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https://www.readbyqxmd.com/read/28822387/indicators-of-survival-and-favorable-functional-outcomes-after-decompressive-craniectomy-a-multi-institutional-retrospective-study
#1
Abid D Khan, Anna J Elseth, Brian Head, Jack Rostas, Julie A Dunn, Thomas J Schroeppel, Richard P Gonzalez
The role of decompressive craniectomy (DC) for severe traumatic brain injury (STBI) remains controversial. The purpose of this study was to identify factors that are indicators of survival and improved functional outcome in patients who undergo DC for STBI. A retrospective review of STBI patients who underwent DC was performed at four trauma centers during a 45-month period. Data collected included age, gender, mechanism of injury, Injury Severity Score (ISS), admission Glasgow Coma Scale (GCS), time from admission to DC, mortality, and extended Glasgow Outcome Score before discharge...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28822018/the-prevalence-of-growth-hormone-deficiency-in-survivors-of-subarachnoid-haemorrhage-results-from-a-large-single-centre-study
#2
Sumithra Giritharan, Joanna Cox, Calvin J Heal, David Hughes, Kanna Gnanalingham, Tara Kearney
OBJECTIVE: The variation in reported prevalence of growth hormone deficiency (GHD) post subarachnoid haemorrhage (SAH) is mainly due to methodological heterogeneity. We report on the prevalence of GHD in a large cohort of patients following SAH, when dynamic and confirmatory pituitary hormone testing methods are systematically employed. DESIGN: In this cross-sectional study, pituitary function was assessed in 100 patients following SAH. Baseline pituitary hormonal profile measurement and glucagon stimulation testing (GST) was carried out in all patients...
August 18, 2017: Pituitary
https://www.readbyqxmd.com/read/28821777/decompressive-craniectomy-in-the-management-of-intracranial-hypertension-after-traumatic-brain-injury-a-systematic-review-and-meta-analysis
#3
Danfeng Zhang, Qiang Xue, Jigang Chen, Yan Dong, Lijun Hou, Ying Jiang, Junyu Wang
We aim to perform a systematic review and meta-analysis to examine the prognostic value of decompressive craniectomy (DC) in patients with traumatic intracranial hypertension. PubMed, EMBASE, Cochrane Controlled Trials Register, Web of Science, http://clinicaltrials.gov/ were searched for eligible studies. Ten studies were included in the systematic review, with four randomized controlled trials involved in the meta-analysis, where compared with medical therapies, DC could significantly reduce mortality rate [risk ratio (RR), 0...
August 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28821378/pathogens-and-outcomes-in-pediatric-septic-shock-patients-supported-by-extracorporeal-membrane-oxygenation
#4
Tu-Hsuan Chang, En-Ting Wu, Chun-Yi Lu, Shu-Chien Huang, Tzu-I Yang, Ching-Chia Wang, Jong-Min Chen, Ping-Ing Lee, Li-Min Huang, Luan-Yin Chang
BACKGROUND: Refractory septic shock is the leading cause of mortality in children. There is limited evidence to support extracorporeal membrane oxygenation (ECMO) use in pediatric septic shock. We described the etiology and outcomes of septic patients in our institution and attempted to find predictive factors. METHODS: We retrospectively reviewed 55 pediatric patients with septic shock who required ECMO support in a tertiary medical center from 2008 to 2015. Septic shock was defined as culture proved or clinical suspected sepsis with hypotension or end-organ hypoperfusion...
