scholarly journals Pregnancy Ketonemia and Development of the Fetal Central Nervous System

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Agata Bronisz ◽  
Mateusz Ozorowski ◽  
Magdalena Hagner-Derengowska
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Ketone Bodies ◽  
Organ Damage ◽  
Energy Deficit ◽  
Fetal Life ◽  
Damage Development ◽  
Current Recommendation ◽  
Increased Risk ◽  
The Central Nervous System

Glucose is the major source of energy for the human brain which in turn uses ketone bodies as a supplement for energy deficit in glucose cell deficiency conditions. Pregnancy complicated by gestational diabetes is a condition associated with significantly increased risk of ketonemia development. The data available proves a changing influence of ketones on the central nervous system during fetal life and in adults as well. Ketone bodies freely pass through the placenta. They can affect fetal growth and organ damage development, especially the central nervous system. As agreed in the current recommendation of the diabetes associations, it is not obligatory for the attending doctor to conduct a routine inspection of ketone bodies during diabetes treatment in pregnancy. This article is a literature review of ketones’ effect on the central nervous system and an attempt to initiate discussion whether we should consider including ketonemia assessment into the standard care package for pregnant women with diabetes and begin some research on the explanation of its influence on fetal development.

scholarly journals Systemic inflammatory response syndrome and multiple-organ damage / dysfunction in complicated canine babesiosis

2001 ◽  
Vol 72 (3) ◽  
Author(s):  
C. Welzl ◽  
A.L. Leisewitz ◽  
L.S. Jacobson ◽  
T. Vaughan-Scott ◽  
E. Myburgh
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Renal Involvement ◽  
Organ Damage ◽  
Multiple Organ ◽  
Systemic Inflammatory Response ◽  
The Body ◽  
Increased Risk

This study was designed to document the systemic inflammatory response syndrome (SIRS) and multiple-organ dysfunction syndrome (MODS) in dogs with complicated babesiosis, and to assess their impact on outcome. Ninety-one cases were evaluated retro-spectively for SIRS and 56 for MODS. The liver, kidneys, lungs, central nervous system and musculature were assessed. Eighty-seven percent of cases were SIRS-positive. Fifty-two percent of the cases assessed for organ damage had single-organ damage and 48 % had MODS. Outcome was not significantly affected by either SIRS or MODS, but involvement of specific organs had a profound effect. Central nervous system involvement resulted in a 57 times greater chance of death and renal involvement in a 5-fold increased risk compared to all other complications. Lung involvement could not be statistically evaluated owing to co-linearity with other organs, but was associated with high mortality. Liver and muscle damage were common, but did not significantly affect outcome. There are manysimilarities between the observations in this study and previous human and animal studies in related fields, lending additional support to the body of evidence for shared underlying pathophysiological mechanisms in systemic inflammatory states.

scholarly journals Demonstration of Subclinical Organ Damage to the Central Nervous System in Essential Hypertension

10.5772/38494 ◽  
2012 ◽  
Author(s):  
Alina Gonzlez-Quevedo ◽  
Sergio Gonzlez ◽  
Otman Fernndez ◽  
Rosaralis Santiesteban ◽  
Luis Quevedo ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Essential Hypertension ◽  
Organ Damage ◽  
The Central Nervous System

Conclusion

2020 ◽  
pp. 237-238
Author(s):  
John F. Peppin ◽  
Joseph V. Pergolizzi ◽  
Robert B. Raffa ◽  
Steven L. Wright
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Side Effects ◽  
Mechanism Of Action ◽  
Term Treatment ◽  
Risk Of Death ◽  
Increased Risk ◽  
Treatment Plans ◽  
The Central Nervous System ◽  
System Data

The authors summarize the harmful and understudied aspects of the overuse of benzodiazepines. Increased and longer-term use of benzodiazepines has been observed to lead to side effects such as sedation, cognitive issues, abuse, and dependence, as well as many other unanticipated side effects that do not fit their known mechanism of action in the central nervous system. Data also shows a correlation between concomitant use of benzodiazepines and opioids and increased risk of death from overdose. The authors advocate for stricter guidelines for prescribing benzodiazepines, as well as close clinical monitor and shorter-term treatment plans.

scholarly journals Association Between Medications Acting on the Central Nervous System and Fall-Related Injuries in Community-Dwelling Older Adults: A New User Cohort Study

2019 ◽  
Vol 75 (5) ◽  
pp. 1003-1009 ◽  
Author(s):  
Shelly L Gray ◽  
Zachary A Marcum ◽  
Sascha Dublin ◽  
Rod Walker ◽  
Negar Golchin ◽  
...  
Keyword(s):  
Older Adults ◽  
Central Nervous System ◽  
Nervous System ◽  
Injury Risk ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Active Medication ◽  
Increased Risk ◽  
The Central Nervous System ◽  
Community Dwelling Older Adults

