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Felipe P Andrade, Roberto Montoro, Renan Oliveira, Gabriela Loures, Luana Flessak, Roberta Gross, Camille Donnabella, Andrea Puchnick, Lisa Suzuki, Rodrigo Regacini
OBJECTIVES: 1) To verify clinical signs correlated with appropriate cranial computed tomography scan indications and changes in the therapeutic approach in pediatric minor head trauma scenarios. 2) To estimate the radiation exposure of computed tomography scans with low dose protocols in the context of trauma and the additional associated risk. METHODS: Investigators reviewed the medical records of all children with minor head trauma, which was defined as a Glasgow coma scale ≥13 at the time of admission to the emergency room, who underwent computed tomography scans during the years of 2013 and 2014...
October 1, 2016: Clinics
Byoung-Joon Oh, Yong-Gyun Im, Eunjung Park, Young-Gi Min, Sang-Cheon Choi
OBJECTIVE: The effect of induced hypothermia on severe acute carbon monoxide (CO) poisoning remains to be addressed further. We investigated the effect of induced hypothermia on severe acute CO poisoning. METHODS: Retrospective chart review was conducted for patients who diagnosed as severe acute CO poisoning in emergency department and underwent induced hypothermia from May 2013 to May 2014. Hospital courses with critical medication and major laboratory results were investigated through the chart review...
June 2016: Clin Exp Emerg Med
Jin Hee Jeong, Jin Hee Lee, Kyuseok Kim, Joong Eui Rhee, Tae Yun Kim, You Hwan Jo, Yu Jin Kim, Jae Hyuk Lee, Changwoo Kang, Soo Hoon Lee, Joonghee Kim, Chan Jong Park, Hyuksool Kwon
OBJECTIVE: Head injury in children is a common problem presenting to emergency departments, and cranial computed tomography scanning is the diagnostic standard for these patients. Several decision rules are used to determine whether computed tomography scans should be used; however, the use of computed tomography scans is often influenced by guardians' preference toward the scans. The objective of this study was to identify changes in guardian preference for minor head injuries after receiving an explanation based on the institutional clinical practice guideline...
December 2015: Clin Exp Emerg Med
Abigail Livny, Anat Biegon, Tammar Kushnir, Sagi Harnof, Chen Hoffmann, Eyal Fruchter, Mark Weiser
Traumatic brain injury (TBI) is known to have a substantial, though highly variable, impact on cognitive abilities. Due to the wide range of cognitive abilities among healthy individuals, an objective assessment of TBI-related cognitive loss requires an accurate measurement of premorbid cognitive performance. To address this problem, we recruited 50 adults who sustained a TBI and had performed a cognitive baseline assessment in adolescence as part of the aptitude tests mandated by the Israeli Defense Forces...
October 18, 2016: Journal of Neurotrauma
Charlayne McStay, Richard Pierce, Carley Riley
Zonisamide is a sulfonamide drug used primarily for the treatment of partial seizures in adults. We describe the case of a 15-year-old woman with a mood disorder who survived without complications after ingestion of an estimated 7.5 g of zonisamide. To the best of our knowledge, there are 4 case reports of individuals with intentional ingestion of more than 4 g of zonisamide as a single agent. Our patient developed coma and hypotension 4 hours after ingestion and was treated with a catecholamine infusion, endotracheal intubation, and mechanical ventilation...
September 30, 2016: Pediatric Emergency Care
Negin Amirshekarizadeh, Hassan Hashemi, Ebrahim Jafarzadehpur, Ali Mirzajani, Abbasali Yekta, Mehdi Khabazkhoob
PURPOSE: To determine the effect of cyclopentolate, tropicamide, and artificial tear drops on higher-order aberrations (HOAs) in normal eyes with OPD-Scan III (Nidek Inc., Tokyo, Japan). METHODS: In this study, 189 eyes of individuals aged 20 to 35 years were selected as samples. Inclusion criteria were a corrected visual acuity of 20/20 or better, a minimum size of about 5 mm for the pupil in the dark, hyperopia and myopia less than 5 D, and astigmatism less than 2 D...
