Introduction. Cytokine and Chemokine Profiles in Acute Carbon Monoxide Poisoning: Marked Elevation of Interleukin-6 in Cerebrospinal Fluid
|
|
- Posy Hilda Lang
- 5 years ago
- Views:
Transcription
1 Cytokine and Chemokine Profiles in Acute Carbon Monoxide Poisoning: Marked levation of Interleukin-6 in Cerebrospinal Fluid Toshimitsu Ide, Y Kamijo, A Ide, K Yoshimura, T ishikawa, K Soma, H Mochizuki Japan March 11 arthquake M9.0 Seismic center Kitasato University, School of Medicine, Sagamihara, Japan Kyoto Hiroshima Kobe Tokyo Disaster area Pacific Ocean 2011 Google Map Kanto region (the Metropolitan area) Introduction Sagamihara our hospital Tokyo Mt. Fuji Yokohama Pacific Ocean 2011 Google Map Image of ncephalopathy Severity and Prognosis of CO poisoning CO xposure ncephalopathy Mild Headache ausea Dizziness Recovery with o Complications Loss of Consciousness Lucid interval (several days to 6 weeks) asymptomatic Time (Day) europsychiatric symptoms Memory disorder Attention disorder Depression Rigidity, Bradykinesia Gait disturbance Ataxia Apallic syndrome etc. Death Cardiopulmonary arrest Moderate Unconsciousness Palsy Loss of vision Severe Coma Seizure Shock ncephalopathy Persistent Vegetative State
2 Background We already reported that early elevation of interleukin-6 concentration in the cerebrospinal fluid (CSF) may be a predictive marker of delayed encephalopathy (D) due to carbon monoxide (CO) poisoning. (Am J merg Med 2009;27: ACCT 2009, San Antonio) However, cytokines other than IL-6 had not been determined Objective To investigate the relationship between outcome of CO poisoning and profile of cytokine/chemokine level in serum and CSF, in order to find any prognostic markers for prediction of the outcome. We also investigated other clinical factors and laboratory findings. Patients Materials & Methods CO poisoned patients transferred by ambulance: 66 patients (Period:ov ~ 4 years) Admission Hyperbaric Oxygen Therapy (3 days) Mild symptoms :9 patients (they didn t have any consciousness loss) Cardiopulmonary arrest:15 patients died Informed Consent Couldn t get informed consent/ Couldn t follow up for 3 month: 3 patients Followed up for 3 months after poisoning 39 patients Samples and Analyses We measured 17 cytokines/chemokines in the CSF and serum of 39 patients who had consciousness loss in their history. CSF and serum were simultaneously obtained within 24 hours after the last exposure and immediately frozen at -80 C for later analysis. The cytokines/chemokines were determined by the microbeads assay method. (Bio-Plex cytokine assay system, Bio-Rad Laboratories.) Patients follow-up: Followed up for 3 months after poisoning 39 patients Group (ncephalopathy) 9 patients (Persistent vegetative state/ encephalopathy) Statistical analyses: The two groups were compared by the Mann-Whitney U test. Group 30 patients (They had o sequelae after acute phase of poisoning)
3 Results Group Group (n=9, median) (n=30, median) P Age S GCS S CO-Hb (%) S White Blood Cell (/mm 3 ) S HCO3 - (mmol/l) S Base xcess (mmol/l) S CPK (IU/L) S Lactic acid S S: not significant Serum group group Variables n=9 n=30 (pg/ml) median (IQR) median (IQR) P-value IL-1β S IL S IL S IL S IL (47-73) 4.0 (1.8-29) <0.01(0.002) IL (10-17) 8.6 (6-10) <0.05(0.04) IL S IL S IL S IL S IL S G-CSF 15.2 (12-40) 2.7 (0-16) <0.05(0.02) GM-CSF S IF-γ S MCP S MIP-1β S TF-α S IQR: interquartile range CSF group group Variables n=9 n=30 (pg/ml) median (IQR) median (IQR) P-value IL-1β 5.3 (2.4-13) 0.1 (0-1) <0.001 (0.0005) IL S IL (1-2.6) 0.3 ( ) <0.001 (0.0009) IL S IL ( ) 13.3 (6.5-37) <0.001 (0.0002) IL S IL ( ) 69.9(45-126) <0.01 (0.002) IL ( ) 3.3 (2-4.8) <0.01 (0.005) IL (4-6.1) 3.2 ( ) <0.05 (0.04) IL S IL S G-CSF (92-137) 10.3 (4-34) <0.01 (0.007) GM-CSF 46.8 (34-66) 16.6 (0-23) <0.01 (0.005) IF-γ (72-170) 0.8 (0-20) <0.001 (0.0007) MCP ( ) ( ) <0.01 (0.002) MIP-1β 32.3 (24-44) 21.2 (14-32) <0.05 (0.04) TF-α 35.0 (21-114) 4.7 (3-9) <0.001 (0.0005) IQR: interquartile range CSF IL-1β CSF IL-4 CSF IL-8 CSF IL-10 CSF IL-6 Serum IL-6 IL-6 in Serum Data plot Caution!! CSF G-CSF CSF IF-γ CSF MCP-1 CSF TF-α A few exceptional cases Complicated with Burn and/or Airway burn Crush syndrome Aspiration peumonia
4 IL-6 in CSF Data plot ROC curve of CSF IL-6 Cutoff point 380 pg/ml A few exceptional cases - Complicated with Hypothermia - Unknown Sensitivity: 100% Specificity: 90% Our present study shows Summary & Discussion CSF IL-6 could be the best predictive marker of encephalopathy after CO poisoning. ot only IL-6, but also several cytokines and chemokines are elevated in CSF than those of serum. Those cytokines/chemokines would reflect the hypoxic stress and the inflammation in the central nervous system and may have relation to later encephalopathy. Carbon Monoxide Hypoxic Stress Blood-Brain Barrier Inframmation in CS Microglia (activated) Astroglia (activated) Oligodendroglia Myelin sheath IL-6,-8 G-CSF IF-γ MCP-1 ncephalopathy Over clinical threshold Demyelination MBP leakage into CSF MBP modification Axon MBP Antigenicity MBP: myelin basic protein 1 st Cytokines elevation 2 nd MBP elevation Hypoxia and CSF cytokines Animal: TF-α, IL-1β, IL-6 (Brain tissue) Clinical: IL-6, IL-8 (Post CPA patients) Resuscitation 2009;80: MR spectroscopy/ Diffusion tensor image Cho/Cr ratio, FA value are useful to evaluate white matter damage in the subacute phase after CO poisoning euroradiology 2010;52:
