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Diagnosis of brain death

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https://www.readbyqxmd.com/read/28210568/clozapine-induced-hypersensitivity-myocarditis-presenting-as-sudden-cardiac-death
#1
Natraj Katta, Sudarshan Balla, Kul Aggarwal
Hypersensitivity myocarditis is a rare but serious adverse effect of clozapine, a commonly used psychiatric drug. We report the case of sudden cardiac death from clozapine-induced hypersensitivity myocarditis diagnosed at autopsy. A 54-year-old Caucasian male on clozapine therapy for bipolar disorder presented with a sudden onset of shortness of breath. Laboratory studies were significant for elevated N-terminal prohormone of brain natriuretic peptide. During his hospital stay, the patient died of sudden cardiac arrest from ventricular tachycardia...
October 2016: Autopsy & case reports
https://www.readbyqxmd.com/read/28205009/mixed-pathologies-including-chronic-traumatic-encephalopathy-account-for-dementia-in-retired-association-football-soccer-players
#2
Helen Ling, Huw R Morris, James W Neal, Andrew J Lees, John Hardy, Janice L Holton, Tamas Revesz, David D R Williams
In retired professional association football (soccer) players with a past history of repetitive head impacts, chronic traumatic encephalopathy (CTE) is a potential neurodegenerative cause of dementia and motor impairments. From 1980 to 2010, 14 retired footballers with dementia were followed up regularly until death. Their clinical data, playing career, and concussion history were prospectively collected. Next-of-kin provided consent for six to have post-mortem brain examination. Of the 14 male participants, 13 were professional and 1 was a committed amateur...
February 15, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28190431/posterior-reversible-encephalopathy-in-the-intensive-care-unit
#3
M Toledano, J E Fugate
Posterior reversible encephalopathy syndrome (PRES) is increasingly diagnosed in the emergency department, and medical and surgical intensive care units. PRES is characterized by acute onset of neurologic symptoms in the setting of blood pressure fluctuations, eclampsia, autoimmune disease, transplantation, renal failure, or exposure to immunosuppressive or cytotoxic drugs, triggers known to admit patients to the intensive care unit (ICU). Although the exact pathophysiology remains unknown, there is growing consensus that PRES results from endothelial dysfunction...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28176180/prevention-of-hypoxemia-during-apnea-testing-a-comparison-of-oxygen-insufflation-and-continuous-positive-airway-pressure
#4
Andreas H Kramer, Philippe Couillard, Ryan Bader, Peter Dhillon, Demetrios J Kutsogiannis, Christopher J Doig
BACKGROUND: Apnea testing is an essential step in the clinical diagnosis of brain death. Current international guidelines recommend placement of an oxygen (O2) insufflation catheter into the endotracheal tube to prevent hypoxemia, but use of a continuous positive airway pressure (CPAP) valve may be more effective at limiting arterial partial pressure of O2 (PO2) reduction. METHODS: We performed a multicenter study assessing consecutive apnea tests in 14 intensive care units (ICUs) in two cities utilizing differing protocols...
February 7, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28158980/early-exposure-to-hyperoxia-and-mortality-in-critically-ill-patients-with-severe-traumatic-injuries
#5
Derek W Russell, David R Janz, William L Emerson, Addison K May, Gordon R Bernard, Zhiguo Zhao, Tatsuki Koyama, Lorraine B Ware
BACKGROUND: Hyperoxia is common early in the course of resuscitation of critically ill patients. It has been associated with mortality in some, but not all, studies of cardiac arrest patients and other critically ill cohorts. Reasons for the inconsistency are unclear and may depend on unmeasured patient confounders, the timing and duration of hyperoxia, population characteristics, or the way that hyperoxia is defined and measured. We sought to determine whether, in a prospectively collected cohort of mechanically ventilated patients with traumatic injuries with and without head trauma, higher maximum partial pressure of arterial oxygen (PaO2) within 24 hours of admission would be associated with increased risk of in-hospital mortality...
