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https://www.readbyqxmd.com/read/28350718/serotonin-syndrome-in-a-pediatric-patient-after-vilazodone-ingestion
#1
Benjamin Laliberte, Omayma A Kishk
Serotonin syndrome (SS) is a serious toxicity that manifests with symptoms such as tremor, hyperthermia, agitation, and altered mental status that may lead to seizures, coma, or death. Selective serotonin reuptake inhibitors may precipitate SS, particularly in combination with other drugs that possess serotonergic activity. We present a case of SS in a 14-month-old after an ingestion of the selective serotonin reuptake inhibitor vilazodone.
March 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28346475/treatment-of-blunt-thoracic-aortic-injury-in-germany-assessment-of-the-traumaregister-dgu%C3%A2
#2
Alexander Gombert, Mohammad E Barbati, Martin Storck, Drosos Kotelis, Paula Keschenau, Hans-Christoph Pape, Hagen Andruszkow, Rolf Lefering, Frank Hildebrand, Andreas Greiner, Michael J Jacobs, Jochen Grommes
PURPOSE: Using the data delivered by the German Trauma Register DGU® from 2002 till 2013, the value of different therapies of blunt thoracic aortic injury (BTAI) in Germany was analyzed. METHODS: Prospectively collected data of patients suffering from BTAI were retrospectively analyzed with focus on the different treatment modalities for grade I-IV injuries. RESULTS: 821 patients suffering from BTAI were identified: 51.6% (424) grade I injury, 35...
2017: PloS One
https://www.readbyqxmd.com/read/28343797/early-brain-edema-is-a-predictor-of-in-hospital-mortality-in-traumatic-brain-injury
#3
Brian Tucker, Jill Aston, Megan Dines, Elena Caraman, Marianne Yacyshyn, Mary McCarthy, James E Olson
BACKGROUND: Identifying patients who may progress to a poor clinical outcome will encourage earlier appropriate therapeutic interventions. Brain edema may contribute to secondary injury in traumatic brain injury (TBI) and thus, may be a useful prognostic indicator. OBJECTIVE: We determined whether the presence of brain edema on the initial computed tomography (CT) scan of TBI patients would predict poor in-hospital outcome. METHODS: We performed a retrospective review of all trauma patients with nonpenetrating head trauma at a Level I Trauma Center...
March 23, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28343726/rapid-measurement-of-low-order-aberrations-using-fourier-transforms-of-crystalline-ronchigrams
#4
Koji Kimoto, Kazuo Ishizuka
The aberrations of the objective lens should be measured and adjusted to realize high spatial resolution in scanning transmission electron microscopy (STEM). Here we report a method of measuring low-order aberrations using the Fourier transforms of Ronchigrams of an arbitrary crystal such as a specimen of interest. We have applied this technique to measure first- and second-order geometrical aberrations using typical standard specimens. Focus and twofold astigmatism are measured using two Ronchigrams obtained under different foci...
March 18, 2017: Ultramicroscopy
https://www.readbyqxmd.com/read/28343456/implementation-of-neurocritical-care-is-associated-with-improved-outcomes-in-traumatic-brain-injury
#5
Mypinder S Sekhon, Peter Gooderham, Brian Toyota, Navid Kherzi, Vivien Hu, Vinay K Dhingra, Morad S Hameed, Dean R Chittock, Donald E Griesdale
Background Traditionally, the delivery of dedicated neurocritical care (NCC) occurs in distinct NCC units and is associated with improved outcomes. Institution-specific logistical challenges pose barriers to the development of distinct NCC units; therefore, we developed a consultancy NCC service coupled with the implementation of invasive multimodal neuromonitoring, within a medical-surgical intensive care unit. Our objective was to evaluate the effect of a consultancy NCC program on neurologic outcomes in severe traumatic brain injury patients...
