Medicine
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The presence of reversible lesions that involve the splenium of the corpus callosum (SCC) has been reported in patients with a broad spectrum of diseases and conditions and is referred to as reversible splenial lesion syndrome (RESLES). To describe the clinicoradiological features and establish a clinical position for this disease, we retrospectively examined the clinicoradiological features of adult RESLES patients, as well as discuss the potential pathophysiological mechanisms of this disease. The clinical and MRI findings of patients who presented with RESLES accompanied by symptoms of neurological disorders were retrospectively reviewed. ⋯ Thus, the clinicoradiological spectrum of RESLES could be classified into 2 principal categories according to differential outcomes. RESLES is a rare entity with a broad clinicoradiological spectrum because of the various diseases and conditions. Although the overall symptoms of RESLES patients tend to be alleviated, the prognosis of patients with a severe disturbance of consciousness, extracallosal lesions, or diffuse slow waves is likely unfavorable.
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By virtue of medical advances and an aging society, people have increased opportunities for healthcare exposure. Little is known about the impact of healthcare exposure on the clinical features and molecular typing of methicillin-susceptible Staphylococcus aureus (MSSA) bacteremia. We classified the onset of MSSA bacteremia into 3 mutually exclusive categories according to the Centers for Disease Control definition, and conducted a retrospective cohort study to investigate the differences among patients with community-associated (CA), healthcare-associated community onset (HACO), and hospital onset (HO) MSSA bacteremia at a medical center from January 1, 2002 through December 31, 2011. ⋯ Infection foci varied with different onset settings. Overall, ST188 was the most predominant sequence type. Onset settings were not independently associated with outcomes.
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Administering diazepam intravenously or rectally in an adult with status epilepticus can be difficult and time consuming. The aim of this study was to examine whether intranasal diazepam is an effective alternative to intravenous diazepam when treating status epilepticus. We undertook a retrospective cohort study based on the medical records of 19 stroke patients presenting with status epilepticus to our institution. ⋯ Intranasal diazepam was administered about 9 times faster than intravenous diazepam (1 vs 9.5 minutes, P = 0.001), resulting in about 3-fold reduction in the time to termination of seizure activity after arrival at the hospital (3 minutes compared with 9.5 minutes in the intravenous group, P = 0.030). No adverse effects of intranasal diazepam were evident from the medical records. Intranasal diazepam administration is safer, easier, and quicker than intravenous administration.
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The objective of this study was to investigate the contribution of handgrip strength in predicting the functional outcome after hip fracture in women. We prospectively investigated white women (N = 193 of 207) who were consecutively admitted to a rehabilitation hospital after a hip fracture. We measured handgrip strength with a Jamar dynamometer (Lafayette Instrument Co, Lafayette, IN), on admission to rehabilitation. ⋯ To define successful rehabilitation, we categorized the Barthel index scores as either high (85 or higher) or low (<85). The adjusted odds ratio for 1 SD increase in grip strength was 1.73 (95% confidence interval [CI] 1.05-2.84, P = 0.032) for having a high Barthel index score at the end of inpatient rehabilitation and 2.24 (95% CI 1.06-5.18) for having a high Barthel index score at the 6-month follow-up. Handgrip strength assessed before rehabilitation independently predicted the functional outcome both after inpatient rehabilitation and at a 6-month follow-up in hip-fracture women.
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To investigate the diurnal variations of the ocular blood flow in healthy eyes using laser speckle flowgraphy (LSFG), and to determine the relationship of the diurnal variations between the ocular blood flow and other ocular parameters. This prospective cross-sectional study was conducted at Nagoya University Hospital. We studied 13 healthy volunteers whose mean age was 33.5 ± 7.6 years. ⋯ Although the diurnal variation of the MBR on the ONH was different from the other parameters, that on the choroid was significantly and positively correlated with the DBP (P = 0.002), mean arterial pressure (P = 0.023), and mean ocular perfusion pressure (P = 0.047). We found significant diurnal variations in the ONH and choroidal blood flow. Although the ONH blood flow had its own diurnal variation because of strong autoregulation, the choroidal blood flow was more likely affected by systemic circulatory factors because of poor autoregulation.