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https://www.readbyqxmd.com/read/29150776/hyperpyrexia-as-the-presenting-symptom-of-intracranial-hypotension
#1
Omar Hussein, Michel Torbey
INTRODUCTION: Hyperpyrexia is a severely elevated core body temperature secondary to an elevated hypothalamic set thermo-regulatory threshold. Hyperthermia is an elevated core body temperature beyond the normal hypothalamic set thermo-regulatory threshold. Intracranial hypotension can present with a wide variety of symptoms ranging from orthostatic headache up to coma. We report a rare case of hyperpyrexia associated with intracranial hypotension. METHODS: A case report of a 55-year-old female patient with a history of angiogram-negative subarachnoid hemorrhage status post-ventriculoperitoneal (VP) shunt placement six years prior to admission who suddenly developed encephalopathy and high fever...
November 17, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29148904/randomized-controlled-study-comparing-2-surgical-techniques-for-decompressive-craniectomy-with-watertight-duraplasty-and-without-watertight-duraplasty
#2
Eduardo Vieira, Thiago C Guimarães, Igor V Faquini, Jose L Silva, Tammy Saboia, Rodrigo V C L Andrade, Thaís L Gemir, Valesca C Neri, Nivaldo S Almeida, Hildo R C Azevedo-Filho
OBJECTIVE Decompressive craniectomy (DC) is a widely used procedure in neurosurgery; however, few studies focus on the best surgical technique for the procedure. The authors' objective was to conduct a prospective randomized controlled trial comparing 2 techniques for performing DC: with watertight duraplasty and without watertight duraplasty (rapid-closure DC). METHODS The study population comprised patients ranging in age from 18 to 60 years who were admitted to the Neurotrauma Service of the Hospital da Restauração with a clinical indication for unilateral decompressive craniectomy...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29148640/short-term-outcome-of-operated-traumatic-brain-injury-patients-for-intracranial-hemorrhage-at-tikur-anbessa-specialized-teaching-hospital-tasth-addis-ababa-ethiopia
#3
Hagos Biluts, Azarias Kassahun, Mersha Abebe
Background: Traumatic brain injury is the leading cause of death and disability in people younger than 40 years of age worldwide. Objective: The study primarily aims at assessing the short-term outcome of patients operated for traumatic intracranial hemorrhage. Patients and Methods: This is a hospital based cross sectional study on patients with traumatic brain injury at Tikur Anbessa Specialized Teaching Hospital in Addis Ababa, Ethiopia, between February 2013 and February 2014...
January 2017: Ethiopian Medical Journal
https://www.readbyqxmd.com/read/29147476/sudden-cardiac-arrest-as-a-rare-presentation-of-myxedema-coma-case-report
#4
Divya Salhan, Deepak Sapkota, Prakash Verma, Saroj Kandel, Omar Abdulfattah, Antony Lixon, Deribe Zwenge, Frances Schmidt
Myxedema coma is a decompensated hypothyroidism which occurs due to long-standing, undiagnosed, or untreated hypothyroidism. Untreated hypothyroidism is known to affect almost all organs including the heart. It is associated with a decrease in cardiac output, stroke volume due to decreased myocardial contractility, and an increase in systemic vascular resistance. It can cause cardiac arrhythmias and the most commonly seen conduction abnormalities are sinus bradycardia, heart block, ventricular tachycardia, and torsade de pointes...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29143568/the-inter-rater-reliability-and-prognostic-value-of-coma-scales-in-nepali-children-with-acute-encephalitis-syndrome
#5
Stephen Ray, Ajit Rayamajhi, Laura J Bonnett, Tom Solomon, Rachel Kneen, Michael J Griffiths
Background Acute encephalitis syndrome (AES) is a common cause of coma in Nepali children. The Glasgow coma scale (GCS) is used to assess the level of coma in these patients and predict outcome. Alternative coma scales may have better inter-rater reliability and prognostic value in encephalitis in Nepali children, but this has not been studied. The Adelaide coma scale (ACS), Blantyre coma scale (BCS) and the Alert, Verbal, Pain, Unresponsive scale (AVPU) are alternatives to the GCS which can be used. Methods Children aged 1-14 years who presented to Kanti Children's Hospital, Kathmandu with AES between September 2010 and November 2011 were recruited...