March 27, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28343409/development-of-a-prediction-model-for-post-concussive-symptoms-following-mild-traumatic-brain-injury-a-track-tbi-pilot-study
#6
Maryse C Cnossen, Ethan A Winkler, John K Yue, David O Okonkwo, Alex Valadka, Ewout W Steyerberg, Hester Lingsma, Geoffrey T Manley
Post-concussive symptoms occur frequently after mild traumatic brain injury (mTBI) and may be categorized as cognitive, somatic, or emotional. We aimed to: 1) assess whether patient demographics and clinical variables predict development of each of these three symptom categories, and 2) develop a prediction model for six-month post-concussive symptoms. MTBI patients (Glasgow Coma Scale score 13-15) from the prospective multicenter Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Pilot study (2010-2012) who completed the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) at six-months post-injury were included...
March 27, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28343321/a-risk-score-based-on-admission-characteristics-to-predict-progressive-hemorrhagic-injury-from-traumatic-brain-injury-in-children
#7
Guo-Wen Hu, Hai-Li Lang, Hua Guo, Lei Wu, Pei Zhang, Wei Kuang, Xin-Gen Zhu
Traumatic brain injury (TBI) is one of the leading causes of death and disability in children, and progressive hemorrhagic injury (PHI) post TBI is associated with poor outcomes. Therefore, the objective of this study was to develop and validate a prognostic model that uses the information available at admission to determine the likelihood of PHI occurrence after TBI in children. The identified demographic data, cause of injury, clinical predictors on admission, computed tomography scan characteristics, and routine laboratory parameters were collected and used to develop a PHI prognostic model with logistic regression analysis, and the prediction model was validated in 68 children...
March 25, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28340601/rantes-levels-in-peripheral-blood-csf-and-contused-brain-tissue-as-a-marker-for-outcome-in-traumatic-brain-injury-tbi-patients
#8
Venencia Albert, Arulselvi Subramanian, Deepak Agrawal, Sanjeev Kumar Bhoi, Pooja Pallavi, A K Mukhopadhayay
BACKGROUND: Traumatic brain injury (TBI) causes activation of several neurochemical and physiological cascades, leading to neurological impairment. We aimed to investigate the level of novel chemokine RANTES in plasma, cerebrospinal fluid (CSF) and contused brain tissue in traumatic brain injury patients and to correlate the expression of this chemokine with the severity of head injury and neurological outcome. METHODS: This longitudinal case control study was performed on 70 TBI patients over a period of 30 months...
March 24, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28338532/is-severe-hypercalcemia-immediately-life-threatening
#9
Camille Guimard, Eric Batard, Frédéric Lavainne, David Trewick
OBJECTIVE: Severe hypercalcemia is often considered an emergency because of a potential risk of cardiac arrest or coma. However, there is little evidence to support this. The aim of our study was to assess whether severe hypercalcemia (Ca>4 mmol/l or 16 mg/dl) was associated with immediately life-threatening cardiac arrhythmias or neurological complications in patients admitted to the Emergency Department (ED). METHODS: A retrospective observational study was carried out over a 5-year period (2008-2012)...
March 23, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28336445/mortality-associated-characteristics-of-traumatic-brain-injury-patients-at-the-university-teaching-hospital-of-kigali-rwanda
#10
Elizabeth Krebs, Charles J Gerardo, Lawrence P Park, Joao Ricardo Nickenig Vissoci, Jean Claude Byiringiro, Fidele Byiringiro, Stephen Rulisa, Nathan Thielman, Catherine Staton
OBJECTIVE: Traumatic Brain Injury (TBI) is a leading cause of death and disability. TBI patients in low and middle- income countries have worse outcomes than those in high-income countries. We aimed to evaluate important clinical indicators associated with mortality for TBI patients at the University Teaching Hospital of Kigali (UTHK) Kigali, Rwanda. METHODS: Prospective consecutive sampling of TBI patients presenting to UTHK Accident and Emergency Department were screened for inclusion criteria: reported head trauma, alteration in consciousness, headache, or visible head trauma...
