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https://www.readbyqxmd.com/read/28925746/impact-of-extended-monitoring-guided-intensive-care-on-outcome-after-severe-traumatic-brain-injury-a-prospective-multicentre-cohort-study-paris-tbi-study
#1
Joaquim Mateo, Didier Payen, Idir Ghout, Fabrice Vallée, Thomas Lescot, Stephane Welschbillig, Karim Tazarourte, Philippe Azouvi, Jean-Jacques Weiss, Philippe Aegerter, Bernard Vigué
OBJECTIVE: We evaluated whether an integrated monitoring with systemic and specific monitoring affect mortality and disability in adults with severe traumatic brain injury (sTBI). METHODS: Adults with severeTBI (Glasgow Coma Scale [GCS] ≤ 8) admitted alive in intensive care units (ICUs) were prospectively included. Primary endpoints were in-hospital 30-day mortality and extended Glasgow outcome score (GOSE) at 3 years. Association with the intensity of monitoring and outcome was studied by comparing a high level of monitoring (HLM) (systemic and ≥3 specific monitoring) and low level of monitoring (LLM) (systemic and 0-2 specific monitoring) and using inverse probability weighting procedure...
September 19, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28925731/detection-of-metabolic-pattern-following-decompressive-craniectomy-in-severe-traumatic-brain-injury-a-microdialysis-study
#2
Deepak Gupta, Raghav Singla, Anna T Mazzeo, Eric B Schnieder, Vivek Tandon, S S Kale, A K Mahapatra
OBJECTIVE: The aim of the study was to detect mitochondrial dysfunction and ischaemia in severe traumatic brain injury and their relationship with outcome. METHODS: Forty-one patients with severe traumatic brain injury (TBI) who underwent decompressive craniectomy were prospectively monitored with intracerebral microdialysis catheters (MD). Variables related to energy metabolism were studied using microdialysis. RESULTS: Twentysix patients (63...
September 19, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28924505/greater-reproductive-investment-but-shorter-lifespan-in-agrosystem-than-in-natural-habitat-toads
#3
Francisco Javier Zamora-Camacho, Mar Comas
Global amphibian decline is due to several factors: habitat loss, anthropization, pollution, emerging diseases, and global warming. Amphibians, with complex life cycles, are particularly susceptible to habitat alterations, and their survival may be impaired in anthropized habitats. Increased mortality is a well-known consequence of anthropization. Life-history theory predicts higher reproductive investment when mortality is increased. In this work, we compared age, body size, and different indicators of reproductive investment, as well as prey availability, in natterjack toads (Epidalea calamita) from agrosystems and adjacent natural pine groves in Southwestern Spain...
2017: PeerJ
https://www.readbyqxmd.com/read/28922710/paediatric-mild-head-injury-is-routine-admission-to-a-tertiary-trauma-hospital-necessary
#4
Krishna Tallapragada, Ratna Soundarya Peddada, Mark Dexter
BACKGROUND: Previous studies have shown that children with isolated linear skull fractures have excellent clinical outcomes and low risk of surgery. We wish to identify other injury patterns within the spectrum of paediatric mild head injury, which need only conservative management. Children with low risk of evolving neurosurgical lesions could be safely managed in primary hospitals. METHODS: We retrospectively analysed all children with mild head injury (i.e. admission Glasgow coma score 13-15) and skull fracture or haematoma on a head computed tomography scan admitted to Westmead Children's Hospital, Sydney over the years 2009-2014...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28922459/therapeutic-plasma-exchange-in-the-treatment-of-complicated-plasmodium-falciparum-malaria-a-case-report
#5
Tsong-Yih Ou, Cheng-Yen Chuang, Chun-Da Chen, Chung-Yi Cheng
Severe falciparum malaria is associated with multiple organ dysfunction and a high rate of fatal outcome. Malaria is a world-wide disease in tropical areas through the bites of vector mosquitoes. Parasitic protozoans introduced by the mosquito's saliva to the blood travel to the liver then mature and reproduce. In humans, malaria is caused by Plasmodium falciparum, P. malariae, P. ovale, P. vivax, and P. knowlesi, and P. falciparum causes most deaths. Typical malaria symptoms include fever, chills, fatigue, headache, nausea, and vomiting...
