scholarly journals A proposal for a tailored protocol for focal suppurative infection of the central nervous system: analysis of an institutional experience in pediatric patients

2019 ◽  
Vol 47 (2) ◽  
pp. E11 ◽  
Author(s):  
Suhas Udayakumaran ◽  
Ticini Joseph
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
System Analysis ◽  
Clinical Signs ◽  
Treatment Protocol ◽  
Response To Treatment ◽  
Research Centre ◽  
Short Term ◽  
The Central Nervous System

OBJECTIVEThe incidence of focal suppurative infections (FSIs) of the brain has significantly decreased owing to the better health and fundamental conditions of the population on the one hand and earlier detection and the availability of more potent antibiotics on the other. Interestingly, the antibiotic protocols have not been well defined in terms of duration despite a prompter diagnosis, definitive management of the etiology, and the advent of various higher-generation antibiotics. In this study, the authors evaluated the current treatment protocol. Their aim was to optimize management protocols for FSIs of the central nervous system based on clinical parameters.METHODSThe study was a retrospective analysis of all children who had undergone surgical management for an FSI at the Division of Paediatric Neurosurgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, in the period from January 2001 to February 2018. In addition to demographic characteristics, the details of culture reports and antibiotic regimens were collected. The response to treatment was compared to changes in the infective profile (C-reactive protein) and imaging. Instances of reaspiration were compared with clinical signs, imaging findings, and infective profiles. Treatment response was separated into two groups: responders within or at 2 weeks and responders beyond 2 weeks. The clinical characteristics of these two groups were compared.RESULTSForty-eight children were treated in the study period. Nineteen patients benefited from the 2-week (short-term) protocol of intravenous antibiotics. Twenty-nine patients required more than 2 weeks (approximately 4 weeks; long-term protocol) for resolution. Of those requiring more than 2 weeks, 69% had cardiogenic etiology. All patients were followed up with a minimum of 3 weeks of oral antibiotics. In a comparative analysis between short-term and long-term responders, only etiology was significantly different. None of the patients who had the short-term protocol had a recurrence.CONCLUSIONSA shorter antibiotic protocol can be used successfully in carefully selected patients who are surgically treated and followed up. It is clear that the 2-week intravenous antibiotic protocol is more suitable for immunocompetent patients who have a noncardiogenic etiology.

Clinical and neurosonographic signs of c entral nervous system in newborns

2014 ◽  
Vol 20 (30) ◽  
pp. 97-100
Author(s):  
Хетагурова ◽  
Yuliana Khetagurova ◽  
Ревазова ◽  
Asya Revazova ◽  
Бораева ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Perinatal Asphyxia ◽  
Newborn Infants ◽  
Clinical Signs ◽  
Significant Progress ◽  
Moderate Severity ◽  
The Central Nervous System ◽  
Significant Mortality

Despite of significant progress in the development of technologies of clinical monitoring and the fetus and newborn pathology study, perinatal asphyxia or, more accurately – cerebral ischemia (CI) remain serious condition, causing significant mortality and long-term morbidity. Chi-acquired syndrome characterized by clinical and laboratory signs of acute brain injury due to asphyxia (ie, hypoxia, acidosis). The paper reflects the main clinical signs and neurosonographic lesion of the Central nervous system (CNS) in neonatal newborn infants with different gestational age who underwent CI mild to moderate severity.

scholarly journals Self-buffering capacity of a human sulfatase for central nervous system delivery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yi Wen ◽  
Nazila Salamat-Miller ◽  
Keethkumar Jain ◽  
Katherine Taylor
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Buffering Capacity ◽  
The Self ◽  
High Concentration ◽  
Formulation Design ◽  
The Central Nervous System ◽  
Therapeutic Enzymes ◽  
Intrathecal Space

AbstractDirect delivery of therapeutic enzymes to the Central Nervous System requires stringent formulation design. Not only should the formulation design consider the delicate balance of existing ions, proteins, and osmolality in the cerebrospinal fluid, it must also provide long term efficacy and stability for the enzyme. One fundamental approach to this predicament is designing formulations with no buffering species. In this study, we report a high concentration, saline-based formulation for a human sulfatase for its delivery into the intrathecal space. A high concentration formulation (≤ 40 mg/mL) was developed through a series of systematic studies that demonstrated the feasibility of a self-buffered formulation for this molecule. The self-buffering capacity phenomenon was found to be a product of both the protein itself and potentially the residual phosphates associated with the protein. To date, the self-buffered formulation for this molecule has been stable for up to 4 years when stored at 5 ± 3 °C, with no changes either in the pH values or other quality attributes of the molecule. The high concentration self-buffered protein formulation was also observed to be stable when exposed to multiple freeze–thaw cycles and was robust during in-use and agitation studies.

scholarly journals Multiplexed neurochemical transmission emulated using a dual-excitatory synaptic transistor

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Mingxue Ma ◽  
Yao Ni ◽  
Zirong Chi ◽  
Wanqing Meng ◽  
Haiyang Yu ◽  
...  
Keyword(s):  
Neural Network ◽  
Central Nervous System ◽  
Nervous System ◽  
Long Term Potentiation ◽  
Short Term ◽  
Term Potentiation ◽  
Binary Neural Network ◽  
Neuromorphic Systems ◽  
Human Brains

