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https://www.readbyqxmd.com/read/29622334/pediatric-major-head-injury-not-a-minor-problem
#1
REVIEW
Aaron N Leetch, Bryan Wilson
Traumatic brain injury is a highly prevalent and devastating cause of morbidity and mortality in children. A rapid, stepwise approach to the traumatized child should proceed, addressing life-threatening problems first. Management focuses on preventing secondary injury from physiologic extremes such as hypoxemia, hypotension, prolonged hyperventilation, temperature extremes, and rapid changes in cerebral blood flow. Initial Glasgow Coma Score, hyperglycemia, and imaging are often prognostic of outcome. Surgically amenable lesions should be evacuated promptly...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29555548/working-party-approved-by-the-french-society-of-anaesthesia-and-intensive-care-medicine-sfar-and-the-french-society-for-the-study-of-diabetes-sfd
#2
Gaëlle Cheisson, Sophie Jacqueminet, Emmanuel Cosson, Carole Ichai, Anne-Marie Leguerrier, Bogdan Nicolescu-Catargi, Alexandre Ouattara, Igor Tauveron, Paul Valensi, Dan Benhamou
Follow on from continuous intravenous administration of insulin with an electronic syringe (IVES) is an important element in the postoperative management of a diabetic patient. The basal-bolus scheme is the most suitable taking into account the nutritional supply and variable needs for insulin, reproducing the physiology of a normal pancreas: (i) slow (long-acting) insulin (= basal) which should immediately take over from IVES insulin simulating basal secretion; (ii) ultra-rapid insulin to simulate prandial secretion (= bolus for the meal); and (iii) correction of possible hyperglycaemia with an additional ultra-rapid insulin bolus dose...
March 16, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29431405/hyperosmolar-hyperglycemic-state
#3
Gregg D Stoner
Hyperosmolar hyperglycemic state is a life-threatening emergency manifested by marked elevation of blood glucose and hyperosmolarity with little or no ketosis. Although there are multiple precipitating causes, underlying infections are the most common. Other causes include certain medications, nonadherence to therapy, undiagnosed diabetes mellitus, substance abuse, and coexisting disease. In children and adolescents, hyperosmolar hyperglycemic state is often present when type 2 diabetes is diagnosed. Physical findings include profound dehydration and neurologic symptoms ranging from lethargy to coma...
December 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/29305272/effect-of-hyperosmolar-therapy-on-outcome-following-spontaneous-intracerebral-hemorrhage-ethnic-racial-variations-of-intracerebral-hemorrhage-erich-study
#4
Manan Shah, Lee Birnbaum, Jennifer Rasmussen, Padmini Sekar, Charles J Moomaw, Jennifer Osborne, Anastasia Vashkevich, Daniel Woo
PURPOSE: We aimed to identify the effect of hyperosmolar therapy (mannitol and hypertonic saline) on outcomes after intracerebral hemorrhage (ICH) in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study. METHODS: Comparison of ICH cases treated with hyperosmolar therapy versus untreated cases was performed using a propensity score based on age, initial Glasgow Coma Scale, location of ICH (lobar, deep, brainstem, and cerebellar), log-transformed initial ICH volume, presence of intraventricular hemorrhage, and surgical interventions...
April 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29282104/association-between-continuous-hyperosmolar-therapy-and-survival-in-patients-with-traumatic-brain-injury-a-multicentre-prospective-cohort-study-and-systematic-review
#5
Karim Asehnoune, Sigismond Lasocki, Philippe Seguin, Thomas Geeraerts, Pierre François Perrigault, Claire Dahyot-Fizelier, Catherine Paugam Burtz, Fabrice Cook, Dominique Demeure Dit Latte, Raphael Cinotti, Pierre Joachim Mahe, Camille Fortuit, Romain Pirracchio, Fanny Feuillet, Véronique Sébille, Antoine Roquilly
BACKGROUND: Intracranial hypertension (ICH) is a major cause of death after traumatic brain injury (TBI). Continuous hyperosmolar therapy (CHT) has been proposed for the treatment of ICH, but its effectiveness is controversial. We compared the mortality and outcomes in patients with TBI with ICH treated or not with CHT. METHODS: We included patients with TBI (Glasgow Coma Scale ≤ 12 and trauma-associated lesion on brain computed tomography (CT) scan) from the databases of the prospective multicentre trials Corti-TC, BI-VILI and ATLANREA...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28947465/cobi-continuous-hyperosmolar-therapy-for-traumatic-brain-injured-patients-trial-protocol-a-multicentre-randomised-open-label-trial-with-blinded-adjudication-of-primary-outcome
#6
Antoine Roquilly, Sigismond Lasocki, Jean Denis Moyer, Olivier Huet, Pierre François Perrigault, Claire Dahyot-Fizelier, Philippe Seguin, Tarek Sharshar, Thomas Geeraerts, Francis Remerand, Fanny Feuillet, Karim Asehnoune
INTRODUCTION: Traumatic brain injury (TBI) is a major cause of death and severe prolonged disability. Intracranial hypertension (ICH) is a critical risk factor of bad outcomes after TBI. Continuous infusion of hyperosmolar therapy has been proposed for the prevention and the treatment of ICH. Whether an early administration of continuous hyperosmolar therapy improves long-term outcomes of patients with TBI is uncertain. The aim of the COBI study (number clinicaltrial.gov 03143751, pre-results stage) is to assess the efficiency and the safety of continuous hyperosmolar therapy in patients with TBI...
