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https://www.readbyqxmd.com/read/28748895/a-case-of-severe-carbamazepine-overdose-treated-successfully-with-combined-hemoperfusion-and-hemodialysis-technique
#1
Natalia Vallianou, Myrto Giannopoulou, Kyriakos Trigkidis, Elefteria Bei, Evangelia Margellou, Theofanis Apostolou
Carbamazepine intoxication manifests as altered mental status ranging from drowsiness to a coma and/or cardiac abnormalities such as sinus tachycardia, prolongation of the QRS interval, ventricular tachycardia, and hypotension. The patient may be agitated, but central nervous system (CNS) depression and presentation with coma is more common and could be lethal. Serious CNS toxicity often requires hemoperfusion and/or hemodialysis (HD). Herein, we present a case of a comatose patient, who was treated with a combination of hemoperfusion and HD in series...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28747450/magnesium-hemostasis-and-outcomes-in-patients-with-intracerebral-hemorrhage
#2
Eric M Liotta, Shyam Prabhakaran, Rajbeer S Sangha, Robin A Bush, Alan E Long, Stephen A Trevick, Matthew B Potts, Babak S Jahromi, Minjee Kim, Edward M Manno, Farzaneh A Sorond, Andrew M Naidech, Matthew B Maas
OBJECTIVE: We tested the hypothesis that admission serum magnesium levels are associated with hematoma volume, hematoma growth, and functional outcomes in patients with intracerebral hemorrhage (ICH). METHODS: Patients presenting with spontaneous ICH were enrolled in an observational cohort study that prospectively collected demographic, clinical, laboratory, radiographic, and outcome data. We performed univariate and adjusted multivariate analyses to assess for associations between serum magnesium levels and initial hematoma volume, final hematoma volume, and in-hospital hematoma growth as radiographic measures of hemostasis, and functional outcome measured by the modified Rankin Scale (mRS) at 3 months...
July 26, 2017: Neurology
https://www.readbyqxmd.com/read/28747418/a-complication-of-meningitis-and-infective-endocarditis-due-to-streptococcus-pyogenes
#3
Kosuke Inoue, Akiyoshi Hagiwara, Akio Kimura, Norio Ohmagari
We described a rare case of meningitis and infective endocarditis (IE) due to Streptococcus pyogenes. An 80-year-old woman was admitted to our hospital with unconsciousness. Glasgow Coma Scale was E1V3M5. We diagnosed her with acute meningitis due to S. pyogenes and started treatment using ceftriaxone. In spite of the improvement of her unconscious state, she developed a new-onset systolic murmur on day 13, and echocardiography revealed severe mitral valve regurgitation with vegetation. Therefore, we also diagnosed her with IE and continued the antibiotics for 6 weeks after we confirmed the negative blood cultures...
July 26, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28747144/abcg2-c-421c-a-is-associated-with-outcomes-following-severe-traumatic-brain-injury
#4
Solomon M Adams, Yvette P Conley, Dianxu Ren, David O Okonkwo, Ava Puccio, C Edward Dixon, Robert Sb Clark, Patrick M Kochanek, Philip E Empey
Traumatic brain injury (TBI) is a leading cause of death with no pharmacologic treatments that improve outcomes. Transporter proteins participate in TBI recovery by maintaining the CNS biochemical milieu. Genetic variations in transporters that alter expression and/or function have been associated with TBI outcomes. The ATP-binding cassette transporter, ABCG2, is a uric acid (UA) transporter that effluxes UA from cells in the CNS and is responsible for systemic UA clearance. Uric acid is a CNS antioxidant and/or a biomarker that might support TBI recovery...
July 26, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28746528/simple-motor-tasks-independently-predict-extubation-failure-in-critically-ill-neurological-patients
#5
Fernanda Machado Kutchak, Marcelo de Mello Rieder, Josué Almeida Victorino, Carla Meneguzzi, Karla Poersch, Luiz Alberto Forgiarini, Marino Muxfeldt Bianchin
Objective: To evaluate the usefulness of simple motor tasks such as hand grasping and tongue protrusion as predictors of extubation failure in critically ill neurological patients. Methods: This was a prospective cohort study conducted in the neurological ICU of a tertiary care hospital in the city of Porto Alegre, Brazil. Adult patients who had been intubated for neurological reasons and were eligible for weaning were included in the study. The ability of patients to perform simple motor tasks such as hand grasping and tongue protrusion was evaluated as a predictor of extubation failure...
