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Article: A Contextual-Bandit-Based Approach for Informed Decision-Making in Clinical Trials.

Varatharajah, Yogatheesan / Berry, Brent

2022 Volume 12, Issue 8

Abstract: Clinical trials are conducted to evaluate the efficacy of new treatments. Clinical trials involving multiple treatments utilize the randomization of treatment assignments to enable the evaluation of treatment efficacies in an unbiased manner. Such ... ...

Abstract	Clinical trials are conducted to evaluate the efficacy of new treatments. Clinical trials involving multiple treatments utilize the randomization of treatment assignments to enable the evaluation of treatment efficacies in an unbiased manner. Such evaluation is performed in post hoc studies that usually use supervised-learning methods that rely on large amounts of data collected in a randomized fashion. That approach often proves to be suboptimal in that some participants may suffer and even die as a result of having not received the most appropriate treatments during the trial. Reinforcement-learning methods improve the situation by making it possible to learn the treatment efficacies dynamically during the course of the trial, and to adapt treatment assignments accordingly. Recent efforts using
Language	English
Publishing date	2022-08-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662250-6
ISSN	2075-1729
ISSN	2075-1729
DOI	10.3390/life12081277
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Article: The Possibility of Eidetic Memory in a Patient Report of Epileptogenic Zone in Right Temporo-Parietal-Occipital Cortex.

Berry, Brent M / Miller, Laura R / Berns, Meaghan / Kucewicz, Michal

Life (Basel, Switzerland)

2023 Volume 13, Issue 4

Abstract: Eidetic memory has been reported in children and in patients with synesthesia but is otherwise thought to be a rare phenomenon. Presented herein is a patient with right-sided language dominance, as proven via multiple functional imaging and ... ...

Abstract	Eidetic memory has been reported in children and in patients with synesthesia but is otherwise thought to be a rare phenomenon. Presented herein is a patient with right-sided language dominance, as proven via multiple functional imaging and neuropsychometric methods, who has a seizure onset zone in the right temporo-parietal-occipital cortex. This patient's medically refractory epilepsy and thus hyperactive cortex could possibly contribute to near eidetic ability with paired-associates learning tasks (in both short-term and long-term retention). There are reports of epilepsy negatively affecting memory, but as far as the authors are aware to date, there is limited evidence of any lesion enhancing cognitive functions (whether through direct lesion or via compensatory mechanism) that would be localized to a seizure onset zone in the dominant temporo-parietal-occipital junction.
Language	English
Publishing date	2023-04-06
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662250-6
ISSN	2075-1729
ISSN	2075-1729
DOI	10.3390/life13040956
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Article: Status Epilepticus in Post-Transplantation Hyperammonemia Involves Careful Metabolic Management.

Puram, Vikram Venkata / Berry, Brent / Ghannam, Malik / Furuya, Yuka

Life (Basel, Switzerland)

2022 Volume 12, Issue 10

Abstract: Hyperammonemia is a condition that may result after solid organ transplantation, particularly lung transplantation. However, it is very uncommon for this presentation to occur more than 30 days post-transplantation. Hyperammonemia and the resulting ... ...

Abstract	Hyperammonemia is a condition that may result after solid organ transplantation, particularly lung transplantation. However, it is very uncommon for this presentation to occur more than 30 days post-transplantation. Hyperammonemia and the resulting encephalopathy typically manifest with altered sensorium, a clinical situation which is not often included in the differential diagnosis of presumed nonconvulsive status epilepticus (NCSE). Seizures are common among this subset of patients with hyperammonemia and may be refractory to traditional treatments. Evidence of elevated intracranial pressure by invasive monitoring and neuroimaging findings of diffuse cerebral edema are commonly reported. Here we examine the therapeutic importance of identifying the specific cause of hyperammonemic encephalopathy, a condition which may result in status epilepticus and ultimately cerebral edema or even brain death.
Language	English
Publishing date	2022-09-21
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2662250-6
ISSN	2075-1729
ISSN	2075-1729
DOI	10.3390/life12101471
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Article ; Online: Thalamic aphasia secondary to glioblastoma multiforme.

