scholarly journals Incidence of dehydration encephalopathy among patients with disturbed consciousness at a hospital emergency unit

2011 ◽  
Vol 1 (1) ◽  
pp. 9 ◽  
Author(s):  
Emina Ogawa ◽  
Ryuji Sakakibara ◽  
Kei Endo ◽  
Fuyuki Tateno ◽  
Yasuo Matsuzawa ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
University Hospital ◽  
Elderly Subjects ◽  
Emergency Unit ◽  
Hospital Emergency ◽  
Initial Manifestation ◽  
Medical Case ◽  
Emergency Units

Systemic dehydration and diffuse central nervous system signs without any other illness is referred to as dehydration encephalopathy (DE). However, the incidence of DE at emergency units remains uncertain. We investigated the incidence of DE among persons with disturbed consciousness who visited the emergency unit. We reviewed the medical case records of the emergency unit at our university hospital during a 6-month period. Among them, 132 patients presented with disturbed consciousness as the sole initial manifestation on arrival. They were 75 men, 47 women; mean age 68 years (16-95 years). After carefully excluding other etiologies, the incidence of DE was 2% among all persons in the emergency unit and 4% among persons older than 68 years.In conclusion, the incidence of DE in our emergency unit was not common. Nevertheless, recognition of DE is extremely important in order to avoid unnecessary medication in elderly subjects.

scholarly journals GCT-10. CAN HIGH LEVEL SERUM hCG-β BE CONSIDERED EQUIVALENT TO A DIAGNOSIS OF CHORIOCARCINOMA IN PRIMARY CENTRAL NERVOUS SYSTEM GERM-CELL TUMOR?

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii329-iii330
Author(s):  
Hiroaki Motegi ◽  
Shigeru Yamaguchi ◽  
Yukitomo Ishi ◽  
Michinari Okamoto ◽  
Akihiro Iguchi ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Germ Cell ◽  
Germ Cell Tumor ◽  
Good Prognosis ◽  
Cell Tumor ◽  
University Hospital ◽  
Kaplan Meier ◽  
Beta Human Chorionic Gonadotropin ◽  
High Level

Abstract BACKGROUND Primary central nervous system(CNS) choriocarcinoma(CC) is very rare and has the poorest prognosis among germ cell tumor (GCT). CC usually has extremely high level (HL) of serum beta-human chorionic gonadotropin (bhCG) over than 1,000 mIU/ml. Some studies assign HL bhCG cases to poor prognosis group even without biopsy. The purpose of this study was to find out if there was a good prognosis subset in the HL bh group. MATERIALS AND METHODS We analyzed 103 cases diagnosed with GCT from 1998 to 2019 in Hokkaido University Hospital and reviewed the literature of CNS CC and bhCG. Survival was assessed using Kaplan-Meier method and log-rank statistics between the group with CC component and that with no CC component but HL bhCG. RESULTS One out of 103 our cases was diagnosed as a mixed GCT with CC component and did not respond to treatment and died 9 months later. Two cases were treated as CC because of HL bhCG (1,226 and 2,739 mIU/ml) despite that the biopsy showed only germinomas and survived(105 and 37 months), that is, no CC component. Combining our cases with 69 cases in the literature, all 7 cases with no CC component but HL bhCG survived but the median survival of the other 65 cases with CC component was 38.2 months (P=0.02). CONCLUSION This study has a limitation of selection bias, however, it suggests that patients with no CC component but HL bhCG may have a better prognosis.

Relapsing myelopathy as the initial manifestation of primary central nervous system angiitis

2007 ◽  
Vol 55 (4) ◽  
pp. 425
Author(s):  
VV Ashraf ◽  
MathewM John ◽  
KG Ramakrishnan ◽  
Anita Mahadevan
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Initial Manifestation

scholarly journals Construction of an Operational Protocol for Multiple Victims and Disasters in Southern Brazil

2019 ◽  
Vol 34 (s1) ◽  
pp. s111-s111
Author(s):  
Sandra Mara Marin ◽  
Jean Bender ◽  
Danielle Bezerra Cabral
Keyword(s):  
Emergency Service ◽  
Descriptive Study ◽  
Future Research ◽  
Emergency Unit ◽  
Southern Brazil ◽  
Hospital Emergency ◽  
Scientific Content ◽  
Emergency Units ◽  
South Of Brazil ◽  
Nursing Professionals

Introduction:Unpredictable events, such as disasters, can change the organizational configuration of health facilities. In a situation of multiple victims, this scenario modifies the flow of care to adapt to the reality that is there. In addition, emergency and emergency units provide immediate care to maintain and preserve the lives of these victims, making it a challenge for all health professionals.Aim:To construct an Operational Protocol for nursing care with multiple victims and disasters in a Hospital Emergency and Emergency Service.Methods:We used a descriptive study with a qualitative approach using the Focal Group technique (GF). The participants included nursing staff and residents who work in the emergency and emergency unit in a hospital in the south of Brazil. The topics from the GF discussion were analyzed by the scientific content of Minayo (2013).Results:The operational assistance protocol for multiple victims and disasters was planned with a redistribution of materials, equipment, human resources of the service, and physical restructuring of the service and other units with the construction of a flow chart to meet the proposed demand.Discussion:In the study, we observed the importance of discussing and planning proposals for care with multiple victims. In addition, the interest of the participants was fundamental to the success of this protocol. This protocol serves as an incentive for nursing professionals and academics for future research that evaluates the effectiveness of using nursing competencies to assist multiple victims in emergency and disaster situations.