November 16, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/29143551/independent-validation-of-the-icu-requirement-score-in-a-cohort-of-acutely-poisoned-adults
#6
Regina Böll, Katrin Romanek, Sabrina Schmoll, Raphael Stich, Armin Ott, Jochen Stenzel, Stefanie Geith, Florian Eyer, Christian Rabe
OBJECTIVE: To independently validate the predictive value of the intensive care requirement score (IRS) in unselected poisoned patients. DESIGN: Retrospective chart review. PATIENTS AND METHODS: Five hundred and seventeen out of 585 admissions for acute intoxications could be analyzed. Eleven were excluded for a condition already requiring intensive care unit (ICU) support at admission (e.g., preclinical intubation). A further 57 admissions were excluded due to missing data...
November 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29142632/delayed-burr-hole-surgery-in-patients-with-acute-subdural-hematoma-clinical-analysis
#7
Yoon Heuck Choi, Seong Rok Han, Chang Hyun Lee, Chan Young Choi, Moon Jun Sohn, Chae Heuck Lee
Objective: To evaluate the effectiveness and efficacy of delayed burr hole surgery in relation to the reduction of postoperative subdural hematoma (SDH) volume in patients with acute SDH. Methods: We retrospectively analyzed patients with acute SDH who received delayed burr hole surgery at our institute. Age, sex, Glasgow coma scale, maximal SDH thickness, volume of SDH, midline shifts, hounsfield unit (HU), and medical history of anticoagulant agent usage were recorded...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29142631/mortality-and-epidemiology-in-256-cases-of-pediatric-traumatic-brain-injury-korean-neuro-trauma-data-bank-system-kntdbs-2010-2014
#8
Hee-Won Jeong, Seung-Won Choi, Jin-Young Youm, Jeong-Wook Lim, Hyon-Jo Kwon, Shi-Hun Song
Objective: Among pediatric injury, brain injury is a leading cause of death and disability. To improve outcomes, many developed countries built neurotrauma databank (NTDB) system but there was not established nationwide coverage NTDB until 2009 and there have been few studies on pediatric traumatic head injury (THI) patients in Korea. Therefore, we analyzed epidemiology and outcome from the big data of pediatric THI. Methods: We collected data on pediatric patients from 23 university hospitals including 9 regional trauma centers from 2010 to 2014 and analyzed their clinical factors (sex, age, initial Glasgow coma scale, cause and mechanism of head injury, presence of surgery)...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29141794/short-term-outcome-of-adem-results-from-a-retrospective-cohort-study-from-south-india
#9
Mary Iype, P A Mohammed Kunju, Geetha Saradakutty, T S Anish, Mini Sreedharan, Shahanaz M Ahamed
INTRODUCTION: Acute disseminated encephalomyelitis (ADEM), an immune mediated inflammatory disease is common in children. The profile and immediate outcome of children hospitalized with ADEM is scarce in the available literature. OBJECTIVES: We aimed to study the clinical profile of children with ADEM and to look for prognostic factors for outcome at discharge from hospital METHODS: We chose a retrospective cohort study of all children diagnosed with ADEM at our institution between January 2006 and December 2015, and they were evaluated, after excluding other diagnoses when they were summoned for a follow up visit...
November 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29141755/case-report-failure-of-therapeutic-coma-in-rabies-encephalitis
#10
Abi Manesh, Reeta Subramaniam Mani, Kishore Pichamuthu, Manjeera Jagannati, Vivek Mathew, Rajiv Karthik, Ooriapadickal Cherian Abraham, Geeta Chacko, George M Varghese
Rabies encephalitis is a fulminant, almost universally fatal infection involving the central nervous system. A unique treatment protocol, including anti-exicitotoxic therapy and induced coma was credited with the survival of a vaccinated teenager with bat rabies encephalitis in 2005. However, multiple efforts to replicate this expensive and intense protocol have not been successful. In this article, we report the failure of the protocol in Indian patients with canine-acquired rabies and elucidate the potential explanations for the failure of the protocol in our patients...