May 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28746183/visual-outcomes-after-balanced-salt-solution-infiltration-during-lenticule-separation-in-small-incision-lenticule-extraction-for-myopic-astigmatism
#6
Ting Liu, Xiaomin Zhu, Kaijian Chen, Ji Bai
To evaluate the refractive outcomes of balanced salt solution infiltration during small-incision lenticule extraction (SMILE).This randomized prospective study enrolled 52 patients (104 eyes) with myopic astigmatism. Patients underwent SMILE to correct the myopic astigmatism in Daping Hospital of the Third Military Medical University between January and July 2013. One eye of each patient received traditional SMILE (control group) and the other received a modified SMILE procedure (liquid infiltration group)...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28744847/factors-considered-by-clinicians-when-prognosticating-intracerebral-hemorrhage-outcomes
#7
David Y Hwang, Stacy Y Chu, Cameron A Dell, Mary J Sparks, Tiffany D Watson, Carl D Langefeld, Mary E Comeau, Jonathan Rosand, Thomas W K Battey, Sebastian Koch, Mario L Perez, Michael L James, Jessica McFarlin, Jennifer L Osborne, Daniel Woo, Steven J Kittner, Kevin N Sheth
BACKGROUND: The early subjective clinical judgment of clinicians outperforms formal prognostic scales for accurate determination of outcome after intracerebral hemorrhage (ICH), with the judgment of physicians and nurses having equivalent accuracy. This study assessed specific decisional factors that physicians and nurses incorporate into early predictions of functional outcome. METHODS: This prospective observational study enrolled 121 ICH patients at five US centers...
July 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28744846/extubation-failure-and-tracheostomy-placement-in-children-with-acute-neurocritical-illness
#8
Ellen C Cohn, Tammy S Robertson, Stacey A Scott, Andre M Finley, Rong Huang, Darryl K Miles
BACKGROUND: There is a lack of data describing the risk factors for extubation failure (EF) or tracheostomy placement in pediatric neurocritical care (NCC) patients. METHODS: A retrospective chart review of children admitted to the pediatric intensive care unit who were intubated for >24 h with an acute neurocritical illness and had an extubation attempt. Bivariate and multivariate statistical analysis was performed to determine significant associations of demographic, neurologic, pulmonary, and clinical variables with EF and tracheostomy placement...
July 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28744772/breakthrough-pain-management-with-sublingual-fentanyl-tablets-in-patients-with-cancer-age-subgroup-analysis-of-a-multicenter-prospective-study
#9
Jordi Guitart, María Isabel Vargas, Vicente De Sanctis, Jordi Folch, Rafael Salazar, José Fuentes, Joan Coma, Julia Ferreras, Jordi Moya, Albert Tomás, Pere Estivill, Francisco Rodelas, Antonio Javier Jiménez, Almudena Sanz
INTRODUCTION: Breakthrough pain (BTP) management in patients with cancer is challenging, especially in the elderly. However, no studies examining the influence of age on BTP medication have been conducted. The aim of this work was to investigate the effect of sublingual fentanyl tablets (SFTs) in terms of efficacy, safety, and quality of life in two age categories. METHODS: We performed age subgroup analyses (<65 and ≥65 years) from a recently completed study conducted in Spain...
July 25, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/28743566/mortality-prediction-in-patients-with-acute-kidney-injury-requiring-renal-replacement-therapy-after-cardiac-surgery
#10
Inga Skarupskienė, Dalia Adukauskienė, Jurgita Kuzminskienė, Laima Rimkutė, Vilma Balčiuvienė, Edita Žiginskienė, Vytautas Kuzminskis, Agnė Adukauskaitė, Daiva Pentiokinienė, Inga Arūnė Bumblytė
BACKGROUND AND OBJECTIVE: Acute kidney injury (AKI) is a common and potentially serious postoperative complication after cardiac surgery, and it remains a cause of major morbidity and mortality. The aim of our study was to assess the prognostic illness severity score and to estimate the significant risk factors for poor outcome of patients with AKI requiring renal replacement therapy (RRT) after cardiac surgery. MATERIALS AND METHODS: We retrospectively analyzed data of adult (>18 years) patients (n=111) who underwent open heart surgery and had developed AKI with need for RRT...
