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https://www.readbyqxmd.com/read/28108097/factors-predicting-recovery-of-oral-intake-in-stroke-survivors-with-dysphagia-in-a-convalescent-rehabilitation-ward
#1
Yasunori Ikenaga, Sayaka Nakayama, Hiroki Taniguchi, Isao Ohori, Nahoko Komatsu, Hitoshi Nishimura, Yasuo Katsuki
BACKGROUND: Percutaneous endoscopic gastrostomy may be performed in dysphagic stroke patients. However, some patients regain complete oral intake without gastrostomy. This study aimed to investigate the predictive factors of intake, thereby determining gastrostomy indications. METHOD: Stroke survivors admitted to our convalescent rehabilitation ward who underwent gastrostomy or nasogastric tube placement from 2009 to 2015 were divided into 2 groups based on intake status at discharge...
January 17, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28107093/adult-clonidine-overdose-prolonged-bradycardia-and-central-nervous-system-depression-but-not-severe-toxicity
#2
Geoffrey K Isbister, Simon P Heppell, Colin B Page, Nicole M Ryan
CONTEXT: There are limited reports of adult clonidine overdose. We aimed to describe the clinical effects and treatment of clonidine overdose in adults. METHODS: This was a retrospective review of a prospective cohort of poisoned patients who took clonidine overdoses (>200 μg). Demographic information, clinical effects, treatment, complications (central nervous system and cardiovascular effects) and length of stay (LOS) were extracted from a clinical database or medical records...
January 20, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28106704/rapid-spontaneously-resolving-acute-subdural-hematoma
#3
Qi Gan, Hexiang Zhao, Hanmei Zhang, Chao You
INTRODUCTION: This study reports a rare patient of a rapid spontaneously resolving acute subdural hematoma. In addition, an analysis of potential clues for the phenomenon is presented with a review of the literature. PATIENT PRESENTATION: A 1-year-and-2-month-old boy fell from a height of approximately 2 m. The patient was in a superficial coma with a Glasgow Coma Scale of 8 when he was transferred to the authors' hospital. Computed tomography revealed the presence of an acute subdural hematoma with a midline shift beyond 1 cm...
January 18, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28106499/retrospective-study-of-long-term-outcome-after-brain-arteriovenous-malformation-rupture-the-rap-score
#4
Eimad Shotar, Matthieu Debarre, Nader-Antoine Sourour, Federico Di Maria, Joseph Gabrieli, Aurélien Nouet, Jacques Chiras, Vincent Degos, Frédéric Clarençon
OBJECTIVE The authors aimed to design a score for stratifying patients with brain arteriovenous malformation (BAVM) rupture, based on the likelihood of a poor long-term neurological outcome. METHODS The records of consecutive patients with BAVM hemorrhagic events who had been admitted over a period of 11 years were retrospectively reviewed. Independent predictors of a poor long-term outcome (modified Rankin Scale score ≥ 3) beyond 1 year after admission were identified. A risk stratification scale was developed and compared with the intracranial hemorrhage (ICH) score to predict poor outcome and inpatient mortality...
January 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28103876/the-norwegian-version-of-the-qolibri-a-study-of-metric-properties-based-on-a-12%C3%A2-month-follow-up-of-persons-with-traumatic-brain-injury
#5
Helene Lundgaard Soberg, Cecilie Roe, Cathrine Brunborg, Nicole von Steinbüchel, Nada Andelic
BACKGROUND: Consequences after Traumatic brain injury (TBI) affect the injured person's self-image and quality of life. The purpose was to assess the health related quality of life (HRQoL) at 12 months after a TBI in patients admitted to regional trauma centres, and to evaluate the metric properties of the Norwegian version of the Quality of Life After Brain Injury (QOLIBRI) questionnaire. METHODS: Two hundred four patients with TBI of all severities were included...
