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https://www.readbyqxmd.com/read/28265859/new-cancer-pain-treatment-options
#1
REVIEW
Kenneth D Candido, Teresa M Kusper, Nebojsa Nick Knezevic
PURPOSE OF REVIEW: Cancer pain is often incapacitating and discouraging to patients; is demoralizing to family members and care takers; and is taxing and difficult to subdue for the pain specialists. The consequences of implementing suboptimal treatment are far-reaching; therefore, effective treatment methods are in a great demand. The face of cancer pain management has changed in considerable ways, and interventional procedures have become an integral part of providing multimodal analgesia in cancer pain treatment...
February 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28259296/critical-review-of-the-addition-of-tumor-treating-fields-ttfields-to-the-existing-standard-of-care-for-newly-diagnosed-glioblastoma-patients
#2
REVIEW
M Mehta, P Wen, R Nishikawa, D Reardon, K Peters
Since 2005, the standard of care for patients with newly diagnosed glioblastoma (GBM) has consisted of maximal resection followed by radiotherapy plus daily temozolomide (TMZ), followed by maintenance TMZ. In patients selected for clinical trials, median overall survival (OS) and progression-free survival (PFS) with this regimen is 15-17 months and 6-7 months, respectively. There have been various, largely unsuccessful attempts to improve on this standard of care. With the FDA approval of the tumor-treating fields (TTFields) device, Optune, for recurrent GBM (2011), and the more recent EF-14 interim trial results and approval for newly diagnosed GBM patients, several questions have arisen...
March 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28162168/-analysis-of-clinical-characteristics-and-outcomes-of-mechanically-ventilated-patients-with-anti-n-methyl-d-aspartate-receptor-encephalitis
#3
Y Zhang, Y Y Su, D Q Gao, H Ye
Objective: To explore the clinical characteristics and long-term outcomes of mechanically ventilated patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. Methods: In this observational study, patients with anti-NMDAR encephalitis were enrolled, who were admitted into Xuanwu Hospital of Capital Medical University from Jan 2012 to Jun 2015.All patients accepted tumor screening, symptomatic therapy, and immunotherapy.Outcomes were assessed by modified Rankin Scale (mRS) after immunotherapy every 6 months, and mRS 0-2 was defined as favorable outcome...
January 17, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28145850/characterization-of-end-of-life-electroencephalographic-surges-in-critically-ill-patients
#4
Lakhmir S Chawla, Megan Terek, Christopher Junker, Seth Akst, Bona Yoon, Ermira Brasha-Mitchell, Michael G Seneff
BACKGROUND: Neuromonitoring devices to assess level of sedation are now used commonly in many hospital settings. We previously reported that electro-encephalic-graphic (EEG) spikes frequently occurred after the time of death in patients being neuro-monitored at the time of cessation of circulation. In addition to our initial report, end of life electrical surges (ELES) have been subsequently documented in animal and human studies by other investigators. The frequency, character, intensity, and significance of ELES are unknown...
February 1, 2017: Death Studies
https://www.readbyqxmd.com/read/28112704/evaluation-and-treatment-of-hyperglycemia-in-critically-ill-patients
#5
Andrea Balloni, Federico Lari, Fabrizio Giostra
The hyperglycemic reaction to stress is part of adaptive metabolic response to critical illness, especially hypoxia, hemorrhage and sepsis. It involves neuro-endocrine and immune pathways leading to the development of insulin resistance and hepatic glucose production by gluconeogenesis and glycogenolysis. Over the last years the concept of stress related hyperglycemia has been replaced by the concept of dysglycemia and its three domains: hyperglycemia, hypoglycemia and glycemic variability. Each of the three domains is independently associated with increased risk of mortality in patients admitted in intensive care unit and non critically ill patients, both medical and surgical...
January 16, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28000130/early-mobilization-in-the-neuro-icu-how-far-can-we-go
#6
Brian F Olkowski, Syed Omar Shah
Immobility that is frequently encountered in the intensive care unit (ICU) can lead to patient complications. Early mobilization of patients in the ICU has been shown to reduce the complications associated with critical illness; however, early mobilization in the neurological intensive care unit (NICU) presents a unique challenge for the multidisciplinary team. The early mobilization of patients with acute neurologic injuries such as acute ischemic stroke, aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, and neurotrauma varies because of differing disease processes and management...
