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Glasgow Coma Scale

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https://www.readbyqxmd.com/read/28634840/self-inflicted-abdominal-stab-wounds-have-a-higher-rate-of-non-therapeutic-laparotomy-laparoscopy-and-a-lower-risk-of-injury
#1
Nikolay Bugaev, Kevin McKay, Janis L Breeze, Sandra S Arabian, Reuven Rabinovici
BACKGROUND: The profile and management of self-inflicted abdominal stab wounds (SI-ASW) patients is still obscure. METHODS: The National Trauma Data Bank (2012) was queried for adults with abdominal stab wounds (n = 9544). Patients with SI-ASW (n = 1724) and non-SI-ASW (n = 7820) were compared. Predictors for non-therapeutic laparotomy/laparoscopy (non-TL) in SI-ASW patients were identified. RESULTS: SI-ASW patients were older, had more females and behavioral disorders, similar physiology, but a lower Injury Severity Score...
June 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28632657/role-of-computed-tomography-in-the-classification-of-pediatric-pelvic-fractures-revisited
#2
Melissa A Bent, William L Hennrikus, Johan E Latorre, Douglas G Armstrong, Brian Shaw, Kerwyn C Jones, Lee S Segal
OBJECTIVES: To determine the need for computerized tomography (CT) scans in the assessment of pediatric pelvic fractures. DESIGN: Retrospective Chart Review. SETTING: Level-1 Pediatric Trauma Center. PATIENTS/PARTICIPANTS: Thirty pediatric trauma patients with pelvic fractures who have obtained both a radiograph and CT scan. MAIN OUTCOME MEASUREMENTS: Fleiss Kappa coefficient to compare interreliability...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28624560/intracranial-hypotension-following-traumatic-brain-injury-a-diagnostic-and-therapeutic-challenge
#3
Jacob Chen Ming Low, Anan Shtaya, Samantha Hettige
BACKGROUND: Intracranial hypotension (IH) is a recognised cause of coma, however, the diagnosis is often challenging, especially in patients with superimposed traumatic brain injury (TBI). CASE REPORT: We report a case of a 67-year-old patient who became comatose following evacuation of bilateral acute subdural haematomas with concurrent respiratory failure. Imaging and intraparenchymal intracranial pressure (ICP) monitoring confirmed secondary IH. She was managed with an epidural blood patch, and a 72 hours period in the trendelenberg position guided by ICP monitoring and clinical assessment...
June 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28623805/heroin-and-pharmaceutical-opioid-overdose-events-emergency-medical-response-characteristics
#4
Caleb J Banta-Green, Phillip O Coffin, Jennie A Schoeppe, Joseph O Merrill, Lauren K Whiteside, Abigail K Ebersol
BACKGROUND: Emergency Medical Services (EMS) data may provide insight into opioid overdose incidence, clinical characteristics, and medical response. This analysis describes patient characteristics, clinical features, and EMS response to opioid overdoses, comparing heroin and pharmaceutical opioid (PO) overdoses, using a structured opioid overdose case criteria definition. METHODS: A case series study was conducted. EMS medical staff screened cases for possible overdoses and study staff categorized the likelihood of opioid overdose...
June 10, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28622477/an-examination-of-factors-affecting-the-length-of-stay-in-a-palliative-care-center
#5
Metin Dincer, Kadriye Kahveci, Cihan Doger
BACKGROUND: With the increase in elderly population, life-threatening chronic diseases are increasing, simultaneously increasing the need for palliative care centers (PCCs). OBJECTIVES: To evaluate the factors affecting the length of stay (LOS) and discharge of patients from a PCC. METHODS: A retrospective scan was made of the records of patients followed up in the PCC between January 2013 and March 2016. A record was made of patient age, gender, diagnosis, conditions/comorbidities, Glasgow Coma Scale, Karnofsky Performance Scale, LOS, prognosis (exitus or surviving), percutaneous endoscopic gastrostomy (PEG), tracheostomy, mechanical ventilator, nutrition (total parenteral nutrition [TPN] or enteral nutrition), and the results of cultures taken during stay in PCCs (blood, tracheal aspirate, urine, rectal swab, wound)...
