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Parietal Lobe

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181. Dementia

) elevated CSF tau, total tau, and phosphorylated tau; 2) decreased fluorine-18-2-fluoro-2-deoxy-D-glucose (FDG) uptake on PET in temporoparietal cortex; and 3) disproportionate atrophy on structural MRI in medial, basal, and lateral temporal lobe and medial parietal cortex. In persons who meet the core clinical criteria for probable AD dementia, biomarker evidence may increase the certainty that the basis of the clinical dementia syndrome is the AD pathophysiological process. The recommendations (...) on the frontal cortex in early FTD [46]. MR spectroscopy could be a helpful secondary test in patients who have clinical findings of FTD, but it is not a first-line imaging test. MRI Functional (fMRI) Head Brain activation has been shown to be significantly decreased in FTD in the frontal and parietal lobes compared with AD [47]. Resting state fMRI demonstrates alterations in structural and functional connectivity in presymptomatic FTD [48]. However, fMRI remains in the realm of research

2019 American College of Radiology

183. Guidelines on autopsy practice: Fetal autopsy (2nd trimester fetal loss and termination of pregnancy for congenital anomaly)

and genitalia · T- or Y-shaped skin incision on body · Central nervous system (CNS) examination: median posterior or transverse posterior parietal scalp incision observation of maturity to assist gestational assessment consider removal under water if suspected CNS malformation (including ventriculomegaly), examination of posterior fossa structures by posterior approach. Consider referring the whole central nervous system for neuropathological examination in appropriate cases. This may include sampling (...) ) will usually produce sufficient fixation to allow adequate sectioning and block sampling to allow the brain to be returned to the body before release for funeral. If there is doubt consult the local neuropathology team. [Level of evidence: GPP] 11 Histological examination Recommended blocks required at full autopsy: 9 · thymus · heart (septum and free walls) · lungs (right and left each lobe) · liver (both major lobes) · pancreas · spleen · adrenal glands CEff 150617 9 FINAL v1 · kidneys · muscle

2017 Royal College of Pathologists

184. Guidelines on autopsy practice: Third trimester antepartum and intrapartum stillbirth

at full autopsy: 8 CEff 150617 9 V1 Draft · thymus · heart (septum and free walls) · lungs (right and left each lobe) · liver (both major lobes) · pancreas · spleen · adrenal glands · kidneys · muscle and diaphragm · stomach, small and large bowels · larynx/trachea and thyroid · bone: rib including growth plate in stillbirth; long bone (including growth plate), vertebral body and skull mandatory for suspected skeletal dysplasia · brain: if preservation allows include cerebral cortex (...) and periventricular white matter (frontal, parietal, temporal and occipital), deep grey matter (caudate, striatum, thalamus), hippocampus, midbrain (inferior colliculi), pons, medulla (inferior olives), cerebellum with dentate nucleus. Sampling may by necessity be more restricted if there is advanced autolysis · other organ lesions as appropriate · placenta (at least three full-thickness blocks, plus focal lesions) · membrane roll · umbilical cord (at least two). [Level of evidence D.] A record of the samples

2017 Royal College of Pathologists

185. EANM-EAN recommendations for the use of brain 18F-Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) in neurodegenerative cognitive impairment and dementia: Delphi consensus Full Text available with Trip Pro

parietal, AUC = 0.69, P = 0.045) . A trend was also observed for AD‐memory dominant cases, with AUC = 0.65 ( P = 0.062) for hypometabolism in bilateral inferior frontal, cuneus and inferior temporal, and right inferior parietal. The logopenic variant of PPA and typical AD dementia could be discriminated (AUC = 0.89) based on the right medial temporal and posterior cingulate gyri, the left inferior, middle and superior temporal lobes, and left supramarginal gyrus . Patients with posterior cortical (...) or in the infrequent DLB cases with a normal pre‐synaptic dopaminergic imaging. The inclusion of FDG‐PET in the new criteria for DLB as a supportive biomarker (a scan not showing hypometabolism in the occipital lobes does not exclude DLB) also contributed to the panellists’ decision. FDG‐PET to differentiate AD from FTLD (PICO 9) Critical outcomes were available in five of the examined papers . These papers found 80%–99% sensitivity range, 63%–98% specificity range, 87%–89.2% accuracy range , - , 0.91–0.97 AUC