Samara, Amjad / Berry, Brent / Ghannam, Malik

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

2020 Volume 74, Page(s) 234–238

Abstract: Background: Thalamic aphasia is an unusual clinical presentation of brain neoplasm with few cases reported. Herein, we present a case of an adult woman with thalamic aphasia due to glioblastoma of the thalamus.: Case presentation: A 57-year-old ... ...

Abstract	Background: Thalamic aphasia is an unusual clinical presentation of brain neoplasm with few cases reported. Herein, we present a case of an adult woman with thalamic aphasia due to glioblastoma of the thalamus. Case presentation: A 57-year-old female patient presented with difficulty walking, slow speech and cognition and altered mental status. At baseline, she was conversant and interactive. Physical examination showed right hemiparesis in addition to word finding difficulties, an impaired naming of objects and semantic paraphasia but preserved repetition and comprehension. The remaining neurological exam was otherwise unremarkable. Brain CT and brain MRI scans showed a left thalamic lesion that is centrally necrotic and peripherally enhancing suggestive of a high-grade neoplasm. Eventually, histopathological examination of brain biopsy confirmed the diagnosis of glioblastoma multiforme. Thalamic aphasia was proposed as an explanation for the neurological symptoms observed in this patient. Conclusions: This patient demonstrates an unusual presentation of glioblastoma multiforme as thalamic aphasia. It may also point to the potential contribution of the understanding of how thalamic aphasia evolves to characterize the role of the thalamus in language functions.
MeSH term(s)	Adult ; Aphasia/pathology ; Brain/pathology ; Brain Neoplasms/pathology ; Female ; Glioblastoma/pathology ; Humans ; Language ; Male ; Middle Aged ; Neurologic Examination ; Thalamus/pathology
Language	English
Publishing date	2020-01-21
Publishing country	Scotland
Document type	Case Reports
ZDB-ID	1193674-5
ISSN	1532-2653 ; 0967-5868
ISSN (online)	1532-2653
ISSN	0967-5868
DOI	10.1016/j.jocn.2020.01.063
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Article: Posterior reversible encephalopathy syndrome with isolated infratentorial involvement: A case report.

Samara, Amjad / Berry, Brent / Ghannam, Malik

Radiology case reports

2019 Volume 14, Issue 5, Page(s) 576–580

Abstract: Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiological entity of acute neurological symptoms associated with characteristic MRI finding. Vasogenic edema in the white matter of parieto-occipital regions is the classical MRI ... ...

Abstract	Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiological entity of acute neurological symptoms associated with characteristic MRI finding. Vasogenic edema in the white matter of parieto-occipital regions is the classical MRI findings. Spinal cord involvement in PRES is extremely rare and frequently underrecognized condition. Recently, a variant-type PRES with isolated involvement of infratentorial structures is getting more attention. Herein, we present a case of hypertensive emergency and associated radiological features of PRES with isolated involvement of the brain stem, cerebellum, and spinal cord.
Language	English
Publishing date	2019-03-01
Publishing country	Netherlands
Document type	Case Reports
ZDB-ID	2406300-9
ISSN	1930-0433
ISSN	1930-0433
DOI	10.1016/j.radcr.2019.02.009
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Article ; Online: Idiopathic intracranial hypertension presenting with isolated unilateral facial nerve palsy: a case report.

Samara, Ahmad / Ghazaleh, Dana / Berry, Brent / Ghannam, Malik

Journal of medical case reports

2019 Volume 13, Issue 1, Page(s) 94

Abstract: Background: Idiopathic intracranial hypertension, also known as pseudotumor cerebri, is a disorder characterized by increased intracranial pressure of unclear pathogenesis in the absence of other structural and obstructive lesions that is predominantly, ...

