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Definition of brain death

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https://www.readbyqxmd.com/read/28287909/clinical-evaluation-of-a-microwave-based-device-for-detection-of-traumatic-intracranial-hemorrhage
#1
Johan Ljungqvist, Stefan Candefjord, Mikael Persson, Lars Jönsson, Thomas Skoglund, Mikael Elam
Traumatic brain injury (TBI) is the leading cause of death and disability among young persons. A key to improve outcome for patients with TBI is to reduce the time from injury to definitive care by achieving high triage accuracy. Microwave technology (MWT) allows for a portable device to be used in the pre-hospital setting for detection of intracranial hematomas at the scene of injury, thereby enhancing early triage and allowing for more adequate early care. MWT has previously been evaluated for medical applications including the ability to differentiate between hemorrhagic and ischemic stroke...
March 13, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28270838/clinical-and-hemodynamic-profiles-of-elderly-patients-with-pulmonary-arterial-hypertension-a-single-center-prospective-study
#2
Ebru Ozpelit, Bahri Akdeniz, Dilek Sezgin, Can Sevinc, Kemal Can Tertemiz, Mehmet Emre Ozpelit, Mustafa Baris, Nezihi Baris
BACKGROUNDS: Pulmonary arterial hypertension (PAH) was previously considered an illness that affects mostly the young, but now it is also increasingly recognized in the elderly. The aim of this study was to compare the features of elderly versus younger patients diagnosed with PAH, and to define the prognostic factors which affect their long-term survival. METHODS: In this prospective, single center study, the clinical, echocardiographic, hemodynamic characteristics, and the outcomes of younger (18-65 years) and elderly (≥ 65 years) patients with definitive diagnosis of precapillary PAH were compared...
January 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28261297/comparison-of-prognostic-value-of-n-terminal-pro-brain-natriuretic-peptide-in-septic-and-non-septic-intensive-care-patients
#3
Namik Ozcan, Ayse Ozcan, Cetin Kaymak, Hulya Basar, Mustafa Kotanoglu, Bektas Kose
INTRODUCTION: The aim of this study is to compare the prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in septic and non-septic intensive care patients. MATERIAL AND METHODS: Fifty consecutive patients admitted to the intensive care unit (ICU) were enrolled in either the septic or non-septic group according to the criteria in the International Sepsis Definitions Conference in 2001. Demographic and clinical data, procalcitonin and lactate levels at admission, and death within 28 days were registered...
March 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28260484/impact-of-a-full-time-donor-management-protocol-on-donors-liver-biopsy-findings-progress-to-date
#4
Meysam Mojtabaee, Alireza Shamsaeefar, Siavash Gholami, Mojtaba Mohsenzadeh, Farahnaz Sadegh Beigee
OBJECTIVES: This study investigated a fixed coordinator-directed donor management strategy's impact on donated liver quality, as determined by definitive biopsy results. MATERIALS AND METHODS: We collected donated liver biopsy results from donations both before and after implementing a fixed coordinator-directed donor management strategy. This strategy involved full-time attendance by a donor coordinator and continued resuscitation of brain-dead donors. All donations took place in a single organ procurement unit...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260450/questionnaire-on-brain-death-and-organ-procurement
#5
Saleh Hammad, Manal Alnammourah, Farah Almahmoud, Mais Fawzi, Abdel-Hadi Breizat
OBJECTIVES: The subject of organs for transplant after brain death raises many concerns, including definition and timing of death, how to permit human organ transplant, and the idea of paying for organs. Many ethical concerns are raised regarding regulations and procedures for organ transplant in developing countries. These include where and how to obtain organs and the concept of justice in organ distribution. MATERIALS AND METHODS: We administered 2682 questionnaires to 628 men and 2054 women over 24 months (range, 18 to 70 years old)...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28240175/clinical-considerations-of-focal-drug-delivery-in-cancer-treatment
#6
Jamie Harris, Bill Chiu
According to the US Center for Disease Control, cancer deaths are the second most common cause of mortality in both adults and children. Definitive treatment of solid tumors involves surgical resection with or without systemic chemotherapy and radiation. The advent of local drug delivery presents a unique treatment modality that can offer substantial benefits in cancer management. Local drug delivery offers targeted drug delivery to cancer tissues while minimizing side effects of the medications. Three main phases in solid tumor management exist for the treating physician: initial diagnosis with tissue biopsy, surgical resection with or without chemotherapy, and management of metastatic disease...
February 24, 2017: Current Drug Delivery
https://www.readbyqxmd.com/read/28235884/is-there-a-place-for-cpr-and-sustained-physiological-support-in-brain-dead-non-donors
#7
Stephen D Brown
This article addresses whether cardiopulmonary resuscitation (CPR) and sustained physiological support should ever be permitted in individuals who are diagnosed as brain dead and who had held previously expressed moral or religious objections to the currently accepted criteria for such a determination. It contrasts how requests for care would normally be treated in cases involving a brain-dead individual with previously expressed wishes to donate and a similarly diagnosed individual with previously expressed beliefs that did not conform to a brain-based conception of death...
