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https://www.readbyqxmd.com/read/28818179/multiple-trauma-and-emergency-room-management
#1
Michael Frink, Philipp Lechler, Florian Debus, Steffen Ruchholtz
BACKGROUND: The care of severely injured patients remains a challenge. Their initial treatment in the emergency room is the essential link between first aid in the field and definitive in-hospital treatment. METHODS: We present important elements of the initial in-hospital care of severely injured patients on the basis of pertinent publications retrieved by a selective search in PubMed and the current German S3 guideline on the care of severely and multiply traumatized patients, which was last updated in 2016...
July 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28816870/spinal-cord-injury-what-are-the-controversies
#2
Christopher S Ahuja, Gregory D Schroeder, Alexander R Vaccaro, Michael G Fehlings
Traumatic spinal cord injuries have a tremendous impact on individuals, families, and society as a whole. Substantial heterogeneity in the patient population, their presentation and underlying pathophysiology has sparked debates along the care spectrum from initial assessment to definitive treatment. This article reviews spinal cord injury (SCI) management followed by a discussion of the salient controversies in the field. Current care practices modeled on the American Association of Neurological Surgeons/Congress of Neurological Surgeons joint section guidelines are highlighted including key recommendations regarding immobilization, avoidance of hypotension, early International Standards for Neurological Classification of SCI examination and intensive care unit treatment...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28807062/neuropsychiatric-characteristics-of-antiterrorist-operation-combatants-in-the-donbass-ukraine
#3
Konstantin N Loganovsky, Natalia A Zdanevich, Marina V Gresko, Donatella Marazziti, Tatiana K Loganovskaja
OBJECTIVE: The present paper aimed to explore the neuropsychiatric characteristics of the antiterrorism (ATO) combatants in the Donets Basin (Donbass) and to propose therapeutic strategies for managing their mental healthcare. METHODS: A total of 54 ATO combatants were included in our study and compared with four groups of subjects exposed to other emergencies, including the Chernobyl disaster and the war in Afghanistan. The neuropsychiatric features were assessed through psychopathological assessments, neurological examinations, and quantitative electroencephalography (qEEG)...
August 15, 2017: CNS Spectrums
https://www.readbyqxmd.com/read/28735260/aetiological-investigations-in-early-developmental-impairment-are-they-worth-it
#4
Anthony Richard Hart, Ruchi Sharma, Mark Atherton, Samer Alabed, Sally Simpson, Stuart Barfield, Judith Cohen, Nicholas McGlashan, Asha Ravi, Michael James Parker, Daniel Ja Connolly
OBJECTIVE: To study the frequency a diagnosis is made in children with early developmental impairment (EDI), and the contribution made to diagnosis by specific investigations. DESIGN: Retrospective case note review. SETTING: Community, neurodisability and neurology department at a UK tertiary centre. PARTICIPANTS: Children referred to determine the aetiology of EDI where a cause was not evident on history and examination...
July 22, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28716324/identifying-patients-with-high-risk-neurogenic-bladder-beyond-detrusor-leak-point-pressure
#5
REVIEW
Elizabeth V Dray, Anne P Cameron
More than 12,000 spinal cord injuries occur annually in the United States; more than 80% of these individuals will experience urinary tract dysfunction. Despite the clinical demand, there is a paucity of guidelines for the care of these patients. Although most urologists are familiar with dangerous urodynamic parameters and the benefits of clean intermittent catheterization, these patients face a myriad of risks that may go unrecognized. In this article, the authors discuss the impact of specific neurologic diseases on the urinary tract, examine the risks inherent to each, and determine strategies for screening, prevention, and treatment of these complications...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28715518/early-accurate-diagnosis-and-early-intervention-in-cerebral-palsy-advances-in-diagnosis-and-treatment
#6
Iona Novak, Cathy Morgan, Lars Adde, James Blackman, Roslyn N Boyd, Janice Brunstrom-Hernandez, Giovanni Cioni, Diane Damiano, Johanna Darrah, Ann-Christin Eliasson, Linda S de Vries, Christa Einspieler, Michael Fahey, Darcy Fehlings, Donna M Ferriero, Linda Fetters, Simona Fiori, Hans Forssberg, Andrew M Gordon, Susan Greaves, Andrea Guzzetta, Mijna Hadders-Algra, Regina Harbourne, Angelina Kakooza-Mwesige, Petra Karlsson, Lena Krumlinde-Sundholm, Beatrice Latal, Alison Loughran-Fowlds, Nathalie Maitre, Sarah McIntyre, Garey Noritz, Lindsay Pennington, Domenico M Romeo, Roberta Shepherd, Alicia J Spittle, Marelle Thornton, Jane Valentine, Karen Walker, Robert White, Nadia Badawi
Importance: Cerebral palsy describes the most common physical disability in childhood and occurs in 1 in 500 live births. Historically, the diagnosis has been made between age 12 and 24 months but now can be made before 6 months' corrected age. Objectives: To systematically review best available evidence for early, accurate diagnosis of cerebral palsy and to summarize best available evidence about cerebral palsy-specific early intervention that should follow early diagnosis to optimize neuroplasticity and function...
