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guideline convulsive

Richard Wennberg, Carmen Hiploylee, Peter Tai, Charles H Tator
BACKGROUND: Epidemiologic studies have suggested that concussion, or mild traumatic brain injury (mTBI), is associated with a twofold or greater increase in relative risk for the development of post-traumatic epilepsy. To assess the clinical validity of these findings, we analyzed the incidence of epilepsy in a large cohort of post-concussion patients in whom concussion was strictly defined according to international guidelines. METHODS: A retrospective cohort study of 330 consecutive post-concussion patients followed by a single concussion specialist...
March 20, 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
Dong Il Chun, Sanghyeon Lee, Sung Hun Won, Jaeho Cho
RATIONALE: The operative procedure for Achilles tendon rupture is relatively simple, but venous thromboembolism is serious complication with a high incidence after Achilles tendon rupture. However, the guideline for thromboprophylaxis in Achilles tendon rupture is unclear. PATIENT CONCERNS: The patient was 32-year-old male and underwent Achilles tendon open repair surgery. He was healthy and there are no abnormal findings other than Achilles tendon rupture. At 3 weeks after operation, the episode of loss of consciousness with convulsive movement occurred...
November 2017: Medicine (Baltimore)
Nicholas O Kuhl, Aaron M Yengo-Kahn, Hannah Burnette, Gary S Solomon, Scott L Zuckerman
OBJECTIVES: The incidence of sport-related concussion (SRC) continues to rise. Presentations of concussed athletes vary from subtle symptoms to notable signs. Between the 4th and 5th iterations of the Concussion in Sport Group (CISG) guidelines, concussive convulsions were removed as a modifying factor, but little evidence or discussion supported this change. While considerable research exists regarding post-traumatic epilepsy in moderate to severe traumatic brain injury, convulsions following SRC are relatively understudied...
February 2018: Physician and Sportsmedicine
Abraham L Querido
Psychoactive drugs pose a risk to both the diver and his or her buddy. Little is known about the safety of diving with antidepressants. Amongst the potential interactions with the diving environment are: somnolence; convulsions; a bleeding tendency (potentially worsening decompression illness, DCI), alterations to glucose metabolism and psychiatric side effects. Fluoxetine may potentially reduce the inflammatory process associated with DCI. This article presents guidelines for recreational diving in combination with antidepressants...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Carsten Krüger, Monika Heinzel-Gutenbrunner, Mohammed Ali
BACKGROUND: Integrated Management of Childhood Illness (IMCI) is regarded as a standard public health approach to lowering child mortality in developing countries. However, little is known about how health workers adhere to the guidelines at the national level in sub-Saharan African countries. METHODS: Data from the Service Provision Assessment surveys of Namibia (NA) (survey year: 2009), Kenya (KE) (2010), Tanzania (TZ) (2006) and Uganda (UG) (2007) were analysed for adherence to the IMCI guidelines by health workers...
December 13, 2017: BMC Health Services Research
Philippe Chanson, Laurence Guignat, Bernard Goichot, Olivier Chabre, Dinane Samara Boustani, Rachel Reynaud, Dominique Simon, Antoine Tabarin, Damien Gruson, Yves Reznik, Marie-Laure Raffin Sanson
A diagnosis of adrenal insufficiency should be suspected in the presence of a number of non-specific symptoms (fatigue, anorexia, weight loss, hypotension, hyponatremia and hyperkalemia amongst adrenal causes of insufficiency). The diagnosis should be considered in case of pituitary disease or a state of shock. Treatment should be commenced immediately without waiting for confirmation from biochemical tests, which rely on cortisol level at 8am (expected to be low) and on ACTH level (expected to be high in the case of primary adrenal insufficiency)...
December 2017: Annales D'endocrinologie
James Braun, Elizabeth Gau, Stacy Revelle, Laurie Byrne, Abhay Kumar
BACKGROUND: This retrospective study analyzed benzodiazepine usage patterns in relation to guideline recommendations for the treatment of generalized convulsive status epilepticus (GCSE) as practiced by emergency medical services (EMS) and the emergency department (ED) of an inner-city hospital. Secondary outcomes of interest were adverse events and admission/discharge outcomes. METHODS: Records of all patients≥18years old diagnosed with GCSE between June 2012 and September 2015 and transported by EMS to our hospital ED were reviewed...
