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https://www.readbyqxmd.com/read/28441453/brainstem-response-patterns-in-deeply-sedated-critically-ill-patients-predict-28-day-mortality
#1
Benjamin Rohaut, Raphael Porcher, Tarik Hissem, Nicholas Heming, Patrick Chillet, Kamel Djedaini, Guy Moneger, Stanislas Kandelman, Jeremy Allary, Alain Cariou, Romain Sonneville, Andréa Polito, Marion Antona, Eric Azabou, Djillali Annane, Shidasp Siami, Fabrice Chrétien, Jean Mantz, Tarek Sharshar
BACKGROUND AND PURPOSE: Deep sedation is associated with acute brain dysfunction and increased mortality. We had previously shown that early-assessed brainstem reflexes may predict outcome in deeply sedated patients. The primary objective was to determine whether patterns of brainstem reflexes might predict mortality in deeply sedated patients. The secondary objective was to generate a score predicting mortality in these patients. METHODS: Observational prospective multicenter cohort study of 148 non-brain injured deeply sedated patients, defined by a Richmond Assessment sedation Scale (RASS) <-3...
2017: PloS One
https://www.readbyqxmd.com/read/28410590/early-predictors-of-poor-outcome-after-out-of-hospital-cardiac-arrest
#2
Louise Martinell, Niklas Nielsen, Johan Herlitz, Thomas Karlsson, Janneke Horn, Matt P Wise, Johan Undén, Christian Rylander
BACKGROUND: Early identification of predictors for a poor long-term outcome in patients who survive the initial phase of out-of-hospital cardiac arrest (OHCA) may facilitate future clinical research, the process of care and information provided to relatives. The aim of this study was to determine the association between variables available from the patient's history and status at intensive care admission with outcome in unconscious survivors of OHCA. METHODS: Using the cohort of the Target Temperature Management trial, we performed a post hoc analysis of 933 unconscious patients with OHCA of presumed cardiac cause who had a complete 6-month follow-up...
April 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28393761/enhancing-clinical-communication-assessments-using-an-audiovisual-bci-for-patients-with-disorders-of-consciousness
#3
Fei Wang, Yanbin He, Jun Qu, Qiuyou Xie, Qing Lin, Xiaoxiao Ni, Yan Chen, Steven Laureys, Ronghao Yu, Yuanqing Li
OBJECTIVE: The JFK Coma Recovery Scale-Revised (JFK CRS-R), a behavioral observation scale, is widely used in the clinical diagnosis/assessment of patients with disorders of consciousness (DOC). However, the JFK CRS-R is associated with a high rate of misdiagnosis (approximately 40%) because DOC patients cannot provide sufficient behavioral responses. A brain-computer interface (BCI) that detects command/intention-specific changes in electroencephalography (EEG) signals without the need for behavioral expression may provide an alternative method...
April 10, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28385054/detecting-early-recovery-of-consciousness-a-comparison-of-methods
#4
Kristin V Day, Michael V DiNapoli, John Whyte
Early detection of the return of consciousness has important implications for prognosis and rehabilitation access. The aim of this study was to compare the Coma Recovery Scale-Revised (CRS-R) with individualised quantitative behavioural assessments (IQBA) to determine which method is capable of detecting command-following earlier and more consistently in persons with disorders of consciousness (DoC). Data from 27 patients with DoC, who underwent both assessments concurrently during inpatient rehabilitation, were retrospectively analysed...
April 7, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28347684/prognostic-model-for-patients-with-traumatic-brain-injuries-and-abnormal-computed-tomography-scans
#5
Jefferson Rosi Junior, Leonardo C Welling, Marcelo Schafranski, Lin Tchia Yeng, Rogério Ruscito do Prado, Edwin Koterba, Almir Ferreira de Andrade, Manoel Jacobsen Teixeira, Eberval Gadelha Figueiredo
Traumatic brain injury (TBI) is an important cause of death and disability worldwide. The prognosis evaluation is a challenge when many variables are involved. The authors aimed to develop prognostic model for assessment of survival chances after TBI based on admission characteristics, including extracranial injuries, which would allow application of the model before in-hospital therapeutic interventions. A cohort study evaluated 1275 patients with TBI and abnormal CT scans upon admission to the emergency unit of Hospital das Clinicas of University of Sao Paulo and analyzed the final outcome on mortality...