September 18, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28922329/conventional-corneal-collagen-cross-linking-versus-transepithelial-diluted-alcohol-and-iontophoresis-assisted-corneal-cross-linking-in-progressive-keratoconus
#6
Kamil Bilgihan, Nilufer Yesilirmak, Yesim Altay, Armagan Yuvarlak, Huseyin Baran Ozdemir
PURPOSE: To compare clinical outcomes of conventional corneal cross-linking (C-CXL) and diluted alcohol and iontophoresis-assisted corneal cross-linking (DAI-CXL) for the treatment of progressive keratoconus (KC). METHODS: Ninety-three eyes of 80 patients with KC were treated by C-CXL (n = 47) or DAI-CXL (n = 46). Visual acuity, keratometry, KC indexes, pachymetry, and aberrations were recorded before treatment and 1, 3, 6, and 12 months after treatment. The demarcation line was assessed 1 month after treatment...
September 14, 2017: Cornea
https://www.readbyqxmd.com/read/28922275/indications-for-ct-angiography-of-the-vertebral-arteries-after-trauma
#7
Joseph P Drain, Douglas S Weinberg, James S Ramey, Timothy A Moore, Heather A Vallier
STUDY DESIGN: Retrospective. OBJECTIVE: The purpose of this project is to identify factors that predict vertebral artery injury (VAI) in an effort to assess risks and benefits of computed tomography angiography (CT-A) of the neck in the trauma setting. We seek to develop guidelines for practitioners to stratify patients at medium/high risk of VAI from those who are at low risk. SUMMARY OF BACKGROUND DATA: VAI and blunt carotid injury (BCI) together comprise blunt cerebrovascular injury (BCVI)...
September 15, 2017: Spine
https://www.readbyqxmd.com/read/28919828/jugular-bulb-oxygen-saturation-correlates-with-full-outline-of-responsiveness-score-in-severe-traumatic-brain-injury-patients
#8
Tjokorda Gde Agung Senapathi, Made Wiryana, Ketut Sinardja, Ketut Wibawa Nada, Ida Bagus Krisna Jaya Sutawan, Christopher Ryalino, Aloysius Alphonso
BACKGROUND: Maintaining brain oxygenation status is the main goal of treatment in severe traumatic brain injury (TBI). Jugular venous oxygen saturation (SjvO2) monitoring is a technique to estimate global balance between cerebral oxygen supply and its metabolic requirement. Full Outline of Responsiveness (FOUR) score, a new consciousness measurement scoring, is expected to become an alternative for Glasgow Coma Scale (GCS) in evaluating neurologic status of patients with severe traumatic head injury, especially for those under mechanical ventilation...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28918089/urinary-incontinence-and-indwelling-urinary-catheters-as-predictors-of-death-after-new-onset-stroke-a-report-of-the-south-london-stroke-register
#9
Gregor John, Steve Primmaz, Siobhan Crichton, Charles Wolfe
OBJECTIVE: To explore the relationship between indwelling urinary catheters (IUCs), urinary incontinence (UI), and death in the poststroke period and to determine when, after the neurological event, UI has the best ability to predict 1-year mortality. METHODS: In a prospective observational study, 4477 patients were followed up for 1 year after a first-ever stroke. The impact of UI or urinary catheters on time to death was adjusted in a Cox model for age, sex, Glasgow Coma Scale, prestroke and poststroke Barthel Index, swallow test, motor deficit, diabetes, and year of inclusion...
September 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28917411/accelerated-15%C3%A2-mw-pulsed-light-crosslinking-to-treat-progressive-keratoconus-two-year-clinical-results
#10
Cosimo Mazzotta, Stefano Baiocchi, Simone Alex Bagaglia, Mario Fruschelli, Alessandro Meduri, Miguel Rechichi
PURPOSE: To assess the clinical and microstructural results of accelerated 15 mW pulsed-light corneal crosslinking (CXL) to treat progressive keratoconus. SETTING: Siena Crosslinking Center, Siena, Italy. DESIGN: Prospective case series. METHODS: After epithelium removal (with Epi-Clear) and 10 minutes stromal soaking with riboflavin 0.1% hydroxypropyl methylcellulose solution, all eyes had 15 mW/cm(2) pulsed-light epithelium-off accelerated CXL for 6 minutes of ultraviolet-A (UVA) irradiation (1 second on/1 second off), maintaining a total UVA exposure of 12 minutes at a fluence of 5...
