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https://www.readbyqxmd.com/read/28650356/trending-fibrinolytic-dysregulation-fibrinolysis-shutdown-in-the-days-after-injury-is-associated-with-poor-outcome-in-severely-injured-children
#1
Christine M Leeper, Matthew D Neal, Christine J McKenna, Barbara A Gaines
OBJECTIVE: To trend fibrinolysis after injury and determine the influence of traumatic brain injury (TBI) and massive transfusion on fibrinolysis status. BACKGROUND: Admission fibrinolytic derangement is common in injured children and adults, and is associated with poor outcome. No studies examine fibrinolysis days after injury. METHODS: Prospective study of severely injured children at a level 1 pediatric trauma center. Rapid thromboelastography was obtained on admission and daily for up to 7 days...
July 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28649477/the-importance-of-catheter-angiography-in-computed-tomography-angiography-negative-subarachnoid-hemorrhage
#2
Ali S Haider, Caleb Gottlich, Anadjeet Khahera, Steven Vayalumkal, Umair Khan, Eliel N Arrey, Jacob Campbell, Richa Thakur, Sam Finn, Kennith F Layton
Computed tomography angiography (CTA) has become an effective tool in the evaluation of patients with subarachnoid hemorrhage (SAH), but it still has limitations. Up to 15% of non-traumatic SAH cases are negative on CTA. The benefits of catheter angiography in the evaluation of certain cases of CTA-negative SAH have been previously demonstrated. Here, we present the case of a 48-year-old female who presented with headache and right-sided hemiparesis, who later became apneic and required intubation. A computed tomography (CT) scan of the head demonstrated a diffuse SAH...
May 17, 2017: Curēus
https://www.readbyqxmd.com/read/28642182/the-effect-of-morbid-obesity-on-subarachnoid-hemorrhage-prognosis-in-the-united-states
#3
Ross-Jordon S Elliott, Daniel Agustin Godoy, Joel E Michalek, Réza Behrouz, Marwah A Elsehety, Shaheryar Hafeez, Denise Rios, Ali Seifi
BACKGROUND: The association between obesity and non-traumatic subarachnoid hemorrhage (SAH) patient outcome is unclear. AIMS: Determine the impact of morbid obesity (body mass index ≥40 kg/m(2)) on non-traumatic SAH outcomes. METHODS: Using the Nationwide Inpatient Sample, we identified hospitalized, non-traumatic SAH patients diagnosed from 2008 to 2013 and tested the effect of obesity on their mortality and clinical outcomes. Odds ratios were estimated with a mixed effects linear logistic model with adjustment for hospital clustering...
June 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28638696/basic-radiological-assessment-of-synovial-diseases-a-pictorial-essay
#4
REVIEW
Aynur Turan, Pınar Çeltikçi, Abdurrahman Tufan, Mehmet Akif Öztürk
The synovium is a specialized tissue lining the synovial joints, bursae, and tendon sheaths of the body. It is affected by various localized or systemic disorders. Synovial diseases can be classified as inflammatory, infectious, degenerative, traumatic, hemorrhagic, and neoplastic. Damage in other intraarticular structures, particularly cartilages, generally occurs as a part of pathologic processes involving the synovium, leading to irreversible joint destruction. Imaging has an essential role in the early detection of synovial diseases prior to irreversible joint damage...
June 2017: European Journal of Rheumatology
https://www.readbyqxmd.com/read/28637514/performance-of-point-of-care-international-normalized-ratio-measurement-to-diagnose-trauma-induced-coagulopathy
#5
Thomas Mistral, Yvonnick Boué, Jean-Luc Bosson, Pauline Manhes, Jules Greze, Julien Brun, Pierre Albaladejo, Jean-François Payen, Pierre Bouzat
BACKGROUND: Trauma-induced coagulopathy (TIC) is a common feature after severe trauma. Detection of TIC is based upon classic coagulation tests including international normalized ratio (INR) value. Point-of-care (POC) devices have been developed to rapidly measure INR at the bedside on whole blood. The aim of the study was to test the precision of the Coagucheck® XS Pro device for INR measurement at hospital admission after severe trauma. METHODS: We conducted a prospective observational study in a French level I trauma center...
