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https://www.readbyqxmd.com/read/29664874/traumatic-brain-injury-and-infectious-encephalopathy-in-children-from-four-resource-limited-settings-in-africa
#1
Ericka L Fink, Amelie von Saint Andre-von Arnim, Rashmi Kumar, Patrick T Wilson, Tigist Bacha, Abenezer Tirsit Aklilu, Tsegazeab Laeke Teklemariam, Shubhada Hooli, Lisine Tuyisenge, Easmon Otupiri, Anthony Fabio, John Gianakas, Patrick M Kochanek, Derek C Angus, Robert C Tasker
OBJECTIVES: To assess the frequency, interventions, and outcomes of children presenting with traumatic brain injury or infectious encephalopathy in low-resource settings. DESIGN: Prospective study. SETTING: Four hospitals in Sub-Saharan Africa. PATIENTS: Children age 1 day to 17 years old evaluated at the hospital with traumatic brain injury or infectious encephalopathy. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We evaluated the frequency and outcomes of children presenting consecutively over 4 weeks to any hospital department with traumatic brain injury or infectious encephalopathy...
April 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29663282/the-frozen-brain-state-of-cryptococcus-gattii-a-globe-trotting-tropical-neurotropic-fungus
#2
Paul T Akins, Brian Jian
Initially reported in tropical regions, Cryptococcus gattii infection is now diagnosed globally. METHODS: case report; Literature review. Although initial reports described outbreaks of pulmonary and central nervous system (CNS) disease in tropical regions such as Australia and New Guinea, it is now clear that Cryptococcus gattii is a global, neurotropic pathogen. In contrast with C. neoformans, C. gattii patients are more likely to present with cryptococcomas in the brain and lungs and are often HIV negative...
April 16, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29662203/potent-antitumor-efficacy-of-anti-gd2-car-t-cells-in-h3-k27m-diffuse-midline-gliomas
#3
Christopher W Mount, Robbie G Majzner, Shree Sundaresh, Evan P Arnold, Meena Kadapakkam, Samuel Haile, Louai Labanieh, Esther Hulleman, Pamelyn J Woo, Skyler P Rietberg, Hannes Vogel, Michelle Monje, Crystal L Mackall
Diffuse intrinsic pontine glioma (DIPG) and other diffuse midline gliomas (DMGs) with mutated histone H3 K27M (H3-K27M)1-5 are aggressive and universally fatal pediatric brain cancers 6 . Chimeric antigen receptor (CAR)-expressing T cells have mediated impressive clinical activity in B cell malignancies7-10 , and recent results suggest benefit in central nervous system malignancies11-13 . Here, we report that patient-derived H3-K27M-mutant glioma cell cultures exhibit uniform, high expression of the disialoganglioside GD2...
April 16, 2018: Nature Medicine
https://www.readbyqxmd.com/read/29659050/continuous-electroencephalography-predicts-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage-a-prospective-study-of-diagnostic-accuracy
#4
Eric S Rosenthal, Siddharth Biswal, Sahar F Zafar, Kathryn L O'Connor, Sophia Bechek, Apeksha V Shenoy, Emily J Boyle, Mouhsin M Shafi, Emily J Gilmore, Brandon P Foreman, Nicolas Gaspard, Thabele M Leslie-Mazwi, Jonathan Rosand, Daniel B Hoch, Cenk Ayata, Sydney S Cash, Andrew J Cole, Aman B Patel, M Brandon Westover
OBJECTIVE: Delayed cerebral ischemia (DCI) is a common, disabling complication of subarachnoid hemorrhage (SAH). Preventing DCI is a key focus of neurocritical care, but interventions carry risk and cannot be applied indiscriminately. While retrospective studies have identified continuous EEG (cEEG) measures associated with DCI, no study has characterized the accuracy of cEEG with sufficient rigor to justify using it to triage patients to interventions or clinical trials. We therefore prospectively assessed the accuracy of cEEG for predicting DCI, following the Standards for Reporting Diagnostic Accuracy Studies...
April 16, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29629983/impact-of-icu-structure-and-processes-of-care-on-outcomes-after-severe-traumatic-brain-injury-a-multicenter-cohort-study
#5
Victoria A McCredie, Aziz S Alali, Damon C Scales, Gordon D Rubenfeld, Brian H Cuthbertson, Avery B Nathens
OBJECTIVES: It is uncertain whether dedicated neurocritical care units are associated with improved outcomes for critically ill neurologically injured patients in the era of collaborative protocol-driven care. We examined the association between dedicated neurocritical care units and mortality and the effects of standardized management protocols for severe traumatic brain injury. DESIGN: We surveyed trauma medical directors from centers participating in the American College of Surgeons Trauma Quality Improvement Program to obtain information about ICU structure and processes of care...