5 CSF versus MRI CSF Merit: make early prediction of encephalopathy give us patient risk control Demerit: invasive technique (but it is easy and safe for neurologist ) MRI (controversial for early prediction) Merit: not invasive (but sometimes need i.v. sedation) Demerit: required high grade MRI (3.0Tesla) can t perform (magnetic metal in the body) artifact (artificial teeth/ motion artifact) Conclusion There are differences in cytokines/chemokines profiles of the two groups in CO poisoning. Cytokines/chemokines analysis of CSF is more useful than that of serum, and the most useful biomarker among these cytokines was CSF IL-6 for prediction of encephalopathy. Acknowledgement This study was supported by The Japanese Ministry of ducation, Culture, Sports, Science and Technology KAKHI :Grant-in-Aid for Young Scientists(B). Thank you for your attention
International Conference on Biological Sciences and Technology (BST 2016)
International Conference on Biological Sciences and Technology (BST 2016) A Better Characterization of Brain Damage in Carbon Monoxide Intoxication Assessed in Vivo Using Diffusion Kurtosis Imaging Wen-Yao
More informationTakaaki Beppu Shunrou Fujiwara Hideaki Nishimoto Atsuhiko Koeda Shinsuke Narumi Kiyoshi Mori Kuniaki Ogasawara Makoto Sasaki
J Neurol (2012) 259:1698 1705 DOI 10.1007/s00415-011-6402-5 ORIGINAL COMMUNICATION Fractional anisotropy in the centrum semiovale as a quantitative indicator of cerebral white matter damage in the subacute
More informationUnsupervised activity is a major risk factor for traumatic coma and its age-specific
The assessment of patients in coma is a medical emergency. The cause should be identified and, where possible, corrected and the brain provided with appropriate protection to reduce further damage. It
More informationLOSS OF CONSCIOUSNESS & ASSESSMENT. Sheba Medical Center Acute Medicine Department MATTHEW WRIGHT
LOSS OF CONSCIOUSNESS & ASSESSMENT Sheba Medical Center Acute Medicine Department MATTHEW WRIGHT OUTLINE Causes Head Injury Clinical Features Complications Rapid Assessment Glasgow Coma Scale Classification
More informationB-cell. Astrocyte SCI SCI. T-cell
RF #2015 P-01 PI: Azizul Haque, PhD Grant Title: Targeting Enolase in Spinal Cord Injury 12-month Technical Progress Report Progress Report (First Six Months): Enolase is one of the most abundantly expressed
More informationImmunological biomarkers predictive of clinical response to chemotherapy and maintenance HAART in HIV + patients with Kaposi sarcoma
P909 Immunological biomarkers predictive of clinical response to chemotherapy and maintenance HAART in HIV + patients with Kaposi sarcoma Tedeschi R, Bidoli E 2, Bortolin MT, Pratesi C, Basaglia G, Zanussi
More informationPredictors for delayed encephalopathy following acute carbon monoxide poisoning
Kudo et al. BMC Emergency Medicine 2014, 14:3 RESEARCH ARTICLE Open Access Predictors for delayed encephalopathy following acute carbon monoxide poisoning Kaoru Kudo 1*, Kotaro Otsuka 1,2, Junko Yagi 1,
More informationRole of MRI in acute disseminated encephalomyelitis
Original Research Article Role of MRI in acute disseminated encephalomyelitis Shashvat Modiya 1*, Jayesh Shah 2, C. Raychaudhuri 3 1 1 st year resident, 2 Associate Professor, 3 HOD and Professor Department
More informationTOXIC AND NUTRITIONAL DISORDER MODULE
TOXIC AND NUTRITIONAL DISORDER MODULE Objectives: For each of the following entities the student should be able to: 1. Describe the etiology/pathogenesis and/or pathophysiology, gross and microscopic morphology
More informationInflammatory Cytokines and Their Prognostic Ability in Cases of Major Burn Injury
Original Article Diagnostic Immunology Ann Lab Med 2015;35:105-110 http://dx.doi.org/10.3343/alm.2015.35.1.105 ISSN 2234-3806 eissn 2234-3814 Inflammatory Cytokines and Their Prognostic Ability in Cases
More informationCarbon monoxide poisoning By Dr Steven White and Richard Morris
Carbon monoxide poisoning By Dr Steven White and Richard Morris Introduction There are approximately 400 admissions to hospital with Carbon Monoxide (CO) poisoning in England each year and around 40-50
More informationClinical Significance of Plasma Ammonia in Patients with Generalized Convulsion
ORIGINAL ARTICLE Clinical Significance of Plasma Ammonia in Patients with Generalized Convulsion Kouichi Tomita 1,NorioOtani 2,FumioOmata 3,4 and Shinichi Ishimatsu 1,2 Abstract Background Plasma ammonia
More informationElectrolytes. Summary: (This area will include a brief description of what the protocol is used for and why someone would need to use it.
