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Glasgow Coma Scale

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https://www.readbyqxmd.com/read/27918475/association-between-the-osteoporosis-self-assessment-tool-for-asians-score-and-mortality-in-patients-with-isolated-moderate-and-severe-traumatic-brain-injury-a-propensity-score-matched-analysis
#1
Cheng-Shyuan Rau, Pao-Jen Kuo, Shao-Chun Wu, Yi-Chun Chen, Hsiao-Yun Hsieh, Ching-Hua Hsieh
Background: The purpose of this study was to use a propensity score-matched analysis to investigate the association between the Osteoporosis Self-Assessment Tool for Asians (OSTA) scores and clinical outcomes of patients with isolated moderate and severe traumatic brain injury (TBI). Methods: The study population comprised 7855 patients aged ≥40 years who were hospitalized for treatment of isolated moderate and severe TBI (an Abbreviated Injury Scale (AIS) ≥3 points only in the head and not in other regions of the body) between 1 January 2009 and 31 December 2014...
December 3, 2016: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/27918377/utility-of-emergency-department-observation-units-for-neurologically-intact-children-with-head-ct-abnormalities-secondary-to-acute-closed-head-injury
#2
Roxanna Lefort, Jill V Hunter, Andrea T Cruz, A Chantal Caviness, Thomas G Luerssen, Aderonke Adekunle-Ojo
OBJECTIVE: The aim of the study was to evaluate the utility of the emergency department observation unit (EDOU) for neurologically intact children with closed head injuries (CHIs) and computed tomography (CT) abnormalities. METHODS: A retrospective cohort study of children aged 0 to 18 years with acute CHI, abnormal head CT, and a Glasgow Coma Scales score of 14 or higher admitted to the EDOU of a tertiary care children's hospital from 2007 to 2010. Children with multisystem trauma, nonaccidental trauma, and previous neurosurgical or coagulopathic conditions were excluded...
December 1, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27917647/admission-neutrophil-count-and-neutrophil-to-lymphocyte-ratio-predict-90-day-outcome-in-intracerebral-hemorrhage
#3
Chuanyuan Tao, Xin Hu, Jiajing Wang, Junpeng Ma, Hao Li, Chao You
AIM: Inflammation plays a role in secondary brain injury after intracerebral hemorrhage (ICH). We aimed to determine the prognostic significance of admission white blood cell (AWC), neutrophil count (ANC), lymphocyte count, monocyte count and neutrophil to lymphocyte ratio (NLR) for 90-day outcome after ICH. PATIENTS & METHODS: A total of 336 patients with spontaneous ICH were retrospectively investigated. Clinical outcome was assessed by modified Rankin Scale at 90 days...
December 5, 2016: Biomarkers in Medicine
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
#4
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/27911891/severe-carbamazepine-intoxication-in-children-analysis-of-a-40-case-series
#5
Mehmet Acikgoz, M Sukru Paksu, Ahmet Guzel, Abdurrahman Alacam, Fatma Alacam
BACKGROUND We compared the factors that might impact the severity and the prognosis of carbamazepine (CBZ) intoxication in children, as well as the efficacy levels of the treatment options. MATERIAL AND METHODS Demographic information and clinical and laboratory findings for 40 patients were evaluated retrospectively. Predictive parameters for the development of serious complications were studied. RESULTS Median age of patients was 14 years; 65% of the patients were female. The most common pathological clinical finding and laboratory abnormality were inability to awaken the patient and hyperglycemia (45% and 60%, respectively)...
December 2, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27906426/continuous-monitoring-of-intracranial-pressure-for-prediction-of-postoperative-complications-of-hypertensive-intracerebral-hemorrhage
#6
S-X Yu, Q-S Zhang, Y Yin, Z Liu, J-M Wu, M-X Yang
OBJECTIVE: This study evaluates the value of continuous dynamic monitoring of intracranial pressure (ICP) in patients with hypertensive intracerebral hemorrhage to predict early postoperative complications. PATIENTS AND METHODS: Data from 80 patients treated in our hospital from February 2014 to February 2015 were analyzed. The patients all underwent decompressive craniectomies, and their ICP changes were monitored invasively and continuously for 1 to 7 days after surgery...
