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Giada Giovannini, Giulia Monti, Manuela Tondelli, Andrea Marudi, Franco Valzania, Markus Leitinger, Eugen Trinka, Stefano Meletti
PURPOSE: Status epilepticus (SE) is a neurological emergency, characterized by high short-term morbidity and mortality. We evaluated and compared two scores that have been developed to evaluate status epilepticus prognosis: STESS (Status Epilepticus Severity Score) and EMSE (Epidemiology based Mortality score in Status Epilepticus). METHODS: A prospective observational study was performed on consecutive patients with SE admitted between September 2013 and August 2015...
March 2017: Seizure: the Journal of the British Epilepsy Association
Usha K Misra, Deepanshu Dubey, Jayantee Kalita
OBJECTIVE: To compare the efficacy and safety of lacosamide (LCM) and sodium valproate (SVA) in lorazepam (LOR)-resistant status epilepticus (SE). METHODS: Patients with LOR-resistant SE were randomized to intravenous LCM 400 mg at a rate of 60 mg/kg/min or SVA 30 mg/kg at a rate of 100 mg/min. The SE severity score (STESS), duration of SE and its etiology, and magnetic resonance imaging (MRI) findings were noted. Primary outcome was seizure cessation for 1 h, and secondary outcomes were 24 h seizure remission, in hospital death and severe adverse events (SAEs)...
February 18, 2017: Epilepsia
E Eskioglou, C Stähli, A O Rossetti, J Novy
OBJECTIVE: EEG monitoring is increasingly used in critically ill patients, but impact on clinical outcome remains unclear. We aimed to investigate the benefit of repeated extended EEG in the prognosis of patients with non-convulsive status epilepticus (SE). MATERIALS & METHODS: We retrospectively collected 29 consecutive patients with non-convulsive SE without coma, who underwent repeated extended EEG between 2013 and 2015. We compared these patients with an historical age-matched group of 58 patients managed between 2011 and 2013 with routine EEG only...
December 27, 2016: Acta Neurologica Scandinavica
Estevo Santamarina, Gloria M González-Cuevas, Anna Sanchez, Rosa M Gracia, Isabel Porta, Manuel Toledo, Manuel Quintana, María Sueiras, Lorena Guzmán, Javier Salas-Puig
PURPOSE: There is concern about the safety of anesthetic drugs (IVADs) in the management of status epilepticus (SE). To clarify this aspect, we aimed to assess the factors associated with a poor prognosis in SE requiring anesthetics. METHOD: We analyzed all SE requiring IVADs between October 2011 and December 2015. Demographics, clinical data, etiology, SE duration, indications for sedation, electroencephalography features, complications and the prognosis at discharge were collected...
February 2017: Seizure: the Journal of the British Epilepsy Association
Preben Aukland, Martin Lando, Ole Vilholm, Elsebeth Bruun Christiansen, Christoph Patrick Beier
BACKGROUND: The "Status Epilepticus Severity Score" (STESS) is the most important clinical score to predict in-hospital mortality of patients with status epilepticus (SE), but its prognostic relevance for long-term survival is unknown. This study therefore examined if STESS and its components retain their prognostic relevance beyond acute treatment. METHODS: One hundred twenty-five non-anoxic patients with SE were retrospectively identified in two hospitals between 2008 and 2014 (39...
November 5, 2016: BMC Neurology
Gabriella Di Domenico, Ivan Tersigni, Bruno Federico, Cinzia Leuter
OBIETTIVI: determinare i fattori associati ai ricoveri ripetuti per identificare i pazienti a rischio di riospedalizzazione entro i 30 giorni dalla dimissione. DISEGNO: analisi retrospettiva delle dimissioni nell'anno 2013 attraverso le schede di dimissione ospedaliera (SDO). SETTING E PARTECIPANTI: 3.900 pazienti ricoverati presso il presidio ospedaliero "Fabrizio Spaziani" di Frosinone. PRINCIPALI MISURE DI OUTCOME: analisi bivariata per l'analisi dell'associazione tra variabili. La regressione logistica è stata utilizzata per identificare i fattori di rischio associati al ricovero ripetuto...