Abstract	Background: Idiopathic intracranial hypertension, also known as pseudotumor cerebri, is a disorder characterized by increased intracranial pressure of unclear pathogenesis in the absence of other structural and obstructive lesions that is predominantly, although not exclusively, seen in obese women of childbearing age. Patients with idiopathic intracranial hypertension commonly present with a headache, transient visual obscurations, and intracranial noises with some cranial nerves occasionally involved, most commonly CN VI. We report idiopathic intracranial hypertension presenting with isolated complete unilateral facial nerve palsy, as the sole cranial nerve involved, which is a presentation rarely reported in the literature. Case presentation: A 40-year-old Hispanic woman with a history of obesity and hypertension presented to our emergency department complaining of bifrontal headache for 3 days associated with nausea, vomiting, transient visual disturbances, and a picture of right-sided cranial nerve VII palsy. Her neurologic examination including other cranial nerves was otherwise normal, but a fundus examination revealed bilateral grade II papilledema. Imaging studies ruled out structural and obstructive lesions as possible causes of her symptoms and lumber puncture results were unremarkable except for an increased opening pressure. She was then started on prednisone and acetazolamide. Two days later, she reported a dramatic improvement in both headache and facial nerve palsy. Conclusions: Idiopathic intracranial hypertension should be suspected in obese young women presenting with headache and transient visual complaints and some cranial nerve abnormalities. Idiopathic intracranial hypertension is a diagnosis of exclusion and imaging studies should always be performed to rule out other structural and obstructive lesions. In this case report, we aimed to draw attention to the possibility of idiopathic intracranial hypertension presenting with unilateral cranial nerve VII palsy as the only cranial nerve involved, which needs a high index of suspicion by clinicians. The mechanisms of cranial nerve VII palsy in idiopathic intracranial hypertension are not well understood and prompt further investigation.
MeSH term(s)	Acetazolamide/therapeutic use ; Adult ; Facial Paralysis/drug therapy ; Facial Paralysis/etiology ; Female ; Headache/etiology ; Humans ; Magnetic Resonance Imaging ; Obesity/complications ; Papilledema/diagnostic imaging ; Papilledema/etiology ; Prednisone/therapeutic use ; Pseudotumor Cerebri/complications ; Pseudotumor Cerebri/diagnostic imaging ; Pseudotumor Cerebri/drug therapy ; Vision Disorders/etiology
Chemical Substances	Acetazolamide (O3FX965V0I) ; Prednisone (VB0R961HZT)
Language	English
Publishing date	2019-04-19
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2269805-X
ISSN	1752-1947 ; 1752-1947
ISSN (online)	1752-1947
ISSN	1752-1947
DOI	10.1186/s13256-019-2060-5
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Article ; Online: Occlusive radiation cerebral vasculopathy implies medical complexity: a case report.

Ghazaleh, Dana / Beran, Azizullah / Berry, Brent / Ghannam, Malik

Journal of medical case reports

2019 Volume 13, Issue 1, Page(s) 170

Abstract: Background: Cranial irradiation is one of the main treatment modalities for central nervous system tumors. It carries many complications, one being occlusive radiation vasculopathy of large vessels. It is an underrecognized etiology for stroke, ... ...