September 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28712906/a-comparison-of-pharmacologic-therapeutic-agents-used-for-the-reduction-of-intracranial-pressure-after-traumatic-brain-injury
#7
REVIEW
Ahmed M Alnemari, Brianna M Krafcik, Tarek R Mansour, Daniel Gaudin
OBJECTIVE: In neurotrauma care, a better understanding of treatments after traumatic brain injury (TBI) has led to a significant decrease in morbidity and mortality in this population. TBI represents a significant medical problem, and complications after TBI are associated with the initial injury and postevent intracranial processes such as increased intracranial pressure and brain edema. Consequently, appropriate therapeutic interventions are required to reduce brain tissue damage and improve cerebral perfusion...
October 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28678332/effect-of-different-blood-glucose-intervention-plans-on-elderly-people-with-type-2-diabetes-mellitus-combined-with-dementia
#8
Y Chen, J Wang, L-J Wang, H Lin, P-J Huang
OBJECTIVE: We analyzed the effects of intensive and mitigatory blood glucose control strategy on elderly people with type 2 diabetes mellitus (T2DM) combined with Alzheimer disease (AD). PATIENTS AND METHODS: We enrolled 90 elderly patients with T2DM combined with AD to participate in this study. They were randomly divided into 3 groups: the control group, the strength group and the mitigation group with 30 cases in each group. In the control group, patients were only treated with diet and exercise while in the strength group patients were treated with oral hypoglycemic medications, subcutaneous insulin infusion or continuous infusion by micropump...
June 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28596470/-epidural-emphysema-associated-with-diabetic-nonketotic-hyperosmolar-coma
#9
Yoshinari Takaya, Tomoyuki Uchiyama, Shunichi Murano
No abstract text is available yet for this article.
June 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28570329/endocrine-emergencies-with-neurologic-manifestations
#10
Makoto Ishii
PURPOSE OF REVIEW: This article provides an overview of endocrine emergencies with potentially devastating neurologic manifestations that may be fatal if left untreated. Pituitary apoplexy, adrenal crisis, myxedema coma, thyroid storm, acute hypercalcemia and hypocalcemia, hyperglycemic emergencies (diabetic ketoacidosis and hyperglycemic hyperosmolar state), and acute hypoglycemia are discussed, with an emphasis on identifying the signs and symptoms as well as diagnosing and managing these clinical entities...
June 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28393586/evaluation-of-glycated-albumin-ga-and-ga-hba1c-ratio-for-diagnosis-of-diabetes-and-glycemic-control-a-comprehensive-review
#11
REVIEW
Sara Yazdanpanah, Mohammad Rabiee, Mohammadreza Tahriri, Mojgan Abdolrahim, Asadollah Rajab, Hossein E Jazayeri, Lobat Tayebi
Diabetes Mellitus (DM) is a group of metabolic diseases characterized by chronic high blood glucose concentrations (hyperglycemia). When it is left untreated or improperly managed, it can lead to acute complications including diabetic ketoacidosis and non-ketotic hyperosmolar coma. In addition, possible long-term complications include impotence, nerve damage, stroke, chronic kidney failure, cardiovascular disease, foot ulcers, and retinopathy. Historically, universal methods to measure glycemic control for the diagnosis of diabetes included fasting plasma glucose level (FPG), 2-h plasma glucose (2HP), and random plasma glucose...
June 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28324468/ascariasis-and-hyperosmolar-hyperglycemic-state-a-surprising-ultrasound-finding-in-the-emergency-department
#12
Giles N Cattermole, Jean-Paul Nzabandora
BACKGROUND: We report the ultrasound finding of ascariasis in a patient with hyperosmolar hyperglycemic state (HHS). Although ascariasis is common in low-resource settings, there has been no previous report associating ascariasis with HHS. CASE PRESENTATION: A 26-year-old Rwandan man was admitted to the emergency department in coma, with a glycemia of 600 mg/dl. He was resuscitated with fluids, intubated and ventilated, and treated with insulin and antibiotics. On day 3, an ascaris worm was passed via his nasogastric tube, and abdominal ultrasound revealed a heavy worm load...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28320579/-acute-necrotising-oesophagitis-associated-with-hyperosmolar-diabetic-coma
#13
J Mostazo-Torres, M Vílchez-Jaimez, D Marín-García
No abstract text is available yet for this article.
