scholarly journals Comparison of clinical and CSF profiles in 62 Adults with tuberculous and pyogenic meningitis

2017 ◽  
Vol 5 (5) ◽  
pp. 2168
Author(s):  
Munish Kumar ◽  
Durgesh Kumar ◽  
Alok Onkar Sahu ◽  
Manoj Kumar Rastogi
Keyword(s):  
Cerebrospinal Fluid ◽  
Tertiary Hospital ◽  
Pyogenic Meningitis ◽  
Protein Ratio ◽  
Cytochemical Analysis ◽  
Duration Of Illness ◽  
Cranial Fossa ◽  
The Mean ◽  
Symptoms And Signs

Background: Many a times differentiating tuberculous meningitis from pyogenic meningitis becomes very difficult. The diagnosis depends upon clinical manifestation and cytochemical analysis of cerebrospinal fluid (CSF). Many researchers found that the CSF glucose: protein ratio less than 0.5 and Adenosine deaminase levels (ADA) in cerebrospinal fluid are useful to differentiate tubercular disease from non-tubercular meningitis.Methods: Sixty-two patients admitted to our tertiary hospital with symptoms and signs of meningitis were selected and divided into two groups: tubercular (n=39) and pyogenic (n= 23), depending upon the accepted criteria. Clinical features and CSF parameters noted in each patient. Cut off value of ADA kept at or above 10 IU/L for tubercular meningitis.Results: The mean age of patients with tubercular meningitis was 39.07±16.67 years and that of pyogenic meningitis 34.35±16.73 years. Clinically fever was present in 60 (96.77%), headache in 49 (79.03%), and vomiting in 44 (70.96%) patients. Meningeal signs – neck rigidity in 46 (74.2%), Kernig’s sign in 37 (59.68%) and Brudzinski’s sign in 18 (29.03%) patients. On CSF cytological and biochemical analysis the mean total white blood cell count was 256.74±184.03 /cmm, mean protein 182.22±113.12 mg/dl and mean sugar 52.85±19.3mg/dl in TBM whereas in pyogenic meningitis 106.17±185.18 / cmm, 88.78±114.35 mg/ dl, and 63.47±19.48 mg/dl respectively. Out of 39 tuberculous patients, 33 patients were found to be having CSF ADA at or above the cutoff value of 10 IU/L while only one among pyogenic meningitis. On comparison between two groups, the CSF ADA level found to be statistically highly significant (P < 0.001) with overall accuracy of the test was 85.5 %.Conclusions: We found that the duration of illness, estimation of cerebrospinal fluid ADA with a cut off value of 10 IU/L and CSF glucose: protein ratio of 0.5 may useful in differentiating tuberculous from pyogenic meningitis. posterior cranial fossa surgeries. This work will also be useful to anthropologists, forensic science experts for determination of sex of the skull along with other parameters.

scholarly journals External syringomyelia in longstanding benign foramen magnum tumors

2020 ◽  
Vol 11 ◽  
pp. 92
Author(s):  
Aimee Goel ◽  
Abhidha Harshad Shah ◽  
Ravikiran Vutha ◽  
Atul Goel
Keyword(s):  
Cerebrospinal Fluid ◽  
Spinal Canal ◽  
Foramen Magnum ◽  
Resonance Imaging ◽  
Canal Diameter ◽  
Significant Difference ◽  
Cranial Fossa ◽  
The Mean ◽  
Pontomedullary Junction ◽  
Anterior Posterior

