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https://www.readbyqxmd.com/read/29239885/the-present-state-of-neurointensivist-training-in-the-united-states-a-comparison-to-other-critical-care-training-programs
#1
Evie G Marcolini, David B Seder, Jordan B Bonomo, Thomas P Bleck, J Claude Hemphill, Lori Shutter, Fred Rincon, Shelly D Timmons, Paul Nyquist
OBJECTIVE: This manuscript describes the state of neurocritical care fellowship training, compares its written standards to those of other critical care fellowship programs, and discusses how programmatic oversight by the United Council for Neurological Subspecialties should evolve to meet American College of Graduate Medical Education standards. This review is a work product of the Society of Critical Care Medicine Neuroscience section and was reviewed and approved by the Council of the Society of Critical Care Medicine...
December 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29228894/is-therapeutic-hypothermia-during-neonatal-extracorporeal-membrane-oxygenation-associated-with-intracranial-hemorrhage
#2
Katherine Cashen, Ron W Reeder, Christina Shanti, Heidi J Dalton, J Michael Dean, Kathleen L Meert
INTRODUCTION: The use of therapeutic hypothermia during neonatal extracorporeal membrane oxygenation (ECMO) as a neurologic protective strategy has gained interest among clinicians despite limited data. Our objective is to describe the relationship between the use of therapeutic hypothermia during neonatal ECMO and complications, mortality and functional status among survivors. METHODS: Secondary analysis of data collected by the Collaborative Pediatric Critical Care Research Network between December 2012 and September 2014...
December 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29228858/common-patterns-of-regional-brain-injury-detectable-by-dti-in-otherwise-normal-appearing-white-matter-in-patients-with-early-moderate-to-severe-traumatic-brain-injury
#3
Kristine O'Phelan, Chad Kuniyuki Otoshi, Thomas M Ernst, Linda Chang
Traumatic brain injury (TBI) alters the lives of millions of people every year. Although mortality rates have improved, due to better prehospital care and reduction of secondary injury in the critical care setting, improvements in functional outcomes after TBI have been difficult to achieve. Diffusion-tensor imaging (DTI) allows detailed measurement of microstructural damage in regional brain tissue after TBI, thus improving our understanding of the extent and severity of TBI. METHODS: Twenty subjects were recruited from a Neurological Intensive Care Unit, and compared to 18 healthy control subjects...
December 11, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29224579/wilder-penfield-sir-arthur-currie-and-the-montreal-neurological-institute
#4
R Mark Sadler
Wilder Penfield and the Montreal Neurological Institute (MNI) are inextricably linked. It was Penfield's unique idea to create a building with an academic atmosphere wherein basic neuroscience and clinical care of neurological patients would benefit from interaction and mutual support. It is clear that without Penfield that there would be no MNI; however, the role of another Canadian icon, Sir Arthur Currie, in the development of the MNI has heretofore been barely mentioned. The thesis of this paper is that Currie had a critical role in the gestation of the MNI that has generally been ignored...
December 11, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29218262/neurologic-outcomes-following-care-in-the-pediatric-intensive-care-unit
#5
Sherrill D Caprarola, Sapna R Kudchadkar, Melania M Bembea
Purpose of review: With increasing survival of children requiring admission to pediatric intensive care units (PICU), neurodevelopmental outcomes of these patients are an area of increased attention. Our goal was to systematically review recently published literature on neurologic outcomes of PICU patients. Recent Findings: Decline in neurofunctional status occurs in 3%-20% of children requiring PICU care. This proportion varies based on primary diagnosis and severity of illness, with children admitted for primary neurologic diagnosis, children who suffer cardiac arrest or who require invasive interventions during the PICU admission, having worse outcomes...
September 2017: Current Treatment Options in Pediatrics
https://www.readbyqxmd.com/read/29217500/peripheral-neuropathy-as-a-complication-of-diabetic-ketoacidosis-in-a-child-with-newly-diagnosed-diabetes-type-1-case-report
#6
Marta Baszyńska-Wilk, Marta Wysocka-Mincewicz, Anna Świercz, Jolanta Świderska, Magdalena Marszał, Mieczysław Szalecki
BACKGROUND: Neurological complications of diabetic ketoacidosis are considered to be very serious clinical problem. The most common complication is cerebral edema. However this group includes also less common syndromes such as ischemic or hemorrhagic stroke, cerebral venous and sinus thrombosis or very rare peripheral neuropathy. CASE REPORT: We present a case of 9-year old girl with new onset type 1 diabetes, diabetic ketoacidosis, cerebral edema, multifocal vasogenic brain lesions and lower limbs peripheral paresis...
