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At least 1,711 records · Page 95Linked to original sources

PubMed1979

DDAVP, a synthetic analogue of vasopressin, in prevention of headache after lumbar puncture and lumbar pneumoencephalography.

In a double-blind controlled trial the possible prophylactic effect of intranasally applicated DDAVP (1-desamino-8-arginine vasopressin, Minurin)--a synthetic analogue of vasopressin--is evaluated regarding the incidence of headache following lumbar puncture (LBP) in 51 patients and following pneumoencephalography (PEG) in 28 patients. DDAVP had no statistically significant effect on the incidence of headache or on the consumption of analgesics in the DDAVP-versus placebo groups (minimal relevant difference = 50%, 2 alpha = 0.05, beta = 0.50).

Adult↗

PubMed1995

High acceptability and low morbidity of diagnostic lumbar puncture in elderly subjects of mixed cognitive status.

A total of 273 participants (186 with clinical dementia; 87 "normal" controls; mean age 72 years) in a prospective, longitudinal, dementia research study, underwent lumbar puncture (LP), where possible, on an annual basis. Reporting of symptoms after all LP's (n = 541) was 21.6%, the predominant complaints being mild localised back-pain (12.8%) and headache (10.7%). All symptoms were self-limiting. Analysis of headaches after all first LP's (n = 273) revealed an incidence of 14.2% with marked differences between subjects under 60 years of age (33%) and those over 60 years (10.1%), between subjects with "minimal" cerebral atrophy (19.5%) and those with "significant" atrophy (5.6%) and, to a lesser extent, between subjects with no or mild cognitive impairment (20.6%) and those with significant impairment (9.5%). Age under 60 years and lack of significant cerebral atrophy were shown to be independent predictors of headache. Acceptability of LP was high as demonstrated by agreement to a second procedure by 92.2% of eligible subjects. Our results show that LP can be successfully incorporated into research with the elderly.

Adult↗

PubMed1977

Percutaneous cardiac puncture in domestic pigs.

Blood sampling by percutaneous cardiac puncture was carried out in 69 domestic pigs. The procedure was shown to be safe and to produce reproducible data. The technique can be carried out without anaesthesia. Repeated sampling is possible over minutes, hours or days, and a wide range of sample volumes can be achieved by this technique.

Animals↗

PubMed1967

Amnesic effects of small bilateral brain puncture in the mouse.

A small acute brain puncture produced retrograde amnesia in a passive avoidance learning situation in mice. If injury to the hippocampus was inflicted either immediately, 1 hour after the learning, or 1 hour before the learning, the animals showed a retention deficit; the degree of this deficit was related to the time interval. No effect of this injury was observed on retest performance when the animals were treated as long as 6 hours before or after the learning trial.

Amnesia↗

PubMed2001

In vitro activities of ABT-773, a new ketolide, against aerobic and anaerobic pathogens isolated from antral sinus puncture specimens from patients with sinusitis.

The comparative in vitro activities of ABT-773 against 207 aerobic and 162 anaerobic antral sinus puncture isolates showed that erythromycin-resistant pneumococcal strains were susceptible to ABT-773 (< or =0.125 microg/ml); the MIC at which 90% of the isolates tested were inhibited for Haemophilus influenzae and other Haemophilus spp. was 4 microg/ml; and all Moraxella spp. and beta-lactamase-producing Prevotella species strains were inhibited by < or =0.125 microg/ml. Among the anaerobes tested, only fusobacteria (45%) required > or =4 microg of ABT-773/ml for inhibition. ABT-773 may offer a therapeutic alternative for sinus infections.

Adult↗

PubMed1995

Pattern of cytokines and pharmacomodulation in sepsis induced by cecal ligation and puncture compared with that induced by endotoxin.

The production of tumor necrosis factor alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), and IL-6 and their pharmacomodulation were evaluated in a model of polymicrobial sepsis induced in mice by cecal ligation and puncture (CLP) and were compared with the effects of endotoxin (lipopolysaccharide [LPS]) treatment. LPS levels rose as early as 1 h after CLP and increased further after 2 and 21 h. TNF-alpha was detectable in serum, spleen, liver, and lungs during the first 4 h, with a peak 2 h after CLP. IL-1 beta was measurable in serum after 24 h, and levels increased significantly in spleen and liver 4 and 8 h after CLP. IL-6 levels increased significantly in serum throughout the first 16 h after CLP. These cytokines were detectable after LPS injection, with kinetics similar to those after CLP but at a significantly higher level. To cast more light on the differences between these two animal models of septic shock, we studied the effects of different reference drugs. Pretreatment with dexamethasone (DEX); ibuprofen (IBU), an inhibitor of cyclooxygenase; and NG-nitro-L-arginine, an inhibitor of nitric oxide synthase, significantly reduced survival, while chlorpromazine (CPZ) and TNF did not affect it. Only the antibiotics and pentoxifylline significantly increased survival in mice with CLP. However, CPZ and DEX protected the mice from LPS mortality. On inhibiting TNF-alpha with DEX, CPZ, or pentoxifylline, survival was reduced, unchanged, and increased, respectively, and on increasing TNF-alpha with IBU and TNF, survival was decreased or unchanged, respectively, suggesting that the modulation of this cytokine does not play a significant role in sepsis induced by CLP, unlike treatment with LPS. The negative effects of IBU and N(G)-nitro-L-arginine suggest a protective role by prostaglandins and nitric oxide in sepsis induced by CLP.