August 4, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28819204/prognostic-factors-and-outcomes-of-unplanned-extubation
#5
Chien-Ming Chao, Mei-I Sung, Kuo-Chen Cheng, Chih-Cheng Lai, Khee-Siang Chan, Ai-Chin Cheng, Shu-Chen Hsing, Chin-Ming Chen
This study investigated the prognostic factors and outcomes of unplanned extubation (UE) in patients in a medical center's 6 intensive care units (ICUs) and calculated their mortality risk. We retrospectively reviewed the medical records of all adult patients in Chi Mei Medical Center who underwent UE between 2009 and 2015. During the study period, there were 305 episodes of UE in 295 ICU patients (men: 199 [67.5%]; mean age: 65.7 years; age range: 18-94 years). The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 16...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28818571/timing-of-palliative-care-team-referrals-for-inpatients-receiving-rapid-response-services-a-retrospective-pilot-study-in-a-us-hospital
#6
M Williams, M Cardona-Morrell, P Stevens, J Bey, M E Smith Glasgow
BACKGROUND/OBJECTIVES: Research indicates up to one-third of rapid response team calls relate to end-of-life symptoms. The CriSTAL criteria were developed as a screening tool to identify high risk of death within three months. The primary purpose of this pilot study was to investigate the timing of palliative care referrals in patients receiving rapid response team services, and patients' CriSTAL criteria score on admission. The potential feasibility of using the CriSTAL tool to stimulate earlier Palliative Care Team (PCT) referral served as an underlying goal, and investigation of a relationship between specific CriSTAL criteria and the prediction of in-hospital death was a secondary objective...
August 8, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28817480/revised-national-estimates-of-emergency-department-visits-for-sepsis-in-the-united-states
#7
Henry E Wang, Allison R Jones, John P Donnelly
OBJECTIVES: The emergency department is an important venue for initial sepsis recognition and care. We sought to determine contemporary estimates of the epidemiology of U.S. emergency department visits for sepsis. DESIGN: Analysis of data from the National Hospital Ambulatory Medical Care Survey. SETTING: U.S. emergency department visits, 2009-2011. PATIENTS: Adult (age, ≥ 18 yr) emergency department sepsis patients...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28816934/midterm-outcomes-of-intracranial-aneurysms-with-bleb-formation-with-densely-coiling-of-the-aneurismal-neck-or-entire-aneurysm
#8
Jun Wan, Lei Zhang, Gang Lu, Weijin Gu, Lei Huang, Liang Ge, Xiaolong Zhang, Lihua Ji, Qing Chen, Ruoyu Di, Yeqing Jiang
To evaluate whether the efficacy and safety of embolization of the aneurysmal neck were better than those of embolization of the entire aneurysm. Previous studies found that embolization of the aneurysmal neck can be used for treating ruptured intracranial aneurysm with bleb formation.In all, 163 patients with ruptured aneurysms with bleb formation who underwent endovascular embolization at the Shanghai Municipal Jing'an District Central Hospital from January 2014 to August 2015 were divided into the embolization of aneurysmal neck group (neck group; 87 cases) and embolization of entire aneurysm group (aneurysm group; 76 cases)...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28816837/individualizing-thresholds-of-cerebral-perfusion-pressure-using-estimated-limits-of-autoregulation
#9
Joseph Donnelly, Marek Czosnyka, Hadie Adams, Chiara Robba, Luzius A Steiner, Danilo Cardim, Brenno Cabella, Xiuyun Liu, Ari Ercole, Peter John Hutchinson, David Krishna Menon, Marcel J H Aries, Peter Smielewski
OBJECTIVES: In severe traumatic brain injury, cerebral perfusion pressure management based on cerebrovascular pressure reactivity index has the potential to provide a personalized treatment target to improve patient outcomes. So far, the methods have focused on identifying "one" autoregulation-guided cerebral perfusion pressure target-called "cerebral perfusion pressure optimal". We investigated whether a cerebral perfusion pressure autoregulation range-which uses a continuous estimation of the "lower" and "upper" cerebral perfusion pressure limits of cerebrovascular pressure autoregulation (assessed with pressure reactivity index)-has prognostic value...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28815746/matthew-baillie-s-specimens-and-engravings
#10
Caitlin Spear, Maggie Reilly, Stuart W McDonald
In 1799, Matthew Baillie, William Hunter's nephew, published his famous atlas of pathology. It was entitled A Series of Engravings Accompanied with Explanations which are Intended to Illustrate the Morbid Anatomy of Some of the Most Important Parts of the Human Body. The present study aims to match the illustrations to extant specimens in the collections of William and John Hunter, preserved at the University of Glasgow and at the Royal College of Surgeons of England respectively. Baillie's book contains 10 fasciculi, consisting of 73 plates and 206 figures...