July 14, 2017: Medicina
https://www.readbyqxmd.com/read/28743388/traumatic-bilateral-dissection-of-cervical-internal-carotid-artery-in-the-wake-of-a-car-accident-a-case-report
#11
N Taoussi, A J Alghamdi, J Bielewicz, P Luchowski, K Rejdak
BACKGROUND: Bilateral carotid artery dissection secondary to severe trauma is rare and can be potentially life -threatening if not diagnosed and treated properly. CASE PRESENTATION: We report a 29-year-old female who was admitted to the emergency department after a car accident. The patient was conscious at the time of admission and presented with an initial Glasgow Coma Scale (GCS) of 15 presenting normal vital signs. The patient developed motor dysphasia with right upper limb paresis a few hours after the admission...
July 10, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28742869/ultrasound-non-invasive-measurement-of-intracranial-pressure-in-neurointensive-care-a-prospective-observational-study
#12
Chiara Robba, Danilo Cardim, Tamara Tajsic, Justine Pietersen, Michael Bulman, Joseph Donnelly, Andrea Lavinio, Arun Gupta, David K Menon, Peter J A Hutchinson, Marek Czosnyka
BACKGROUND: The invasive nature of the current methods for monitoring of intracranial pressure (ICP) has prevented their use in many clinical situations. Several attempts have been made to develop methods to monitor ICP non-invasively. The aim of this study is to assess the relationship between ultrasound-based non-invasive ICP (nICP) and invasive ICP measurement in neurocritical care patients. METHODS AND FINDINGS: This was a prospective, single-cohort observational study of patients admitted to a tertiary neurocritical care unit...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28742618/changes-in-higher-order-aberrations-after-phototherapeutic-keratectomy-for-subepithelial-corneal-infiltrates-after-epidemic-keratoconjunctivitis
#13
Burcin Kepez Yildiz, Semih Urvasizoglu, Yusuf Yildirim, Alper Agca, Nilay K Besek, Korhan Fazil, Erdem Eris, Ebru Demet Aygit, Muhittin Taskapili, Ahmet Demirok
PURPOSE: To investigate how corneal aberrations change after phototherapeutic keratectomy (PTK) for subepithelial infiltrates after adenoviral keratoconjunctivitis. METHODS: The records of patients who underwent transepithelial PTK for subepithelial infiltrates were retrospectively reviewed. Preoperative best-corrected visual acuity (VA) and the results of slit-lamp biomicroscopy examinations were recorded. The PTK procedure was performed under topical anesthesia with an Amaris excimer laser...
July 24, 2017: Cornea
https://www.readbyqxmd.com/read/28742109/young-sprague-dawley-rats-infected-by-plasmodium-berghei-a-relevant-experimental-model-to-study-cerebral-malaria
#14
Sokhna Keita Alassane, Marie-Laure Nicolau-Travers, Sandie Menard, Olivier Andreoletti, Jean-Pierre Cambus, Noémie Gaudre, Myriam Wlodarczyk, Nicolas Blanchard, Antoine Berry, Sarah Abbes, David Colongo, Babacar Faye, Jean-Michel Augereau, Caroline Lacroux, Xavier Iriart, Françoise Benoit-Vical
Cerebral malaria (CM) is the most severe manifestation of human malaria yet is still poorly understood. Mouse models have been developed to address the subject. However, their relevance to mimic human pathogenesis is largely debated. Here we study an alternative cerebral malaria model with an experimental Plasmodium berghei Keyberg 173 (K173) infection in Sprague Dawley rats. As in Human, not all infected subjects showed cerebral malaria, with 45% of the rats exhibiting Experimental Cerebral Malaria (ECM) symptoms while the majority (55%) of the remaining rats developed severe anemia and hyperparasitemia (NoECM)...