A Diagnostic Pointer to Adult Metachromatic Leucodystrophy

1980 ◽  
Vol 137 (2) ◽  
pp. 186-187 ◽  
Author(s):  
John A. O. Besson
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Autosomal Recessive ◽  
Demyelinating Disease ◽  
Initial Manifestation ◽  
The Central Nervous System ◽  
Metachromatic Leucodystrophy ◽  
Arylsulphatase A ◽  
Recessive Defect

Adult metachromatic leucodystrophy (MLD) is a rare demyelinating disease of the central nervous system caused by a genetic autosomal recessive defect and mediated through a deficiency in the enzyme arylsulphatase A (Peiffer, 1970). The initial manifestation may take the form of symptoms suggestive of schizophrenia or dementia (Sourander et al, 1962; Austin et al, 1968).

Central nervous system aquaporin-4 autoimmunity presenting with an isolated cerebral abnormality

2012 ◽  
Vol 18 (9) ◽  
pp. 1340-1343 ◽  
Author(s):  
Su-Hyun Kim ◽  
Woojun Kim ◽  
Myeong-Cherl Kook ◽  
Eun-kyung Hong ◽  
Ho Jin Kim
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Optic Neuritis ◽  
Treatment Response ◽  
Comprehensive Evaluation ◽  
Cerebral Lesion ◽  
Cerebral Lesions ◽  
Initial Manifestation ◽  
Clinical Presentations ◽  
History Of

Advances in the understanding of central nervous system aquarporin-4 autoimmunity have promoted the recognition of diverse clinical presentations beyond the traditional view of neuromyelitis optica. We describe a patient who developed hemiparesis caused by an extensive cerebral lesion as an initial manifestation of central nervous system aquarporin-4 autoimmunity. Although the patient had no history of optic neuritis or myelitis, not only was serum anti-aquarporin-4 antibody positive, but an imaging, treatment response and histopathological features also revealed characteristic findings suggestive of central nervous system aquarporin-4 autoimmunity. The present case highlights the importance of a comprehensive evaluation for anti-aquarporin-4 antibody even in patients presenting with isolated cerebral lesions.

scholarly journals Viral Molecular Testing of Cerebrospinal Fluid in Adults with Suspected Central Nervous System Infection in an Italian University Hospital Laboratory: A Retrospective Study on 1462 Consecutive Patients

2021 ◽  
Vol 15 (1) ◽  
pp. 26-35
Author(s):  
Monica Basso ◽  
Daniela Zago ◽  
Irene Pozzetto ◽  
Claudia Del Vecchio ◽  
Elisa Franchin ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Central Nervous System Infection ◽  
Human Herpesvirus ◽  
University Hospital ◽  
Unknown Etiology ◽  
Molecular Testing ◽  
Younger Patients ◽  
Hospital Laboratory

Background: Generally, about half of the patients with central nervous system infections cases remain unexplained. Therefore, we aimed to describe which viruses were detected in unselected patients with a suspected central nervous system infection and the first diagnostic workflow in a university hospital laboratory. Methods: A comprehensive virus testing in cerebrospinal fluid with an in-house real-time PCR method was employed. Determining how many and which viruses to test was at the full discretion of the treating physician. Results: 1462 patients were evaluated from 2011 to 2017 and 9 898 viral PCRs were made: 176 subjects (12%) had a positive result. There was great heterogeneity in the frequency of patients tested for each virus, ranging from 97.9% (1431 out of 1462) for herpes simplex virus (HSV) to 1.9% (28 out of 1462) for Parvovirus B19, positive in 1 patient. Enterovirus (EV) was the leading virus detected: the frequency was higher with respect to HSV (5.2% vs 2.4%, p=0.0004), varicella-zoster virus (VZV)(5.2% vs 2.9%, p=0.0052), human herpesvirus-6 (5.2% vs 1.7%, p=0.0014) and human herpesvirus-7 (HHV-7)(5.2% vs 2.5%, p=0.0406). Both VZV (83.5%) and HSV (97.9%) were tested significantly more than EV (68.7%, p<0.0001) and HHV-7 (24.1%, p<0.0001): the latter had a positivity comparable to HSV and it was detected in younger patients (median age 29 years), as for EV (median age 35 years). There was no difference found in the age of positive subjects with respect to negative ones for the other viruses tested. Conclusion: EV was the fifth virus frequently included in the diagnostic workflow but the most frequently detected, mostly in subjects aged less 40, as HHV-7 was. Testing these two viruses in all younger patients could reduce the number of unknown etiology.

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