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https://www.readbyqxmd.com/read/29677069/evolution-of-deceased-organ-donation-activity-vs-efficiency-over-a-15-year-period-an-international-comparison
#1
Julius Weiss, Andreas Elmer, Beatriz Mahíllo, Beatriz Domínguez-Gil, Danica Avsec, Alessandro Nanni Costa, Bernadette J J M Haase-Kromwijk, Karim Laouabdia, Franz F Immer
BACKGROUND: The donation rate (DR) per million population is not ideal for an efficiency comparison of national deceased organ donation programs. The DR does not account for variabilities in the potential for deceased donation which mainly depends on fatalities from causes leading to brain death. In this study, the donation activity was put into relation to the mortality from selected causes. Based on that metric, this study assesses the efficiency of different donation programs. METHODS: This is a retrospective analysis of 2001-2015 deceased organ donation and mortality registry data...
April 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29659999/increased-body-mass-index-associated-with-reduced-risk-of-delayed-cerebral-ischemia-and-subsequent-infarction-after-aneurysmal-subarachnoid-hemorrhage
#2
Lorenzo Rinaldo, Alejandro A Rabinstein, Giuseppe Lanzino
BACKGROUND: Increased body mass index (BMI) may be protective against cerebral ischemia in certain clinical contexts. OBJECTIVE: To investigate whether increased BMI was associated with delayed cerebral ischemia (DCI) and subsequent infarction after aneurysmal subarachnoid hemorrhage (aSAH). METHODS: We retrospectively reviewed the clinical course of patients presenting to our institution for management of aSAH. Patient were segregated according to BMI< or ≥29...
April 4, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29659050/continuous-electroencephalography-predicts-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage-a-prospective-study-of-diagnostic-accuracy
#3
Eric S Rosenthal, Siddharth Biswal, Sahar F Zafar, Kathryn L O'Connor, Sophia Bechek, Apeksha V Shenoy, Emily J Boyle, Mouhsin M Shafi, Emily J Gilmore, Brandon P Foreman, Nicolas Gaspard, Thabele M Leslie-Mazwi, Jonathan Rosand, Daniel B Hoch, Cenk Ayata, Sydney S Cash, Andrew J Cole, Aman B Patel, M Brandon Westover
OBJECTIVE: Delayed cerebral ischemia (DCI) is a common, disabling complication of subarachnoid hemorrhage (SAH). Preventing DCI is a key focus of neurocritical care, but interventions carry risk and cannot be applied indiscriminately. While retrospective studies have identified continuous EEG (cEEG) measures associated with DCI, no study has characterized the accuracy of cEEG with sufficient rigor to justify using it to triage patients to interventions or clinical trials. We therefore prospectively assessed the accuracy of cEEG for predicting DCI, following the Standards for Reporting Diagnostic Accuracy Studies...
April 16, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29644765/correlation-between-novel-3d-high-resolution-manometry-esophagogastric-junction-metrics-and-ph-metry-in-reflux-disease-patients
#4
Y Xiao, Z Lin, Y Li, J E Pandolfino, M Chen, P J Kahrilas
BACKGROUND AND AIMS: We recently developed 2 novel 3D high-resolution manometry (HRM) metrics of esophagogastric junction (EGJ) contractility to differentiate the lower esophageal sphincter (LES) and crural diaphragm (CD) elements of EGJ pressure. This study aimed to compare these metrics to the EGJ-contractile integral (EGJ-CI) and to analyze their correlation with esophageal acid exposure time (AET) on pH-metry. METHODS: Thirty-one gastro-oesophageal reflux disease (GERD) patients and 20 control subjects underwent 24-hour pH-metry and HRM using a 3D-HRM catheter...
April 11, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29619659/spontaneous-elevation-of-blood-pressure-after-sah-an-epiphenomenon-of-disease-severity-and-demand-but-not-a-surrogate-for-outcome
#5
F Teping, W Albanna, H Clusmann, H Schulze-Steinen, M Mueller, A Hoellig, G A Schubert
BACKGROUND: Spontaneous blood pressure increase is frequently observed after aneurysmal subarachnoid hemorrhage (aSAH). These episodes of spontaneous blood pressure alterations are usually tolerated under the assumption of an endogenous response to maintain cerebral perfusion. The relevance of blood pressure variability and its relationship to disease severity and outcome, however, remain obscure. METHODS: A total of 115 consecutive patients with aSAH were included for this retrospective analysis of a continuously collected data pool...
