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Critical Care Neurology

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https://www.readbyqxmd.com/read/29152931/can-red-blood-cell-distribution-width-predict-outcome-after-cardiac-arrest
#1
Vito Fontana, Savino Spadaro, Paola Villois, Claudia Righy Shinotsuka, Alberto Fogagnolo, Leda Nobile, Jean-Louis Vincent, Jacques Creteur, Fabio S Taccone
BACKGROUND: In critically ill patients, high red blood cell distribution width (RDW) values have been associated with increased hospital mortality, but there are no data on the impact of RDW on outcomes of patients resuscitated from cardiac arrest (CA). The aim of this study was to investigate the relationship between RDW and long-term neurologic outcome in CA survivors. METHODS: We performed a retrospective analysis of an institutional database including all unconscious adult patients admitted to the intensive care unit (ICU) after non-traumatic CA between January 2007 and January 2015...
November 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29146024/effect-of-serum-albumin-concentration-on-neurological-outcome-after-out-of-hospital-cardiac-arrest-from-the-critical-comprehensive-registry-of-intensive-cares-for-ohca-survival-study-in-osaka-japan
#2
Tasuku Matsuyama, Taku Iwami, Tomoki Yamada, Koichi Hayakawa, Kazuhisa Yoshiya, Taro Irisawa, Yoshio Abe, Tetsuro Nishimura, Toshifumi Uejima, Yasuo Ohishi, Takeyuki Kiguchi, Masashi Kishi, Masafumi Kishimoto, Shota Nakao, Yasuyuki Hayashi, Taku Sogabe, Takaya Morooka, Junichi Izawa, Tomonari Shimamoto, Toshihiro Hatakeyama, Tomoko Fujii, Junya Sado, Takeshi Shimazu, Takashi Kawamura, Tetsuhisa Kitamura
The aim of this study was to assess whether serum albumin concentration upon hospital arrival had prognostic indications on out-of-hospital cardiac arrest (OHCA). This prospective, multicenter observational study conducted in Osaka, Japan (the CRITICAL [Comprehensive Registry of Intensive Cares for OHCA Survival] study), enrolled all patients with consecutive OHCA transported to 14 participating institutions. We included adult patients aged ≥18 years with nontraumatic OHCA who achieved return of spontaneous circulation and whose serum albumin concentration was available from July 2012 to December 2014...
October 19, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29142086/shortage-of-generic-neurologic-therapeutics-an-escalating-threat-to-patient-care
#3
Jacklyn O Omorodion, Rami M Algahtani, Mark S Zocchi, Erin R Fox, Jesse M Pines, Henry J Kaminski
OBJECTIVE: To assess longitudinal trends in shortages of generic drugs used for neurologic conditions over a 15-year period in the United States. METHODS: Drug shortage data from the University of Utah Drug Information Service (UUDIS) from 2001 to 2015 were analyzed. Medications were included that were likely to be prescribed by a neurologist to treat a primary neurologic condition or critical for care of a patient with a neurologic condition. Trends in shortage length were assessed using standard descriptive statistics...
November 15, 2017: Neurology
https://www.readbyqxmd.com/read/29141694/the-icu-diary-study-prospective-multicenter-comparative-study-of-the-impact-of-an-icu-diary-on-the-wellbeing-of-patients-and-families-in-french-icus
#4
Maïté Garrouste-Orgeas, Cécile Flahault, Léonor Fasse, Stéphane Ruckly, Nora Amdjar-Badidi, Laurent Argaud, Julio Badie, Amélie Bazire, Naike Bige, Eric Boulet, Lila Bouadma, Cédric Bretonnière, Bernard Floccard, Alain Gaffinel, Xavier de Forceville, Hubert Grand, Rebecca Halidfar, Olfa Hamzaoui, Mercé Jourdain, Paul-Henri Jost, Eric Kipnis, Audrey Large, Alexandre Lautrette, Olivier Lesieur, Virginie Maxime, Emmanuelle Mercier, Jean Paul Mira, Yannick Monseau, Erika Parmentier-Decrucq, Jean-Philippe Rigaud, Antoine Rouget, François Santoli, Georges Simon, Fabienne Tamion, Nathalie Thieulot-Rolin, Marina Thirion, Sandrine Valade, Isabelle Vinatier, Christel Vioulac, Sebastien Bailly, Jean-François Timsit
BACKGROUND: Post-intensive care syndrome includes the multiple consequences of an intensive care unit (ICU) stay for patients and families. It has become a new challenge for intensivists. Prevention programs have been disappointing, except for ICU diaries, which report the patient's story in the ICU. However, the effectiveness of ICU diaries for patients and families is still controversial, as the interpretation of the results of previous studies was open to criticism hampering an expanded use of the diary...