AbstractThe ability to emulate multiplexed neurochemical transmission is an important step toward mimicking complex brain activities. Glutamate and dopamine are neurotransmitters that regulate thinking and impulse signals independently or synergistically. However, emulation of such simultaneous neurotransmission is still challenging. Here we report design and fabrication of synaptic transistor that emulates multiplexed neurochemical transmission of glutamate and dopamine. The device can perform glutamate-induced long-term potentiation, dopamine-induced short-term potentiation, or co-release-induced depression under particular stimulus patterns. More importantly, a balanced ternary system that uses our ambipolar synaptic device backtrack input ‘true’, ‘false’ and ‘unknown’ logic signals; this process is more similar to the information processing in human brains than a traditional binary neural network. This work provides new insight for neuromorphic systems to establish new principles to reproduce the complexity of a mammalian central nervous system from simple basic units.

Mycophenolate mofetil as induction and long-term maintaining treatment in childhood: Primary angiitis of the central nervous system

2017 ◽  
Vol 84 (3) ◽  
pp. 353-356 ◽  
Author(s):  
Anna Rosati ◽  
Alessandra Cosi ◽  
Massimo Basile ◽  
Alice Brambilla ◽  
Renzo Guerrini ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Mycophenolate Mofetil ◽  
Primary Angiitis ◽  
The Central Nervous System

Long-term impact of neonatal inflammation on demyelination and remyelination in the central nervous system

Glia ◽  
2014 ◽  
Vol 62 (10) ◽  
pp. 1659-1670 ◽  
Author(s):  
Karelle Bénardais ◽  
Viktoria Gudi ◽  
Lijie Gai ◽  
Jasmin Neßler ◽  
Vikramjeet Singh ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
The Central Nervous System ◽  
Long Term Impact

scholarly journals Embryonal rhabdomyosarcoma with distant spinal cord metastasis: case and MR-imaging

2020 ◽  
Vol 19 (4) ◽  
pp. 158-164
Author(s):  
N. A. Strumila ◽  
A. S. Krasnov ◽  
M. M. Andrianov ◽  
G. V. Teresсhenko
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Treatment Protocol ◽  
Soft Tissue Sarcomas ◽  
Distant Metastases ◽  
Good Prognosis ◽  
Embryonal Rhabdomyosarcoma ◽  
The Central Nervous System ◽  
Magnetic Resonance Imaging Mri

Embryonal rhabdomyosarcoma (eRMS) is one of the most common soft tissue sarcomas in children, accounting for 4.5% of all childhood tumors. Half of the eRMS occuring in the head and neck are parameningeal. About 40% of patients with eRMS can develop distant metastases. In patients with intracranial tumors, metastatic spread can occur along the central nervous system (CNS) meninges. The literature describes only 4 clinical cases of eRMS with distant metastases in the spinal cord and along the meninges. Only in two out of these four cases, CSF cytology was positive (meaning that tumor cells were detected in cerebrospinal fluid). Magnetic resonance imaging (MRI) of the central nervous system with contrast enhancement can be used to detect distant metastases in the CNS and meninges. We present a clinical case of a 4-year old girl with parameningeal eRMS. MRI of the CNS performed as part of a diagnostic check-up revealed nodal metastatic foci along the meninges of the spinal cord. In accordance with the treatment protocol, the patient was diagnosed with stage 4 disease and received intensive polychemotherapy resulting in the disappearance of the nodal lesions in the spinal cord and a good prognosis. The parents gave their consent to the use of their child's data, including photographs, for research purposes and in publications.

Hormonal-sympathetic interactions in long-term regulation of arterial pressure: an hypothesis

1995 ◽  
Vol 268 (6) ◽  
pp. R1343-R1358 ◽  
Author(s):  
V. L. Brooks ◽  
J. W. Osborn
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Arterial Pressure ◽  
Plasma Concentrations ◽  
Circumventricular Organs ◽  
Feedback Signal ◽  
Salt Loading ◽  
Alternate Model ◽  
The Central Nervous System

The importance of the sympathetic nervous system in short-term regulation of arterial pressure is well accepted. However, the question of whether neural systems participate in long-term control of pressure has been debated for decades and remains unresolved. The principal argument against such a control system is that arterial baroreceptors adapt to sustained changes in arterial pressure. In addition, denervation of baroreceptors has minimal to no effect on basal levels of arterial pressure chronically. This argument assumes, however, that baroreceptors provide the primary chronic feedback signal to the central nervous system. An alternate model is proposed in which circulating hormones, primarily arginine vasopressin and angiotensin II, provide a long-term afferent signal to the central nervous system via binding to specific receptors in central sites lacking a blood-brain barrier (circumventricular organs). Studies suggest that the release of the hormones and the sympathetic response to alterations in their plasma concentrations are nonadaptive but may be gated by baroreceptor input. Evidence that this "hormonal-sympathetic reflex" model may explain the long-term alterations in sympathetic activity in response to chronic salt depletion and salt loading as well as congestive heart failure is presented. Finally, the role of an impaired hormonal sympathetic reflex in hypertension, specifically salt-dependent hypertension, is discussed.

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