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https://www.readbyqxmd.com/read/27914661/statin-discontinuation-and-mortality-in-an-older-adult-population-with-traumatic-brain-injury-a-four-year-multi-centre-observational-cohort-study
#1
Alessandro Orlando, Christine Thomas, Matthew Carrick, D Sue Slone, Charles W Mains, David Bar-Or
INTRODUCTION: Statin discontinuation has been investigated in a wide range of diseases and injuries, but there is a paucity of data in the older adult population with traumatic brain injury (TBI). The purpose of this study was to re-examine the extent to which early discontinuation of pre-injury statin (PIS) therapy increases the risk of poor patient outcomes in older adult patients suffering a TBI. METHODS: This was a retrospective observational cohort study of adult trauma patients with a blunt TBI across three trauma centres over four years...
November 25, 2016: Injury
https://www.readbyqxmd.com/read/27873233/four-score-predicts-early-outcome-in-patients-after-traumatic-brain-injury
#2
Tee-Tau Eric Nyam, Kam-Hou Ao, Shu-Yu Hung, Mei-Li Shen, Tzu-Chieh Yu, Jinn-Rung Kuo
BACKGROUND: The aim of the study was to determine whether the Full Outline of UnResponsiveness (FOUR) score, which includes eyes opening (E), motor function (M), brainstem reflex (B), and respiratory pattern (R), can be used as an alternate method to the Glasgow Coma Scale (GCS) in predicting intensive care unit (ICU) mortality in traumatic brain injury (TBI) patients. METHODS: From January 2015 to June 2015, patients with isolated TBI admitted to the ICU were enrolled...
November 21, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27873051/clinical-and-radiological-course-of-intracerebral-haemorrhage-associated-with-the-new-non-vitamin-k-anticoagulants
#3
Christian von der Brelie, Alexandros Doukas, Rebecca Naumann, Astrid Dempfle, Naomi Larsen, Michael Synowitz, Olav Jansen, Maximilian Mehdorn, Senol Jadik
BACKGROUND: Clinical outcome and mortality in intracerebral haemorrhage (ICH) associated with anticoagulant treatment is poor. Novel direct oral anticoagulant drugs (NOACs) are increasingly prescribed. Management of NOAC-associated ICH might be more challenging. The aim of this study was to compare the clinical and radiological course of ICH patients being treated with different forms of oral anticoagulant drugs. METHOD: The study is a retrospective observational study...
November 21, 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27871133/civilian-cerebral-gunshot-wounds-a-south-african-experience
#4
Victor Kong, Jocinta Odendaal, Benn Sartorius, Damian Clarke, Petra Brysiewicz, Ellen Jerome, John Bruce, Grant Laing
BACKGROUND: Cerebral gunshot wounds represent one of the most lethal forms of traumatic brain injury, but there is a paucity of literature on the topic, especially from the developing world. We reviewed our experience and describe the spectrum and outcome of civilian cerebral gunshot wounds in a major metropolitan trauma centre in South Africa. METHODS: This was a retrospective study of all patients with isolated cerebral gunshot wounds managed by the Pietermaritzburg Metropolitan Trauma Service over a 5-year period from 2010 to 2014...
November 21, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27858396/evaluation-of-short-term-neurological-outcomes-in-children-diagnosed-with-brain-abscesses
#5
Manolya Acar, Murat Sutcu, Hacer Akturk, Aygozel Muradova, Selda Hancerli-Torun, Nuran Salman, Mine Caliskan, Nail Izgi, Ayper Somer
AIM: To evaluate the neurological outcomes of children diagnosed with brain abscesses in the early post-treatment period. MATERIAL AND METHODS: This study was a retrospective analysis of pediatric brain abscess patients between January 2000 and December 2015 during a 16 years period. Patients were divided into two groups according to their outcome at the end of the treatment. The patients with good outcome were the ones without any neurological sequelae (GOS score 5)...
