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Neurological Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Sudden severe headache is much less common than chronic headache, and the differential diagnosis includes SAH, meningitis and cortical venous thrombosis. Sudden severe headache warrants referral to hospital for clinical assessment and a CT scan. Where CT is done within 6 hours and is normal, the risk of ‘CT-negative SAH’ is very low, and LP is not usually required. Patients over 50 should have an erythrocyte sedimentation rate (ESR) to rule out temporal arteritis (see Chapter 4, Rheumatic disease). CT may show other causes of headache such as subdural haematoma or brain tumour, but MRI may be required to show descent of the cerebellar tonsils through the foramen magnum; in idiopathic intracranial hypotension, imaging may be normal but LP shows a low opening pressure. Extracranial causes of headache include sinusitis, dental abscess and glaucoma.
Alkaptonuria
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop
Index of the inflammatory nature of the disease is elevated sedimentation rate ranging from 55–110 mm/hour [14]. Levels of osteocalcin are elevated in some patients, representing the formation of new bone [14], and urinary collagen N-telopeptide, an index of bone resorption is also elevated.
Inflammation
Published in George Feuer, Felix A. de la Iglesia, Molecular Biochemistry of Human Disease, 2020
George Feuer, Felix A. de la Iglesia
During the inflammatory process, fluid leaks out from the capillaries into the tissue, and plasma proteins remain behind in the vessels. The increased protein coats the red cells making them clump together. This clumping process causes an increase in the normal settling out of red cells, i.e., the sedimentation of these relatively dense particles in the fluid medium. If the blood of a healthy individual is treated with heparin to prevent coagulation, the erythrocytes settle out very slowly. In contrast, if the blood of a patient with acute or chronic inflammation is allowed to stand, the erythrocytes will settle very rapidly, being heavier than the plasma density. Red blood cells are normally kept in suspension by the colloid action of serum proteins, particularly albumins. The relative amounts and composition of serum proteins are altered in disease, thus the colloid stability is interfered with resulting in accelerated sedimentation rate of erythrocytes. In addition, the sedimentation rate is faster when the particles in the blood are larger, as is the case of red blood cell clumping in inflammation.
Relationship between serum-soluble receptor for advanced glycation end products (sRAGE) and disease activity in rheumatoid arthritis patients
Published in Modern Rheumatology, 2019
Mohammad Reza Jafari Nakhjavani, Mahdi Jafarpour, Amir Ghorbanihaghjo, Sima Abedi Azar, Aida Malek Mahdavi
Five milliliters of venous blood samples was collected after 12-h overnight fasting. The serum samples were separated from whole blood and were kept at −70 °C until biochemical analysis. Serum sRAGE (BioVendor Research and Diagnostic Products), anti-cyclic citrullinated peptide (Anti-CCP) (Medizym., Berlin, Germany), and C-reactive protein (CRP) (Monobined Inc., Lake Forest, CA) levels were measured by ELISA according to the manufacturer’s recommendations, using an ELISA plate reader (Model stat fax 2100, Awareness, Ramsey, MN). Serum creatinine, blood urea nitrogen (BUN), and rheumatoid factor (RF) were measured by the standard enzymatic colorimetric method (Pars Azmoon Co, Tehran, Iran) with an automated chemical analyzer (Abbott analyzer, Abbott laboratories, Abbott Park, North Chicago, IL). The erythrocyte sedimentation rate (ESR) was measured using whole blood and complete blood counts with differential counts analyzed by the H1-Technicon blood cell counter.
Repeated cobalt and chromium ion measurements in patients with large-diameter head metal-on-metal ReCap-M2A-Magnum total hip replacement
Published in Acta Orthopaedica, 2019
Heikki Mäntymäki, Petteri Lankinen, Tero Vahlberg, Aleksi Reito, Antti Eskelinen, Keijo Mäkelä
All participating patients had their blood samples taken from the antecubital vein using a 21-gauge BD Vacutainer Eclipse blood collection needle (Becton, Dickinson and Co, Franklin Lakes, NJ, USA). The first 10 mL tube of blood was used for analysis of standard laboratory tests such as C-reactive protein and erythrocyte sedimentation rate measurement. The second blood sample was taken in Vacuette NH trace elements tube (Greiner Bio-One GmbH, Kremsmünster, Austria) containing sodium heparin. Cobalt and chromium analyses from whole blood were performed using an accredited method with Inductively Coupled Plasma Mass Spectrometry (ICP-MS, VITA Laboratory, Helsinki, Finland in collaboration with Medical Laboratory of Bremen, Germany). The detection limit for Cr was 0.2 ppb and for Co 0.2 ppb. The intra-assay variation for WB Cr and Co was 2.2% and 2.7% and inter-assay variation was 6.7% and 7.9%, respectively.
Attention-Deficit Hyperactivity and Obsessive-Compulsive Symptoms in Adult Patients With Primary Restless Legs Syndrome: Different Phenotypes of the Same Disease?
Published in Behavioral Sleep Medicine, 2019
Imad Ghorayeb, Ashley Gamas, Zoé Mazurie, Willy Mayo
The severity of RLS symptoms was determined using the International RLS Rating Scale (IRLS; Walters et al., 2003). Patients were excluded if they had a secondary cause of RLS, including pregnancy, end-stage renal disease, confirmed diabetic neuropathy, and a history of taking drugs known to cause or exacerbate RLS (e.g., neuroleptics or antihistamines). Depression was not formally assessed, but patients with antidepressants were not excluded if their RLS occurred prior to the use of antidepressants. A morning fasting blood sample of all patients, collected by cubital vein-puncture, was routinely tested for hemoglobin, ferritin, transferrin, iron, and sedimentation rate (used as an inflammatory index). As iron status may be affected by inflammation, those patients with increased sedimentation rate were excluded from the study. Informed consent was obtained from all the patients. They were informed of their rights pursuant to the Act n° 78-17 of January 6, 1978 “loi Informatique et Libertés” (CNIL-France).