September 30, 2016: Eye & Contact Lens
Koray Gumus, Aysegul Guven, Miray Altnkaynak, Merve Keskin
OBJECTIVES: The aim of this study was to compare different measurement tools and parameters, including a new computer-assisted image processing technique for the quantitative analysis of the percentage of pterygium on the corneal surface, horizontal/vertical lengths obtained using slitlamp beam and surgical compass. METHODS: A total of 21 pterygia of 17 patients were included in the study. The pterygia were measured by three different methods: a slitlamp beam, a surgical compass, and a new computer-assisted image processing method...
September 30, 2016: Eye & Contact Lens
Andrew A Udy, Chelsey Vladic, Edward Robert Saxby, Jeremy Cohen, Anthony Delaney, Oliver Flower, Matthew Anstey, Rinaldo Bellomo, David James Cooper, David V Pilcher
OBJECTIVE: The primary aim of this study was to describe in-hospital mortality in subarachnoid hemorrhage patients requiring ICU admission. Secondary aims were to identify clinical characteristics associated with inferior outcomes, to compare subarachnoid hemorrhage mortality with other neurological diagnoses, and to explore the variability in subarachnoid hemorrhage standardized mortality ratios. DESIGN: Multicenter, binational, retrospective cohort study. SETTING: Data were extracted from the Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation Adult Patient Database...
October 3, 2016: Critical Care Medicine
Thomas Godet, Russell Chabanne, Julien Marin, Sophie Kauffmann, Emmanuel Futier, Bruno Pereira, Jean-Michel Constantin
BACKGROUND: The decision to extubate brain-injured patients with residual impaired consciousness holds a high degree of uncertainty of success. The authors developed a pragmatic clinical score predictive of extubation failure in brain-injured patients. METHODS: One hundred and forty brain-injured patients were prospectively included after the first spontaneous breathing trial success. Assessment of multiparametric hemodynamic, respiratory, and neurologic functions was performed just before extubation...
October 3, 2016: Anesthesiology
Huimin Lin, Samuel T H Chew
An 85-year-old female with chronic kidney disease and newly acquired seizures on oral phenytoin received intravenous ertapenem 500 mg once daily for a urinary tract infection and bacteraemia involving extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. After three ertapenem doses, she developed seizures which self-aborted. Corrected phenytoin level was sub-therapeutic initially, but became therapeutic following a phenytoin dose increase. On Day 14 of ertapenem, the patient suffered another episode of seizure...
December 2015: Drug Saf Case Rep
S Gibiino, A Trappoli, B Balzarro, A R Atti, D De Ronchi
A 71-year-old man developed coma with severe respiratory failure, hypotension, and tachycardia induced by the intentional ingestion of quetiapine fumarate extended release (XR) 20 g. At the time, he had been treated for bipolar depression with venlafaxine 75 mg/day, lamotrigine 100 mg/day, pregabalin 75 mg/day, and quetiapine XR 400 mg/day for approximately 1 year. Comorbidities were hypertension treated with metoprolol, diabetes mellitus type 2 treated with metformin, and benign prostatic hyperplasia treated with silodosin...
December 2015: Drug Saf Case Rep
Laura Pérez-Lago, Santiago Izco, Marta Herranz, Griselda Tudó, María Carcelén, Iñaki Comas, Olalla Sierra, Juliá González, María Jesús Ruiz-Serrano, Juan Eyene, Emilio Bouza, Darío García-de-Viedma
OBJECTIVE: Molecular epidemiology techniques in tuberculosis (TB) can identify high-risk strains that are actively transmitted. We aimed to implement a novel strategy to optimize the identification and control of MDR-TB in a specific population. METHODS: We developed a strain-specific-PCR tailored from whole-genome-sequencing (WGS) data to track a specific multidrug-resistant prevalent strain in Equatorial Guinea (EG-MDR). RESULTS: The PCR was applied prospectively on remnants of GeneXpert reaction mixtures owing to the lack of culture facilities in EG...
