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https://www.readbyqxmd.com/read/28728875/the-use-and-uptake-of-pupillometers-in-the-intensive-care-unit
#1
Matthew Hao Lee, Biswadev Mitra, Jiun Kae Pui, Mark Fitzgerald
BACKGROUND: Traumatic brain injury (TBI) is a significant public health issue. Assessing pupil reactivity is a crucial aspect of its management and the pupillometer has been shown to be a more objective tool compared to the standard penlight. Its use, however, is not widespread. OBJECTIVE: To investigate the paucity in uptake, we examined the frequency of use of pupillometers (NeurOptics(®)NPi-100™) amongst Intensive Care Unit (ICU) doctors and nurses, evaluated its user-friendliness and explored barriers to its use...
July 17, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28726590/a-method-of-managing-severe-traumatic-brain-injury-in-the-absence-of-intracranial-pressure-monitoring-the-ice-protocol
#2
Randall Chesnut, Nancy Temkin, Sureyya Dikmen, Carlos Rondina, Walter Videtta, Gustavo Petroni, Silvia Lujan, Victor Alanis, Antonio Luis Eiras Falcao, Gustavo La Fuente, Luis Gonzalez, Manuel Jibaja, Arturo Lavendez, Freddy Sandi Lora, Roberto Merida, Ricardo Romero, James Pridgeon, Jason Barber, Joan Machamer, Kelley Chaddock
Purpose - The imaging- and clinical-examination (ICE) algorithm used in the BEST TRIP ICP randomized controlled trial is the only prospectively investigated clinical protocol for TBI management without ICP monitoring. As the default literature standard, it warrants careful evaluation. Methods - We present the ICE protocol in detail and analyse the demographics, outcome, treatment intensity, frequency of intervention usage, and related adverse events in the ICE-protocol cohort. Results - The 167 ICE protocol patients were young (median 29 years) with a median Glasgow Coma Scale motor score of 4 but with anisocoria or abnormal pupillary reactivity in 40%...
July 20, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28661950/establishing-normative-data-for-pupillometer-assessment-in-neuroscience-intensive-care-the-end-panic-registry
#3
DaiWai M Olson, Sonja E Stutzman, Folefac Atem, Julia D Kincaide, Thuy-Tien Ho, Byron A Carlisle, Venkatesh Aiyagari
BACKGROUND: Trained medical practitioners have been assessing the pupillary light reflex for more than 2 millennia. However, the interrater reliability of the pupillary light reflex remains low. To overcome the drawbacks of a subjective interpretation of pupillary size and reactivity, automated pupillometers are becoming increasingly commonplace, but practitioners do not have adequate data from which to judge whether the numerical values provided by the pupillometer are "within reference limits...
August 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28643996/age-related-outcome-of-patients-after-traumatic-brain-injury-a-single-centre-observation
#4
Rolf Erlebach, Alberto Pagnamenta, Stephanie Klinzing, Federica Stretti, Silvia Cottini, Reto Schüpbach, Peter Steiger, Giovanna Brandi
BACKGROUND: Study-purpose is to analyze clinical features of patients with traumatic brain injury (TBI), their age-related outcomes and determinants of long- term outcome. METHODS: This retrospective cohort study was conducted in a level I University Swiss trauma center. Consecutive patients with moderate to severe TBI admitted for more than 48 hours to the Intensive Care Unit were included. Patients' and trauma characteristics, management during ICU-stay, prognostic scores and long- term outcomes were analyzed...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28578187/pupillometric-and-saccadic-measures-of-affective-and-executive-processing-in-anxiety
#5
Piril Hepsomali, Julie A Hadwin, Simon P Liversedge, Matthew Garner
Anxious individuals report hyper-arousal and sensitivity to environmental stimuli, difficulties concentrating, performing tasks efficiently and inhibiting unwanted thoughts and distraction. We used pupillometry and eye-movement measures to compare high vs. low anxious individuals hyper-reactivity to emotional stimuli (facial expressions) and subsequent attentional biases in a memory-guided pro- and antisaccade task during conditions of low and high cognitive load (short vs. long delay). High anxious individuals produced larger and slower pupillary responses to face stimuli, and more erroneous eye-movements, particularly following long delay...
