scholarly journals Is There Long-term Signal Intensity Increase in the Central Nervous System on T1-weighted Images after MR Imaging with the Hepatospecific Contrast Agent Gadoxetic Acid? A Cross-sectional Study in 91 Patients

Radiology ◽  
2017 ◽  
Vol 282 (3) ◽  
pp. 708-716 ◽  
Author(s):  
Johannes Kahn ◽  
Helena Posch ◽  
Ingo G. Steffen ◽  
Dominik Geisel ◽  
Christian Bauknecht ◽  
...  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Maria Torheim Bjelkarøy ◽  
Socheat Cheng ◽  
Tahreem Ghazal Siddiqui ◽  
Jūratė Šaltytė Benth ◽  
Ramune Grambaite ◽  
...  

Abstract Objectives Central nervous system depressant medications (CNSD) including benzodiazepines, z-hypnotics and opioids are regularly prescribed for the older patient. These medications are linked to dependence and associated with severe side effects in some older patients. Consensus recommendations for this group suggest limiting their use. We have recently described a high proportion of long-term CNSD use and dependence among older in-hospital patients. In this study, we aim to investigate factors associated with pain intensity and presentation of pain among older adults with long-term use of CNSDs compared to non-users. Methods Two hundred and forty six elderly hospitalised patients were recruited consecutively in a cross-sectional study. Data was collected from patients and electronic health records (EHR). Independent variables were sex, age, education, emotional symptoms (hospital anxiety and depression scale [HADS]), cognitive function (Mini-mental State Examination test [MMSE]), comorbidity (cumulative illness rating score – geriatrics [CIRS-G]), loneliness (the six-item De Jong Gierveld Loneliness Scale) and prolonged (≥4 weeks) use of any CNSDs or prolonged use of opioids (≥4 weeks). All variables, including pain intensity, were collected at one time point consistent with the cross-sectional study design. Statistical analyses included descriptive statistics and linear regression models using the above mentioned variables and pain intensity (visual analogue scale for pain intensity [VAS] pain 0–100) as outcome. Additional information regarding pain presentation was extracted from the patients’ EHR. Results Mean pain intensity VAS (SD) was 35.2 (30.4) and 18.1 (24.2) respectively, for patients with vs. without prolonged use of CNSDs. In the multivariable linear regression analysis, prolonged use of CNSDs and opioids were positively associated with pain intensity (VAS) (regression coefficient (95% CI) 20.7 (11.0; 30.3), p<0.001, and 19.8 (5.7; 33.8), p=0.006, respectively), while sex, age, education, MMSE, HADS, CIRS-G and loneliness scores were not. Pain related to back (23.2%) and lower extremities (23.2%) were most common pain sites, and those with one or more pain sites reported overall higher pain intensity compared to those with no reported pain sites (p<0.006). Conclusions Prolonged use of CNSD medications as well as prolonged use of opioids are both positively associated with pain intensity. The results may have implications for treatment and long-term pain management for older patients.


2019 ◽  
Vol 23 (03) ◽  
pp. e317-e321 ◽  
Author(s):  
Gabriela Rodrigues da Silva ◽  
Rafaela Soares Rech ◽  
Deisi Cristina Gollo Marques Vidor ◽  
Karoline Weber dos Santos

Introduction Chewing and swallowing are physiologically interconnected functions, which share motor structures and supranuclear regions of the central nervous system (CNS), involving a sensorimotor synchrony. Objective To analyze the influence of masticatory behavior on muscular compensations in the oral phase of swallowing in smokers compared with nonsmokers. Methods A cross-sectional study comparing smokers and nonsmokers composed of 24 participants in each group. The aspects of food crunching, masticatory pattern, masticatory speed, atypical muscular contractions, and lip closure were analyzed during mastication. In swallowing, aspects of contraction of the orbicular and mental muscles, head movement and presence of deglutition, mastication, smoking, and of stomatognathic system of residues after swallowing were characterized. Results Statistically significant differences were identified between the study groups related to food grinding pattern, masticatory velocity, and mental contraction during swallowing. There was no significant association between masticatory function and compensations during swallowing. Conclusion Differences were observed in the pattern of chewing and swallowing in smokers compared with nonsmokers, but no influence of masticatory performance was observed in the presence of muscle compensations during the oral phase of swallowing.


