Characteristics of Patients with SARS-CoV-2 Positive Cerebrospinal Fluid: A Systematic Review

Abstract Background: The coronavirus disease 2019 (COVID-19) has been shown to affect several systems, notably the respiratory system. However, there has been considerable evidence implicating the nervous system in COVID-19 infection. This study aims to investigate the clinical characteristics of patients whose cerebrospinal fluid (CSF) tested positive for SARS-CoV-2.Methods: A comprehensive search of PubMed, EMBASE, Scopus, WHO Coronavirus database, bioRxiv, medRxiv, and Web of Science databases was carried out in August 2020. Original studies involving patients who tested positive for SARS-COV-2 in their CSF were included. Key search terms encompassed all variations of “COVID-19” AND “Cerebrospinal Fluid”.Results: A total of 525 studies were identified. 56 full-text articles were assessed, of which 14 were included. In total, 14 patients tested positive for SARS-CoV-2 in their CSF. 21.4% (3/14) of patients had negative nasopharyngeal (NP) swabs despite a positive CSF sample. 14.2% (2/14) of patients who initially had positive NP swabs developed neurological deterioration after a supposed recovery as indicated by their negative NP swabs, but their CSF still tested positive for SARS-CoV-2. Common symptoms were headache (42.8%; 6/14), fever (35.6%; 5/14), vomiting (28.6%; 4/14), cough (28.6; 4/14), visual disturbances (28.6%; 4/14), diarrhea (21.4%; 3/14), and seizures (21.4%; 3/14). Four patients (28.6%) were admitted to ICU, one (7.14%) was admitted to a rehabilitation facility, and two (14.3%) died.Conclusions: Physicians should be familiar with the presenting neurological features of COVID-19, and be aware that they can occur despite a negative NP swab. The results of this study are intended to aid in the development of informed guidelines to diagnose and treat COVID-19 patients with neurological manifestations.

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Neurological manifestations of dengue infection: clinical characteristics and cerebrospinal fluid analysis

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2005000500040 ◽

2005 ◽

Vol 63 (3b) ◽

pp. 898-898

Author(s):

Cristiane Nascimento Soares

Keyword(s):

Cerebrospinal Fluid ◽

Clinical Characteristics ◽

Dengue Infection ◽

Neurological Manifestations ◽

Cerebrospinal Fluid Analysis ◽

Fluid Analysis

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Diagnósticos de enfermagem para pacientes com traumatismo cranioencefálico: revisão integrativa

Enfermería Global ◽

10.6018/eglobal.435321 ◽

2021 ◽

Vol 20 (4) ◽

pp. 584-628

Author(s):

Maria Isabel Caetano da Silva ◽

Raul Roriston Gomes da Silva ◽

Sandy Hellen Santos Nogueira ◽

Simone Marcelino Lopes ◽

Rayane Moreira de Alencar ◽

...

Keyword(s):