May 31, 2017: Biological Psychology
https://www.readbyqxmd.com/read/28569348/black-tar-heroin-skin-popping-as-a-cause-of-wound-botulism
#6
Ihtesham A Qureshi, Mohtashim A Qureshi, Mohammad Rauf Afzal, Alberto Maud, Gustavo J Rodriguez, Salvador Cruz-Flores, Darine Kassar
BACKGROUND: Botulism is a rare potentially fatal and treatable disorder caused by a bacteria-produced toxin that affects the presynaptic synaptic membrane resulting in a characteristic neuromuscular dysfunction. It is caused by either the ingestion of the toxin or the bacteria, inhalation, or wound infection. We present our observations with a descriptive case series of wound botulism secondary to black tar heroin (BTH) injection. METHODS: We report a retrospective single-center case series of 15 consecutive cases of wound botulism presenting to University Medical Center of El Paso...
May 31, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28554534/ophthalmic-manifestations-of-xeroderma-pigmentosum-a-perspective-from-the-united-kingdom
#7
Rongxuan Lim, Mieran Sethi, Ana M S Morley
PURPOSE: To document the ocular manifestations of xeroderma pigmentosum (XP), presenting via the United Kingdom (UK) XP service, and to analyze the correlations between XP genotype and ophthalmic phenotype. DESIGN: Prospective observational case series. SUBJECTS: Eighty-nine patients seen by the UK Nationally Commissioned XP Service, from April 2010 to December 2014, with a genetically confirmed diagnosis of XP. METHODS: Patients underwent a full ophthalmic examination at each visit...
May 26, 2017: Ophthalmology
https://www.readbyqxmd.com/read/28515685/pupillary-response-to-negative-emotional-stimuli-is-differentially-affected-in-meditation-practitioners
#8
Alejandra Vasquez-Rosati, Enzo P Brunetti, Carmen Cordero, Pedro E Maldonado
Clinically, meditative practices have become increasingly relevant, decreasing anxiety in patients and increasing antibody production. However, few studies have examined the physiological correlates, or effects of the incorporation of meditative practices. Because pupillary reactivity is a marker for autonomic changes and emotional processing, we hypothesized that the pupillary responses of mindfulness meditation practitioners (MP) and subjects without such practices (non-meditators (NM)) differ, reflecting different emotional processing...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28497927/the-potential-role-of-pain-related-sseps-in-the-early-prognostication-of-long-term-functional-outcome-in-post-anoxic-coma
#9
Alessandra Del Felice, Stefano Bargellesi, Federico Linassi, Bruno Scarpa, Emanuela Formaggio, Paolo Boldrini, Stefano Masiero, Paolo Zanatta
BACKGROUND: Cardiac arrest (CA) is a common cause of disability. Multimodal evaluation has improved prognosis but precocious biomarkers are not appropriate in determining long-term functional outcome. AIM: to identify early prognostication markers of long-term functional outcome in post-anoxic coma. DESIGN: retrospective assessment of outcomes. POPULATION: Individuals older than 18 years with post-anoxic coma hospitalized in intensive care units after cardiac arrest (CA) regardless of cause (cardiac or non-cardiac) and location of event (in or out-of-hospital)...
May 12, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28439168/ocular-injuries-in-patients-of-zygomatico-complex-zmc-fractures
#10
Altaf Hussain Malik, Aijaz A Shah, Irshad Ahmad, Babar Ai Shah
PURPOSE: Mid face injuries commonly destroy the integrity of the orbital skeleton, and are frequently complicated by injury to the eye, ranging between 2.7 and 90.6 % as reported in literature. The eye injuries range from simple subconjunctival haemorrhage to globe rupture. The paper aims to study the types of ocular injuries in patients with ZMC fractures. PATIENTS AND METHODS: A study of 67 patients, who had sustained facial trauma sufficient to lead to a facial bone fracture, was undertaken in the department of Oral and Maxillofacial Surgery, Govt Dental College, Srinagar from 2008 to 2014 and the patients received a comprehensive examination by an ophthalmologist within 1 week of injury...