Electrolytes Version: 1 Edited by: Jason Kim (note that the following list should be linked to the appropriate location.) Summary Reagents and Materials Protocol Reagent Preparation Reagent 1 Reagent 2
More informationDr Paul Holmes Guy s and St Thomas NHS Foundation Trust, London
Dr Paul Holmes Guy s and St Thomas NHS Foundation Trust, London HIV and Lumbar punctures in 2018 Paul Holmes Consultant Neurologist Guy s and St Thomas Hospitals I have no competing interests Summary of
More informationENVIRONMENTAL EMERGENCIES
Joanna Jakubaszko-Jabłońska ENVIRONMENTAL EMERGENCIES Chair of Emergency Medicine Wroclaw Medical University Emergency treatment of near-drowning victims Clinical findings: The victim may present with
More informationToxins. Learning Objectives. Chemistry of Carbon Monoxide. Carbon Monoxide
Toxins Carbon Monoxide Version Date: 2/6/2013 Learning Objectives Upon the completion of this program participants will be able to: 1. Understand the pathophysiology of carbon monoxide (CO)poisoning 2.
More informationTraumatic Brain Injury TBI Presented by Bill Masten
1 2 Cerebrum two hemispheres and four lobes. Cerebellum (little brain) coordinates the back and forth ballet of motion. It judges the timing of every movement precisely. Brainstem coordinates the bodies
More informationDelayed Encephalopathy of Acute Carbon Monoxide Intoxication: Diffusivity of Cerebral White Matter Lesions
AJNR Am J Neuroradiol 24:1592 1597, September 2003 Delayed Encephalopathy of Acute Carbon Monoxide Intoxication: Diffusivity of Cerebral White Matter Lesions Ji-hoon Kim, Kee-Hyun Chang, In Chan Song,
More informationCOPYRIGHT 2012 THE TRANSVERSE MYELITIS ASSOCIATION. ALL RIGHTS RESERVED
The Transverse Myelitis Association...advocating for those with acute disseminated encephalomyelitis, neuromyelitis optica, optic neuritis and transverse myelitis ACUTE DISSEMINATED ENCEPHALOMYELITIS (ADEM)
More informationTITLE: TREATMENT OF ADULT SEVERE TRAUMATIC BRAIN INJURY USING AUTOLOGOUS BONE MARROW MONONUCLEAR CELLS
AD Award Number: W81XWH-11-1-0460 TITLE: TREATMENT OF ADULT SEVERE TRAUMATIC BRAIN INJURY USING AUTOLOGOUS BONE MARROW MONONUCLEAR CELLS PRINCIPAL INVESTIGATOR: Charles S. Cox, Jr, M.D. CONTRACTING ORGANIZATION:
More informationToxins. Carbon Monoxide
Toxins Carbon Monoxide Version Date: 2/6/2013 Rev 6/15/15 Carbon Monoxide What is the likely SPO2 level on an obtunded victim suspected of CO poisoning with a Hgb CO of 30 and placed on a non rebreather
More informationLaura Tormoehlen, M.D. Neurology and EM-Toxicology Indiana University
Laura Tormoehlen, M.D. Neurology and EM-Toxicology Indiana University Disclosures! No conflicts of interest to disclose Neuroimaging 101! Plain films! Computed tomography " Angiography " Perfusion! Magnetic
More informationx = ( A) + (3.296 B) (0.070 C) (1.006 D) + (2.426 E) Receiver Operating Characteristic ROC
7 1... 4. 5. 6. 7. 8. 9. 1. 000 1 01 11 006 01 1 11 6 Glasgow outcome scale GOS GOS 4 n=477 55 A C D 5 ph B E = 1/(1 + e x) x = ( 0.0 A) + (.96 B) (0.070 C) (1.006 D) + (.46 E) 19.489 estimated probability
More informationAppendix. Potentially Preventable Complications (PPCs) identify. complications that can occur during an admission. There are 64
Calikoglu S, Murray R, Feeney D. Hospital pay-for-performance programs in Maryland produced strong results, including reduced hospital-acquired infections. Health Aff (Millwood). 2012;31(12). Appendix
More informationUNIVERSITY OF TENNESSEE HOSPITAL 1924 Alcoa Highway * Knoxville, TN (865) LABEL
1003 UNIVERSITY OF TENNESSEE HOSPITAL 1924 Alcoa Highway * Knoxville, TN 37920 (865) 544-9000 LABEL Knoxville Neurology Clinic Orders and Progress tes : NAME: MED REC#: PHYSICIAN: DATE: DATE PHYSICIAN'S
More informationIndex. Note: Page numbers of article titles are in bold face type.
