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https://www.readbyqxmd.com/read/28932559/pupillary-abnormalities-in-non-selected-critically-ill-patients-an-observational-study
#1
Philippe Portran, Martin Cour, Romain Hernu, Sylvie de la Salle, Laurent Argaud
BACKGROUND: Repeated pupillary examination is a key element of neurologic surveillance in intensive care units (ICU). However, in non-selected critically ill patients, the clinical interest of monitoring pupillary diameter and light reflex is poorly documented. We aimed to determine the prevalence and the etiologies of pupillary abnormalities (PAs) in this ICU patient population. METHODS: We performed a prospective, observational study in a medical university affiliated ICU over a 6-month period...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28929378/external-ventricular-drains-after-subarachnoid-hemorrhage-is-less-more
#2
David Y Chung, Stephan A Mayer, Guy A Rordorf
External ventricular drains (EVD) are essential in the early management of hydrocephalus and elevated intracranial pressure after subarachnoid hemorrhage (SAH). Once in place, management of the EVD is thought to influence long-term patient outcomes, rates of ventriculitis, incidence of delayed cerebral ischemia, need for a ventriculoperitoneal shunt, and intensive care unit (ICU) and hospital length of stay. The available evidence supports adopting early clamp trials and intermittent cerebrospinal fluid (CSF) drainage...
September 19, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28913489/cerebral-salt-wasting-syndrome-in-patients-with-minor-head-trauma-two-case-reports
#3
Gabriela Csipak, Natalia Hagau
We describe two polytrauma patients without severe head trauma who developed Cerebral Salt Wasting Syndrome (CSWS) during their stay in our ICU with natriuresis, hyponatremia and hypovolemia. Hyponatremia encountered in CSWS and the syndrome of inadequate antidiuretic hormone secretion (SIADH) is a common electrolyte finding in patients with severe head trauma, subarachnoid hemorrhage, malignancy and infections of the central nervous system. CSWS was an unexpected electrolyte finding in our patients with minor head trauma without neurological or neurosurgical problems...
October 2016: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28899285/predicting-rehabilitation-length-of-stay-in-canada-it-s-not-just-about-impairment
#4
B Catharine Craven, Dilnur Kurban, Farnoosh Farahani, Carly S Rivers, Chester Ho, A Gary Linassi, Dany H Gagnon, Colleen O'Connell, Karen Ethans, Laurent J Bouyer, Vanessa K Noonan
INTRODUCTION: Current tertiary Spinal Cord Injury (SCI) rehabilitation funding and rehabilitation length of stay (R-LOS) in most North American jurisdictions are linked to an individual's impairment. Our objectives were to: 1) describe the impact of relevant demographic, impairment and medical complexity variables at rehabilitation admission on R-LOS among adult Canadians with traumatic SCI; and 2) identify factors which extend R-LOS. METHODS: Data from 1,376 adults with traumatic SCI were obtained via chart abstraction and administrative data linkage from 15 Rick Hansen SCI Registry sites (2004-2014)...