June 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28406812/electroencephalography-predicts-poor-and-good-outcomes-after-cardiac-arrest-a-two-center-study
#11
MULTICENTER STUDY
Andrea O Rossetti, Diego F Tovar Quiroga, Elsa Juan, Jan Novy, Roger D White, Nawfel Ben-Hamouda, Jeffrey W Britton, Mauro Oddo, Alejandro A Rabinstein
OBJECTIVE: The prognostic role of electroencephalography during and after targeted temperature management in postcardiac arrest patients, relatively to other predictors, is incompletely known. We assessed performances of electroencephalography during and after targeted temperature management toward good and poor outcomes, along with other recognized predictors. DESIGN: Cohort study (April 2009 to March 2016). SETTING: Two academic hospitals (Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Mayo Clinic, Rochester, MN)...
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28337603/multimodal-outcome-prognostication-after-cardiac-arrest-and-targeted-temperature-management-analysis-at-36%C3%A2-%C3%A2-c
#12
Spyridoula Tsetsou, Jan Novy, Christian Pfeiffer, Mauro Oddo, Andrea O Rossetti
BACKGROUND: Targeted temperature management (TTM) represents the standard of care in comatose survivors after cardiac arrest (CA) and may be applied targeting 33° or 36 °C. While multimodal prognostication has been extensively tested for 33 °C, scarce information exists for 36 °C. METHODS: In this cohort study, consecutive comatose adults after CA treated with TTM at 36 °C between July 2014 and October 2016 were included. A combination of neurological examination, electrophysiological features, and serum neuron-specific enolase (NSE) was evaluated for outcome prediction at 3 months (mortality; good outcome defined as cerebral performance categories (CPC) score of 1-2, poor outcome defined as CPC 3-5)...
March 23, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28324264/reverse-locked-in-syndrome
#13
Pooja Raibagkar, Ram V Chavali, Tamara B Kaplan, Jennifer A Kim, Meaghan V Nitka, Sherry H-Y Chou, Brian L Edlow
BACKGROUND: Basilar artery occlusion can cause locked-in syndrome, which is characterized by quadriplegia, anarthria, and limited communication via eye movements. Here, we describe an uncommon stroke syndrome associated with endovascular recanalization of the top of the basilar artery: "reverse locked-in syndrome." METHODS: We report the case of a patient with atypical neurological deficits caused by acute ischemic stroke of the midbrain tegmentum. We perform neuroanatomic localization of the patient's infarcts by mapping the magnetic resonance imaging (MRI) data onto a brainstem atlas...
August 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28323524/comparison-of-two-predictive-models-for-short-term-mortality-in-patients-after-severe-traumatic-brain-injury
#14
Klara Kesmarky, Cecile Delhumeau, Marie Zenobi, Bernhard Walder
The Glasgow Coma Scale (GCS) and the Abbreviated Injury Score of the head region (HAIS) are validated prognostic factors in traumatic brain injury (TBI). The aim of this study was to compare the prognostic performance of an alternative predictive model including motor GCS, pupillary reactivity, age, HAIS, and presence of multi-trauma for short-term mortality with a reference predictive model including motor GCS, pupil reaction, and age (IMPACT core model). A secondary analysis of a prospective epidemiological cohort study in Switzerland including patients after severe TBI (HAIS >3) with the outcome death at 14 days was performed...
April 26, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28286831/predictive-factors-of-survival-and-6-month-favorable-outcome-of-very-severe-head-trauma-patients-a-historical-cohort-study
#15
Karin Vathanalaoha, Thakul Oearsakul, Thara Tunthanathip
INTRODUCTION: Very severe head trauma cases, defined as Glasgow Coma Scale (GCS) scores of less than 6, have a higher mortality rate and poorer outcome. The purpose of this study was to recognize factors associated with survival and 6-month favorable outcome of very severe head trauma patients presenting to emergency department. METHODS: In this historical cohort study, the authors retrospectively reviewed medical records of head trauma patients who were admitted to the emergency department with post-resuscitation GCS scores of less than 6...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28107273/influence-of-depth-of-hypnosis-on-pupillary-reactivity-to-a-standardized-tetanic-stimulus-in-patients-under-propofol-remifentanil-target-controlled-infusion-a-crossover-randomized-pilot-study
#16
Nada Sabourdin, Jean-Baptiste Peretout, Eliane Khalil, Marie-Laurence Guye, Nicolas Louvet, Isabelle Constant
BACKGROUND: Pupillometry allows the measurement of pupillary diameter variations in response to nociceptive stimuli. This technique has been used to monitor the balance between analgesia and nociception. Under general anesthesia, the amplitude of pupillary dilation is related to the amount of administered opioids. The objective of this study was to determine whether at a constant infusion rate of opioids, the pupillary response was influenced by depth of hypnosis assessed by the bispectral index (BIS)...