October 30, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29141595/eeg-dynamical-correlates-of-focal-and-diffuse-causes-of-coma
#11
MohammadMehdi Kafashan, Shoko Ryu, Mitchell J Hargis, Osvaldo Laurido-Soto, Debra E Roberts, Akshay Thontakudi, Lawrence Eisenman, Terrance T Kummer, ShiNung Ching
BACKGROUND: Rapidly determining the causes of a depressed level of consciousness (DLOC) including coma is a common clinical challenge. Quantitative analysis of the electroencephalogram (EEG) has the potential to improve DLOC assessment by providing readily deployable, temporally detailed characterization of brain activity in such patients. While used commonly for seizure detection, EEG-based assessment of DLOC etiology is less well-established. As a first step towards etiological diagnosis, we sought to distinguish focal and diffuse causes of DLOC through assessment of temporal dynamics within EEG signals...
November 15, 2017: BMC Neurology
https://www.readbyqxmd.com/read/29141387/-anterior-corneal-high-order-aberrations-in-eyes-with-senile-cataract-in-a-chinese-population
#12
X J Xing, H Song, X Tang
Objective: To investigate the distribution of anterior corneal high-order aberrations (HOAs) in Chinese eyes with cataract and their correlations with age and axial length for the choice of aspheric intraocular lens. Methods: Retrospective study. Six hundred twenty-five Chinese patients with cataract[male: 260, female: 365, age: (71.2±8.0) years] were categorized into 4 groups in accordance with their axial lengths. Anterior corneal HOAs in the central 6- mm zone was measured with an iTrace wavefront analyzer...
November 11, 2017: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/29139015/defining-the-optimal-midline-shift-threshold-to-predict-poor-outcome-in-patients-with-supratentorial-spontaneous-intracerebral-hemorrhage
#13
Wen-Song Yang, Qi Li, Rui Li, Qing-Jun Liu, Xing-Chen Wang, Li-Bo Zhao, Peng Xie
BACKGROUND: Midline shift (MLS) has been associated with unfavorable outcome in patients with intracerebral hemorrhage (ICH). However, the optimal criteria to define the MLS measurements that indicate future outcome in ICH patients are absent, and the quantitative threshold of MLS that differentiates favorable and poor clinical outcome should be further explored. METHODS: We enrolled patients with ICH who underwent admission computed tomography (CT) within 6 h after onset of symptoms...
November 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/29137682/cefepime-induced-neurotoxicity-a-systematic-review
#14
Lauren E Payne, David J Gagnon, Richard R Riker, David B Seder, Elizabeth K Glisic, Jane G Morris, Gilles L Fraser
BACKGROUND: Cefepime is a widely used antibiotic with neurotoxicity attributed to its ability to cross the blood-brain barrier and exhibit concentration-dependent ϒ-aminobutyric acid (GABA) antagonism. Neurotoxic symptoms include depressed consciousness, encephalopathy, aphasia, myoclonus, seizures, and coma. Data suggest that up to 15% of ICU patients treated with cefepime may experience these adverse effects. Risk factors include renal dysfunction, excessive dosing, preexisting brain injury, and elevated serum cefepime concentrations...
November 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29137466/evaluation-of-extremity-injuries-presented-to-emergency-department
#15
Ali Karakus, Guven Kuvandik, Ezgi Atalay
OBJECTIVE: In this study, we aimed to review cases with firearms injury of extremities presented to our hospital. METHODS: After approval by Institutional Board, electronic database was retrospectively screened for firearms injury of extremities between 2012 and 2015. Overall, 600 cases with firearms injury of extremities were included in the study. Cases were assessed for demographic and clinical characteristics, Mangled extremity severity score (MESS), Glasgow Coma Scale (GCS), costs and outcomes...