December 20, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27987330/protection-of-dexmedetomidine-against-ischemia-reperfusion-induced-apoptotic-insults-to-neuronal-cells-occurs-via-an-intrinsic-mitochondria-dependent-pathway
#7
Gong-Jhe Wu, Jui-Tai Chen, Hsiao-Chien Tsai, Ta-Liang Chen, Shing-Hwa Liu, Ruei-Ming Chen
Dexmedetomidine, an agonist of alpha2-adrenergic receptors, is used for critically ill patients to induce and maintain sedation and analgesia. Brain ischemia/reperfusion (I/R) usually causes severe neuronal injuries to intensive care unit patients. This study was aimed to evaluate the effects of dexmedetomidine on I/R-induced insults to neuronal cells and the possible mechanisms. Treatment of neuro-2a cells with dexmedetomidine did not affect cell viability but could protect against I/R-induced cell death. Separately, the I/R-triggered cell shrinkage, DNA fragmentation, and apoptosis in neuro-2a cells were alleviated by dexmedetomidine...
December 17, 2016: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/27833207/brain-death-and-true-patient-care
#8
Doyen Nguyen
The "brain death" standard as a criterion of death is closely associated with the need for transplantable organs from heart-beating donors. Are all of these potential donors really dead, or does the documented evidence of patients destined for organ harvesting who improve, or even recover to live normal lives, call into question the premise underlying "brain death"? The aim of this paper is to re-examine the notion of "brain death," especially its clinical test-criteria, in light of a broad framework, including medical knowledge in the field of neuro-intensive care and the traditional ethics of the medical profession...
August 2016: Linacre Quarterly
https://www.readbyqxmd.com/read/27779577/extracorporeal-membrane-oxygenation-for-adult-respiratory-distress-syndrome-in-trauma-patients-a-case-series-and-systematic-literature-review
#9
Chiara Robba, Andrea Ortu, Federico Bilotta, Alessandra Lombardo, Mypinder S Sekhon, Fabio Gallo, Basil F Matta
BACKGROUND: Venovenous extracorporeal membrane oxygenation (vv-ECMO) is an established salvage therapy for severe respiratory failure, and may provide an alternative form of treatment for trauma-induced adult respiratory distress syndrome (ARDS) when conventional treatments have failed. The need for systemic anticoagulation is a relative contraindication for patients with bleeding risks, especially in multitraumatic injury. METHODS: We describe a case series of four trauma patients with ARDS who were managed with ECMO admitted to the neuro critical care unit at Addenbrooke's Hospital, Cambridge (UK), from January 2000 to January 2016...
January 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27771198/yield-of-repeated-intermittent-eeg-for-seizure-detection-in-critically-ill-adults
#10
Yannick Fogang, Benjamin Legros, Chantal Depondt, Nicolas Mavroudakis, Nicolas Gaspard
INTRODUCTION: Seizures are common in critically ill patients and prevalence can exceed 30% in the neuro-intensive care unit (ICU). Continuous EEG monitoring (cEEG) is the gold standard for seizure detection in critically ill patients. OBJECTIVES: To determine the yield of intermittent EEG (iEEG) to detect critically ill adult patients with seizures and to identify the factors that affect this yield. METHODS: We retrospectively analyzed cEEG data and medical records from 977 consecutive critically ill patients undergoing cEEG...
February 2017: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/27647155/implementation-of-a-neurocritical-care-program-improved-seizure-detection-and-decreased-antiseizure-medication-at-discharge-in-neonates-with-hypoxic-ischemic-encephalopathy
#11
Rani Ameena Bashir, Liza Espinoza, Sakeer Vayalthrikkovil, Jeffrey Buchhalter, Leigh Irvine, Luis Bello-Espinosa, Khorshid Mohammad
BACKGROUND: We report the impact of implementing continuous video electroencephalography monitoring for neonates with hypoxic-ischemic encephalopathy via a protocol in the context of neonatal neuro-critical care program. METHODS: Neonates with hypoxic-ischemic encephalopathy were studied retrospectively two years before and after implementing continuous video electroencephalography for 72 hours as a care protocol. Before continuous video electroencephalography, a 60-minute routine electroencephalography was performed at the discretion of the provider...
November 2016: Pediatric Neurology
https://www.readbyqxmd.com/read/27468506/-autonomic-nervous-system-and-its-imbalance-in-neuro-intensive-care-unit
#12
REVIEW
K A Popugaev, A Yu Lubnin, M V Zabelin, A S Samoylov
The autonomic nervous system (ANS) provides homeostasis due to the innervation of the secretory glands, smooth muscle and cardiac muscle. Higher centers of the ANS (primarily the hypothalamus, some centers of the brain stem and limbic system) form a integrative network, which plays a key role in coordinating the functioning of the endocrine, immune system and other parts of the central nervous system. Intracranial centers of the ANS are responsible for the consciousness, behavioral, emotional, and other components of the higher nervous activity...
March 2016: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/27442421/the-fetal-brain-role-of-progesterone-and-allopregnanolone
#13
REVIEW
Nicola Pluchino, Marinella Russo, Andrea R Genazzani
Progesterone and allopregnanolone have crucial and different roles in brain development, function and recovery after injury. Pregnancy is characterized by an increased synthesis of progesterone and its neuro-active metabolites by the placenta, maternal and fetal brain. This supports the critical role of these steroids in maternal brain adaptation during pregnancy and development of the fetal brain. Moreover, allopregnanolone may play a brain-protective role during complications of pregnancy, complications of pregnancy, such as preterm delivery or intrauterine growth restriction (IUGR), by reducing the impact of hypoxia and excitotoxic brain damage or impairment myelination...