February 3, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28149766/unexpected-long-survival-of-brain-oligometastatic-non-small-cell-lung-cancer-nsclc-treated-with-multimodal-treatment-a-single-center-experience-and-review-of-the-literature
#6
Concetta Elisa Onesti, Daniela Iacono, Silvia Angelini, Salvatore Lauro, Marco Mazzotta, Mario Alberto Occhipinti, Raffaele Giusti, Paolo Marchetti
Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death worldwide. Fifty percent of the cases are metastatic at diagnosis and about 20% develop brain metastasis. The brain involvement represents a negative prognostic factor. However, some patients could benefit from locoregional treatments of metastatic foci and experience an unexpected long survival or healing. In the previous years some classifications were proposed to identify patients' prognostic category, according to stage of the primary tumor, the timing of metastases occurrence (synchronous or metachronous) and the number of metastatic sites...
December 2016: Translational Lung Cancer Research
https://www.readbyqxmd.com/read/28123618/comparison-of-neurological-clinical-manifestation-in-patients-with-hemorrhagic-and-ischemic-stroke
#7
Seyedhossein Ojaghihaghighi, Samad Shams Vahdati, Akram Mikaeilpour, Ali Ramouz
BACKGROUND: Cerebrovascular accident (CVA) is the third leading cause of death and disability in developed countries. Anyone suspected of having a stroke should be taken immediately to a medical facility for diagnosis and treatment. The symptoms that follow a stroke aren't significant and depend on the area of the brain that has been affected and the amount of tissue damaged. Parameters for predicting long-term outcome in such patients have not been clearly delineated, therefore the aim of this study was to investigate this possibility and to test a system that might practicably be used routinely to aid management and predict outcomes of individual stroke patients...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28114163/doppler-ultrasonography-of-the-central-retinal-vessels-in-children-with-brain-death
#8
Becky J Riggs, Joanna S Cohen, Bhavana Shivakumar, Carmelina Trimboli-Heidler, Jason T Patregnani, Marijean M Miller, Michael C Spaeder, Nathan P Dean
OBJECTIVE: The purpose of this observational study is to explore if bedside Doppler ultrasonography of the central retinal vessels has the potential to become an ancillary study to support the timely diagnosis of brain death in children. DESIGN: Seventeen-month prospective observational cohort. SETTING: Forty-four bed pediatric medical and surgical ICU in an academic teaching hospital. PATIENTS: All children 0-18 years old who were clinically evaluated for brain death at Children's National Health Systems were enrolled and followed until discharge or death...
January 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28111406/pediatric-traumatic-brain-injury-characteristic-features-diagnosis-and-management
#9
Takashi Araki, Hiroyuki Yokota, Akio Morita
Traumatic brain injury (TBI) is the leading cause of death and disability in children. Pediatric TBI is associated with several distinctive characteristics that differ from adults and are attributable to age-related anatomical and physiological differences, pattern of injuries based on the physical ability of the child, and difficulty in neurological evaluation in children. Evidence suggests that children exhibit a specific pathological response to TBI with distinct accompanying neurological symptoms, and considerable efforts have been made to elucidate their pathophysiology...
January 20, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28102883/exploring-prognostic-factors-for-her2-positive-metastatic-breast-cancer-a-retrospective-cohort-study-in-a-major-swiss-hospital
#10
Lilian Bringolf, Bernhard Pestalozzi, Daniel Fink, Konstantin Dedes
BACKGROUND: Trastuzumab (Herceptin®, Roche) has significantly improved the prognosis of patients with HER2-positive metastatic breast cancer. Some patients remain in remission for many years. However, there are no prognostic markers associated with long-term survival. This study aimed to analyse treatment patterns of HER2-positive metastatic breast cancer at a single institution and explore prognostic factors for long-term survival after HER2-targeted treatment. PATIENTS AND METHODS: This was a retrospective cohort study of all patients with HER2-positive metastatic breast cancer receiving first-line treatment with HER2-targeted therapy between 2004 and 2014 at the University Hospital of Zurich (n = 81)...
January 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28088900/synaptic-plasticity-dementia-and-alzheimer-disease
#11
Stephen D Skaper, Laura Facci, Morena Zusso, Pietro Giusti
Neuroplasticity is not only shaped by learning and memory but is also a mediator of responses to neuron attrition and injury (compensatory plasticity). As an ongoing process it reacts to neuronal cell activity and injury, death, and genesis, which encompasses the modulation of structural and functional processes of axons, dendrites, and synapses. The range of structural elements that comprise plasticity includes long-term potentiation (a cellular correlate of learning and memory), synaptic efficacy and remodelling, synaptogenesis, axonal sprouting and dendritic remodelling, and neurogenesis and recruitment...