March 17, 2017: Semergen
https://www.readbyqxmd.com/read/27896327/a-case-of-mediastinitis-accompanied-with-hyperosmolar-nonketotic-coma
#14
Mazhar Muslum Tuna, Faruk Kilinc, Zafer Pekkolay, Hikmet Soylu, Alpaslan Kemal Tuzcu
Mediastinitis is a serious infection involving mediastinal spaces after cervical infections spread along the facial planes. A late diagnosis of mediastinitis may result in death. Here we present a diabetic patient suffered from mediastinit accompanied with hyperosmolar nonketotic coma. A 61 years old male patient with type 2 diabetes was admitted to our hospital, with complaint of generalized worsening and fever. A diagnosis of nonketotic hyperosmolar coma was done and proper treatment started immediately. Neck tomography revealed abscess formation in the upper mediastinum...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27851592/1958-unique-survival-story-of-hyperosmolar-coma-due-to-huge-co-ingestion-of-ethylene-glycol-and-ethanol
#15
Jessita S Natasha Albert Messiah Dhas, Raghad Hussein, Mohammed Mogri, Lokendra Thakur
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27695597/continuous-qualitative-electroencephalography-as-a-noninvasive-neuromonitor
#16
Zachary D Threlkeld, Mohan Kottapally, Aimee Aysenne, Nerissa Ko
Intracranial pressure (ICP) monitoring frequently guides key decisions in the management of diseases causing intracranial hypertension. Although typically measured by invasive means, contraindications may leave the clinician with little recourse for dynamic ICP evaluation-particularly when the patient's mental status is compromised. We describe here a healthy 18-year-old woman who subacutely progressed to coma due to diffuse cerebral venous sinus thrombosis. Heparinization precluded the use of invasive ICP monitoring, and electroencephalography (EEG) was used novelly as a surrogate ICP monitor...
October 2016: Neurohospitalist
https://www.readbyqxmd.com/read/27632060/intracranial-pressure-monitoring-in-infants-and-young-children-with-traumatic-brain-injury
#17
Rebecca R Dixon, Maryalice Nocera, Adam J Zolotor, Heather T Keenan
OBJECTIVE: To examine the use of intracranial pressure monitors and treatment for elevated intracranial pressure in children 24 months old or younger with traumatic brain injury in North Carolina between April 2009 and March 2012 and compare this with a similar cohort recruited 2000-2001. DESIGN: Prospective, observational cohort study. SETTING: Twelve PICUs in North Carolina. PATIENTS: All children 24 months old or younger with traumatic brain injury, admitted to an included PICU...
November 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27625237/is-intracranial-pressure-monitoring-useful-in-children-with-severe-traumatic-brain-injury
#18
Sekar Arunkumar, Bhagavatula Indira Devi, Dhaval Shukla, Madhusudhan Reddy
BACKGROUND: Intracranial pressure monitoring (ICP) is considered as optional for management of severe traumatic brain injury (TBI) in children. AIMS: This study was performed to determine whether ICP monitoring is beneficial in the managing severe TBI in children. SETTINGS AND DESIGN: Neurosurgical intensive care unit (ICU) of a tertiary care referral center; prospective observational study. MATERIALS AND METHODS: Children aged 16 years or less with severe TBI defined as "postresuscitation Glasgow Coma Scale (GCS) score of 8 or less admitted to an ICU" were enrolled...
September 2016: Neurology India
https://www.readbyqxmd.com/read/27568371/hyperosmolar-therapy-in-pediatric-traumatic-brain-injury-a-retrospective-study
#19
Nadia Roumeliotis, Christian Dong, Géraldine Pettersen, Louis Crevier, Guillaume Emeriaud
OBJECTIVES: The objectives of the study are to describe the use of hyperosmolar therapy in pediatric traumatic brain injury (TBI) and examine its effect on intracranial pressure (ICP) and cerebral perfusion pressure (CPP). DESIGN: A retrospective review of patients with severe TBI admitted to the pediatric intensive care unit (PICU) was conducted. Inclusion criteria were ICP monitoring and administration of a hyperosmolar agent (20 % mannitol or 3 % hypertonic saline) within 48 h of PICU admission; for which dose and timing were recorded...
December 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/26679969/demographic-and-clinical-profiles-of-type-2-diabetes-mellitus-patients-initiating-canagliflozin-versus-dpp-4-inhibitors-in-a-large-u-s-managed-care-population
#20
COMPARATIVE STUDY
Michael Grabner, Xiaomei Peng, Caroline Geremakis, Jay Bae
BACKGROUND: Canagliflozin is the first sodium-glucose co-transporter-2 (SGLT-2) inhibitor-a new class of oral antidiabetic (OAD) medication-approved for type 2 diabetes mellitus (T2DM) treatment in the United States. Approved less than 2 years ago, use of canagliflozin is largely uncharacterized. OBJECTIVE: To investigate and compare baseline demographic, clinical, and economic characteristics of patients initiating canagliflozin and dipeptidyl peptidase-4 (DPP-4) inhibitors in the real-world setting...
December 2015: Journal of Managed Care & Specialty Pharmacy
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