January 19, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28102097/familiar-auditory-sensory-training-in-chronic-traumatic-brain-injury-a-case-study
#6
Emily Galassi Sullivan, Ann Guernon, Brett Blabas, Amy A Herrold, Theresa L-B Pape
PURPOSE: The evaluation and treatment for patients with prolonged periods of seriously impaired consciousness following traumatic brain injury (TBI), such as a vegetative or minimally conscious state, poses considerable challenges, particularly in the chronic phases of recovery. METHOD: This blinded crossover study explored the effects of familiar auditory sensory training (FAST) compared with a sham stimulation in a patient seven years post severe TBI. Baseline data were collected over 4 weeks to account for variability in status with neurobehavioral measures, including the Disorders of Consciousness scale (DOCS), Coma Near Coma scale (CNC), and Consciousness Screening Algorithm...
January 19, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28099375/routine-neurosurgical-consultation-is-not-necessary-in-mild-blunt-traumatic-brain-injury
#7
Paul R Lewis, Casey E Dunne, James D Wallace, Jason B Brill, Richard Y Calvo, Jayraan Badiee, Michael J Sise, Vishal Bansal, C Beth Sise, Steven R Shackford
BACKGROUND: The Brain Trauma Foundation guidelines provide indications for neurosurgical intervention in traumatic brain injury (TBI) with moderate or severe intracranial hemorrhage (ICH). In TBI patients with less severe ICH, the utility of neurosurgical consultation remains unclear. We sought to determine if routine neurosurgical consultation is necessary for mild blunt TBI patients with ICH. METHODS: A retrospective cohort study was conducted on 500 consecutive blunt TBI patients aged 15 years or older with Glasgow Coma Scale score ≥13 and ICH on initial head computed tomography (CT) admitted to a Level 1 trauma center over 28 months...
January 17, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28099295/comparison-of-resource-utilization-and-length-of-hospitalization-between-overweight-and-healthy-weight-pediatric-trauma-patients-presenting-to-a-pediatric-emergency-department-with-moderate-to-severe-injury-a-prospective-study
#8
Theresa Romano, Ioannis Koutroulis, Evan Weiner, Anthony Little, Sabina Singh
OBJECTIVES: Our study aimed to compare overweight and healthy-weight pediatric trauma patient outcomes, specifically with respect to hospital length of stay and resource utilization. We hypothesized that overweight pediatric trauma patients would have increased hospital length of stay and radiographic study use compared with their healthy-weight counterparts. METHODS: This was a prospective, observational, cohort study of pediatric trauma patients aged 2 to 19 years presenting to an urban pediatric emergency department over a period of 1 year...
January 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28098631/after-the-fall-the-tapestry-of-disturbance-and-recovery
#9
Nalini M Nadkarni
On July 3, 2015, Nalini Nadkarni, a world-renowned ecologist who had been studying the biologic processes of ecosystem disturbance and recovery, sustained a catastrophic 50-foot free-fall from the top of the rainforest canopy to the forest floor at her remote field research site. She lost consciousness in shock and sustained life-threatening injuries. Her accompanying students hiked out, radio-called 911, and the Harborview Medical Center (Seattle) Medivac team arrived 4 hours later to rescue her. Her prognosis was extremely grim; her family gathered in anticipation of her death as she underwent four operations during her 10 days in the ICU...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28097921/how-to-care-for-a-patient-s-eyes-in-critical-care-settings
#10
Janet Marsden, Richard Davies
Rationale and key points Eye care is an important aspect of the nursing management of patients who are critically ill. All patients in acute care settings with absent or compromised eye defence mechanisms are at risk of eye complications and ocular surface disease. This article aims to assist nurses to care for the eyes of patients in critical care settings to enable early detection and routine management of ophthalmic issues, thereby avoiding visual compromise on patient discharge from critical care settings...
December 14, 2016: Nursing Standard
https://www.readbyqxmd.com/read/28097180/the-role-of-nurses-in-coping-process-of-family-caregivers-of-vegetative-patients-a-qualitative-study
#11
Zahra Imanigoghary, Hamid Peyrovi, Esmat Nouhi, Majid Kazemi
BACKGROUND: Vegetative state (VS) occurs through return of the brain stem after coma state. After hospital discharge, responsibility of caring for VS patients is transferred to their families, which causes a high burden on them. Nurses have an important role in helping the family caregivers to meet their needs and cope with difficulties. To explore the role of nurses during coping process of family caregivers of VS patients. METHODS: This study is a part of a larger qualitative study which was performed in Kerman province, Iran during 2014- 2015...