Background: The effect of benign foramen magnum tumours on cranial and spinal dimensions and cerebrospinal fluid (CSF) spaces is unclear. In this study, we measured alterations in cerebrospinal fluid (CSF) spaces in the spinal canal and in the posterior cranial fossa distant from the site of benign foramen magnum tumors. Methods: Twenty-nine magnetic resonance imaging scans of patients with foramen magnum tumors (8 meningiomas and 21 C2 neurinomas) were identified for radiological morphometric analysis and compared with normal control scans. The anterior-posterior distance between the pontomedullary junction and the clivus, the spinal canal diameter, spinal cord diameter, and cord-canal ratios were measured at the C6 and T2 levels. Results: The mean spinal canal diameter was significantly higher in tumor scans at both the C6 and T2 spinal levels than in controls (13.8 mm vs. 11.4 mm at C6; p<0.0001, and 12.9 mm vs. 11.9 mm at T2; P=0.01). Further, the mean cord:canal ratio was significantly lower in tumor scans at both levels (0.49 vs. 0.64 at C6; P<0.0001, and 0.45 vs. 0.54 at T2; P=0.0009). There was no significant difference in mean anteroposterior distance from the clivus to the pontomedullary junction (10.4 mm vs. 10.3 mm; P=0.91). Conclusion: In the presence of benign foramen magnum tumors, the spinal canal diameter and CSF volume in the spinal canal increased at the C6 and T2 levels, distant from the tumor site, a phenomenon we describe as “external syringomyelia”.

scholarly journals Shapes and Sizes of Sella Turcica Using Computerized Tomography (CT) from Tertiary Hospital in Sokoto, Nigeria

2020 ◽  
pp. 8-15
Author(s):  
Z. Usman ◽  
A. D. Zagga ◽  
G. H. Yunusa ◽  
U. Abubakar ◽  
A. Bello ◽  
...  
Keyword(s):  
Sella Turcica ◽  
Posterior Wall ◽  
Middle Cranial Fossa ◽  
Tertiary Hospital ◽  
Transverse Diameter ◽  
Body Parts ◽  
Shape Variation ◽  
Significant Difference ◽  
Cranial Fossa

Cephalometry deals with measurement of body parts or radiological specimen. Sella turcica is an important anatomical structure located in the middle cranial fossa, housing the pituitary gland. Various shapes and sizes of the sellae turcica were reported. In this study, using computerized tomographic (CT) scans from a tertiary hospital, one hundred and seventy five (175) scans were analyzed using Radiant version 4.2 (Medixant 2017) for determination of sizes and shapes of the sella. Average dimensions from the study include: Length (12.4 mm), A-P diameter (14.1 mm), depth (9.6 mm) and transverse diameter (13.8 mm). Shapes were classified as being round (56.6%), oval (32%) and flat (11.4%). In another classification of shape variation, the findings are: Normal (68.6%), anterior oblique (9.1%), pyramidal (6.9%), double contour floor (5.7%), notching on the posterior wall (5.1%) and sella bridge (4.6%). Males tend to have higher sella sizes than females and there is statistical significant difference between them especially in respect to A-P diameter and length parameters. However, there is no sex predilection to shapes.

Influence of the matrix type over the concentration of GDF-15

2020 ◽  
Vol 68 (8) ◽  
pp. 1402-1404
Author(s):  
José Miguel Rivera-Caravaca ◽  
Juan Antonio Vílchez ◽  
Carlos Rodríguez-Rojas ◽  
María Dolores Albadalejo-Otón ◽  
Pablo Gil-Pérez ◽  
...  
Keyword(s):  
Prognostic Biomarker ◽  
Vitamin K Antagonists ◽  
Tertiary Hospital ◽  
Healthy Controls ◽  
Related Condition ◽  
Growth Differentiation Factor 15 ◽  
The Matrix ◽  
The Mean ◽  
Roche Diagnostics

Growth differentiation factor 15 (GDF-15) has been suggested as a prognostic biomarker for bleeding and mortality in atrial fibrillation (AF). To date, serum and EDTA matrices are standardized for the GDF-15 assay but it is unclear if it can be measured also in citrate. In this study, we aim to investigate if the Elecsys GDF-15 assay (Roche Diagnostics, Mannheim, Germany) can be determined accurately in citrate samples in a cohort of 10 patients with AF and 10 healthy controls. From January 2018 to March 2018, we included healthy controls and patients with AF under vitamin K antagonists in a tertiary hospital. Blood samples were drawn in both groups. We included 10 controls (50% males, mean age 36.4±8.9 years) and 10 patients with AF (80% males, mean age 76.5±16.6 years). The mean GDF-15 levels were increased in patients with AF in comparison to healthy controls, as expected by the presence of a heart-related condition and the higher age of this population. In healthy controls, GDF-15 levels showed an optimal correlation between EDTA-serum (r=0.975; p<0.001), EDTA-citrate (r=0.972; p<0.001), and serum-citrate (r=0.997; p<0.001) samples. This was also observed in patients with AF: EDTA-serum (r=0.975; p<0.001), serum-citrate (r=0.835; p=0.003), and EDTA-citrate (r=0.768; p=0.009). Our results demonstrate that citrate samples may be used for the determination of GDF-15 in AF given the positive and good correlation with EDTA and serum matrices. Further studies should validate these observations.