13, 2017: CNS & Neurological Disorders Drug Targets
https://www.readbyqxmd.com/read/28080901/cerebellar-and-mesencephalon-neoplasia-in-a-nile-hipoppotamus-hippopotamus-amphibious
#12
Francesca Schiaffino, Samantha J Sander, Marcia E Pereira Bacares, Katie J Barnes, Matti Kiupel, Timothy Walsh, Suzan Murray
A 52-yr-old female Nile hippopotamus ( Hippopotamus amphibious ) was presented for acute onset anorexia, depression, lethargy, instability, and weakness in the pelvic limbs. Clinical signs were rapidly progressive, despite empiric therapy with anti-inflammatory medications, resulting in the death of the animal. Gross necropsy evaluation revealed two tan, firm masses in the cerebellum and mesencephalon and a single mass in the right cranial adrenal gland. All three masses had a similar histologic morphology, and immunohistochemical investigation confirmed the general diagnosis of an adenocarcinoma, but the exact cell of origin remains unclear...
December 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28062320/melanized-fungal-infections-in-kidney-transplant-recipients-contributions-to-optimize-clinical-management
#13
D Wagner de Castro Lima Santos, L Fernando Aranha Camargo, S Santos Gonçalves, M Marufuji Ogawa, J Tomimori, M M Simões E Silva Enokihara, J Osmar Medina Pestana, Arnaldo Lopes Colombo
OBJECTIVES: This is a retrospective and observational study addressing clinical and therapeutic aspects of melanized fungal infections in kidney transplant recipients. METHODS: We retrospectively reviewed medical records of all patients admitted between January 1996 and December 2013 in a single institution who developed infections by melanized fungi. RESULTS: We reported on 56 patients aged between 30 and 74 years with phaeohyphomycosis or chromoblastomycosis (0...
January 3, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28058140/predictive-value-of-brain-arrest-neurological-outcome-scale-branos-on-mortality-and-morbidity-after-cardiac-arrest
#14
Cengiz Şahutoğlu, Mehmet Uyar, Kubilay Demirağ, Hasan İsayev, Ali Reşat Moral
OBJECTIVE: There are several prediction scales and parameters for prognosis after a cardiac arrest. One of these scales is the brain arrest neurological outcome scale (BrANOS), which consists of duration of cardiac arrest, Glasgow Coma Scale score and Hounsfield unit measured on cranial computed tomography (CT) scan. The objective of this study is to investigate the effectiveness of BrANOS on predicting the mortality and disability after a cardiac arrest. METHODS: We retrospectively investigated cardiac arrest patients who were hospitalized in our intensive care unit (ICU) within a 3-year period...
December 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28052939/no-association-between-radiation-dose-from-pediatric-ct-scans-and-risk-of-subsequent-hodgkin-lymphoma
#15
Amy Berrington de Gonzalez, Neige Journy, Choonsik Lee, Lindsay M Morton, Richard Harbron, Douglas R Stewart, Louise Parker, Alan W Craft, Kieran McHugh, Mark Little, Mark Pearce
BACKGROUND: We examined the relationship between estimated radiation dose from CT scans and subsequent Hodgkin lymphoma in the UK pediatric CT scans cohort. METHODS: A retrospective, record linkage cohort included patients aged 0-21 years who underwent CT scans between 1980 and 2002 and were followed up for cancer or death until 2008. Poisson regression analysis was used to evaluate the relationship between estimated radiation dose (lagged by two years) and incident Hodgkin lymphoma diagnosed at least two years after the first CT scan...
