination. Results: A total of 14 patients with lumbar herniated disc disease (10 males, 4 females suffered from progressive neurological deficit with an average age of (52.07±10.9 years old. Early disc height was 9.38±0.5 mm and progressive neurological deficit state disc height was 4.03±0.53 mm, which were significantly different statisticaly (p<0.01. Symptoms of radiculopathy were seen in 11 patients and cauda equine syndrome in three patients. Modic changes grade 1 was found in five patients, grade 2 in eight patients,grade 3 in one patient, Pfirmman grade 2 in eleven patients and grade 3 in three patients. Thecal sac compression 1/3 compression was seen in four patients and 2/3 compression in ten patients. Conclusions: Neurosurgeon should raise concerns on the characteristic changes of intervertebral disc in magnetic resonance imaging examination to avoid further neural injury in lumbar herniated disc patients.

  19. [Deficiency, disability, neurology and television series].

    Science.gov (United States)

    Collado-Vázquez, Susana; Martínez-Martínez, Ariadna; Cano-de-la-Cuerda, Roberto

    2015-06-01

    The portrayal of neurological disability and deficiency on television has not always been approached in the same way, but has instead tended to reflect the standpoint taken by society with regard to these issues and how they are dealt with according to the prevailing conceptions and values at each particular time. To address the appearance of neurological pathologies in television series and to ponder on the image they have in such contexts. Deficiency and disability of neurological origin have often been depicted on television in series, telefilms and documentaries, and in a wide variety of ways. Here we examine different television series and how they have dealt with neurological pathology, its diagnosis and its treatment, as well as the figure of the healthcare professional and social-familial adaptation. Examples cited include series such as House MD, Glee, American Horror Story, Homeland or Game of Thrones. Television series are a useful tool for making some neurological pathologies better known to the public and for dispelling the myths surrounding others, provided that the pathologies are dealt with in a realistic manner, which is not always the case. More care should be taken with regard to the way in which health professionals are portrayed in television series, as it is not always done correctly and may mislead viewers, who take what they see on the TV as being real.

  20. Neurology and the Internet: a review.

    Science.gov (United States)

    Moccia, Marcello; Brigo, Francesco; Tedeschi, Gioacchino; Bonavita, Simona; Lavorgna, Luigi

    2018-06-01

    Nowadays, the Internet is the major source to obtain information about diseases and their treatments. The Internet is gaining relevance in the neurological setting, considering the possibility of timely social interaction, contributing to general public awareness on otherwise less-well-known neurological conditions, promoting health equity and improving the health-related coping. Neurological patients can easily find several online opportunities for peer interactions and learning. On the other hand, neurologist can analyze user-generated data to better understand patient needs and to run epidemiological studies. Indeed, analyses of queries from Internet search engines on certain neurological diseases have shown a strict temporal and spatial correlation with the "real world." In this narrative review, we will discuss how the Internet is radically affecting the healthcare of people with neurological disorders and, most importantly, is shifting the paradigm of care from the hands of those who deliver care, into the hands of those who receive it. Besides, we will review possible limitations, such as safety concerns, financial issues, and the need for easy-to-access platforms.

  1. Feeding problems in children with neurological disorders.

    Science.gov (United States)

    Jamroz, Ewa; Głuszkiewicz, Ewa; Grzybowska-Chlebowczyk, Urszula; Woś, Halina

    2012-01-01

    The aim of this study was to evaluate the prevalence of selected risk factors of weight deficiency in children with chronic metabolic diseases. The study group involved 160 children, from 2 months to 15 years (mean age 3.14 years), with diseases of the nervous system and body weight deficiency. According to the type of neurological disease the following groups of patients were separated: static encephalopathies, progressive encephalopathies, disorders of mental development of undetermined etiology, genetically determined diseases. As the exponent of malnutrition, z-score of weight-for-age standards was used. An inclusion criterion for the study group was z-score of weight-for-age children, neurological disorders, oral motor dysfunction, diseases of other organs, gastrointestinal motility disorders (oral cavity, esophagus, intestines) and type of nutritional therapy. The most advanced malnutrition was in children with progressive encephalopathies and genetically determined diseases. Seizures and muscular hypotonia were most common neurological disorders. Oral motor dysfunctions were observed in 40% of patients. Malnutrition in children with neurological disorders is associated mainly with neurological deficits. In this group of children monitoring of somatic development and early nutritional intervention are necessary.

  2. Neurology referrals to a liaison psychiatry service.

    LENUS (Irish Health Repository)

    Fitzgerald, P

    2012-02-03

    The objective of the present study was to assess the activity of the Liaison Psychiatry service of Cork University Hospital in relation to all in-patient neurology referrals over a 12-month period. Of 1685 neurology admissions, 106 (6%) were referred to liaison psychiatry for assessment. 91 referrals (86%) met criteria for a psychiatric disorder according to DSM-IV, the commonest being major depression (24%) and somatoform disorder (23%). Patients with multiple sclerosis or epilepsy comprised nearly half of all referrals (48 cases; 45%). Approximately 20% of M.S. in-patients (21 cases) were referred for psychiatric assessment, with the corresponding figure in epilepsy being 25% (18 cases). Although only 106 (6%) neurology in-patients were referred to liaison psychiatry, psychiatric diagnoses were documented in 327 (20%) discharge forms, presumably reflecting previous diagnosis. The above findings indicate that psychiatric illness is common among neurology inpatients screened by liaison psychiatry yet referral rates are relatively low in terms of the overall number of neurology in-patients. Psychiatric disorders were diagnosed in 86% of referrals indicating high concordance between neurologists and liaison psychiatry regarding the presence of a psychiatric disorder.

  3. Dengue: a new challenge for neurology

    Directory of Open Access Journals (Sweden)

    Marzia Puccioni-Sohler

    2012-11-01

    Full Text Available Dengue infection is a leading cause of illness and death in tropical and subtropical regions of the world. Forty percent of the world’s population currently lives in these areas. The clinical picture resulting from dengue infection can range from relatively minor to catastrophic hemorrhagic fever. Recently, reports have increased of neurological manifestations. Neuropathogenesis seems to be related to direct nervous system viral invasion, autoimmune reaction, metabolic and hemorrhagic disturbance. Neurological manifestations include encephalitis, encephalopathy, meningitis, Guillain-Barré syndrome, myelitis, acute disseminated encephalomyelitis, polyneuropathy, mononeuropathy, and cerebromeningeal hemorrhage. The development of neurological symptoms in patients with positive Immunoglobulin M (IgM dengue serology suggests a means of diagnosing the neurological complications associated with dengue. Viral antigens, specific IgM antibodies, and the intrathecal synthesis of dengue antibodies have been successfully detected in cerebrospinal fluid. However, despite diagnostic advancements, the treatment of neurological dengue is problematic. The launch of a dengue vaccine is expected to be beneficial.

  4. Transient global amnesia and neurological events: the Framingham Heart Study

    Directory of Open Access Journals (Sweden)

    Jose Rafael Romero

    2013-05-01

    Full Text Available Background/ objective: Transient global amnesia (TGA is a temporary amnestic syndrome characterized by lack of other focal neurological deficits. Cerebrovascular disease, migraine and seizures have been suggested as underlying mechanisms. TGA may be a risk factor for cerebrovascular or other neurological events. We studied the relation of TGA, vascular risk factors, brain magnetic resonance imaging (MRI indices of subclinical ischemia and neurological events in a community-based sample. Design/setting: A total of 12 TGA cases were ascertained using standard criteria by experienced neurologists, and matched to 41 stroke- and seizure-free controls. Vascular risk factors, brain MRI findings, and subsequent cerebrovascular or seizure events were compared in cases and controls. Participants: Framingham Heart Study (FHS original and offspring cohort participants were included.Results: No significant differences between the groups were observed in the prevalence of vascular risk factors, or brain MRI measures. Few incident stroke/transient ischemic attacks (TIA (1 event among the cases and 4 in controls or subsequent seizures occurred in either group. Head CT during the acute event (n=11 and brain MRI (n=7 were negative for acute abnormalities. Electroencephalograms (EEG (n=5 were negative for epileptiform activity. Extracranial vascular studies were negative for significant stenosis in all cases.Conclusions: In our community-based study TGA was not related to traditional vascular risk factors, or cerebrovascular disease. However, our study is limited by small sample size and power, and larger studies are required to exclude an association.

  5. Minor Neurological Dysfunctions (MNDs in Autistic Children without Intellectual Disability

    Directory of Open Access Journals (Sweden)

    Gabriele Tripi

    2018-04-01

    Full Text Available Background: Children with autism spectrum disorder (ASD require neurological evaluation to detect sensory-motor impairment. This will improve understanding of brain function in children with ASD, in terms of minor neurological dysfunctions (MNDs. Methods: We compared 32 ASD children without intellectual disability (IQ ≥ 70 with 32 healthy controls. A standardized and age-specific neurological examination according to Touwen was used to detect the presence of MNDs. Particular attention was paid to severity and type of MNDs. Results: Children with ASD had significantly higher rates of MNDs compared to controls (96.9% versus 15.6%: 81.3% had simple MNDs (p < 0.0001 and 15.6% had complex MNDs (p = 0.053. The prevalence of MNDs in the ASD group was significantly higher (p < 0.0001 than controls. With respect to specific types of MNDs, children with ASD showed a wide range of fine manipulative disability, sensory deficits and choreiform dyskinesia. We also found an excess of associated movements and anomalies in coordination and balance. Conclusions: Results replicate previous findings which found delays in sensory-motor behavior in ASD pointing towards a role for prenatal, natal and neonatal risk factors in the neurodevelopmental theory of autism.

  6. Neurocritical care education during neurology residency: AAN survey of US program directors.

    Science.gov (United States)

    Sheth, K N; Drogan, O; Manno, E; Geocadin, R G; Ziai, W

    2012-05-29

    Limited information is available regarding the current state of neurocritical care education for neurology residents. The goal of our survey was to assess the need and current state of neurocritical care training for neurology residents. A survey instrument was developed and, with the support of the American Academy of Neurology, distributed to residency program directors of 132 accredited neurology programs in the United States in 2011. A response rate of 74% (98 of 132) was achieved. A dedicated neuroscience intensive care unit (neuro-ICU) existed in 64%. Fifty-six percent of residency programs offer a dedicated rotation in the neuro-ICU, lasting 4 weeks on average. Where available, the neuro-ICU rotation was required in the vast majority (91%) of programs. Neurology residents' exposure to the fundamental principles of neurocritical care was obtained through a variety of mechanisms. Of program directors, 37% indicated that residents would be interested in performing away rotations in a neuro-ICU. From 2005 to 2010, the number of programs sending at least one resident into a neuro-ICU fellowship increased from 14% to 35%. Despite the expansion of neurocritical care, large proportions of US neurology residents have limited exposure to a neuro-ICU and neurointensivists. Formal training in the principles of neurocritical care may be highly variable. The results of this survey suggest a charge to address the variability of resident education and to develop standardized curricula in neurocritical care for neurology residents.

  7. Neurology and psychiatry: waking up to opportunities of sleep. State of the art and clinical/research priorities for the next decade

    NARCIS (Netherlands)

    Bassetti, C.L.; Ferini-Strambi, L.; Brown, S.; Adamantidis, A.; Benedetti, F.; Bruni, O.; Cajochen, C.; Dolenc-Groselj, L.; Ferri, R.; Gais, S.; Huber, R.; Khatami, R.; Lammers, G.J.; Luppi, P.H.; Manconi, M.; Nissen, C.; Nobili, L.; Peigneux, P.; Pollmacher, T.; Randerath, W.; Riemann, D.; Santamaria, J.; Schindler, K.; Tafti, M.; van Someren, E.J.W.; Wetter, T.C.

    2015-01-01

    In recent years, evidence has emerged for a bidirectional relationship between sleep and neurological and psychiatric disorders. First, sleep-wake disorders (SWDs) are very common and may be the first/main manifestation of underlying neurological and psychiatric disorders. Secondly, SWDs may

  8. Neurology and psychiatry : waking up to opportunities of sleep. : State of the art and clinical/research priorities for the next decade

    NARCIS (Netherlands)

    Bassetti, C L; Ferini-Strambi, L; Brown, S; Adamantidis, A; Benedetti, F; Bruni, O; Cajochen, C; Dolenc-Groselj, L; Ferri, R; Gais, S; Huber, R; Khatami, R; Lammers, G J; Luppi, P H; Manconi, M; Nissen, C; Nobili, L; Peigneux, P; Pollmächer, T; Randerath, W; Riemann, D; Santamaria, J; Schindler, K; Tafti, M; Van Someren, E; Wetter, T C

    2015-01-01

    In recent years, evidence has emerged for a bidirectional relationship between sleep and neurological and psychiatric disorders. First, sleep-wake disorders (SWDs) are very common and may be the first/main manifestation of underlying neurological and psychiatric disorders. Secondly, SWDs may

  9. Increased pediatric functional neurological symptom disorders after the Boston marathon bombings: a case series.

    Science.gov (United States)

    Guerriero, Réjean M; Pier, Danielle B; de Gusmão, Claudio M; Bernson-Leung, Miya E; Maski, Kiran P; Urion, David K; Waugh, Jeff L

    2014-11-01

    Functional neurological symptom disorders are frequently the basis for acute neurological consultation. In children, they are often precipitated by high-frequency everyday stressors. The extent to which a severe traumatic experience may also precipitate functional neurological abnormalities is unknown. For the 2-week period after the Boston Marathon bombings, we prospectively collected data on patients whose presentation suggested a functional neurological symptom disorder. We assessed clinical and demographic variables, duration of symptoms, extent of educational impact, and degree of connection to the Marathon bombing. We contacted all patients at 6 months after presentation to determine the outcome and accuracy of the diagnosis. In a parallel study, we reported a baseline of 2.6 functional neurological presentations per week in our emergency room. In the week after the Marathon bombings, this frequency tripled. Ninety-one percent of presentations were delayed by 1 week, with onset around the first school day after a city-wide lockdown. Seventy-three percent had a history of a prior psychiatric diagnosis. At the 6 months follow-up, no functional neurological symptom disorder diagnoses were overturned and no new organic diagnosis was made. Pediatric functional neurological symptom disorder may be precipitated by both casual and high-intensity stressors. The 3.4-fold increase in incidence after the Boston Marathon bombings and city-wide lockdown demonstrates the marked effect that a community-wide tragedy can have on the mental health of children. Care providers must be aware of functional neurological symptom disorders after stressful community events in vulnerable patient populations, particularly those with prior psychiatric diagnoses. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. A national neurological excellence centers network.

    Science.gov (United States)

    Pazzi, S; Cristiani, P; Cavallini, A

    1998-02-01

    The most relevant problems related to the management of neurological disorders are (i) the frequent hospitalization in nonspecialist departments, with the need for neurological consultation, and (ii) the frequent requests of GPs for highly specialized investigations that are very expensive and of little value in arriving at a correct diagnosis. In 1996, the Consorzio di Bioingegneria e Informatica Medica in Italy realized the CISNet project (in collaboration with the Consorzio Istituti Scientifici Neuroscienze e Tecnologie Biomediche and funded by the Centro Studi of the National Public Health Council) for the implementation of a national neurological excellence centers network (CISNet). In the CISNet project, neurologists will be able to give on-line interactive consultation and off-line consulting services identifying correct diagnostic/therapeutic procedures, evaluating the need for both examination in specialist centers and admission to specialized centers, and identifying the most appropriate ones.