December 8, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/29198281/neuropsychological-assessment-past-and-future
#7
Kaitlin B Casaletto, Robert K Heaton
Neuropsychological assessment tools are the staple of our field. The development of standardized metrics sensitive to brain-behavior relationships has shaped the neuropsychological questions we can ask, our understanding of discrete brain functions, and has informed the detection and treatment of neurological disorders. We identify key turning points and innovations in neuropsychological assessment over the past 40-50 years that highlight how the tools used in common practice today came to be. Also selected for emphasis are several exciting lines of research and novel approaches that are underway to further probe and characterize brain functions to enhance diagnostic and treatment outcomes...
October 2017: Journal of the International Neuropsychological Society: JINS
https://www.readbyqxmd.com/read/29197154/risk-factors-for-serious-outcomes-associated-with-influenza-illness-in-high-versus-low-and-middle-income-countries-systematic-literature-review-and-meta-analysis
#8
Brenda L Coleman, Shaza A Fadel, Tiffany Fitzpatrick, Sera-Melisa Thomas
AIM: To determine factors associated with a serious outcome (hospital admission or severe outcome: critical care or death) and associated with illness caused by laboratory-confirmed influenza, with a specific interest in low- and middle-income countries (LMIC). METHOD: Databases were searched on 11 March 2016 for reports of influenza and factors associated with mortality or morbidity in humans, with no language restrictions. Pooled risks were estimated using random-effects models...
December 2, 2017: Influenza and Other Respiratory Viruses
https://www.readbyqxmd.com/read/29194171/improving-the-accuracy-of-delirium-assessments-in-neuroscience-patients-scaling-a-quality-improvement-program-to-improve-nurses-skill-compliance-and-accuracy-in-the-use-of-the-confusion-assessment-method-in-the-intensive-care-unit-tool
#9
Justin DiLibero, Susan DeSanto-Madeya, Rachael Dottery, Lauren Sullivan, Sharon C O'Donoghue
BACKGROUND: Delirium affects up to 80% of critically ill patients; however, many cases of delirium go unrecognized because of inaccurate assessments. The effectiveness of interventions to improve assessment accuracy among the general population has been established, but assessments among neuroscience patients are uniquely complicated due to the presence of structural neurologic changes. OBJECTIVES: The purposes of this quality improvement project were to improve the accuracy of nurse's delirium assessments among neuroscience patients and to determine the comparative effectiveness of the intervention between medical and neuroscience patients...
January 2018: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/29191488/introduction-to-neuroimaging
#10
REVIEW
Elizabeth George, Jeffrey P Guenette, Thomas C Lee
Primary care physicians are often tasked with evaluating neurologic symptoms and imaging plays a critical role in neurologic diagnoses. Neuroradiology routinely employs advanced imaging modalities and hence, determination of the appropriate imaging test and interpretation of findings in the clinical context can understandably be overwhelming. In this review article, we introduce resources that can guide physicians in the selection of neuroimaging tests and summarize guidelines on contrast agent administration...
November 27, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29174722/functional-progression-of-patients-with-neurological-diseases-in-a-tertiary-paediatric-intensive-care-unit-our-experience
#11
P Madurga Revilla, J López Pisón, P Samper Villagrasa, J P García Íñiguez, R Garcés Gómez, M Domínguez Cajal, I Gil Hernández
INTRODUCTION: Neurological diseases explain a considerable proportion of admissions to paediatric intensive care units (PICU), and are a significant cause of morbidity and mortality. This study aims to analyse the functional progression of children with critical neurological conditions. MATERIAL AND METHODS: Retrospective descriptive study of children admitted to PICU with neurological diseases over a period of 3 years (2012-2014), assessing vital and functional prognosis at PICU discharge and at one year according to the Pediatric Cerebral and Overall Performance Category scales (PCPC-POPC) and the Functional Status Scale (FSS)...