Temporal bone encephalocele and cerebrospinal fluid fistula repair utilizing the middle cranial fossa or combined mastoid–middle cranial fossa approach

2013 ◽  
Vol 119 (5) ◽  
pp. 1314-1322 ◽  
Author(s):  
Matthew L. Carlson ◽  
William R. Copeland ◽  
Colin L. Driscoll ◽  
Michael J. Link ◽  
David S. Haynes ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Hearing Loss ◽  
Temporal Bone ◽  
Middle Cranial Fossa ◽  
Middle Fossa ◽  
Titanium Mesh ◽  
Operative Strategy ◽  
History Of ◽  
Cranial Fossa ◽  
The Mean

Object The goals of this study were to report the clinical presentation, radiographic findings, operative strategy, and outcomes among patients with temporal bone encephaloceles and cerebrospinal fluid fistulas (CSFFs) and to identify clinical variables associated with surgical outcome. Methods A retrospective case series including all patients who underwent a middle fossa craniotomy or combined mastoid–middle cranial fossa repair of encephalocele and/or CSFF between 2000 and 2012 was accrued from 2 tertiary academic referral centers. Results Eighty-nine consecutive surgeries (86 patients, 59.3% women) were included. The mean age at time of surgery was 52.3 years, and the left side was affected in 53.9% of cases. The mean delay between symptom onset and diagnosis was 35.4 months, and the most common presenting symptoms were hearing loss (92.1%) and persistent ipsilateral otorrhea (73.0%). Few reported a history of intracranial infection (6.7%) or seizures (2.2%). Thirteen (14.6%) of 89 cases had a history of major head trauma, 23 (25.8%) were associated with chronic ear disease without prior operation, 17 (19.1%) occurred following tympanomastoidectomy, and 1 (1.1%) developed in a patient with a cerebral aqueduct cyst resulting in obstructive hydrocephalus. The remaining 35 cases (39.3%) were considered spontaneous. Among all patients, the mean body mass index (BMI) was 35.3 kg/m2, and 46.4% exhibited empty sella syndrome. Patients with spontaneous lesions were statistically significantly older (p = 0.007) and were more commonly female (p = 0.048) compared with those with nonspontaneous pathology. Additionally, those with spontaneous lesions had a greater BMI than those with nonspontaneous disease (p = 0.102), although this difference did not achieve statistical significance. Thirty-two surgeries (36.0%) involved a middle fossa craniotomy alone, whereas 57 (64.0%) involved a combined mastoid–middle fossa repair. There were 7 recurrences (7.9%); 2 patients with recurrence developed meningitis. The use of artificial titanium mesh was statistically associated with the development of recurrent CSFF (p = 0.004), postoperative wound infection (p = 0.039), and meningitis (p = 0.014). Also notable, 6 of the 7 cases with recurrence had evidence of intracranial hypertension. When the 11 cases that involved using titanium mesh were excluded, 96.2% of patients whose lesions were reconstructed with an autologous multilayer repair had neither recurrent CSFF nor meningitis at the last follow-up. Conclusions Patients with temporal bone encephalocele and CSFF commonly present with persistent otorrhea and conductive hearing loss mimicking chronic middle ear disease, which likely contributes to a delay in diagnosis. There is a high prevalence of obesity among this patient population, which may play a role in the pathogenesis of primary and recurrent disease. A middle fossa craniotomy or a combined mastoid–middle fossa approach incorporating a multilayer autologous tissue technique is a safe and reliable method of repair that may be particularly useful for large or multifocal defects. Defect reconstruction using artificial titanium mesh should generally be avoided given increased risks of recurrence and postoperative meningitis.