June 21, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28634501/subarachnoid-hemorrhage-and-long-term-stroke-risk-after-traumatic-brain-injury
#6
Nicholas A Morris, Joséphine Cool, Alexander E Merkler, Hooman Kamel
BACKGROUND: Recent studies suggest that traumatic brain injury (TBI) is a risk factor for subsequent ischemic stroke, even years after the initial insult. The mechanisms of the association remain unclear. The presence of traumatic subarachnoid hemorrhage (tSAH) may mediate the effect of TBI on long-term stroke risk, as it has previously been linked to short-term vasospasm and delayed cerebral ischemia. METHODS: Using administrative claims data, we conducted a retrospective cohort study of acute care hospitalizations...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28633545/late-recovery-of-awareness-in-prolonged-disorders-of-consciousness-a-cross-sectional-cohort-study
#7
Kudret Yelden, Sophie Duport, Leon M James, Agnieszka Kempny, Simon F Farmer, Alex P Leff, E Diane Playford
PURPOSE: To detect any improvement of awareness in prolonged disorders of consciousness in the long term. METHODS: A total of 34 patients with prolonged disorders of consciousness (27 vegetative state and seven minimally conscious state; 16 males; aged 21-73) were included in the study. All patients were initially diagnosed with vegetative/minimally conscious state on admission to our specialist neurological rehabilitation unit. Re-assessment was performed 2-16 years later using Coma Recovery Scale-Revised...
June 21, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28632582/the-effect-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-partial-aortic-occlusion-and-aggressive-blood-transfusion-on-traumatic-brain-injury-in-a-swine-multiple-injuries-model
#8
M Austin Johnson, Timothy K Williams, Sarah-Ashley E Ferencz, Anders J Davidson, Rachel M Russo, William T O'Brien, Joseph M Galante, J Kevin Grayson, Lucas P Neff
BACKGROUND: Despite clinical reports of poor outcomes, the degree to which resuscitative endovascular balloon occlusion of the aorta (REBOA) exacerbates traumatic brain injury (TBI) is not known. We hypothesized that combined effects of increased proximal mean arterial pressure (pMAP), carotid blood flow (Qcarotid), and intracranial pressure (ICP) from REBOA would lead to TBI progression compared with partial aortic occlusion (PAO) or no intervention. METHODS: Twenty-one swine underwent a standardized TBI via computer Controlled cortical impact followed by 25% total blood volume rapid hemorrhage...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28630664/overlapping-stent-assisted-coil-embolization-for-a-ruptured-intracranial-vertebral-artery-dissection
#9
Katsunori Asai, Hajime Nakamura, Takeo Nishida, Shayne Morris, Takayuki Sakaki
Ruptured intracranial vertebral artery dissection is a cause of non-traumatic subarachnoid hemorrhage. Urgent intervention should be considered to prevent fatal rebleeding. Endovascular parent artery occlusion, which is the initial treatment of choice, is not suitable for patients with a hypoplastic or occlusive contralateral vertebral artery. We report a case of ruptured vertebral artery dissection, which was successfully treated with double overlapping stent-assisted coiling.