June 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28622071/survival-in-out-of-hospital-rapid-sequence-intubation-of-non-traumatic-brain-pathologies
#6
Pieter Francsois Fouche, Paul Andrew Jennings, Karen Smith, Malcolm Boyle, Gabriel Blecher, Jonathan Knott, Mani Raji, Pamela Rosengarten, Michael Roberto Augello, Stephen Bernard
INTRODUCTION: Rapid sequence intubation (RSI) is not only used in traumatic brain injuries in the out-of-hospital setting, but also for non-traumatic brain pathologies (NTBP) such as brain tumors, meningitis, encephalitis, hypoxic/anoxic brain injury, stroke, arteriovenous malformations, tumors, aneurysms, brain hemorrhage, as well as brain injury due to diabetes, seizures and toxicity, metabolic conditions, and alcohol and drug overdose. Previous research suggests that RSI is common in non-traumatic coma, but with an unknown prevalence of NTBP in those that receive RSI...
June 16, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28616086/homeopathic-treatment-for-prolonged-postoperative-coma-a-case-report
#7
G Vithoulkas, V Văcăraș, J Kavouras, A D Buzoianu, M Mărginean, D Văcăraș, S Cozma
Coma is the state of unrousable unconsciousness. There are variations in the degree of coma and the findings and signs found on the patient's clinical examination depend on the underlying cause of the disorder. The Glasgow Coma scale evaluates the best motor, verbal and eye answers of the patient. A patient is considered to be in a coma if his Glasgow Coma Scale is below 8 points. The progress that we have made throughout the years has also led to complications that can culminate in a major catastrophe like death, permanent brain damage, coma...
April 2017: Journal of Medicine and Life
https://www.readbyqxmd.com/read/28612131/three-factor-versus-four-factor-prothrombin-complex-concentrate-for-the-emergent-management-of-warfarin-associated-intracranial-hemorrhage
#8
Daniel Fischer, Jeffrey Sorensen, Gabriel V Fontaine
BACKGROUND: Four-factor prothrombin complex concentrates (PCC) produce a more rapid and complete INR correction compared with 3-factor PCC in patients receiving warfarin. It is unknown if this improves clinical outcomes in the setting of intracranial hemorrhage (ICH). METHODS: This multicenter, retrospective cohort study included patients presenting with warfarin-associated ICH reversed with either 4- or 3-factor PCC. The primary outcome was in-hospital mortality...
June 13, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28608353/-causes-of-hospital-mortality-due-to-brain-haemorrhage-in-patients-with-arteriovenous-malformation
#9
J Vilalta, F Arikan, R Torne, R Najarro, D Lopez, A Rodriguez-Hernandez, D Gandara, P Banos
AIM: To determine the causes of mortality in cases of brain haemorrhage among patients with arteriovenous malformations (AVM) treated in a tertiary hospital. PATIENTS AND METHODS: The patients with AVM who died over the period 1990-2014 were selected from a prospective register of vascular malformations. Demographic aspects, localisation of the AVM, associated aneurysms and previous treatments were reviewed. Three main causes of death were established: initial bleeding/rebleeding, those related with the treatment of the AVM and other causes not related with AVM...
June 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28605557/practice-patterns-for-neurosurgical-utilization-and-outcome-in-acute-intracerebral-hemorrhage-intensive-blood-pressure-reduction-in-acute-cerebral-hemorrhage-trials-1-and-2-studies
#10
Rui Guo, David J Blacker, Xia Wang, Hisatomi Arima, Pablo M Lavados, Richard I Lindley, John Chalmers, Craig S Anderson, Thompson Robinson
BACKGROUND: The prognosis in acute spontaneous intracerebral hemorrhage (ICH) is related to hematoma volume, where >30 mL is commonly used to define large ICH as a threshold for neurosurgical decompression but without clear supporting evidence. OBJECTIVES: To determine the factors associated with large ICH and neurosurgical intervention among participants of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials (INTERACT). METHODS: We performed pooled analysis of the pilot INTERACT1 (n = 404) and main INTERACT2 (n = 2839) studies of ICH patients (<6 h of onset) with elevated systolic blood pressure (SBP, 150-220 mm Hg) who were randomized to intensive (target SBP < 140 mm Hg) or contemporaneous guideline-recommended (target SBP < 180 mm Hg) management...