September 12, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28892964/dengue-haemorrhagic-encephalitis-rare-case-report-with-review-of-literature
#5
Aditya Singh Kutiyal, Chetanya Malik, Gitika Hyanki
Dengue is an endemic arboviral infection prevalent especially in tropical countries including Southern and Southeast Asia. Central Nervous System (CNS) involvement in dengue infection is uncommon. Haemorrhagic encephalitis is a rare presentation in dengue. This is a case of a 58-year-old male who presented with fever, petechial rash and altered sensorium. Dengue serology IgM was reactive and MRI brain was suggestive of haemorrhagic encephalitis. Patient was managed in Intensive Care Unit (ICU) but eventually succumbed to his illness...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28890836/new-diagnosis-of-aids-based-on-salmonella-enterica-subsp-i-enterica-enteritidis-a-meningitis-in-a-previously-immunocompetent-adult-in-the-united-states
#6
Andrew C Elton, James Levin, Matthew P Lazio
Salmonella meningitis is a rare manifestation of meningitis typically presenting in neonates and the elderly. This infection typically associates with foodborne outbreaks in developing nations and AIDS-endemic regions. We report a case of a 19-year-old male presenting with altered mental status after 3-day absence from work at a Wisconsin tourist area. He was febrile, tachycardic, and tachypneic with a GCS of 8. The patient was intubated and a presumptive diagnosis of meningitis was made. Treatment was initiated with ceftriaxone, vancomycin, acyclovir, dexamethasone, and fluid resuscitation...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/28885343/risk-factors-and-the-surgery-affection-of-respiratory-complication-and-its-mortality-after-acute-traumatic-cervical-spinal-cord-injury
#7
Xiao-Xiong Yang, Zong-Qiang Huang, Zhong-Hai Li, Dong-Feng Ren, Jia-Guang Tang
The aim of this study is to estimate the risk factors of both respiratory complication (RC) and mortality after acute traumatic cervical spinal cord injury (TCSCI). Between July 2005 and July 2015, in 181 patients (142 males and 39 females; mean age 41.0 years) with acute TCSCI, we compared the difference and odds ratio in RC group (n = 73) with that of non-RC group (n = 108), and also death group (n = 15) and survival group (n = 166). We collected injury-related information after half a year of injury, which is as follows: the causes of injury, time of surgery, ICU (intensive care unit) days, ventilator days, ASIA (American Spinal Injury Association) classification, neurological injury, CIPS (Clinical Pulmonary Infection Score), and BMI (body mass index)...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28883847/effects-of-aspiration-pneumonia-on-the-intensive-care-requirements-and-in-hospital-mortality-of-hospitalised-patients-with-acute-cerebrovascular-disease
#8
Adil Can Güngen, Yusuf Aydemir, Belma Dogan Güngen, Esra Ertan Yazar, Orhan Yağız, Yeşim Güzey Aras, Hatice Gümüş, Ünal Erkorkmaz
INTRODUCTION: In this study, we aimed to evaluate the effects of the development of aspiration pneumonia (AP) on the intensive care unit (ICU) requirements and in-hospital mortality of patients hospitalised in the neurology ward due to an acute cerebrovascular accident (CVA). MATERIAL AND METHODS: Five hundred and three patients hospitalised in the neurology ward following an acute CVA were retrospectively analysed. The patients were divided into two groups: those with AP (group 1) and those without AP (group 2)...
August 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28866263/use-of-multiplex-pcr-based-molecular-diagnostics-in-diagnosis-of-suspected-cns-infections-in-tertiary-care-setting-a-retrospective-study
#9
Mahendra Javali, Purushottam Acharya, Aneesh Mehta, Aju Abraham John, Rohan Mahale, R Srinivasa
OBJECTIVES: CNS infections like meningitis and encephalitis pose enormous healthcare challenges due to mortality, sequelae and socioeconomic burden. In tertiary setting, clinical, microbiological, cytological and radiological investigations are not distinctive enough for diagnosing microbial etiology. Molecular diagnostics is filling this gap. We evaluated the clinical impact of a commercially available multiplex molecular diagnostic system - SES for diagnosing suspected CNS infections...
August 30, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28866108/characteristics-and-outcome-of-patients-with-hypothermic-out-of-hospital-cardiac-arrest-experience-from-a-european-trauma-center
#10
Elfriede Ruttmann, Marion Dietl, Tobias Kastenberger, Rene El Attal, Mathias Ströhle, Hanno Ulmer, Peter Mair
BACKGROUND: Aim of the study was to investigate patient characteristics, survival rates and neurological outcome among hypothermic patients with out-of-hospital cardiac arrest (OHCA) admitted to a trauma center. METHODS: A review of patients with OHCA and a core temperature ≤32°C admitted to a trauma center between 2004 and 2016. RESULTS: Ninety-six patients (mean temperature 25.8°C±3.9°C) were entered in the study, 37 (39%) of them after avalanche burial...