November 15, 2017: Journal of the Neurological Sciences
Kirsty A Houston, Jack G Gibb, Kathryn Maitland
Background : Diarrhoea complicates over half of admissions to hospital with severe acute malnutrition (SAM). World Health Organization (WHO) guidelines for the management of dehydration recommend the use of oral rehydration with ReSoMal (an oral rehydration solution (ORS) for SAM), which has lower sodium (45mmols/l) and higher potassium (40mmols/l) content than old WHO ORS. The composition of ReSoMal was designed specifically to address theoretical risks of sodium overload and potential under-treatment of severe hypokalaemia with rehydration using standard ORS...
2017: Wellcome Open Research
Anna C Seale, Christina W Obiero, Kelsey D Jones, Hellen C Barsosio, Johnstone Thitiri, Moses Ngari, Susan Morpeth, Shebe Mohammed, Gregory Fegan, Neema Mturi, James A Berkley
BACKGROUND: Neonatal mortality remains high in sub-Saharan Africa, and a third of deaths are estimated to result from infection. While coagulase-negative staphylococci (CoNS) are leading neonatal pathogens in resource-rich settings, their role, and the need for early anti-Staphylococcal treatment in empiric antibiotic guidelines, is unknown in sub-Saharan Africa. METHODS: We examined systematic clinical and microbiologic surveillance data from all neonatal admissions to Kilifi County Hospital (1998-2013) to determine associated case fatality and/or prolonged duration of admission associated with CoNS in neonates treated according to standard World Health Organization guidelines...
November 2017: Pediatric Infectious Disease Journal
Cecilia Ekéus, Karin Wrangsell, Sandra Penttinen, Katarina Åberg
OBJECTIVE: To investigate the association between complicated vacuum extraction (VE) deliveries and neonatal complications. METHODS: Observational study including data on the management of 596 consecutive VE-deliveries at 6 different birth clinics in Sweden in 2013. We used logistic regression to examine the association between a complicated VE and: extracranial bleeding, severe neonatal complication (intracranial hemorrhage and/or asphyxia/low Apgar score and/or convulsions, and/or encephalopathy), and brachial plexus injury...
July 10, 2017: Journal of Maternal-fetal & Neonatal Medicine
Stefano Tamburin, Marco Faccini, Rebecca Casari, Angela Federico, Laura Morbioli, Enrica Franchini, Luigi Giuseppe Bongiovanni, Fabio Lugoboni
High-dose benzodiazepine (BZD) dependence represents an emerging and under-reported addiction phenomenon and is associated with reduced quality of life. To date there are no guidelines for the treatment of high-dose BZD withdrawal. Low-dose slow flumazenil infusion was reported to be effective for high-dose BZD detoxification, but there is concern about the risk of convulsions during this treatment. We evaluated the occurrence of seizures in 450 consecutive high-dose BZD dependence patients admitted to our unit from April 2012 to April 2016 for detoxification with low-dose slow subcutaneous infusion of flumazenil associated with routine anticonvulsant prophylaxis...
October 2017: Journal of Psychopharmacology
Amit Agrawal, Anita Banergee
BACKGROUND: Neonatal seizures are the most common clinical manifestation of Central Nervous System (CNS) dysfunction and are associated with various neurological sequelae. There are currently no evidence-based guidelines for the management of neonatal seizures and currently used drugs such as phenobarbital, and phenytoin have limited efficacy and potential toxicities. Newer second line anticonvulsant, levetiracetam, has been used in refractory neonatal seizures despite limited data and off-label use...
October 16, 2017: Current Drug Metabolism
Adam Williamson, Scott Muir
Background and aims National guidelines outlining medical standards for fitness to drive are provided by The Driver and Vehicle Licensing Agency. We aimed to establish whether patients presenting with collapse or loss of consciousness received documented advice regarding driving restrictions, if appropriate for their working diagnosis. Methods and results A retrospective case note review was undertaken over a four-month period for emergency patients clinically coded as seizure/convulsion (R568) and collapse/syncope (R55X); 163 patients had a primary or working diagnosis on discharge that suggested driving status and restrictions could have been reviewed...
