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Neuro-Critical Care

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https://www.readbyqxmd.com/read/29779815/use-of-standard-enteral-formula-versus-enteric-formula-with-prebiotic-content-in-nutrition-therapy-a-randomized-controlled-study-among-neuro-critical-care-patients
#1
Piril Tuncay, Fatma Arpaci, Mutlu Doganay, Deniz Erdem, Arzu Sahna, Hulya Ergun, Dilek Atabey
OBJECTIVE: To compare use of standard enteral formula versus enteric formula with prebiotic content in terms of nutrition therapy related outcomes among neurocritical care patients. METHODS: A total of 46 adult neurocritical care patients who received nutrition therapy with standard enteral formula (SEF group; n = 23) or enteral formula with prebiotic content (EFPC group; n = 23) during their hospitalization in intensive care unit (ICU) were included in this prospective randomized controlled study...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29752016/perioperative-research-into-memory-prime-cognitive-impairment-following-a-severe-burn-injury-and-critical-care-admission-part-1
#2
Edward J R Watson, Klará Nenadlová, Olivia H Clancy, Mena Farag, Naz A Nordin, Agnes Nilsen, Ashley R T Mehmet, Ahmed Al-Hindawi, Sundhiya Mandalia, Lisa M Williams, Trudi L Edginton, Marcela P Vizcaychipi
INTRODUCTION: An investigation into long-term cognitive impairment and Quality of Life (QoL) after severe burns. METHODS: A proof of principle, cohort design, prospective, observational clinical study. Patients with severe burns (>15% TBSA) admitted to Burns ICU for invasive ventilation were recruited for psychocognitive assessment with a convenience sample of age and sex-matched controls. Participants completed psychological and QoL questionnaires, the Cogstate® electronic battery, Hopkins Verbal Learning, Verbal Fluency and Trail making tasks...
May 8, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29722296/reconstruction-of-difference-rod-imaging-for-cone-beam-ct-neuro-angiography
#3
Pengwei Wu, Joseph Webster Stayman, Michael Mow, Wojciech Zbijewski, Alejandro Sisniega, Nafi Aygun, Robert Stevens, David H Foos, Xiaohui Wang, Jeffrey H Siewerdsen
Timely evaluation of neurovasculature via CT angiography (CTA) is critical to detection of pathology such as ischemic stroke. Cone-beam CTA (CBCT-A) systems provide potential advantages in timely use at the point-of-care, although challenges of a relatively slow gantry rotation speed introduce tradeoffs among image quality, data consistency, and data sparsity. This work describes and evaluates a new reconstruction-of-difference (RoD) approach that is robust to such challenges.
 Methods: A fast digital simulation framework was developed to test the performance of RoD over standard reference reconstruction methods like filtered back-projection (FBP) and penalized likelihood (PL) over a broad range of imaging conditions, grouped into three scenarios to test the trade-off between data consistency, data sparsity and peak contrast...
May 3, 2018: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29712529/cost-effectiveness-development-for-the-postoperative-care-of-craniotomy-patients-a-safe-transitions-pathway-in-neurological-surgery
#4
Joseph A Osorio, Michael M Safaee, Jennifer Viner, Sujatha Sankaran, Sarah Imershein, Ezekiel Adigun, Gabriela Weigel, Mitchel S Berger, Michael W McDermott
OBJECTIVE The authors' institution is in the top 5th percentile for hospital cost in the nation, and the neurointensive care unit (NICU) is one of the costliest units. The NICU is more expensive than other units because of lower staff/patient ratio and because of the equipment necessary to monitor patient care. The cost differential between the NICU and Neuro transitional care unit (NTCU) is $1504 per day. The goal of this study was to evaluate and to pilot a program to improve efficiency and lower cost by modifying the postoperative care of patients who have undergone a craniotomy, sending them to the NTCU as opposed to the NICU...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29692920/brain-tumor-biobanking-in-the-precision-medicine-era-building-a-high-quality-resource-for-translational-research-in-neuro-oncology
#5
REVIEW
Quinn T Ostrom, Karen Devine, Jordonna Fulop, Yingli Wolinsky, Peter Liao, Lindsay Stetson, Marta Couce, Andrew E Sloan, Jill S Barnholtz-Sloan
The growth of precision medicine has made access to biobanks with high-quality, well-annotated neuro-oncology biospecimens critical. Developing and maintaining neuro-oncology biobanks is best accomplished through multidisciplinary collaboration between clinicians and researchers. Balancing the needs and leveraging the skills of all stakeholders in this multidisciplinary effort is of utmost importance. Collaboration with a multidisciplinary team of clinicians, health care team members, and institutions, as well as patients and their families, is essential for access to participants in order to obtain informed consent, collect samples under strict standard operating procedures, and accurate and relevant clinical annotation...