April 4, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29615017/clinical-and-radiographic-outcome-of-dynamic-cervical-implant-dci-arthroplasty-for-degenerative-cervical-disc-disease-a-minimal-five-year-follow-up
#6
Lin-Nan Wang, Bo-Wen Hu, Lei Wang, Yue-Ming Song, Xi Yang, Li-Min Liu, Hao Liu
BACKGROUND: To evaluate the mid- to long-term clinical and radiographic outcomes of anterior cervical discectomy and dynamic cervical implant (DCI) arthroplasty for degenerative cervical disc disease. METHODS: From April 2010 to October 2010, 38 patients with single- or double-level cervical disc herniation underwent anterior cervical discectomy and DCI arthroplasty. The clinical results and radiographic outcomes of these 38 patients (42 levels) were retrospectively evaluated...
April 4, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29611615/health-effects-of-hyperbaric-exposure-on-chamber-attendants-a-literature-review
#7
Richard Pougnet, Laurence Pougnet, David Lucas, Anne Henckes, Brice Loddé, Jean-Dominique Dewitte
BACKGROUND: Inside attendants working in hyperbaric chambers are exposed to risks related to the hyperbaric environment, handling and care. The aim of this study is to review the literature focusing on the impact of this activity on health. MATERIALS AND METHODS: This is a literature review using the Medline database. RESULTS: Eight articles studied decompression illness (DCI). The incidence of DCI ranged from 0 to 37 per 100,000 sessions in hyperbaric chambers (SHC)...
2018: International Maritime Health
https://www.readbyqxmd.com/read/29611451/permeability-imaging-as-a-predictor-of-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage
#8
Jonathan J Russin, Axel Montagne, Francesco D'Amore, Shuhan He, Mark S Shiroishi, Robert C Rennert, Jena Depetris, Berislav V Zlokovic, William J Mack
Blood-brain barrier (BBB) dysfunction has been implicated in ischemic risk following aneurysmal subarachnoid hemorrhage (aSAH), but never directly imaged. We prospectively examined whether post-bleed day 4 dynamic contrast-enhanced magnetic resonance (DCE-MR) BBB permeability imaging could predict development of delayed cerebral ischemia (DCI). Global MR-derived BBB permeability ( Ktrans ) was significantly higher in aSAH patients who subsequently developed DCI (five patients; 2.28 ± 0.09 × 10-3 min-1 ) compared to those who experienced radiographic vasospasm only (three patients; 1...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29600883/investigational-drugs-for-vasospasm-after-subarachnoid-hemorrhage
#9
Roberta T Tallarico, Michael A Pizzi, William D Freeman
Aneurysmal subarachnoid hemorrhage (aSAH) represents 3% of all strokes in the US. When the patient survives it can lead to permanent incapacity especially if the patient develops vasospasm. The vasospasm is a multifactorial disorder and can lead to delayed cerebral ischemia (DCI). Most of the drugs tested to treat vasospasm failed to improve outcome and the only exception is nimodipine. Areas covered: In this review, the authors describe the multifactorial process of vasospasm leading DCI after aSAH, discussing the treatments available based on the past and latest researches...
April 6, 2018: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/29588235/a-comparison-of-computed-tomography-based-scales-with-and-without-consideration-of-the-presence-or-absence-of-intraventricular-hemorrhage-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#10
Tetsuji Inagawa, Masaaki Shibukawa, Toshikazu Hidaka
OBJECTIVE: There has been controversy as to whether intraventricular hemorrhage (IVH) after aneurysmal subarachnoid hemorrhage (SAH) contributes to angiographic cerebral vasospasm (aCV) and delayed cerebral ischemia (DCI). CT-based SAH scales that did and did not consider IVH were compared in terms of ability to predict aCV, DCI, and outcome. METHODS: We reviewed 390 patients with ruptured aneurysms who had been treated surgically by day 3 by the same surgeon (T...
