RESUMO
A 71-year-old man presented with sudden onset, generalized tonic-clonic seizures and altered mental status. Initial brain magnetic resonance imaging was normal but a brain FDG-PET scan showed hypermetabolism in the left ventral striatum and septal area. Initial cerebrospinal fluid (CSF) examination showed mildly elevated protein but herpes simplex virus (HSV) polymerase chain reaction (PCR) was negative. A repeat CSF examination performed 9 days later showed a positive HSV PCR. Histopathological and immunohistochemical examination of autopsy specimen confirmed the presence of CD45+ lymphocytes and HSV antigen, suggesting the presence of both inflammation and viral infection corresponding to PET abnormality.
Assuntos
Encefalite por Herpes Simples/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Septo do Cérebro/diagnóstico por imagem , Estriado Ventral/diagnóstico por imagem , Aciclovir/uso terapêutico , Idoso , Antivirais/uso terapêutico , Encefalite por Herpes Simples/tratamento farmacológico , Evolução Fatal , Fluordesoxiglucose F18 , Humanos , Masculino , Compostos Radiofarmacêuticos , Septo do Cérebro/metabolismo , Estriado Ventral/metabolismoRESUMO
The word "hypermetabolism" needs to be replaced by "hypometabolism" at only ONE place and NOT throughout the article.So the correction could be stated as:"In the case description section, the sentence "A repeat dedicatedbrain FDG-PET scan performed on day 9, under burst suppression,showed diffuse hypermetabolism with persistent relativehypermetabolism in the left ventral striatum and septalarea (Fig. 1b)."should read as"A repeat dedicatedbrain FDG-PET scan performed on day 9, under burst suppression,showed diffuse hypometabolism with persistent relativehypermetabolism in the left ventral striatum and septalarea (Fig. 1b)." At all other places, the word hypermetabolism is appropriate.
RESUMO
Acute ischemic stroke remains a major public health concern, with low national treatment rates for the condition, demonstrating a disconnection between the evidence of treatment benefit and delivery of this treatment. Intravenous thrombolysis and endovascular thrombectomy are both strongly evidence supported and exquisitely time sensitive therapies. The mismatch between the distribution and incidence of stroke presentations and the availability of specialist care significantly affects access to care. Telestroke, the use of telemedicine for stroke, aims to surmount this hurdle by distributing stroke expertise more effectively, through video consultation with and examination of patients in locations removed from specialist care. This is the first of a detailed two part review, and explores the growth and current practice of telestroke, including the specific role it plays in the assessment and management of patients after emergent large vessel occlusion.
Assuntos
Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Telemedicina/tendências , Gerenciamento Clínico , Humanos , Telemedicina/métodos , Terapia Trombolítica/métodos , Terapia Trombolítica/tendênciasRESUMO
Acute ischemic stroke remains a major public health concern, with low national treatment rates for the condition, demonstrating a disconnection between the evidence of treatment benefit and delivery of this treatment. Intravenous thrombolysis and endovascular thrombectomy are both strongly evidence supported and exquisitely time sensitive therapies. The mismatch between the distribution and incidence of stroke presentations and the availability of specialist care significantly affects access to care. Telestroke, the use of telemedicine for stroke, aims to surmount this hurdle by distributing stroke expertise more effectively, through video consultation with and examination of patients in locations removed from specialist care. This is the second of a two part review, and is focused on the challenges telestroke faces for wider adoption. It further details the anticipated evolution of this novel therapeutic platform, and the potential roles it holds in stroke prevention, ambulance based care, rehabilitation, and research.
Assuntos
Acidente Vascular Cerebral/economia , Acidente Vascular Cerebral/terapia , Telemedicina/economia , Telemedicina/tendências , Administração Intravenosa , Procedimentos Endovasculares/economia , Procedimentos Endovasculares/tendências , Fibrinólise , Humanos , Acidente Vascular Cerebral/diagnóstico , Trombectomia/economia , Trombectomia/tendências , Terapia Trombolítica/economia , Terapia Trombolítica/tendênciasRESUMO
Management of massive hemoptysis in patients with active pulmonary tuberculosis is complicated. Transcatheter hemostatic embolization of bleeding vessels with absorbable material has been reported to be useful in controlling this problem. Twelve patients with active pulmonary tuberculosis who had major or massive hemoptysis were managed at Cook County Hospital, Chicago, from 1982 to 1986. Various methods of treatment have been evaluated. The technique of angiographic embolization and the criteria for selection of patients for its use constitute the basis of this report.