January 1, 2017: Scottish Medical Journal
Fahad A Bashiri, Muddathir H Hamad, Yasser S Amer, Manal M Abouelkheir, Sarar Mohamed, Amal Y Kentab, Mustafa A Salih, Mohammad N Al Nasser, Ayman A Al-Eyadhy, Mohammed A Al Othman, Tahani Al-Ahmadi, Shaikh M Iqbal, Ali M Somily, Hayfaa A Wahabi, Khalid J Hundallah, Ali H Alwadei, Raidah S Albaradie, Waleed A Al-Twaijri, Mohammed M Jan, Faisal Al-Otaibi, Abdulrahman M Alnemri, Lubna A Al-Ansary
No abstract text is available yet for this article.
April 2017: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
E Lw Fung, B Bh Fung
Convulsive status epilepticus is the most extreme form of seizure. It is a medical and neurological emergency that requires prompt and appropriate treatment. Treatment of convulsive status epilepticus is usually divided into stages/steps. The International League Against Epilepsy has released a new definition of status epilepticus that may help to unify the definition in future studies. Over the last few years new information has become available regarding its management. The Rapid Anticonvulsant Medication Prior to Arrival Trial demonstrated non-inferiority of intramuscular midazolam in early status epilepticus compared with intravenous lorazepam...
February 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
Elena Chiappini, Elisabetta Venturini, Giulia Remaschi, Nicola Principi, Riccardo Longhi, Pier-Angelo Tovo, Paolo Becherucci, Francesca Bonsignori, Susanna Esposito, Filippo Festini, Luisa Galli, Bice Lucchesi, Alessandro Mugelli, Gian Luigi Marseglia, Maurizio de Martino
OBJECTIVE: To review new scientific evidence to update the Italian guidelines for managing fever in children as drafted by the panel of the Italian Pediatric Society. STUDY DESIGN: Relevant publications in English and Italian were identified through search of MEDLINE and the Cochrane Database of Systematic Reviews from May 2012 to November 2015. RESULTS: Previous recommendations are substantially reaffirmed. Antipyretics should be administered with the purpose to control the child's discomfort...
January 2017: Journal of Pediatrics
Lin Shi
According to the seventh report of Joint National Committee (JNC 7), hypertensive emergency (HE), a kind of hypertensive crisis, is defined as a sudden and abrupt elevation in blood pressure so as to cause acute target organ dysfunctions, including central nervous system, cardiovascular system or kidneys. Patients with HE require immediate reduction in markedly elevated blood pressure. Currently, there are no international guidelines for children HE, so the JNC definition is commonly used. Hypertensive emergency in children is rare but a life-threatening emergency...
September 2016: Journal of Hypertension
Francesco Brigo, Nicola Luigi Bragazzi, Susanna Bacigaluppi, Raffaele Nardone, Eugen Trinka
BACKGROUND: Some guidelines or expert consensus indicate that intravenous (IV) lorazepam (LZP) is preferable to IV diazepam (DZP) for initial treatment of convulsive status epilepticus (SE). We aimed to critically assess all the available data on efficacy and tolerability of IV LZP compared with IV DZP as first-line treatment of convulsive SE. METHODS: Systematic search of the literature (MEDLINE, CENTRAL, EMBASE, to identify randomized controlled trials (RCTs) comparing IV LZP versus IV DZP used as first-line treatment for convulsive SE (generalized or focal)...
November 2016: Epilepsy & Behavior: E&B
Yusuke Toda, Mineo Yamazaki, Tomohiro Ota, Yosuke Fujisawa, Kazumi Kimura
A 64-year-old man with fever, appetite loss, and pain in the back of the neck visited our hospital. We diagnosed him as having bacterial meningitis because of pleocytosis of the cerebrospinal fluid, and started treatment with antibiotics. Multiple cerebral infarcts were found on brain MRI. We suspected that the origin of the bacterial meningitis was infective endocarditis, and administered Cefepime and Gentamicin according to the guidelines for treatment of infective endocarditis. Three days later, he became drowsy and had myoclonus and flapping of the extremities...
October 28, 2016: Rinshō Shinkeigaku, Clinical Neurology
Lin Shi
According to the seventh report of Joint National Committee (JNC 7), hypertensive emergency (HE), a kind of hypertensive crisis, is defined as a sudden and abrupt elevation in blood pressure so as to cause acute target organ dysfunctions, including central nervous system, cardiovascular system or kidneys. Patients with HE require immediate reduction in markedly elevated blood pressure. Currently, there are no international guidelines for children HE, so the JNC definition is commonly used. Hypertensive emergency in children is rare but a life-threatening emergency...
September 2016: Journal of Hypertension
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