Abstract	Background: Cranial irradiation is one of the main treatment modalities for central nervous system tumors. It carries many complications, one being occlusive radiation vasculopathy of large vessels. It is an underrecognized etiology for stroke, especially in the younger population. The pathophysiological process is controversial, but there is much literature supporting the theory of its being a secondary form of moyamoya disease. Case presentation: A 31-year-old Caucasian man with a history of pineal blastoma at the age of 3 years, which was treated with resection, radiotherapy, and chemotherapy, presented to our institution with right M1 stroke. Further assessment by computed tomographic perfusion study with acetazolamide demonstrated steal phenomenon of the right middle cerebral artery territory (type III response) with a small internal region of matched cerebral blood volume defect (that is, infarct core). Coincidentally, he was found to have multiple brain masses consistent with meningiomas. Occlusive radiation vasculopathy was the most likely culprit of the patient's stroke. The patient was treated medically with "baby" acetylsalicylic acid and clopidogrel for 3 months, then continued only on baby acetylsalicylic acid. Conclusion: Late-onset occlusive radiation vasculopathy is a potentially severe iatrogenic manifestation of radiotherapy that requires a high index of suspicion as an etiology of stroke in young population, especially those with coexistent meningioma that might be a strong indicator for occlusive radiation vasculopathy as the stroke culprit. We reviewed the available literature to better understand the pathogenesis, clinical presentation, and treatment options of occlusive radiation vasculopathy. Applying perfusion studies with acetazolamide measures the cerebrovascular reserve in patients with occlusive radiation vasculopathy, which could help in determining the appropriate available treatment option.
MeSH term(s)	Adult ; Brain/diagnostic imaging ; Brain Neoplasms/therapy ; Cancer Survivors ; Cerebral Angiography ; Cerebrovascular Disorders/diagnostic imaging ; Cerebrovascular Disorders/drug therapy ; Cerebrovascular Disorders/etiology ; Cranial Irradiation/adverse effects ; Humans ; Infarction, Middle Cerebral Artery/diagnostic imaging ; Infarction, Middle Cerebral Artery/drug therapy ; Infarction, Middle Cerebral Artery/etiology ; Magnetic Resonance Angiography ; Magnetic Resonance Imaging ; Male ; Perfusion Imaging ; Pineal Gland ; Pinealoma/therapy ; Platelet Aggregation Inhibitors/therapeutic use ; Radiation Injuries/etiology
Chemical Substances	Platelet Aggregation Inhibitors
Language	English
Publishing date	2019-06-03
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2269805-X
ISSN	1752-1947 ; 1752-1947
ISSN (online)	1752-1947
ISSN	1752-1947
DOI	10.1186/s13256-019-2104-x
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Article ; Online: Creutzfeldt-Jakob Disease May Present Early With Unusual Bulbar Predominance.

Ghannam, Malik / Patel, Roshni / Nichols, Kent / Smith, Andrew / Robertson, Jetter / Berry, Brent M

The neurologist

2021 Volume 26, Issue 2, Page(s) 69–72

Abstract: Introduction: Creutzfeldt-Jakob disease (CJD) is a prion protein disorder of significant consequence and currently incurable. Diagnosis can be challenging early in the disease course. CJD can present in many ways but often fits a pattern of cognitive ... ...

Abstract	Introduction: Creutzfeldt-Jakob disease (CJD) is a prion protein disorder of significant consequence and currently incurable. Diagnosis can be challenging early in the disease course. CJD can present in many ways but often fits a pattern of cognitive problems, cerebellar disturbance, behavioral/psychological changes, and perhaps myoclonus. Case report: We herein present the case of a 69-year-old White male with subacute progressive bulbar and limb weakness over ten weeks period. Early on, he was diagnosed with amyotrophic lateral sclerosis versus autoimmune-related bulbar neuropathy and treated as such. However, he continued to deteriorate clinically that prompted another admission, upon readmission, his cerebrospinal fluid RTQuick and 14-3-3 from the National Prion Disease Pathology Surveillance Center (NPDPSC) did eventually return positive. Hence he was diagnosed with CJD. Conclusions: CJD may present with progressive bulbar symptoms similar to acute inflammatory demyelinating polyradiculoneuropathy (MF variant), motor neuron disease, or autoimmune brainstem encephalitis. It becomes even higher on the differentials especially with no response to immunotherapy.
MeSH term(s)	Aged ; Brain ; Creutzfeldt-Jakob Syndrome/diagnosis ; Disease Progression ; Encephalitis ; Humans ; Male ; Myoclonus
Language	English
Publishing date	2021-03-04
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	1361380-7
ISSN	2331-2637 ; 1074-7931
ISSN (online)	2331-2637
ISSN	1074-7931
DOI	10.1097/NRL.0000000000000321
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Zs.A 4641: Show issues

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Article: Pleural effusion in 11:14 translocation q1 multiple myeloma in the setting of proteasome inhibitor presents therapeutic complexity.