April 6, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29629931/magnetic-resonance-imaging-in-neurocritically-ill-patients-who-fails-and-how
#6
Joong-Goo Kim, Myung-Ah Ko, Han-Bin Lee, Sang-Beom Jeon
OBJECTIVES: Performing magnetic resonance imaging (MRI) in neurocritically ill patients is challenging because it often requires sedation and withholding care in the neurological intensive care unit. This study investigated the incidence of and reasons for failed or complicated MRI (MRI-FC) in such patients. METHODS: A consecutive series of 218 neurocritically ill patients who underwent brain MRI were retrospectively evaluated. Failed or complicated MRI included failure to obtain all ordered sequences, unscheduled sedative administration, decrease in oxygen saturation to less than 90%, hypotension (≥40-mm Hg decrease and/or use of inotropic agents), and cardiac or respiratory arrest...
April 6, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29621072/a-comprehensive-onboarding-and-orientation-plan-for-neurocritical-care-advanced-practice-providers
#7
Tamra M Langley, Jeremy Dority, Justin F Fraser, Kevin W Hatton
BACKGROUND: As the role of advanced practice providers (APPs) expands to include increasingly complex patient care within the intensive care unit, the educational needs of these providers must also be expanded. An onboarding process was designed for APPs in the neurocritical care service line. METHODS: Onboarding for new APPs revolved around 5 specific areas: candidate selection, proctor assignment, 3-phased orientation process, remediation, and mentorship. To ensure effective training for APPs, using the most time-conscious approach, the backbone of the process is a structured curriculum...
April 4, 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29620711/pediatric-neurocritical-care-and-neuromonitoring-in-2018-maybe-we-need-to-go-back-to-the-basics
#8
Anita Patel, Michael J Bell
No abstract text is available yet for this article.
April 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29611254/oxytocin-levels-in-saliva-correlate-better-than-plasma-levels-with-concentrations-in-the-cerebrospinal-fluid-of-patients-in-neurocritical-care
#9
Jan Martin, Simone M Kagerbauer, Jens Gempt, Armin Podtschaske, Alexander Hapfelmeier, Gerhard Schneider
In the converging fields of neuroendocrinology and behavioural neuroscience, the interaction between peripheral secretion and central release of oxytocin in humans has not yet been comprehensively assessed. As the human brain is not directly accessible and as the collection of human cerebrospinal fluid (CSF) usually requires invasive procedures, easier accessible compartments such as blood or saliva attract increasing attention. In this study, we prospectively determined oxytocin concentrations in the three compartments plasma, CSF and saliva of fifty critically ill patients with neurological and neurosurgical diseases...
April 3, 2018: Journal of Neuroendocrinology
https://www.readbyqxmd.com/read/29600909/spontaneous-occult-intracranial-hypotension-precipitating-life-threatening-cerebral-venous-thrombosis-case-report
#10
Avital Perry, Christopher S Graffeo, Waleed Brinjikji, William R Copeland, Alejandro A Rabinstein, Michael J Link
Spontaneous intracranial hypotension (SIH) is an uncommon headache etiology, typically attributable to an unprovoked occult spinal CSF leak. Although frequently benign, serious complications may occur, including cerebral venous thrombosis (CVT). The objective of this study was to examine a highly complicated case of CVT attributable to SIH as a lens for understanding the heterogeneous literature on this rare complication, and to provide useful, evidence-based, preliminary clinical recommendations. A 43-year-old man presented with 1 week of headache, dizziness, and nausea, which precipitously evolved to hemiplegia...
March 30, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29589329/tactical-neurocritical-care
#11
Julio A Chalela, Patrick E Britell
Neurocritical care is usually practiced in the comfort of an intensive care unit within a tertiary care medical center. Physicians deployed to the frontline with the US military or allied military are required to use their critical care skills and their neurocritical skills in austere environments with limited resources. Due to these factors, tactical critical care and tactical neurocritical care differ significantly from traditional critical care. Operational constraints, the tactical environment, and resource availability dictate that tactical neurocritical care be practiced within a well-defined, mission-constrained framework...