November 15, 2017: Trials
https://www.readbyqxmd.com/read/29139014/the-ictal-interictal-continuum-to-treat-or-not-to-treat-and-how
#5
Clio Rubinos, Alexandra S Reynolds, Jan Claassen
Continuous electroencephalography (cEEG) monitoring is becoming increasingly used in neurologic and non-neurologic intensive care units (ICUs). Non-convulsive seizures (NCSz) and periodic discharges (PDs) are commonly seen in critically ill patients. Some of these PD patterns, also known as the ictal-interictal continuum (IIC), are associated with an increased risk of seizures and poor outcome. However, we do not fully understand the significance of these periodic patterns and the decision of how aggressively to treat remains controversial...
November 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29132978/intensive-care-in-severe-malaria-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#6
REVIEW
Dilip R Karnad, Mohd Basri Mat Nor, Guy A Richards, Tim Baker, Pravin Amin
Severe malaria is common in tropical countries in Africa, Asia, Oceania and South and Central America. It may also occur in travelers returning from endemic areas. Plasmodium falciparum accounts for most cases, although P vivax is increasingly found to cause severe malaria in Asia. Cerebral malaria is common in children in Africa, manifests as coma and seizures, and has a high morbidity and mortality. In other regions, adults may also develop cerebral malaria but neurological sequelae in survivors are rare...
November 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29128378/ebola-virus-disease-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#7
REVIEW
Guy A Richards, Tim Baker, Pravin Amin
Ebola virus is a filovirus that can cause fatal hemorrhagic fever (HF) and five distinct species exist that vary in terms of geographical distribution and virulence. Once the more virulent forms enter the human population, transmission occurs primarily through direct contact with infected body fluids and may result in significant outbreaks. The devastating has been the recent West African outbreak. Clinically, signs and symptoms are similar to those of the other VHFs [4]. The incubation period is 2-21days, followed by fever, headache, myalgia, diarrhoea, vomiting and dehydration; thereafter, there may be recovery or deterioration with collapse, neurological manifestations and bleeding, that can lead to a fatal outcome...
November 3, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29116817/perceptions-of-a-psychoeducation-program-for-caregivers-of-persons-with-dementia-at-end-of-life-a-qualitative-study
#8
Pamela Durepos, Sharon Kaasalainen, Sandra Carroll, Alexandra Papaioannou
OBJECTIVES: Caregivers (CG) of persons with dementia have described positive and challenging experiences related to caring for a person with a neurological disease. This study explored perceived benefits and challenges of a unique psychoeducation program provided at end of life (EOL) jointly attended by current and bereaved CGs of persons with dementia, residing in a hospital Specialized Care Unit. METHOD: Semi-structured interviews were held with sixteen participants and analyzed with content analysis...
November 8, 2017: Aging & Mental Health
https://www.readbyqxmd.com/read/29115280/real-time-cerebellar-neuroprosthetic-system-based-on-a-spiking-neural-network-model-of-motor-learning
#9
Tao Xu, Na Xiao, Xiaolong Zhai, Pak Kwan Chan, Chung Tin
Damage to the brain, as a result of various medical conditions, impacts everyday life of patients and there is still no complete cure to neurological disorders. Neuroprostheses that can functionally replace the damaged neural circuit have recently emerged as a possible solution to these problems. Here we describe the development of a real-time cerebellar neuroprosthetic system to substitute neural function in cerebellar circuitry for learning delay eyeblink conditioning (DEC). Approach: The system was empowered by a biologically realistic spiking neural network (SNN) model of the cerebellar neural circuit, which considers the neuronal population and anatomical connectivity of the network...