January 4, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28050694/survival-prediction-using-temporal-muscle-thickness-measurements-on-cranial-magnetic-resonance-images-in-patients-with-newly-diagnosed-brain-metastases
#16
Julia Furtner, Anna S Berghoff, Omar M Albtoush, Ramona Woitek, Ulrika Asenbaum, Daniela Prayer, Georg Widhalm, Brigitte Gatterbauer, Karin Dieckmann, Peter Birner, Bernadette Aretin, Rupert Bartsch, Christoph C Zielinski, Veronika Schöpf, Matthias Preusser
OBJECTIVES: To evaluate the prognostic relevance of temporal muscle thickness (TMT) in brain metastasis patients. METHODS: We retrospectively analysed TMT on magnetic resonance (MR) images at diagnosis of brain metastasis in two independent cohorts of 188 breast cancer (BC) and 247 non-small cell lung cancer (NSCLC) patients (overall: 435 patients). RESULTS: Survival analysis using a Cox regression model showed a reduced risk of death by 19% with every additional millimetre of baseline TMT in the BC cohort and by 24% in the NSCLC cohort...
January 3, 2017: European Radiology
https://www.readbyqxmd.com/read/28028552/venous-thromboembolic-events-in-critically-ill-traumatic-brain-injury-patients
#17
Markus B Skrifvars, Michael Bailey, Jeffrey Presneill, Craig French, Alistair Nichol, Lorraine Little, Jacques Duranteau, Olivier Huet, Samir Haddad, Yaseen Arabi, Colin McArthur, D James Cooper, Rinaldo Bellomo
PURPOSE: To estimate the prevalence, risk factors, prophylactic treatment and impact on mortality for venous thromboembolism (VTE) in patients with moderate to severe traumatic brain injury (TBI) treated in the intensive care unit. METHODS: A post hoc analysis of the erythropoietin in traumatic brain injury (EPO-TBI) trial that included twice-weekly lower limb ultrasound screening. Venous thrombotic events were defined as ultrasound-proven proximal deep venous thrombosis (DVT) or clinically detected pulmonary embolism (PE)...
December 27, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/28024551/end-of-life-issues-in-cardiac-critical-care-the-option-of-organ-donation
#18
REVIEW
Karim Serri, Pierre Marsolais
Despite important advances in the care of postcardiac arrest patients, severe brain injury remains one of the major causes of death in the cardiac intensive care unit. Neurological prognostication after cardiac arrest has evolved significantly since the introduction of therapeutic hypothermia. It now relies on a multimodal approach and a minimal observation period of 72 hours is usually advocated. However, when brain injury is severe and the prognosis considered dismal, patients become eligible for organ donation...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28018883/determinants-of-alternate-level-of-care-delayed-discharge-among-acute-care-survivors-of-hypoxic-ischemic-brain-injury-a-population-based-cohort-study
#19
David Stock, Cassandra Cowie, Vincy Chan, Angela Colantonio, Walter P Wodchis, David Alter, Nora Cullen
BACKGROUND: Delayed discharge, captured as alternate-level-of-care days, represents inefficient use of high-demand acute care resources and results in potentially poorer patient outcomes. We performed a study to determine the extent of alternate-level-of-care days among patients who survived hypoxic-ischemic brain injury in inpatient hospital care in Ontario and to identify predictors of alternate-level-of-care use in this population. METHODS: A population-based cohort of acute care survivors of hypoxic-ischemic brain injury aged 20 years or more from 2002/03 through 2011/12 was identified...
October 2016: CMAJ Open
https://www.readbyqxmd.com/read/28012128/death-of-a-seven-month-old-child-in-a-washing-machine-a-case-report
#20
Antonio Osculati, Silvia Damiana Visonà, Laura Re, Marta Sozzi, Francesca Castelli, Luisa Andrello, Claudia Vignali
The authors present a case which brings out a unique modality of child homicide by placing the baby in a washing machine and turning it on. The murder was perpetrated by the baby's mother, who suffered from a serious depressive disorder. A postmortem RX and then a forensic autopsy were performed, followed by histologic examinations and toxicology. On the basis of the results of the autopsy, as well as the histology and the negative toxicological data, the cause of death was identified as acute asphyxia. This diagnosis was rendered in light of the absence of other causes of death, as well as the presence of typical signs of asphyxia, such as epicardial and pleural petechiae and, above all, the microscopic examinations, which pointed out a massive acute pulmonary emphysema...
December 24, 2016: International Journal of Legal Medicine
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