  11. Inventory of pediatric neurology "manpower" in Canada.

    Science.gov (United States)

    Keene, Daniel L; Humphreys, Peter

    2005-08-01

    To review the demographics and workload characteristics of pediatric neurology in Canada. A standardized survey questionnaire was mailed out to practicing pediatric neurologists in Canada in 2001. Variables examined were age, gender, hours on call, regular hours worked per week, type of practice and projected changes in practice over next five to ten years. Results were compared to the 1994 Pediatric Neurology Manpower Survey which had used the same survey instrument. Fifty-six (70%) pediatric neurologists practicing in Canada returned the survey. As was the case in 1994, no significant differences in workload were found based on age or gender. The average age of the practicing pediatric neurologist in 2001 was 51 years compared to 45 years in 1994. The proportion of physicians over 55 years in 2001 was 35% compared to 25% in 1994. Pediatric neurology in Canada is an aging specialty needing a significant recruitment of new members

  12. Perinatal pharmacology: applications for neonatal neurology.

    Science.gov (United States)

    Smits, Anne; Allegaert, Karel

    2011-11-01

    The principles of clinical pharmacology also apply to neonates, but their characteristics warrant a tailored approach. We focus on aspects of both developmental pharmacokinetics (concentration/time relationship) and developmental pharmacodynamics (concentration/effect relationship) in neonates. We hereby aimed to link concepts used in clinical pharmacology with compound-specific observations (anti-epileptics, analgosedatives) in the field of neonatal neurology. Although in part anecdotal, we subsequently illustrate the relevance of developmental pharmacology in the field of neonatal neurology by a specific intervention (e.g. whole body cooling), specific clinical presentations (e.g. short and long term outcome following fetal exposure to antidepressive agents, the development of new biomarkers for fetal alcohol syndrome) and specific clinical needs (e.g. analgosedation in neonates, excitocytosis versus neuro-apoptosis/impaired synaptogenesis). Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  13. Rare Neurological Complications After Sleeve Gastrectomy.

    Science.gov (United States)

    Tabbara, Malek; Carandina, Sergio; Bossi, Manuela; Polliand, Claude; Genser, Laurent; Barrat, Christophe

    2016-12-01

    Bariatric surgery is considered to be the most effective treatment of morbid obesity and improvement of obesity-related comorbidities, such as type II diabetes. However, both peripheral and central neurological complications can occur after bariatric surgery. Such complications tend to occur more frequently after bypass surgery than after sleeve gastrectomy (SG). The objective of this study was to identify the patients that presented post-operative neurological complications after undergoing SG and describe the incidence, presentation, and management of these complications. This was a retrospective study of 592 cases of SG performed between 2009 and 2014 with a special focus on patients who presented neurological complications. Of the 592 SG cases, only seven (1.18 %) patients presented neurological complications. All patients had uneventful post-operative course, but all reported feeding difficulties, accompanied by severe dysphagia, and rapid weight loss, with a mean weight loss of 35 kg (30-40 kg) 3 months after SG. All patients were readmitted owing to neurological symptoms that included paresthesia, abolition of deep tendon reflexes of the lower limbs, muscle pain, and motor and sensitive deficits in some cases. There were two cases of Wernicke's encephalopathy. All patients were treated for neuropathy secondary to vitamin B1 deficiency and had a significant improvement and/or resolution of their symptoms. Neurological complications after SG are rare and are often preceded by gastrointestinal symptoms, rapid weight loss, and lack of post-operative vitamin supplementation. Re-hospitalization and multidisciplinary team management are crucial to establish the diagnosis and initiate treatment.

  14. [Sir William Richard Gowers: author of the "bible of neurology"].

    Science.gov (United States)

    Hirose, Genjiro

    2014-11-01

    William Richard Gowers is one of the great pioneers in neurology and the author of the well-known neurology textbook, "A Manual of Diseases of the Nervous System." His concepts of neurology are based on meticulously and carefully accumulated knowledge of history, observations, and neurological examinations of patients with various neurological diseases. He is not only a great neurologist but also a great teacher who loves teaching students and physicians through well-prepared lectures. We can glean the essence of the field of neurology through his life story and numerous writings concerning neurological diseases.

  15. 'Present nuclear emergency responses in India: tracing requirements and guidelines suggested after Fukushima accident in regards to public and plant safety

    International Nuclear Information System (INIS)

    Jawale, Priyanka M.

    2014-01-01

    In this poster the primary initiative is to educate the public at large and instill confidence about the present Emergency Response Systems of DAE and the imminent agencies in India. Poster attempts to analyse present regulatory and safety systems, mechanisms like plant and site emergency response plans are in place to handle radiation emergencies and how public will not be affected in any manner. In India also we needed some supplementary provisions to cope up with major disasters in Nuclear Power Plants (NPP) apart from the existing one. Some of the NPPs are not under the UN safeguards, which can not import Uranium also need extra care and protection. Regulatory and safety functions of Atomic Energy in India are carried out by the Atomic Energy Regulatory Board (Atomic Energy Regulatory Board), the poster attempts to explain the present regulatory and safety mechanism under Atomic Energy Regulatory Board. We have the plant and site emergency response plans in place. The well planned functioning of these is demonstrated here. India is equipped with detail plans of emergency response system, to handle the radiation emergencies in public domain even at the locations where DAE facility is not available

  16. Modern network science of neurological disorders.

    Science.gov (United States)

    Stam, Cornelis J

    2014-10-01

    Modern network science has revealed fundamental aspects of normal brain-network organization, such as small-world and scale-free patterns, hierarchical modularity, hubs and rich clubs. The next challenge is to use this knowledge to gain a better understanding of brain disease. Recent developments in the application of network science to conditions such as Alzheimer's disease, multiple sclerosis, traumatic brain injury and epilepsy have challenged the classical concept of neurological disorders being either 'local' or 'global', and have pointed to the overload and failure of hubs as a possible final common pathway in neurological disorders.

  17. Unspecific neurologic symptoms as possible psychogenic complaints.

    Science.gov (United States)

    Franz, M; Schepank, H; Schellberg, D

    1993-01-01

    Prevalence and course of psychogenically influenced symptoms in neurology and their dependence on age and gender are reported. The epidemiological basis of the data is a long-term follow-up investigation of a high-risk population for about 10 years (n = 240): the Mannheim Cohort Study on Epidemiology of Psychogenic Disorders. Seven psychogenic symptoms of neurologic relevance (headache, lumbar and cervical vertebral complaints, functional vertigo, hyperkinesias, pareses, sleep and concentration disturbances) are characterized in regard to frequency, course and diagnostic significance.

  18. Richard Bright and his neurological studies.

    Science.gov (United States)

    Pearce, J M S

    2009-01-01

    Richard Bright was one of the famous triumvirate of Guy's Hospital physicians in the Victorian era. Remembered for his account of glomerulonephritis (Bright's disease) he also made many important and original contributions to medicine and neurology. These included his work on cortical epileptogenesis, descriptions of simple partial (Jacksonian) seizures, infantile convulsions, and a variety of nervous diseases. Most notable were his reports of neurological studies including papers on traumatic tetanus, syringomyelia, arteries of the brain, contractures of spinal origin, tumours of the base of the brain, and narcolepsy. His career and these contributions are outlined. Copyright 2009 S. Karger AG, Basel.

  19. Neurological complications of renal dialysis and transplantation.

    Science.gov (United States)

    Karunaratne, Kushan; Taube, David; Khalil, Nofal; Perry, Richard; Malhotra, Paresh A

    2018-04-01

    Neurological complications from renal replacement therapy contribute significantly to morbidity and mortality in patients with renal failure. Such complications can affect either the central or peripheral nervous systems. Most neurological disturbances associated with the uraemic state do not respond fully to renal replacement therapy. There are also complications specifically associated with dialysis and transplantation. A multidisciplinary approach, involving both nephrologists and neurologists, is critical for the diagnosis and effective management of these disorders. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Neurological disorders in Iraqi refugees in Jordan: data from the United Nations Refugee Assistance Information System.

    Science.gov (United States)

    Mateen, Farrah J; Carone, Marco; Nyce, Sayre; Ghosn, Jad; Mutuerandu, Timothy; Al-Saedy, Huda; Lowenstein, Daniel H; Burnham, Gilbert

    2012-04-01

    The United Nations High Commissioner for Refugees (UNHCR) recognizes 43.7 million forcibly displaced persons and asylum seekers due to conflict and persecution worldwide. Neurological disorders have rarely been described in displaced persons but likely pose a significant burden of disease. We describe the disease spectrum and health service utilization of Iraqi refugees and asylum seekers with neurological disorders using an information system developed by the UNHCR. Neurological disorders were actively monitored among the 7,642 UNHCR-registered Iraqi refugees and asylum seekers who received health and humanitarian assistance using a pilot, centralized, database called the Refugee Assistance Information System (RAIS) in the Kingdom of Jordan in 2010. There were 122 neurological diagnoses reported in 1,328 refugees (mean age 41 years, 49% female, 10% disabled, 43% with pending resettlement applications) in 2,659 health visits, accounting for 17% of all refugees who sought health assistance in RAIS. Referral to a neurologist occurred in 178 cases (13.4%). The most frequent ICD-10 neurological diagnoses were dorsalgia (back pain) (29.7% of individuals with neurological disorders), headache (13.1%), and epilepsy (12.6%). Approximately 1 in 20 Iraqi refugees with a neurological diagnosis self-reported a history of torture, which was higher than Iraqi refugees without a history of torture [66/1,328 versus 196/6,314, odds ratio (OR) = 1.63, 95% confidence interval (CI) 1.21-2.18]. Neurological disease affects a high proportion of Iraqi refugees, including victims of torture and the disabled. Refugees require dedicated care for treatment of neurological disease with a focus on pain disorders and epilepsy.

  1. Application of mass spectrometry-based proteomics for biomarker discovery in neurological disorders

    Directory of Open Access Journals (Sweden)

    Venugopal Abhilash

    2009-01-01

    Full Text Available Mass spectrometry-based quantitative proteomics has emerged as a powerful approach that has the potential to accelerate biomarker discovery, both for diagnostic as well as therapeutic purposes. Proteomics has traditionally been synonymous with 2D gels but is increasingly shifting to the use of gel-free systems and liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS. Quantitative proteomic approaches have already been applied to investigate various neurological disorders, especially in the context of identifying biomarkers from cerebrospinal fluid and serum. This review highlights the scope of different applications of quantitative proteomics in understanding neurological disorders with special emphasis on biomarker discovery.

  2. Nystagmus-based approach to vertebrobasilar stroke presenting as vertigo without initial neurologic signs.

    Science.gov (United States)

    Kim, Min-Beom; Boo, Sung Hyun; Ban, Jae Ho

    2013-01-01

    We aimed to investigate the clinical courses and common nystagmus of isolated vertigo patients with vertebrobasilar stroke. The patients who presented with isolated acute spontaneous vertigo with spontaneous nystagmus (acute vestibular syndrome) at the Emergency Department were retrospectively analyzed. They were referred to the Otolaryngology Department due to the absence of neurologic signs or even of imaging abnormalities after the initial examination at the Emergency Department. Various clinical features, including presenting symptoms, delayed neurologic signs, the site of infarction, and videonystagmographic (VNG) findings were analyzed. Of the 468 cases of acute vestibular syndrome, 23 (4.9%) cases of radiologically proven vertebrobasilar stroke were identified. Of the 23 patients, 17 (74%) showed aggravation of vertigo or delayed neurologic signs during the admission. In the analysis of VNG, 11 (48%) cases of direction-changing gaze-evoked nystagmus, 7 (30%) cases of fixation failure in the caloric test, 6 (27%) cases of periodic alternating nystagmus, and 4 (17%) cases of atypical head-shaking nystagmus were presented. Stroke occurred in the cerebellum (n=18, 78%), medulla (n=4, 17%), and pons (n=1, 4%). In the early stage of vertebrobasilar stroke, an accurate diagnosis was difficult in the Emergency Department even though a radiologic study was performed, but various VNG abnormalities and delayed neurologic signs could help to diagnose whether the origin is central or not. Copyright © 2013 S. Karger AG, Basel.

  3. Solving the puzzle of neurological diseases: an interview with Huda Zoghbi

    Directory of Open Access Journals (Sweden)

    Huda Y. Zoghbi

    2017-05-01

    Full Text Available Huda Zoghbi's achievements in the field of neurology are internationally acclaimed. She is best known for elucidating the genetic basis of two complex neurological disorders, spinocerebellar ataxia type 1 and Rett syndrome, and has been honored with many prizes, including The Shaw Prize in Life Science and Medicine in 2016 and the 2017 Breakthrough Prize for Life Sciences. A diligent and creative research scientist at the bench, a respected lab mentor and founding Director of the Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital, her inspiration has always been the burning need to help patients faced with devastating neurological problems. Her pursuit of the mechanisms mediating spinocerebellar ataxia and Rett syndrome has been dogged, requiring 30 years of focused effort. As highlighted in this interview, her work is now paying dividends by starting to reveal potential therapeutic targets for these intractable and complex disorders.

  4. Contemporary approach to neurologic prognostication of coma after cardiac arrest.

    Science.gov (United States)

    Ben-Hamouda, Nawfel; Taccone, Fabio S; Rossetti, Andrea O; Oddo, Mauro

    2014-11-01

    Coma after cardiac arrest (CA) is an important cause of admission to the ICU. Prognosis of post-CA coma has significantly improved over the past decade, particularly because of aggressive postresuscitation care and the use of therapeutic targeted temperature management (TTM). TTM and sedatives used to maintain controlled cooling might delay neurologic reflexes and reduce the accuracy of clinical examination. In the early ICU phase, patients' good recovery may often be indistinguishable (based on neurologic examination alone) from patients who eventually will have a poor prognosis. Prognostication of post-CA coma, therefore, has evolved toward a multimodal approach that combines neurologic examination with EEG and evoked potentials. Blood biomarkers (eg, neuron-specific enolase [NSE] and soluble 100-β protein) are useful complements for coma prognostication; however, results vary among commercial laboratory assays, and applying one single cutoff level (eg, > 33 μg/L for NSE) for poor prognostication is not recommended. Neuroimaging, mainly diffusion MRI, is emerging as a promising tool for prognostication, but its precise role needs further study before it can be widely used. This multimodal approach might reduce false-positive rates of poor prognosis, thereby providing optimal prognostication of comatose CA survivors. The aim of this review is to summarize studies and the principal tools presently available for outcome prediction and to describe a practical approach to the multimodal prognostication of coma after CA, with a particular focus on neuromonitoring tools. We also propose an algorithm for the optimal use of such multimodal tools during the early ICU phase of post-CA coma.

  5. Paraneoplastic neurological disorders in children with benign ovarian tumors.

    Science.gov (United States)

    Hsu, Mei-Hsin; Huang, Chao-Ching; Hung, Pi-Lien; Huang, Hsiu-Mei; Huang, Li-Tung; Huang, Chao-Cheng; Sheen, Jiunn-Ming; Huang, Song-Chei; Chang, Ying-Chao

    2014-03-01

    Paraneoplastic neurological diseases (PND) are rare, but potentially treatable disorders. Paraneoplastic encephalitis is rapidly emerging as an important but likely under-recognized condition in children. The aim of this study was to assess the prevalence and spectrum of PND in children with benign ovary tumor and the long-term outcome. We retrospectively reviewed the charts of all female patients below 18years of age diagnosed with a benign ovarian tumor proven by pathology between January 1993 and December 2010. All the clinical symptoms developed within 5years of tumor diagnosis and the related investigations were recorded. There were total 133 children and adolescents with benign ovarian tumors, mostly mature teratoma. Six patients (4.5%) had neuropsychiatric manifestations and all but one were beyond age 10years. The most common neuropsychiatric presentations were depression or low mood (84%), headache (50%), mutism (50%), hypoventilation (50%), seizures (30%), hallucination (30%), vomiting and hypersalivation (30%). Three patients (2.2%) had serious PND including acute disseminated encephalomyelitis in 1 and anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis in 2. Although all of three improved after tumor removal, one without immunotherapy had neurological sequelae and prolonged ICU stay. The prevalence of PND in benign ovary tumor is not so uncommon in children. It is important to survey ovary tumors in female adolescents with subacute presentation of multiple-level involvement of neuraxis where no clear alternate diagnosis is possible. Treatment of serious PND associated with ovary tumors should include immunotherapy in addition to tumor removal. Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  6. Targeting ligand-gated ion channels in neurology and psychiatry: is pharmacological promiscuity an obstacle or an opportunity?