March 24, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29563892/incorporating-high-frequency-physiologic-data-using-computational-dictionary-learning-improves-prediction-of-delayed-cerebral-ischemia-compared-to-existing-methods
#11
Murad Megjhani, Kalijah Terilli, Hans-Peter Frey, Angela G Velazquez, Kevin William Doyle, Edward Sander Connolly, David Jinou Roh, Sachin Agarwal, Jan Claassen, Noemie Elhadad, Soojin Park
Purpose: Accurate prediction of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) can be critical for planning interventions to prevent poor neurological outcome. This paper presents a model using convolution dictionary learning to extract features from physiological data available from bedside monitors. We develop and validate a prediction model for DCI after SAH, demonstrating improved precision over standard methods alone. Methods: 488 consecutive SAH admissions from 2006 to 2014 to a tertiary care hospital were included...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29560598/asymmetric-and-symmetric-dimethylarginines-are-markers-of-delayed-cerebral-ischemia-and-neurological-outcome-in-patients-with-subarachnoid-hemorrhage
#12
Daniel Appel, Miriam Seeberger, Edzard Schwedhelm, Patrick Czorlich, Alwin E Goetz, Rainer H Böger, Juliane Hannemann
BACKGROUND: Delayed cerebral ischemia (DCI) is the major cause of lethality and neuronal damage in patients who survived the primary subarachnoid hemorrhage (SAH). Asymmetric and symmetric dimethylarginines (ADMA and SDMA) inhibit nitric oxide production from L-arginine via distinct mechanisms. Elevated ADMA levels are associated with vasospasm after SAH. We aimed to study the time course of ADMA and SDMA in plasma and ventricular cerebrospinal fluid (CSF) and their associations with DCI and outcome...
March 20, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29557102/pre-hospital-management-of-decompression-illness-expert-review-of-key-principles-and-controversies
#13
Simon J Mitchell, Michael H Bennett, Phillip Bryson, Frank K Butler, David J Doolette, James R Holm, Jacek Kot, Pierre Lafère
Guidelines for the pre-hospital management of decompression illness (DCI) had not been formally revised since the 2004 Divers Alert Network/Undersea and Hyperbaric Medical Society workshop held in Sydney, entitled "Management of mild or marginal decompression illness in remote locations". A contemporary review was initiated by the Diver's Alert Network and undertaken by a multinational committee with members from Australasia, the USA and Europe. The process began with literature reviews by designated committee members on: the diagnosis of DCI; first aid strategies for DCI; remote triage of possible DCI victims by diving medicine experts; evacuation of DCI victims; effect of delay to recompression in DCI; pitfalls in management when DCI victims present at hospitals without diving medicine expertise and in-water recompression...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29556884/predicting-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage-using-physiological-time-series-data
#14
Soojin Park, Murad Megjhani, Hans-Peter Frey, Edouard Grave, Chris Wiggins, Kalijah L Terilli, David J Roh, Angela Velazquez, Sachin Agarwal, E Sander Connolly, J Michael Schmidt, Jan Claassen, Noemie Elhadad
To develop and validate a prediction model for delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) using a temporal unsupervised feature engineering approach, demonstrating improved precision over standard features. 488 consecutive SAH admissions from 2006 to 2014 to a tertiary care hospital were included. Models were trained on 80%, while 20% were set aside for validation testing. Baseline information and standard grading scales were evaluated: age, sex, Hunt Hess grade, modified Fisher Scale (mFS), and Glasgow Coma Scale (GCS)...
March 20, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29548963/predictive-factors-of-fever-after-aneurysmal-subarachnoid-hemorrhage-and-its-impact-on-delayed-cerebral-ischemia-and-clinical-outcomes
#15
Yung Ki Park, Hyeong-Joong Yi, Kyu-Sun Choi, Young-Jun Lee, Hyoung-Joon Chun, Sae Min Kwon
OBJECTIVE: Fever is relatively common and worsens neurologic injury after aneurysmal subarachnoid hemorrhage (SAH). The aim of this study was to display the time course of body temperature, identify predictive factors of fever after SAH, and evaluate its impact on delayed cerebral ischemia (DCI) and clinical outcomes. METHODS: Four hundred twelve patients with SAH and ruptured aneurysms who were treated at our institution between January 2007 and December 2016 were retrospectively analyzed...