Animals↗

PubMed2001

Effects of calorie restriction on polymicrobial peritonitis induced by cecum ligation and puncture in young C57BL/6 mice.

Calorie restriction (CR) is known to prolong the life span and maintain an active immune function in aged mice, but it is still not known if rodents under CR can respond optimally to bacterial infection. We report here on the influence of CR on the response of peritoneal macrophages to lipopolysaccharide, splenic NF-kappaB and NF-interleukin-6 (IL-6) activities, and mortality in polymicrobial sepsis induced by cecal ligation and puncture (CLP). Macrophages from 6-month-old C57BL/6 mice on a calorie-restricted diet were less responsive to lipopolysaccharide, as evidenced by lower levels of IL-12 and IL-6 protein and mRNA expression. Furthermore, in vitro lipopolysaccharide-stimulated macrophages from mice under CR also expressed decreased lipopolysaccharide receptor CD14 levels as well as Toll-like receptor 2 (TLR2) and TLR4 mRNA levels. In addition, the phagocytic capacity and class II (I-A(b)) expression of macrophages were also found to be significantly lower in mice under CR. Mice under CR died earlier (P < 0.005) after sepsis induced by CLP, which appeared to be a result of increased levels in serum of the proinflammatory cytokines tumor necrosis factor alpha and IL-6 and splenic NF-kappaB and NF-IL-6 activation 4 h after CLP. However, mice under CR survived significantly (P < 0.005) longer than mice fed ad libitum when injected with paraquat, a free radical-inducing agent. These data suggest that young mice under CR may be protected against oxidative stress but may have delayed maturation of macrophage function and increased susceptibility to bacterial infection.

Aging↗

PubMed1992

Lipopolysaccharide-tumor necrosis factor-glucocorticoid interactions during cecal ligation and puncture-induced sepsis in mature versus senescent mice.

Previous work in our laboratory demonstrated increased sensitivity of senescent (24-month-old) mice to cecal ligation and puncture (CLP) sepsis compared with that of mature (12-month-old) mice. In this study the median lethal dose of the strain of Escherichia coli most frequently isolated during CLP sepsis was determined. No significant age-associated difference in the mean lethal dose or the mean survival time was noted; however, sham surgery before injection of E. coli decreased the mean lethal dose by at least 100-fold. With surgical manipulation, the average time to death after bacterial injection simulated more closely that observed after CLP surgery. Host responses to CLP sepsis were investigated by measuring the levels of corticosterone, glucose, and tumor necrosis factor (TNF) in the sera of mature and senescent mice at 2-h intervals after surgery. Corticosterone levels increased gradually during the course of sepsis in mature mice; however, senescent mice demonstrated a pronounced elevation in hormone levels at 2 and 4 h after surgery. At subsequent sampling intervals the corticosterone levels remained elevated, although they were similar for both ages. At all sampling intervals, the glucose levels in serum were lower in senescent mice than in mature mice. Pronounced hypoglycemia (less than 80 mg/dl) was observed in senescent mice at 8 h postsurgery. TNF was detected in serum within a narrow time frame in both age groups at 6, 8, and 10 h postsurgery. Although elevated TNF levels in serum were not seen in every mouse in each group (approximately 50%), the data hinted that senescent animals produced larger quantities of TNF during CLP sepsis than did mature animals. E. coli lipopolysaccharide (1 mg/kg) was injected intraperitoneally, and the TNF levels in serum and peritoneal lavage fluid were measured at 30, 60, and 90 min. Senescent mice demonstrated a level of TNF in serum at 90 min after lipopolysaccharide treatment that was 20-fold higher than that of mature mice (299,877 pg/ml versus 15,594 pg/ml). The amount of TNF produced locally in the peritoneum was also substantially higher in senescent mice than in mature animals (1,716 pg/ml versus 776 pg/ml). The increased production of TNF in senescent animals, despite elevated circulating corticosterone levels, suggested an age-related defect in glucocorticoid-directed downregulation of TNF production. This was confirmed in lipopolysaccharide-treated animals given exogenous dexamethasone.(ABSTRACT TRUNCATED AT 400 WORDS)

Aging↗

PubMed1992

Recovery of intralipid from lumbar puncture after migration of saphenous vein catheter.

A term female infant was admitted to the intensive care unit with the diagnosis of tetralogy of Fallot with critical pulmonary stenosis. On the seventh day of life a long saphenous line was inserted that remained without complications until seven days later when the infant appeared septic. A lumbar puncture demonstrated the presence of intra-lipid in the cerebrospinal fluid that we interpreted as due to migration of the saphenous catheter. The child had an uneventful recovery.