January 2017: International Journal of Community Based Nursing and Midwifery
https://www.readbyqxmd.com/read/28096588/prolonged-coma-after-anesthesia
#12
Surath Manimala Rao
No abstract text is available yet for this article.
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28095735/criterion-validity-of-the-d-kefs-color-word-and-verbal-fluency-switching-paradigms-following-traumatic-brain-injury
#13
Luke B Anderson, Rebekah Jaroh, Hillary Smith, Carrie-Ann H Strong, Jacobus Donders
The present study was composed of two parts examining the clinical utility of the Delis-Kaplan Executive Function System (D-KEFS) Verbal Fluency and Color-Word subtests in traumatic brain injury (TBI). In the first part, the performance of 128 outpatients with mild to severe TBI on the Verbal Fluency and Color-Word subtests was examined in relation to two primary indicators of TBI severity: length of coma and the presence of intracranial lesions on neuroimaging through regression analysis. After controlling for education, ethnicity, and complicating premorbid and comorbid factors, length of coma predicted performance on the Color-Word Inhibition/Switching subtest, whereas the presence of diffuse lesions was related to Verbal Fluency Category Switching performance...
January 17, 2017: Journal of Clinical and Experimental Neuropsychology
https://www.readbyqxmd.com/read/28094429/a-comparison-between-the-effectiveness-of-full-outline-of-unresponsiveness-and-glasgow-coma-score-at-neurosurgical-intensive-care-unit-patients
#14
Nail Caglar Temiz, Gulsah Kose, Ozkan Tehli, Cengizhan Acikel, Sevgi Hatipoglu
AIM: To evaluate the effectiveness and the use of Glasgow Coma Score (GCS) and Full Outline of Unresponsiveness (FOUR) score by nurses in the follow-up and evaluation of patients who admitted to neurosurgical intensive care unit for cranial surgery or head trauma. MATERIAL AND METHODS: The study was performed at a neurosurgical intensive care unit. Sample size was calculated 47 patients as 5% a, 95% Power and values less than 0.5 at correlation were accepted nonsense...
December 21, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28093562/factors-associated-with-a-family-s-delay-of-decision-for-organ-donation-after-brain-death
#15
Sang Youb Han, Jae Il Kim, Eun-Woo Lee, Hye-Yeon Jang, Kum Hyun Han, Se Won Oh, Young-Nam Roh
BACKGROUND This study aimed to explore the factors associated with a family's delay of decision for organ donation after brain death, and to investigate the effect of such a delay on organ donation. MATERIAL AND METHODS Medical records and data on counseling about organ donation with the families of 107 brain-dead potential donors between September 2012 and March 2016 at a single tertiary medical center were retrospectively reviewed. RESULTS The final consent rate was 58% (62/107), and successful donation was performed in 40% (43/107)...
January 17, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28093358/mapping-the-functional-connectome-traits-of-levels-of-consciousness
#16
Enrico Amico, Daniele Marinazzo, Carol Di Perri, Lizette Heine, Jitka Annen, Charlotte Martial, Mario Dzemidzic, Murielle Kirsch, Vincent Bonhomme, Steven Laureys, Joaquín Goñi
Examining task-free functional connectivity (FC) in the human brain offers insights on how spontaneous integration and segregation of information relate to human cognition, and how this organization may be altered in different conditions, and neurological disorders. This is particularly relevant for patients in disorders of consciousness (DOC) following severe acquired brain damage and coma, one of the most devastating conditions in modern medical care. We present a novel data-driven methodology, connICA, which implements Independent Component Analysis (ICA) for the extraction of robust independent FC patterns (FC-traits) from a set of individual functional connectomes, without imposing any a priori data stratification into groups...