November 23, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29169546/telehealth-electronic-monitoring-to-reduce-postdischarge-complications-and-surgical-site-infections-after-arterial-revascularization-with-groin-incision
#12
RANDOMIZED CONTROLLED TRIAL
Albeir Y Mousa, Mike Broce, Elaine Davis, Barbara McKee, Michael Yacoub
It is intuitive that postdischarge surgical complications are associated with increased patient dissatisfaction, and are directly associated with an increase in medical expenditures. It is also easy to make the connection that many post-hospital discharge surgical complications, including surgical site infections (SSIs), could be influenced or exacerbated by patient comorbidities. The authors of a recent study reported that female gender, obesity, diabetes, smoking, hypertension, coronary artery disease, critical limb ischemia, chronic obstructive pulmonary disease, dyspnea, and neurologic disease were significant predictors of SSIs after vascular reconstruction was performed...
December 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29165737/management-of-hemostasis-for-pediatric-patients-on-ventricular-assist-devices
#13
Iki Adachi, Vadim Kostousov, Lisa Hensch, Martin A Chacon-Portillo, Jun Teruya
Ventricular-assist devices (VADs) have seen increased utilization in the pediatric population. Formerly, this therapeutic modality was limited to only the pulsatile VAD, EXCOR (Berlin Heart GmbH). However, the continuous flow VAD devices, HeartMate II (Abbott Inc.) and HeartWare (Medtronic Inc.), are now increasingly used in this population. Postoperatively, VAD patients are acutely anticoagulated using unfractionated heparin, often beginning 24 to 48 hours after VAD placement. Once the patient is stabilized and ready to transition to a lower acuity or outpatient setting, low-molecular-weight heparin or warfarin therapy may be instituted...
November 17, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29163327/the-state-of-neurocritical-care-fellowship-training-and-attitudes-toward-accreditation-and-certification-a-survey-of-neurocritical-care-fellowship-program-directors
#14
Rajat Dhar, Venkatakrishna Rajajee, Anna Finley Caulfield, Matthew B Maas, Michael L James, Avinash Bhargava Kumar, Stephen A Figueroa, David McDonagh, Agnieszka Ardelt
Neurocritical care as a recognized and distinct subspecialty of critical care has grown remarkably since its inception in the 1980s. As of 2016, there were 61 fellowship training programs accredited by the United Council for Neurologic Subspecialties (UCNS) in the United States and more than 1,000 UCNS-certified neurointensivists from diverse medical backgrounds. In late 2015, the Program Accreditation, Physician Certification, and Fellowship Training (PACT) Committee of the Neurocritical Care Society (NCS) was convened to promote and support excellence in the training and certification of neurointensivists...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29157660/encephalitis-and-myelitis-in-tropical-countries-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#15
REVIEW
Gisele Sampaio Silva, Guy A Richards, Tim Baker, Pravin R Amin
Tropical diseases are those that occur primarily or solely in the tropics, and as such include infectious diseases that are particularly prevalent in hot, humid conditions. The incidence of encephalitis in tropical countries is reported to be as high as 6.34/100,000/year. The term encephalitis implies inflammation of the brain and includes the presence of encephalopathy with two and more of the following features: fever, seizures and/or focal neurological findings; a cerebrospinal fluid pleocytosis; electroencephalographic findings or abnormal neuroimaging suggestive of encephalitis...
November 3, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29152931/can-red-blood-cell-distribution-width-predict-outcome-after-cardiac-arrest
#16
Vito Fontana, Savino Spadaro, Paola Villois, Claudia Righy Shinotsuka, Alberto Fogagnolo, Leda Nobile, Jean-Louis Vincent, Jacques Creteur, Fabio S Taccone
BACKGROUND: In critically ill patients, high red blood cell distribution width (RDW) values have been associated with increased hospital mortality, but there are no data on the impact of RDW on outcomes of patients resuscitated from cardiac arrest (CA). The aim of this study was to investigate the relationship between RDW and long-term neurologic outcome in CA survivors. METHODS: We performed a retrospective analysis of an institutional database including all unconscious adult patients admitted to the intensive care unit (ICU) after non-traumatic CA between January 2007 and January 2015...