July 17, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28697713/an-update-of-the-italian-stroke-organization-stroke-prevention-awareness-diffusion-group-guidelines-on-carotid-endarterectomy-and-stenting-a-personalized-medicine-approach
#7
Gaetano Lanza, Carlo Setacci, Stefano Ricci, Patrizio Castelli, Alberto Cremonesi, Jessica Lanza, Claudio Novali, Carlo Pratesi, Paola Santalucia, Francesco Speziale, Augusto Zaninelli, Gian Franco Gensini
Although proof-based medicine has generated much valid evidence for the drawing up of guidelines and recommendations for best clinical practice in symptomatic and asymptomatic carotid stenosis, whether and when it is better to employ endarterectomy or stenting as the intervention of choice still remain matters of debate. Moreover, guidelines have been targeted up to now to the 'representative' patient, as resulting from the statistical analyses of the studies conducted on the safety and efficacy of both interventions as well as on medical therapy alone...
July 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28697652/ask-the-experts-how-to-treat-individuals-with-spatial-neglect-a-survey-study
#8
Peii Chen, Marco Pitteri, Glen Gillen, Harsha Ayyala
PURPOSE: Spatial neglect (SN) impedes rehabilitation success and leaves long-term consequences. We asked experts to provide their opinions in addressing SN by scenario (ideal vs. reality) and by recovery phase (earliest, acute, subacute, and chronic). Experts were individuals who have assessed or treated patients with SN clinically. MATERIALS AND METHODS: This study was conducted using an anonymous survey on the Internet with 189 responders over 3 months. Located in 23 different countries, 127 experts of seven disciplines were included (occupational therapy, physical therapy, nursing, speech and language pathology or therapy, neurology, physical medicine and rehabilitation, and psychology or neuropsychology)...
July 11, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28697570/adherence-to-clinical-practice-guidelines-during-dementia-work-up-in-a-real-world-setting-a-study-from-the-registry-of-dementias-of-girona
#9
Oriol Turró-Garriga, Laia Calvó-Perxas, Joan Vilalta-Franch, Marta Hernández-Ferrándiz, Margarita Flaqué, Marta Linares, Marta Cullell, Jordi Gich, Isabel Casas, Héctor Perkal, Josep Garre-Olmo
BACKGROUND: There are several position statements and clinical practice guidelines (CPG) for diagnosing dementia. OBJECTIVE: Our aims were to evaluate the adherence to CPG among specialists in the 7 memory clinics included in the Registry of Dementias of Girona (ReDeGi), and to compare the results between 2007-2011 and 2012-2015. We also determined the time and number of visits required to achieve a diagnosis, the supplementary tests ordered, and the drugs prescribed according to dementia subtypes...
2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/28655027/zolpidem-for-the-treatment-of-neurologic-disorders-a-systematic-review
#10
Martin N Bomalaski, Edward S Claflin, Whitney Townsend, Mark D Peterson
Importance: Given its selective action on the ω1 subtype of the γ-aminobutyric acid A receptor, zolpidem tartrate presents a potential treatment mechanism for other neurologic disorders. Objective: To synthesize studies that used zolpidem to treat neurologic disorders. Evidence Review: Eligibility criteria included any published English-language article that examined the use of zolpidem for noninsomnia neurologic disorders in humans for all dates up to March 20, 2015...