November 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27904004/delayed-diagnosis-of-blunt-carotid-trauma-in-a-seat-belt-syndrome-with-associated-abdominal-wall-injury-a-case-report
#7
Savino Occhionorelli, Dario Andreotti, Daniela Tartarini, Lorenzo Cappellari, Rocco Stano, Lucia Morganti, Giorgio Vasquez
: The aim of this case report is to be aware of occult carotid lesions in thoracic- abdominal trauma because, carotid artery injury consequent to blunt trauma is rare, affecting less than 1% of patients as reported in literature. A 45-years-old female, involved in a traffic accident, arrived to Emergency Room hemodynamically stable, with a Glasgow Coma Scale of 15, complaining abdominal pain, without any neurological signs. She underwent Computed Tomography (CT) scan that showed a complete disruption of left abdominal wall muscles, associated with massive bowel loops herniation...
November 28, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27902657/the-assessment-of-the-risk-of-unplanned-extubation-in-an-adult-intensive-care-unit
#8
Semine Aydoğan, Nurten Kaya
BACKGROUND: In order to plan and implement nursing intervention to reduce the incidence rate of unplanned extubation problem in the intensive care unit (ICU), it is necessary to determine the risk factors of unplanned extubation and the patients under risk. AIMS: This study was undertaken with the aim of evaluating the risk of unplanned extubation of endotracheal tube in adult ICU. DESIGN: This was a case-control study. METHODS: The population constituted patients hospitalized in the adult ICU during 1-year period in a university hospital...
January 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27902388/the-exploration-of-risk-factors-of-concurrent-bacteremia-among-critically-ill-patients-with-severe-dengue
#9
Chin-Ming Chen, Khee-Siang Chan, Kuo-Chen Cheng, Willy Chou, Hui-Chun Chao, Chiu-Yin Yeh, Wen-Liang Yu
We investigated the clinical features of intensive care unit (ICU) patients with a concomitant severe dengue infection and bacteremia to identify risk factors for this comorbidity. The records of all ICU dengue patients admitted during a July 31-November 31, 2015 were reviewed. Patients with "concurrent bacteremia" (positive bacterial blood culture within 72 hours of ICU admission) were identified. ICU admission was required for 142 patients; 22 (15.5%) had concurrent bacteremia. Streptococcus spp. was the most common pathogen, then Escherichia coli, and then Staphylococcus spp...
November 7, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27895451/non-cardiogenic-pulmonary-edema-rhabdomyolysis-and-myocardial-injury-following-heroin-inhalation-a-case-report
#10
G Bazoukis, A Spiliopoulou, K Mourouzis, P Grigoropoulou, A Yalouris
BACKGROUND: Heroin use by non-injecting routes of administration (snorting, swallowing, "chasing the dragon") is considered to be safer but is not risk-free for fatal overdose or serious side effects. We report the case of an adolescent who was transferred unconscious to the emergency department after heroin inhalation. Description of the case: A 17-year-old male was transferred to the emergency department unconscious (Glasgow coma scale: 6/15) after heroin inhalation. He was treated with non-rebreather mask and intravenous infusion of naloxone with gradual improvement of consciousness and arterial blood gasses...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27895443/the-validation-and-inter-rater-reliability-of-the-serbian-translation-of-the-richmond-agitation-and-sedation-scale-in-post-anesthesia-care-unit-patients
#11
Karlicic Stasevic, M Stasevic, S Jankovic, Dejanovic Djukic, A Dutina, I Grbic
BACKGROUND: Targeted light sedation is recommended because it shortens the time of mechanical ventilation and the length of stay in an intensive care unit (ICU). However, there is no validated scale for sedation and agitation in ICU in the Serbian speaking area. The aim of the current study was to validate, verify the reliability and enable the application of the Richmond Agitation and Sedation Scale (RASS) in the Serbian speaking area. METHODS: In this prospective cohort study, RASS was applied to 301 adult patients hospitalized in surgical ICUs by two different research team members...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27895360/paediatric-external-ventricular-drains-experience-from-a-tertiary-care-hospital-of-a-developing-country