August 2017: Journal of Cataract and Refractive Surgery
https://www.readbyqxmd.com/read/28916374/amp-activated-protein-kinase-protects-against-anoxia-in-drosophila-melanogaster
#11
Justin J Evans, Chengfeng Xiao, R Meldrum Robertson
During anoxia, proper energy maintenance is essential in order to maintain neural operation. Starvation activates AMP-activated protein kinase (AMPK), an evolutionarily conserved indicator of cellular energy status, in a cascade which modulates ATP production and consumption. We investigated the role of energetic status on anoxia tolerance in Drosophila and discovered that starvation or AMPK activation increases the speed of locomotor recovery from an anoxic coma. Using temporal and spatial genetic targeting we found that AMPK in the fat body contributes to starvation-induced fast locomotor recovery, whereas, under fed conditions, disrupting AMPK in oenocytes prolongs recovery...
September 12, 2017: Comparative Biochemistry and Physiology. Part A, Molecular & Integrative Physiology
https://www.readbyqxmd.com/read/28915898/physician-staffed-helicopter-emergency-medical-service-has-a-beneficial-impact-on-the-incidence-of-prehospital-hypoxia-and-secured-airways-on-patients-with-severe-traumatic-brain-injury
#12
Toni Pakkanen, Antti Kämäräinen, Heini Huhtala, Tom Silfvast, Jouni Nurmi, Ilkka Virkkunen, Arvi Yli-Hankala
BACKGROUND: After traumatic brain injury (TBI), hypotension, hypoxia and hypercapnia have been shown to result in secondary brain injury that can lead to increased mortality and disability. Effective prehospital assessment and treatment by emergency medical service (EMS) is considered essential for favourable outcome. The aim of this study was to evaluate the effect of a physician-staffed helicopter emergency medical service (HEMS) in the treatment of TBI patients. METHODS: This was a retrospective cohort study...
September 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28915305/trauma-epidemiology-of-women-in-puerto-rico-2002-2011
#13
Sofía Muns-Aponte, Omar García-Rodríguez, Ediel O Ramos-Meléndez, Pablo Rodríguez-Ortiz
OBJECTIVE: Recent literature has suggested that trauma is heterogenic and that physiological response to it differs between sexes. The study represented in this manuscript aimed to describe gender differences in the mortality rates of trauma patients at the Puerto Rico Trauma Hospital (PRTH). MATERIALS AND METHODS: This was a cross-sectional study performed at PRTH. A total of 14,874 injured patients admitted to the hospital from 2002 to 2011 were included in the sample and divided into 2 groups, based on sex...
September 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28915130/dolichoectasia-of-vertebrobasilar-arteries-as-a-cause-of-hydrocephalus-and-ischemic-cerebral-stroke
#14
Miodrag Zdravković, Milos Kostov, Sladjana Petrovic, Jovana Zdravkovic
INTRODUCTION: Dolichoectasia of vertebrobasilar artery is a rare vasculopathy, which is characterized by ectasia, elongation, and tortuosity of the basilar artery. CASE DESCRIPTION: A 85-year-old man was referred to the Clinic of Neurology with sudden-onset coma. A brain computed tomography scan showed remarkable fusiform dilatation with elongation of basilar artery, with compressive effect on brain stem. Autopsy confirmed existence of vertebrobasilar dolichoectasia, with organized old thrombus and partially with recent occlusive thrombosis...
September 14, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28914632/stepwise-guided-photorefractive-keratectomy-in-treatment-of-irregular-astigmatism-after-penetrating-keratoplasty-and-deep-anterior-lamellar-keratoplasty
#15
Nir Sorkin, Adi Einan-Lifshitz, Sagi Abelson, Tanguy Boutin, Mahmood Showail, Armand Borovik, Zach Ashkenazy, Clara C Chan, David S Rootman
PURPOSE: To report the outcome of stepwise ablation using topography-guided photorefractive keratectomy to treat irregular astigmatism after either penetrating keratoplasty (PKP) or deep anterior lamellar keratoplasty (DALK). METHODS: This is a retrospective, interventional analysis including patients with irregular astigmatism after either PKP or DALK, who underwent topography-guided photorefractive keratectomy. The entire cohort was analyzed, as well as the PKP and DALK groups separately...