July 1, 2016: Hormone Molecular Biology and Clinical Investigation
https://www.readbyqxmd.com/read/27439226/fresh-approach-for-critically-ill-patients-with-time-sensitive-needs
#14
(no author information available yet)
To meet the needs of critically ill patients with time-sensitive needs, the University of Maryland Medical Center (UMMC) created the Critical Care Resuscitation Unit (CCRU), a six-bed, short-stay ICU designed to accelerate care to resource-heavy patients who require immediate evaluation and treatment. The CCRU is modeled after UMMC's trauma resuscitation unit, but with resources and staff geared toward non-trauma, critically ill patients, many of whom require life-saving care. The unit is largely staffed by emergency providers who have undergone additional training in critical care...
July 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27364336/invasive-seizure-monitoring-in-the-critically-ill-brain-injury-patient-current-practices-and-a-review-of-the-literature
#15
REVIEW
Charles B Mikell, Timothy G Dyster, Jan Claassen
Seizures commonly occur in a variety of serious neurological illnesses, and lead to additional morbidity and worsened outcomes. Recently, it has become clear that not all seizures in the acute brain injury setting are evident on scalp EEG. To address this, we have developed a protocol for depth electrode placement in the neuro-intensive care unit for patients in whom the clinical suspicion of occult seizures is high. In the current manuscript, we review the literature on depth EEG monitoring for ictal events in critically-ill, unconscious patients, focusing on the incidence of seizures not detected with scalp EEG in various conditions...
October 2016: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/27316579/neuropharmacological-properties-of-withania-somnifera-indian-ginseng-an-overview-on-experimental-evidence-with-emphasis-on-clinical-trials-and-patents
#16
Sarat C Yenisetti, M J Manjunath, C Muralidhara
BACKGROUND: Owing to the increasing aged population globally, disorders and diseases of the CNS are anticipated to increase and profoundly impact the health care. As these neurodegenerative diseases (NDD) are complex, multifactorial and do not have identified etiological factors, unfortunately, drugs developed for the purpose have not met with the expected success. Hence, there has been a constant demand for the development of natural therapeutic adjuvants which are safe and possess the potential to attenuate multiple pathways...
2016: Recent Patents on CNS Drug Discovery
https://www.readbyqxmd.com/read/27290545/a-comparison-in-tracheostomy-weaning-and-complications-rate-between-neuro-critical-care-patients-and-general-critical-care-patients
#17
M Colomo, T Chamroo, N Muchoki, J Darroch, G De la Cerda
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27290235/in-neuro-critical-care-capnia-can-be-optimally-controlled-using-a-closed-loop-ventilation-system-based-on-end-tidal-co2-signal-intellivent-asv-%C3%A2-preliminary-results-of-a-prospective-interventional-study
#18
L Piquilloud, A Polupan, I Matskovskiy, A Oshorov, D Novotni, T Laubscher, M Oddo, P Jolliet, J P Revelly
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27271341/cerebral-function-monitoring-on-a-general-paediatric-ward-feasibility-and-potential
#19
Vivek Kalra, Shahul Sikkander Shaw, Stacey Dixon, Divyen K Shah, Paul Clarke
UNLABELLED: Cerebral function monitoring is widely used in neonatal intensive care, but its potential role in assessment of older infants is scarcely reported. We reviewed the use of cerebral function monitoring on a general paediatric ward in a series of young infants admitted with abnormal movements. Review of the amplitude-integrated EEG obtained by cerebral function monitoring revealed electrographic seizures in four of seven infants monitored. We also surveyed general paediatric wards in hospitals in our region of the UK to ask about current use of cerebral function monitoring and local availability of formal electroencephalography services...
August 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27244560/critical-illness-in-patients-with-multiple-sclerosis-a-matched-case-control-study
#20
Anush Karamyan, Martin W Dünser, Douglas J Wiebe, Georg Pilz, Peter Wipfler, Vaclav Chroust, Helmut F Novak, Larissa Hauer, Eugen Trinka, Johann Sellner
BACKGROUND: Over the course of multiple sclerosis (MS) several conditions may arise that require critical care. We aimed to study the reasons for admission and outcome in patients with MS admitted to a neuro-intensive care unit (NICU). METHODS: We retrospectively searched the electronic charts of a 9-bedded NICU in a tertiary hospital for patients with a diagnosis of multiple sclerosis (MS) from 1993-2015, and matched them to NICU controls without MS based on age and gender...
2016: PloS One
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