Nursing Care ◽

Clinical Characteristics ◽

Web Of Science ◽

Craniocerebral Trauma ◽

Clinical Manifestations ◽

Head Region ◽

Search Terms ◽

Nursing Diagnosis ◽

Nursing Professionals ◽

Nursing Diagnoses

Introducción: El trauma craneoencefálico (LCT) es cualquier impacto que afecta la región de la cabeza que involucra el cuero cabelludo, el cráneo, el cerebro y los vasos sanguíneos, afectando estas estructuras. Los profesionales de enfermería desempeñan un papel fundamental al ayudar a estos pacientes.Objetivo: Enumerar los diagnósticos de enfermería (DE) de NANDA I que se pueden proponer para pacientes hospitalizados con LCT.Método: Revisión integral de la literatura, realizada en las bases de datos: LILACS, BDENF, IBECS, MEDLINE, CINAHL, SCOPUS y WEB OF SCIENCE, utilizando los términos de búsqueda: “Traumatismo craneocerebral / craneocerebral”, “Diagnóstico de enfermería / Diagnóstico de enfermería " y " Enfermagem / Enfermería ". Se incluyeron artículos en portugués, inglés y español.Resultados: Se seleccionaron 12 artículos. A partir de la lectura de los estudios, en función de las características clínicas y las necesidades básicas afectadas de los pacientes con LCT, 18 ED se enumeran, organizan en orden alfabético y de acuerdo con el dominio en el que se encuentran en NANDA YO.Consideraciones finales: Los resultados de esta investigación permitieron caracterizar aspectos importantes relacionados con el paciente con LCT y llevar el enfoque de la literatura sobre diagnósticos de enfermería a esta audiencia. Hay una brecha en las investigaciones que abordan las DE para pacientes con LCT, teniendo en cuenta que una parte importante de la investigación informa sobre las manifestaciones clínicas percibidas durante la atención de enfermería y no aporta los diagnósticos elaborados. Introduction: Traumatic Brain Injury (TBI) is any impact that affects the head region involving the scalp, skull, brain and blood vessels, affecting these structures. Nursing professionals play a fundamental role during the care of these patients.Objective: To list the Nursing Diagnoses (ND) of NANDA I that can be proposed for patients hospitalized with TBI.Method: Integrative literature review, performed at the following databases: LILACS, BDENF, IBECS, MEDLINE, CINAHL, SCOPUS and WEB OF SCIENCE, using the search terms: “Traumatismos Craniocerebrais/Craniocerebral Trauma”, “Diagnóstico de Enfermagem/Nursing Diagnosis” and “Enfermagem/Nursing”. Articles in Portuguese, English and Spanish were included.Results: The selection included 12 articles. From the reading of the studies, based on the clinical characteristics and the basic needs affected by patients with TBI, 18 ND were listed, organized alphabetically and according to their domain in NANDA I.Final considerations: The findings of this research allowed characterizing important aspects related to the patient with TBI and bringing the literature approach on nursing diagnoses to this population. There is a gap in the investigations that address ND for patients with TBI, taking into account that a significant part of the studies report on the clinical manifestations perceived during nursing care and do not bring the elaborated diagnoses. Introdução: Traumatismo Cranioencefálico (TCE) é qualquer impacto que atinge a região da cabeça envolvendo couro cabeludo, crânio, cérebro e vasos sanguíneos, afetando essas estruturas. Os profissionais de Enfermagem desempenham um papel fundamental durante a assistência a esses pacientes. Objetivo: Elencar os Diagnósticos de Enfermagem (DE) da NANDA I que podem ser propostos para pacientes internados com TCE.Método: Revisão integrativa da literatura, realizada nas bases de dados: LILACS, BDENF, IBECS, MEDLINE, CINAHL, SCOPUS e WEB OF SCIENCE, utilizando os termos de busca: “Traumatismos Craniocerebrais/Craniocerebral Trauma”, “Diagnóstico de Enfermagem/ Nursing Diagnosis” e “Enfermagem/Nursing”. Foram incluídos artigos nos idiomas português, inglês e espanhol.Resultados: Foram selecionados 12 artigos. A partir da leitura dos estudos, com base nas características clínicas e nas necessidades básicas afetadas dos pacientes com TCE foram elencados 18 DE, estão organizados em ordem alfabética e de acordo com o domínio em que se encontra na NANDA I.Considerações finais: Os achados dessa pesquisa possibilitaram caracterizar aspectos importantes relacionados ao paciente com TCE e trazer a abordagem da literatura sobre os diagnósticos de enfermagem a esse público. Percebe-se uma lacuna nas investigações que abordem os DE para pacientes com TCE, levando em consideração que uma parte significativa das pesquisas relatam sobre as manifestações clínicas percebidas durante o cuidado de enfermagem e não trazem os diagnósticos elaborados.