Neurosurg Clin N Am 13 (2002) 259 264 Index Note: Page numbers of article titles are in bold face type. A Abdominal injuries, in child abuse, 150, 159 Abrasions, in child abuse, 157 Abuse, child. See Child
More informationOnline Data Supplement. Immune Profile of the Airway Mucosal Lining Fluid in Neonates Skewed by. Maternal Atopy
Online Data Supplement Immune Profile of the Airway Mucosal Lining Fluid in Neonates Skewed by Maternal Atopy Authors: Følsgaard NV, MD; Chawes BL, MD, PhD ; Rasmussen MA 2, MSci;Bischoff A, MD; Carson
More informationThe Journal of Veterinary Medical Science
Advance Publication The Journal of Veterinary Medical Science Accepted Date: 9 Jan 2015 J-STAGE Advance Published Date: 23 Jan 2015 1 2 3 The Journal of Veterinary Medical Science-14-0578.R2 November 02,
More informationInduction of Innate Immune Responses in HVTN 071: a Trial using the MRKAd5 gag/pol/nef Vaccine from the Step Study
Induction of Innate Immune Responses in HVTN 71: a Trial using the MRKAd5 gag/pol/nef Vaccine from the Step Study Erica Andersen-Nissen Vaccine and Infectious Disease Institute Fred Hutchinson Cancer Research
More informationAccepted Manuscript. Comparison of costs and outcomes of patients presenting with a rare brainstem syndrome. Devin E. Prior, Vijay Renga
Accepted Manuscript Comparison of costs and outcomes of patients presenting with a rare brainstem syndrome Devin E. Prior, Vijay Renga PII: S2405-6502(18)30036-4 DOI: https://doi.org/10.1016/j.ensci.2018.11.004
More informationPAEDIATRIC ACUTE CARE GUIDELINE. Resuscitation Coma
Princess Margaret Hospital for Children PAEDIATRIC ACUTE CARE GUIDELINE Resuscitation Coma Scope (Staff): Scope (Area): All Emergency Department Clinicians Emergency Department This document should be
More informationMini Research Paper: Traumatic Brain Injury. Allison M McGee. Salt Lake Community College
Running Head: Mini Research Paper: Traumatic Brain Injury Mini Research Paper: Traumatic Brain Injury Allison M McGee Salt Lake Community College Abstract A Traumatic Brain Injury (also known as a TBI)
More informationNeuroprognostication after cardiac arrest
Neuroprognostication after cardiac arrest Sam Orde 1st May 2018 Set the scene 55 yo man, found collapsed in park, looks like he d been jogging, no pulse, bystander CPR, ambulance arrives 5 mins later,
More informationHEAD INJURY. Dept Neurosurgery
HEAD INJURY Dept Neurosurgery INTRODUCTION PATHOPHYSIOLOGY CLINICAL CLASSIFICATION MANAGEMENT - INVESTIGATIONS - TREATMENT INTRODUCTION Most head injuries are due to an impact between the head and another
More informationDISORDERS OF THE NERVOUS SYSTEM
DISORDERS OF THE NERVOUS SYSTEM Bell Work What s your reaction time? Go to this website and check it out: https://www.justpark.com/creative/reaction-timetest/ Read the following brief article and summarize
More informationUrinary cytokines/chemokines after magnetic resonance-guided high intensity focused ultrasound for palliative treatment of painful bone metastases
Original Article Urinary cytokines/chemokines after magnetic resonance-guided high intensity focused ultrasound for palliative treatment of painful bone metastases Ahmad Bushehri 1, Gregory Czarnota 1,
More informationHead injuries. Severity of head injuries
Head injuries ED Teaching day 23 rd October Severity of head injuries Minor GCS 14-15 Must not have any of the following: Amnesia 10min Neurological sign or symptom Skull fracture (clinically or radiologically)
More informationFailure to wake. Robin S. Howard
Failure to wake Robin S. Howard National Hospital for Neurology and Neurosurgery, Queen Square St. Thomas Hospital, Guys & St. Thomas NHS (Foundation) Trust Royal College of Physicians - November 2017
More information03/31/ Compartment Syndrome. Disclosure Information Andrew H. Schmidt, M.D.