Radiology ◽  
2017 ◽  
Vol 284 (1) ◽  
pp. 299-301 ◽  
Author(s):  
Cornelia Harz ◽  
Laura Schöckel ◽  
Jan Endrikat ◽  
Hubertus Pietsch ◽  
Thomas Balzer

Author(s):  
Samira Asadollahi ◽  
Mahta Mazaheri ◽  
Razieh Sadat Tabatabaee ◽  
Sahel Khajehnoori ◽  
Mahmood Noorishadkam ◽  
...  

Background: Congenital abnormalities are diseases that occur during fertilization of the egg or development of the fetus and lead to disability, illness or mortality. This study aimed to investigate the prevalence and the factors associated with fetomaternal abnormalities in therapeutic abortions.                                                                                       Methods: This cross-sectional study was performed on 391 mothers referred to Yazd legal medicine organization for pregnancy termination from March 2017 to March 2020. The data about their fetuses were extracted and recorded. Results:The most common fetal abnormalities observed in this study were central nervous system abnormalities (21.1%), subsequently chromosomal disorders (16.8%), hydropsfetalis, cystic hygroma (15.9%), syndromic disorders (10.1%), single-gene disorders (8.1%), dysmorphology (8.1%), musculoskeletal disorders (7.8%), and cardiovascular disorders (7.2%). Conclusion: The main maternal causes for therapeutic abortion were cardiovascular disease, kidney diseases and cancers, while the most common fetal disorders leading to therapeutic abortion were central nervous system disorders such as anencephaly.


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e048528
Author(s):  
Thomas J Moore ◽  
Phillip W Wirtz ◽  
Stefan P Kruszewski ◽  
G Caleb Alexander

ObjectiveTo assess the 5-year changes in the adult medical use of central nervous system (CNS) stimulants with higher risk of dependence and evaluate the population characteristics of users and their medical and/or neurological conditions.DesignCross-sectional study.SettingAnnual US Medical Expenditure Panel Survey, a stratified random sample of approximately 30 000 persons designed to produce national population estimates. It focuses on reported medical spending, medical services used, health status and prescription medications.ParticipantsAdults age 19 years and older who reported obtaining one or more prescriptions for amphetamine or methylphenidate products during two survey years, 2013 and 2018.Main outcomes measuresPrescriptions obtained, the specific stimulant product and annual treatment days of drug supplied.ResultsIn 2018, an estimated 4.1 million US adults (95% CI 3.4 million to 4.8 million) reported prescriptions for CNS stimulants, having filled a mean of 7.3 (95% CI 6.8 to 7.8) prescriptions with a mean of 226 (95% CI 210 to 242) days’ supply. Compared with 2013, the estimated number of adults reporting using CNS stimulants in 2018 increased by 1.8 million (95% CI 1.0 million to 2.7 million) or 79.8%. Most 2018 adult stimulant users reported taking psychoactive medication for one or more mental, behavioural or neurodevelopment disorders. Overall, 77.8% (95% CI 72.6% to 83.0%) reported some medication for adult attention deficit disorder, 26.8% (95% CI 22.2% to 31.5%) took medication for anxiety, 25.1% (95% CI 19.9% to 30.3%) for depression and 15.3% (95% CI 9.8% to 20.8%) indicated drug treatment for other mental or neurological disorders. Adult CNS stimulant use was higher in females, in younger age cohorts and among individuals of white race/ethnicity.ConclusionsAdult medical use of prescription stimulants increased markedly in 5 years and occurred in a population often reporting multiple mental or neurological disorders. Further action is needed to understand and manage this new resurgence in drugs with high risks of dependence.


2021 ◽  
Author(s):  
Luiza Kohler Seixas ◽  
Marcio da Silva Paz ◽  
Claudia Suemi Kamoi Kay ◽  
Lineu Cesar Werneck ◽  
Paulo José Lorenzoni ◽  
...  

