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Chronic meningitis is a syndrome characterised by persistent and progressive signs and symptoms of meningitis along with cerebrospinal fluid (CSF) pleocytosis and elevated protein that fail to improve over 4 weeks. A detailed and careful history and examination is required along with CSF parameters to guide a clinician towards the aetiology of the...
Citations
Objective: ultrasound imaging based on nanobubbles was used as the examination method in this study. Abdominal examination was performed on patients with and without diabetes during pregnancy, and the examination data between patients in different groups were compared and analyzed. Methods: 74 pregnant women were selected and enrolled in this study. Thirty-five pregnant women with diabetes were enrolled in the experimental group (Exp group) and 39 pregnant women without diabetes were assigned to the control group (Ctrl group). Results: there were no significant differences in fetal abdominal circumference, femoral length, and biparietal diameter between the two groups. The liver length and head circumference in the Exp group were higher based on the Ctrl group, with a statistical significance. Moreover, the occurrence probability of abnormal fetal growth and development indexes in the Exp group was higher and exhibited a statistical significance to that in the Ctrl group. Conclusion: patients with diabetes were more likely to have abnormal pregnancies. It is necessary to adopt color examination for clinical screening of diabetic pregnant women, so that the life safety of pregnant women and fetus can be guaranteed, reflecting the good application prospect of ultrasound examination.
Background
Intimate partner violence (IPV) can result in significant harm to women and families and is especially prevalent when women are pregnant or recent mothers. Maternal and child health nurses (MCHN) in Victoria, Australia are community-based nurse/midwives who see over 95% of all mothers with newborns. MCHN are in an ideal position to identify and support women experiencing IPV, or refer them to specialist family violence services. Evidence for IPV screening in primary health care is inconclusive to date. The Victorian government recently required nurses to screen all mothers when babies are four weeks old, offering an opportunity to examine the effectiveness of MCHN IPV screening practices. This protocol describes the development and design of MOVE, a study to examine IPV screening effectiveness and the sustainability of screening practice.
Methods/design
MOVE is a cluster randomised trial of a good practice model of MCHN IPV screening involving eight maternal and child health nurse teams in Melbourne, Victoria. Normalisation Process Theory (NPT) was incorporated into the design, implementation and evaluation of the MOVE trial to enhance and evaluate sustainability. Using NPT, the development stage combined participatory action research with intervention nurse teams and a systematic review of nurse IPV studies to develop an intervention model incorporating consensus guidelines, clinical pathway and strategies for individual nurses, their teams and family violence services. Following twelve months’ implementation, primary outcomes assessed include IPV inquiry, IPV disclosure by women and referral using data from MCHN routine data collection and a survey to all women giving birth in the previous eight months. IPV will be measured using the Composite Abuse Scale. Process and impact evaluation data (online surveys and key stakeholders interviews) will highlight NPT concepts to enhance sustainability of IPV identification and referral. Data will be collected again in two years.
Discussion
MOVE will be the first randomised trial to determine IPV screening effectiveness in a community based nurse setting and the first to examine sustainability of an IPV screening intervention. It will further inform the debate about the effectiveness of IPV screening and describe IPV prevalence in a community based post-partum and early infant population.
Trial registration
ACTRN12609000424202
Mollaret meningitis (MM) occurs mainly in females and is characterized by recurrent episodes of headache, transient neurological abnormalities, and the cerebrospinal fluid containing mononuclear cells. HSV-2 was usually identified as the causative agent. Recently, we found that recurrent headaches in non-HIV-infected subjects were due to acquired cerebral toxoplasmosis (CT). The aim of the study was therefore to focus on molecular pathomechanisms that may lead to reactivation of latent CT and manifest as MM. Literature data cited in this work were selected to illustrate that various factors may affect latent CNS Toxoplasma gondii infection/inflammation intensity and/or host defense mechanisms, i.e., the production of NO, cytokines, tryptophan degradation by indoleamine 2,3-dioxygenase, mechanisms mediated by an IFN-gamma responsive gene family, limiting the availability of intracellular iron to T. gondii, and production of reactive oxygen/nitrogen species, finally inducing choroid plexitis and/or vasculitis. Examples of triggers revealing MM and accompanying disturbances of IFN-gamma-mediated immune responses that control HSV-2 and T. gondii include: female predominance (female mice are more susceptible to T. gondii infection than males); HSV-2 infection (increased IFN-gamma, IL-12); metaraminol (increased plasma catecholamine levels, changes in cytokine expression favoring T(H)2 cells responses); probably cholesterol contained in debris from ruptured epidermoid cysts (decreased NO; increased TNF-alpha, IL-6, IL-8). These irregularities induced by the triggers may be responsible for reactivation of latent CT and development of MM. Thus, subjects with MM should have test(s) for T. gondii infection performed obligatorily.
1.0 Summary 1.1 HIV Testing 1.2 Methodology 1.3 Adherence 1.4 Gender and ethnicity 1.5 When to start treatment 1.5.1 Primary HIV infection 1.5.2 Symptomatic HIV Infection 1.5.3 Asymptomatic HIV Infection 1.5.3.1 Individuals with CD4 counts o200 cells/mL 1.5.3.2 Individuals with CD4 counts 4350 cells/mL 1.5.3.3 Individuals with CD4 counts