Catheters, Indwelling↗

PubMed1997

Depth of insertion of a lumbar puncture needle.

The depth of lumbar puncture needle insertion was recorded in 107 children. Height provided the best guide to the minimum and maximum depths of insertion. Mean depth of insertion (cm) = 0.03 x height of child (cm).

Adolescent↗

PubMed2007

Cystoid puncture for chronic cystoid macular oedema.

OBJECTIVE: To evaluate the new surgical technique of cystoid macular oedema puncture (CMOP) in patients with longstanding cystoid macular oedema refractory to standard treatments. DESIGN: Interventional, retrospective case series METHODS: Retrospective review of patients with chronic cystoid macular oedema from vascular retinopathy for whom maximal medical or surgical treatment failed and who underwent pars plana vitrectomy and CMOP. Clinical findings, best-corrected Snellen visual acuity, stereo colour fundus photography, intravenous fluorescein angiograms, and optical coherence tomography were obtained before and after treatment to evaluate the efficacy and safety of the treatment. RESULTS: Seven patients were included in the study. Cystoid macular oedema was due to diabetic retinopathy in five patients, central retinal vein occlusion in one patient and branch retinal vein occlusion in one patient. Preoperative intravitreal steroids failed for all patients, and three patients also had focal grid photocoagulation. Previous pars plana vitrectomy, with elevation of the posterior hyaloid, internal limiting membrane peeling, and intravitreal steroid injection, had failed in three patients. The median time to CMOP was 488 days. Resolution or improvement of cystoid oedema occurred in all patients as determined by fluorescein angiography or optical coherence tomography, or both. However, visual acuity was unchanged in five patients, declined in one patient and stable in one patient. CONCLUSIONS: Although cystoid macular oedema does improve quantitatively after CMOP, the technique fails to improve visual acuity in patients.

Aged↗

PubMed1973

Renal puncture in infancy.

Renal puncture was used in the diagnosis of five infants with suspected cystic disease of the kidney. This technique is simple and it may provide information that may otherwise be difficult to obtain.

Female↗

PubMed1968

Vasopressin in prevention of lumbar puncture headache.

A double-blind controlled trial of aqueous vasopressin injection (Pitressin) in the prophylaxis of lumbar puncture reactions in 50 patients showed that the incidence of reactions was unaffected, but that severe reactions occurred less frequently in the treatment group. Moderately severe side-effects occurred in 27% of those receiving vasopressin.

Clinical Trials as Topic↗

PubMed2002

Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Bed rest after lumbar puncture.

A short cut review was carried out to establish whether a period of bed rest reduces the incidence of headache or other complications in patients undergoing diagnostic lumbar puncture. Altogether 85 papers were found using the reported search, of which five presented the best evidence to answer the clinical question. The author, date, and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Bed Rest↗

PubMed2005

Best evidence topic report: reinsertion of the stylet before needle removal in diagnostic lumbar puncture.

A short cut review was carried out to establish whether re-insertion of the stylet before needle removal changed the incidence of post-lumbar puncture syndrome and headache. Altogether 235 papers were found using the reported search, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Adult↗

PubMed2005

Best evidence topic report. Timing of lumbar puncture in suspected subarachnoid haemorrhage.

A short cut review was carried out to establish how long after onset of headache a lumbar puncture should be carried out to rule out subarachnoid haemorrhage. Altogether 142 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this best paper are tabulated. A clinical bottom line is stated.

Evidence-Based Medicine↗

PubMed2005

Best evidence topic report. Topical analgesia for pain reduction in arterial puncture.

A short cut review was carried out to establish whether topical local anaesthetic reduces the pain of arterial puncture. 431 papers were found using the reported search, of which two presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.

Administration, Topical↗

PubMed1961

The rate of blood loss from skin punctures during the Ivy bleeding time test.

The rate of blood loss from skin punctures during the performance of the Ivy bleeding time test has been measured by a simple technique in normal individuals, in patients without defects of the haemostatic or coagulation system, and in patients with known haemorrhagic disorders.A wide range was found in normal individuals, but repeated tests on a single individual showed a smaller variation. Nearly half of the tests on patients with von Willebrand's disease, thrombocytopenia, ;capillary type' of bleeding, or haemorrhagic renal failure gave abnormally high rates of blood loss. Haemophilic, Christmas disease, and Dinedevan-treated patients gave low volumes and rates of blood loss.A group of patients has been encountered in whom the bleeding time was normal but the rate of blood loss was increased. The majority of these had haemorrhagic symptoms and other evidence of a defective haemostatic or coagulation system. It is suggested that a consideration of the rate of blood loss in those patients with a normal bleeding time gives additional help in interpreting the Ivy test. A high rate may indicate the need for further investigation of the haemostatic and coagulation system.

Bleeding Time↗