March 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28336222/evaluation-of-the-shifting-of-the-line-of-sight-and-higher-order-aberrations-of-eyes-with-keratoconus-after-corneal-cross-linking
#11
Pinar Kosekahya, Mustafa Koc, Kemal Tekin, Murat Uzel, Cemile Ucgul Atilgan, Mehtap Caglayan, Pelin Yilmazbas
AIM: To evaluate changes in the coordinates of the line of sight (LoS) and higher order aberrations (HOAs) of eyes with keratoconus, following corneal cross-linking (CXL). METHODS: All patients (93 eyes) underwent detailed ophthalmologic examination and Pentacam HR measurements at baseline and at 3, 6, and 12 months after corneal CXL. LoS coordinates on the horizontal (x) and vertical (y) axes, vertical coma, vertical trefoil, spherical aberration, total root-mean square (RMS), and HOA-RMS values were recorded along with visual acuity and topographical parameters...
March 20, 2017: Contact Lens & Anterior Eye: the Journal of the British Contact Lens Association
https://www.readbyqxmd.com/read/28336122/familial-acute-necrotizing-encephalopathy-with-ranbp2-mutation-the-first-report-in-northeast-asia
#12
Yun-Jeong Lee, Su-Kyeong Hwang, So Mi Lee, Soonhak Kwon
BACKGROUND: Acute necrotizing encephalopathy (ANE) is a rare but rapidly progressing encephalopathy following a febrile illness, commonly a viral infection. It is characterized by the features of acute encephalopathy such as seizure, alteration of consciousness, and symmetric involvement of the bilateral thalamus on neuroimaging tests. Although most ANE cases have occurred sporadically, familial or recurrent ANE has been reported in Caucasian patients, with genetic susceptibility to ANE noted in some patients due to a RANBP2 mutation...
March 20, 2017: Brain & Development
https://www.readbyqxmd.com/read/28336014/clinical-significance-of-fibrinogen-degradation-product-among-traumatized-patients
#13
Kouhei Ishikawa, Kazuhiko Omori, Kei Jitsuiki, Hiromichi Ohsaka, Hiroshi Ito, Katsuhito Shimoyama, Toru Fukunaga, Norikazu Urabe, Souichirou Kitamura, Youichi Yanagawa
OBJECTIVE: We retrospectively analyzed trauma patients who were transported by a physician-staffed helicopter (doctor helicopter) to investigate the clinical significance of the fibrinogen degradation product (FDP) level on arrival. METHODS: From February 2011 to July 2016, a medical chart review was retrospectively performed for all patients with trauma who were transported by the doctor helicopter. The subjects were divided into 2 groups: a survival group and a fatal group...
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28335668/directions-for-use-of-intracranial-pressure-monitoring-in-treatment-of-severe-traumatic-brain-injury-using-data-from-the-japan-neurotrauma-data-bank
#14
Eiichi Suehiro, Yuichi Fujiyama, Hiroyasu Koizumi, Michiyasu Suzuki
Neuromonitoring can be used to observe intracranial pathological conditions in neurointensive care, but use of intracranial pressure (ICP) monitoring is low in Japan. In this study, we retrospectively investigated the effects of ICP monitoring in treatment of severe traumatic brain injury (TBI) using data from the Japan Neurotrauma Data Bank (JNTDB). The study was conducted in 1,091 subjects enrolled in the JNTDB (Project 2009) from July 2009 to June 2011. The subjects were divided into those treated with and without ICP monitoring in intensive care for severe TBI...
March 23, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28335557/ros-production-and-erk-activity-are-involved-in-the-effects-of-d-%C3%AE-hydroxybutyrate-and-metformin-in-a-glucose-deficient-condition
#15
Santosh Lamichhane, Tonking Bastola, Ramesh Pariyar, Eun-Sol Lee, Ho-Sub Lee, Dae Ho Lee, Jungwon Seo
Hypoglycemia, a complication of insulin or sulfonylurea therapy in diabetic patients, leads to brain damage. Furthermore, glucose replenishment following hypoglycemic coma induces neuronal cell death. In this study, we investigated the molecular mechanism underlying glucose deficiency-induced cytotoxicity and the protective effect of d-β-hydroxybutyrate (D-BHB) using SH-SY5Y cells. The cytotoxic mechanism of metformin under glucose deficiency was also examined. Cell viability under 1 mM glucose (glucose deficiency) was significantly decreased which was accompanied by increased production of reactive oxygen species (ROS) and decreased phosphorylation of extracellular signal-regulated kinase (ERK) and glycogen synthase 3 (GSK3β)...