    Science.gov (United States)

    Bianchi, Matt T; Botzolakis, Emmanuel J

    2010-03-02

    The traditional emphasis on developing high specificity pharmaceuticals ("magic bullets") for the treatment of Neurological and Psychiatric disorders is being challenged by emerging pathophysiology concepts that view disease states as abnormal interactions within complex networks of molecular and cellular components. So-called network pharmacology focuses on modifying the behavior of entire systems rather than individual components, a therapeutic strategy that would ideally employ single pharmacological agents capable of interacting with multiple targets ("magic shotguns"). For this approach to be successful, however, a framework for understanding pharmacological "promiscuity"--the ability of individual agents to modulate multiple molecular targets--is needed. Pharmacological promiscuity is more often the rule than the exception for drugs that target the central nervous system (CNS). We hypothesize that promiscuity is an important contributor to clinical efficacy. Modulation patterns of existing therapeutic agents may provide critical templates for future drug discovery in Neurology and Psychiatry. To demonstrate the extent of pharmacological promiscuity and develop a framework for guiding drug screening, we reviewed the ability of 170 therapeutic agents and endogenous molecules to directly modulate neurotransmitter receptors, a class of historically attractive therapeutic targets in Neurology and Psychiatry. The results are summarized in the form of 1) receptor-centric maps that illustrate the degree of promiscuity for GABA-, glycine-, serotonin-, and acetylcholine-gated ion channels, and 2) drug-centric maps that illustrated how characterization of promiscuity can guide drug development. Developing promiscuity maps of approved neuro-pharmaceuticals will provide therapeutic class-based templates against which candidate compounds can be screened. Importantly, compounds previously rejected in traditional screens due to poor specificity could be reconsidered in this

  7. Neurologic disorders of mineral metabolism and parathyroid disease.

    Science.gov (United States)

    Agrawal, Lily; Habib, Zeina; Emanuele, Nicholas V

    2014-01-01

    Disorders of mineral metabolism may cause neurologic manifestations of the central and peripheral nervous systems. This is because plasma calcium stabilizes excitable membranes in the nerve and muscle tissue, magnesium is predominantly intracellular and is required for activation of many intracellular enzymes, and extracellular magnesium affects synaptic transmission. This chapter reviews abnormalities in electrolytes and minerals which can be associated with several neuromuscular symptoms including neuromuscular irritability, mental status changes, cardiac and smooth muscle changes, etc. © 2014 Elsevier B.V. All rights reserved.

  8. Emergency Communication

    Science.gov (United States)

    : Environmental Documents, Reports LANL Home Calendar Search Contacts Resources » Emergency Communication Emergency Communication Stay informed of emergencies, weather delays, closures, other alerts. Find links to

  9. Understanding Neurological Disease Mechanisms in the Era of Epigenetics

    Science.gov (United States)

    Qureshi, Irfan A.; Mehler, Mark F.

    2015-01-01

    The burgeoning field of epigenetics is making a significant impact on our understanding of brain evolution, development, and function. In fact, it is now clear that epigenetic mechanisms promote seminal neurobiological processes, ranging from neural stem cell maintenance and differentiation to learning and memory. At the molecular level, epigenetic mechanisms regulate the structure and activity of the genome in response to intracellular and environmental cues, including the deployment of cell type–specific gene networks and those underlying synaptic plasticity. Pharmacological and genetic manipulation of epigenetic factors can, in turn, induce remarkable changes in neural cell identity and cognitive and behavioral phenotypes. Not surprisingly, it is also becoming apparent that epigenetics is intimately involved in neurological disease pathogenesis. Herein, we highlight emerging paradigms for linking epigenetic machinery and processes with neurological disease states, including how (1) mutations in genes encoding epigenetic factors cause disease, (2) genetic variation in genes encoding epigenetic factors modify disease risk, (3) abnormalities in epigenetic factor expression, localization, or function are involved in disease pathophysiology, (4) epigenetic mechanisms regulate disease-associated genomic loci, gene products, and cellular pathways, and (5) differential epigenetic profiles are present in patient-derived central and peripheral tissues. PMID:23571666

  10. The child neurology clinical workforce in 2015

    Science.gov (United States)

    Bale, James F.; Mintz, Mark; Joshi, Sucheta M.; Gilbert, Donald L.; Radabaugh, Carrie; Ruch-Ross, Holly

    2016-01-01

    Objectives: More than a decade has passed since the last major workforce survey of child neurologists in the United States; thus, a reassessment of the child neurology workforce is needed, along with an inaugural assessment of a new related field, neurodevelopmental disabilities. Methods: The American Academy of Pediatrics and the Child Neurology Society conducted an electronic survey in 2015 of child neurologists and neurodevelopmental disabilities specialists. Results: The majority of respondents participate in maintenance of certification, practice in academic medical centers, and offer subspecialty care. EEG reading and epilepsy care are common subspecialty practice areas, although many child neurologists have not had formal training in this field. In keeping with broader trends, medical school debts are substantially higher than in the past and will often take many years to pay off. Although a broad majority would choose these fields again, there are widespread dissatisfactions with compensation and benefits given the length of training and the complexity of care provided, and frustrations with mounting regulatory and administrative stresses that interfere with clinical practice. Conclusions: Although not unique to child neurology and neurodevelopmental disabilities, such issues may present barriers for the recruitment of trainees into these fields. Creative approaches to enhance the recruitment of the next generation of child neurologists and neurodevelopmental disabilities specialists will benefit society, especially in light of all the exciting new treatments under development for an array of chronic childhood neurologic disorders. PMID:27566740

  11. Neurological disorders in children with autism

    Directory of Open Access Journals (Sweden)

    N. N. Zavadenko

    2015-01-01

    Full Text Available During a clinical examination of children with autistic spectrum disorders, attention should be drawn to both their major clinical manifestations and neurological comorbidities. The paper considers the mechanisms of autism-induced neurological disorders, the spectrum of which may include manifestations, such as retarded and disharmonic early psychomotor development; the specific features of sensory perception/processing; rigidity and monotony of motor and psychic reactions; motor disinhibition and hyperexcitability; motor stereotypies; uncoordinated movements; developmental coordination disorders (dyspraxia; impaired expressive motor skills; speech and articulation disorders; tics; epilepsy. It describes the specific features of neurological symptoms in Asperger’s syndrome, particularly in semantic-pragmatic language disorders, higher incidence rates of hyperlexia, motor and vocal tics. The incidence rate of epilepsy in autistic spectrum disorders is emphasized to be greater than the average population one. At the same time, the risk of epilepsy is higher in mentally retarded patients with autism. Identification of neurological disorders is of great importance in determining the tactics of complex care for patients with autistic spectrum disorders. 

  12. Are Students with Developmental Dyslexia Neurologically Different?

    Science.gov (United States)

    Goldsmith-Phillips, Josephine

    1994-01-01

    Reviews the controversy over a biological basis for developmental dyslexia and illustrates it with two case studies of junior high school students. Reviews neurological evidence for developmental dyslexia, and proposes seven signs characteristic of reading disability that may qualify as dyslexia. (SR)

  13. Chapter 17: cognitive assessment in neurology.

    Science.gov (United States)

    Henderson, Victor W

    2010-01-01

    Modern interests in cognitive assessment began with Franz Gall's early 19th century theory of mental organology and Paul Broca's reports in the 1860s on patients with focal brain injury and aphemia. These workers spurred interest in assessing delimited mental abilities in relation to discrete cerebral areas. With roots in experimental and educational psychology, the intelligence testing movement added assessment tools that could be applied to neurological patients. Early- to mid-20th-century landmarks were Alfred Binet and Theodore Simon's intelligence scale, Howard Knox's nonverbal performance tests, and the intelligence quotient conceived by Lewis Terman and refined by David Wechsler. Also developed during this era were Henry Head's Serial Tests for aphasic patients and Kurt Goldstein's tests for brain-injured patients with impairments in "abstract attitude" and concept formation. Other investigators have contributed procedures for the evaluation of language functions, memory, visuospatial and visuoconstructive skills, praxis, and executive functions. A further milestone was the development of short standardized cognitive instruments for dementia assessment. Within a neurological arena, the historical emphasis has been on a flexible, process-driven approach to the service of neurological diagnosis and syndrome identification. Advances in clinical psychology, neurology, and the cognate clinical neurosciences continue to enrich assessment options.

  14. Mind-body interventions: applications in neurology.

    Science.gov (United States)

    Wahbeh, Helané; Elsas, Siegward-M; Oken, Barry S

    2008-06-10

    Half of the adults in the United States use complementary and alternative medicine with mind-body therapy being the most commonly used form. Neurology patients often turn to their physicians for insight into the effectiveness of the therapies and resources to integrate them into their care. The objective of this article is to give a clinical overview of mind-body interventions and their applications in neurology. Medline and PsychInfo were searched on mind-body therapies and neurologic disease search terms for clinical trials and reviews and published evidence was graded. Meditation, relaxation, and breathing techniques, yoga, tai chi, and qigong, hypnosis, and biofeedback are described. Mind-body therapy application to general pain, back and neck pain, carpal tunnel syndrome, headaches, fibromyalgia, multiple sclerosis, epilepsy, muscular dysfunction, stroke, aging, Parkinson disease, stroke, and attention deficit-hyperactivity disorder are reviewed. There are several conditions where the evidence for mind-body therapies is quite strong such as migraine headache. Mind-body therapies for other neurology applications have limited evidence due mostly to small clinical trials and inadequate control groups.

  15. [Cinema and neurology: early educational applications].

    Science.gov (United States)

    Collado-Vázquez, Susana; Carrillo, Jesús M

    2015-03-01

    Since its earliest days, cinema has been used in the teaching of neurology both to illustrate the professor's explanations and to make learning easier for students. To analyse some of the first applications of cinema to the teaching and learning of neurology. Shortly after the birth of the film projector it became apparent that it could be a valuable aid in teaching medicine, and especially neurology. Initially, actual recordings made by doctors themselves were used, and later documentaries, short films and feature films were employed as means of showing diagnostic and therapeutic methods, as well as different pathological signs, such as movement disorders. The intention was not to replace other methodologies but instead to complement them and to make the process of acquiring knowledge easier. Applying cinema in teaching is a useful way to portray the contents of different subjects, especially in the field of neurology, and to favour the acquisition of both specific and cross-disciplinary competences, with very positive results being obtained among students.

  16. Interactive drama in complex neurological disability management

    NARCIS (Netherlands)

    Fenech, Anne

    2009-01-01

    Purpose. To establish whether interactive drama has any effect on the responses of people with complex neurological disabilities resident in a long term care facility. Method. This was a service evaluation using interviews with a group of 31 independently consenting long term care residents, and 27

  17. Neurological and neurosurgical manifestations of human ...

    African Journals Online (AJOL)

    Neurological and neurosurgical manifestations of human immunodeficiency virus (HIV) infection in Mrica. Adelola Adeloye MS FRCS FRCP. Professor. Department of Surgery, College of Medicine. Blantyre, Malawi. Introduction. AIDS was first recognised in the United States of . America in the late 1970s among homosexual ...

  18. [Anesthesia for patients with neurological diseases].

    Science.gov (United States)

    Kimura, Masafumi; Saito, Shigeru

    2010-09-01

    Several surgical treatments can be employed for the patients with neurological disorders, such as multiple sclerosis, Guillain-Barré syndrome, Parkinson's disease, amyotrophic lateral sclerosis, Alzheimer disease and spinal cord injury. It is possible that anesthesia related complications are induced in these neurologically complicated patients in the perioperative period. Respiratory dysfunction and autonomic nervous system dysfunction are most common in this population. Respiratory muscle weakness and bulbar palsy may cause aspiration pneumonia. Sometimes, postoperative ventilatory support is mandatory in these patients. Autonomic nervous system dysfunction may cause hypotension secondary to postural changes, blood loss, or positive airway pressure. Some therapeutic agents prescribed for neurological symptoms have drug interaction with anesthetic agents. Patients with motor neuron disease should be considered to be vulnerable to hyperkalemia in response to a depolarizing muscle relaxant. Although perioperative treatment guideline for most neurologic disorders has not been reported to lessen perioperative morbidity, knowledge of the clinical features and the interaction of common anesthetics with the drug therapy is important in planning intraoperative and postoperative management.

  19. Nutrition of patients with severe neurologic impairment

    Directory of Open Access Journals (Sweden)

    Orel Anija

    2017-12-01

    Full Text Available Commercial enteral formulas are generally recommended for gastrostomy feeding in patients with severe neurologic impairment. However, pureed food diets are still widely used and even gaining popularity among certain groups. We tried to compare the effectiveness of gastrostomy feeding for treatment of severe malnutrition with either enteral formulas or pureed feeds.

  20. Neurological complications of Zika virus infection.

    Science.gov (United States)

    Carod-Artal, Francisco Javier

    2018-04-26

    Zika virus (ZIKV) disease is a vector-borne infectious disease transmitted by Aedes mosquitoes. Recently, ZIKV has caused outbreaks in most American countries. Areas covered: Publications about neurological complications of ZIKV infection retrieved from pubmed searchers were reviewed, and reference lists and relevant articles from review articles were also examined. Vertical/intrauterine transmission leads to congenital infection and causes microcephaly and congenital ZIKV syndrome. ZIKV preferentially infects human neural progenitor cells and triggers cell apoptosis. ZIKV RNA has been identified in foetal brain tissue and brains of microcephalic infants who died; amniotic fluid and placentas of pregnant mothers; and umbilical cord, cerebro-spinal fluid and meninges of newborns. The increase in the number of Guillain-Barre syndrome (GBS) cases during the ZIKV outbreak in the Americas provides epidemiological evidence for the link between ZIKV infection and GBS. Less frequently reported ZIKV neurological complications include encephalitis/meningoencephalitis, acute disseminated encephalomyelitis, myelitis, cerebrovascular complications (ischemic infarction; vasculopathy), seizures and encephalopathy, sensory polyneuropathy and sensory neuronopathy. Analysis of GBS incidence could serve as an epidemiological 'marker' or sentinel for ZIKV disease and other neurological complications associated to ZIKV. Expert commentary: An expanding spectrum of neurological complications associated with ZIKV infection is being recognised.

  1. [The carrier model of neurology in Hungary: a proposal for the solution until 2020].

    Science.gov (United States)

    Bereczki, Dániel; Csiba, László; Komoly, Sámuel; Vécsei, László; Ajtay, András

    2011-11-30

    Based on our previous survey on the capacities of neurological services and on the predictable changes in the neurologist workforce in Hungary, we present a proposal for the organization of the structure of neurological services in the future. We discuss the diagnostic groups treated by neurologists, the neurological services and their progressive organization. Using the current capacities as baseline, we propose patient groups to be treated by neurologists in the future, and the levels of services. Based on the tendencies seen in the last years we suggest to consider to allocate acute stroke services exclusively to stroke units in neurological departments, and we identify a few other diagnostic groups where neurology should have a larger share in patient care. We define three levels for inpatient care: university departments, regional/county hospitals, city hospitals. Instead of minimum criteria we assign outpatient and inpatient standards that are functional from the economic point of view as well. University departments cover all areas of neurological services, have a function in graduate and postgraduate training, and on a regional basis they participate in professional quality assurance activities at the county and city hospital levels, and would have a more independent role in residency training. As far as patient care is concerned, the task of the regional/county hospitals would be similar to that of university departments - without the exclusively university functions. A general neurological service would be offered at the city hospital level - the representation of all subspecialties of neurology is not required. Neurorehabilitation would be organized at special units of neurological wards at the city hospital level, at independent neurorehabilitation wards in regional/county hospitals, and also as an outpatient service offered at the patients' home. The most significant organizational change would affect the outpatient neurological services. In addition

  2. Childhood Emergencies

    Science.gov (United States)

    ... SUBSCRIBE Emergency 101 Share this! Home » Emergency 101 Childhood Emergencies Keeping children healthy and safe is every ... and tools to prevent, recognize and address a childhood emergency is the first step in keeping your ...

  3. Eye Emergencies

    Science.gov (United States)

    ... The Marfan Foundation Marfan & Related Disorders What is Marfan Syndrome? What are Related Disorders? What are the Signs? ... Emergencies Eye Emergencies Lung Emergencies Surgeries Eye Emergencies Marfan syndrome significantly increases your risk of retinal detachment, a ...

  4. Emergency contraception

    Science.gov (United States)

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Family planning - emergency contraception ... IUD placed inside the uterus CHOICES FOR EMERGENCY CONTRACEPTION Two emergency contraceptive pills may be bought without a prescription. ...