June 26, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28653798/spinal-cord-injury-pain-instrument-and-paindetect-questionnaire-convergent-construct-validity-in-individuals-with-spinal-cord-injury
#11
S Franz, C Schuld, E P Wilder-Smith, L Heutehaus, S Lang, S Gantz, S Schuh-Hofer, R-D Treede, T N Bryce, H Wang, N Weidner
BACKGROUND: Neuropathic pain (NeuP) is a frequent sequel of spinal cord injury (SCI). The SCI Pain Instrument (SCIPI) was developed as a SCI-specific NeuP screening tool. A preliminary validation reported encouraging results requiring further evaluation in terms of psychometric properties. The painDETECT questionnaire (PDQ), a commonly applied NeuP assessment tool, was primarily validated in German, but not specifically developed for SCI and not yet validated according to current diagnostic guidelines...
June 27, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28648908/intraventricular-cavernomas-of-the-third-ventricle-report-of-two-cases-and-a-systematic-review-of-the-literature
#12
Vivek B Beechar, Visish M Srinivasan, Oleg E Reznik, Anish Sen, Tiemo J Klisch, Alexander E Ropper, Jacob J Mandel, Kent A Heck, Timothy J Seipel, Akash J Patel
BACKGROUND: Intraventricular cavernous malformations (IVCMs) are relatively rare benign vascular malformations. Patients may be asymptomatic or present with symptoms including headache, seizure, hemorrhage, and neurological deficits. We report two cases of patients with cavernomas in the third ventricle and at the foramen of Monro (FoM) and a systematic review of the literature to examine the clinical features and the efficacy of the current standard of care for these lesions. METHODS: A systematic review was performed according to PRISMA guidelines...
June 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28638568/dizziness-in-a-community-hospital-central-neurological-causes-clinical-predictors-and-diagnostic-yield-and-cost-of-neuroimaging-studies
#13
Hussam Ammar, Rukma Govindu, Ragai Fouda, Wael Zohdy, Emilio Supsupin
Objectives: Neuroimaging is contributing to the rising costs of dizziness evaluation. This study examined the rate of central neurological causes of dizziness, relevant clinical predictors, and the costs and diagnostic yields of neuroimaging in dizziness assessment. Methods: We retrospectively reviewed the records of 521 adult patients who visited the hospital during a 12-month period with dizziness as the chief complaint. Clinical findings were analyzed using Fisher's exact test to determine how they correlated with central neurological causes of dizziness identified by neuroimaging...
March 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28630838/a-case-report-of-an-unusual-case-of-tuberculous-osteomyelitis-causing-spontaneous-pathological-fracture-of-humerus-in-a-middle-aged-female
#14
Umesh Birole, Ashish Ranade, Mahesh Mone
INTRODUCTION: Tuberculosis is a major health problem worldwide. Extrapulmonary tuberculosis is often secondary to some primary foci in lungs. There are reports of tuberculous osteomyelitis involving maxilla, ulna, femur, and shoulder joint but none have reported pathological fracture in humeral diaphysis due to tuberculosis osteomyelitis without shoulder joint involvement. We report a case of pathological fracture of humerus diaphysis due to tuberculous osteomyelitis with normal articular space...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28621630/evaluation-of-surgical-treatment-for-neuropathic-pain-from-neuroma-in-patients-with-injured-peripheral-nerves
#15
Valérie Decrouy-Duruz, Thierry Christen, Wassim Raffoul
OBJECTIVE Chronic neuropathic pain after peripheral nerve injury is a major clinical problem. Its management is difficult, and therapeutic approaches vary and include oral medication, neurostimulation, and surgery. The aim of this study was to assess the adequacy of surgical nerve revision in a large series of patients with long-term follow-up. METHODS The authors reviewed the charts of 231 patients (335 nerve injuries) who experienced neuropathic pain after peripheral nerve injury and underwent surgery for nerve revision at the authors' institution between 1997 and 2012...
June 16, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28605741/electroencephalography-patterns-and-prognosis-in-acute-ischemic-stroke
#16
Fabricio O Lima, João A G Ricardo, Ana C Coan, Diogo C Soriano, Wagner M Avelar, Li L Min
BACKGROUND AND PURPOSE: The prognostic significance of interictal epileptiform discharges (IED) and periodic patterns (PP) after ischemic stroke has not been assessed. We sought to test whether IED and PP, detected on standard Electroencephalography (EEG) performed during the acute phase of ischemic stroke are associated with a worse functional outcome. METHODS: One-hundred-fifty-seven patients 18 years or older with a diagnosis of acute ischemic stroke presenting within 72 h from stroke onset were prospectively enrolled and followed...