March 13, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29547164/aggressive-management-of-vasospasm-with-direct-intra-arterial-nimodipine-therapy
#16
Vinayak Narayan, Hima Pendharkar, Bhagavatula Indira Devi, Dhananjaya I Bhat, Dhaval P Shukla
Background: The conventional medical management of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is associated with uncertainty of outcome and complications. Aims and Objectives: To examine the effect of direct intra-arterial nimodipine therapy on outcome in patients with delayed cerebral ischemia (DCI). Settings and Design: The retrospective observational study was conducted at a single neurosurgical unit and interventional neuroradiolgy suite of a center managing SAH...
March 2018: Neurology India
https://www.readbyqxmd.com/read/29543485/psychometric-evaluation-of-a-measure-of-intimate-partner-communication-during-deployment
#17
Christina Balderrama-Durbin, Christopher R Erbes, Melissa A Polusny, Dawne Vogt
Intimate partner communication has become a part of the daily routine of military couples during deployment. However, there is a scarcity of research examining the individual and relationship implications of communication during deployment, likely due in part to the lack of existing measures of deployment communication. The current study examined the psychometric characteristics of a newly developed, multidimensional tool for assessing the process and outcomes of deployment communication in a sample of 391 recently deployed male Army National Guard soldiers and their female intimate partners...
February 2018: Journal of Family Psychology: JFP
https://www.readbyqxmd.com/read/29542847/impaired-motility-in-barrett-s-esophagus-a-study-using-high-resolution-manometry-with-physiologic-challenge
#18
S Sanagapalli, A Emmanuel, R Leong, S Kerr, L Lovat, R Haidry, M Banks, D Graham, A Raeburn, N Zarate-Lopez, R Sweis
BACKGROUND: Esophageal dysmotility may predispose to Barrett's esophagus (BE). We hypothesized that high-resolution manometry (HRM) performed with additional physiologic challenge would better delineate dysmotility in BE. METHODS: Included patients had typical reflux symptoms and underwent endoscopy, HRM with single water swallows and adjunctive testing with solids and rapid drink challenge (RDC) before ambulatory pH-impedance monitoring. BE and endoscopy-negative reflux disease (ENRD) subjects were compared against functional heartburn patient-controls (FHC)...
March 15, 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29529609/risk-factors-and-clinical-impact-of-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage-analysis-from-the-china-national-stroke-registry
#19
Wanying Duan, Yuesong Pan, Chunjuan Wang, Yilong Wang, Xingquan Zhao, Yongjun Wang, Liping Liu
BACKGROUND: Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) is a significant cause of morbidity and mortality. While it is important to detect early signs of DCI, patients with high risk of DCI are difficult to identify, and the potential risk factors are uncertain. This study aimed to identify independent risk factors of DCI and clarify their clinical impact on outcome and the disease course. METHODS: For this nationwide, multicenter, prospective clinical study involving consecutive patients with aSAH recruited from the China National Stroke Registry, demographic, clinical, radiological, and laboratorial data during hospitalisation, in-hospital complications, functional outcomes, and mortality at 3, 6, and 12 months were recorded...
March 12, 2018: Neuroepidemiology
https://www.readbyqxmd.com/read/29528448/white-blood-cell-count-improves-prediction-of-delayed-cerebral-ischemia-following-aneurysmal-subarachnoid-hemorrhage
#20
Fawaz Al-Mufti, Kalina Anna Misiolek, David Roh, Aws Alawi, Andrew Bauerschmidt, Soojin Park, Sachin Agarwal, Philip M Meyers, E Sander Connolly, Jan Claassen, J Michael Schmidt
BACKGROUND: Immune dysregulation has long been implicated in the development of delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH). OBJECTIVE: To determine the relationship of inflammatory cell biomarkers with DCI. METHODS: We evaluated 849 aSAH patients who were enrolled into a prospective observational cohort study and had a white blood cell (WBC) differential obtained within 72 h of bleed onset. RESULTS: WBC count > 12...
March 8, 2018: Neurosurgery
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