  5. The evolution and future of minimalism in neurological surgery.

    Science.gov (United States)

    Liu, Charles Y; Wang, Michael Y; Apuzzo, Michael L J

    2004-11-01

    The evolution of the field of neurological surgery has been marked by a progressive minimalism. This has been evident in the development of an entire arsenal of modern neurosurgical enterprises, including microneurosurgery, neuroendoscopy, stereotactic neurosurgery, endovascular techniques, radiosurgical systems, intraoperative and navigational devices, and in the last decade, cellular and molecular adjuvants. In addition to reviewing the major developments and paradigm shifts in the cyclic reinvention of the field as it currently stands, this paper attempts to identify forces and developments that are likely to fuel the irresistible escalation of minimalism into the future. These forces include discoveries in computational science, imaging, molecular science, biomedical engineering, and information processing as they relate to the theme of minimalism. These areas are explained in the light of future possibilities offered by the emerging field of nanotechnology with molecular engineering.

  6. [Reconciliating neurology and psychiatry: The prototypical case of frontotemporal dementia].

    Science.gov (United States)

    Lagarde, J; Sarazin, M

    2017-10-01

    psychiatric disorders, and a possible molecular link between bvFTD and psychoses, which could eventually lead to new therapeutic approaches, has been recently suggested. Thus, bvFTD illustrates how the links between neurology and psychiatry are close and tend to evolve with the progress of scientific knowledge. It is necessary to strengthen collaboration between the two disciplines both to improve the care - diagnosis and management of these patients - and to promote the emergence of innovative clinical research. Copyright © 2016 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  7. Involuntary psychiatric holds - the structure of admissions on the example of Institute of Psychiatry and Neurology in Warsaw.

    Science.gov (United States)

    Markiewicz, Inga; Heitzman, Janusz; Gardyńska-Ziemba, Ewa

    2016-01-01

    The aim of the study was to analyse the structure of involuntary psychiatric holds in Institute of Psychiatry and Neurology in Warsaw, throughout the year. Our research interests included socio-demographic profiles of the patients, time of admissions (time of a day/night/ season), type of diagnoses at admission and suicide attempts preceding the admission. We also analysed the normative aspect of involuntary admissions, i.e. which Articles of the Polish Mental Health Act constituted the basis for these patients admission, and if the choice of articles was justifiable by a diagnosis of the mental disorder. The primary research tool consisted of an original questionnaire allowing for the collection of relevant data. The material was submitted to statistical analysis, using primarily simple percentage methods. Involuntary psychiatric holds constituted 15.8% of the total number of admissions to the Institute of Psychiatry and Neurology (3,498 persons) in 2012. 522 persons with mental disorders were subject to involuntary admission on emergency basis (292 women and 260 men). Majority of patients was over 40 years old. The number of patients admitted to the Institute of Psychiatry and Neurology on emergency basis without the consent ranged from 38 to 62 people per month. Season did not differentiate significantly the number of admitted persons, majority of patients was admitted during the day (82%). Among the diagnosed patients, paranoid schizophrenia was the most frequent illness (43%), delirium tremens (7%), bipolar disorders (6%), dementia (5%), other psychotic disorders (5%), paranoid syndrome (5%), schizoaffective disorder (5%), other diagnoses (less than 1%). 4% of admissions to the Institute of Psychiatry and Neurology were due to attempted suicide. 37% of patients were admitted to the Institute of Psychiatry and Neurology under Article 23.1 of the Mental Health Act, 34% under Article 22.2, in accordance with Article 24.1 - only 7% of patients. Invoking Article 28

  8. Nanomaterial-based electrochemical sensing of neurological drugs and neurotransmitters

    International Nuclear Information System (INIS)

    Sanghavi, Bankim J.; Swami, Nathan S.; Wolfbeis, Otto S.; Hirsch, Thomas

    2015-01-01

    Nanomaterial-modified detection systems represent a chief driver towards the adoption of electrochemical methods, since nanomaterials enable functional tunability, ability to self-assemble, and novel electrical, optical and catalytic properties that emerge at this scale. This results in tremendous gains in terms of sensitivity, selectivity and versatility. We review the electrochemical methods and mechanisms that may be applied to the detection of neurological drugs. We focus on understanding how specific nano-sized modifiers may be applied to influence the electron transfer event to result in gains in sensitivity, selectivity and versatility of the detection system. This critical review is structured on the basis of the Anatomical Therapeutic Chemical (ATC) Classification System, specifically ATC Code N (neurotransmitters). Specific sections are dedicated to the widely used electrodes based on the carbon materials, supporting electrolytes, and on electrochemical detection paradigms for neurological drugs and neurotransmitters within the groups referred to as ATC codes N01 to N07. We finally discuss emerging trends and future challenges such as the development of strategies for simultaneous detection of multiple targets with high spatial and temporal resolutions, the integration of microfluidic strategies for selective and localized analyte pre-concentration, the real-time monitoring of neurotransmitter secretions from active cell cultures under electro- and chemotactic cues, aptamer-based biosensors, and the miniaturization of the sensing system for detection in small sample volumes and for enabling cost savings due to manufacturing scale-up. The Electronic Supporting Material (ESM) includes review articles dealing with the review topic in last 40 years, as well as key properties of the analytes, viz., pK a values, half-life of drugs and their electrochemical mechanisms. The ESM also defines analytical figures of merit of the drugs and neurotransmitters. The

  9. A controlled study of team-based learning for undergraduate clinical neurology education

    Directory of Open Access Journals (Sweden)

    Umapathi Thirugnanam

    2011-10-01

    Full Text Available Abstract Background Team-based learning (TBL, a new active learning method, has not been reported for neurology education. We aimed to determine if TBL was more effective than passive learning (PL in improving knowledge outcomes in two key neurology topics - neurological localization and neurological emergencies. Methods We conducted a modified crossover study during a nine-week internal medicine posting involving 49 third-year medical undergraduates, using TBL as the active intervention, compared against self-reading as a PL control, for teaching the two topics. Primary outcome was the mean percentage change in test scores immediately after (post-test 1 and 48 hours after TBL (post-test 2, compared to a baseline pre-test. Student engagement was the secondary outcome. Results Mean percentage change in scores was greater in the TBL versus the PL group in post-test 1 (8.8% vs 4.3%, p = 0.023 and post-test 2 (11.4% vs 3.4%, p = 0.001. After adjustment for gender and second year examination grades, mean percentage change in scores remained greater in the TBL versus the PL group for post-test 1 (10.3% vs 5.8%, mean difference 4.5%,95% CI 0.7 - 8.3%, p = 0.021 and post-test 2 (13.0% vs 4.9%, mean difference 8.1%,95% CI 3.7 - 12.5%, p = 0.001, indicating further score improvement 48 hours post-TBL. Academically weaker students, identified by poorer examination grades, showed a greater increase in scores with TBL versus strong students (p Conclusions Compared to PL, TBL showed greater improvement in knowledge scores, with continued improvement up to 48 hours later. This effect is larger in academically weaker students. TBL is an effective method for improving knowledge in neurological localization and neurological emergencies in undergraduates.

  10. Contemporary Teaching of Neurology. Teaching Neurological Behavior to General Practitioners: A Fresh Approach

    Science.gov (United States)

    Derouesne, C.; Salamon, R.

    1977-01-01

    Ways in which teaching neurology can be simplified for the nonspecialist practitioner are addressed in this assessment of the state-of-the-art in France. The hypothesis implies simplifying both the diagnoses and symptomatology. (LBH)

  11. Medical Emergencies in Goa

    Science.gov (United States)

    Saddichha, Sahoo; Saxena, Mukul Kumar

    2010-01-01

    Background: Most emergencies in Goa arise due to road traffic accidents and drowning, which have been compounded by the rise in number of recorded accidents in 2007 to be above 4000. It is believed that 11 people meet with an accident on Goa's roads every day and this is expected to rise by 10% by next year. Similar is the case with drownings and other medical emergencies. We therefore aimed to conduct a cross-sectional survey of medical emergencies and identify various types of emergencies presenting to emergency departments. Materials and Methods: Using a stratified random sampling design, all emergencies presenting to the three government hospitals in Goa, which handle 90% of all emergencies currently, were studied on specially designed data sheets in order to collect data. Emergency medical technicians (ETs) were placed in the Casualty Ward of the medical colleges and they recorded all emergencies on the data sheet. The collected data were then analyzed for stratification and mapping of emergencies. Results: GMC Hospital attended to majority of emergencies (62%), which were mainly of the nature of accidents or assaults (17%) and fever related (17%). Most emergencies were noncritical and about 1% expired. Maximum emergencies also presented from Salcette and Bardez, and occurred among young males in the age group of 19-45 years. Males were also more prone to accidents while females had pregnancies as emergencies. Conclusion: Potential emergency services need to target young males with higher concentrations required in Salcette in South Goa and Bardez in North Goa. PMID:20606921

  12. The "Growing" Reality of the Neurological Complications of Global "Stem Cell Tourism".

    Science.gov (United States)

    Julian, Katie; Yuhasz, Nick; Hollingsworth, Ethan; Imitola, Jaime

    2018-04-01

    "Stem cell tourism" is defined as the unethical practice of offering unproven cellular preparations to patients suffering from various medical conditions. This phenomenon is rising in the field of neurology as patients are requesting information and opportunities for treatment with stem cells for incurable conditions such as multiple sclerosis and amyotrophic lateral sclerosis, despite their clinical research and experimental designation. Here, we review the recent trends in "stem cell tourism" in both the United States and abroad, and discuss the recent reports of neurological complications from these activities. Finally, we frame critical questions for the field of neurology regarding training in the ethical, legal, and societal issues of the global "stem cell tourism," as well as suggest strategies to alleviate this problem. Although there are ongoing legitimate clinical trials with stem cells for neurological diseases, procedures offered by "stem cell clinics" cannot be defined as clinical research. They lack the experimental and state-of-the-art framework defined by peers and the FDA that focus on human research that safeguard the protection of human subjects against economical exploitation, unwanted side effects, and futility of unproven procedures. "Stem cell tourism" ultimately exploits therapeutic hope of patients and families with incurable neurological diseases and can put in danger the legitimacy of stem cell research as a whole. We posit that an improvement in education, regulation, legislation, and involvement of authorities in global health in neurology and neurosurgery is required. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  13. Online tools for individuals with depression and neurologic conditions: A scoping review.

    Science.gov (United States)

    Lukmanji, Sara; Pham, Tram; Blaikie, Laura; Clark, Callie; Jetté, Nathalie; Wiebe, Samuel; Bulloch, Andrew; Holroyd-Leduc, Jayna; Macrodimitris, Sophia; Mackie, Aaron; Patten, Scott B

    2017-08-01

    Patients with neurologic conditions commonly have depression. Online tools have the potential to improve outcomes in these patients in an efficient and accessible manner. We aimed to identify evidence-informed online tools for patients with comorbid neurologic conditions and depression. A scoping review of online tools (free, publicly available, and not requiring a facilitator) for patients with depression and epilepsy, Parkinson disease (PD), multiple sclerosis (MS), traumatic brain injury (TBI), or migraine was conducted. MEDLINE, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews, and Cochrane CENTRAL Register of Controlled Trials were searched from database inception to January 2017 for all 5 neurologic conditions. Gray literature using Google and Google Scholar as well as app stores for both Android and Apple devices were searched. Self-management or self-efficacy online tools were not included unless they were specifically targeted at depression and one of the neurologic conditions and met the other eligibility criteria. Only 4 online tools were identified. Of these 4 tools, 2 were web-based self-management programs for patients with migraine or MS and depression. The other 2 were mobile apps for patients with PD or TBI and depression. No online tools were found for epilepsy. There are limited depression tools for people with neurologic conditions that are evidence-informed, publicly available, and free. Future research should focus on the development of high-quality, evidence-based online tools targeted at neurologic patients.

  14. Therapists' experiences and perceptions of teamwork in neurological rehabilitation: critical happenings in effective and ineffective teamwork.

    Science.gov (United States)

    Suddick, Kitty M; De Souza, Lorraine H

    2007-12-01

    This paper reports the second part of an exploratory study into occupational therapists' and physiotherapists' perceptions and experiences of teamwork in neurological rehabilitation: the factors that were thought to influence effective and ineffective teamwork, and the meaning behind effective and ineffective teamwork in neurological rehabilitation. The study was undertaken through semi-structured interviews of 10 therapists from three different neurological rehabilitation teams based in the United Kingdom, and used the critical incident technique. Through analysis of the data, several main themes emerged regarding the perceived critical happenings in effective and ineffective teamwork. These were: team events and characteristics, team members' characteristics, shared and collaborative working practices, communication, specific organizational structures, environmental, external, and patient and family-related factors. Effective and ineffective team-work was perceived to impact on a number of levels: having implications for the team, the patient, individual team members, and the neurological rehabilitation service. The study supported the perceived value of team work within neurological rehabilitation. It also indicated the extensive and variable factors that may influence the team-working process as well as the complex and diverse nature of the process.

  15. Trends in American Board of Psychiatry and Neurology specialties and neurologic subspecialties

    Science.gov (United States)

    Faulkner, L.R.; Juul, D.; Pascuzzi, R.M.; Aminoff, M.J.; Crumrine, P.K.; DeKosky, S.T.; Jozefowicz, R.F.; Massey, J.M.; Pirzada, N.; Tilton, A.

    2010-01-01

    Objective: To review the current status and recent trends in the American Board of Psychiatry and Neurology (ABPN) specialties and neurologic subspecialties and discuss the implications of those trends for subspecialty viability. Methods: Data on numbers of residency and fellowship programs and graduates and ABPN certification candidates and diplomates were drawn from several sources, including ABPN records, Web sites of the Accreditation Council for Graduate Medical Education and the American Medical Association, and the annual medical education issues of the Journal of the American Medical Association. Results: About four-fifths of neurology graduates pursue fellowship training. While most recent neurology and child neurology graduates attempt to become certified by the ABPN, many clinical neurophysiologists elect not to do so. There appears to have been little interest in establishing fellowships in neurodevelopmental disabilities. The pass rate for fellowship graduates is equivalent to that for the “grandfathers” in clinical neurophysiology. Lower percentages of clinical neurophysiologists than specialists participate in maintenance of certification, and maintenance of certification pass rates are high. Conclusion: The initial enthusiastic interest in training and certification in some of the ABPN neurologic subspecialties appears to have slowed, and the long-term viability of those subspecialties will depend upon the answers to a number of complicated social, economic, and political questions in the new health care era. PMID:20855855

  16. Status of neurology medical school education: results of 2005 and 2012 clerkship director survey.

    Science.gov (United States)

    Carter, Jonathan L; Ali, Imran I; Isaacson, Richard S; Safdieh, Joseph E; Finney, Glen R; Sowell, Michael K; Sam, Maria C; Anderson, Heather S; Shin, Robert K; Kraakevik, Jeff A; Coleman, Mary; Drogan, Oksana

    2014-11-04

    To survey all US medical school clerkship directors (CDs) in neurology and to compare results from a similar survey in 2005. A survey was developed by a work group of the American Academy of Neurology Undergraduate Education Subcommittee, and sent to all neurology CDs listed in the American Academy of Neurology database. Comparisons were made to a similar 2005 survey. Survey response rate was 73%. Neurology was required in 93% of responding schools. Duration of clerkships was 4 weeks in 74% and 3 weeks in 11%. Clerkships were taken in the third year in 56%, third or fourth year in 19%, and fourth year in 12%. Clerkship duration in 2012 was slightly shorter than in 2005 (fewer clerkships of ≥4 weeks, p = 0.125), but more clerkships have moved into the third year (fewer neurology clerkships during the fourth year, p = 0.051). Simulation training in lumbar punctures was available at 44% of schools, but only 2% of students attempted lumbar punctures on patients. CDs averaged 20% protected time, but reported that they needed at least 32%. Secretarial full-time equivalent was 0.50 or less in 71% of clerkships. Eighty-five percent of CDs were "very satisfied" or "somewhat satisfied," but more than half experienced "burnout" and 35% had considered relinquishing their role. Trends in neurology undergraduate education since 2005 include shorter clerkships, migration into the third year, and increasing use of technology. CDs are generally satisfied, but report stressors, including inadequate protected time and departmental support. © 2014 American Academy of Neurology.