#12
Abbas Qalab, Rayaan Asad, Mahnaz Hakeem, Maria Ahmed, Haque Anwar, Aneela Darbar
The aim of the study was to describe indications and complications of external ventricular drain (EVD) placement in children aged between 1 month and 16 years. This retrospective chart review was conducted at the Aga Khan University Hospital, Karachi, and comprised all children who underwent EVD placement from January 2007 to December 2014. Of the 177 patients identified, 117(66%) were males 60(34%) were girls. The overall mean age was 5.4±5.2 years. The median Glasgow Coma Scale score on presentation and discharge was 13 (interquartile range [IQR]: 7) and 15 (IQR: 4), respectively...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27895358/paediatric-traumatic-brain-injury-presentation-prognostic-indicators-and-outcome-analysis-from-a-tertiary-care-center-in-a-developing-country
#13
Badar Ujjan, Muhammad Waqas, Muhammad Babar Khan, Saqib Kamran Bakhshi, Muhammad Ehsan Bari
Traumatic brain injury (TBI) is the leading cause of morbidity and mortality in children worldwide. This study was conducted to report the presentation, management, outcomes and prognostic indicators in a large series of patients from a tertiary care centre in a developing country. It is a review of prospectively collected data of paediatric patients with TBI admitted at our centre between July 2010 and December 2013. A total of 291 patients with a mean age of 7.2±5.0 years were dichotomised into survivors and non-survivors, and variables were compared between the two groups...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27894327/a-statistical-analysis-protocol-for-the-time-differentiated-target-temperature-management-after-out-of-hospital-cardiac-arrest-tth48-clinical-trial
#14
Hans Kirkegaard, Asger Roer Pedersen, Ville Pettilä, Jakob Hjort, Bodil Steen Rasmussen, Inge de Haas, Jørgen Feldbæk Nielsen, Susanne Ilkjær, Anne Kaltoft, Anni Nørgaard Jeppesen, Anders Morten Grejs, Christophe Henri Valdemar Duez, Alf Inge Larsen, Valdo Toome, Urmet Arus, Fabio Silvio Taccone, Christian Storm, Timo Laitio, Markus B Skrifvars, Eldar Søreide
BACKGROUND: The TTH48 trial aims to determine whether prolonged duration (48 hours) of targeted temperature management (TTM) at 33 (±1) °C results in better neurological outcomes compared to standard duration (24 hours) after six months in comatose out-of-hospital cardiac arrest (OHCA) patients. METHODS: TTH48 is an investigator-initiated, multicentre, assessor-blinded, randomised, controlled superiority trial of 24 and 48 hours of TTM at 33 (±1) ° C performed in 355 comatose OHCA patients aged 18 to 80 years who were admitted to ten intensive care units (ICUs) in six Northern European countries...
November 28, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27890758/surgical-outcome-of-patients-with-very-small-intracranial-aneurysms-a-single-center-experience-from-southern-iran
#15
Abdolkarim Rahmanian, Fariborz Ghaffarpasand, Nima Derakhshan
OBJECTIVES: To report the surgical outcome of very small intracranial aneurysms (VSIAs; ≤3mm) in a large referral neurovascular center in Southern Iran. METHODS: This cross-sectional study was conducted in Southern Iran during a6-year period between 2010 and 2016. We included all the patients with VSIAs (≤3mm) who underwent surgery in our center. All the patients were operated by a single neurosurgeon. Pre- and postoperative CT angiography, intraoperative imaging with indo-cyanine green video angiography was performed in all the cases...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27890300/evaluating-clinical-care-in-the-prehospital-setting-is-rapid-emergency-medicine-score-the-missing-metric-of-ems
#16
Scott M Alter, Allison Infinger, Doug Swanson, Jonathan R Studnek
INTRODUCTION: The Rapid Emergency Medicine Score (REMS) was developed to predict emergency department patient mortality. Our objective was to utilize REMS to assess initial patient acuity and evaluate clinical change during prehospital care. METHODS: All non-cardiac arrest emergency transports from April 1, 2013 to March 31, 2014 were analyzed from a single EMS agency. Using age, pulse rate, mean arterial pressure, respiratory rate, oxygen saturation, and Glasgow Coma Scale, initial and final REMS were calculated...
