CSF examination

Other diagnostic tests to consider for differential diagnosis erythrocyte sedimentation rate, urinalysis, toxicology, chest x-ray, heavy metal screen, HIV testing, cerebrospinal fluid (CSF) examination, electroencephalography, and neuropsychological tests such as the Folstein Mini Mental Status Exam. 

CSF examination via lumbar puncture (LP, spinal tap) contraindicated in patients with cardiorespiratory compromise,... 

We investigated 53 samples of cerebrospinal fluid (CSF) in patients with neuroborreliosis. The clinical diagnosis of neuroborreliosis was confirmed by positive antibody titers and intrathecal synthesis of immunoglobulins in CSF examined in the IgM and IgG classes by the EFISA method or Western blot or confirmed by direct detection by PCR. 

Burger B, Zimmermann M, Mann G et al. Diagnostic cerebrospinal fluid (CSF) examination in children with acute lymphoblastic leukemia (ALL) significance of low leukocyte counts with blasts or traumatic lumbar puncture. J Clin Oncol 2003 21 184-188. 

If CT and CSF examination are normal within two weeks of headache onset, then SAH has been excluded. However, since xanthochromia is only detected in 70% of patients after three weeks and only 40% after four weeks, patients presenting beyond two weeks require investigation with CT or MR angiography or by catheter angiography. 

Apart from the classic biomarkers, i.e., tau protein(s) and their phosphorylated forms as well as AP peptides, several other candidate biomarkers have been tested, as recently and extensively reviewed by Frank et al. (2003). Neuronal thread proteins (NTPs) are a family of molecules expressed in the CNS. In a post mortem study, brains of AD patients expressed significant increases of NTP immunoreactivity (de la Monte and Wands, 1992). Following this finding, CSF examination for NTP revealed increased concentration of NTP which correlated tvith progression of dementia and neuronal degeneration (de la Monte et al, 1992). Sensitivity and specificity of this protein as a possible marker of AD, however, have not been determined in a large enough number of patients. 

CSF examination every 6 months until the cell count is normal if it has not decreased at 6 months or is not normal by 2 years, retreatment should be considered... 

A full neuromuscular evaluation is needed to adequately analyze the cause of a neuromuscular problem in an aging patient, as it is in a patient of any age. This includes detailed blood tests, nerve conductions, electromyography (EMG), and a muscle biopsy (performed under local anesthetic, as an out-patient) studied by a battery of histo-chemical techniques. Often, cerebrospinal fluid (CSF) examination is also needed. Sometimes relevant magnetic resonance imaging is necessary. 

To understand the extent to whieh the and (and for heteronuelear eases) CSFs eouple, it is useful to examine the energies... 

To simplify the analysis of the above CSFs, the familiar homonuelear ease in whieh z = 1.0 will be examined first. The proeess of substituting the above expressions for a and a into the Slater determinants that define the singlet and triplet CSFs ean be illustrated as follows ... 

This chapter will review some recently completed studies on the long-term effects of MDMA in nonhuman primates. The goals of these studies were to (1) determine if the neurotoxic effects of MDMA, which have been well documented in the rodent (see below), generalize to the primate (2) compare the relative sensitivity of primates and rodents to the neurotoxic effects of MDMA (3) ascertain if the toxic effects of MDMA in the monkey are restricted to nerve fibers (as they are in the rat), or if they involve cell bodies as well (4) evaluate how closely toxic doses of MDMA in the monkey approximate those used by humans and (5) examine whether 5-hydroxyindoleacetic acid (5-HIAA) in the cerebrospinal fluid (CSF) can be used to detect MDMA-induced serotonergic damage in the CNS of primates. Before presenting the results of these studies, previous results in the... 

MS diagnostic criteria were revised in 2001 and are known as the McDonald criteria (Fig. 26-2).18-20 MS diagnosis requires that plaques be disseminated in time and space. Previously, diagnosis relied heavily on clinical examination. The McDonald criteria allow the clinician to use the clinical exam in combination with magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) data to make a diagnosis sooner, and thus begin treatment earlier (Table 26-1). 

Ideally, lumbar puncture to obtain cerebrospinal fluid (CSF) for direct examination and laboratory analysis, as well as blood cultures and other relevant cultures, should be obtained before initiation of antimicrobial therapy. However, initiation of antimicrobial therapy should not be delayed if a pretreatment lumbar puncture cannot be performed. 

Fungal meningitis CSF culture, CSF and serum cryptococcal antigen titers, microscopic examination of CSF specimens... 

T. pallidum rapidly penetrates intact mucous membranes or microscopic dermal abrasions, and within a few hours, enters the lymphatics and blood to produce systemic illness. During the secondary stage, examinations commonly demonstrate abnormal findings in the cerebrospinal fluid (CSF). As the infection progresses, the parenchyma of the brain and spinal cord may subsequently be damaged. 

Follow-up is dependent on the CSF findings. If pleocytosis is present, re-examine the CSF every 6 months until the WBC count normalizes. Consider recommending a second course of treatment if the CSF white count does not decline after 6 months or completely normalize after 2 years.15 Failure to normalize may require retreatment most treatment failures occur in immunocompromised patients. 

Mycobacterium tuberculosis var. hominis is the primary cause of tuberculous meningitis. Tuberculous meningitis may exist in the absence of disease in the lung or extrapulmonary sites. Upon initial examination, CSF usually contains 100 to 1,000 WBC/mm3, which may be 75% to 80% polymorphonuclear cells. Over time, the pattern of WBCs in the CSF will shift to lymphocytes and monocytes. 

Examination of cerebrospinal fluid (CSF) in patients with cryptococcal meningitis generally reveals an elevated opening pressure, CSF pleocytosis (usually lymphocytes), leukocytosis, a decreased CSF glucose, an elevated CSF protein, and a positive cryptococcal antigen. 

Relatively few reports have examined the benefits or perils of herb combinations. Because the activity of a particular herb in a mixture might differ from its activity as a single component, it would be prudent to test the effects of prescribed formulas. The potential for herbal formulae to affect the immune system are increasingly being found in the use of Kampo (Japanese herbal) medicinals as described in an excellent review by Borchers and colleagues. [94], For example, Shosaiko-to is a seven-herb mixture that has been shown to protect patients from viral hepatitis via modulation of several cytokines such as IFN-a/p, G-CSF, and TNF-a. Animal studies have been conducted to evaluate the immunomodulatory effects of the various herbs in Shosaiko-to. Interestingly, four of its individual constituents induced several-fold higher levels of TNF-a when... 

Recent studies have examined the separation of APP and Notch processing effects in vivo. Dibenzazepinone 29 (LY-411,575) demonstrates significant reductions in plasma, CSF, and brain A (3 in transgenic mice [80-83]. Several toxicities attributed to inhibition of Notch processing, including effects on the intestine, thymus, and spleen, have also been characterized. Doses associated with partial inhibition of cortical A (340 levels by 29 in mice did not cause intestinal changes... 

An understanding of this well-documented circulatory route for CSF will be expected in the examinations. 

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