August 17, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28814933/inflammatory-biomarkers-and-their-value-in-predicting-survival-and-outcome-among-patients-with-spontaneous-intracerebral-haemorrhage
#11
Senthil Kumar Rajapathy, Zamzuri Idris, Regunath Kandasamy, Albert Wong Sii Hieng, Jafri Malin Abdullah
BACKGROUND: Spontaneous intracerebral haemorrhage (SICH) has emerged as one of the most devastating forms of stroke in recent decades. This disease is noted to carry a 30-day mortality rate of approximately 45%. An increasing number of studies have implicated a complex immune-mediated and inflammation-mediated cascade of responses in the pathophysiology of SICH and the resultant neurologic outcome. Several clinical studies have demonstrated an association between inflammatory markers and outcome in patients with SICH...
May 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/28814581/hyperammonaemic-encephalopathy-following-an-uncomplicated-surgery
#12
Stuart McIntosh, Karima Medjoub, Kevin Deans, Sara Sexton
A 59-year-old woman who underwent an uncomplicated exploratory laparotomy, adhesiolysis, small bowel resection and anterolateral thigh flap had a complicated postoperative period characterised by wound dehiscence and poor nutritional intake. 29 days postoperatively, a tremor developed in her upper limbs associated with weakness. Her Glasgow Coma Scale (GCS) fell to 4 and she was transferred to the intensive care unit. The patient was reviewed by multiple specialists and multiple differentials were considered and eliminated...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28812367/the-usefulness-of-diffusion-weighted-magnetic-resonance-imaging-performed-in-the-acute-phase-as-an-early-predictor-of-delayed-neuropsychiatric-sequelae-in-acute-carbon-monoxide-poisoning
#13
Y S Kim, Y S Cha, M S Kim, H J Kim, Y S Lee, H Youk, H I Kim, O H Kim, K-C Cha, H Kim, K H Lee, S O Hwang
Delayed onset of neuropsychiatric symptoms after apparent recovery from acute carbon monoxide (CO) poisoning has been described as delayed neuropsychiatric sequelae (DNS). No previous study has determined whether early use of diffusion-weighted magnetic resonance imaging (DWI) can predict which patients will develop DNS in the acute CO poisoning. This retrospective observational study was performed on adult patients with acute CO poisoning consecutively treated over a 17-month period. All included patients with acute CO poisoning underwent DWI to evaluate brain injury within 72 h after CO exposure...
January 1, 2017: Human & Experimental Toxicology
https://www.readbyqxmd.com/read/28811766/prognostic-factors-determining-morbidity-and-mortality-in-organophosphate-poisoning
#14
Ayca Acikalin, Nezihat Rana Dişel, Selcuk Matyar, Ahmet Sebe, Zeynep Kekec, Yuksel Gokel, Emre Karakoc
OBJECTIVE: Our aim in this retrospective study was to determine the factors affecting poor prognosis and mortality of organophosphate (OP) poisoning by reviewing patient data. We also reviewed present knowledge to make conclusions on certain longstanding debates in light of the literature. METHODS: In this retrospective descriptive study, patients who were admitted to and hospitalized in the emergency department (ED) or intensive care unit (ICU) of a university hospital with the diagnosis of OP poisoning between December 2010 and December 2015 were evaluated...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28811137/influence-of-guidelines-on-management-of-paediatric-mild-traumatic-brain-injury-ct-assessment-and-admission-policy
#15
J J Lenstra, A R A Pikstra, J M Fock, Z Metting, J van der Naalt
BACKGROUND: The annual number of paediatric injury-related emergency visits and application of computed tomography (CT) has substantially increased, with associated higher risk of malignancies. In 2010, a guideline for CT-assessment based on risk factors for patients with mild traumatic brain injury (mTBI) became effective in all Emergency Departments (ED) in the Netherlands. This study evaluated the influence of this guideline on the frequency of CT-assessments, hospital admissions and factors that are related to guideline adherence...