Optimized atomic absorption spectrophotometry of zinc in cerebrospinal fluid.

1983 ◽  
Vol 29 (3) ◽  
pp. 486-491 ◽  
Author(s):  
R Palm ◽  
R Sjöström ◽  
G Hallmans
Keyword(s):  
Cerebrospinal Fluid ◽  
Atomic Absorption ◽  
Direct Determination ◽  
Atomic Absorption Spectrophotometry ◽  
Absorption Spectrophotometry ◽  
Flame Atomic Absorption ◽  
Zn Concentration ◽  
Insignificant Difference ◽  
The Mean

Abstract This method for direct determination of Zn in cerebrospinal fluid (CSF) involves flame atomic absorption spectrophotometry with a pulse nebulizer technique. Standard solutions of Zn in 150 mmol/L NaCl were used. We could account for 88% of added standard with the method in individual samples from 10 patients and in pooled CSF. The method is acceptably precise, CVs in pooled CSF ranging from 4 to 12%. The mean CSF-Zn concentration for nine healthy men was 0.18 (SD 0.04) mumol/L and for nine healthy women 0.15 (SD 0.03) mumol/L, a statistically insignificant difference. These values are lower than those in previous reports, which may have been the result of contamination problems, nonatomic absorption, or nonstandardized sampling. In the healthy volunteers, the CSF-Zn concentration was positively correlated with serum-Zn, CSF-protein, and CSF-albumin concentrations, as well as with the CSF/serum ratio for albumin.

scholarly journals Infants Teething Problems and Mothers' Beliefs in South East of Iran

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Ghasem Miri-Aliabad ◽  
Ali Khajeh ◽  
Alireza Teimouri
Keyword(s):  
Data Collection ◽  
Signs And Symptoms ◽  
Treatment Delay ◽  
Deciduous Tooth ◽  
Diagnosis And Treatment ◽  
Demographic Information ◽  
East Of Iran ◽  
The Mean ◽  
Symptoms And Signs

Background: Teething is a physiological process, which usually does not cause problems. A variety of symptoms are ascribed to infant teething, despite little evidence to support such belief. The wrong beliefs and misconceptions about the symptoms of teething may present serious risks to infants. Objectives: This study aims for determination of the mothers' attitude about the symptoms and signs of infants teething. Methods: Data collection was done using a questionnaire, containing demographic information of the respondents as well as a number of 20 questions about the signs and symptoms of teething. In this study, 220 questionnaires were completed by mothers having 6 - 30 months’ children, with at least one deciduous tooth. Results: The mean age of the mothers was 28.26 ± 5.10 years old. Mean of the first deciduous tooth eruption in them was 7.16 ± 1.60 month. All mother associated, at least, one symptom with teething. In this study, mothers' beliefs were as follows: gum rubbing (91%), biting objects (86%), restlessness and irritability (84%), fever (75%), drooling (70%), and diarrhea (62%). Conclusions: Regarding that symptoms such as fever, diarrhea, and restlessness and irritability are attributed to teething, this can distract parents from serious illnesses, leading to diagnosis and treatment delay.

Determination of 3-Methoxy-4-Hydroxyphenylethylene Glycol, a Noradrenaline Metabolite, in Cerebrospinal Fluid and Urine

1973 ◽  
Vol 19 (9) ◽  
pp. 1031-1035 ◽  
Author(s):  
R O’Keeffe ◽  
B W L Brooksbank
Keyword(s):  
Cerebrospinal Fluid ◽  
Internal Standard ◽  
Accurate Method ◽  
Electron Capture Detection ◽  
Gas Liquid Chromatography ◽  
Significant Difference ◽  
Phenolic Group ◽  
The Mean ◽  
Lumbar Cerebrospinal Fluid