March 24, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28298042/the-effect-of-cranioplasty-following-decompressive-craniectomy-on-cerebral-blood-perfusion-neurological-and-cognitive-outcome
#6
Adnan Hussain Shahid, Manju Mohanty, Navneet Singla, Bhagwant Rai Mittal, Sunil Kumar Gupta
OBJECTIVE Decompressive craniectomy is an established therapy for refractory intracranial hypertension. Cranioplasty following decompressive craniectomy not only provides protection to the brain along with cosmetic benefits, but also enhances rehabilitation with meaningful functional recovery of potentially reversible cortical and subcortical damaged areas of the affected as well as the contralateral hemisphere. The aim of the study was to assess neurological and cognitive outcome as well as cerebral blood flow after cranioplasty...
March 3, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28273219/evaluation-of-care-for-traffic-accidents-victims-made-by-on-duty-emergency-physicians-and-surgeons-in-the-emergency-room
#7
Vlaudimir Dias Marques, Mauricio Medeiros Lemos, Cesar Orlando Peralta Bandeira, Amélia Cristina Seidel, Sandra Maria Peloso, Maria Dalva DE Barros Carvalho
OBJECTIVE: to evaluate the care for victims of traffic accidents by on call emergency physicians and/or surgeons in the emergency room. METHODS: we conducted a retrospective, descriptive and exploratory study on the care for traffic accidents victims in the urban area of ​​Maringá-PR, between July 2013 and July 2014 in reference hospitals. We assessed demographics and vocational training through a questionnaire sent to the attending physicians. RESULTS: of the 688 records evaluated, 99% of patients had a prehospital Revised Trauma Score of 12...
December 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28272853/acute-extradural-haematomas-in-children-a-single-neurosurgery-unit-s-12-year-experience
#8
B Enicker, H Louw, T Madiba
BACKGROUND: Acute extradural haematomas (AEDHs) occur infrequently in children. This study was undertaken to review our experience with management and outcomes of this condition in children treated in the Neurosurgery Unit at Inkosi Albert Luthuli Central Hospital. METHOD: A retrospective review of medical records of all children (age less than or equal to (≤) 12 years) with a diagnosis of AEDH admitted from January 2003 to December 2014 was performed. Records were analyzed for demographics, mechanisms of injury, clinical presentation, neuroradiology findings, management and outcomes at discharge...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28252218/the-bandung-neurosurgery-patient-outcomes-project-indonesia-part-i-methods-participant-characteristics-and-pre-discharge-outcomes
#9
Susan McAllister, Amelia Ganefianty, Ahmad Faried, Agung Budi Sutiono, Kalih Sarjono, Regina Melia, Sheila Sumargo, Muhammad Zafrullah Arifin, Sarah Derrett
INTRODUCTION: Little is known about neurosurgery patient outcomes in Indonesia. Our study sought to describe patient characteristics, health care pathways, health-related quality of life, and health/rehabilitation care needs of patients admitted to, and discharged from, a major neurosurgery department. METHODS: Eligible patients were aged ≥18 years admitted to the Neurosurgery Department in a regional referral hospital in Bandung, Indonesia. Baseline data was collected on admission...
March 2, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28250601/early-administration-of-selenium-in-patients-with-acute-traumatic-brain-injury-a-randomized-double-blinded-controlled-trial
#10
Omid Moradi Moghaddam, Mohammad Niakan Lahiji, Valiollah Hassani, Shakiba Mozari
AIM: The present study was carried out to examine this hypothesis that administration of selenium can prevent the development of injuries by brain trauma and thus can modulate patients' functional recovery and also improve posttraumatic outcome. MATERIALS AND METHODS: This double-blinded controlled trial was carried out on 113 patients who were hospitalized following traumatic brain injury (TBI) with Glasgow Coma Scale score of 4-12 that were randomly assigned to receive selenium within 8 h after injury plus standard treatment group or routine standard treatment alone as the control...