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28628541/apathy-due-to-injury-of-the-prefrontocaudate-tract-following-mild-traumatic-brain-injury
#10
Sung Ho Jang, Hyeok Gyu Kwon
In this study, we report on a patient who developed apathy resulting from injury to the prefrontocaudate tract following mild traumatic brain injury (TBI), which was observed on diffusion tensor tractography (DTT). A 46-year-old female patient was involved in a bus accident. Her history included intracerebral hemorrhage (ICH) in the left putamen 4 years ago before the head trauma, and her family reported that she had fully recovered. She developed apathy after the TBI, worsening over time. Decreased neural connectivity of the left caudate nucleus (CN) to the left upper medial prefrontal cortex (PFC) resulting from the ICH was observed on the pre-TBI-DTT, whereas on the post-TBI-DTT (28 months after TBI), the neural connectivity of the left CN to the left upper medial PFC was increased, whereas that to the left lower medial PFC and orbitofrontal cortex was decreased...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28627981/early-vitrectomy-for-dense-vitreous-hemorrhage-in-adults-with-non-traumatic-and-non-diabetic-retinopathy
#11
Ting Zhang, Jingjing Zhang, Xiaolei Sun, Jingyi Tian, Weiyun Shi, Gongqiang Yuan
Objective To evaluate the etiologies for dense vitreous hemorrhage in adults with non-traumatic and reveal management of early vitrectomy for the disease. Methods Study included 105 eyes from 105 patients. Outcome measures were etiologies of vitreous hemorrhage, formation of retinal and/or disk neovascular membrane (NVM), incidence of retinal tear and detachment, visual acuity (VA) and postoperative complications. Results Mean time between presentation and surgery was 7.1 days. The most common etiologies were retinal vein occlusion (RVO) (58...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28627348/-effect-of-hydrogen-rich-water-on-the-cd34-expression-in-lesion-boundary-brain-tissue-of-rats-with-traumatic-brain-injury
#12
Ying Liu, Qing Lan, Difen Wang, Xianjun Chen, Jia Yuan, Hailing Zhang
OBJECTIVE: To observe the effect of hydrogen-rich water on the CD34 expression and angiogenesis in lesion boundary brain tissue of rats with traumatic brain injury (TBI). METHODS: A total of 54 adult male Sprague-Dawley (SD) rats were divided into three groups by random number table: namely sham-operated group (sham group), trauma group (TBI group), and trauma + hydrogen-rich water group (TBI+HW group), the rats in each group were subdivided into 1, 3 and 7 days subgroups according to the time points after trauma, with 6 rats in each subgroup...
March 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625900/delayed-brainstem-hemorrhage-secondary-to-mild-traumatic-head-injury-report-of-a-case-with-good-recovery
#13
Kun Hou, Jinchuan Zhao, Xianfeng Gao, Xiaobo Zhu, Guichen Li
No abstract text is available yet for this article.
June 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28625277/the-diagnosis-and-treatment-of-hemoptysis
#14
Harald Ittrich, Maximilian Bockhorn, Hans Klose, Marcel Simon
BACKGROUND: Hemoptysis, i.e., the expectoration of blood from the lower airways, has an annual incidence of approximately 0.1% in ambulatory patients and 0.2% in inpatients. It is a potentially life-threatening medical emergency and carries a high mortality. METHODS: This review article is based on pertinent publications retrieved by a selective search in PubMed. RESULTS: Hemoptysis can be a sign of many different diseases. Its cause remains unknown in about half of all cases...
June 5, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28623949/hemoglobin-concentrations-and-rbc-transfusion-thresholds-in-patients-with-acute-brain-injury-an-international-survey
#15
Rafael Badenes, Mauro Oddo, José I Suarez, Massimo Antonelli, Jeffrey Lipman, Giuseppe Citerio, Fabio Silvio Taccone
BACKGROUND: The optimal hemoglobin (Hb) threshold at which to initiate red blood cell (RBC) transfusion in patients with acute brain injury is unknown. The aim of this survey was to investigate RBC transfusion practices used with these patients. METHODS: We conducted a web-based survey within various societies of critical care medicine for intensive care unit (ICU) physicians who currently manage patients with primary acute brain injury. RESULTS: A total of 868 responses were obtained from around the world, half of which (n = 485) were from European centers; 204 (24%) respondents had a specific certificate in neurocritical care, and most were specialists in anesthesiology or intensive care and had less than 15 years of practice experience...
June 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28622071/survival-in-out-of-hospital-rapid-sequence-intubation-of-non-traumatic-brain-pathologies
#16
Pieter Francsois Fouche, Paul Andrew Jennings, Karen Smith, Malcolm Boyle, Gabriel Blecher, Jonathan Knott, Mani Raji, Pamela Rosengarten, Michael Roberto Augello, Stephen Bernard
INTRODUCTION: Rapid sequence intubation (RSI) is not only used in traumatic brain injuries in the out-of-hospital setting, but also for non-traumatic brain pathologies (NTBP) such as brain tumors, meningitis, encephalitis, hypoxic/anoxic brain injury, stroke, arteriovenous malformations, tumors, aneurysms, brain hemorrhage, as well as brain injury due to diabetes, seizures and toxicity, metabolic conditions, and alcohol and drug overdose. Previous research suggests that RSI is common in non-traumatic coma, but with an unknown prevalence of NTBP in those that receive RSI...