2017: PloS One
https://www.readbyqxmd.com/read/28741220/independent-impact-of-plasma-homocysteine-levels-on-neurological-outcome-following-head-injury
#15
Sivashanmugam Dhandapani, Ankur Bajaj, Chandrasekar Gendle, Inderjeet Saini, Irwanjeet Kaur, Isha Chaudhary, Jasandeep, Jaspinder Kaur, Geetanjali Kalyan, Manju Dhandapani, Sunil K Gupta
Homocysteine (tHcy) has been hardly studied among patients with head injury. This study was to evaluate whether there is any independent impact of tHcy levels on neurological outcome following head injury in a multivariate model. Patients admitted within 24 h of injury were included in the study, along with 20 age- and gender-matched controls. Plasma levels of tHcy were measured at admission using direct immunoassay. All the variables were analyzed with respect to tHcy levels and outcome according to Glasgow Outcome Score (GOS) at 3 months...
July 24, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28739474/traumatic-subaxial-cervical-facet-subluxation-and-dislocation-epidemiology-radiographic-analyses-and-risk-factors-for-spinal-cord-injury
#16
Ryan D Quarrington, Claire F Jones, Petar Tcherveniakov, Jillian M Clark, Simon J I Sandler, Yu Chao Lee, Shabnam Torabiardakani, John J Costi, Brian J C Freeman
BACKGROUND CONTEXT: Distractive-flexion injuries (DFIs) of the subaxial cervical spine are major contributors to spinal cord injury (SCI). Prompt assessment and early intervention of DFIs associated with SCI is crucial to optimize patient outcome; however, neurological examination of patients with subaxial cervical injury is often difficult, as patients commonly present with reduced levels of consciousness. Therefore, it is important to establish potential associations between injury epidemiology and radiographic features, and neurological involvement...
July 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28739290/implementation-of-the-canadian-ct-head-rule-and-its-association-with-use-of-computed-tomography-among-patients-with-head-injury
#17
Adam L Sharp, Brian Z Huang, Tania Tang, Ernest Shen, Edward R Melnick, Arjun K Venkatesh, Michael H Kanter, Michael K Gould
STUDY OBJECTIVE: Approximately 1 in 3 computed tomography (CT) scans performed for head injury may be avoidable. We evaluate the association of implementation of the Canadian CT Head Rule on head CT imaging in community emergency departments (EDs). METHODS: We conducted an interrupted time-series analysis of encounters from January 2014 to December 2015 in 13 Southern California EDs. Adult health plan members with a trauma diagnosis and Glasgow Coma Scale score at ED triage were included...
July 21, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28738952/medication-errors-in-injured-patients
#18
Scott C Dolejs, Christopher F Janowak, Ben L Zarzaur
Trauma patients are vulnerable to medication error given multiple handoffs throughout the hospital. The purpose of this study was to assess trends in medication errors in trauma patients and the role these errors play in patient outcomes. Injured adults admitted from 2009 to 2015 to a Level I trauma center were included. Medication errors were determined based on a nurse-driven, validated, and prospectively maintained database. Multivariable logistic regression modeling was used to control for differences between groups...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28738936/favorable-outcomes-in-blunt-chest-injury-with-noninvasive-bi-level-positive-airway-pressure-ventilation
#19
Pascal Udekwu, Sahill Patel, Meagan Farrell, Rhonda Vincent
Recent clinical research in patients with blunt chest injury has focused on the benefits of surgical fixation of rib fractures. Noninvasive ventilation (NIV) has been demonstrated to prevent the need for intubation and ventilation in posttraumatic respiratory failure. The preemptive use of NIV in patients with rib fractures has not been extensively studied. Our study evaluated the outcomes of patients with ≥3 rib fractures and hospitalized for ≥ 4 days. Seventy-one patients treated with NIV were compared with 270 patients without NIV...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28738538/diosmin-improved-cognitive-deficit-and-amplified-brain-electrical-activity-in-the-rat-model-of-traumatic-brain-injury
#20
Mohammad Ali Mirshekar, Hamed Fanaei, Fereshteh Keikhaei, Fatemeh Sargolzaee Javan
OBJECTIVE: Traumatic brain injury (TBI) is one of the main causes of intellectual and cognitive disabilities in humans. Clinically, it is essential to limit the progress of cognitive impairment after TBI. It is reported that diosmin has a neuroprotective effect that can limit the progress of the impairment. The aim of this study was to evaluate the effects of diosmin on neurological score, memory, tumor necrosis factor-α (TNF-α) level and long-term potentiation in hippocampal dentate gyrus after the injury...
July 20, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
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