February 24, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28205009/mixed-pathologies-including-chronic-traumatic-encephalopathy-account-for-dementia-in-retired-association-football-soccer-players
#8
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...
March 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28199174/role-of-troponins-i-and-t-and-n-terminal-prohormone-of-brain-natriuretic-peptide-in-monitoring-cardiac-safety-of-patients-with-early-stage-human-epidermal-growth-factor-receptor-2-positive-breast-cancer-receiving-trastuzumab-a-herceptin-adjuvant-study-cardiac
#9
Dimitrios Zardavas, Thomas M Suter, Dirk J Van Veldhuisen, Jutta Steinseifer, Johannes Noe, Sabine Lauer, Nedal Al-Sakaff, Martine J Piccart-Gebhart, Evandro de Azambuja
Purpose Women receiving trastuzumab with chemotherapy are at risk for trastuzumab-related cardiac dysfunction (TRCD). We explored the prognostic value of cardiac markers (troponins I and T, N-terminal prohormone of brain natriuretic peptide [NT-proBNP]) to predict baseline susceptibility to develop TRCD. We examined whether development of cardiac end points or significant left ventricular ejection fraction (LVEF) drop was associated with markers' increases. Patients and Methods Cardiac marker assessments were coupled with LVEF measurements at different time points for 533 patients from the Herceptin Adjuvant (HERA) study who agreed to participate in this study...
March 10, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28182114/evolution-of-cerebral-atrophy-in-a-patient-with-super-refractory-status-epilepticus-treated-with-barbiturate-coma
#10
Christopher R Newey, Pravin George, Premkumar Nattanmai, Christine Ahrens, Stephen Hantus, Aarti Sarwal
Introduction. Status epilepticus is associated with neuronal breakdown. Radiological sequelae of status epilepticus include diffusion weighted abnormalities and T2/FLAIR cortical hyperintensities corresponding to the epileptogenic cortex. However, progressive generalized cerebral atrophy from status epilepticus is underrecognized and may be related to neuronal death. We present here a case of diffuse cerebral atrophy that developed during the course of super refractory status epilepticus management despite prolonged barbiturate coma...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28169857/intersection-of-prognosis-and-palliation-in-neurocritical-care
#11
Michael Rubin, Jordan Bonomo, J Claude Hemphill
PURPOSE OF REVIEW: Difficult discussions regarding end-of-life care are common in neurocritical care. Because of a patient's neurological impairment, decisions regarding continuing or limiting aggressive care must often be made by patients' families in conjunction with medical providers. This review provides perspective on three major aspects of this circumstance: prognostication, family-physician discussions, and determination of death (specifically as it impacts on organ donation). RECENT FINDINGS: Numerous studies have now demonstrated that prediction models developed from populations of brain-injured patients may be misleading when applied to individual patients...
April 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28087824/neuropathology-of-sudep-role-of-inflammation-blood-brain-barrier-impairment-and-hypoxia
#12
Zuzanna Michalak, Dima Obari, Matthew Ellis, Maria Thom, Sanjay M Sisodiya
OBJECTIVE: To seek a neuropathologic signature of sudden unexpected death in epilepsy (SUDEP) in a postmortem cohort by use of immunohistochemistry for specific markers of inflammation, gliosis, acute neuronal injury due to hypoxia, and blood-brain barrier (BBB) disruption, enabling the generation of hypotheses about potential mechanisms of death in SUDEP. METHODS: Using immunohistochemistry, we investigated the expression of 6 markers (CD163, human leukocyte antigen-antigen D related, glial fibrillary acid protein, hypoxia-inducible factor-1α [HIF-1α], immunoglobulin G, and albumin) in the hippocampus, amygdala, and medulla in 58 postmortem cases: 28 SUDEP (definite and probable), 12 epilepsy controls, and 18 nonepileptic sudden death controls...
February 7, 2017: Neurology
https://www.readbyqxmd.com/read/28073578/prophylactic-cranial-irradiation-after-definitive-chemoradiotherapy-for-limited-stage-small-cell-lung-cancer-do-all-patients-benefit
#13
Ahsan S Farooqi, Emma B Holliday, Pamela K Allen, Xiong Wei, James D Cox, Ritsuko Komaki
PURPOSE: Prophylactic cranial irradiation (PCI) can improve overall survival (OS) and suppress brain metastases (BM) in patients with limited-stage small cell lung cancer (LS-SCLC) after complete response to primary therapy. However, PCI can be toxic. We sought to identify characteristics of patients who may not benefit from PCI. METHODS: We identified 658 patients who received chemoradiotherapy at MD Anderson in 1986-2012; 364 received PCI and 294 did not. Median follow-up time was 21...