October 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/29137197/effect-of-age-on-glasgow-coma-scale-in-patients-with-moderate-and-severe-traumatic-brain-injury-an-approach-with-propensity-score-matched-population
#16
Cheng-Shyuan Rau, Shao-Chun Wu, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Pao-Jen Kuo, Ching-Hua Hsieh
Background: The most widely used methods of describing traumatic brain injury (TBI) are the Glasgow Coma Scale (GCS) and the Abbreviated Injury Scale (AIS). Recent evidence suggests that presenting GCS in older patients may be higher than that in younger patients for an equivalent anatomical severity of TBI. This study aimed to assess these observations with a propensity-score matching approach using the data from Trauma Registry System in a Level I trauma center. Methods: We included all adult patients (aged ≥20 years old) with moderate to severe TBI from 1 January 2009 to 31 December 2016...
November 13, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29137064/clinical-features-and-prognostic-factors-in-patients-with-intraventricular-hemorrhage-caused-by-ruptured-arteriovenous-malformations
#17
Zengpanpan Ye, Xiaolin Ai, Xin Hu, Fang Fang, Chao You
Intraventricular hemorrhage (IVH) was associated with poor outcomes in patients with intracerebral hemorrhage. IVH had a high incidence in patients with ruptured arteriovenous malformations (AVMs). In this study, we aimed to discuss the clinical features and prognostic factors of outcomes in the patients with AVM-related IVH.From January 2010 to January 2016, we collected the data of the patients with AVM-related IVH retrospectively. The data, including clinical and radiological parameters, were collected to evaluate the clinical features...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29135710/adjustment-of-intrastromal-corneal-ring-segments-after-unsuccessful-implantation-in-keratoconic-eyes
#18
Tiago Monteiro, José Ferreira Mendes, Fernando Faria-Correia, Nuno Franqueira, David Madrid-Costa, José F Alfonso
PURPOSE: To evaluate visual, refractive, and corneal topography outcomes in eyes with keratoconus that have undergone exchange/adjustment surgery with a new intrastromal corneal ring segment (ICRS) combination after unsuccessful visual and/or refractive outcomes after primary ICRS surgery. METHODS: A retrospective nonrandomized case series was conducted including consecutive eyes of patients with keratoconus that underwent ICRS adjustment after an unsuccessful visual outcome...
November 13, 2017: Cornea
https://www.readbyqxmd.com/read/29135535/blood-glucose-concentrations-in-prehospital-trauma-patients-with-traumatic-shock-a-retrospective-analysis
#19
Janett Kreutziger, Wolfgang Lederer, Stefan Schmid, Hanno Ulmer, Volker Wenzel, Maarten W Nijsten, Daniel Werner, Thomas Schlechtriemen
BACKGROUND: Deranged glucose metabolism after moderate to severe trauma with either high or low concentrations of blood glucose is associated with poorer outcome. Data on prehospital blood glucose concentrations and trauma are scarce. OBJECTIVES: The primary aim was to describe the relationship between traumatic shock and prehospital blood glucose concentrations. The secondary aim was to determine the additional predictive value of prehospital blood glucose concentration for traumatic shock when compared with vital parameters alone...
November 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29133974/higher-order-optical-aberrations-and-visual-acuity-in-a-randomized-controlled-trial-comparing-transepithelial-versus-epithelium-off-corneal-crosslinking-for-progressive-keratoconus
#20
Daniel A Godefrooij, Mustapha El Kandoussi, Nienke Soeters, Robert Pl Wisse
Purpose: The purpose of this study was to compare the effects of transepithelial crosslinking (trans-CXL) versus epithelium-off crosslinking (epi-off CXL) for progressive keratoconus with respect to the development of higher order aberrations (HOAs) and their effects on visual acuity. Materials and methods: A total of 61 patients were randomized and examined preoperatively and 1, 3, 6, and 12 months postoperatively in an academic referral center. Total corneal HOAs were compared between the two treatment groups using mixed linear modeling...
2017: Clinical Ophthalmology
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