November 8, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/29111352/use-of-antibiotics-in-paediatric-long-term-care-facilities
#10
Meghan T Murray, Candace L Johnson, Bevin Cohen, Olivia Jackson, Laney K Jones, Lisa Saiman, Elaine L Larson, Natalie Neu
BACKGROUND: Adult long term care (LTC) have high rates of antibiotic use, raising concerns about antimicrobial resistance. Few studies have examined antibiotic use in paediatric LTC. AIM: We sought to describe antibiotic use in three paediatric LTC facilities and to describe the factors associated with use. METHODS: A retrospective cohort study was conducted September 2012 - December 2015 in three paediatric LTC facilities. Medical records were reviewed for demographics, healthcare-associated infections (HAI), antimicrobial use, and diagnostic testing...
October 27, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29104430/pitfalls-in-the-diagnosis-and-management-of-invasive-pneumococcal-meningoencephalitis-what-we-can-learn-from-a-case
#11
Pascale S Grzonka, Raoul Sutter
Invasive pneumococcal meningitis is a life-threatening infectious disease affecting the central nervous system. It continues to be the most common type of community-acquired acute bacterial meningitides. Despite advances in neuro-critical care, the case fatality rate remains high. Rapid diagnosis and initiation of antibiotic therapy precludes mortality and long-term neurological sequelae in survivors. However, not all cases are easily recognised, and unanticipated complications may impede optimal course and outcome...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/29098756/reducing-the-risk-of-healthcare-associated-infections-through-lean-six-sigma-the-case-of-the-medicine-areas-at-the-federico-ii-university-hospital-in-naples-italy
#12
Giovanni Improta, Mario Cesarelli, Paolo Montuori, Liberatina Carmela Santillo, Maria Triassi
RATIONALE, AIMS, AND OBJECTIVES: Lean Six Sigma (LSS) has been recognized as an effective management tool for improving healthcare performance. Here, LSS was adopted to reduce the risk of healthcare-associated infections (HAIs), a critical quality parameter in the healthcare sector. METHODS: Lean Six Sigma was applied to the areas of clinical medicine (including general medicine, pulmonology, oncology, nephrology, cardiology, neurology, gastroenterology, rheumatology, and diabetology), and data regarding HAIs were collected for 28,000 patients hospitalized between January 2011 and December 2016...
November 3, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29095167/feasibility-of-early-motor-assisted-upper-extremity-cycle-ergometry-in-critically-ill-neurological-patients-with-upper-extremity-weakness-and-variable-cognitive-status-a-case-series
#13
S Deluzio, I Vora, S Kumble, E K Zink, R D Stevens, M N Bahouth
Upper extremity paresis, common in many neurological conditions, is a major contributor of long-term disability and decreased quality of life. Evidence shows that repetitive, bilateral arm movement improves upper extremity coordination after neurological injury. However, it is difficult to integrate upper extremity interventions into very early rehabilitation of critically ill neurological patients due to patient arousal and medical acuity. This report describes the safety and feasibility of bilateral upper extremity cycling in critically ill neurological patients with bilateral or unilateral paresis...
October 31, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29091782/ante-peri-and-postnatal-factors-associated-with-intraventricular-hemorrhage-in-very-premature-infants
#14
Martin Poryo, Judith Caroline Boeckh, Ludwig Gortner, Michael Zemlin, Perrine Duppré, Daniel Ebrahimi-Fakhari, Stefan Wagenpfeil, Matthias Heckmann, Eva Mildenberger, Anne Hilgendorff, Andreas W Flemmer, Georg Frey, Sascha Meyer
BACKGROUND: Intraventricular hemorrhage (IVH) is one of the most serious complications in preterm infants and is associated with neurological sequelae and mortality. Over the past few decades, the rate of IVH has decreased due to improved neonatal intensive care. However, up to 15-25% of very and extremely premature infants (<32 and <28weeks of pregnancy (WOP) respectively) still suffer from IVH. STUDY PURPOSE: The aim of this study was to perform an updated, multicenter analysis to identify ante-, peri, and postnatal factors other than gestational age/birth weight associated with IVH of any grade in a large cohort of very and extremely premature infants...