September 2016: Epidemiologia e Prevenzione
María Sol Pacha, Lucas Orellana, Emanuel Silva, Glenda Ernst, Fatima Pantiu, Julieta Quiroga Narvaez, Ricardo Reisin, Oscar Martinez
Status epilepticus (SE) is a severe neurological condition with significant morbidity and mortality. A reliable tool for prognosis is needed to take decision regarding treatment strategies. We compared 2 available prognostic scores of outcome: the Status Epilepticus Severity Score (STESS) and the Epidemiology-based Mortality score in SE (EMSE). We included 46 patients with SE evaluated out the last 5years in our hospital. We excluded patients with postanoxic encephalopathy or incomplete data. Among the 46 patients with SE, in-hospital mortality was 28%...
November 2016: Epilepsy & Behavior: E&B
Vincent Alvarez, Jong Woo Lee, M Brandon Westover, Frank W Drislane, Jan Novy, Mohamed Faouzi, Nicola A Marchi, Barbara A Dworetzky, Andrea O Rossetti
OBJECTIVE: Our aim was to analyze and compare the use of therapeutic coma (TC) for refractory status epilepticus (SE) across different centers and its effect on outcome. METHODS: Clinical data for all consecutive adults (>16 years) with SE of all etiologies (except postanoxic) admitted to 4 tertiary care centers belonging to Harvard Affiliated Hospitals (HAH) and the Centre Hospitalier Universitaire Vaudois (CHUV) were prospectively collected and analyzed for TC details, mortality, and duration of hospitalization...
October 18, 2016: Neurology
M González-Cuevas, E Santamarina, M Toledo, M Quintana, J Sala, M Sueiras, L Guzman, J Salas-Puig
BACKGROUND AND PURPOSE: The severity of status epilepticus (SE) has an important impact in clinical outcomes. The Status Epilepticus Severity Score (STESS) is a score for predicting mortality in SE at admission. The baseline modified Rankin Scale (mRS) might be a prognostic factor for assessing the short-tem outcomes of SE. Therefore, our aim was to evaluate the effectiveness of mRS and whether its addition to the STESS improves the prediction of mortality. METHODS: Consecutive patients with SE and aged >16 years were recruited during 3 years...
October 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Adele De Pascale, Álvaro Quiñones, Paola Cimbolli
The post-rationalist psychotherapy academy (non-classic cognitive approach) started at the end of the 80's with a series of consistent hypotheses. It is an academy which stems from contemporary psychotherapy and develops different areas, giving a strong contribution to theoretical and clinical psychotherapy. This academy has presented development as all other psychotherapy schools have, as well as the same difficulties and solutions. In this article, our aim is to show some tendencies that don't present an epistemological, theoretical, methodological and coherency, since these tendencies don't allow any confutation, which is the fundamental premise of Vittorio Guidano's academy...
January 2016: Rivista di Psichiatria
Qiong Gao, Tang-peng Ou-Yang, Xiao-long Sun, Feng Yang, Chen Wu, Tao Kang, Xiao-gang Kang, Wen Jiang
BACKGROUND: Prediction of the functional outcome for patients with convulsive status epilepticus (CSE) has been a challenge. The aim of this study was to characterize the prognostic factors and functional outcomes of patients after CSE in order to develop a practicable scoring system for outcome prediction. METHODS: We performed a retrospective explorative analysis on consecutive patients diagnosed with CSE between March, 2008 and November, 2014 in a tertiary academic medical center in northwest China...
2016: Critical Care: the Official Journal of the Critical Care Forum
Bong Su Kang, Dong Wook Kim, Kwang Ki Kim, Hye Jin Moon, Young-Soo Kim, Hyun Kyung Kim, Seo-Young Lee, Yong Seo Koo, Jung-Won Shin, Jangsup Moon, Jun-Sang Sunwoo, Jung-Ick Byun, Yong Won Cho, Ki-Young Jung, Kon Chu, Sang Kun Lee
BACKGROUND: Two clinical scoring systems, the status epilepticus severity score (STESS) and the epidemiology-based mortality score in status epilepticus (EMSE), are used to predict mortality in patients with status epilepticus (SE). The aim of this study was to compare the outcome-prediction function of the two scoring systems regarding in-hospital mortality using a multicenter large cohort of adult patients with SE. Moreover, we studied the potential role of these two scoring systems in predicting the functional outcome in patients with SE...
