scholarly journals Temporal Trends in the Incidence and Clinical Characteristics of Hydrocephalus Requiring Cerebrospinal Fluid Shunt at Kanmon Medical Center

2020 ◽  
Vol 69 (3) ◽  
pp. 135-140
Author(s):  
Akifumi IZUMIHARA ◽  
Katsuhiro YAMASHITA
Keyword(s):  
Cerebrospinal Fluid ◽  
Clinical Characteristics ◽  
Medical Center ◽  
Temporal Trends ◽  
Cerebrospinal Fluid Shunt

Mechanical complications of cerebrospinal fluid shunt. Differences between adult and pediatric populations: myths or reality?

2021 ◽  
Author(s):  
Guillaume Coll ◽  
Francis Abed Rabbo ◽  
Emmanuel de Schlichting ◽  
Aurélien Coste ◽  
Jean Chazal ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Cerebrospinal Fluid Shunt ◽  
Mechanical Complications ◽  
Pediatric Populations

scholarly journals AB0442 CLINICAL FEATURES OF POLYMYOSITIS AND DERMATOMYOSITIS PATIENTS WITH SEVERE DYSPHAGIA

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1249.1-1249
Author(s):  
Y. Hayashi ◽  
K. Izumi ◽  
S. Hama ◽  
M. Higashida-Konishi ◽  
M. Ushikubo ◽  
...  
Keyword(s):  
Interstitial Pneumonia ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Age Of Onset ◽  
Inflammatory Diseases ◽  
Medical Center ◽  
Hospital Organization ◽  
Initial Examination ◽  
Severe Dysphagia ◽  
Frequent Complication

Background:Polymyositis (PM) and dermatomyositis (DM) are autoimmune inflammatory diseases characterized by proximal myositis. Dysphagia has been reported to develop in 35 to 62% of PM/DM patients and known as poor prognosis factor.Objectives:The purpose of this study is to determine the clinical characteristics of PM/DM patients who present with deglutition disorder.Methods:Consecutive patients with PM/DM who visited National Hospital Organization Tokyo Medical Center between April 2010 and January 2021 are included in this study. We compared clinical features between the patients with and without dysphagia. The diagnosis of dysphagia was based on videofluorography swallow study, and dysphagia requiring gastrostomy was defined as severe dysphagia. The clinical characteristics compared in this study were following: age of onset, levels of serum creatine kinase (CK) and lactate dehydrogenase(LDH), sense of dysphagia, manual muscle test (MMT) score, and complication of malignancy or interstitial pneumonia.Results:A total of 73 patients with PM/DM were identified. Among them, 12 patients were diagnosed with dysphagia, and 5 patients developed severe dysphagia. Patients with dysphagia had the following characteristics compared to patients without dysphagia: higher levels of serum LDH (833.7 ± 500.1 U/L vs 471.9 ± 321.0 U/L, p = 0.0088), higher levels of serum CK at initial examination (6070.3 ± 7184.8 IU/L vs 1534.7 ± 2978.8 IU/L, p = 0.0086) and more frequent sense of dysphagia (90.9% vs 10.6%, p< 0.0001), lower MMT score(3.18 ± 1.07 vs 4.31 ± 0.75, p = 0.0017). In addition to those, patients with severe dysphagia presented older age of onset (mean age 69.4 ± 12.0 vs 51.7 ± 14.8, p = 0.014), more frequent complication of malignancy (80.0% vs 14.8%, p= 0.0048) and less frequent complication of interstitial pneumonia (0.0% vs 55.5%, p= 0.023).Conclusion:These results indicate that dysphagia develops frequently in PM/DM patients with higher levels of serum LDH or CK, sense of dysphagia and low MMT score. Among them, patients with elderly onset or malignancy are at risk for sever dysphagia, and should be treated carefully.Disclosure of Interests:None declared.

scholarly journals Advances in Diagnosis of Progressive Pulmonary and Disseminated Coccidioidomycosis