October 26, 2017: Early Human Development
https://www.readbyqxmd.com/read/29089218/-how-to-manage-vertigo-in-adult
#15
Hella Vuong Chaney, Dominique Rohmer, Anne Charpiot
The interrogation and the clinical examination are critical in the research of vertigo etiology. In the context of vertigo, the vital emergencies are of neurological and vascular origins. It is therefore necessary to be able to identify them quickly and simply. Vertigo is a symptom to relieve and the cause is to be diagnosed. Careful questioning combined with neurological examination, nystagmus study, Halmagyi test and skew deviation search are more reliable than imaging in the first 48hours to detect a stroke...
October 28, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29088951/update-on-critical-care-for-acute-spinal-cord-injury-in-the-setting-of-polytrauma
#16
John K Yue, Ethan A Winkler, Jonathan W Rick, Hansen Deng, Carlene P Partow, Pavan S Upadhyayula, Harjus S Birk, Andrew K Chan, Sanjay S Dhall
Traumatic spinal cord injury (SCI) often occurs in patients with concurrent traumatic injuries in other body systems. These patients with polytrauma pose unique challenges to clinicians. The current review evaluates existing guidelines and updates the evidence for prehospital transport, immobilization, initial resuscitation, critical care, hemodynamic stability, diagnostic imaging, surgical techniques, and timing appropriate for the patient with SCI who has multisystem trauma. Initial management should be systematic, with focus on spinal immobilization, timely transport, and optimizing perfusion to the spinal cord...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29076412/efficacy-duration-and-timing-of-withdrawal-of-prophylactic-treatment-with-antiepileptic-drugs-in-neurosurgical-conditions
#17
Daniel R Calnan, Erin D'Agostino, Matthew R Reynolds, Kimon Bekelis
Seizure control is a critical component of care in many neurosurgical conditions. The development of seizures in patients without a previously identified seizure disorder occurs in a significant proportion of traumatic brain injury, subarachnoid hemorrhage, and brain tumor patients. In this literature review and synthesis, we will discuss the incidence of seizures in selected conditions, indications and evidence for the initiation of antiepileptic drugs (AEDs), suggested duration of usage for AEDs, and current AED guidelines by the American Academy of Neurology (AAN), Congress of Neurological Surgeons (CNS), American Academy of Neurological Surgeons (AANS) and international committees...
October 24, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29073361/high-risk-sarcoidosis-current-concepts-and-research-imperatives
#18
William H Sauer, Barney J Stern, Robert Baughman, Daniel A Culver, Walter Royal
Sarcoidosis is a disease with heterogeneous manifestations and outcomes, varying in part based on organ involvement. Specifically, sarcoidosis patients at risk for poor outcomes include individuals with treatment-resistant pulmonary sarcoidosis, including fibrotic pulmonary disease and pulmonary hypertension, as well as those with cardiac, neurologic and multi-organ disease. The limited but available data relating to these high-risk sarcoidosis patients, defined as those patients with presentations requiring medical intervention to avoid progressive disability or premature death, was evaluated as part of the National Heart Lung and Blood Institute's (NHLBI) workshop to improve understanding of these disease manifestations...
October 26, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29058949/lipomas-of-the-brachial-plexus-a-case-series-and-review-of-the-literature
#19
Alexander Graf, Kai Yang, David King, William Dzwierzynski, James Sanger, Patrick Hettinger
BACKGROUND: Lipomas are common benign tumors. When they develop in proximity to peripheral nerves, they can cause neurologic symptoms secondary to mass effect. Previous reports have shown symptom resolution after removal of lipomas compressing various upper extremity peripheral nerves. However, brachial plexus lipomas are relatively rare. Our multidisciplinary experience with brachial plexus lipoma resection is reviewed in the largest case series to date. METHODS: A retrospective chart review of all patients undergoing resection of brachial plexus lipomatous tumors between 2006 and 2016 was performed...
October 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29052742/-triple-arthrodesis-for-correction-of-cavovarus-deformity
#20
REVIEW
A Barg, R Ruiz, B Hintermann
OBJECTIVE: The aim is to correct the underlying cavovarus deformity and to achieve a pain-free and stable hindfoot. INDICATIONS: Rigid neurologic, posttraumatic, congenital, and idiopathic cavovarus deformities. CONTRAINDICATIONS: General surgical or anesthesiological risks, infections, critical soft tissue conditions, neurovascular impairment of the lower extremity, noncompliance, patients with severely reduced bone quality, insulin-dependent diabetes mellitus, smoking...
October 20, 2017: Operative Orthopädie und Traumatologie
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