  17. Neurology as career option among postgraduate medical students

    Directory of Open Access Journals (Sweden)

    Namit B Gupta

    2013-01-01

    Full Text Available Background: In the context of inadequacy of neurology workforce in India, it is important to understand factors that post-graduate medical students consider for and against choosing neurology as their career option. Understanding these factors will help in planning strategies to encourage students to pursue a career in neurology. At present, there is a paucity of studies addressing this issue in India. Aims and Objectives: (1 To analyze factors, which post-graduate students consider for and against choosing neurology as a career specialty. (2 To access the level and quality of neurology exposure in the current MBBS and MD curricula. Materials and Methods: Statewide questionnaire based study was conducted in the state of Maharashtra for students eligible to take DM neurology entrance examination (MD Medicine and MD Pediatrics. Results: In this survey, 243 students were enrolled. Factors bringing students to neurology were - intellectual challenge and logical reasoning (72%, inspired by role model teachers (63%, better quality-of-life (51% and scope for independent practice without expensive infrastructure (48%. Factors preventing students from taking neurology were - perception that most neurological diseases are degenerative (78%, neurology is mainly an academic specialty (40%, neurophobia (43% and lack of procedures (57%. Inadequate exposure and resultant lack of self-confidence were common (31%, 70-80%. 84% of the students felt the need for a short term certification course in neurology after MD. Conclusions: To attract more students to neurology, "role model" teachers of neurology could interact and teach students extensively. Neurologists′ efforts to shed their diagnostician′s image and to shift their focus to therapeutics will help change the image of neurology. Out-patient neurology clinics should be incorporated early in the student′s career. Procedures attract students; hence, they should be made conversant with procedures and

  18. Neurological abnormalities associated with CDMA exposure.

    Science.gov (United States)

    Hocking, B; Westerman, R

    2001-09-01

    Dysaesthesiae of the scalp and neurological abnormality after mobile phone use have been reported previously, but the roles of the phone per se or the radiations in causing these findings have been questioned. We report finding a neurological abnormality in a patient after accidental exposure of the left side of the face to mobile phone radiation [code division multiple access (CDMA)] from a down-powered mobile phone base station antenna. He had headaches, unilateral left blurred vision and pupil constriction, unilateral altered sensation on the forehead, and abnormalities of current perception thresholds on testing the left trigeminal ophthalmic nerve. His nerve function recovered during 6 months follow-up. His exposure was 0.015-0.06 mW/cm(2) over 1-2 h. The implications regarding health effects of radiofrequency radiation are discussed.

  19. Neuroelectrophysiological studies on neurological autoimmune diseases

    Directory of Open Access Journals (Sweden)

    Yin-hong LIU

    2014-09-01

    Full Text Available The neuroelectrophysiological manifestations of four clinical typical neurological autoimmune diseases including multiple sclerosis (MS, Guillain-Barré syndrome (GBS, myasthenia gravis (MG, and polymyositis and dermatomyositis were reviewed in this paper. The diagnostic value of evoked potentials for multiple sclerosis, nerve conduction studies (NCS for Guillain-Barré syndrome, repetitive nerve stimulation (RNS and single-fiber electromyography (SFEMG for myasthenia gravis, and needle electromyography for polymyositis and dermatomyositis were respectively discussed. This review will help to have comprehensive understanding on electrophysiological examinations and their clinical significance in the diagnosis of neurological autoimmune diseases. doi: 10.3969/j.issn.1672-6731.2014.09.004

  20. Neurological manifestations of Chikungunya and Zika infections

    Directory of Open Access Journals (Sweden)

    Talys J. Pinheiro

    Full Text Available ABSTRACT The epidemics of Chikungunya virus (CHIKV and Zika virus (ZIKV infections have been considered the most important epidemiological occurrences in the Americas. The clinical picture of CHIKV infection is characterized by high fever, exanthema, myalgia, headaches, and arthralgia. Besides the typical clinical picture of CHIKV, atypical manifestations of neurological complications have been reported: meningo-encephalitis, meningoencephalo-myeloradiculitis, myeloradiculitis, myelitis, myeloneuropathy, Guillain-Barré syndrome and others. The diagnosis is based on clinical, epidemiological, and laboratory criteria. The most common symptoms of ZIKV infection are skin rash (mostly maculopapular, fever, arthralgia, myalgia, headache, and conjunctivitis. Some epidemics that have recently occurred in French Polynesia and Brazil, reported the most severe conditions, with involvement of the nervous system (Guillain-Barré syndrome, transverse myelitis, microcephaly and meningitis. The treatment for ZIKV and CHIKV infections are symptomatic and the management for neurological complications depends on the type of affliction. Intravenous immunoglobulin, plasmapheresis, and corticosteroid pulse therapy are options.

  1. [Bioethics in Russian neurology and epileptology].

    Science.gov (United States)

    Mikhalkovska-Karlova, E P

    2016-01-01

    Historical roots and further development of bioethics in domestic neurology and epileptology are considered. The main bioethical principles were established during the formation of the Russian clinical school and neurosciences. It is most distinctly seen in the development of bioethics in neurology and epileptology. In the author's opinion, the Russian scientist V.M. Bekhterev had played a prominent role in the field. In the time when the term "bioethics" was not coined and its principles were not formulated, V.M. Bekhterev had created the Russian league against epilepsy and established the foundations of the International League Against Epilepsy (ILAE) as the organizations working on the problems of medical and social care to patients with epilepsy. In Russia, the Russian society of neurologists has been doing a great work in the field.

  2. Psychiatry and neurology: from dualism to integration.

    Science.gov (United States)

    Sobański, Jerzy A; Dudek, Dominika

    2013-01-01

    The two objectives of the following paper are: to make few remarks on the topic absorbing neurologists, psychiatrists, and neuropsychiatrists - integration and division of their specialties; and to describe the situation in Poland, reflected in the latest literature. The authors describe the former and present processes of approaches and divisions in psychiatry and neurology. They indicate dissemination of mutual methods of structural and action brain neuroimaging, neurophysiology, neurogenetics, and advanced neurophysiology diagnostics. As it seems, even the effectiveness of psychotherapy, has recently been associated with changes in brain in functional and even structural markers. The authors indicate the value of the strive to join the still divided specialties, reflected worldwide in attempts of common education and clinical cooperation of physicians. It can be expected that subsequent years will bring further triumphs of neuropsychiatry - a field that combines psychiatry and neurology.

  3. Neurological manifestations of excessive alcohol consumption.

    Science.gov (United States)

    Planas-Ballvé, Anna; Grau-López, Laia; Morillas, Rosa María; Planas, Ramón

    2017-12-01

    This article reviews the different acute and chronic neurological manifestations of excessive alcohol consumption that affect the central or peripheral nervous system. Several mechanisms can be implicated depending on the disorder, ranging from nutritional factors, alcohol-related toxicity, metabolic changes and immune-mediated mechanisms. Recognition and early treatment of these manifestations is essential given their association with high morbidity and significantly increased mortality. Copyright © 2017 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

  4. Music therapy in neurological rehabilitation settings

    OpenAIRE

    Elżbieta Galińska

    2015-01-01

    The neurologic music therapy is a new scope of music therapy. Its techniques deal with dysfunctions resulting from diseases of the human nervous system. Music can be used as an alternative modality to access functions unavailable through non-musical stimulus. Processes in the brain activated by the influence of music can be generalized and transferred to non-musical functions. Therefore, in clinical practice, the translation of non-musical therapeutic exercises into analogous, isomorphic ...

  5. [The problem of suicide in neurologic rehabilitation].

    Science.gov (United States)

    Kallert, T W

    1994-05-01

    Associations between somatic as well as, in particular, neurological diseases and suicidal acts are outlined, with studies of different diseases having shown that they represent only one factor in motivating the suicidal act. Biographical predispositions and stressful variables from the current social situation are always added. Depressive and organic brain syndromes that can often be found during neurological rehabilitation are discussed in their significance as risk factors for suicidal behavior, also seeking to identify distinct phases of the rehabilitation process afflicted with high suicide risk. An active and carefully directed approach to exploration as well as grasping the psychopathological symptomatology are fundamental elements in the assessment of suicide risk. In this respect, observations of the patient's behaviour and information obtained from relatives are of special importance in neurological rehabilitation clinics. The "presuicidal syndrome" (Ringel) continues to be of high clinical value in assessing the psychodynamics of the individual patient in his development towards the suicidal act. Reflections of suicidal tendencies in countertransference reactions and the communication pathology of suicidal behaviour are more recent aspects that enrich the assessment of suicide risk. Therapeutic management of suicidal patients can firstly be characterized by the principle of specific diagnosis and treatment of the underlying disease; this means that optimum medical care even has a suicide-preventive function. The other principle considers the establishment of a therapeutical relationship as a must, and some critical points in the personal contact with suicidal patients are dealt with in some detail. Especially in neurological rehabilitation clinics, custodial aspects must not be neglected.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Neurological complications are avoidable during CABG.

    Science.gov (United States)

    Haider, Zulfiqar; Jalal, Anjum; Alamgir, Asif Rashid; Rasheed, Irfan

    2018-01-01

    To review the incidence of stroke in patients undergoing CABG and the impact of a preventive strategy adopted at tertiary care unit of cardiac surgery. The data of all patients who underwent isolated CABG (N= 722) from July 2016 to August 2017 at Faisalabad Institute of Cardiology was retrieved for this retrospective study. All operations were done on cardiopulmonary bypass and cold blood cardioplegia. Numeric data was summarized as Mean ± Standard Deviation while categoric variables were summarized into frequency and percentage. Mean age of patients was 53.83±8.8 years. Mean Parsonnet and Logistic EuroScore were 4.3±3.2 and 3.3±0.9 respectively. Forty nine patients (6.78%) had significant carotid artery disease. Mean number of grafts was 2.8±0.82. Diabetes was present in 27.8% patients. Neurological complications were noticed in 14 patients (1.94%) who included 12 permanent paralyses. Further subgroup analysis revealed that 67 patients who were operated by single clamp technique remained free of neurological complications. This is clinically remarkable finding but due to small population size it is statistically non- significant. The incidence of neurological complications can be reduced significantly by adopting the appropriate preventing measures. Use of Single Clamp technique may be the reasons of such a low incidence of stroke in this study.

  7. Radiopharmaceutical Stem Cell Tracking for Neurological Diseases

    Directory of Open Access Journals (Sweden)

    Paulo Henrique Rosado-de-Castro

    2014-01-01

    Full Text Available Although neurological ailments continue to be some of the main causes of disease burden in the world, current therapies such as pharmacological agents have limited potential in the restoration of neural functions. Cell therapies, firstly applied to treat different hematological diseases, are now being investigated in preclinical and clinical studies for neurological illnesses. However, the potential applications and mechanisms for such treatments are still poorly comprehended and are the focus of permanent research. In this setting, noninvasive in vivo imaging allows better understanding of several aspects of stem cell therapies. Amongst the various methods available, radioisotope cell labeling has become one of the most promising since it permits tracking of cells after injection by different routes to investigate their biodistribution. A significant increase in the number of studies utilizing this method has occurred in the last years. Here, we review the different radiopharmaceuticals, imaging techniques, and findings of the preclinical and clinical reports published up to now. Moreover, we discuss the limitations and future applications of radioisotope cell labeling in the field of cell transplantation for neurological diseases.

  8. Residency Training: Work engagement during neurology training.

    Science.gov (United States)

    Zis, Panagiotis; Anagnostopoulos, Fotios; Artemiadis, Artemios K

    2016-08-02

    Work engagement, defined as a positive, fulfilling, work-related state of mind that is characterized by vigor, dedication, and absorption, can ameliorate patient care and reduce medical errors. The purpose of this cross-sectional study was to investigate work engagement among neurology residents in the region of Attica, Greece. In total, 113 residents participated in this study. Demographic and work-related characteristics, as well as emotional exhaustion and personality traits (neuroticism), were examined via an anonymous questionnaire. Work engagement was measured by the Utrecht Work Engagement Scale. The study sample had a mean age of 34.6 ± 3.6 years, ranging from 26 to 45 years. Sixty-two (54.9%) participants were women and 45 (39.8%) were married. After adjusting for sex, emotional exhaustion, and neuroticism, the main factors associated with work engagement were autonomy and chances for professional development. Providing more chances for trainees' professional development as well as allowing for and supporting greater job autonomy may improve work engagement during neurology training. © 2016 American Academy of Neurology.

  9. Nanotechnology based diagnostics for neurological disorders

    Energy Technology Data Exchange (ETDEWEB)

    Kurek, Nicholas S; Chandra, Sathees B., E-mail: schandra@roosevelt.edu [Department of Biological, Chemical and Physical Sciences, Roosevelt University, Chicago, IL (United States)

    2012-07-01

    Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

  10. Neurological Manifestations In Inflammatory Bowel Disease

    Directory of Open Access Journals (Sweden)

    youssef HNACH

    2015-06-01

    Full Text Available IntroductionThe purpose of this retrospective study was to report neurological manifestations noted in patients who were monitored for inflammatory bowel disease, in order to document the pathophysiological, clinical, progressive, and therapeutic characteristics of this entity.Material and methodsWe conducted a retrospective study on patients monitored -in the gastroenterology service in Ibn Sina Hospital in Rabat, Morocco- for inflammatory bowel disease from 1992 till 2013 and who developed neurological manifestations during its course. Patients with iatrogenic complications were excluded, as well as patients with cerebrovascular risk factors.ResultsThere were 6 patients, 4 of whom have developed peripheral manifestations. Electromyography enabled the diagnosis to be made and the outcome was favorable with disappearance of clinical manifestations and normalization of the electromyography.The other 2 patients, monitored for Crohn’s disease, developed ischemic stroke. Cerebral computed tomography angiography provided positive and topographic diagnosis. Two patients were admitted to specialized facilities.ConclusionNeurological manifestations in inflammatory bowel disease are rarely reported.  Peripheral neuropathies and stroke remain the most common manifestations. The mechanisms of these manifestations are not clearly defined yet. Currently, we hypothesize the interaction of immune mediators.

  11. Nanotechnology based diagnostics for neurological disorders

    Energy Technology Data Exchange (ETDEWEB)

    Kurek, Nicholas S.; Chandra, Sathees B., E-mail: schandra@roosevelt.edu [Department of Biological, Chemical and Physical Sciences, Roosevelt University, Chicago, IL (United States)

    2012-07-01

    Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

  12. [Neurology in mediaeval medical poetry in Latin].

    Science.gov (United States)

    de Frutos-González, V; Guerrero-Peral, A L

    Medical poems written in Latin during the Middle Ages constitute an important part of mediaeval literature on medicine and offer the advantage of making it easier for the reader to memorise their contents. They were to exert a notable influence of later medical literature. An analysis of works such as Medicinalis liber by Benedictus Crispus of Milan; De cultura hortorum by Walahfrid Strabo; the anonymous work known as Macer floridus; De pulsibus, De urinis, and De signis et symptomatibus aegritudinum, three treatises by Aegidius of Corbeil or the Poema anatomicum, belonging to the Salerno Medical School, reveals what neurological aspects were known in the Middle Ages and how important this medical discipline was in that period. References to pathologies in the field of neurology are very frequent in mediaeval medical poems in Latin. They deal with diseases involving the nerves, cephalea, tremors, epilepsy, vertigos and disorders affecting memory or the sense organs. These mediaeval medical works in Latin offer us an interesting insight into the way neurological diseases were viewed by western physicians in the Middle Ages, as well as describing the remedies that were employed at that time to treat them, most of which involved the use of plants that were considered to have medicinal properties.

  13. [Drooling therapy in children with neurological disorders].

    Science.gov (United States)

    Táboas-Pereira, M Andrea; Paredes-Mercado, Cecilia; Alonso-Curcó, Xènia; Badosa-Pagès, Joaquim; Muchart, Jordi; Póo, Pilar

    2015-07-16

    Drooling is the inability to retain saliva in the mouth and its progression to the digestive tract, being a common problem in pediatric patients with neurological disorders. Three different treatment options are available. To assess the effectiveness and safety of trihexyphenidyl, scopolamine and botulinum toxin infiltration in the treatment of drooling in children with neurological disorders. This is an open and prospective type study. We include patients treated in the Neurology Service that present excessive drooling, affecting their quality of life, between 2009 and 2013. We enrolled 46 patients in the study. The treatment with oral trihexyphenidyl was indicated in 46, obtaining good result in 15 (32.6%), three with temporary effect and the rest with lasting effect. Three patients presented side effects (6.5%). Four out of 11 (36.36%) patients treated with scopolamine patch had beneficial effects. One was withdrawn due to lack of efficacy and six due to side effects. Twenty-five patients were infiltrated with botulinum toxin, with a significant decrease of drooling in 16 patients (64%) after the first injection. We observed no significant changes in nine patients. Only one out of 25 showed side effects (mild dysphagia). Currently there is not a fully effective therapeutic option for drooling. We recommend starting treatment with trihexyphenidyl. A second option could be the scopolamine patch and botulinum toxin as a third option. Botulinum toxin infiltration in salivary glands is shown as an effective and safe alternative in our study.