January 13, 2017: NeuroImage
https://www.readbyqxmd.com/read/28091809/a-review-of-penetrating-brain-trauma-epidemiology-pathophysiology-imaging-assessment-complications-and-treatment
#17
REVIEW
Mona T Vakil, Ajay K Singh
Gunshot injuries are the most common cause of penetrating brain injury (PBI) and carry a high morbidity and mortality. The incidence of PBI has increased over the last decade with an estimated 35,000 civilian deaths annually. Patients that survive to reach the hospital require rapid triage and imaging evaluation. CT findings in conjunction with the Glasgow Coma Scale are typically used to determine which patients are surgical candidates. Radiologists should be familiar with the various injury patterns and imaging findings which are poor prognostic indicators, notably brainstem, bilateral hemispheric, multilobar, or transventricular injuries...
January 14, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28089112/predictive-utility-of-the-total-glasgow-coma-scale-versus-the-motor-component-of-the-glasgow-coma-scale-for-identification-of-patients-with-serious-traumatic-injuries
#18
REVIEW
Roger Chou, Annette M Totten, Nancy Carney, Spencer Dandy, Rongwei Fu, Sara Grusing, Miranda Pappas, Ngoc Wasson, Craig D Newgard
STUDY OBJECTIVE: The motor component of the Glasgow Coma Scale (mGCS) has been proposed as an easier-to-use alternative to the total GCS (tGCS) for field assessment of trauma patients by emergency medical services. We perform a systematic review and meta-analysis to compare the predictive utility of the tGCS versus the mGCS or Simplified Motor Scale in field triage of trauma for identifying patients with adverse outcomes (inhospital mortality or severe brain injury) or who underwent procedures (neurosurgical intervention or emergency intubation) indicating need for high-level trauma care...
January 11, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28087807/field-validation-of-the-los-angeles-motor-scale-as-a-tool-for-paramedic-assessment-of-stroke-severity
#19
Joon-Tae Kim, Pil-Wook Chung, Sidney Starkman, Nerses Sanossian, Samuel J Stratton, Marc Eckstein, Frank D Pratt, Robin Conwit, David S Liebeskind, Latisha Sharma, Lucas Restrepo, May-Kim Tenser, Miguel Valdes-Sueiras, Jeffrey Gornbein, Scott Hamilton, Jeffrey L Saver
BACKGROUND AND PURPOSE: The Los Angeles Motor Scale (LAMS) is a 3-item, 0- to 10-point motor stroke-deficit scale developed for prehospital use. We assessed the convergent, divergent, and predictive validity of the LAMS when performed by paramedics in the field at multiple sites in a large and diverse geographic region. METHODS: We analyzed early assessment and outcome data prospectively gathered in the FAST-MAG trial (Field Administration of Stroke Therapy-Magnesium phase 3) among patients with acute cerebrovascular disease (cerebral ischemia and intracranial hemorrhage) within 2 hours of onset, transported by 315 ambulances to 60 receiving hospitals...
January 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28087785/thermolytic-degradation-of-synthetic-cannabinoids-chemical-exposures-and-pharmacological-consequences
#20
Brian F Thomas, Timothy W Lefever, Ricardo A Cortes, Alexander L Kovach, Anderson O Cox, Purvi R Patel, Gerald T Pollard, Julie A Marusich, Richard A Kevin, Thomas F Gamage, Jenny L Wiley
Synthetic cannabinoids are manufactured clandestinely with little quality control and are distributed as herbal "Spice" for smoking or as bulk compound for mixing with a solvent and inhalation via electronic vaporizers. Intoxication with synthetic cannabinoids has been associated with seizure, excited delirium, coma, kidney damage, and other disorders. The chemical alterations produced by heating these structurally novel compounds for consumption are largely unknown. Here we show that heating synthetic cannabinoids containing tetramethylcyclopropyl-ring substituents produced thermal degradants with pharmacological activity that varied considerably from their parent compounds...
January 13, 2017: Journal of Pharmacology and Experimental Therapeutics
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