2018 European Academy of Neurology

189. Effects of drinking on late-life brain and cognition Full Text available with Trip Pro

for these actions is thought to include NMDA and GABA-A receptors. High doses of alcohol acutely reduce prefrontal and temporal lobe function, including planning, verbal fluency, memory and complex motor control including cerebellar function. The pattern of impairment has been compared with that seen in hippocampal damage. Excessive alcohol consumption can also lead to a number of conditions with psychiatric symptoms, including psychotic disorders and delirium. In this review we focus on structural brain (...) validation. Thresholds are likely to be different according to sex, comorbid conditions and genetic susceptibility. Effects on brain structure Brain atrophy in chronic alcoholism is well described. The frontal lobes are thought to be particularly vulnerable. Kril et al found frontal cortex reductions of 23% in uncomplicated alcoholism, replicating earlier findings. MRI studies have also reported widespread cortical atrophy, which may particularly affect the frontal lobes. Interestingly, longitudinal MRI

2018 Evidence-Based Mental Health

192. CRACKCast E101 – Stroke

by the anterior and posterior circulations. The anterior circulation originates from the carotid system and perfuses 80% of the brain, including the optic nerve, retina, and fronto-parietal and anterior-temporal lobes. The first branch off the internal carotid artery is the ophthalmic artery, which supplies the optic nerve and retina. As a result, the sudden onset of painless monocular blindness (amaurosis fugax) identifies the stroke as involving the anterior circulation (specifically the ipsilateral carotid (...) . The brainstem also contains the reticular activating system, which is responsible for mediating consciousness, and the emesis centers. Unlike those with anterior circulation strokes, patients with posterior circulation stroke can have loss of consciousness and frequently have nausea and vomiting. The posterior cerebral artery supplies portions of the parietal and occipital lobes, so vision and thought processing are impaired. One of the more curious facets of this syndrome is that the patient may be unaware

2017 CandiEM

193. Management of Brain Arteriovenous Malformations: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association Full Text available with Trip Pro

seizures. Multivariate logistic regression showed that clinical presentation with seizures correlated with a location in the temporal and frontal lobes and with a superficial topography. The strongest association (OR, 3.48; 95% CI, 1.77–6.85) was observed between seizures and bAVM location in the temporal lobe. A study of 302 consecutive patients with unruptured bAVMs added superficial venous drainage and presence of varices in the venous drainage as features associated with seizures ( P =0.005 and P (...) (anterior, middle, or posterior) cerebral divisions had lower risk of ICH (OR, 0.40; P <0.001). The authors noted positive associations with ICH for bAVM size (OR, 0.96; P <0.001), solely deep venous drainage (OR, 3.19; P <0.001), and associated aneurysm (OR, 2.72; P <0.001). Using DSA-based evaluation, Shankar et al reviewed 78 patients with nonhemorrhagic bAVMs presenting with (n=33) and without (n=45) seizures for distinguishing angioarchitectural features. They noted location (frontal, parietal

2017 American Heart Association

194. Management of brain arteriovenous malformations

patients with nonhemorrhagic bAVMs presenting with (n=33) and without (n=45) seizures for distinguishing angioarchitectural features. They noted location (frontal, parietal, temporal lobe; OR, 4.52; 95% CI, 0.95–21.47), venous outflow stenosis (OR, 6.71; 95% CI, 1.99–22.56), and long (>3-cm superficial course) pial draining vein (OR, 5.71; 95% CI, 1.32–24.56). The authors enumerated these values as a 3-point score with a receiver-operating characteristic curve of 0.841 (95% CI, 0.749–0.933 (...) -year risk of developing epilepsy after a first seizure was 58%. , One prospective observational study collected records of 101 consecutive patients with unruptured and ruptured bAVMs during a 10-year period and compared patients with and without seizures. Multivariate logistic regression showed that clinical presentation with seizures correlated with a location in the temporal and frontal lobes and with a superficial topography. The strongest association (OR, 3.48; 95% CI, 1.77–6.85) was observed