  14. Nanotechnology based diagnostics for neurological disorders

    International Nuclear Information System (INIS)

    Kurek, Nicholas S.; Chandra, Sathees B.

    2012-01-01

    Nanotechnology involves probing and manipulating matter at the molecular level. Nanotechnology based molecular diagnostics have the potential to alleviate the suffering caused by many diseases, including neurological disorders, due to the unique properties of nanomaterials. Most neurological illnesses are multifactorial conditions and many of these are also classified as neurobehavioral disorders. Alzheimer's disease, Parkinson's disease, Huntington disease, cerebral ischemia, epilepsy, schizophrenia and autism spectrum disorders like Rett syndrome are some examples of neurological disorders that could be better treated, diagnosed, prevented and possibly cured using nanotechnology. In order to improve the quality of life for disease afflicted people, a wide range of nanomaterials that include gold and silica nanoparticles, quantum dots and DNA along with countless other forms of nanotechnology have been investigated regarding their usefulness in advancing molecular diagnostics. Other small scaled materials like viruses and proteins also have potential for use as molecular diagnostic tools. Information obtained from nanotechnology based diagnostics can be stored and manipulated using bioinformatics software. More advanced nanotechnology based diagnostic procedures for the acquisition of even greater proteomic and genomic knowledge can then be developed along with better ways to fight various diseases. Nanotechnology also has numerous applications besides those related to biotechnology and medicine. In this article, we will discuss and analyze many novel nanotechnology based diagnostic techniques at our disposal today. (author)

  15. Sparring And Neurological Function In Professional Boxers

    Directory of Open Access Journals (Sweden)

    John W Stiller

    2014-07-01

    Full Text Available AbstractDespite increased interest regarding the potentially long-term negative impact of chronic traumatic brain injury (CTBI, limited research had been conducted regarding such injuries and neurological outcomes in real world settings. To increase understanding regarding the relationship between sparring (e.g., number of years actively training for professional boxing and neurological functioning, professional boxers (n = 237 who competed in Maryland between 2003 to 2008 completed measures regarding sparring exposure (Cumulative Sparring Index; CSI and performance on tests of cognition (Symbol Digit Modalities Test; SDMT and balance (Sharpened Romberg Test; SRT. Measures were completed prior to boxing matches. Higher scores on the CSI (increased sparring exposure were associated with poorer performance on both tests of cognition (SDMT and balance (SRT. A threshold effect was noted regarding performance on the SDMT, with those reporting CSI values greater than about 150 experiencing a decline in cognition. A history of frequent and/or intense sparring may pose a significant risk for developing boxing associated neurological sequelae. Implementing administration of clinically meaningful tests before bouts, such as the CSI, SDMT, and/or the SRT, as well as documentation of results into the boxer’s physicals or medical profiles may be an important step for improving boxing safety.

  16. Clinical statistics of patients with dizziness consulting the emergency outpatient clinic

    International Nuclear Information System (INIS)

    Ogawa, Yasuo; Hagiwara, Akira; Kitajima, Naoharu; Inagaki, Taro; Shimizu, Masaaki; Furuse, Hiroko; Konomi, Ujimoto; Yukawa, Kumiko; Suzuki, Mamoru

    2007-01-01

    Between May 2004 and April 2006, 468 emergency patients with vertigo or dizziness consulted the otorhinolarygological emergency room of Tokyo Medical University. Patients with vertigo or dizziness comprised about 9% of the whole otorhinolaryngological emergency patients. The number of female patients was larger than that of male patients. About half of the patients were brought to our hospital by ambulance. Nystagmus was observed in 219 patients (46.8%). Incidence of nystagmus was highest on positional nystagmus test. Brain CT was obtained in 185 patients (39.5%), but there were no abnormal findings in any patients. The most frequent diagnosis was inner ear disorder (22%), followed by Meniere's disease (7%), vestibular neuritis (6%), Benign paroxysmal positional vertigo (BPPV) (6%). Cerebral infarction was observed in 1.9%. Eighty-four patients were admitted. Major diseases requiring admission were vestibular neuritis and inner ear disorder. In patients with cerebral infarction, brain CT was normal. These patients were all elderly males over 60 years old. Their nystagmus in the emergency room did not suggest central disorder, or they did not have other neurological findings. Neurological signs and symptoms appeared thereafter. In the emergency room, establishing a diagnosis by limited examination is difficult. Careful examination is necessary, since vertigo or dizzy patient with a central disorder can show sudden change. (author)

  17. The Clinical Spectrum of Neurological Manifestations in HIV/AIDS ...

    African Journals Online (AJOL)

    Background: The human immunodeficiency virus (HIV) is primarily neurotrophic and lymphotrophic. Diverse neurologic sequealae have been documented with variations based on disease severity, but geographic variation may determine the distribution of these neurological complications. Objective: This study was ...

  18. Risks and benefits of antireflux operations in neurologically impaired children

    NARCIS (Netherlands)

    Borgstein, E. S.; Heij, H. A.; Beugelaar, J. D.; Ekkelkamp, S.; Vos, A.

    1994-01-01

    Gastro-oesophageal reflux (GER) in neurologically impaired children often causes feeding problems and complications of oesophagitis and is frequently resistant to medical treatment. Fifty neurologically impaired children underwent anterior gastropexy as anti-reflux operation, combined with

  19. Neurology in Federico Fellini?s work and life.

    Science.gov (United States)

    Teive, Hélio Afonso Ghizoni; Caramelli, Paulo; Cardoso, Francisco Eduardo Costa

    2014-09-01

    The authors present a historical review of the neurological diseases related to the famous moviemaker Federico Fellini. There is an account of diseases depicted on his movies as well as his ischemic stroke and consequent neurological deficit - left spatial neglect.

  20. Psychiatric morbidity in a Nigerian neurology clinic | Ajiboye | East ...

    African Journals Online (AJOL)

    Psychiatric morbidity in a Nigerian neurology clinic. ... Log in or Register to get access to full text downloads. ... The study supports previous reports that psychiatric disorders are quite common among patients with neurological disorders.

  1. Neuromarketing and consumer neuroscience: contributions to neurology.

    Science.gov (United States)

    Javor, Andrija; Koller, Monika; Lee, Nick; Chamberlain, Laura; Ransmayr, Gerhard

    2013-02-06

    'Neuromarketing' is a term that has often been used in the media in recent years. These public discussions have generally centered around potential ethical aspects and the public fear of negative consequences for society in general, and consumers in particular. However, positive contributions to the scientific discourse from developing a biological model that tries to explain context-situated human behavior such as consumption have often been neglected. We argue for a differentiated terminology, naming commercial applications of neuroscientific methods 'neuromarketing' and scientific ones 'consumer neuroscience'. While marketing scholars have eagerly integrated neuroscientific evidence into their theoretical framework, neurology has only recently started to draw its attention to the results of consumer neuroscience. In this paper we address key research topics of consumer neuroscience that we think are of interest for neurologists; namely the reward system, trust and ethical issues. We argue that there are overlapping research topics in neurology and consumer neuroscience where both sides can profit from collaboration. Further, neurologists joining the public discussion of ethical issues surrounding neuromarketing and consumer neuroscience could contribute standards and experience gained in clinical research. We identify the following areas where consumer neuroscience could contribute to the field of neurology:First, studies using game paradigms could help to gain further insights into the underlying pathophysiology of pathological gambling in Parkinson's disease, frontotemporal dementia, epilepsy, and Huntington's disease.Second, we identify compulsive buying as a common interest in neurology and consumer neuroscience. Paradigms commonly used in consumer neuroscience could be applied to patients suffering from Parkinson's disease and frontotemporal dementia to advance knowledge of this important behavioral symptom.Third, trust research in the medical context lacks

  2. Neuromarketing and consumer neuroscience: contributions to neurology

    Science.gov (United States)

    2013-01-01

    Background ‘Neuromarketing’ is a term that has often been used in the media in recent years. These public discussions have generally centered around potential ethical aspects and the public fear of negative consequences for society in general, and consumers in particular. However, positive contributions to the scientific discourse from developing a biological model that tries to explain context-situated human behavior such as consumption have often been neglected. We argue for a differentiated terminology, naming commercial applications of neuroscientific methods ‘neuromarketing’ and scientific ones ‘consumer neuroscience’. While marketing scholars have eagerly integrated neuroscientific evidence into their theoretical framework, neurology has only recently started to draw its attention to the results of consumer neuroscience. Discussion In this paper we address key research topics of consumer neuroscience that we think are of interest for neurologists; namely the reward system, trust and ethical issues. We argue that there are overlapping research topics in neurology and consumer neuroscience where both sides can profit from collaboration. Further, neurologists joining the public discussion of ethical issues surrounding neuromarketing and consumer neuroscience could contribute standards and experience gained in clinical research. Summary We identify the following areas where consumer neuroscience could contribute to the field of neurology: First, studies using game paradigms could help to gain further insights into the underlying pathophysiology of pathological gambling in Parkinson’s disease, frontotemporal dementia, epilepsy, and Huntington’s disease. Second, we identify compulsive buying as a common interest in neurology and consumer neuroscience. Paradigms commonly used in consumer neuroscience could be applied to patients suffering from Parkinson’s disease and frontotemporal dementia to advance knowledge of this important behavioral symptom

  3. [Should hospitalization be required after the emergency discharge of patients with borderline personality disorder who have attempted suicide (FRENCH CRISIS cohort)?].

    Science.gov (United States)

    Cailhol, L; Riedi, G; Mathur, A; Czapla, P; Charpentier, S; Genestal, M; Birmes, P

    2014-09-01

    Borderline personality disorder (BPD) is characterized by a pervasive pattern of instability and impulsivity. There is a high prevalence of BPD patients among those admitted to the emergency department for suicide attempts. However, little empirical research exists to assist clinicians in deciding whether to hospitalize a suicidal patient. Some authors have argued that hospitalization does not prevent suicide and could actually harm these patients, thereby leading to psychosocial regression. Parasuicidal behaviors could be reinforced by the attention given during hospitalization. Our purpose was to determine whether the hospitalization of suicidal patients who have a high risk of BPD after discharge from the emergency department is associated with a recurrence of suicidal behavior at 6months. We designed a prospective study, acquiring patients from three emergency hospitals. The participants were suicidal subjects admitted for voluntary drug intoxication and were 18years of age or older. The participants completed the Personality Disorder Questionnaire (PDQ-4+) to assess BPD symptomatology. Information on the recurrence of suicidal behavior at 6months was obtained by interview of patients and the review of the charts from the 3 hospitals involved in the study. Other assessments included the BDI-13 (severity of depression), the Hopelessness Scale (hopelessness), the TAS-20 (alexythymia), the AUDIT (alcohol disorder) and the MINI (axis I disorders). A total of 606 subjects admitted for a suicide attempt participated in this study. A total of 320 (52.8 %) of the subjects completed the PDQ-4+. The sample was divided into three groups: participants at high risk of having at least one BPD (n=197), a group at high risk of having at least one non-BPD PD (n=84) and a group with low risk of having a PD (n=39). Hospitalization following an emergency was not associated with a recurrence of suicide attempts at 6months among patients at high risk of BPD. A logistical

  4. Morbidity and Mortality Patterns among Neurological Patients in the ...

    African Journals Online (AJOL)

    Background/Objective: The morbidity and mortality of neurological patients managed in the intensive care unit reflect the causes of neurological disorders and the effectiveness of management. Method: The morbidity and mortality patterns of neurological patients admitted into the intensive care unit of the University of Benin ...

  5. Neurological sequelae in survivors of cerebral malaria | Oluwayemi ...

    African Journals Online (AJOL)

    Introduction: Cerebral malaria is a common cause of neurological sequelae and death in childhood. Information on persistent neurological sequelae post hospital discharge and their predisposing factors are scarce. Methods: This is a prospective study describing persisting neurological impairments post discharge among ...

  6. Psychological assessment of malingering in psychogenic neurological disorders and non-psychogenic neurological disorders : relationship to psychopathology levels

    NARCIS (Netherlands)

    van Beilen, M.; Griffioen, B. T.; Gross, A.; Leenders, K. L.

    2009-01-01

    Background and purpose: It remains unknown whether psychological distress causes malingering in patients with psychogenic symptoms. Methods: We studied 26 patients with psychogenic neurological disorders on psychopathology and malingering in comparison with 26 patients with various neurological

  7. Investigation the requirements of supply and distribution emergency logistics management and categorization its sub-criteria using AHP: a case study

    Directory of Open Access Journals (Sweden)

    Sadegh Feizollahi

    2012-10-01

    Full Text Available The management of procurement and distribution is one of the most important branches of the crisis management and events that, has great importance in the field of management. In this paper, we perform an empirical study to investigate important factors on emergency logistic emergency preparation distribution management among people who worked for governorship, hygiene and treatment, Red Crescent, electricity, water and sewage and transportation of central province of Ilam in west part of Iran. The survey distributed a questionnaire among some people and examined six hypotheses. The results of our survey indicate that employees who worked for these organizations maintained high levels of skills; they were able to access what they needed in their organization. In addition, the survey indicates that the access to the necessary information in their organizations; they are able to take care of their documentations. They could also execute their jobs based on good schedules and accomplished their tasks, properly. They survey also performed a multi-criteria decision making approach using AHP to prioritize important activities to improve logistic operations. The results indicate that having a good database is number one priority with relative weight of 0.51, followed by appropriate operating planning with relative weight of 0.295. Supply control came on the third position with relative weight of 0.134 and finally task assignment came as the last priority with relative weight of 0.061.

  8. Getting to value in neurological care: a roadmap for academic neurology.

    Science.gov (United States)

    Holloway, Robert G; Ringel, Steven P

    2011-06-01

    Academic neurology is undergoing transformational changes. The public investment in biomedical research and clinical care is enormous and there is a growing perception that the return on this huge investment is insufficient. Hospitals, departments, and individual neurologists should expect more scrutiny as information about their quality of care and financial relationships with industry are increasingly reported to the public. There are unprecedented changes occurring in the financing and delivery of health care and research that will have profound impact on the mission and operation of academic departments of neurology. With the passage of the Patient Protection and Affordable Care Act (PPACA) there will be increasing emphasis on research that demonstrates value and includes the patient's perspective. Here we review neurological investigations of our clinical and research enterprises that focus on quality of care and comparative effectiveness, including cost-effectiveness. By highlighting progress made and the challenges that lie ahead, we hope to create a clinical, educational, and research roadmap for academic departments of neurology to thrive in today's increasingly regulated environment. Copyright © 2011 American Neurological Association.

  9. Lung Emergencies

    Science.gov (United States)

    ... The Marfan Foundation Marfan & Related Disorders What is Marfan Syndrome? What are Related Disorders? What are the Signs? ... Emergencies Lung Emergencies Surgeries Lung Emergencies People with Marfan syndrome can be at increased risk of sudden lung ...