February 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28243098/delirium-after-a-traumatic-brain-injury-predictors-and-symptom-patterns
#11
Jutaporn Maneewong, Benchalak Maneeton, Narong Maneeton, Tanat Vaniyapong, Patrinee Traisathit, Natthanidnan Sricharoen, Manit Srisurapanont
BACKGROUND: Delirium in traumatic brain injury (TBI) is common, may be predictable, and has a multifaceted symptom complex. This study aimed to examine: 1) the sum score of Glasgow Coma Scale (GCS) and if its component scores could predict delirium in TBI patients, and 2) the prominent symptoms and their courses over the first days after TBI. METHODS: TBI patients were recruited from neurosurgical ward inpatients. All participants were hospitalized within 24 hours after their TBI...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28239544/measures-of-metabolism-and-complexity-in-the-brain-of-patients-with-disorders-of-consciousness
#12
Olivier Bodart, Olivia Gosseries, Sarah Wannez, Aurore Thibaut, Jitka Annen, Melanie Boly, Mario Rosanova, Adenauer G Casali, Silvia Casarotto, Giulio Tononi, Marcello Massimini, Steven Laureys
BACKGROUND: Making an accurate diagnosis in patients with disorders of consciousness remains challenging. (18)F-fluorodeoxyglucose (FDG)-PET has been validated as a diagnostic tool in this population, and allows identifying unresponsive patients with a capacity for consciousness. In parallel, the perturbational complexity index (PCI), a new measure based on the analysis of the electroencephalographic response to transcranial magnetic stimulation, has also been suggested as a tool to distinguish between unconscious and conscious states...
2017: NeuroImage: Clinical
https://www.readbyqxmd.com/read/28230712/updating-evidence-for-using-hypothermia-in-pediatric-severe-traumatic-brain-injury-conventional-and-bayesian-meta-analytic-perspectives
#13
Robert C Tasker, Frederick W Vonberg, Elizabeth D Ulano, Alireza Akhondi-Asl
OBJECTIVE: To evaluate clinical trials of hypothermia management on outcome in pediatric patients with severe traumatic brain injury using conventional and Bayesian meta-analyses. DATA SOURCES: Screening of PubMed and other databases to identify randomized controlled trials of hypothermia for pediatric severe traumatic brain injury published before September 2016. STUDY SELECTION: Four investigators assessed and reviewed randomized controlled trial data...
April 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28226284/does-suboccipital-decompression-and-evacuation-of-intraparenchymal-hematoma-improve-neurological-outcome-in-patients-with-spontaneous-cerebellar-hemorrhage
#14
Katharina A M Hackenberg, Andreas W Unterberg, Carla S Jung, Julian Bösel, Silvia Schönenberger, Klaus Zweckberger
OBJECTIVE: Spontaneous cerebellar hemorrhages (SCH) can lead to life-threatening complications with high mortality rates of 20-50%. Although complications of SCH can be prevented by surgical therapy, there is a lack of consensus concerning the optimal surgical technique for evacuating SCH. METHODS: In this retrospective study 85 patients with SCH were divided into four treatment groups: (1) Decompression and Hematoma Evacuation via suboccipital craniectomy and removal of the posterior arch of C1 (DHE)...
April 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28149821/usefulness-of-full-outline-of-unresponsiveness-score-to-predict-extubation-failure-in-intubated-critically-ill-patients-a-pilot-study
#15
Tarek Said, Anis Chaari, Karim Abdel Hakim, Dalia Hamama, William Francis Casey
OBJECTIVE: To assess the usefulness of the full outline of unresponsiveness (FOUR) score in predicting extubation failure in critically ill intubated patients admitted with disturbed level of conscious in comparison with the Glasgow coma scale (GCS). PATIENTS AND METHODS: All intubated critically ill patients with a disturbed level of consciousness were assessed using both the FOUR score and the GCS. The FOUR score and the GCS were compared regarding their predictive value for successful extubation at 14 days after intubation as a primary outcome measure...