March 27, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29579816/systodiastolic-separation-expresses-cerebral-circulatory-arrest
#12
A Cacciatori, M Godino, R Mizraji
There is a situation before the cerebral circulatory cessation phase, the systodiastolic separation in transcranial Doppler (TCD), which may raise doubts to the operator technician who performs it. A total of 266 studies were performed in 188 neurocritical patients over a 9-year period: 88 cases (77%) corresponded to cerebral circulatory arrest (CCA) which accompanies brain death (BD); 9 (5%) presented the systodiastolic separation pattern. In 1 of those 9 there was persistence of cough reflex and spontaneous breathing; in 5, CCA was not reached; only 3 evolved to CCA...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29579815/utility-of-transcranial-doppler-in-the-coordination-of-transplants-10-years-of-experience
#13
A Cacciatori, M Godino, R Mizraji
Transcranial Doppler (TCD) integrated to multimodal neuromonitoring of neurocritical patients is a useful tool in the clinical follow-up. A retrospective and descriptive study of 194 patients who were admitted into the intensive care unit (ICU) was carried out from December 2007 to February 2017. We analyzed the distribution of study frequencies with respect to the pathologies that motivated them, the characteristics of patients who evolved to brain death (BD), and most frequent patterns of cerebral circulatory arrest...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29579814/epidemiologic-and-evolutionary-profile-of-patients-with-subarachnoid-hemorrhage-with-glasgow-coma-scale-score-of-8-or-less-who-entered-the-follow-up-program-of-the-national-institute-of-donation-and-transplantation
#14
N Tommasino, M Saravia, A Rodriguez, R Mizraji
INTRODUCTION: The improvement in understanding the process that determines the death of an individual and his or her evolution toward brain death allows organization and planning of health policies, optimization of clinical activity and management of organ and tissue procurement processes for transplantation. OBJECTIVE: This study sought to analyze the epidemiological and evolutionary profile of patients with spontaneous subarachnoid hemorrhage (SAH) with a Glasgow Coma Scale score (GCS) ≤8 who entered follow-up in the Neurocritical Patient Monitoring Program (SPN) of Instituto Nacional de Donación y Trasplante (INDT), Uruguay...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29579812/neurocritical-patient-characteristics-related-to-brain-death
#15
M C Bacqué, M E Barone, A Yankowski, A Antik, L Trunzo, S Fioretti, P Penone
BACKGROUND: The lack of viable organs for transplantation led to the creation in Argentina of the Glasgow 7 Program based on the detection and follow-up of acute neurologic patients admitted with Glasgow scores ≤7 in selected hospitals. The objective of this study was to determine the likelihood of hospitalized acute neurologic patients progressing to brain death (BD) based on several variables, including age, sex, and admission diagnosis. METHODS: This study was a retrospective cohort analysis of data obtained from the SINTRA (Procurement and Transplantation National Information System) database between 2006 and 2015...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29569130/correlation-of-noninvasive-blood-pressure-and-invasive-intra-arterial-blood-pressure-in-patients-treated-with-vasoactive-medications-in-a-neurocritical-care-unit
#16
Ali A Saherwala, Sonja E Stutzman, Mohamed Osman, Junaid Kalia, Stephen A Figueroa, DaiWai M Olson, Venkatesh Aiyagari
BACKGROUND: The correlation between noninvasive (oscillometric) blood pressure (NBP) and intra-arterial blood pressure (IAP) in critically ill patients receiving vasoactive medications in a Neurocritical Care Unit has not been systematically studied. The purpose of this study is to examine the relationship between simultaneously measured NBP and IAP recordings in these patients. METHODS: Prospective observational study of patients (N = 70) admitted to a neurocritical care unit receiving continuous vasopressor or antihypertensive infusions...
March 22, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29555607/platelet-dysfunction-and-intracerebral-hemorrhage-in-a-patient-treated-with-empiric-piperacillin-tazobactam-in-the-neurocritical-care-unit
#17
Matthew Bower, Candace Borders, Andrew Schnure, Leonid Groysman, Minh-Ha Tran
No abstract text is available yet for this article.
March 16, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29552342/pre-stroke-undiagnosed-dysphagia-lusoria-as-a-rare-cause-of-aspiration-pneumonia-with-respiratory-failure-in-a-stroke-patient
#18
Vera Spatenkova, Pavlina Krejzarova, Jaroslav Jedlicka
Introduction: Dysphagia is a risk factor for aspiration pneumonia and acute respiratory failure in acute stroke patients. Dysphagia lusoria is caused by compression on the esophagus from artery lusoria, when the aberrant right subclavian artery arises from the descending aortic arch. We present a rare case report of pre-stroke undiagnosed dysphagia lusoria as a cause of aspiration pneumonia with acute respiratory failure in a 67-year-old female patient admitted with a minor left intracerebral hemorrhage in the left basal ganglia...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29546536/ten-false-beliefs-in-neurocritical-care
#19
Geert Meyfroidt, David Menon, Alexis F Turgeon
No abstract text is available yet for this article.
March 15, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29524721/non-invasive-intracranial-pressure-monitoring-for-severe-traumatic-brain-injury-in-children-a-concise-update-on-current-methods
#20
REVIEW
Vinayak Narayan, Nasser Mohammed, Amey R Savardekar, Devi Prasad Patra, Christina Notarianni, Anil Nanda
BACKGROUND: Traumatic brain injury [TBI] is a leading cause of pediatric morbidity and mortality worldwide and intracranial pressure [ICP] monitoring plays a crucial role in its management. Based on existing literature, the authors review the current practicing non-invasive ICP monitoring devices and their accuracy in predicting raised ICP in pediatric TBI. MATERIALS AND METHODS: A thorough literature search was conducted on PubMed, Medline and Cochrane data base, articles were selected systematically, reviewed completely and relevant data was summarized and discussed...
March 7, 2018: World Neurosurgery
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