October 25, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27888608/efficacy-and-safety-of-combined-intraventricular-fibrinolysis-with-lumbar-drainage-for-prevention-of-permanent-shunt-dependency-after-intracerebral-hemorrhage-with-severe-ventricular-involvement-a-randomized-trial-and-individual-patient-data-meta-analysis
#17
Dimitre Staykov, Joji B Kuramatsu, Jürgen Bardutzky, Bastian Volbers, Stefan T Gerner, Stephan P Kloska, Arnd Doerfler, Stefan Schwab, Hagen B Huttner
Objective Intraventricular hemorrhage (IVH) is a negative prognostic factor in intracerebral hemorrhage (ICH) and is associated with permanent shunt dependency in a substantial proportion of patients after ICH. IVH treatment by intraventricular fibrinolysis (IVF) was recently linked to reduced mortality rates in the CLEAR III study and IVF represents a safe and effective strategy to hasten clot resolution that may reduce shunt rates. Additionally, promising results from observational studies reported reductions in shunt dependency for a combined treatment approach of IVF plus lumbar drains (LD)...
November 26, 2016: Annals of Neurology
https://www.readbyqxmd.com/read/27888344/impact-of-urgent-resuscitative-surgery-for-life-threatening-torso-trauma
#18
Hisashi Matsumoto, Yoshiaki Hara, Takanori Yagi, Nobuyuki Saito, Kazuki Mashiko, Hiroaki Iida, Tomokazu Motomura, Fumihiko Nakayama, Kazuhiro Okada, Hiroshi Yasumatsu, Taigo Sakamoto, Takao Seo, Yusuke Konda, You Hattori, Hiroyuki Yokota
PURPOSE: This study investigated the advantages of performing urgent resuscitative surgery (URS) in the emergency department (ED); namely, our URS policy, to avoid a delay in hemorrhage control for patients with severe torso trauma and unstable vital signs. METHODS: We divided 264 eligible cases into a URS group (n = 97) and a non-URS group (n = 167) to compare, retrospectively, the observed survival rate with the predicted survival using the Trauma and Injury Severity Score (TRISS)...
November 25, 2016: Surgery Today
https://www.readbyqxmd.com/read/27885947/quickbrain-mri-for-the-detection-of-acute-pediatric-traumatic-brain-injury
#19
David C Sheridan, Craig D Newgard, Nathan R Selden, Mubeen A Jafri, Matthew L Hansen
OBJECTIVE The current gold-standard imaging modality for pediatric traumatic brain injury (TBI) is CT, but it confers risks associated with ionizing radiation. QuickBrain MRI (qbMRI) is a rapid brain MRI protocol that has been studied in the setting of hydrocephalus, but its ability to detect traumatic injuries is unknown. METHODS The authors performed a retrospective cohort study of pediatric patients with TBI who were undergoing evaluation at a single Level I trauma center between February 2010 and December 2013...
November 25, 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/27884333/c-spine-injury-and-mandibular-fractures-lifesaver-broken-in-two-spots
#20
Michael W Chu, Tahereh Soleimani, Tyler A Evans, Sarah I Fernandez, Leigh Spera, Carrie Klene, Ben L Zarzaur, Sunil S Tholpady
BACKGROUND: Trauma is a leading cause of injury and mortality and may involve mandibular fractures and cervical spine injuries. Manipulation of the spine during trauma protocols and operative treatment has the potential to cause serious spinal cord injuries. The purpose of this study was to identify risk factors associated with cervical spine injury (CSI) in patients with mandibular fractures. METHODS: The National Trauma Databank (2007-2010) was used to identify patients with mandibular fractures...
December 2016: Journal of Surgical Research
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