Compartment Syndrome Andrew H. Schmidt, M.D. Professor, Dept. of Orthopedic Surgery, Univ. of Minnesota Chief of Orthopedic Surgery, Hennepin County Medical Center 50% Clinical 50% Basic Science Disclosure
More informationHypoxic brain injury
Hypoxic brain injury Headway s publications are all available to freely download from the information library on the charity s website, while individuals and families can request hard copies of the booklets
More informationMultiplexed immunoassay-based serum cytokine profiling for potential prognosis predictors in patients with metastatic breast cancer
Original Article Multiplexed immunoassay-based serum cytokine profiling for potential prognosis predictors in patients with metastatic breast cancer Hongyan Huang, Yanbin Zhang, Sha Li, Jing Zhao, Xiaoli
More informationPhysicochemical Properties Can Be Key Determinants of Mesoporous Silica Nanoparticle Potency In Vitro
1 Physicochemical Properties Can Be Key Determinants of Mesoporous Silica Nanoparticle Potency In Vitro Dalibor Breznan 1*, Dharani D. Das 1, Christine MacKinnon-Roy 1, Stéphane Bernatchez 2, Abdelhamid
More informationInfection-Associated Neurological Syndromes
Infection-Associated Neurological Syndromes Anand P, MD PhD Medical Director, BloodCenter of Wisconsin Assistant Professor, Medical College of Wisconsin ASFA Annual Meeting San Antonio, TX, May 8th, 2015
More informationMULTIPLE SCLEROSIS PROFILE
MULTIPLE SCLEROSIS PROFILE What is Multiple Sclerosis? Multiple sclerosis (MS) is a chronic, inflammatory disease of unknown etiology that involves an immune-mediated attack on the central nervous system
More informationWhole-tumor apparent diffusion coefficient measurements in nephroblastoma: Can it identify blastemal predominance? Abstract Purpose To explore the
Whole-tumor apparent diffusion coefficient measurements in nephroblastoma: Can it identify blastemal predominance? Abstract Purpose To explore the potential relation between whole-tumor apparent diffusion
More informationPBL SEMINAR. HEMOGLOBIN, O 2 -TRANSPORT and CYANOSIS An Overview
1 University of Papua New Guinea School of Medicine and Health Sciences Division of Basic Medical Sciences Discipline of Biochemistry and Molecular Biology PBL SEMINAR HEMOGLOBIN, O 2 -TRANSPORT and CYANOSIS
More informationConcussion Management
Concussion Management Jennifer Gray, DO Medical Co-Director, ThinkSMART! Concussion Management Program Department of Physical Medicine and Rehabilitation St. Charles Hospital Residency Program Director,
More informationHockey New South Wales Head Injury Guidelines Effective November
Hockey New South Wales Effective November 2011 1 Table of Contents Part 1: Guidelines Statement 3 Head Injuries 3 Two Types of Head Injuries 3 Symptoms of Head Injuries 3 Head Injury Notifications 3 Important
More informationNeurological Prognosis after Cardiac Arrest Guideline
Neurological Prognosis after Cardiac Arrest Guideline I. Associated Guidelines and Appendices 1. Therapeutic Hypothermia after Cardiac Arrest 2. Hypothermia after Cardiac Arrest Algorithm II. Rationale
More informationSerum YKL-40 as a marker of liver fibrosis in patients with non-alcoholic fatty
Supplementary Information Serum YKL- as a marker of liver fibrosis in patients with non-alcoholic fatty liver disease Erina Kumagai 1,,#, Yohei Mano 1,#, Sachiyo Yoshio 1, Hirotaka Shoji 1, Masaya Sugiyama
More informationPatho-physiology of nervous System Talk 2 Syndromes in neurosciences. Petr Maršálek Dept pathological physiology 1.Med. F. CUNI
Patho-physiology of nervous System Talk 2 Syndromes in neurosciences Petr Maršálek Dept pathological physiology 1.Med. F. CUNI Talks on NS Talk 1 - Pain and Motor disorders Talk 2 - This - Syndromes in
More informationCO poisoning causes serious damage to the brain and cardiac
REVIEW ARTICLE The Role of MR Imaging in Assessment of Brain Damage from Carbon Monoxide Poisoning: A Review of the Literature T. Beppu ABSTRACT SUMMARY: The aim of this article is to review how MR imaging
More informationALS 713: Prognostication in Normothermia
ALS 713: Prognostication in Normothermia TFQO: Clifton Callaway (COI #214) EVREVs: Claudio Sandroni (COI #134); Tobias Cronberg (COI #35) Taskforce: ALS COI Disclosure (specific to this systematic review)
More informationSubhairline EEG Part II - Encephalopathy
Subhairline EEG Part II - Encephalopathy Teneille Gofton September 2013 Objectives To review the subhairline EEG changes seen with encephalopathy To discuss specific EEG findings in encephalopathy To outline
More informationSupplementary Materials for
www.sciencesignaling.org/cgi/content/full/8/381/ra59/dc1 Supplementary Materials for Analysis of single-cell cytokine secretion reveals a role for paracrine signaling in coordinating macrophage responses
More informationFORENSIC SCIENCE NEWSLETTER Forensic Pathology and Neuropathology. William A. Cox, M.D., FCAP.