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Surgical Fires in Otolaryngology: A Systematic and Narrative Review

Otolaryngology ◽

10.1177/0194599817746926 ◽

2018 ◽

Vol 158 (4) ◽

pp. 598-616 ◽

Cited By ~ 7

Author(s):

Andrew T. Day ◽

Erika Rivera ◽

Janice L. Farlow ◽

Christine G. Gourin ◽

Brian Nussenbaum

Keyword(s):

General Anesthesia ◽

Web Of Science ◽

Monitored Anesthesia Care ◽

Safety Practices ◽

Search Terms ◽

Comprehensive Search ◽

Data Source ◽

Surgical Fire ◽

Inspired Oxygen

Objective To bring attention to the epidemiology, prevention, management, and consequences of surgical fires in otolaryngology by reviewing the literature. Data Sources PubMed, EMBASE, Web of Science, and Scopus. Review Methods Comprehensive search terms were developed, and searches were performed from data source inception through August 2016. A total of 4506 articles were identified; 2351 duplicates were removed; and 2155 titles and abstracts were independently reviewed. Reference review was also performed. Eligible manuscripts described surgical fires involving patients undergoing otolaryngologic procedures. Results Seventy-two articles describing 87 otolaryngologic surgical fire cases were identified. These occurred during oral cavity or oropharyngeal procedures (11%), endoscopic laryngotracheal procedures (25%), tracheostomies (36%), “other” general anesthesia procedures (3%), and monitored anesthesia care or local procedures (24%). Oxidizing agents consisted of oxygen alone (n = 63 of 81, 78%), oxygen and nitric oxide (n = 17 of 81, 21%), and room air (n = 1 of 81, 1%). The fractional inspired oxygen delivered was >30% in 97% of surgical fires in non–nitrous oxide general anesthesia cases (n = 35 of 36). Laser-safe tubes were used in only 12% of endoscopic laryngotracheal cases with endotracheal tube descriptions (n = 2 of 17). Eighty-six percent of patients experienced acute complications (n = 76 of 87), including 1 intraoperative death, and 22% of patients (n = 17 of 77) experienced long-term complications. Conclusion Surgical fires in otolaryngology persist despite aggressive multi-institutional efforts to curb their incidence. Guideline recommendations to minimize the concentration of delivered oxygen and use laser-safe tubes when indicated were not observed in many cases. Improved institutional fire safety practices are needed nationally and internationally.

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Neurological manifestations of dengue infection: clinical characteristics and cerebrospinal fluid analysis

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2006000100037 ◽

2006 ◽

Vol 64 (1) ◽

pp. 161-163 ◽

Cited By ~ 1

Author(s):

Cristiane Nascimento Soares

Keyword(s):

Cerebrospinal Fluid ◽

Clinical Characteristics ◽

Dengue Infection ◽

Neurological Manifestations ◽

Cerebrospinal Fluid Analysis ◽

Fluid Analysis

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“Tennis Leg”: A State-of-the-Science Review

Workplace Health & Safety ◽

10.1177/2165079920961966 ◽

2021 ◽

pp. 216507992096196

Author(s):

Sandra J. Domeracki

Keyword(s):

Web Of Science ◽

Occupational Injury ◽

Tennis Elbow ◽

Historical Context ◽

Tendon Injury ◽

Related Case ◽

Work Related ◽

Search Terms ◽

Working Age ◽

History Of

Background: Tennis leg (TL), a musculotendon injury to the gastrocnemius, has been associated with the eponymous sport since 1883. This article examines the historical context of TL as a sports compared with an occupational injury. This was juxtaposed with the history of tennis elbow, a tendon injury to the upper extremity also associated with sport. Methods: Bibliometric databases (PubMed, Web of Science [WOS], Hathi Trust) were keyword-searched; relevant citations were investigated in depth. Results: The search yielded 71 citations for TL (PubMed). The majority ( n = 43) were key word linked to sport terms; only one was linked to work-related search terms. Furthermore, none of the top four cited publications (Web of Science) alluded to work-related risk factors in TL in full textual analysis. Hathi Trust yielded the earliest work-related case, reported in a non-biomedical source. Tennis elbow was more frequently reported ( n = 189 citations in PubMed) and more frequently linked ( n = 193; 9.7%) to occupational search terms. Conclusion/Application to Practice: The history of TL, juxtaposed with tennis elbow, demonstrates how nosology can influence but does not wholly explain disease attribution, potentially to the detriment of taking into account occupational causality. The lack of recognition of occupational factors revealed in this literature search was notable because TL occurred most commonly in males of working age. By providing perspective on how historical context and nosology can affect the conceptualization of disease, this review may help inform prevention, treatment, and regulatory policy.