Background: The most prevalent autoimmune diseases (AID) of the Central Nervous System (CNS) are Multiple Sclerosis (MS) and Neuromyelitis Optica Spectrum Disorder (NMOSD), both being demyelinating diseases. Recent studies show that patients with CNS demyelinating diseases have a higher risk of presenting associated diagnosis of another AIDs. Objectives: The present study aimed to evaluate the frequency of autoimmune comorbidities and autoantibodies in patients with MS and NMOSD. Design and setting: Were analyzed the medical records of 126 patients with MS or NMOSD, from the Demyelinating Diseases Outpatient Clinic in the Neurological and Psychiatric Unit in the Complexo Hospital de Clinicas da Universidade Federal do Parana (CHC-UFPR), taking in consideration the presence of AIDs and autoantibodies. Methods: The variables were organized in a Microsoft® Office Excel spreadsheet for statistical analysis. Results: Of the 126 analyzed cases, 111 (88%) corresponded to MS and 15 (12%) to NMOSD. From the total, at least one AID was associated in 11 patients (8.7%), six of which were diagnosed with MS and five with NMOSD (p<0.05). Regarding autoantibodies, there were 21 cases (16.7%) in which antinuclear antibodies (ANA) were present, and 12 cases (9.5%) in which autoantibodies other than ANA were present (p<0.05). Conclusions: The results of the study showed a higher frequency of AIDs in patients with CNS demyelinating diseases compared to the normal population. The results found in this study may contribute to improve the treatment and follow-up of patients with CNS demyelinating diseases, so that the concomitance of other AIDs is considered by the clinician.


BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e035212
Author(s):  
Alice E Holton ◽  
Cora Keeney ◽  
Benedict Ryan ◽  
Gráinne Cousins

ObjectivePrevious prevalence estimates of POtentially Serious Alcohol–Medication INteractions in Older adults (POSAMINO) are based on in-home inventories of medications; however, this method is associated with under-reporting of medications when compared with dispensing records. This study aims to estimate the prevalence of POSAMINO among community-dwelling older adults using drug dispensing data from the community pharmacy setting.DesignCross-sectional study.SettingIrish Community Pharmacy.Participants1599 consecutive older adults presenting with a prescription to 1 of 120 community pharmacies nationwide; community-dwelling, aged ≥65 years, able to speak and understand English, with no evidence of cognitive impairment. The mean age of sample was 75.5 years (SD 6.5); 55% (n=884) female.Measures38 POSAMINO criteria were identified using participants’ pharmacy dispensing records linked to self-reported alcohol consumption (beverage-specific quantity and frequency measures) over the last 12 months.ResultsThe overall prevalence of POSAMINO in the study population was 28%, with 10% at risk of at least one POSAMINO criteria and 18% at risk of two or more. Exposure to POSAMINO most commonly involved cardiovascular agents (19%) and central nervous system agents (15%). Exposure to a higher number of POSAMINO criteria was associated with younger age (adjusted incident rate ratio (AIRR): 0.97; 95% CI: 0.95 to 0.98), male sex (AIRR: 0.55; 95% CI: 0.45 to 0.67) and a higher number of comorbidities (AIRR: 1.05; 95% CI: 1.01 to 1.13).ConclusionThis study adds to the growing body of evidence, which suggests that older adults are vulnerable to potentially serious alcohol–medication interactions, particularly those involving cardiovascular and central nervous system agents, increasing their risk of orthostatic hypotension, gastrointestinal bleeds and increased sedation. Application of the POSAMINO criteria at the point of prescribing may facilitate the risk stratification of older adults and prioritise alcohol screening and brief alcohol interventions in those at greatest risk of harm.


2021 ◽  
pp. 29-31
Author(s):  
R.Shanthi Malar ◽  
Govindarajulu Govindarajulu ◽  
N.Thamilpavai Arulnambi ◽  
S. Gopal

BACKGROUND: Covid 19 has caused a global pandemic since November 2019. Neurological manifestations also occur in addition to respiratory symptoms and distress. Recently it has been found that the neurological symptoms of covid 19 are also common. OBJECTIVE: To study the neurological manifestations of patients with covid 19 MATERIALS AND METHODS: In this cross sectional study design, patients admitted in GOVT Kilpauk Medical College ,Chennai with symptoms and signs of Covid 19 infection with laboratory confirmed / CT with informed consent. Neurological examination done by trained neurologist and symptoms were analysed into those involving the central nervous system and peripheral nervous system RESULTS: Of 349 patients mean SD age,55.14[14.06]; 232 males [66%] with COVID 19 and 117 females [33%], Of 349 patients ,covid positive patients 179 [51.3%] ,covid negative 170 [48.7 %] .The most common symptoms of patients are giddiness 282[ 80.8%], weakness of limbs 312[ 89%], myalgia 91 [26%], bells palsy 67 [19%], ataxia 57 [16.3%], seizures 54 [15%] ,loss of taste 37 [10.6%] ,loss of smell 12 [3.4%] ,neck rigidity 10 [2.8%] . The mortality rate of patients ,covid positive with pneumonia 98 cases [58.3%], covid negative 70 [ 41.7%]. CONCLUSION : Patients with covid -19 commonly have neurological manifestations .


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