August 3, 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28809620/pancreatitis-in-a-high-hiv-prevalence-environment
#16
Frank Anderson, Sandie R Thomson
BACKGROUND: Acute pancreatitis is common in HIV-positive individuals in reports from regions with a low incidence of HIV infection. This association has not been reported in areas with a high incidence of HIV infection. OBJECTIVE: To examine the prevalence and outcomes of HIV-associated acute pancreatitis in a high HIV prevalence environment, and trends over the period May 2001 - November 2010. METHODS: The records of patients admitted with acute pancreatitis from 2001 to 2010 were reviewed, looking for HIV status, CD4 counts and medications at presentation...
July 28, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28808366/clinical-features-and-outcomes-of-patients-with-posterior-reversible-encephalopathy-syndrome
#17
M S Kalaiselvan, M K Renuka, A S Arunkumar
AIMS: The aim of this study was to study the clinical features and outcomes of patients with posterior reversible encephalopathy syndrome (PRES) admitted to the Intensive Care Unit (ICU). SUBJECTS AND METHODS: All adult patients admitted to our ICU with acute onset neurologic symptoms with focal vasogenic edema on magnetic resonance imaging (MRI) were included in the study. Data were collected on demography, coexisting illness, admission severity of illness, neurological symptoms, blood pressure, treatment initiated, and MRI findings...
July 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28807384/external-validation-of-vascular-study-group-of-new-england-risk-predictive-model-of-mortality-after-elective-abdominal-aorta-aneurysm-repair-in-the-vascular-quality-initiative-and-comparison-against-established-models
#18
Mohammad H Eslami, Denis V Rybin, Gheorghe Doros, Jeffrey J Siracuse, Alik Farber
OBJECTIVE: The purpose of this study is to externally validate a recently reported Vascular Study Group of New England (VSGNE) risk predictive model of postoperative mortality after elective abdominal aortic aneurysm (AAA) repair and to compare its predictive ability across different patients' risk categories and against the established risk predictive models using the Vascular Quality Initiative (VQI) AAA sample. METHODS: The VQI AAA database (2010-2015) was queried for patients who underwent elective AAA repair...
August 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28807194/the-impact-of-glasgow-coma-scale-age-prognosis-score-on-geriatric-traumatic-brain-injury-outcomes
#19
Muhammad Khan, Terence O'Keeffe, Faisal Jehan, Narong Kulvatunyou, Abdullah Kattaa, Lynn Gries, Andrew Tang, Bellal Joseph
BACKGROUND: As the population ages, increasing number of geriatric patients sustain traumatic brain injury (TBI). Communication of accurate prognostic information is crucial for making informed decisions on behalf of such patients. Therefore, the aim of our study was to develop a simple and clinically applicable tool that accurately predicts the prognosis in geriatric TBI patients. METHODS: We performed a 1-y (2011) retrospective analysis of isolated geriatric TBI patients (age ≥65 y, head abbreviated injury score [AIS] ≥ 3, and other body AIS < 3) in the National Trauma Data Bank...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28806309/single-center-experience-of-over-a-hundred-implantations-of-a-transcutaneous-bone-conduction-device
#20
Panagiotis A Dimitriadis, Daniel Hind, Kay Wright, Vicki Proctor, Larissa Greenwood, Suzanne Carrick, Jaydip Ray
OBJECTIVE: To assess outcomes with a novel passive transcutaneous bone conduction device (t-BCD). STUDY DESIGN: Prospective data collection and patient review. SETTING: Tertiary referral center. PATIENTS: Patients who underwent implantation with the t-BCD between November 2013 and September 2016. INTERVENTION: Implantation of BAHA Attract. MAIN OUTCOME MEASURES: Surgical outcome, patient reported outcomes including the "Glasgow Benefit Inventory" and the "Client Oriented Scale of Improvement" for adults and the "Speech, Spatial and Qualities of Hearing scale" (SSQ-12) for children...
August 10, 2017: Otology & Neurotology
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