October 17, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27849133/do-heroin-overdose-patients-require-observation-after-receiving-naloxone
#6
Michael W Willman, David B Liss, Evan S Schwarz, Michael E Mullins
CONTEXT: Heroin use in the US has exploded in recent years, and heroin overdoses requiring naloxone are very common. After awakening, some heroin users refuse further treatment or transport to the hospital. These patients may be at risk for recurrent respiratory depression or pulmonary edema. In those transported to the emergency department, the duration of the observation period is controversial. Additionally, non-medical first responders and lay bystanders can administer naloxone for heroin and opioid overdoses...
November 16, 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27793075/does-modafinil-improve-the-level-of-consciousness-for-people-with-a-prolonged-disorder-of-consciousness-a-retrospective-pilot-study
#7
Samira Kashinath Dhamapurkar, Barbara A Wilson, Anita Rose, Peter Watson, Agnes Shiel
BACKGROUND AND AIM: Modafinil is best known as a sleep regulator among healthy individuals, but studies suggest that it reduces excessive daytime sleepiness in patients with brain injury. This retrospective pilot study evaluated the effectiveness of Modafinil for people with a prolonged disorder of consciousness and whether those with a traumatic brain injury did better than those with a non-traumatic brain injury. METHOD: Twenty four prolonged disorder of consciousness patients who were prescribed Modafinil, were assessed at least four times both before and during treatment...
October 28, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27790397/endovascular-treatment-to-stop-life-threatening-bleeding-from-branches-of-the-external-carotid-artery-in-patients-with-traumatic-maxillofacial-fracture
#8
Woosung Lee, Yu Shik Shim, Joonho Chung
OBJECTIVE: The purpose of this study was to report our preliminary experience with endovascular treatment (EVT) for life-threatening bleeding from branches of the external carotid artery (ECA) in patients with traumatic maxillofacial fractures. MATERIALS AND METHODS: A total of 12 patients seen between March 2010 and December 2014 were included in this study. All subjects met the following criteria: 1) presence of maxillofacial fracture; 2) continuous blood loss from oronasal bleeding; and 3) EVT to stop bleeding...
June 2016: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/27785968/mild-traumatic-brain-injury-longitudinal-study-of-cognition-functional-status-and-post-traumatic-symptoms
#9
Sureyya Dikmen, Joan Machamer, Nancy Temkin
More than 75% of traumatic brain injuries (TBIs) seeking medical attention are mild, and outcome in that group is heterogeneous. Until sensitive and valid biomarkers are identified, methods are needed to classify mild TBI into more homogeneous subgroups. Four hundred twenty-one adults with mild TBI were divided into groups based on Glasgow Coma Scale (GCS) 13-15 without computed tomography (CT) abnormalities, GCS 15 with CT abnormalities, and GCS 13-14 with CT abnormalities, and were compared with 120 trauma controls on 1-month and 1-year outcomes...
December 2, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27768663/incidence-risk-factors-and-mortality-associated-with-acute-respiratory-distress-syndrome-in-combat-casualty-care
#10
Pauline K Park, Jeremy W Cannon, Wen Ye, Lorne H Blackbourne, John B Holcomb, William Beninati, Lena M Napolitano
BACKGROUND: The overall incidence and mortality of acute respiratory distress syndrome (ARDS) in civilian trauma settings have decreased over the past four decades; however, the epidemiology and impact of ARDS on modern combat casualty care are unknown. We sought to determine the incidence, risk factors, resource utilization, and mortality associated with ARDS in current combat casualty care. METHODS: This was a retrospective review of mechanically ventilated US combat casualties within the Department of Defense Trauma Registry (formerly the Joint Theater Trauma Registry) during Operation Iraqi Freedom/Enduring Freedom (October 2001 to August 2008) for ARDS development, resource utilization, and mortality...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27752625/treatment-of-acute-carbon-monoxide-poisoning-with-induced-hypothermia
#11
Byoung-Joon Oh, Yong-Gyun Im, Eunjung Park, Young-Gi Min, Sang-Cheon Choi
OBJECTIVE: The effect of induced hypothermia on severe acute carbon monoxide (CO) poisoning remains to be addressed further. We investigated the effect of induced hypothermia on severe acute CO poisoning. METHODS: Retrospective chart review was conducted for patients who diagnosed as severe acute CO poisoning in emergency department and underwent induced hypothermia from May 2013 to May 2014. Hospital courses with critical medication and major laboratory results were investigated through the chart review...