September 1, 2017: Resuscitation
https://www.readbyqxmd.com/read/28860012/continuous-versus-intermittent-neuromuscular-blockade-in-patients-during-targeted-temperature-management-after-resuscitation-from-cardiac-arrest-a-randomized-double-blinded-double-dummy-clinical-trial
#11
Mathias Stöckl, Christoph Testori, Fritz Sterz, Michael Holzer, Christoph Weiser, Andreas Schober, Graham Nichol, Martin Frossard, Harald Herkner, Jasmin Kechvar, Heidrun Losert
AIM OF THE STUDY: Current guidelines recommend targeted temperature management to improve neurological outcome after cardiac arrest. Evidence regarding an ideal sedative/analgesic regimen including skeletal muscle paralysis is limited. METHODS: Patients were randomized to either a continuous administration of rocuronium (continuous-NMB-group) or to a continuous administration of saline supplemented by rocuronium bolus administration if demanded (bolus-NMB-group)...
August 30, 2017: Resuscitation
https://www.readbyqxmd.com/read/28854911/d-dimer-levels-and-cerebral-infarction-in-critically-ill-cancer-patients
#12
Jeong-Am Ryu, Oh Young Bang, Geun-Ho Lee
BACKGROUND: D-dimer levels have been used in the diagnosis of a variety of thrombosis-related diseases. In this study, we evaluated whether measuring D-dimer levels can help to diagnose cerebral infarction (CI) in critically ill cancer patients. METHODS: We retrospectively evaluated all cancer patients who underwent brain magnetic resonance imaging (MRI) between March 2010 and February 2014 at the medical oncology intensive care unit (ICU) of Samsung Medical Center...
August 30, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28845129/sepsis-epidemiology-and-outcome-in-the-paediatric-intensive-care-unit-of-vilnius-university-children-s-hospital
#13
Odeta Bobelytė, Ieva Gailiūtė, Vytautas Zubka, Virginija Žilinskaitė
Research was carried out at the paediatric intensive care unit (paediatric ICU) of the Children's Hospital, affiliate of Vilnius University Hospital Santariškių klinikos. BACKGROUND: Being the most common cause of children's death, sepsis is a challenge for most physicians. In order to improve the outcomes, it is important to know the aetiology and peculiarities of sepsis in a particular region and hospital. The aim of this study was to analyse the outcomes of sepsis in a paediatric intensive care unit and their relation with patients' characteristics and causative microorganisms...
2017: Acta medica Lituanica
https://www.readbyqxmd.com/read/28844159/do-video-eeg-monitoring-findings-in-icu-patients-with-acute-stroke-predict-development-of-seizures-and-survival-during-follow-up
#14
Halil Onder, Ethem Murat Arsava, Mehmet Akif Topcuoglu, Nese Dericioglu
PURPOSE: Ischemic or hemorrhagic stroke are among the most common causes of seizures, especially in the elderly. EEG is the only technique that can detect epileptiform abnormalities (EA) and nonconvulsive status epilepticus (NCSE), which may negatively affect recovery of these patients. Herein we aimed to investigate the potential predictive value of long-term EEG findings in terms of poststroke seizures (PSS) and survival, in stroke patients followed up in the neurological intensive care unit (NICU)...
August 1, 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/28840065/management-of-acute-subdural-hematoma-in-a-patient-with-portopulmonary-hypertension-on-prostanoid-therapy
#15
Richard Rammo, Adam Robin, Jessin John, Aqueel Pabaney, Panayiotis Varelas, Max Kole
BACKGROUND: Treprostinil is a prostacyclin analog used to treat portopulmonary hypertension (PPHTN) and is one of several drugs shown to increase survival, but results in platelet dysfunction. Little is known about the management of patients on treprostinil who present with an acute subdural hematoma (aSDH). We describe such a case and offer our recommendations on management based on our experience and review of the literature. CASE DESCRIPTION: A 63-year-old, right-handed female with a history of PPHTN presented with severe headache and was found to have a large left aSDH with midline shift on imaging...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28836154/randomized-controlled-trial-of-moderate-hypothermia-versus-deep-hypothermia-anesthesia-on-brain-injury-during-stanford-a-aortic-dissection-surgery
#16
Xufang Sun, Hua Yang, Xinyu Li, Yue Wang, Chuncheng Zhang, Zhimin Song, Zhenxiang Pan
This study aimed to compare the effects of moderate versus deep hypothermia anesthesia for Stanford A aortic dissection surgery on brain injury. A total of 82 patients who would undergo Stanford A aortic dissection surgery were randomized into two groups: moderate hypothermia group (MH, n = 40, nasopharyngeal temperature 25 °C, and rectal temperature 28 °C) and deep hypothermia group (DH, n = 42, nasopharyngeal temperature 20 °C, and rectal temperature 25 °C). Different vascular replacement techniques including aortic root replacement, Bentall, and Wheat were used...