October 2016: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28149077/outcome-prediction-after-traumatic-brain-injury-comparison-of-the-performance-of-routinely-used-severity-scores-and-multivariable-prognostic-models
#16
Marek Majdan, Alexandra Brazinova, Martin Rusnak, Johannes Leitgeb
OBJECTIVES: Prognosis of outcome after traumatic brain injury (TBI) is important in the assessment of quality of care and can help improve treatment and outcome. The aim of this study was to compare the prognostic value of relatively simple injury severity scores between each other and against a gold standard model - the IMPACT-extended (IMP-E) multivariable prognostic model. MATERIALS AND METHODS: For this study, 866 patients with moderate/severe TBI from Austria were analyzed...
January 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28125307/chinese-translation-of-the-coma-recovery-scale-revised
#17
Haibo Di, Minhui He, Ying Zhang, Lijuan Cheng, Fuyan Wang, Yunzhi Nie, Wangshan Huang, Steven Laureys, Caroline Schnakers
BACKGROUND: Misdiagnosis rate is high in patients with disorders of consciousness, potentially leading to an inappropriate clinical management of these patients. Sensitive standardised rating scales offer some protections from these diagnostic errors. In this context, the use of the Coma Recovery Scale-Revised (CRS-R) has strongly been recommended by the American Congress of Rehabilitation Medicine. OBJECTIVE: Here, we present the work that has been performed to translate this important diagnostic tool in Chinese...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28123622/full-outline-of-unresponsiveness-score-and-the-glasgow-coma-scale-in-prediction-of-pediatric-coma
#18
Atahar Jamal, Naveen Sankhyan, Murlidharan Jayashree, Sunit Singhi, Pratibha Singhi
BACKGROUND: This study was done to compare the admission Full Outline of Unresponsiveness (FOUR) score and Glasgow Coma Scale (GCS) as predictors of outcome in children with impaired consciousness. METHODS: In this observational study, children (5-12 years) with impaired consciousness of <7 days were included. Children with traumatic brain injury, on sedatives or neuromuscular blockade; with pre-existing cerebral palsy, mental retardation, degenerative brain disease, vision/hearing impairment; and seizure within last 1 hour were excluded...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28108097/factors-predicting-recovery-of-oral-intake-in-stroke-survivors-with-dysphagia-in-a-convalescent-rehabilitation-ward
#19
Yasunori Ikenaga, Sayaka Nakayama, Hiroki Taniguchi, Isao Ohori, Nahoko Komatsu, Hitoshi Nishimura, Yasuo Katsuki
BACKGROUND: Percutaneous endoscopic gastrostomy may be performed in dysphagic stroke patients. However, some patients regain complete oral intake without gastrostomy. This study aimed to investigate the predictive factors of intake, thereby determining gastrostomy indications. METHOD: Stroke survivors admitted to our convalescent rehabilitation ward who underwent gastrostomy or nasogastric tube placement from 2009 to 2015 were divided into 2 groups based on intake status at discharge...
January 17, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28103876/the-norwegian-version-of-the-qolibri-a-study-of-metric-properties-based-on-a-12%C3%A2-month-follow-up-of-persons-with-traumatic-brain-injury
#20
Helene Lundgaard Soberg, Cecilie Roe, Cathrine Brunborg, Nicole von Steinbüchel, Nada Andelic
BACKGROUND: Consequences after Traumatic brain injury (TBI) affect the injured person's self-image and quality of life. The purpose was to assess the health related quality of life (HRQoL) at 12 months after a TBI in patients admitted to regional trauma centres, and to evaluate the metric properties of the Norwegian version of the Quality of Life After Brain Injury (QOLIBRI) questionnaire. METHODS: Two hundred four patients with TBI of all severities were included...
January 19, 2017: Health and Quality of Life Outcomes
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