Abstract Background It is well established that individual medications that affect the central nervous system (CNS) increase falls risk in older adults. However, less is known about risks associated with taking multiple CNS-active medications. Methods Employing a new user design, we used data from the Adult Changes in Thought study, a prospective cohort of community-dwelling people aged 65 and older without dementia. We created a time-varying composite measure of CNS-active medication exposure from electronic pharmacy fill data and categorized into mutually exclusive categories: current (within prior 30 days), recent (31–90 days), past (91–365 days), or nonuse (no exposure in prior year). We calculated standardized daily dose and identified new initiation. Cox proportional hazards models examined the associations between exposures and the outcome of fall-related injury identified from health plan electronic databases. Results Two thousand five hundred ninety-five people had 624 fall-related injuries over 15,531 person-years of follow-up. Relative to nonuse, fall-related injury risk was significantly greater for current use of CNS-active medication (hazard ratio [HR] = 1.95; 95% CI = 1.57–2.42), but not for recent or past use. Among current users, increased risk was noted with all doses. Risk was increased for new initiation compared with no current use (HR = 2.81; 95% CI = 2.09–3.78). Post hoc analyses revealed that risk was especially elevated with new initiation of opioids. Conclusions We found that current use, especially new initiation, of CNS-active medications was associated with fall-related injury in community-dwelling older adults. Increased risk was noted with all dose categories. Risk was particularly increased with new initiation of opioids.

scholarly journals Cryptococcosis in Patients following Kidney Transplantation: A 9-Year Retrospective Clinical Analysis at a Chinese Tertiary Hospital

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Meifang Yang ◽  
Xuan Zhang ◽  
Jianhua Hu ◽  
Hong Zhao ◽  
Lanjuan Li
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Kidney Transplantation ◽  
Tertiary Hospital ◽  
Clinical Analysis ◽  
High Dose ◽  
Kidney Transplant Recipients ◽  
Pulmonary System ◽  
Increased Risk ◽  
The Central Nervous System

Background. Cryptococcosis following kidney transplantation (KT) is rare but is associated with considerably increased risk of mortality. At present, data on the association between cryptococcosis and KT in mainland China remain relatively limited. Objectives. This study aims to review our experience related to the management of cryptococcosis following KT at a Chinese tertiary hospital. Methods. All patients with cryptococcosis following KT admitted to our hospital from January 2010 to December 2018 were reviewed. Results. A total of 37 patients with cryptococcosis were enrolled (males: 62.2%). The mean age of the patients was 49.5 ± 9.38 (20–64) years. The average time to infection following KT was 7.0 ± 5.50 years (5 months to 21 years), and 30 patients (81.1%) had cryptococcosis onset >2 years following transplantation. The most common site of infection was the central nervous system, followed by the pulmonary system and skin. Most patients received fluconazole or voriconazole with or without flucytosine as their initial treatment regimen at our hospital. The 2-week mortality rate was 8.1% (3/37), and five patients (13.5%) died within 6 months of being diagnosed with cryptococcosis. Remarkably, all patients who received high-dose fluconazole (800 mg daily) or voriconazole ± flucytosine survived. Conclusions. Cryptococcosis in kidney transplant recipients is typically a late-occurring infection, with most patients having cryptococcosis onset >2 years following KT at our hospital. The central nervous system, pulmonary system, and skin are the main sites of infection. Voriconazole or high-dose fluconazole can be used as an alternative therapy for post-KT cryptococcosis.

Birth Defects in Twins: Study in a Spanish Population

1991 ◽  
Vol 40 (3-4) ◽  
pp. 337-344 ◽  
Author(s):  
M.A. Ramos-Arroyo
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Birth Defects ◽  
Congenital Malformations ◽  
Collaborative Study ◽  
Congenital Defects ◽  
Relative Risks ◽  
Increased Risk ◽  
The Central Nervous System ◽  
Using Data

AbstractThe risk for specific defects among twins compared to singletons was studied using data collected by the Spanish Collaborative Study of Congenital Malformations (ECEMC). A total of 136 twins had a major and/or minor congenital defect. The overall rate of congenital defects in twins (2.37%) did not deviate significantly from the rate in singletons (2.21%). Like-sex (LS) and male-male (MM) twin pairs had a slightly higher rate of birth defects than unlike-sex (US) and female-female (FF) pairs, respectively. Defects of the central nervous system, cardiovascular system and genitourinary system were significantly more frequent in LS twins than in singletons, with relative risks of 2.8, 2.5 and 1.6, respectively. No significantly increased risk was found among US twins. Among defects of the central nervous system, the rates of anencephaly, encephalocele and hydrocephaly were significantly higher in total and LS twins; however, no significantly increased risk for spina bifida was observed when compared to singletons. MM twins were also 1.9 times more likely to have hypospadias, but the risk among males of male-female (FM) pairs was decreased.

scholarly journals Varicella Zoster Virus Encephalitis

2019 ◽  
Vol 3 (4) ◽  
pp. 380-382
Author(s):  
Jared Lizzi ◽  
Tyler Hill ◽  
Julian Jakubowski
Keyword(s):  
Risk Factors ◽  
Central Nervous System ◽  
Nervous System ◽  
Varicella Zoster Virus ◽  
Immunocompromised Patient ◽  
Clinical Suspicion ◽  
The Body ◽  
Varicella Zoster ◽  
Increased Risk ◽  
The Central Nervous System

Varicella zoster virus in the adult patient most commonly presents as shingles. Shingles is a painful vesicular eruption localized to a specific dermatome of the body. One of the potential complications of this infection is involvement of the central nervous system causing encephalitis. An increased risk of this complication is associated with the immunocompromised patient. In this case report, we review the history and physical exam findings that should raise clinical suspicion for varicella zoster encephalitis, as well as the epidemiology, risk factors, treatment, and prognosis of this type of infection.