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Cerebrospinal fluid γ-aminobutyric acid levels in dogs with chronic portosystemic encephalopathy

Clinical Science ◽

10.1042/cs0710749 ◽

1986 ◽

Vol 71 (6) ◽

pp. 749-753 ◽

Cited By ~ 9

Author(s):

J. E. Maddison ◽

D. Yau ◽

P. Stewart ◽

G. C. Farrell

Keyword(s):

Cerebrospinal Fluid ◽

Aminobutyric Acid ◽

Plasma Ammonia ◽

Portosystemic Encephalopathy ◽

Dog Model ◽

Csf Levels ◽

Neurological Features ◽

The Brain ◽

Biochemical Abnormalities

1. Cerebrospinal fluid (CSF) γ-aminobutyric acid (GABA) levels were measured in a dog model of spontaneous chronic portosystemic encephalopathy. 2. Dogs with congenital portacaval shunts (intra- or extra-hepatic) develop neurological features of abnormal psychomotor behaviour and depressed consciousness that are consistent with the symptoms of chronic portosystemic encephalopathy in humans. In the five dogs studied, plasma ammonia was elevated, as was CSF tryptophan, both usual biochemical abnormalities in portosystemic encephalopathy. 3. CSF levels of GABA in five dogs with portosystemic encephalopathy (100 ± 13 pmol/ml) were not significantly different from those in five control dogs (96 ± 14 pmol/ml). CSF levels of GABA were not altered after ammonia infusion. 4. If enhanced GABA-ergic neurotransmission, due to influx of gut-derived GABA into the brain, is responsible for the pathophysiology of chronic portosystemic encephalopathy in this model, it is not reflected by increased levels of GABA in CSF.

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Bibliometric Evaluation of Publications (2000-2020) on the Prognosis of Gastric Cancer

INQUIRY The Journal of Health Care Organization Provision and Financing ◽

10.1177/00469580211056015 ◽

2021 ◽

Vol 58 ◽

pp. 004695802110560

Author(s):

Yujie Zhang ◽

Chaoran Yu

Keyword(s):

Gastric Cancer ◽

Bibliometric Analysis ◽

Web Of Science ◽

Future Perspective ◽

R Software ◽

Japanese Gastric Cancer Association ◽

Search Terms ◽

Increasing Trends ◽

Program Version

Background: Gastric cancer remains a global malignancy. The role of bibliometric analysis is increasingly valued. It is feasible and necessary to perform a bibliometric analysis to regurgitate studies in the prognosis of gastric cancer. Materials and methods: Web of Science was selected for the dataset resource. Articles published between 2000 and 2020 within the database of Web of Science Core Collection were included with predefined search terms. CiteSpace version 5.7.R1 and R software program version 4.0.3 were used for bibliometric analysis with parameters extrapolated from included studies. Results: A total of 1721 articles were included from 2000 to 2020 with remarkably increasing trends. China (n=1183), Japan (n=218), and South Korea (n=119) showed the most publications. SUN YAT SEN University, FUDAN University, and NANJING MED University were the top institutions with most publications. Keywords with strongest citation bursts between 2000 and 2020 were characterized. Particularly, “statistics”, “resistance”, “mortality”, “lncrna”, “diagnosis”, “outcome”, “migration”, “promote,” and “regulatory t cell” were the latest rising keywords since 2017, indicating possible study trends ahead. Several articles showed strongest citation bursts, including Jemal A. CA-CANCER J CLIN, Van Cutsem E. LANCET, and Japanese Gastric Cancer Association GASTRIC CANCER. Conclusion: This bibliometric analysis provides a thought-provoking, insightful result concerning the trajectory of research development in prognosis of gastric cancer with a future perspective.