December 2017: Neuro-oncology Practice
https://www.readbyqxmd.com/read/29580936/safety-and-feasibility-of-a-neuroscience-critical-care-program-to-mobilize-patients-with-primary-intracerebral-hemorrhage
#6
Mona N Bahouth, Melinda C Power, Elizabeth K Zink, Kate Kozeniewski, Sowmya Kumble, Sandra Deluzio, Victor C Urrutia, Robert D Stevens
OBJECTIVE: To measure the impact of a progressive mobility program on patients admitted to a neuroscience critical care unit (NCCU) with intracerebral hemorrhage (ICH). The early mobilization of critically ill patients with spontaneous ICH is a challenge due to the potential for neurologic deterioration and hemodynamic lability in the acute phase of injury. Patients admitted to the ICU have been excluded from randomized trials of early mobilization after stroke. DESIGN: An interdisciplinary working group developed a formalized NCCU Mobility Algorithm which allocates patients to incremental passive or active mobilization pathways on the basis of level of consciousness and motor function...
March 23, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29549499/the-intracranial-pressure-curve-correlates-to-the-pulsatile-component-of-cerebral-blood-flow
#7
Mårten Unnerbäck, Eric L Bloomfield, Sven Söderström, Peter Reinstrup
Current methods to measure cerebral blood flow (CBF) in the neuro critical care setting cannot monitor the CBF continuously. In contrast, continuous measurement of intracranial pressure (ICP) is readily accomplished, and there is a component of ICP that correlates with arterial inflow of blood into the cranial cavity. This property may have utility in using continuous ICP curve analysis to continuously estimate CBF. We examined the data from 13 patients, monitored with an intraventricular ICP device determining the pulsatile amplitude ICPamp as well as the area under the ICP curve (AUCICP )...
March 16, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29492546/hdf5-based-data-format-for-archiving-complex-neuro-monitoring-data-in-traumatic-brain-injury-patients
#8
Manuel Cabeleira, Ari Ercole, Peter Smielewski
OBJECTIVES: Modern neuro-critical care units generate high volumes of data. These data originate from a multitude of devices in various formats and levels of granularity. We present a new data format intended to store these data in an ordered and homogenous way. MATERIAL AND METHODS: The adopted data format was based on the hierarchical model, HDF5, which is capable of dealing with a mixture of small and very large datasets with equal ease. It is possible to access and manipulate individual data elements directly within a single file, and this is extensible and versatile...
2018: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/29434566/assessment-of-platelet-function-in-traumatic-brain-injury-a-retrospective-observational-study-in-the-neuro-critical-care-setting
#9
Caroline Lindblad, Eric Peter Thelin, Michael Nekludov, Arvid Frostell, David W Nelson, Mikael Svensson, Bo-Michael Bellander
Background: Despite seemingly functional coagulation, hemorrhagic lesion progression is a common and devastating condition following traumatic brain injury (TBI), stressing the need for new diagnostic techniques. Multiple electrode aggregometry (MEA) measures platelet function and could aid in coagulopathy assessment following TBI. The aims of this study were to evaluate MEA temporal dynamics, influence of concomitant therapy, and its capabilities to predict lesion progression and clinical outcome in a TBI cohort...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29415773/end-expiratory-occlusion-maneuver-to-predict-fluid-responsiveness-in-the-intensive-care-unit-an-echocardiographic-study
#10
Delphine Georges, Hugues de Courson, Romain Lanchon, Musa Sesay, Karine Nouette-Gaulain, Matthieu Biais
BACKGROUND: In mechanically ventilated patients, an increase in cardiac index during an end-expiratory-occlusion test predicts fluid responsiveness. To identify this rapid increase in cardiac index, continuous and instantaneous cardiac index monitoring is necessary, decreasing its feasibility at the bedside. Our study was designed to investigate whether changes in velocity time integral and in peak velocity obtained using transthoracic echocardiography during an end-expiratory-occlusion maneuver could predict fluid responsiveness...