March 21, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28332157/systematic-overdosing-of-oxa-and-cloxacillin-in-severe-infections-treated-in-icu-risk-factors-and-side-effects
#16
Mathilde Neuville, Najoua El-Helali, Eric Magalhaes, Aguila Radjou, Roland Smonig, Jean-François Soubirou, Guillaume Voiriot, Alban Le Monnier, Stéphane Ruckly, Lila Bouadma, Romain Sonneville, Jean-François Timsit, Bruno Mourvillier
BACKGROUND: Oxacillin and cloxacillin are the most frequently used penicillins for the treatment of severe methicillin-susceptible Staphylococcus aureus infections in intensive care units (ICUs), especially endocarditis. International recommendations do not suggest any adaptation of the dosage in case of renal impairment. We wanted to assess the risk factors for overdosing in ICU and the related observed side effects. METHODS: All patients with a therapeutic drug monitoring of oxa- or cloxacillin between 2008 and 2014 were included...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28329002/emergency-department-outpatient-treatment-of-alcohol-intoxicated-bicyclists-increases-the-cost-of-medical-care-in-japan
#17
Yosuke Homma, Sunao Yamauchi, Michiko Mizobe, Yoshiyuki Nakashima, Jin Takahashi, Hiraku Funakoshi, Kevin Y Urayama, Sachiko Ohde, Osamu Takahashi, Takashi Shiga
Riding a bicycle under the influence of alcohol is illegal in Japan. Nevertheless, intoxicated bicyclists are frequently treated at hospital emergency departments for bicycle-related injuries. This patient population usually requires more hospital resources, even for relatively minor injuries. Therefore, we hypothesized that bicycle-related crashes involving bicyclists under the influence of alcohol cost more to treat than those that do not involve alcohol intoxication. The aim of the present study was to examine the costs associated with bicycle-related minor injuries and alcohol intoxication of the bicyclist...
2017: PloS One
https://www.readbyqxmd.com/read/28328690/the-first-use-of-pralidoxime-in-a-child-with-rivastigmine-poisoning
#18
Eylem Ulaş Saz, Ali Yurtseven, Mehmet Arda Kilinç, Yusuf Sari, Hasan Ağin
The aim of this report is to describe the successful use of pralidoxime in a pediatric patient who accidentally ingested 12 mg of rivastigmine and presented to the emergency department with weakness, drowsiness, hyporeactivity to environmental stimuli, and full cholinergic syndrome. CASE: The patient presented to the emergency department 2 hours after a suspected ingestion of rivastigmine. He was sleepy but oriented and cooperative, hypotonic, and hyporeflexic and has a Glasgow Coma Scale score of 13 (E3M6V4)...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28327922/factors-influencing-the-reliability-of-the-glasgow-coma-scale-a-systematic-review
#19
Florence Cm Reith, Anneliese Synnot, Ruben van den Brande, Russell L Gruen, Andrew Ir Maas
BACKGROUND: The Glasgow Coma Scale (GCS) characterizes patients with diminished consciousness. In a recent systematic review, we found overall adequate reliability across different clinical settings, but reliability estimates varied considerably between studies, and methodological quality of studies was overall poor. Identifying and understanding factors that can affect its reliability is important, in order to promote high standards for clinical use of the GCS. OBJECTIVE: The aim of this systematic review was to identify factors that influence reliability and to provide an evidence base for promoting consistent and reliable application of the GCS...
March 15, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327921/the-superior-cerebellar-artery-aneurysm-a-posterior-circulation-aneurysm-with-favorable-microsurgical-outcomes
#20
Ana Rodríguez-Hernández, Brian P Walcott, Harjus Birk, Michael T Lawton
BACKGROUND: Superior cerebellar artery (SCA) aneurysms are usually grouped with aneurysms that arise from the upper basilar artery or more broadly, the posterior circulation. However, the SCA aneurysm has distinctive anatomy that facilitates safe surgical management, notably few associated perforating arteries, and excellent exposure in the carotid-oculomotor triangle. OBJECTIVE: To demonstrate the outcomes of patients treated with microsurgery in a continuous surgical series...
January 24, 2017: Neurosurgery
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