Ghannam, Malik / Bryan, Maria / Kuross, Erik / Berry, Brent

Memo

2018 Volume 11, Issue 1, Page(s) 71–76

Abstract: Background: Primary malignant pleural effusion has been reported in about 134 cases of multiple myeloma (MM). Associated pleural effusions in cases of MM portend a poor prognosis and identifying them is highly relevant. Reported is the case of a man ... ...

Abstract	Background: Primary malignant pleural effusion has been reported in about 134 cases of multiple myeloma (MM). Associated pleural effusions in cases of MM portend a poor prognosis and identifying them is highly relevant. Reported is the case of a man diagnosed with MM who developed primary myelomatous pleural effusion in the setting of multiple relapses and subsequent mortality within 2 months of the pleural effusion diagnosis. Presentation: A 61-year-old African American man was diagnosed with MM in 2011. He received induction therapy of lenalidomide and dexamethasone and an autologous stem cell transplant in 2012. Over the next 5 years, the patient went through alternating periods of remission and relapse that were treated with two rounds of thoracic spine radiation therapy and chemotherapeutic agents. In September 2017, the patient presented with worsening dyspnea and was found to have pleural effusion. Fluid analysis showed plasma cell dyscrasia. Fluid drainage was performed, then the patient was discharged after 1 week which was followed by rapid re-accumulation of fluid and rehospitalization about 10 days after discharge. The patient passed away a few weeks after the second admission. Conclusion: Pleural effusion carries a differential diagnosis which may include malignancy but is commonly thought to be less specific to multiple myeloma but should still remain in the differential diagnosis. To our knowledge, this is the first case of myelomatous pleural effusion (MPE) that was reported after multiple relapses of MM. MPE is a very rare complication of MM, and its presence is a strong indicator of imminent mortality and need for comfort care in case of multiple relapses. End-stage pleural effusion in MM in the setting of proteasome inhibitor adds more therapeutic and diagnostic challenges.
Language	English
Publishing date	2018-02-21
Publishing country	Austria
Document type	Journal Article
ZDB-ID	2428960-7
ISSN	1865-5076 ; 1865-5041
ISSN (online)	1865-5076
ISSN	1865-5041
DOI	10.1007/s12254-018-0388-y
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Article: A repeated observation approach for estimating the street homeless population.

Berry, Brent

Evaluation review

2007 Volume 31, Issue 2, Page(s) 166–199

Abstract: Risks of life on the street caused by inclement weather, harassment, and assault threaten the unsheltered homeless population. We address some challenges of enumerating the street homeless population by testing a novel capture-recapture (CR) estimation ... ...

Abstract	Risks of life on the street caused by inclement weather, harassment, and assault threaten the unsheltered homeless population. We address some challenges of enumerating the street homeless population by testing a novel capture-recapture (CR) estimation approach that models individuals' intermittent daytime visibility. We tested walking and vehicle-based variants of CR in downtown Toronto in March. Estimates that assume individual variability of sighting probabilities are most consistent with our knowledge of the homeless and achieve the most favorable confidence intervals, estimated detection probabilities, and coefficient of variation. Estimation bias from interobserver discrepancies, duplicate counting, and violation of the closed population assumption were minimized with uniform identification criteria, training, and sampling design. Bias caused by the social grouping of the homeless was small. Despite the limitations of visual identification, CR approaches as part of a multiple-method program can aid community responses to immediate needs on the street, especially during the harsh winter months.
MeSH term(s)	Adolescent ; Adult ; Female ; Homeless Persons/statistics & numerical data ; Humans ; Male ; Middle Aged ; Ontario/epidemiology ; Population Surveillance/methods ; Urban Population
Language	English
Publishing date	2007-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	1500138-6
ISSN	1552-3926 ; 0193-841X ; 0145-4692
ISSN (online)	1552-3926
ISSN	0193-841X ; 0145-4692
DOI	10.1177/0193841X06296947
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