June 2016: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/27749342/subarachnoid-hemorrhage-patients-admitted-to-intensive-care-in-australia-and-new-zealand-a-multicenter-cohort-analysis-of-in-hospital-mortality-over-15-years
#12
Andrew A Udy, Chelsey Vladic, Edward Robert Saxby, Jeremy Cohen, Anthony Delaney, Oliver Flower, Matthew Anstey, Rinaldo Bellomo, David James Cooper, David V Pilcher
OBJECTIVE: The primary aim of this study was to describe in-hospital mortality in subarachnoid hemorrhage patients requiring ICU admission. Secondary aims were to identify clinical characteristics associated with inferior outcomes, to compare subarachnoid hemorrhage mortality with other neurological diagnoses, and to explore the variability in subarachnoid hemorrhage standardized mortality ratios. DESIGN: Multicenter, binational, retrospective cohort study. SETTING: Data were extracted from the Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation Adult Patient Database...
October 3, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27749290/extubation-failure-in-brain-injured-patients-risk-factors-and-development-of-a-prediction-score-in-a-preliminary-prospective-cohort-study
#13
Thomas Godet, Russell Chabanne, Julien Marin, Sophie Kauffmann, Emmanuel Futier, Bruno Pereira, Jean-Michel Constantin
BACKGROUND: The decision to extubate brain-injured patients with residual impaired consciousness holds a high degree of uncertainty of success. The authors developed a pragmatic clinical score predictive of extubation failure in brain-injured patients. METHODS: One hundred and forty brain-injured patients were prospectively included after the first spontaneous breathing trial success. Assessment of multiparametric hemodynamic, respiratory, and neurologic functions was performed just before extubation...
October 3, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27636352/prehospital-glucose-testing-for-children-with-seizures-a-proposed-change-in-management
#14
Katherine Remick, Christopher Redgate, Daniel Ostermayer, Amy H Kaji, Marianne Gausche-Hill
OBJECTIVE: Many Emergency Medicine Services (EMS) protocols require point-of-care blood glucose testing (BGT) for any pediatric patient who presents with seizure or altered level of conscious. Few data describe the diagnostic yield of BGT when performed on all pediatric seizures regardless of presenting mental status. We analyzed a large single center dataset of pediatric patients presenting with prehospital seizures to determine the prevalence of hypoglycemic seizures and the utility of repeat BGT in the emergency department (ED)...
September 16, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27630460/comparison-of-outcome-predictions-by-the-glasgow-coma-scale-and-the-full-outline-of-unresponsiveness-score-in-the-neurological-and-neurosurgical-patients-in-the-intensive-care-unit
#15
Kishor Khanal, Sanjeeb Sudarshan Bhandari, Ninadini Shrestha, Subhash Prasad Acharya, Moda Nath Marhatta
Assessment of level of consciousness is very important in predicting patient's outcome from neurological illness. Glasgow coma scale (GCS) is the most commonly used scale, and Full Outline of UnResponsiveness (FOUR) score is also recently validated as an alternative to GCS in the evaluation of the level of consciousness. We carried out a prospective study in 97 patients aged above 16 years. We measured GCS and FOUR score within 24 h of Intensive Care Unit admission. The mean GCS and the FOUR scores were lower among nonsurvivors than among the survivors and were statistically significant (P < 0...