January 27, 2016: Critical Care: the Official Journal of the Critical Care Forum
Erkki Pesonen, Pirkko Pussinen, Ilpo Huhtaniemi
OBJECTIVE: The objective of this study was to explore whether circulating testosterone (T) concentration is associated with the occurrence and risk for acute coronary syndromes (ACS). METHOD: This case-control study included male patients with acute myocardial infarction (AMI) (n=174) or unstable angina pectoris (UAP) (n=90) and healthy controls (n=238). Patients gave serum samples during the acute (n=264) and recovery (n=132) phases after a median of 10.5 months after the incident event...
April 2016: European Journal of Endocrinology
Dominik Madžar, Anna Geyer, Ruben U Knappe, Stephanie Gollwitzer, Joji B Kuramatsu, Stefan T Gerner, Hajo M Hamer, Hagen B Huttner
The aim of the study was to identify factors influencing long-term outcome and to evaluate the prognostic power of the Status Epilepticus Severity Score (STESS) in refractory status epilepticus (RSE). We retrospectively extracted data on baseline characteristics, RSE details, and hospital course including complications from all patients treated for RSE in our institution between January 2001 and January 2013. Functional outcome was assessed using the modified Rankin Scale (mRS) and was defined as good when either RSE did not lead to functional decline or when the resulting mRS score was 2 or below...
March 2016: Journal of Neurology
Manoj Kumar Goyal, Sudheer Chakravarthi, Manish Modi, Ashish Bhalla, Vivek Lal
OBJECTIVE: The treatment protocols for status epilepticus (SE) range from small doses of intravenous benzodiazepines to induction of coma. The pros and cons of more aggressive treatment regimen remain debatable. The importance of an index need not be overemphasized which can predict outcome of SE and guide the intensity of treatment. We tried to evaluate utility of one such index Status epilepticus severity score (STESS). METHODS: 44 consecutive patients of SE were enrolled in the study...
December 2015: Clinical Neurology and Neurosurgery
Leena Kämppi, Jaakko Ritvanen, Harri Mustonen, Seppo Soinila
Introduction. This study was designed to identify the delays and factors related to and predicting the cessation of generalized convulsive SE (GCSE). Methods. This retrospective study includes 70 consecutive patients (>16 years) diagnosed with GCSE and treated in the emergency department of a tertiary hospital over 2 years. We defined cessation of SE stepwise using clinical seizure freedom, achievement of burst-suppression, and return of consciousness as endpoints and calculated delays for these cessation markers...
2015: Epilepsy Research and Treatment
Efstratios Georgakarakos, Antonios Xenakis, Theodosios Bisdas, George S Georgiadis, Nikolaos Schoretsanitis, George A Antoniou, Miltos Lazarides
PURPOSE: This study investigated the impact of the variant angulations on the values and distribution of wall shear stress on the renal branches and the mating vessels of a pivotal fenestrated design. METHODS: An idealized endograft model of two renal branches was computationally reconstructed with variable angulations of the left renal branch. These ranged from the 1:30' to 3:30' o'clock position, corresponding from 45° to 105° with increments of 15°. A fluid-structure-interaction analysis was performed to estimate the wall shear stress...
August 2016: Vascular
M Leitinger, G Kalss, A Rohracher, G Pilz, H Novak, J Höfler, I Deak, G Kuchukhidze, J Dobesberger, A Wakonig, E Trinka
BACKGROUND: Status epilepticus (SE) is a frequent neurological emergency complicated by high mortality and often poor functional outcome in survivors. The aim of this study was to review available clinical scores to predict outcome. METHODS: Literature review. PubMed Search terms were "score", "outcome", and "status epilepticus" (April 9th 2015). Publications with abstracts available in English, no other language restrictions, or any restrictions concerning investigated patients were included...
August 2015: Epilepsy & Behavior: E&B
Vincent Alvarez, Frank W Drislane, M Brandon Westover, Barbara A Dworetzky, Jong Woo Lee
OBJECTIVE: Continuous electroencephalography (cEEG) is important for treatment guidance in status epilepticus (SE) management, but its role in clinical outcome prediction is unclear. Our aim is to determine which cEEG features give independent outcome information after correction for clinical predictor. METHODS: cEEG data of 120 consecutive adult patients with SE were prospectively collected in three academic medical centers using the 2012 American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology...
June 2015: Epilepsia
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March 2015: Anticancer Research
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