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28008074/increased-neural-and-pupillary-reactivity-to-emotional-faces-in-adolescents-with-current-and-remitted-major-depressive-disorder
#17
Katie L Burkhouse, Max Owens, Cope Feurer, Effua Sosoo, Anastacia Kudinova, Brandon E Gibb
This study combined multiple levels of analysis to examine whether disrupted neural and pupillary reactivity to emotional faces serves as a state- or trait-like marker of adolescent major depressive disorder (MDD). The study examined differences in pupil dilation and the event-related potential (ERP) late positive potential (LPP) component to emotional faces before and after a negative mood induction between 71 adolescents (age 11-18 years) with (i) a current diagnosis of MDD, (ii) a past episode of MDD currently in full remission and (iii) no lifetime history of any Axis I disorder...
May 1, 2017: Social Cognitive and Affective Neuroscience
https://www.readbyqxmd.com/read/27982219/nonarteritic-anterior-ischemic-optic-neuropathy-following-pars-plana-vitrectomy-for-macular-hole-treatment-case-report
#18
Leonardo Provetti Cunha, Luciana Virgínia Ferreira Costa Cunha, Carolina Ferreira Costa, Mário Luiz Ribeiro Monteiro
Herein, we report a case of nonarteritic anterior ischemic optic neuropathy (NAION) following uneventful pars plana vitrectomy for macular hole treatment. A 56-year-old previously healthy woman presented with a full-thickness macular hole in right eye (OD) and small cup-to-disc ratios in both eyes. Five days after surgery, she noticed sudden painless loss of vision in OD and was found to have an afferent pupillary defect and intraocular pressure of 29 mmHg. Fundus examination showed right optic disc edema and the resolution of a macular hole with an inferior altitudinal visual field defect...
September 2016: Arquivos Brasileiros de Oftalmologia
https://www.readbyqxmd.com/read/27796652/prognostic-value-of-corpus-callosum-injuries-in-severe-head-trauma
#19
Marta Cicuendez, Ana Castaño-León, Ana Ramos, Amaya Hilario, Pedro A Gómez, Alfonso Lagares
BACKGROUND: This study was performed to investigate the relationship between corpus callosum (CC) injury and prognosis in traumatic axonal injury (TAI). METHOD: We retrospectively reviewed 264 patients with severe head trauma who underwent a conventional MR imaging in the first 60 days after injury. They were selected from a prospectively collected database of 1048 patients with severe head trauma admitted in our hospital. TAI lesions were defined as areas of increased signal intensity on T2 and FLAIR or areas of decreased signal on gradient-echo T2...
January 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27784772/predicting-survival-after-acute-civilian-penetrating-brain-injuries-the-spin-score
#20
MULTICENTER STUDY
Susanne Muehlschlegel, Didem Ayturk, Aditi Ahlawat, Saef Izzy, Thomas M Scalea, Deborah M Stein, Timothy Emhoff, Kevin N Sheth
OBJECTIVE: To identify predictors associated with survival in civilian penetrating traumatic brain injury (pTBI) utilizing a contemporary, large, diverse 2-center cohort, and to develop a parsimonious survival prediction score for pTBI. METHODS: Our cohort comprised 413 pTBI patients retrospectively identified from the local trauma registries at 2 US level 1 trauma centers, of which one was predominantly urban and the other predominantly rural. Predictors of in-hospital and 6-month survival identified in univariate and multivariable logistic regression were used to develop the simple Surviving Penetrating Injury to the Brain (SPIN) score...
November 22, 2016: Neurology
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