February 8, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29394481/transitioning-patients-from-the-intensive-care-unit-to-the-general-pediatric-unit-a-piece-of-the-puzzle-in-family-centered-care
#11
Lisa Manente, Terri McCluskey, Rachel Shaw
Transitioning patients from one unit to another is a nursing function that occurs daily. When done effectively, it streamlines continuity of care, decreases anxiety, ensures patients and families maintain confidence in care providers, and avoids readmissions to the intensive care unit (ICU). This article describes a transition plan for transferring patients from the ICU to the general pediatric unit developed by an inpatient, non-critical care cardiology/neuro logical unit to facilitate a smooth and informational transition from the ICU to the non-critical unit...
March 2017: Pediatric Nursing
https://www.readbyqxmd.com/read/29355914/intraoperative-imaging-technology-to-maximise-extent-of-resection-for-glioma
#12
REVIEW
Michael D Jenkinson, Damiano Giuseppe Barone, Andrew Bryant, Luke Vale, Helen Bulbeck, Theresa A Lawrie, Michael G Hart, Colin Watts
BACKGROUND: Extent of resection is considered to be a prognostic factor in neuro-oncology. Intraoperative imaging technologies are designed to help achieve this goal. It is not clear whether any of these sometimes very expensive tools (or their combination) should be recommended as standard care for people with brain tumours. We set out to determine if intraoperative imaging technology offers any advantage in terms of extent of resection over standard surgery and if any one technology was more effective than another...
January 22, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29316820/cost-effectiveness-of-access-to-critical-cerebral-emergency-support-services-access-a-neuro-emergent-telemedicine-consultation-program
#13
Justin Whetten, David N van der Goes, Huy Tran, Maurice Moffett, Colin Semper, Howard Yonas
AIMS: Access to Critical Cerebral Emergency Support Services (ACCESS) was developed as a low-cost solution to providing neuro-emergent consultations to rural hospitals in New Mexico that do not offer comprehensive stroke care. ACCESS is a two-way audio-visual program linking remote emergency department physicians and their patients to stroke specialists. ACCESS also has an education component in which hospitals receive training from stroke specialists on the triage and treatment of patients...
April 2018: Journal of Medical Economics
https://www.readbyqxmd.com/read/29282579/accuracy-of-outside-radiologists-reports-of-computed-tomography-exams-of-emergently-transferred-patients
#14
Jeffrey D Robinson, Ken F Linnau, Daniel S Hippe, Kellie L Sheehan, Joel A Gross
PURPOSE: Growing numbers of patient with advanced imaging being transferred to trauma centers has resulted in increased numbers of outside CT scans received at trauma centers. This study examines the degree of agreement between community radiologists' interpretations of the CT scans of transferred patients and trauma center radiologists' reinterpretation. METHODS: All CT scans of emergency transfer patients received over a 1 month period were reviewed by an emergency radiologist...