NEUROPATHOLOGY FORENSIC SCIENCE NEWSLETTER Forensic Pathology and Neuropathology William A. Cox, M.D., FCAP www.forensicjournals.cm May 15, 2016 This issue of the Forensic Science Newsletter will address
More informationare associated with sickle cell disease and carriers: a study of patients from the southeastregion of Iran
CXC chemokines CXCL1, CXCL9, CXCL10 and CXCL12 are associated with sickle cell disease and carriers: a study of patients from the southeastregion of Iran Mojgan Noroozi Karimabad Molecular Medicine Research
More informationPrognosis in. Encephalopathy. Hypoxic-Ischemic. Özge Aydemİr MD
Prognosis in Hypoxic-Ischemic Encephalopathy Özge Aydemİr MD Major problems we have to face while caring infants with HIE are; Øto provide families with reliable information about outcome. Øto decide how
More informationInternational Journal of Advanced Research in Biological Sciences ISSN : Research Article
International Journal of Advanced Research in Biological Sciences ISSN : 2348-8069 www.ijarbs.com Research Article Serum level of IL-6, IL-10 and PCT as a prognostic marker in post traumatic sepsis patients.
More informationInteractive seminar - neurosciences. 1_of 40+
Interactive seminar - neurosciences 1_of 40+ Q1/1 EMG myopathies versus neuropathies Interactive seminar - neurosciences 2_of 40+ Q1/2 Neuropathies versus myopathies Clinical findings Muscle weakness Loss
More informationHead Injury Guidelines POL 5700
Issued by: WHS Effective Date: 1 st Oct 13 Rev: A Page 1 of 5 1. PURPOSE Concussion - Important information What is a concussion? A concussion is an injury to the brain. A blow to the head usually causes
More information/ / / / / / Hospital Abstraction: Stroke/TIA. Participant ID: Hospital Code: Multi-Ethnic Study of Atherosclerosis
Multi-Ethnic Study of Atherosclerosis Participant ID: Hospital Code: Hospital Abstraction: Stroke/TIA History and Hospital Record 1. Was the participant hospitalized as an immediate consequence of this
More information3. Which of the following would be inconsistent with respiratory alkalosis? A. ph = 7.57 B. PaCO = 30 mm Hg C. ph = 7.63 D.
Pilbeam: Mechanical Ventilation, 4 th Edition Test Bank Chapter 1: Oxygenation and Acid-Base Evaluation MULTIPLE CHOICE 1. The diffusion of carbon dioxide across the alveolar capillary membrane is. A.
More informationISF criteria (International sepsis forum consensus conference of infection in the ICU) Secondary peritonitis
Appendix with supplementary material. This appendix was part of the submitted manuscript and has been peer reviewed. It is posted as supplied by the authors. Supplementary Tables Table S1. Definitions
More informationCentral nervous system
Central nervous system By Dr. Mohsen Dashti Clinical Medicine & Pathology 316 7 th Lecture Lecture outline Review of structure & function. Symptoms, signs & tests. Specific diseases. Review of structure
More informationTh17 Pathway Research By Bio-Plex
Th17 Pathway Research By Bio-Plex Zhiyang Shen, Senior Product Manager Bio-Rad Laboratories, Inc 2011 年 6 月 28 日星期二 T helper cell research Timeline: advances on T helper research. Figure depicts some of
More informationIrish Children s Triage System
Irish Children s Triage System (ICTS) Bridget Conway On behalf of the Emergency Department team Our Lady's Children's Hospital, Crumlin April 14 th 2016 Triage Trier, to separate, sort, sift or select
More informationNo social problems noted No past med hx Mother had spontaneous rupture of fetal membranes SB born on Needed to be resuscitated at birth
No social problems noted No past med hx Mother had spontaneous rupture of fetal membranes SB born on 9-16-2011 Needed to be resuscitated at birth (included assisted vent) Had generalized edema and possible
More informationMild Traumatic Brain Injury
Mild Traumatic Brain Injury Concussions This presentation is for information purposes only, not for any commercial purpose, and may not be sold or redistributed. David Wesley, M.D. Outline Epidemiology
More informationJeffrey N. Bernstein MD. *Simple asphyxiants *Systemic asyphyxiants *Chemical irritants
Jeffrey N. Bernstein MD Simple asphyxiants Systemic asyphyxiants Chemical irritants 1746 (est) people killed overnight 3000 Cattle Countless wild animals There was no evidence of bleeding, physical
More informationCentral nervous system demyelinating diseases - Multiple sclerosis -
Central nervous system demyelinating diseases - Multiple sclerosis - Amilton Antunes Barreira Department of Neurology Faculdade de Medicina and Hospital das Clínicas de Ribeirão Preto - USP Diseases of
More informationAurora Health Care South Region EMS st Quarter CE Packet
Name: Dept: Date: Aurora Health Care South Region EMS 2010 1 st Quarter CE Packet Meningitis Meningitis is an inflammatory disease of the leptomeninges. Leptomeninges refer to the pia matter and the arachnoid
More informationH erpes simplex virus encephalitis (HSVE) is associated
1544 PAPER Evaluation of combination therapy using aciclovir and corticosteroid in adult patients with herpes simplex virus encephalitis S Kamei, T Sekizawa, H Shiota, T Mizutani, Y Itoyama, T Takasu,
More informationCNS pathology Third year medical students. Dr Heyam Awad 2018 Lecture 5: disturbed fluid balance and increased intracranial pressure
CNS pathology Third year medical students Dr Heyam Awad 2018 Lecture 5: disturbed fluid balance and increased intracranial pressure ILOs Understand causes and symptoms of increased intracranial pressure.