  10. Public’s Knowledge of Neurology in Headache and Vertigo: A Cross-section from Malatya

    Directory of Open Access Journals (Sweden)

    Aslıhan Baran

    2015-09-01

    Full Text Available OBJECTIVE: In this study,we aim to investigate the perception of neurology’s scope as a branch of medicine using the examples of headaches and vertigo disorders while establishing a relationship with the sociodemographic characteristics of the paticipants in our region. METHODS: 303 patients and patient relatives in Malatya who consulted to family physicians and emergency departments were included in this study. After the giving an informed consent, they were given a questionnare that was administered either in the written form or orally, based on their literacy status. We operationally defined neurolgy awareness as the relationship between complaints of headache and vertigo and their perceived relevance to neurolgy. RESULTS: In our study, 40%(n=121 of the participants reported that they would go to a neurology outpatient clinic if they have a headache and 44,9%(n=136 of the participants reported the same for vertigo complaints. On the other hand, 60%(n=182 of the participants reported that they would go to departments other than neurology if have headache and 55,1%(n=167 if they have vertigo complaints. The rate of patients who actually consulted in a neurology outpatient clinic with a headache complaint was 28.8% (n=45 whereas the rate for those who consulted in departments other than neurology was 71.2% (n=111. The rate of patients who actually consulted in a neurology outpatient clinic with a vertigo complaint was 39.6% (n=36 whereas the rate for those who consulted in departments other than neurology while having vertigo complaints was 60.4% (n=55. The public’s knowledge of neurolgy and both headache and vertigo were more extensive in with higher educational level, urban upbringing, urban residential status and women in general. There was no significant statistical relationship between age and income level with public’s knowledge of Neurology. CONCLUSION: In this study, more than one third of the participants associated complaints

  11. Impact of Early Vasopressor Administration on Neurological Outcomes after Prolonged Out-of-Hospital Cardiac Arrest.

    Science.gov (United States)

    Hubble, Michael W; Tyson, Clark

    2017-06-01

    Introduction Vasopressors are associated with return of spontaneous circulation (ROSC), but no long-term benefit has been demonstrated in randomized trials. However, these trials did not control for the timing of vasopressor administration which may influence outcomes. Consequently, the objective of this study was to develop a model describing the likelihood of favorable neurological outcome (cerebral performance category [CPC] 1 or 2) as a function of the public safety answering point call receipt (PSAP)-to-pressor-interval (PPI) in prolonged out-of-hospital cardiac arrest. Hypothesis The likelihood of favorable neurological outcome declines with increasing PPI. This investigation was a retrospective study of cardiac arrest using linked data from the Cardiac Arrest Registry to Enhance Survival (CARES) database (Centers for Disease Control and Prevention [Atlanta, Georgia USA]; American Heart Association [Dallas, Texas USA]; and Emory University Department of Emergency Medicine [Atlanta, Georgia USA]) and the North Carolina (USA) Prehospital Medical Information System. Adult patients suffering a bystander-witnessed, non-traumatic cardiac arrest between January 2012 and June 2014 were included. Logistic regression was used to calculate the adjusted odds ratio (OR) of neurological outcome as a function of PPI, while controlling for patient age, gender, and race; endotracheal intubation (ETI); shockable rhythm; layperson cardiopulmonary resuscitation (CPR); and field hypothermia. Of the 2,100 patients meeting inclusion criteria, 913 (43.5%) experienced ROSC, 618 (29.4%) survived to hospital admission, 187 (8.9%) survived to hospital discharge, and 155 (7.4%) were discharged with favorable neurological outcomes (CPC 1 or 2). Favorable neurological outcome was less likely with increasing PPI (OR=0.90; PCPR, and ETI were not independent predictors of favorable neurological outcome. In this evaluation, time to vasopressor administration was significantly associated with

  12. Rett syndrome: a neurological disorder with metabolic components

    Science.gov (United States)

    Kyle, Stephanie M.

    2018-01-01

    Rett syndrome (RTT) is a neurological disorder caused by mutations in the X-linked gene methyl-CpG-binding protein 2 (MECP2), a ubiquitously expressed transcriptional regulator. Despite remarkable scientific progress since its discovery, the mechanism by which MECP2 mutations cause RTT symptoms is largely unknown. Consequently, treatment options for patients are currently limited and centred on symptom relief. Thought to be an entirely neurological disorder, RTT research has focused on the role of MECP2 in the central nervous system. However, the variety of phenotypes identified in Mecp2 mutant mouse models and RTT patients implicate important roles for MeCP2 in peripheral systems. Here, we review the history of RTT, highlighting breakthroughs in the field that have led us to present day. We explore the current evidence supporting metabolic dysfunction as a component of RTT, presenting recent studies that have revealed perturbed lipid metabolism in the brain and peripheral tissues of mouse models and patients. Such findings may have an impact on the quality of life of RTT patients as both dietary and drug intervention can alter lipid metabolism. Ultimately, we conclude that a thorough knowledge of MeCP2's varied functional targets in the brain and body will be required to treat this complex syndrome. PMID:29445033

  13. Neurological sequelae of the operation "baby lift" airplane disaster.

    Science.gov (United States)

    Cohen, M; Conners, C K; Brook, I; Feldman, S; Mason, J K; Dugas, M; Collis, L; Copeland, B; Lewis, O; Denhoff, E

    1994-01-01

    The aircraft disaster of the first flight of Operation "Baby Lift", which departed from Saigon, Vietnam, April 4, 1975, was survived by 149 orphaned children on their way to adoptive homes in the West. It had 157 passenger fatalities. The aircraft disaster exposed the surviving children to a complex disaster environment in which subatmospheric decompression, hypoxia, and deceleration were experienced, many children suffered a transient unconsciousness. We examined 135 surviving children between 1978 and 1985. The U.S. resident children were examined in the years 1979 to 1982 at an average age of 8 years and 6 months. They displayed the following symptomatology: attention deficit (> 75%), hyperactivity (> 65%), impulse disorder (> 55%), learning disabilities (> 35%), speech and language pathology (> 70%), and soft neurological signs (> 75%). The European children were examined in the years 1983 to 1985. On arrival at the adoptive home, 2 weeks after the accident they displayed the following symptomatology: muscle hypotonia (26%), seizures (2.5%), and regressed developmental milestones (33%). At the time of the diagnostic evaluations (1983 to 1985) the average age was 11 years and 8 months. They displayed the following symptomatology: attention deficit (59%), hyperactivity (52%), impulse disorder (48%), learning disabilities (43%), soft neurological signs (43%), epilepsy (16%), and speech and language pathology (34%). We conclude that a complex disaster environment can cause brain damage in children without prolonged unconsciousness, and that victims of disasters require a thorough evaluation from a multidisciplinary team.

  14. Gastrointestinal and nutritional problems in neurologically impaired children.

    Science.gov (United States)

    Quitadamo, Paolo; Thapar, Nikhil; Staiano, Annamaria; Borrelli, Osvaldo

    2016-11-01

    The current increasing survival of children with severe central nervous system damage has created a major challenge for medical care. Gastrointestinal and nutritional problems in neurologically impaired children have been recently recognized as an integral part of their disease, often leading to growth failure and worsened quality of life for both children and caregivers. Nutritional support is essential for the optimal care of these children. Undernourished handicapped children might not respond properly to intercurrent diseases and suffer unnecessarily. On the other hand, restoring a normal nutritional status results in a better quality of life in many. The easiest and least invasive method to increase energy intake is to improve oral intake. However, oral intake can be maintained as long as there is no risk of aspiration, the child is growing well and the time required to feed the child remains within acceptable limits. When oral intake is unsafe, insufficient or too time consuming, enteral nutrition should be initiated. Damage to the developing central nervous system may result in significant dysfunction in the gastrointestinal tract and is reflected in impairment in oral-motor function, rumination, gastro-oesophageal reflux (GER), with or without aspiration, delayed gastric emptying and constipation. These problems can all potentially contribute to feeding difficulty in disabled children, carrying further challenging long-term management issues. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  15. Entrepreneurship, Emerging Technologies, Emerging Markets

    NARCIS (Netherlands)

    Thukral, Inderpreet S.; Von Ehr, James; Walsh, Steven Thomas; Groen, Arend J.; van der Sijde, Peter; Adham, Khairul Akmaliah

    2008-01-01

    Academics and practitioners alike have long understood the benefits, if not the risks, of both emerging markets and emerging technologies.Yet it is only recently that foresighted firms have embraced emerging technologies and emerging markets through entrepreneurial activity. Emerging technologies

  16. Use Your Brain: A Neurologically Driven Application of REBT with Children

    Science.gov (United States)

    Grey, Earl

    2010-01-01

    A large body of research has indicated that rational emotive behavioral therapy (REBT) is highly effective for treating many chief complaints. Because of the neurological and developmental limitations of young children, a counselor is required to use concrete and stimulating ways to treat young children. By incorporating art, color, and texture to…

  17. Bridging neuroanatomy, neuroradiology and neurology: three-dimensional interactive atlas of neurological disorders.

    Science.gov (United States)

    Nowinski, W L; Chua, B C

    2013-06-01

    Understanding brain pathology along with the underlying neuroanatomy and the resulting neurological deficits is of vital importance in medical education and clinical practice. To facilitate and expedite this understanding, we created a three-dimensional (3D) interactive atlas of neurological disorders providing the correspondence between a brain lesion and the resulting disorder(s). The atlas contains a 3D highly parcellated atlas of normal neuroanatomy along with a brain pathology database. Normal neuroanatomy is divided into about 2,300 components, including the cerebrum, cerebellum, brainstem, spinal cord, arteries, veins, dural sinuses, tracts, cranial nerves (CN), white matter, deep gray nuclei, ventricles, visual system, muscles, glands and cervical vertebrae (C1-C5). The brain pathology database contains 144 focal and distributed synthesized lesions (70 vascular, 36 CN-related, and 38 regional anatomy-related), each lesion labeled with the resulting disorder and associated signs, symptoms, and/or syndromes compiled from materials reported in the literature. The initial view of each lesion was preset in terms of its location and size, surrounding surface and sectional (magnetic resonance) neuroanatomy, and labeling of lesion and neuroanatomy. In addition, a glossary of neurological disorders was compiled and for each disorder materials from textbooks were included to provide neurological description. This atlas of neurological disorders is potentially useful to a wide variety of users ranging from medical students, residents and nurses to general practitioners, neuroanatomists, neuroradiologists and neurologists, as it contains both normal (surface and sectional) brain anatomy and pathology correlated with neurological disorders presented in a visual and interactive way.

  18. Behavioural and psychiatric symptoms in cognitive neurology.

    Science.gov (United States)

    Robles Bayón, A; Gude Sampedro, F

    2017-03-01

    Behavioural and psychiatric symptoms (BPS) are frequent in neurological patients, contribute to disability, and decrease quality of life. We recorded BPS prevalence and type, as well as any associations with specific diagnoses, brain regions, and treatments, in consecutive outpatients examined in a cognitive neurology clinic. A retrospective analysis of 843 consecutive patients was performed, including a review of BPS, diagnosis, sensory impairment, lesion topography (neuroimaging), and treatment. The total sample was considered, and the cognitive impairment (CI) group (n=607) was compared to the non-CI group. BPS was present in 59.9% of the patients (61.3% in the CI group, 56.4% in the non-CI group). One BPS was present in 31.1%, two in 17.4%, and three or more in 11.4%. BPS, especially depression and anxiety, are more frequent in women than in men. Psychotic and behavioural symptoms predominate in subjects aged 65 and older, and anxiety in those younger than 65. Psychotic symptoms appear more often in patients with sensory impairment. Psychotic and behavioural symptoms are more prevalent in patients with degenerative dementia; depression and anxiety in those who suffer a psychiatric disease or adverse effects of substances; emotional lability in individuals with a metabolic or hormonal disorder; hypochondria in those with a pain syndrome; and irritability in subjects with chronic hypoxia. Behavioural symptoms are more frequent in patients with anomalies in the frontal or right temporal or parietal lobes, and antipsychotics constitute the first line of treatment. Leaving standard treatments aside, associations were observed between dysthymia and opioid analgesics, betahistine and statins, and between psychotic symptoms and levodopa, piracetam, and vasodilators. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Paraneoplastic neurologic syndrome: A practical approach

    Directory of Open Access Journals (Sweden)

    Sudheeran Kannoth

    2012-01-01

    Full Text Available Paraneoplastic neurological syndromes (PNS are rare disorders associated with cancer, not caused by direct invasion, metastasis or consequences of treatment. They are usually autoimmune in nature. Often, PNS precedes the manifestations of cancer. Onconeural antibodies are important in the diagnosis and management of these disorders. These antibodies are specific for the malignancy rather than for a particular neurological syndrome. Often, there are different antibodies associated with the same syndrome. Multiple antibodies are also known to coexist in a given patient with malignancy. While investigating a patient for suspected PNS, the entire gamut of onconeural antibodies should be investigated so as not to miss the diagnosis. In 30-40% of the cases, PNS can occur without antibodies. Investigations for identifying the underlying cancer can be directed by the antibody panel. If conventional screening for cancer is negative, a positron emission scanning/computed tomography scan can be useful. Patients need follow-up surveillance for cancer if not detected in the first instance. Cancer detection and treatment, immunotherapy and supportive care are important components of treatment of PNS. Immunotherapy is very effective in PNS associated with cell membrane-associated antibodies like voltage-gated potassium channel complex, NMDA receptor antibodies and voltage-gated calcium channel antibodies. Immunotherapy includes steroids, IVIgG, plasmaphereis, cytotoxic medications and rituximab. Supportive therapy includes symptomatic treatment with antiepileptic and analgesic medications, physiotherapy, speech therapy and occupational therapy. PNS can mimic any neurologic syndrome. A high index of clinical suspicion is important for early diagnosis and prompt management and better outcome.

  20. Hypnosis as therapy for functional neurologic disorders.

    Science.gov (United States)

    Deeley, Q

    2016-01-01

    Suggestion in hypnosis has been applied to the treatment of functional neurologic symptoms since the earliest descriptions of hypnosis in the 19th century. Suggestion in this sense refers to an intentional communication of beliefs or ideas, whether verbally or nonverbally, to produce subjectively convincing changes in experience and behavior. The recognition of suggestion as a psychologic process with therapeutic applications was closely linked to the derivation of hypnosis from earlier healing practices. Animal magnetism, the immediate precursor of hypnosis, arrived at a psychologic concept of suggestion along with other ideas and practices which were then incorporated into hypnosis. Before then, other forms of magnetism and ritual healing practices such as exorcism involved unintentionally suggestive verbal and nonverbal stimuli. We consider the derivation of hypnosis from these practices not only to illustrate the range of suggestive processes, but also the consistency with which suggestion has been applied to the production and removal of dissociative and functional neurologic symptoms over many centuries. Nineteenth-century practitioners treated functional symptoms with induction of hypnosis per se; imperative suggestions, or commands for specific effects; "medical clairvoyance" in hypnotic trance, in which patients diagnosed their own condition and predicted the time and manner of their recovery; and suggestion without prior hypnosis, known as "fascination" or "psychotherapeutics." Modern treatments largely involve different types of imperative suggestion with or without hypnosis. However, the therapeutic application of suggestion in hypnosis to functional and other symptoms waned in the first half of the 20th century under the separate pressures of behaviorism and psychoanalysis. In recent decades suggestion in hypnosis has been more widely applied to treating functional neurologic symptoms. Suggestion is typically applied within the context of other

  1. Fetal MRI: obstetrical and neurological perspectives

    Energy Technology Data Exchange (ETDEWEB)

    Gressens, Pierre [INSERM E 9935 and Service de Neurologie Pediatrique, Hopital Robert Debre, 48 Blvd Serurier, 75019, Paris (France); Luton, Dominique [Maternity Department, Hopital Robert Debre, Paris (France)

    2004-09-01

    Despite major advances in the understanding and in the genetics of several diseases of the developing brain, early prediction of the neurological prognosis of brain abnormality discovered in utero or of white matter damage discovered in a preterm neonate remains particularly difficult. Advances in prenatal diagnosis and the increased rate of survival of extremely preterm infants who are at higher risk of developing white matter damage underline the critical and urgent need for reliable predictive techniques. New imaging techniques such as diffusion-weighted imaging, magnetic resonance spectroscopy or functional MRI applied to the fetus represent promising tools in this perspective. (orig.)

  2. Frida Kahlo's neurological deficits and her art.

    Science.gov (United States)

    Budrys, Valmantas

    2013-01-01

    World-famous Mexican painter Frida Kahlo is an impressive example of a professional artist whose artistic subject matter was extremely influenced by her chronic, severe illness. Many of her best-known works depict her physical and mental suffering. She was one of those very uncommon artists who dared to show their nude, sick body. This chapter describes and explains the biographical events and works of Frida Kahlo that are closely related to neurology: congenital anomaly (spina bifida), poliomyelitis, spine injury, and neuropathic pain. © 2013 Elsevier B.V. All rights reserved.

  3. Psychologic theories in functional neurologic disorders.

    Science.gov (United States)

    Carson, A; Ludwig, L; Welch, K

    2016-01-01

    In this chapter we review key psychologic theories that have been mooted as possible explanations for the etiology of functional neurologic symptoms, conversion disorder, and hysteria. We cover Freudian psychoanalysis and later object relations and attachment theories, social theories, illness behavior, classic and operant conditioning, social learning theory, self-regulation theory, cognitive-behavioral theories, and mindfulness. Dissociation and modern cognitive neuroscience theories are covered in other chapters in this series and, although of central importance, are omitted from this chapter. Our aim is an overview with the emphasis on breadth of coverage rather than depth. © 2016 Elsevier B.V. All rights reserved.