June 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28602881/minimally-invasive-surgery-for-hypertensive-intracerebral-hemorrhage-patients-with-large-hematoma-volume-a-retrospective-study
#11
Weijun Wang, Ningquan Zhou, Chao Wang
OBJECTIVE: Therapeutic efficacy of hypertensive intracerebral hemorrhage (HICH) patients with large hematoma volume is poor. This study aimed to explore the efficacy of minimally invasive surgery for HICH patients with large hematoma volume. METHODS: A total of 104 HICH patients with a hematoma volume >50mL were treated with different surgical approaches. The patients were allotted to minimally invasive surgery group (minimally invasive, n=70) and conventional craniotomy group (craniotomy group, n=34)...
June 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28602178/differential-effects-of-the-glasgow-coma-scale-score-and-its-components-an-analysis-of-54-069-patients-with-traumatic-brain-injury
#12
Florence C M Reith, Hester F Lingsma, Belinda J Gabbe, Fiona E Lecky, Ian Roberts, Andrew I R Maas
INTRODUCTION: The Glasgow Coma Scale (GCS) is widely used in the assessment of clinical severity and prediction of outcome after traumatic brain injury (TBI). The sum score is frequently applied, but the differential influence of the components infrequently addressed. We aimed to investigate the contribution of the GCS components to the sum score, floor and ceiling effects of the components, and their prognostic effects. METHODS: Data on adult TBI patients were gathered from three data repositories: TARN (n=50,064), VSTR (n=14,062), and CRASH (n=9,941)...
June 1, 2017: Injury
https://www.readbyqxmd.com/read/28601692/the-effects-of-family-centered-affective-stimulation-on-brain-injured-comatose-patients-level-of-consciousness-a-randomized-controlled-trial
#13
F Salmani, E Mohammadi, M Rezvani, A Kazemnezhad
BACKGROUND: Despite the well-defined effects of sensory stimulation, the knowledge of the pure effects of affective stimulation is scarce. OBJECTIVE: To evaluate the effects of family-centered affective stimulation on the level of consciousness among comatose patients with brain injuries. DESIGN: This study was designed as a three-group double-blinded Randomized Controlled Trial. METHODS: Ninety consecutive patients with traumatic brain injuries and a Glasgow Coma Scale score of 5-8 were selected...
June 4, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28600907/effect-of-hypokalemia-on-functional-outcome-at-3-months-post-stroke-among-first-ever-acute-ischemic-stroke-patients
#14
Fan Gao, Cheng-Tai Wang, Chen Chen, Xing Guo, Li-Hong Yang, Xian-Cang Ma, Jian-Feng Han
BACKGROUND Hypokalemia has been confirmed to be a predictor of adverse cardiovascular and renal outcomes. There is a paucity of studies focusing on the potential connection between the serum K+ level and the outcome after acute ischemic stroke (AIS). This study investigated whether hypokalemia in the acute stroke stage contributes to worse functional outcome in AIS patients. MATERIAL AND METHODS This retrospective cohort study included consecutive patients with first-ever AIS admitted between June 2015 and March 2016...
June 10, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28600579/road-crashes-in-older-persons-and-the-use-of-comorbidity-polypharmacy-score-in-an-asian-population
#15
Mui Teng Chua, Keshav Bhandari, Victor Yk Ong, Win Sen Kuan
INTRODUCTION: Age-related physiological changes predispose older road users to higher mortality from traffic crashes. We aimed to describe the injury epidemiology of these patients, and explore the association between the comorbidity polypharmacy score (CPS) and outcomes. MATERIALS AND METHODS: This retrospective study utilised data from the Trauma Registry in the National University Hospital, Singapore, between January 2011 and December 2014. Patients involved in traffic crashes aged 45 years and above with injury severity scores (ISS) of 9 and higher were included...