Abstract We describe a sensitive, accurate method for quantitative determination of 3-methoxy-4-hydroxyphenylethylene glycol (MHPG) in cerebrospinal fluid and urine. The method entails enzymatic hydrolysis of conjugated MHPG, acetylation of the phenolic group, thin-layer chromatographic purification, and estimation of total MHPG as the acetyl heptafluorobutyryl derivative by gas—liquid chromatography with electron capture detection and with use of aldrin as internal standard. Results obtained by this method compare favorably with those by other published procedures. Precision, calculated as the mean ± SD of the percentage differences between duplicate estimations, was 8.4 ± 8.0% for cerebrospinal fluid (3 ml) or 6.9 ± 6.6% for urine (2 ml). Total MHPG in lumbar cerebrospinal fluid specimens from 49 individuals ranged from 6.1 to 19.7 ng/ml, with no significant difference between the mean for control subjects and that for patients with affective disorders.

scholarly journals Dementia and legal determination of capacity

2017 ◽  
Vol 75 (6) ◽  
pp. 349-353
Author(s):  
Valeska Maria Eboli Bello Delineau ◽  
Rodrigo Rizek Schultz
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Tertiary Hospital ◽  
Legal Issues ◽  
Main Diagnosis ◽  
Advanced Stage ◽  
Legal Capacity ◽  
Large Numbers ◽  
The Mean

ABSTRACT One of the consequences of dementia is the possibility of a guardianship proceeding that will deprive patients of legal capacity in taking decisions and managing their own assets. Objective To assess the legal capacity and guardianship proceedings in patients diagnosed with dementia. Methods Ninety-seven patients diagnosed with dementia and seen at a tertiary hospital were evaluated. Results Of these 97 patients, 60 (62%) were female. The mean age of the patients was 77.9 years; average schooling was 5.5 years. The main diagnosis was Alzheimer’s disease (73%): 16 patients were at a mild stage, eight at a moderate stage and 73 at an advanced stage of dementia. Only 28 patients had been legally declared incapable. Conclusion The large numbers of patients at an advanced stage of dementia, and the relatively few patients legally declared incapable show that legal issues in dementia are problematic.

A new sample collection method for the assessment of the percentage of water absorbed in frozen and quick-frozen poultry cuts (chicken breasts with skin)

2016 ◽  
Vol 8 (39) ◽  
pp. 7080-7086
Author(s):  
Leonardo Rodrigo Fonseca Tigre Maia ◽  
Sergio Borges Mano ◽  
Eliane Teixeira Mársico ◽  
Carlos Adam Conte Júnior ◽  
Carlos Frederico Marques Guimarães ◽  
...  
Keyword(s):  
Water Content ◽  
Total Water Content ◽  
Total Water ◽  
Sample Collection ◽  
Protein Ratio ◽  
Collection Method ◽  
The Mean

The determination of the mean physiological water/protein ratio of samples obtained from homogenized poultry cuts using a powerful mincer is an efficient way of determining their total water content.

Detection of Circulating Tissue Factor and Factor VII in a Normal Population

1996 ◽  
Vol 75 (05) ◽  
pp. 772-777 ◽  
Author(s):  
Sybille Albrecht ◽  
Matthias Kotzsch ◽  
Gabriele Siegert ◽  
Thomas Luther ◽  
Heinz Großmann ◽  
...  
Keyword(s):  
Tissue Factor ◽  
Normal Population ◽  
Mean Value ◽  
Factor Vii ◽  
Significant Difference ◽  
Age Dependent ◽  
The Mean ◽  
Highly Correlated ◽  
And Gender

SummaryThe plasma tissue factor (TF) concentration was correlated to factor VII concentration (FVIIag) and factor VII activity (FVIIc) in 498 healthy volunteers ranging in age from 17 to 64 years. Immunoassays using monoclonal antibodies (mAbs) were developed for the determination of TF and FVIIag in plasma. The mAbs and the test systems were characterized. The mean value of the TF concentration was 172 ± 135 pg/ml. TF showed no age- and gender-related differences. For the total population, FVIIc, determined by a clotting test, was 110 ± 15% and the factor VIlag was 0.77 ± 0.19 μg/ml. FVII activity was significantly increased with age, whereas the concentration demonstrated no correlation to age in this population. FVII concentration is highly correlated with the activity as measured by clotting assay using rabbit thromboplastin. The ratio between FVIIc and FVIIag was not age-dependent, but demonstrated a significant difference between men and women. Between TF and FVII we could not detect a correlation.

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