  4. [Psychogenetic neurological disorders in draft age personnel].

    Science.gov (United States)

    Akhmetianov, L A; Ovchinnikov, A V

    2012-07-01

    The tendency of psychogenetic neurological disorders increases with predominance in young persons being students of high schools, students of military, technical and other lyceum was shown. The origin of diseases are psychotraumas (family, work), stress. Also genetic and hereditary factors take place that are indicative for individual rehabilitation organization. The basics of psychosomatic diseases pathogenesis are the disintegration mechanisms in brain structure activity,the disorders of integrative apparatus which provides the relationship between somatic, emotional and vegetative functions. The confirmation of brain work disintegration is achieved by modern computer diagnostic systems. As psychogenic diseases increase the need in methods of computer electroencephalography, evoked potentials, and rheoencephalography application is more actual.

  5. The neurologic complications of bariatric surgery.

    Science.gov (United States)

    Berger, Joseph R; Singhal, Divya

    2014-01-01

    Bariatric surgery has been increasingly employed to manage morbid obesity. Approximately 150000 bariatric procedures are performed in the US annually. Neurologic complications arise in as many as 5% of individuals having this surgery. Although the etiology of some of these complications remains obscure, the majority are the consequence of vitamin (most commonly thiamine and vitamin B12) or mineral (most commonly copper) deficiency and familiarity with these disorders is essential. Their rapid diagnosis and appropriate treatment is essential to avoid long-term, irreversible consequences including, in some instances, death. © 2014 Elsevier B.V. All rights reserved.

  6. Clinical neurogenetics: neurologic presentations of metabolic disorders.

    Science.gov (United States)

    Kwon, Jennifer M; D'Aco, Kristin E

    2013-11-01

    This article reviews aspects of the neurologic presentations of selected treatable inborn errors of metabolism within the category of small molecule disorders caused by defects in pathways of intermediary metabolism. Disorders that are particularly likely to be seen by neurologists include those associated with defects in amino acid metabolism (organic acidemias, aminoacidopathies, urea cycle defects). Other disorders of small molecule metabolism are discussed as additional examples in which early treatments have the potential for better outcomes. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Computed tomography for neurological intensive care patients

    International Nuclear Information System (INIS)

    Rodiek, S.; Neu, I.

    1977-01-01

    The first 100 computed tomographic (CT) examinations of the patients on the neurological intensive care ward are discussed and reported on the basis of selected typical findings. Characteristic patterns of the CT findings in determined cerebral diseases are explained. The possibility and necessity of CT observations of the development of inflammatory and cerebrovascular processes in particular are emphasized. A comparison of our experience with CT and other neuroradiological methods, is made. The clinical diagnoses, including the respective number of cases and the pertinent CT findings, are presented in a Table. (orig.) [de

  8. Contribution of positron emission tomography in neurology

    International Nuclear Information System (INIS)

    Salmon, E.; Franck, G.

    1992-01-01

    Positron Emission Tomography (PET) is a scanner technique using tracers labelled with shortlived radioisotopes which allows to study and quantify human metabolic processes or drug pharmacology in vivo. The technique is first applied in physiological studies. Sleep, normal brain metabolism or cerebral activations have been studied. The pharmacological approach concerns both drug distribution in the human brain and blood flow or metabolic variations under treatment. Main neurological applications in pathology are cerebrovascular disorders, diseases leading to dementia, epilepsy, movement disorders, and brain tumors. In each field of application, PET gives unique and frequently early informations. It nicely combines both dynamic informations and measurement precision. (author)

  9. Speech and Language Disturbances in Neurology Practice

    Directory of Open Access Journals (Sweden)

    Oğuz Tanrıdağ

    2009-12-01

    Full Text Available Despite the well-known facts discerned from interesting cases of speech and language disturbances over thousands of years, the scientific background and the limitless discussions for nearly 150 years, this field has been considered one of the least important subjects in neurological sciences. In this review, we first analyze the possible causes for this “stepchild” attitude towards this subject and we then summarize the practical aspects concerning speech and language disturbances. Our underlying expectation with this review is to explain the facts concerning those disturbances that might offer us opportunities to better understand the nervous system and the affected patients

  10. Neurological and Sleep Disturbances in Bronchiectasis

    Directory of Open Access Journals (Sweden)

    Chun Seng Phua

    2017-11-01

    Full Text Available Bronchiectasis unrelated to cystic fibrosis is a chronic lung disease that is increasingly recognised worldwide. While other common chronic lung conditions such as chronic obstructive lung disease have been associated with cardiovascular disease, there is a paucity of data on the relationship between bronchiectasis and cardiovascular risks such as stroke and sleep disturbance. Furthermore, it is unclear whether other neuropsychological aspects are affected, such as cognition, cerebral infection, anxiety and depression. In this review, we aim to highlight neurological and sleep issues in relation to bronchiectasis and their importance to patient care.

  11. Management of pediatric central nervous system emergencies: a review for general radiologists.

    Science.gov (United States)

    Rebollo Polo, M

    2016-05-01

    To review the most common and most important diseases and disorders of the central nervous system (CNS) in pediatric emergencies, discussing the indications for different imaging tests in each context. In pediatric patients, acute neurologic symptoms (seizures, deteriorating level of consciousness, focal neurologic deficits, etc.) can appear in diverse clinical situations (trauma, child abuse, meningoencephalitis, ischemia…). It is important to decide on the most appropriate neuroimaging diagnostic algorithm for each situation and age group, as well as to know the signs of the most typical lesions that help us in the etiological differential diagnosis. Pediatric patients' increased vulnerability to ionizing radiation and the possible need for sedation in studies that require more time are factors that should be taken into account when indicating an imaging test. It is essential to weigh the risks and benefits for the patient and to avoid unnecessary studies. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  12. Regulation of the State Office of Nuclear Safety No. 318/2002 of 13 June 2002 specifying details to ensure emergency preparedness of nuclear facilities and workplaces handling ionizing radiation sources, and requirements for the contents of internal emergency plans and emergency rules

    International Nuclear Information System (INIS)

    2002-01-01

    The Regulation addresses the following issues: definition of a radiological event and interventions to be accomplished if a radiological event takes place; emergency preparedness; establishing a radiological event; assessment of a radiological event; warnings, notifications and alarms during a radiological event; intervention - management, procedures, instructions; radiological situation monitoring programme; provisions to restrict human exposure; health care provisions; documentation; informing the State Office of Nuclear Safety; personnel instructions and training; emergency preparedness inspection; internal emergency plan; emergency rules; and related issues. This Regulation supersedes Regulation No. 219/1997. (P.A.)

  13. A emergência da empresa virtual e os requisitos para os sistemas de informação The emergency of virtual enterprise and the requirements for information systems

    Directory of Open Access Journals (Sweden)

    Américo L. Azevedo

    2000-12-01

    Full Text Available A vantagem competitiva das empresas passa cada vez mais pelo desenvolvimento de novas estruturas organizacionais, nomeadamente pelo estabelecimento de redes de cooperação com todas as entidades intervenientes na cadeia de fornecimento, e novas metodologias de gestão e planejamento, apoiadas fortemente por tecnologias de informação e de comunicação. Este artigo tem como principal finalidade apresentar o conceito de Empresa Virtual como o paradigma organizacional das empresas emergentes, e explorar a sua estreita relação com as tecnologias de informação e comunicação. Após caracterizar o conceito de Empresa Virtual e de caracterizar o mercado dos sistemas de informação empresarial, é identificado um conjunto de requisitos base para as tecnologias de informação e de comunicação, de suporte a este tipo de organização, nomeadamente para o processo de planejamento e negociação de novas encomendas.Globalisation together with technological advances have dramatically changed the process of value creation at the end of this century. Nowadays, more and more companies are being organised as networks of different units and are therefore becoming global businesses covering multiple manufacturing sites consisting of different shop floors, subcontractors and suppliers. The concept of Virtual Enterprise was born in this environment. The aim of this paper is to present the Virtual Enterprise as a new organisational paradigm and to explore the tight relationship with the information and communication technologies. Our research has shown that traditional enterprise information systems do not suitably cope with some of the new demanding requirements of a distributed and heterogeneous manufacturing environment. In this context, this paper presents a set of requirements that supports this new organisational paradigm.

  14. Effciency of HIV-infected patients detection in neurological hospitals of large industrial center

    Directory of Open Access Journals (Sweden)

    Shmelev V.V.

    2012-06-01

    Full Text Available

    Aim of the study: to evaluate the effciency of detection for HIV-infection in patients of neurological departments of Saratov. Materials and methods. We retrospectively analyzed 25 250 medical histories of patients hospitalized into neurological departments of Saratov hospitals between January 2007 and April 2012. Results. Blood samples of 2010 patients (7,96 % were tested for the presence of HIV-antibodies. 37 patients were HIV-positive (1,84 % of examined patients and 0,15 % of the total number of patients. Conclusion. Increasing popularity and variety of clinical manifestations of HIV-infection requires the expansion of neurological patients whom serum test for antibodies against HIV is needed.

  15. A study on subsequent neurologic complications in children with acute leukemia

    International Nuclear Information System (INIS)

    Kobayashi, Naoaki; Shimazaki, Haruyo; Hoshi, Yasutaka; Akatsuka, Jun-ichi

    1989-01-01

    Twenty-seven children with acute leukemia were studied in order to detect the subsequent neurologic complications due to chemotherapy and radiation therapy. Twenty-four patients with ALL received central nervous system prophylaxis including cranial irradiation. The methods of evaluation consisted of electroencephalogram (EEG), computed tomography of the head (CT scan), soft neurological sign, intelligence quotient (IQ) and Bender Gestalt test. The patients with relapse showed severe abnormalities in various kinds of examinations. Younger children at diagnosis were associated with a higher abnormality rate of soft neurological signs and Bender Gestalt test. Factors which were found to be closely associated with a lower IQ score included younger children at diagnosis and longer duration of remission time. These results indicate the need for caution for the dosage of cranial irradiation for younger patients in CNS prophylaxis, and improvement of a lower IQ score in long-term survivors requires further investigation as to the appropriate intellectual environment for their development after remission. (author)

  16. Neurological Complications Related to Elective Orthopedic Surgery: Part 1: Common Shoulder and Elbow Procedures.

    Science.gov (United States)

    Dwyer, Tim; Henry, Patrick D G; Cholvisudhi, Phantila; Chan, Vincent W S; Theodoropoulos, John S; Brull, Richard

    2015-01-01

    Many anesthesiologists are unfamiliar with the rate of surgical neurological complications of the shoulder and elbow procedures for which they provide local anesthetic-based anesthesia and/or analgesia. Part 1 of this narrative review series on neurological complications of elective orthopedic surgery describes the mechanisms and likelihood of peripheral nerve injury associated with some of the most common shoulder and elbow procedures, including open and arthroscopic shoulder procedures, elbow arthroscopy, and total shoulder and elbow replacement. Despite the many articles available, the overall number of studied patients is relatively low. Large prospective trials are required to establish the true incidence of neurological complications following elective shoulder and elbow surgery. As the popularity of regional anesthesia increases with the development of ultrasound guidance, anesthesiologists should have a thoughtful understanding of the nerves at risk of surgical injury during elective shoulder and elbow procedures.

  17. Recognizing and reducing cognitive bias in clinical and forensic neurology.

    Science.gov (United States)

    Satya-Murti, Saty; Lockhart, Joseph

    2015-10-01

    In medicine, cognitive errors form the basis of bias in clinical practice. Several types of bias are common and pervasive, and may lead to inaccurate diagnosis or treatment. Forensic and clinical neurology, even when aided by current technologies, are still dependent on cognitive interpretations, and therefore prone to bias. This article discusses 4 common biases that can lead the clinician astray. They are confirmation bias (selective gathering of and neglect of contradictory evidence); base rate bias (ignoring or misusing prevailing base rate data); hindsight bias (oversimplification of past causation); and good old days bias (the tendency for patients to misremember and exaggerate their preinjury functioning). We briefly describe strategies adopted from the field of psychology that could minimize bias. While debiasing is not easy, reducing such errors requires awareness and acknowledgment of our susceptibility to these cognitive distortions.

  18. Attitudes of neurology specialists toward older adults.

    Science.gov (United States)

    Seferoğlu, Meral; Yıldız, Demet; Pekel, Nilüfer Büyükkoyuncu; Güneş, Aygül; Yıldız, Abdülmecit; Tufan, Fatih

    2017-08-01

    Attitude of healthcare providers toward older people is very important in the aging world. Neurologists contact older adults very frequently. We aimed to investigate the attitudes of neurologists toward older adults. We recorded participants age; sex; duration of clinical practice in neurology; existence of older adult relatives; and history of geriatrics education, nursing home visits, older adult patient density in their clinical practice, and participation in voluntary public activities. UCLA Geriatrics Attitude Scale was used to evaluate participants' attitudes. A total of 100 neurologists participated in this study. Seventy-seven percent had positive, 3 % had neutral, and 20 % had negative attitudes. Twenty-seven percent of the participants had history of geriatrics education, and these participants tended to have a higher rate of positive attitudes. Neurologists with positive attitudes tended to be older than those with negative attitudes. Participants with history of living with older adult relatives had lower rates of positive attitudes. The most common diagnoses of the patients the participants encountered were stroke and dementia. Independent factors associated with positive attitudes were history of geriatrics education and older age. History of living with older relatives tended to have a negative effect. Most of the negative items of the attitude scale were associated with the natural course and behavior of the common diseases in neurology practice. Generalization of geriatrics education may translate into a better understanding and improved care for older patients. Development of instruments and implementation of qualitative studies to assess attitudes of neurologists toward older adults are needed.

  19. Retinitis pigmentosa, pigmentary retinopathies, and neurologic diseases.

    Science.gov (United States)

    Bhatti, M Tariq

    2006-09-01

    Retinitis pigmentosa (RP) refers to a group of inherited retinal diseases with phenotypic and genetic heterogeneity. The pathophysiologic basis of the progressive visual loss in patients with RP is not completely understood but is felt to be due to a primary retinal photoreceptor cell degenerative process mainly affecting the rods of the peripheral retina. In most cases RP is seen in isolation (nonsyndromic), but in some other cases it may be a part of a genetic, metabolic, or neurologic syndrome or disorder. Nyctalopia, or night blindness, is the most common symptom of RP. The classic fundus appearance of RP includes retinal pigment epithelial cell changes resulting in retinal hypo- or hyperpigmentation ("salt-and-pepper"), retinal granularity, and bone spicule formation. The retinal vessels are often narrowed or attenuated and there is a waxy pallor appearance of the optic nerve head. Electroretinography will demonstrate rod and cone photoreceptor cell dysfunction and is a helpful test in the diagnosis and monitoring of patients with RP. A detailed history with pedigree analysis, a complete ocular examination, and the appropriate paraclinical testing should be performed in patients complaining of visual difficulties at night or in dim light. This review discusses the clinical manifestations of RP as well as describing the various systemic diseases, with a special emphasis on neurologic diseases, associated with a pigmentary retinopathy.

  20. Neurological caricatures since the 15th century.

    Science.gov (United States)

    Lorusso, Lorenzo

    2008-01-01

    During the Renaissance, different artists began to draw medical illustrations from various viewpoints. Leonardo da Vinci was among those who sought to portray the emotional as well as the physical qualities of man. Other European artists described caricatural aspects of medical activities. In Northern Europe, Albrecht Durer, Hieronymus Bosch, and Pieter Brueghel were also famous for drawing caricatures. Later English artists, notably William Hogarth, Thomas Rowlandson, James Gillray, and the Cruikshanks, satirized life in general and the medical profession in particular. In Spain, Francisco Goya's works became increasingly macabre and satirical following his own mysterious illness and, in France, Honore Daumier used satire and humor to expose medical quackery. Also physicians such as Charles Bell and Jean-Martin Charcot were talented caricaturists. Their own personal artistic styles reflected their approach and gave a different "image" of neurology. Caricatures were popular portraits of developments in science and medicine and were frequently used whenever scientific language was too difficult to disseminate, in particular in the field of neurology.