Biomedical subjects
J Marcelis
Publications and source records attributed to J Marcelis.
Headache associated with changes in intracranial pressure.
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Idiopathic intracranial hypertension without papilledema.
We describe 10 patients with idiopathic intracranial hypertension who did not have papilledema. Idiopathic intracranial hypertension without papilledema, although rarely reported, may well be a clinically important headache syndrome. Historical and demographic features of patients with idiopathic intracranial hypertension without papilledema are similar to those of patients with papilledema. Obese women with chronic daily headache and symptoms of increased intracranial pressure, pulsatile tinnitus, history of head trauma or meningitis, an empty sella on imaging studies, or a headache that is unrelieved by standard therapy should have a diagnostic lumbar puncture. Findings from laboratory and neurologic investigations are normal in most patients with idiopathic intracranial hypertension without papilledema. Initial management should include removal of possible inciting agents, weight loss if applicable, and standard headache therapy. Lumbar puncture and diuretic therapy should precede a trial of corticosteroids. Surgery (lumboperitoneal or ventriculoperitoneal shunt or perhaps optic nerve sheath fenestration) may be indicated for prolonged incapacitating headache that is not responsive to medical management or lumbar puncture.
Spontaneous low cerebrospinal fluid pressure headache.
A 69 year old man presented with headache on arising and relieved with recumbency. His clinical presentation, laboratory data, response to treatment and radiographic evaluation were consistent with spontaneous low cerebrospinal fluid pressure from CSF hyperabsorption. Cisternography showed rapid accumulation in the kidneys and urinary bladder, without evidence of CSF leak. His headache was eventually controlled with two blood patches and oral caffeine.
A new selective medium for the culture of clostridia from human faeces.
A new selective medium, sulphite-polymixin-milk (SPM) agar, for the isolation of clostridia from faeces is described. This medium contains whole cow's milk, which favours the growth of clostridia over that of Bacteroides and Bifidobacterium spp., and only small amounts of colistin (10 micrograms/ml) for suppressing growth of coliforms. The alkaline end-products of clostridia give rise to yellow colonies on a red background which are easy to distinguish from the red colonies of other not completely inhibited bacteria. The medium is suitable for isolation of many clostridia species. Comparisons were made between SPM and several other media for recovery of clostridia. The detection limit on SPM agar was more than 10(3) below that on Reinforced Clostridia Agar (Oxoid CM101).