April 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29142631/mortality-and-epidemiology-in-256-cases-of-pediatric-traumatic-brain-injury-korean-neuro-trauma-data-bank-system-kntdbs-2010-2014
#15
Hee-Won Jeong, Seung-Won Choi, Jin-Young Youm, Jeong-Wook Lim, Hyon-Jo Kwon, Shi-Hun Song
Objective: Among pediatric injury, brain injury is a leading cause of death and disability. To improve outcomes, many developed countries built neurotrauma databank (NTDB) system but there was not established nationwide coverage NTDB until 2009 and there have been few studies on pediatric traumatic head injury (THI) patients in Korea. Therefore, we analyzed epidemiology and outcome from the big data of pediatric THI. Methods: We collected data on pediatric patients from 23 university hospitals including 9 regional trauma centers from 2010 to 2014 and analyzed their clinical factors (sex, age, initial Glasgow coma scale, cause and mechanism of head injury, presence of surgery)...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29114990/contextualisation-of-patient-centred-care-a-comparative-qualitative-study-of-healthcare-professionals-approaches-to-communicating-with-seriously-ill-patients-about-their-dependent-children
#16
A Dencker, M Kristiansen, B A Rix, P Bøge, T Tjørnhøj-Thomsen
Patients' family relations play an important part in the provision of patient-centred cancer care, not least when healthcare professionals encounter seriously ill patients with dependent children. Little is known about how children are perceived and dealt with in clinical encounters. In this qualitative comparative study, we explore the influence of medical contexts in three Danish hospital wards, haematology, oncological gynaecology and neuro-intensive care, on communication with patients about their children...
January 2018: European Journal of Cancer Care
https://www.readbyqxmd.com/read/29104430/pitfalls-in-the-diagnosis-and-management-of-invasive-pneumococcal-meningoencephalitis-what-we-can-learn-from-a-case
#17
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/29081427/clinical-and-video-head-impulse-test-in-the-diagnosis-of-posterior-circulation-stroke-presenting-as-acute-vestibular-syndrome-in-the-emergency-department
#18
Ayse Guler, Funda Karbek Akarca, Cenk Eraslan, Ceyda Tarhan, Cem Bilgen, Tayfun Kirazli, Nese Celebisoy
INTRODUCTION: Head impulse test (HIT) is the critical bedside examination which differentiates vestibular neuritis (VN) from posterior circulation stroke (PCS) in acute vestibular syndrome (AVS). Video-oculography based HIT (vHIT) may have aadditional strength in making the differentiation. METHODS: Patients admitted to the emergency department of a tertiary-care medical center with AVS were studied. An emergency specialist and a neurologist performed HIT. vHIT was conducted by an neuro-otology research fellow...
2017: Journal of Vestibular Research: Equilibrium & Orientation
https://www.readbyqxmd.com/read/28988019/acute-intermittent-porphyria-after-right-hemi-colectomy
#19
Shadi Alshammary, Reem Al Dulaijan, Khaldoon Saleh, Hazem Zakaria, Ahmed Eldamati, Norah Alwakeel, Abdulmohsen Al-Mulhim
INTRODUCTION: Acute intermittent porphyria is a rare autosomal dominant metabolic disease. It is caused by a genetic mutation that results in deficiency of porphobilinogen deaminase enzyme, the third enzyme in heme biosynthesis. Acute intermittent porphyria precipitated by surgery is very rare. CASE PRESENTATION: We present a 24 year-old woman who developed acute intermittent porphyria five days after right hemi-colectomy. Her presentation included neuro-visceral and psychiatric manifestations, and severe hyponatremia...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28894384/technology-that-achieves-the-triple-aim-an-economic-analysis-of-the-brainpath%C3%A2-approach-in-neurosurgery
#20
Sidney P Norton, Evan M Dickerson, Charles G Kulwin, Mitesh V Shah
BACKGROUND: The Triple Aim is defined as: improving the patient experience of care, improving the health of populations, and reducing the per capita cost of health care. The purpose of this analysis was to evaluate the economic value of a new neurosurgical technique, the BrainPath™ approach, for use in patients with subcortical tumors and intracerebral hemorrhage (ICH). METHODS: Inpatient length of stay (LOS) data were collected for ICH and brain tumor surgical patient cases between August 2013 and November 2015...
2017: ClinicoEconomics and Outcomes Research: CEOR
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