2020 ◽  
Author(s):  
Christelle Kassis ◽  
Michelle Durkin ◽  
Eric Holbrook ◽  
Robert Myers ◽  
Lawrence Wheat
Keyword(s):  
Cerebrospinal Fluid ◽  
Retrospective Study ◽  
Medical Center ◽  
Antigen Detection ◽  
Antibody Detection ◽  
Main Method ◽  
System Sensitivity ◽  
Serum Antigen ◽  
Urine And Serum ◽  
Immunocompetent Patients

Abstract Background Antibody detection is the main method for diagnosis of coccidioidomycosis, but it has limitations. The Coccidioides antigen enzyme immunoassay is recommended for testing cerebrospinal fluid in suspected meningitis. Reports on urine and serum antigen detection evaluated small numbers of patients who were mostly immunocompromised. The purpose of this study was to assess the accuracy of combined antibody and antigen detection for diagnosis. Methods A retrospective study, including all patients in whom Coccidioides antigen detection in serum was performed between January 2013 and May 2017, was conducted at Valleywise Health Medical Center (formerly Maricopa Integrated Health System). Sensitivity and specificity of antigen and antibody were evaluated in 158 cases and 487 controls. Results The sensitivity of antibody detection by immunodiffusion (ID) was 84.2%. The sensitivity of antigen detection was 57.0% if both urine and serum were tested and 36.7% if urine alone was tested. The sensitivity of combining antigen and ID antibody detection was 93.0%. The sensitivity of urine and serum antigen detection was 55.4% in proven and 58.7% in probable cases, 79.1% in disseminated and 41.6% in pulmonary cases, and 74.7% in immunocompromised and 40.0% in immunocompetent patients. Specificity was 99.4% for antigen detection and 96.5% for ID antibody detection. Diagnostic accuracy was 95.4% for ID antibody and antigen detection, 93.6% for ID antibody alone, and 89.1% for pathology or culture. Conclusions These findings support combined antibody and antigen detection for diagnosis of progressive coccidioidomycosis. The diagnosis may have been missed if antigen detection was not performed.

scholarly journals Evaluation of Microbial Bacterial and Fungal Diversity in Cerebrospinal Fluid Shunt Infection

PLoS ONE ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e83229 ◽  
Author(s):  
Tamara D. Simon ◽  
Christopher E. Pope ◽  
Samuel R. Browd ◽  
Jeffrey G. Ojemann ◽  
Jay Riva-Cambrin ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Fungal Diversity ◽  
Shunt Infection ◽  
Cerebrospinal Fluid Shunt

Subdural hemorrhage of the cauda equina. A rare complication of cerebrospinal fluid shunt. Case report

1996 ◽  
Vol 19 (2) ◽  
pp. 113-117 ◽  
Author(s):  
Gabriele Wurm ◽  
Peter Pogady ◽  
Karin Lungenschmid ◽  
Johannes Fischer
Keyword(s):  
Cerebrospinal Fluid ◽  
Case Report ◽  
Rare Complication ◽  
Cauda Equina ◽  
Subdural Hemorrhage ◽  
Cerebrospinal Fluid Shunt

scholarly journals Favorable Outcome of Neonatal Cerebrospinal Fluid Shunt-Associated Candida Meningitis with Caspofungin

2013 ◽  
Vol 57 (5) ◽  
pp. 2391-2393 ◽  
Author(s):  
Jop Jans ◽  
Roger J. M. Brüggemann ◽  
V. Christmann ◽  
Paul E. Verweij ◽  
Adilia Warris
Keyword(s):  
Cerebrospinal Fluid ◽  
Medical Devices ◽  
Systemic Exposure ◽  
Favorable Outcome ◽  
Cerebrospinal Fluid Shunt ◽  
Device Removal ◽  
Content Type ◽  
Pharmacokinetic Assessment ◽  
Complex Cases

ABSTRACTInvasiveCandidainfections associated with medical devices are very difficult to cure without device removal. We present a case of neonatal cerebrospinal fluid shunt-associatedCandidameningitis, in which removal of the device was precluded, that was successfully treated with caspofungin. Pharmacokinetic assessment of caspofungin concentrations in cerebrospinal fluid showed that exposure was adequate in the presence of a high systemic exposure. In complex cases of neonatalCandidainfections involving medical devices, the addition of caspofungin might be beneficial.

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