June 16, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28616020/minocycline-targets-multiple-secondary-injury-mechanisms-in-traumatic-spinal-cord-injury
#17
REVIEW
Robert B Shultz, Yinghui Zhong
Minocycline hydrochloride (MH), a semi-synthetic tetracycline derivative, is a clinically available antibiotic and anti-inflammatory drug that also exhibits potent neuroprotective activities. It has been shown to target multiple secondary injury mechanisms in spinal cord injury, via its anti-inflammatory, anti-oxidant, and anti-apoptotic properties. The secondary injury mechanisms that MH can potentially target include inflammation, free radicals and oxidative stress, glutamate excitotoxicity, calcium influx, mitochondrial dysfunction, ischemia, hemorrhage, and edema...
May 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28614145/non-human-primate-rhesus-macaque-models-of-severe-pressure-targeted-hemorrhagic-and-poly-traumatic-hemorrhagic-shock
#18
Forest R Sheppard, Antoni R Macko, Jacob J Glaser, Philip J Vernon, Alexander J Burdette, R Madelaine Paredes, Craig A Koeller, Anthony E Pusateri, Douglas K Tadaki, Sylvain Cardin
BACKGROUND: We endeavored to develop clinically translatable non-human primate (NHP) models of severe poly-traumatic hemorrhagic shock. METHODS: NHPs were randomized into five pressure-targeted severe hemorrhagic shock (PTHS) ± additional injuries scenarios: 30-min PTHS (PTHS-30), 60-min PTHS (PTHS-60), PTHS-60 + soft tissue injury (PTHS-60+ST), PTHS-60+ST + femur fracture (PTHS-60+ST+FF) and decompensated PTHS+ST+FF (PTHS-D). Physiologic parameters were recorded and blood samples collected at five time points with animal observation through T = 24hrs...
June 13, 2017: Shock
https://www.readbyqxmd.com/read/28614144/early-fibrinolysis-associated-with-hemorrhagic-progression-following-traumatic-brain-injury
#19
Jay Karri, Jessica C Cardenas, Nena Matijevic, Yao-Wei Wang, Sangbum Choi, Liang Zhu, Bryan A Cotton, Ryan Kitagawa, John B Holcomb, Charles E Wade
BACKGROUND: Progressive hemorrhagic injury (PHI) is common in patients with severe traumatic brain injury (TBI) and is associated with worse outcomes. PHI pathophysiology remains poorly understood and difficult to predict. We performed an exploratory analysis aimed at identify markers in need of further investigation to establish their predictive value in PHI following TBI. METHODS: We performed a retrospective chart review of prospectively collected data from 424 highest-level activation trauma patients from January 2012 through December 2013...
June 13, 2017: Shock
https://www.readbyqxmd.com/read/28611890/index-to-predict-in-hospital-mortality-in-older-adults-after-non-traumatic-emergency-department-intubations
#20
Kei Ouchi, Samuel Hohmann, Tadahiro Goto, Peter Ueda, Emily L Aaronson, Daniel J Pallin, Marcia A Testa, James A Tulsky, Jeremiah D Schuur, Mara A Schonberg
INTRODUCTION: Our goal was to develop and validate an index to predict in-hospital mortality in older adults after non-traumatic emergency department (ED) intubations. METHODS: We used Vizient administrative data from hospitalizations of 22,374 adults ≥75 years who underwent non-traumatic ED intubation from 2008-2015 at nearly 300 U.S. hospitals to develop and validate an index to predict in-hospital mortality. We randomly selected one half of participants for the development cohort and one half for the validation cohort...
June 2017: Western Journal of Emergency Medicine
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