October 13, 2016: Clinical Microbiology and Infection
Joaquín Valle Alonso, Francisco Javier Fonseca Del Pozo, Manuel Vaquero Álvarez, Elisa Lopera Lopera, Marisol Garcia Segura, Ricardo García Arévalo
BACKGROUND AND OBJECTIVE: To compare two scales for assessment of patients with mild head injury. The Canadian CT Head Rule (CCHR) and New Orleans Criteria (NOC) according to their diagnostic accuracy in patients attending an emergency department, and to determine the most important predictive values. METHOD: Cross-sectional study in a first-level Hospital in the period of January 2011 to January 2013. Patients with mild head injury criteria were included. All the patients underwent a computed tomography (CT) of the head as part of internal protocol and the CCHR and NOC criteria were recorded for each patient...
October 10, 2016: Medicina Clínica
Lara R Arauna, Javier Mendoza-Revilla, Alex Mas-Sandoval, Hassan Izaabel, Asmahan Bekada, Soraya Benhamamouch, Karima Fadhlaoui-Zid, Pierre Zalloua, Garrett Hellenthal, David Comas
North Africa is characterized by its diverse cultural and linguistic groups and its genetic heterogeneity. Genomic data has shown an amalgam of components mixed since pre-Holocean times. Though no differences have been found in uniparental and classical markers between Berbers and Arabs, the two main ethnic groups in the region, the scanty genomic data available have highlighted the singularity of Berbers. We characterize the genetic heterogeneity of North African groups, focusing on the putative differences of Berbers and Arabs, and estimate migration dates...
October 15, 2016: Molecular Biology and Evolution
Bruno A Randi, Marília F Felício, Carolina S Lázari, Maria Irma S Duarte, Ilana Halpern, Yeh-Li Ho
No abstract text is available yet for this article.
November 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
(no author information available yet)
No abstract text is available yet for this article.
November 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Romain Lefaucheur, Axel Lebas, Emmanuel Gérardin, Lou Grangeon, Ozlem Ozkul-Wermester, Carole Aubier-Girard, Olivier Martinaud, David Maltête
A 29-year-old man was admitted for acute cognitive impairment. Three weeks earlier, he had been admitted for coma due to sniffed heroin abuse responsive to naloxone infusion. At admission, the patient presented with apraxia, severe memory impairment and anosognosia. Brain MRI revealed symmetric hyperintensities of supratentorial white matter, sparing brainstem and cerebellum, on FLAIR and B1000 sequences. Four months later, repeated neuropsychological assessment revealed dramatic improvement of global cognitive functions...
October 11, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
W M Hajjar, S A Bin Abdulqader, S S Aldayel, A W Alfardan, N I Alzaidy
BACKGROUND: Organ transplantation is the optimal treatment for end-stage organ diseases. The demand for organs has exceeded the available supply, which becomes a major obstacle worldwide. Identifying the factors affecting this gap will help in overcoming this obstacle. The purpose of the work was to study the knowledge, attitudes, and beliefs of organ donation and to determine the knowledge of brain death among social media users. METHODS: A cross-sectional study was conducted among social media users living in Saudi Arabia...
September 2016: Transplantation Proceedings
A Castillo, J Porro, M Garrido-Baserba, D Rosso, D Renzi, F Fatone, V Gómez, J Comas, M Poch
Wastewater treatment selection is a complex task usually addressed by applying separate tools for the correct assessment of multi-criteria evaluation. Novedar_EDSS integrates technical, environmental, economic and social assessment capabilities in one single platform. The aim of this work is to evaluate and demonstrate the capabilities of this environmental decision support system (EDSS). For that purpose, 4 case studies of real projects were selected to validate the results in the EDSS by comparing them with those from the study of alternatives performed by the decision makers...
October 11, 2016: Journal of Environmental Management
Stephen J Traub, Eelco F Wijdicks
Coma represents a true medical emergency. Drug intoxications are a leading cause of coma; however, other metabolic disturbances and traumatic brain injury are also common causes. The general emergency department approach begins with stabilization of airway, breathing, and circulation, followed by a thorough physical examination to generate a limited differential diagnosis that is then refined by focused testing. Definitive treatment is ultimately disease-specific. This article presents an overview of the pathophysiology, causes, examination, and treatment of coma...
November 2016: Emergency Medicine Clinics of North America
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