More informationEarly Diffusion MR Imaging Findings and Short-Term Outcome in Comatose Patients with Hypoglycemia
ORIGINAL RESEARCH K. Johkura Y. Nakae Y. Kudo T.N. Yoshida Y. Kuroiwa Early Diffusion MR Imaging Findings and Short-Term Outcome in Comatose Patients with Hypoglycemia BACKGROUND AND PURPOSE: The relationship
More informationSerum neutrophil gelatinase-associated lipocalin levels predict the neurological outcomes of out-of-hospital cardiac arrest victims
Kaneko et al. BMC Cardiovascular Disorders (2017) 17:111 DOI 10.1186/s12872-017-0545-y RESEARCH ARTICLE Open Access Serum neutrophil gelatinase-associated lipocalin levels predict the neurological outcomes
More informationCystic Fibrosis Complications ANDRES ZIRLINGER, MD STANFORD UNIVERSITY MEDICAL CENTER MARCH 3, 2012
Cystic Fibrosis Complications ANDRES ZIRLINGER, MD STANFORD UNIVERSITY MEDICAL CENTER MARCH 3, 2012 INTRODUCTION PNEUMOTHORAX HEMOPTYSIS RESPIRATORY FAILURE Cystic Fibrosis Autosomal Recessive Genetically
More informationObjectives. Design: Setting &Patients: Patients. Measurements and Main Results: Common. Adverse events VS Mortality
ADVERSE EVENTS AND THEIR RELATION TO MORTALITY IN OUT-OF-HOSPITAL CARDIAC ARREST PATIENTS TREATED WITH THERAPEUTIC HYPOTHERMIA Reporter R1 吳志華 Supervisor VS 王瑞芳 100.04.02 Niklas Nielsen, MD, PhD; Kjetil
More informationHEAVY METALS : Review
HEAVY METALS : Review INHALED TOXINS Dr. Tawfiq Almezeiny MBBS FRCPC (CCM) Introduction Airborne toxins typically produce local noxious effects on the airways and lungs. Examples of Inhalational exposure:
More informationHypoglycemia, Electrolyte disturbances and acid-base imbalances
Hypoglycemia, Electrolyte disturbances and acid-base imbalances Pediatric emergency PICU division Pediatric department Medical faculty, University of Sumatera Utara H. Adam Malik Hospital 1 Hypoglycemia
More informationSerum biomarkers for predicting outcome after TBI
Józef Opara, Andrzej Małecki, Elżbieta Małecka Serum biomarkers for predicting outcome after TBI Jerzy Kukuczka Academy of Physical Education in Katowice TBI biomarkers A biomarker, or biological marker,
More informationA Neurologist s Approach to Altered Mental Status
A Neurologist s Approach to Altered Mental Status S. Andrew Josephson, MD Department of Neurology University of California San Francisco October 23, 2008 The speaker has no disclosures Case 1 A 71 year-old
More informationMarchiafava Bignami Disease (MBD) and Diffusion Tensor Image (DTI) Tractography. Priscilla Chukwueke, MD, MPH
Marchiafava Bignami Disease (MBD) and Diffusion Tensor Image (DTI) Tractography Priscilla Chukwueke, MD, MPH INTRODUCTION Definition: A rare CNS disease characterized by demyelination of the Corpus Callosum.
