Friday, October 19, 2018

Velum interpositum

https://radiopaedia.org/articles/velum-interpositum

The velum interpositum is a small membrane containing a potential space just above and anterior to the pineal gland which can become enlarged to form a cavum velum interpositum.

Gross anatomy
The velum interpositum is formed by an invagination of pia mater forming a triangular membrane the apex of which points anteriorly.

Boundaries
superiorly: the columns of the fornices and hippocampal commissure (psalterium) reaching as far forward as the foramen of Monro
inferiorly: the internal cerebral veins and tela choroidea of the third ventricle
inferolaterally: the thalamus
posteriorly: the narrow base of the triangle abuts the splenium of the corpus callosum 1

It varies in shape from persion to person, sometimes interposed between the internal cerebral veins and splenium, and depending on whether or not there is a cavum vergae (in which case the columns of the fornices are displaced inferiorly, narrowing the velum interpositum).

When somewhat distended by fluid it forms a small triangular (in axial section) space and is referred to as a cavum velum interpositum. If larger and exterting mass effect it is known as a cavum velum interpositum cyst.

Image result for velum interpositum

Normal values for serum albumin in pregnancy


https://academic.oup.com/tropej/article/28/4/193/1695011


https://www.ncbi.nlm.nih.gov/pubmed/7507040
Early Hum Dev. 1993 Oct;34(3):209-15.
Albumin levels in pregnancy: a hypothesis--decreased levels of albumin are related to increased levels of alpha-fetoprotein.

Maher JE1, Goldenberg RL, Tamura T, Cliver SP, Hoffman HJ, Davis RO, Boots L.
Department of Obstetrics and Gynecology, University of Alabama at Birmingham 35233-7333.

Abstract
Serum albumin levels decrease during pregnancy while the concentration of most other maternal serum proteins of hepatic origin remain stable or increase. In a study of 289 women, most maternal characteristics such as race, age, smoking, a history of previous low birth-weight, infant sex and gestational age at delivery were not related to maternal serum albumin levels at 18 or 30 weeks' gestational age. The degree of maternal obesity significantly correlated with the concentration of albumin. There was a significant negative correlation in individual women between maternal serum levels of albumin and alpha-fetoprotein, with high levels of maternal serum alpha-fetoprotein predicting lower levels of albumin. We hypothesize that there may be a negative feedback effect of alpha-fetoprotein of fetal origin on the maternal production of albumin during pregnancy.
PMID: 7507040

Sunday, September 16, 2018

Pathergy (Uptodate)

Pathergy refers to an erythematous papular or pustular response to local skin injury. It is defined as a pustule-like lesion or papule that appears 48 hours after skin prick by a 20-gauge needle. Pathergy is less common in North American and North European patients with Behçet syndrome (10 to 20 percent) than in patients from more endemic areas (50 to 75 percent) [32]. Dermographism is a response to light scratching of the skin that may be present in some patients [33]. A vascular pathergy-like response may be evident after vascular procedures, resulting in phlebitis or aneurysms [34,35]. Reference 32-35 is 1-4.

  1. Assar S, Sadeghi B, Davatchi F, et al. The association of pathergy reaction and active clinical presentations of Behçet's disease. Reumatologia 2017; 55:79.
  2. Dinç A, Karaayvaz M, Caliskaner AZ, et al. Dermographism and atopy in patients with Behçet's disease. J Investig Allergol Clin Immunol 2000; 10:368.
  3. Lê Thi Huong D, Wechsler B, Papo T, et al. Arterial lesions in Behçet's disease. A study in 25 patients. J Rheumatol 1995; 22:2103.
  4. O'Duffy JD. Vasculitis in Behçet's disease. Rheum Dis Clin North Am 1990; 16:423.

Sunday, August 26, 2018

Valproate reduces stroke risk?

Stroke 2018; 49: 54-61
Brooke's RL et al, from the Stroke Research Group
Histone deacetylase inhibitor
Variant of a histone deacetylase gene is associated with large artery stroke (HDAC9)
Sodium Valproate is a non specific inhibitor of HDAC9