2017 American Academy of Neurology

197. Magnetic resonance imaging measures of brain atrophy from the EXPEDITION3 trial in mild Alzheimer's disease. Full Text available with Trip Pro

centrally by tensor-based morphometry with a standard FreeSurfer brain parcellation. Prespecified volumetric measures, including whole brain and ventricles, along with anatomically localized regions in the temporal, parietal, and frontal lobes were evaluated in those participants.Group-mean differences in brain atrophy rates were directionally consistent across a number of brain regions but small in magnitude (1.3-6.9% slowing) and not statistically significant when corrected for multiple comparisons

2019 Alzheimer's & dementia (New York, N. Y.) Controlled trial quality: uncertain

198. Neuroimaging Findings in US Government Personnel With Possible Exposure to Directional Phenomena in Havana, Cuba. Full Text available with Trip Pro

significantly greater ventral diencephalon and cerebellar gray matter volumes and significantly smaller frontal, occipital, and parietal lobe white matter volumes; significantly lower mean diffusivity in the inferior vermis of the cerebellum (patients: 7.71 × 10-4 mm2/s; controls: 8.98 × 10-4 mm2/s; difference, -1.27 × 10-4 [95% CI, -1.93 × 10-4 to -6.17 × 10-5] mm2/s; P < .001); and significantly lower mean functional connectivity in the auditory subnetwork (patients: 0.45; controls: 0.61; difference

2019 JAMA

199. Akynzeo (netupitant / palonosetron)

. Gall bladder: microscopic signs of phospholipidosis NOAEL: 200 mg/kg B-167720 (non-GLP) Dog/ beagle 1/sex/group 3, 10, 30, 30, 60, 100 and 150; escalating dose design Oral 150 mg/kg None Slight or moderate parietal cell necrosis in the glandular stomach. Minimal vacuolated macrophage infiltration in lymphoid tissues and lungs indicates minimal phospholipidosis. Four single dose studies in mice, rats and dogs. The major toxicity findings included death, microscopic changes in multiple organs (...) and this was agreed by the CHMP. Administration of netupitant to rabbits during the period of organogenesis was shown to increase the incidence of some foetal malformations: limb and paw positional anomalies, minimal/partial fusion of sternebrae, and agenesis of accessory lung lobe. The NOAEL for embryo-fetal development is 3 mg/kg/day. Taking into account the teratogen effect of netupitant in rabbit without a safety margin, a contraindication of AKYNZEO during pregnancy with a contraception measure for women

2015 European Medicines Agency - EPARs

200. Anaemia - B12 and folate deficiency

(IF), which is produced by parietal cells in the stomach, to form an IF–B12 complex. The complex binds to surface receptors for IF in the distal ileum, which then allows absorption of vitamin B12 to take place. (an autoimmune disorder which results in reduced production of IF) is the most common cause of severe vitamin B12 deficiency. Other causes of vitamin B12 deficiency are rare, but include: Drugs — colchicine, metformin, nitrous oxide, protein pump inhibitors, H2-receptor antagonists. Gastric — total (...) , vegan diet. [ ; ; ] Pernicious anaemia Pernicious anaemia Pernicious anaemia is caused by an autoimmune process which affects the gastric mucosa, leading to atrophy. This atrophy reduces the number of parietal cells which secrete intrinsic factor (IF). IF is essential for absorption of vitamin B12. Antibodies to IF are very specific for pernicious anaemia, however they are only present in around 50% of people. Anti-parietal cell antibodies occur in 90% of people with pernicious anaemia, however

2019 NICE Clinical Knowledge Summaries

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