September 12, 2017: Cornea
https://www.readbyqxmd.com/read/28913605/emergency-neurological-life-support-status-epilepticus
#16
Jan Claassen, Joshua N Goldstein
Patients with prolonged or rapidly recurring convulsions lasting more than 5 min should be considered to be in status epilepticus (SE) and receive immediate resuscitation. Although there are few randomized clinical trials, available evidence and experience suggest that early and aggressive treatment of SE improves patient outcomes, for which reason this was chosen as an Emergency Neurological Life Support protocol. The current approach to the emergency treatment of SE emphasizes rapid initiation of adequate doses of first line therapy, as well as accelerated second line anticonvulsant drugs and induced coma when these fail, coupled with admission to a unit capable of neurological critical care and electroencephalography monitoring...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28913601/emergency-neurological-life-support-approach-to-the-patient-with-coma
#17
Rhonda S Cadena, Aarti Sarwal
Coma is an acute failure of neuronal systems governing arousal and awareness and represents a medical emergency. When encountering a comatose patient, the clinician must have an organized approach to detect easily remediable causes, prevent ongoing neurologic injury, and determine a hierarchical plan for diagnostic tests, treatments, and neuromonitoring. Coma was chosen as an Emergency Neurological Life Support protocol because timely medical and surgical interventions can be life-saving, and the initial work-up of such patients is critical to establishing a correct diagnosis...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28913501/acute-poisoning-due-to-ingestion-of-datura-stramonium-a-case-report
#18
Sebastian Daniel Trancă, Robert Szabo, Mihaela Cociş
Datura stramonium (DS) is a widespread annual plant, containing atropine, hyoscyamine, and scopolamine, which can produce poisoning with a severe anticholinergic syndrome. Teenagers ingest the roots, seeds or the entire plant to obtain its hallucinogenic and euphoric effects. We presented the case of a 22 year old male who was admitted to the Emergency Room in a coma after consuming Datura stramonium, 2 hours earlier. The patient presented with fever, tachycardia with right bundle branch block, and urinary retention...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28912713/meta-analysis-for-clinical-evaluation-of-xingnaojing-injection-for-the-treatment-of-cerebral-infarction
#19
REVIEW
Xiao Ma, Yu X Yang, Nian Chen, Qian Xie, Tao Wang, Xuan He, Jian Wang
Objective: Xingnaojing injection (XNJ) is derived from An-Gong-Niu-Huang pill, a well-known traditional Chinese patent medicine, which is widely used for stroke. To evaluate the therapeutic effect of XNJ on cerebral infarction, an extensive meta-analysis was used. Methods: Six major electronic databases including the Chinese Biomedical Database (CBM), Wanfang, the VIP medicine information system (VMIS) and the China National Knowledge Infrastructure (CNKI), PubMed, Embase, and the Cochrane Library were examined to retrieve randomized controlled trials designed to evaluate the clinical efficacy of XNJ in treating CI before November 26, 2016...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28912029/inclusion-of-highest-glasgow-coma-scale-motor-score-in-mortality-risk-adjustment-for-benchmarking-of-trauma-center-performance
#20
David Gomez, James P Byrne, Aziz S Alali, Wei Xiong, Chris Hoeft, Melanie Neal, Harris Subacius, Avery B Nathens
BACKGROUND: The Glasgow Coma Scale (GCS) score is the most widely utilized measure of traumatic brain injury (TBI) severity. Currently, the arrival GCS motor score (mGCS) is used in risk-adjustment models for external benchmarking of mortality. However, there is evidence that the highest mGCS in the first 24 hours after injury might be a better predictor of death. Our objective was to evaluate the impact of including highest mGCS on the performance of risk-adjustment models and subsequent external benchmarking results...
September 11, 2017: Journal of the American College of Surgeons
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