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The Biosafety and Risk Management in Preparation and Processing of Cerebrospinal Fluid and Other Neurological Specimens With Potential Coronavirus Infection

Frontiers in Neurology ◽

10.3389/fneur.2020.613552 ◽

2021 ◽

Vol 11 ◽

Author(s):

Chien-Chin Chen ◽

Pei-Chun Chiang ◽

Tsung-Hsien Chen

Keyword(s):

Risk Assessment ◽

Cerebrospinal Fluid ◽

Disease Process ◽

Evidence Based ◽

Neurological Manifestations ◽

Cerebrovascular Events ◽

Recent Outbreak ◽

Acute Necrotizing ◽

Coronavirus Infection ◽

Global Threat

The recent outbreak of coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2, has become a global threat. Due to neurological manifestations presented throughout the coronavirus disease process, the potential involvement of COVID-19 in central nervous system has attracted considerable attention. Notably, the neurologic system could be widely affected, with various complications such as acute cerebrovascular events, encephalitis, Guillain-Barré syndrome, and acute necrotizing hemorrhagic encephalopathy. However, the risk assessment of exposure to potential biohazards in the context of the COVID-19 pandemic has not been clearly clarified regarding the sampling, preparation, and processing neurological specimens. Further risk managements and implantations are seldom discussed either. This article aims to provide current recommendations and evidence-based reviews on biosafety issues of preparation and processing of cerebrospinal fluid and neurological specimens with potential coronavirus infection from the bedside to the laboratory.

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Clinical evaluation of oropharyngeal dysphagia in Machado-Joseph disease

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032010000400003 ◽

2010 ◽

Vol 47 (4) ◽

pp. 334-338 ◽

Cited By ~ 4

Author(s):

Sabrina Mello Alves Corrêa ◽

Valter Nilton Felix ◽

Jonas Lírio Gurgel ◽

Rubens A. A Sallum ◽

Ivan Cecconello

Keyword(s):

Clinical Evaluation ◽

Clinical Characteristics ◽

Oropharyngeal Dysphagia ◽

Neurological Manifestations ◽

Severity Scale ◽

Pharyngeal Phase ◽

History Of ◽

Machado Joseph Disease ◽

Dysphagic Patients

CONTEXT: In Machado-Joseph disease, poor posture, dystonia and peripheral neuropathy are extremely predisposing to oropharyngeal dysphagia, which is more commonly associated with muscular dystrophy. OBJECTIVE: To evaluate the clinical characteristics of oropharyngeal dysphagia in Machado-Joseph disease patients. METHOD: Forty individuals participated in this study, including 20 with no clinical complaints and 20 dysphagic patients with Machado-Joseph disease of clinical type 1, who were all similar in terms of gender distribution, average age, and cognitive function. The medical history of each patient was reviewed and each subject underwent a clinical evaluation of deglutition. At the end, the profile of dysphagia in patients with Machado-Joseph disease was classified according to the Severity Scale of Dysphagia, as described by O'Neil and collaborators. RESULTS: Comparison between dysphagic patients and controls did not reveal many significant differences with respect to the clinical evaluation of the oral phase of deglutition, since afflicted patients only demonstrated deficits related to the protrusion, retraction and tonus of the tongue. However, several significant differences were observed with respect to the pharyngeal phase. Dysphagic patients presented pharyngeal stasis during deglutition of liquids and solids, accompanied by coughing and/or choking as well as penetration and/or aspiration; these signs were absent in the controls. CONCLUSIONS: Oropharyngeal dysphagia is part of the Machado-Joseph disease since the first neurological manifestations. There is greater involvement of the pharyngeal phase, in relation to oral phase of the deglutition. The dysphagia of these patients is classified between mild and moderate.

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