February 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28067742/what-definition-is-used-to-describe-second-impact-syndrome-in-sports-a-systematic-and-critical-review
#14
REVIEW
Steven D Stovitz, Jonathan D Weseman, Matthew C Hooks, Robert J Schmidt, Jonathan B Koffel, Jon S Patricios
Concern about what has been termed, "second impact syndrome" (SIS) is a major factor determining return-to-play decisions after concussion. However, definitions of SIS vary. We used Scopus to conduct a systematic review and categorize the definitions used to describe SIS. Of the 91 sources identified, 79 (87%) clearly specified that SIS involved either cerebral edema or death after a concussion when a prior concussion had not resolved. Twelve articles (13%) could be interpreted as merely the events of two consecutive concussions...
January 2017: Current Sports Medicine Reports
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
#15
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/28017304/e-cigarettes-what-a-practicing-cardiologist-needs-to-know
#16
EDITORIAL
Joshua Liberman, Samuel Wann
Cardiologists and other physicians caring for patients who either smoke tobacco or are potential or active users of E-cigarettes have many questions about this increasingly popular method for delivering nicotine to the brain: (1) What are E-cigarettes? (2) What harm do E-cigarettes pose to users and bystanders? (3) Can E-cigarettes help tobacco smokers quit? (4) Are E-cigarettes a gateway to tobacco smoking, addicting new users, particularly the young, to nicotine? and (5) Should E-cigarettes be tolerated, or even favored over tobacco, as a less harmful substitute for those unable to stop smoking tobacco? This editorial summarizes evidence and expert opinion, preparing the physician for informed discussion of this controversial subject with their patients and colleagues...
February 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27932184/intrapancreatic-splenule-in-a-pancreas-allograft-case-report
#17
K Yadav, O K Serrano, R Kandaswamy
A 16-year-old white man was involved in a motor vehicle collision and suffered head, chest, and abdominal trauma. Despite initial resuscitative efforts, he progressed to brain death and was designated to be an organ donor by his family. He had no earlier medical or surgical history and no high-risk behaviors. Blood work revealed normal creatinine, liver function tests, lipase, and amylase. Viral serologies were negative except for cytomegalovirus IgG and Epstein-Barr virus nucleic acid. Imaging revealed a right kidney contusion, a manubrial fracture, and fractures of right first rib and bilateral scapulae...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27876002/sporadic-creutzfeldt-jakob-disease-with-unusual-initial-presentation-as-posterior-reversible-encephalopathy-syndrome-a-case-report
#18
Edgaras Dirzius, Renata Balnyte, Vesta Steibliene, Rymante Gleizniene, Inga Gudinaviciene, Andrius Radziunas, Kestutis Petrikonis
BACKGROUND: Creutzfeldt - Jakob disease (CJD) is a rapidly progressive and fatal neurodegenerative prion disease. MRI findings are included in diagnostic criteria for probable CJD, giving a sensitivity and specificity more than 90%, but the atypical radiological presentations in the early stage of the disease could cause the diagnostic difficulties. CJD can be definitively diagnosed by histopathological confirmation, brain biopsy or at autopsy. CASE PRESENTATION: We present a case of 53-year-old woman with a history of a rapidly progressive dementia with symptoms of visual impairment, increased extrapyramidal type muscle tonus, stereotypical movements and ataxic gait resulting in the patient's death after13 months...
November 22, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27870453/do-microglia-play-a-role-in-sex-differences-in-tbi
#19
REVIEW
Henry W Caplan, Charles S Cox, Supinder S Bedi
Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality for both males and females and is, thus, a major focus of current study. Although the overall death rate of TBI for males is roughly three times higher than that for females, males have been disproportionately represented in clinical and preclinical studies. Gender differences are known to exist in many neurologic disorders, such as multiple sclerosis and stroke, and differences appear to exist in TBI. Furthermore, it is known that microglia have sexually dimorphic roles in CNS development and other neurologic conditions; however, most animal studies of microglia and TBI have focused on male subjects...
January 2, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/27853394/long-term-impact-after-fulminant-guillain-barr%C3%A3-syndrome-case-report-and-literature-review
#20
Alain Rougé, Jérémie Lemarié, Sébastien Gibot, Pierre Edouard Bollaert
A 47-year-old man was admitted to the intensive care unit a few hours after presenting to emergency department with acute diplopia and dysphonia. Swallowing disorders and respiratory muscular weakness quickly required invasive ventilation. On day 3, the patient was in a "brain-death"-like state with deep coma and absent brainstem reflexes. Electroencephalogram ruled out brain death diagnosis as a paradoxical sleep trace was recorded. Cerebrospinal fluid analysis, electrophysiologic studies, and a recent history of diarrhea led to the diagnosis of Campylobacter jejuni-related fulminant Guillain-Barré syndrome (GBS) mimicking brain death...
2016: International Medical Case Reports Journal
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