November 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29146024/effect-of-serum-albumin-concentration-on-neurological-outcome-after-out-of-hospital-cardiac-arrest-from-the-critical-comprehensive-registry-of-intensive-cares-for-ohca-survival-study-in-osaka-japan
#17
Tasuku Matsuyama, Taku Iwami, Tomoki Yamada, Koichi Hayakawa, Kazuhisa Yoshiya, Taro Irisawa, Yoshio Abe, Tetsuro Nishimura, Toshifumi Uejima, Yasuo Ohishi, Takeyuki Kiguchi, Masashi Kishi, Masafumi Kishimoto, Shota Nakao, Yasuyuki Hayashi, Taku Sogabe, Takaya Morooka, Junichi Izawa, Tomonari Shimamoto, Toshihiro Hatakeyama, Tomoko Fujii, Junya Sado, Takeshi Shimazu, Takashi Kawamura, Tetsuhisa Kitamura
The aim of this study was to assess whether serum albumin concentration upon hospital arrival had prognostic indications on out-of-hospital cardiac arrest (OHCA). This prospective, multicenter observational study conducted in Osaka, Japan (the CRITICAL [Comprehensive Registry of Intensive Cares for OHCA Survival] study), enrolled all patients with consecutive OHCA transported to 14 participating institutions. We included adult patients aged ≥18 years with nontraumatic OHCA who achieved return of spontaneous circulation and whose serum albumin concentration was available from July 2012 to December 2014...
October 19, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29142086/shortage-of-generic-neurologic-therapeutics-an-escalating-threat-to-patient-care
#18
Jacklyn O Omorodion, Rami M Algahtani, Mark S Zocchi, Erin R Fox, Jesse M Pines, Henry J Kaminski
OBJECTIVE: To assess longitudinal trends in shortages of generic drugs used for neurologic conditions over a 15-year period in the United States. METHODS: Drug shortage data from the University of Utah Drug Information Service (UUDIS) from 2001 to 2015 were analyzed. Medications were included that were likely to be prescribed by a neurologist to treat a primary neurologic condition or critical for care of a patient with a neurologic condition. Trends in shortage length were assessed using standard descriptive statistics...
November 15, 2017: Neurology
https://www.readbyqxmd.com/read/29141694/the-icu-diary-study-prospective-multicenter-comparative-study-of-the-impact-of-an-icu-diary-on-the-wellbeing-of-patients-and-families-in-french-icus
#19
Maïté Garrouste-Orgeas, Cécile Flahault, Léonor Fasse, Stéphane Ruckly, Nora Amdjar-Badidi, Laurent Argaud, Julio Badie, Amélie Bazire, Naike Bige, Eric Boulet, Lila Bouadma, Cédric Bretonnière, Bernard Floccard, Alain Gaffinel, Xavier de Forceville, Hubert Grand, Rebecca Halidfar, Olfa Hamzaoui, Mercé Jourdain, Paul-Henri Jost, Eric Kipnis, Audrey Large, Alexandre Lautrette, Olivier Lesieur, Virginie Maxime, Emmanuelle Mercier, Jean Paul Mira, Yannick Monseau, Erika Parmentier-Decrucq, Jean-Philippe Rigaud, Antoine Rouget, François Santoli, Georges Simon, Fabienne Tamion, Nathalie Thieulot-Rolin, Marina Thirion, Sandrine Valade, Isabelle Vinatier, Christel Vioulac, Sebastien Bailly, Jean-François Timsit
BACKGROUND: Post-intensive care syndrome includes the multiple consequences of an intensive care unit (ICU) stay for patients and families. It has become a new challenge for intensivists. Prevention programs have been disappointing, except for ICU diaries, which report the patient's story in the ICU. However, the effectiveness of ICU diaries for patients and families is still controversial, as the interpretation of the results of previous studies was open to criticism hampering an expanded use of the diary...
November 15, 2017: Trials
https://www.readbyqxmd.com/read/29139014/the-ictal-interictal-continuum-to-treat-or-not-to-treat-and-how
#20
Clio Rubinos, Alexandra S Reynolds, Jan Claassen
Continuous electroencephalography (cEEG) monitoring is becoming increasingly used in neurologic and non-neurologic intensive care units (ICUs). Non-convulsive seizures (NCSz) and periodic discharges (PDs) are commonly seen in critically ill patients. Some of these PD patterns, also known as the ictal-interictal continuum (IIC), are associated with an increased risk of seizures and poor outcome. However, we do not fully understand the significance of these periodic patterns and the decision of how aggressively to treat remains controversial...
November 14, 2017: Neurocritical Care
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