August 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27624508/acute-porphyria-presenting-as-major-trauma-case-report-and-literature-review
#16
Joel Norton, Christine Hymers, Penelope Stein, Joanne May Jenkins, Duncan Bew
BACKGROUND: Acute porphyria is historically known as "the little imitator" in reference to its reputation as a notoriously difficult diagnosis. Variegate porphyria is one of the four acute porphyrias, and can present with both blistering cutaneous lesions and acute neurovisceral attacks involving abdominal pain, neuropsychiatric features, neuropathy, hyponatremia, and a vast array of other nonspecific clinical features. CASE REPORT: A 40-year-old man presented to the Emergency Department (ED) as a major trauma call, having been found in an "acutely confused state" surrounded by broken glass...
November 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27601380/noncontrast-computed-tomography-hypodensities-predict-poor-outcome-in-intracerebral-hemorrhage-patients
#17
Gregoire Boulouis, Andrea Morotti, H Bart Brouwers, Andreas Charidimou, Michael J Jessel, Eitan Auriel, Octavio Pontes-Neto, Alison Ayres, Anastasia Vashkevich, Kristin M Schwab, Jonathan Rosand, Anand Viswanathan, Mahmut E Gurol, Steven M Greenberg, Joshua N Goldstein
BACKGROUND AND PURPOSE: Noncontrast computed tomographic (CT) hypodensities have been shown to be associated with hematoma expansion in intracerebral hemorrhage (ICH), but their impact on functional outcome is yet to be determined. We evaluated whether baseline noncontrast CT hypodensities are associated with poor clinical outcome. METHODS: We performed a retrospective review of a prospectively collected cohort of consecutive patients with primary ICH presenting to a single academic medical center between 1994 and 2016...
October 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27593823/television-tip-overs-and-head-traumas-in-childhood-results-of-36-children-from-a-reference-center-in-central-anatolia-turkey
#18
Ahmet Küçük, Abdulfettah Tümtürk
AIM: Television tip overs and head traumas in children showed an increase in the recent years in Turkey and throughout the World. In this study, the injury types, the surgical interventions and the children exposed to head trauma due to an accident caused by a falling television were investigated retrospectively. Some cautions were suggested in order to prevent these injuries. MATERIAL AND METHODS: In the study, the gender, age, Pediatric Glasgow Coma Scale, radiologic findings, the need for intensive care unit, the period spent in the hospital, the applied surgical treatments, the accompanied treatment and pathology of 36 children's case treated in the neurosurgery department of the Erciyes University School of Medicine were evaluated...
April 26, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27511325/simvastatin-s-effects-on-survival-and-outcome-in-traumatic-braininjury-patients-a-comparative-study
#19
Taraneh Naghibi, Sara Madani, Saideh Mazloomzadeh, Faramarz Dobakhti
BACKGROUND/AIM: Mortality and morbidity still remain high in patients with traumatic brain injuries. Understanding the role of new treatments in these patients is critical. The aim of this study was to determine the effect of simvastatin on survival and outcome in traumatic brain injury patients. MATERIALS AND METHODS: Forty-four patients were assigned to receive either simvastatin or a placebo. The serum interleukin-6 and C-reactive protein levels were measured at the first 24 h and 48 h after trauma...
2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/27490048/intrastromal-corneal-ring-segment-implantation-in-409-paracentral-keratoconic-eyes
#20
Luis Fernández-Vega Cueto, Carlos Lisa, Aranzazu Poo-López, David Madrid-Costa, Jesús Merayo-Lloves, Jose F Alfonso
PURPOSE: To assess the efficacy outcomes of implanting intrastromal corneal ring segments (ICRS) to correct paracentral keratoconus. METHODS: Four hundred nine eyes with paracentral keratoconus, in which the differences between the axes of refractive cylinder and the corneal flattest meridian and the comatic aberration map were less than 30 degrees, were evaluated before and after the implantation of Ferrara-type ICRS. Snellen uncorrected and best-corrected distance visual acuity, residual refractive errors analyzed with vector analysis, and the root mean square for corneal coma-like aberration for a pupil size of 4...
November 2016: Cornea
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