June 13, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28600460/standard-operating-procedures-improve-acute-neurologic-care-in-a-sub-saharan-african-setting
#17
Lamin E S Jaiteh, Stefan A Helwig, Abubacarr Jagne, Andreas Ragoschke-Schumm, Catherine Sarr, Silke Walter, Martin Lesmeister, Matthias Manitz, Sebastian Blaß, Sarah Weis, Verena Schlund, Neneh Bah, Jil Kauffmann, Mathias Fousse, Sabina Kangankan, Asmell Ramos Cabrera, Kai Kronfeld, Christian Ruckes, Yang Liu, Ousman Nyan, Klaus Fassbender
OBJECTIVE: Quality of neurologic emergency management in an under-resourced country may be improved by standard operating procedures (SOPs). METHODS: Neurologic SOPs were implemented in a large urban (Banjul) and a small rural (Brikama) hospital in the Gambia. As quality indicators of neurologic emergency management, performance of key procedures was assessed at baseline and in the first and second implementation years. RESULTS: At Banjul, 100 patients of the first-year intervention group exhibited higher rates of general procedures of emergency management than 105 control patients, such as neurologic examination (99...
July 11, 2017: Neurology
https://www.readbyqxmd.com/read/28594706/diagnosis-of-tuberous-sclerosis-complex-in-a-patient-referred-for-uncontrolled-hypertension-and-renal-dysfunction-a-case-highlighting-the-importance-of-proper-diagnostic-work-up-of-hypertensive-patients
#18
Pantelis A Sarafidis, Athanasios Bikos, Charalampos Loutradis, Stergios Tzikas, Efstratios Vakirlis, Eugenia Avdelidou, Dimitrios Zafeiriou, Aikaterini Papagianni, Vasileios Vassilikos
: We report a case of a 39-year-old woman with resistant hypertension and renal dysfunction. The patient was hospitalized 3 months earlier for dyspnea at the Department of Cardiology, where she was diagnosed with heart failure (left ventricle injection fraction: 25-30%), pulmonary hypertension, chronic kidney disease (serum creatinine: 1.58 mg/dl), and resistant hypertension and discharged with optimal heart failure treatment. At presentation to our clinic, apart from uncontrolled hypertension for more than 10 years and history of pre-eclampsia and fetal loss, the patient had obesity (BMI: 38 kg/m) and facial fibromas...
June 7, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28589868/-two-year-follow-up-of-infants-born-at-24-weeks-gestation-first-outcomes-following-implementation-of-the-new-guideline-for-perinatal-policy-in-cases-of-extreme-prematurity
#19
C S H Aarnoudse-Moens, M Rijken, R M Swarte, P Andriessen, H J Ter Horst, S M Mulder-de Tollenaer, C Koopman-Esseboom, A R C Laarman, K Steiner, A H B M van der Hoeven, R F Kornelisse, J J Duvekot, N Weisglas-Kuperus
OBJECTIVE: Since 2010 the guideline 'Guideline for perinatal policy in cases of extreme prematurity' has advised an active policy in infants born at 24 weeks gestation. We investigated how infants born at 24 and 25 weeks gestation in the first year following the implementation of the guideline had developed by the age of 2 years. DESIGN: Retrospective national cohort study. METHOD: The study population consisted of all surviving infants born in the Netherlands at 24 or 25 weeks gestation in the period from 1 October 2010 to 1 October 2011...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28586081/bed%C3%A3-mning-av-neuro%C3%A2-logisk-prognos-efter-hj%C3%A3-rtstopp-uppdaterade-rekommendationer-fr%C3%A3-n-svenska-hlr-r%C3%A3-dets-expertgrupp
#20
Christian Rylander, Hans Friberg, Elna-Marie Larsson, Lars Johan Liedholm, Sten Rubertsson, Tobias Cronberg
Assessment of neurologic prognosis after cardiac arrest. Updated recommendations from the Swedish CPR Council Expert Group European Resuscitation Council (ERC) issued updated guidelines for postresuscitation care in 2015. This paper provides updated Swedish recommendations for neurological prognostication of patients remaining unconscious after cardiac arrest (CA). The prognostication should be based on independent methods; clinical and neurophysiological examinations, imaging and biomarkers. It should not be performed earlier than three days after CA and any influence from sedatives must be negligible...
June 2, 2017: Läkartidningen
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