Challenges in paediatric perfusion

Perfusion ◽  
2002 ◽  
Vol 17 (4) ◽  
pp. 291-293
Author(s):  
W J Brawn
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Cardiopulmonary Bypass ◽  
Organ Damage ◽  
The Central Nervous System ◽  
Heart Lesions

In the last 50 years cardiopulmonary bypass has evolved dramatically, so that even the most complex heart lesions can be repaired successfully. However, we are aware that whilst survival may be excellent, organ damage, even though minor, particularly to the central nervous system is common. The next challenge in paediatric perfusion is to reduce this damage to a minimum.

scholarly journals Point-of-care detection of lactate in cerebrospinal fluid

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
C. Stephani ◽  
A. H. K. Choi ◽  
O. Moerer
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Point Of Care ◽  
Blood Gas ◽  
Csf Drainage ◽  
Increased Risk ◽  
Neurosurgical Patients ◽  
Csf Lactate ◽  
The Central Nervous System

Abstract Purpose Measurements of cerebrospinal fluid (CSF) lactate can aid in detecting infections of the central nervous system and surrounding structures. Neurosurgical patients with temporary lumbar or ventricular CSF drainage harbor an increased risk for developing infections of the central nervous system, which require immediate therapeutic responses. Since blood gas analyzers enable rapid blood-lactate measurements, we were interested in finding out if we can reliably measure CSF-lactate by this point-of-care technique. Methods Neurosurgical patients on our intensive care unit (ICU) with either lumbar or external ventricular drainage due to a variety of reasons were included in this prospective observational study. Standard of care included measurements of leucocyte counts, total protein and lactate measurements in CSF by the neurochemical laboratory of our University Medical Center twice a week. With respect to this study, we additionally performed nearly daily measurements of cerebrospinal fluid by blood gas analyzers to determine the reliability of CSF-lactate measured by blood gas analyzers as compared to the standard measurements with a certified device. Results 62 patients were included in this study. We performed 514 CSF-lactate measurements with blood gas analyzers and compared 180 of these to the in-house standard CSF-lactate measurements. Both techniques correlated highly significantly (Pearson correlation index 0.94) even though lacking full concordance in a Bland–Altman plotting. Of particular importance, regular measurements enabled immediate detection of central infection in three patients who had developed meningitis during the course of their treatment. Conclusion Blood gas analyzers measure CSF-lactate with sufficient reliability and can help in the timely detection of a developing meningitis. In addition to and triggering established CSF diagnostics, CSF-lactate measurements by blood gas analyzers may improve surveillance of patients with CSF drainage. This study was retrospectively registered on April 20th 2020 in the German trial register. The trial registration number is DRKS00021466.

scholarly journals Allogeneic Epidural Blood Patch in the Setting of Persistent Spinal Headache and Disseminated Coccidioidomycosis

2009 ◽  
Vol 3;12 (3;5) ◽  
pp. 639-643 ◽  
Author(s):  
Terrence L. Trentman
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Dural Puncture ◽  
Epidural Blood Patch ◽  
Blood Donation ◽  
Autologous Blood ◽  
Post Dural Puncture Headache ◽  
Increased Risk ◽  
Blood Patch ◽  
The Central Nervous System

In most cases of post-dural puncture headache, the positional symptoms will resolve spontaneously within 2 weeks. Conservative therapies include oral analgesics and hydration, bed rest, and abdominal binders. For refractory cases, an autologous epidural blood patch remains the treatment of choice. However, in certain cases the use of autologous blood for the blood patch may place the patient at risk for infectious or malignant contamination of the central nervous system. Coccidioidomycosis results from inhalation of the arthroconidia (spore) stage of the fungal lifecycle. The most common manifestation of coccidioidomycosis is acute pulmonary symptoms, while the most feared complication is meningitis. Immunocompromised patients are at increased risk of fungemia; therefore, introduction of fungal elements into the central nervous system can occur if autologous blood is used for an epidural blood patch. We report a case of persistent dural-puncture headache in the setting of disseminated coccidioidomycosis. An autologous blood epidural blood patch was considered but deferred due to risk of coccidioidomycosis meningitis. Other epidural space interventions such as fibrin glue injection or saline infusions were judged to be too imprecise or ineffective. The patient was successfully treated with allogeneic blood donated by his wife, but only after testing of her blood as is required for any directed blood donation. Allogeneic epidural blood patches are an option for refractory dural puncture headaches when autologous blood may cause meningitis or malignant seeding of the central nervous system. Key words: Epidural blood patch, post-dural puncture headache, Coccidioidomycosis, arthroconidia, acute pulminary symptoms

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