May 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28599608/a-brain-electrical-activity-eeg-based-biomarker-of-functional-impairment-in-traumatic-head-injury-a-multisite-validation-trial
#16
Daniel Hanley, Leslie S Prichep, Neeraj Badjatia, Jeff Bazarian, RIchard P Chiacchierini, Kenneth C Curley, John S Garrett, Elizabeth B Jones, Rosanne Naunheim, Brian J O'Neil, John O'Neill, Wright David, J Stephen Huff
The potential clinical utility of a novel quantitative EEG-based Brain Function Index (BFI) as a measure of the presence and severity of functional brain injury was studied as part of an independent prospective validation trial. The BFI was derived using EEG features associated with functional brain impairment reflecting current consensus on the physiology of concussive injury. 720 adult patients (18-85 years) evaluated within 72 hours of sustaining a closed head injury were enrolled at 11 US Emergency Departments...
June 9, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28594680/antibiotic-therapy-in-comatose-mechanically-ventilated-patients-following-aspiration-differentiating-pneumonia-from-pneumonitis
#17
Jean Baptiste Lascarrou, Floriane Lissonde, Aurélie Le Thuaut, Konstantinos Bachoumas, Gwenhael Colin, Matthieu Henry Lagarrigue, Isabelle Vinatier, Maud Fiancette, Jean Claude Lacherade, Aihem Yehia, Aurélie Joret, Christine Lebert, Sandra Bourdon, Laurent Martin Lefèvre, Jean Reignier
OBJECTIVES: To determine the proportion of patients with documented bacterial aspiration pneumonia among comatose ICU patients with symptoms suggesting either bacterial aspiration pneumonia or non-bacterial aspiration pneumonitis. DESIGN: Prospective observational study. SETTING: University-affiliated 30-bed ICU. PATIENTS: Prospective cohort of 250 patients admitted to the ICU with coma (Glasgow Coma Scale score ≤ 8) and treated with invasive mechanical ventilation...
June 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28594285/cognitive-event-related-potentials-during-the-sub-acute-phase-of-severe-traumatic-brain-injury-and-their-relationship-to-outcome
#18
Solveig L Hauger, Kjell Olafsen, Caroline Schnakers, Nada Andelic, Kristian Bernhard Nilsen, Eirik Helseth, Ingrid Funderud, Stein Andersson, Anne-Kristine Schanke, Marianne Løvstad
Predicting outcome in the early phase after severe traumatic brain injury (sTBI) is a major clinical challenge, particularly identifying patients with potential of good cognitive outcome. The current single center prospective study aimed to explore presence and normalization of electroencephalography (EEG)-based event related potentials (ERPs) in the early phase following sTBI, and their relationship to functional and cognitive outcome 6 months post-injury. Fourteen adult patients with sTBI were recruited from the neurointensive care unit (mean age=38...
June 8, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28590996/helicopter-transport-from-the-scene-of-injury-are-there-improved-outcomes-for-pediatric-trauma-patients
#19
Sandra M Farach, Nebbie E Walford, Lindsey Bendure, Ernest K Amankwah, Paul D Danielson, Nicole M Chandler
BACKGROUND: There is conflicting data to support the routine use of helicopter transport (HT) for the transfer of trauma patients. The purpose of this study was to evaluate outcomes for trauma patients transported via helicopter from the scene of injury to a regional pediatric trauma center. METHODS: The institutional trauma registry was queried for trauma patients presenting from January 2000 through March 2012. Of 9119 patients, 1709 patients who presented from the scene were selected for further evaluation...
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28590352/big-for-small-validating-brain-injury-guidelines-in-pediatric-traumatic-brain-injury
#20
Asad Azim, Faisal S Jehan, Peter Rhee, Terence O'Keeffe, Andrew Tang, Gary Vercruysse, Narong Kulvatunyou, Rifat Latifi, Bellal Joseph
INTRODUCTION: Brain Injury Guidelines (BIG) were developed to reduce over utilization of Neurosurgical Consultation (NC) as well as CT imaging. Currently, BIG have been successfully applied to adult populations, but the value of implementing these guidelines among pediatric patients remains unassessed. Therefore, the aim of this study was to evaluate the established BIG (BIG-1 category) for managing pediatric traumatic brain injury (TBI) patients with intracranial hemorrhage (ICH) without neurosurgical consultation (No-NC)...
June 6, 2017: Journal of Trauma and Acute Care Surgery
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