Noah’s story: Enterovirus and a race against the clock
“I’m so excited to babyproof my house,” says Elisa Holt. “I haven’t had to. Now, Noah wants to climb and do all of these normal baby things.” The toddler, born in March 2014, sailed through his first six months of life. As summer turned to fall, enterovirus D68 (EV-D68), a mysterious virus linked with paralysis, started to dominate headlines. On Oct. 3, 2014, Elisa was nursing Noah when she realized something was wrong with her son. “I went to sit him up and he just fell over. I did it again and the same thing happened.” When she realized he wasn’t moving his feet, legs or toes, she called her son’s pediatrician, who directed her to Beverly Hospital. “We are so so thankful for the emergency room doctor [Dr. Munirah Qualls] who told us, ‘I don’t know. I’m going to send you to Boston Children’s Hospital.’ I know Noah would not be where he is today if the Beverly Hospital doctor did not move us as fast as she did.” Within 15 minutes, an ambulance arrived to rush Noah to Boston Children’s. The emergency department was on high alert for EV D-68 — a tricky virus that can mask itself as many other illnesses. “Noah’s doctors were racing against the clock to make a diagnosis,” Elisa says. She and her husband Mitch cuddled their baby boy. “We were waiting to see what Noah’s future held. How did we end up here? Would his paralysis...
ConclusionsMore than three retriever passes may increase the rate of recanalization, but not the likelihood of favorable functional outcomes in ischemic stroke patients treated with mechanical thrombectomy. Notably, multiple retriever passes may also increase the risk of intracranial hemorrhage.Evidence-Based MedicineLevel of Evidence: Level 4, Case Series.
AbstractPurposeIn patients with acute occlusions of the middle cerebral artery, the collaterals play an important role in infarct growth and potentially on clinical outcome. As the primary collateral pathway, the posterior cerebral artery with the posterior communicating artery (PComA) is important. We analyzed the influence of the presence of an ipsilateral PComA on infarct growth and clinical outcome.MethodsWe included 101 patients with M1 occlusions and subsequent endovascular treatment and differentiated patients without an ipsilateral PComA from those with an ipsilateral PComA.ResultsThere was no difference in the rat...
AbstractPurposeThe aim of this study is to assess the feasibility of aspiration mechanical thrombectomy in patients with massive and submassive pulmonary embolism (PE) and contraindications to thrombolysis.Materials and MethodsEighteen patients presenting massive (8/18) or submassive (10/18) PE were prospectively enrolled between October 2016 and November 2017. All the patients enrolled had contraindications to thrombolysis (haemorrhagic stroken = 1, ischaemic stroke in the preceding 6 monthsn = 7, central nervous system damage or neoplasmsn = 1, recent major trauma/surgery/he...
Cerebrovasc Dis 2018;46:I
ConclusionPreoperative skin disinfection with IPA–CHG is superior to only IPA, and it should be recommended. The addition of a retrosternal gentamicin-releasing sponge further reduces the rate of mediastinitis.
HeartFlow said yesterday that it won reimbursement coverage from the Japanese Ministry of Health, Labor and Welfare for its HeartFlow FFRct fractional flow reserve analysis. The Redwood City, Calif.-based company said that it has already received approval from the Japanese Pharmaceuticals and Medical Devices Agency, and that reimbursement will go into effect beginning on December 1. “When a patient presents with symptoms suggesting CAD, we want to be able to quickly and effectively diagnose patients while reducing the need for unnecessary tests or invasive procedures. In clinical studies, we were able to see fir...
Conclusions: The study suggested that a dysfunction of the ipsilesional M1 and abnormal interhemispheric interactions might underlie the motor disability in acute ischemic stroke. Modifying the excitability of the motor cortex and correcting the abnormal motor network connectivity associated with the motor deficit might be the therapeutic target in early neurorehabilitation for stroke patients. PMID: 30420876 [PubMed - in process]
ConclusionGE attenuated mHTT aggregations through the control of mitochondrial fusion and the fission pathway.Graphical abstract
ConclusionPRR improved neuronal injuries that were induced by transient cerebral ischemia via inhibiting gliosis and elevating antioxidants.
Condition: Hemorrhagic Stroke Interventions: Drug: Brevibloc, 10 Mg/mL Intravenous Solution; Drug: Nitroprusside, Sodium Sponsor: Cristália Produtos Químicos Farmacêuticos Ltda. Not yet recruiting
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