A 30-year-old female patient who was 25 weeks pregnant presented to the emergency department with a 1-month history of mild headache and 2 weeks of progressive somnolence and photophobia accompanied by binocular horizontal diplopia and right gaze deviation. The patient also described new neck pain with passive head movements, without neck stiffness. Overall, the pregnancy was uncomplicated, with no high-risk features. Fever, chills, cough, shortness of breath, and abdominal or chest pain were denied. The patient had no history of rash, intravenous drug use, immunosuppressive medication use, or documented congenital abnormalities. She had not traveled recently, although she lived in Vancouver, British Columbia, Canada, 2 years prior to presentation. There was no recent or recurrent bacterial or viral illness. At clinical examination, the patient exhibited a decreased level of alertness and appeared tired. Vital signs were unremarkable, with a normal temperature (37.1 °C). Cranial nerve assessment revealed mild right abducens nerve palsy; neurologic examination was otherwise normal. Fundoscopic examination showed moderate grade 3 papilledema, left greater than right, with obscuration of some of the vessels leaving the disk. A CT scan of the head at admission was interpreted as normal (Fig 1). MRI of the brain performed 5 days later, due to persistent symptoms, revealed infratentorial and supratentorial imaging abnormalities (Figs 2-5). Lumbar puncture revealed high cerebral spinal fluid (CSF) opening pressure (32 cm HO; upper limit of normal, 25 cm HO). The CSF was clear, and analysis revealed an elevated total nucleated cell count (136 ×10/L; reference range, 0-5 ×10/L), with predominant lymphocytic moderate pleocytosis (100 ×10/L; reference range, 0-5 ×10/L) (59% lymphocytes) and normal glucose (3.3 mmol/L; reference range, 2.2-3.9 mmol/L) and normal total protein (0.27 g/L; reference range, 0.16-0.49 g/L) levels. Blood culture results for mycobacteria and anaerobic and aerobic microorganisms showed no growth. Findings from extensive additional diagnostic workup, including serologic testing for herpes simplex virus, varicella-zoster virus, enterovirus, , and mycobacteria, were negative. The HIV test result was negative, and the CD4 lymphocyte count and complement and immunoglobulin levels were within normal range. Autoimmune screening results were also negative.
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http://dx.doi.org/10.1148/radiol.240620 | DOI Listing |
Anal Bioanal Chem
December 2024
DTI-Danish Technological Institute, Aarhus, Denmark.
Biomass is a key element in biofuels which can be defined as a fuel produced through contemporary biological processes, and its increased use can support the EU's aims of reducing greenhouse gas emissions. Information on the nature and the quality of the biomass or biofuel is important in order to support the optimization of their combustion with respect to realizing higher efficiencies and lower emissions during energy production. Three reference materials were produced by a collaborative approach among national metrology institutes and designated institutes within the scope of the EMPIR project: BIOFMET.
View Article and Find Full Text PDFBMC Med
December 2024
Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology & Population Health, London, School of Hygiene and Tropical Medicine, London, UK.
Background: Direct oral anticoagulants (DOACs) have been reported to be associated with a higher risk of mortality compared with an older alternative, warfarin using primary care data in the United Kingdom (UK). However, other studies observed contradictory findings. We therefore aimed to investigate the association between mortality and warfarin, compared with DOACs.
View Article and Find Full Text PDFTransfusion
December 2024
School of Biomedical Sciences, Faculty of Health, University of Plymouth, Plymouth, UK.
Background: The Rh blood group system (ISBT004) is encoded by two homologous genes, RHD and RHCE. Polymorphism in these two genes gives rise to 56 antigens, which are highly immunogenic and clinically significant. This study extended previous work on the establishment of RHD allele specific reference sequences using next generation sequencing (NGS) with the Ion Personal Genome Machine (Ion PGM) to sequence the complete RHCE gene.
View Article and Find Full Text PDFNihon Koshu Eisei Zasshi
December 2024
Tokyo Metropolitan Institute for Geriatrics and Gerontology, Research Team for Social Participation and Healthy Aging.
Objective This study examined the factors associated with the status of group activities provided to older adults during the COVID-19 pandemic by community groups aiming to improve the health and social interactions of older adults. Methods A mail survey was conducted with 372 leaders of neighborhood associations and Senior Citizen Clubs in November 2020 in Ward A, Tokyo. The questionnaire asked leaders about the status of group activities provided by neighborhood associations and the aforementioned clubs for older adults.
View Article and Find Full Text PDFNihon Hoshasen Gijutsu Gakkai Zasshi
December 2024
Department of Radiology, Tatebayashi Kosei General Hospital.
Purpose: In radiation therapy for prostate cancer, bladder ultrasound diagnostic devices are utilized. However, the performance of all devices has not been fully evaluated. This study aims to assess the effectiveness of three devices-Lilium IP200 (IP200; Lilium Otsuka, Kanagawa), CubeScan BioCon-900S (900S; JCT, Hiroshima), and BVI 6100 (BVI 6100; Verathon, Bothell, WA, USA)-as tools for measuring bladder volume.
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