More informationDelirium & Dementia. Nicholas J. Silvestri, MD
Delirium & Dementia Nicholas J. Silvestri, MD Outline Delirium vs. Dementia Neural pathways relating to consciousness Encephalopathy Stupor Coma Dementia Delirium vs. Dementia Delirium Abrupt onset Lasts
More informationResearch Article Identifying Prognostic Criteria for Survival after Resuscitation Assisted by Extracorporeal Membrane Oxygenation
Critical Care Research and Practice Volume 2016, Article ID 9521091, 5 pages http://dx.doi.org/10.1155/2016/9521091 Research Article Identifying Prognostic Criteria for Survival after Resuscitation Assisted
More informationAcute encephalopathy with callosal, subcortical and thalamic lesions
Neurology Asia 205; 20() : 85 89 Acute encephalopathy with callosal, subcortical and thalamic lesions Yuko Nakano MD, Yukifumi Monden MD PhD, 2 Masashi Mizuguchi MD PhD, Masako Nagashima MD, Yasunori Koike
More informationReview Evaluation of Residuals of Traumatic Brain Injury (R-TBI) Disability Benefits Questionnaire * Internal VA or DoD Use Only*
Review Evaluation of Residuals of Traumatic Brain Injury (R-TBI) Disability Benefits Questionnaire * Internal VA or DoD Use Only* Name of patient/veteran: SSN: Your patient is applying to the U. S. Department
More informationResearch Article A Positive Babinski Reflex Predicts Delayed Neuropsychiatric Sequelae in Chinese Patients with Carbon Monoxide Poisoning
BioMed Research International, Article ID 814736, 5 pages http://dx.doi.org/10.1155/2014/814736 Research Article A Positive Babinski Reflex Predicts Delayed Neuropsychiatric Sequelae in Chinese Patients
More informationISPUB.COM. Review Of Currently Used Inhalation Anesthetics: Part II. O Wenker SIDE EFFECTS OF INHALED ANESTHETICS CARDIOVASCULAR SYSTEM
ISPUB.COM The Internet Journal of Anesthesiology Volume 3 Number 3 O Wenker Citation O Wenker.. The Internet Journal of Anesthesiology. 1998 Volume 3 Number 3. Abstract SIDE EFFECTS OF INHALED ANESTHETICS
More informationVol. 26 No IL 1 IL 6 IL 8. interleukin IL 6. Key words CCL4 IL Interleukin 6
Vol. 26No. 121 1 1 1 1 73 4 17 8 2 GCSF CCL4 IL1IL6IL8 60500 30 8 1 2 3 interleukinil6 4 Key wordsccl4ilinterleukin6 1 1600023 671 22 NOx 5 2008 12 2009 5 A 77 4 Genzyme Diagnostics FLU 1 3 ml 1 15,000
More informationFOR OPTIMAL GUT HEALTH KEMIN.COM/GUTHEALTH
FOR OPTIMAL GUT HEALTH KEMIN.COM/GUTHEALTH ALETA A SOURCE OF 1,3-BETA GLUCANS Aleta is highly bioavailable, offering a concentration greater than 5% of 1,3-beta glucans. Aleta provides a consistent response
More informationAssociation between rapid serum sodium correction and rhabdomyolysis in water intoxication: a retrospective cohort study
Kashiura et al. Journal of Intensive Care (2017) 5:37 DOI 10.1186/s40560-017-0233-0 RESEARCH Open Access Association between rapid serum sodium correction and rhabdomyolysis in water intoxication: a retrospective
More informationTraumatic Brain Injury
Traumatic Brain Injury Mark J. Harris M.D. Associate Professor University of Utah Salt Lake City USA Overview In US HI responsible for 33% trauma deaths. Closed HI 80% Missile / Penetrating HI 20% Glasgow
More informationFacilitating EndotracheaL Intubation by Laryngoscopy technique and Apneic Oxygenation Within the Intensive Care Unit (FELLOW)
Facilitating EndotracheaL Intubation by Laryngoscopy technique and Apneic Oxygenation Within the Intensive Data Analysis Plan: Apneic Oxygenation vs. No Apneic Oxygenation Background Critically ill patients
More informationPEDIATRIC BRAIN CARE
PEDIATRIC BRAIN CARE The brain matters most! OVERVIEW OF NEURO ASSESSMENT 1. Overall responsiveness/activity 2. The eyes 3.? Increased ICP 4. Movements 5.? Seizures 6. Other OVERALL RESPONSIVENESS/ ACTIVITY
More informationPediatric emergencies (SHOCK & COMA) Dr Mubarak Abdelrahman Assistant Professor Jazan University
Pediatric emergencies (SHOCK & COMA) Dr Mubarak Abdelrahman Assistant Professor Jazan University SHOCK Definition: Shock is a syndrome = inability to provide sufficient oxygenated blood to tissues. Oxygen
More informationWhat the s wrong with this person?
Ketamine for Prehospital Management of Excited Delirium Syndrome: Is it all just a bunch of hype?!? Financial Disclosure Asa M. Margolis, DO, MPH, MS, FACEP Assistant Professor Division of Special Operation
More informationBellringer. What type of neuron carries messages from the brain and spinal cord to the muscles and glands?
Bellringer What type of neuron carries messages from the brain and spinal cord to the muscles and glands? a. Sensory b. Motor c. Associative d. Afferent Which part of the brain stem controls respiration?
More informationEmergency Medicine Scope of Practice
Emergency Medicine Scope of Practice All Physician Assistants working in Emergency Medicine will encounter a wide variety of non acute, urgent and emergent patient complaints and conditions. Given the
More informationOriginal Article Brainstem auditory evoked potentials in patients with delayed encephalopathy after acute carbon monoxide poisoning
Int J Clin Exp Med 2016;9(7):14000-14005 www.ijcem.com /ISSN:1940-5901/IJCEM0025428 Original Article Brainstem auditory evoked potentials in patients with delayed encephalopathy after acute carbon monoxide
More information