August 23, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28832892/bronchial-wheezing-predicts-inflammation-and-respiratory-failure-in-fire-smoke-victims
#17
E R Nakstad, H C D Aass, H Opdahl, A Witsø, F Borchsenius, F Heyerdahl, O H Skjønsberg
BACKGROUND: Acute fire smoke inhalation injury involves inflammatory mediators whose roles are poorly understood. We carried out a prospective observational study of fire smoke victims to identify clinical and biochemical markers that may predict pulmonary dysfunction and investigated possible correlations between dysfunction and cytokines in bronchoalveolar lavage (BAL) fluid and blood. METHODS: Forty patients with respiratory and/or neurological symptoms following acute fire smoke inhalation had pulmonary function tests and blood gas analyses performed on admission, at discharge, and after 3 months...
August 17, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28828964/clinical-nutrition-and-gastrointestinal-dysfunction-in-critically-ill-stroke-patients
#18
Robert Patejdl, Matthias Kästner, Stephan Kolbaske, Matthias Wittstock
Background Data on the epidemiology and risk factors of altered gastrointestinal motility (AGIM) is virtually lacking for patients suffering from non-traumatic neurologic diseases and stroke. This study investigated whether patterns of AGIM differ between patients with stroke and other severe acute brain diseases. Methods Clinical records of stroke and non-stroke patients treated at a neurological intensive care unit (ICU) were reviewed at day 1-5 and at day 10 after admission. The data was analyzed for the course of enteral/parenteral nutrition and for and for signs and symptoms of gastrointestinal dysfunction...
August 22, 2017: Neurological Research
https://www.readbyqxmd.com/read/28808927/lymphopaenia-in-cardiac-arrest-patients
#19
Paola Villois, David Grimaldi, Savino Spadaro, Claudia Righy Shinotsuka, Vito Fontana, Sabino Scolletta, Federico Franchi, Jean-Louis Vincent, Jacques Creteur, Fabio Silvio Taccone
BACKGROUND: A decrease in circulating lymphocytes has been described as a marker of poor prognosis after septic shock; however, scarce data are available after cardiac arrest (CA). The aim of this study was to evaluate the impact of lymphopaenia after successful cardiopulmonary resuscitation. METHODS: This is a retrospective analysis of an institutional database including all adult CA patients admitted to the intensive care unit (ICU) between January 2007 and December 2014 who survived for at least 24 h...
August 14, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28808901/the-utility-of-routine-intensive-care-admission-for-patients-undergoing-intracranial-neurosurgical-procedures-a-systematic-review
#20
Cesar Cimonari de Almeida, M Dustin Boone, Yosef Laviv, Burkhard S Kasper, Clark C Chen, Ekkehard M Kasper
BACKGROUND: Patients who have undergone intracranial neurosurgical procedures have traditionally been admitted to an intensive care unit (ICU) for close postoperative neurological observation. The purpose of this study was to systematically review the evidence for routine ICU admission in patients undergoing intracranial neurosurgical procedures and to evaluate the safety of alternative postoperative pathways. METHODS: We were interested in identifying studies that examined selected patients who presented for elective, non-emergent intracranial surgery whose postoperative outcomes were compared as a function of ICU versus non-ICU admission...
August 14, 2017: Neurocritical Care
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