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By Richard Gough Paramedic tutor, Post Qualification Manager
Alica M Goldman
PURPOSE OF REVIEW: Human and experimental research has identified cardioautonomic and respiratory dysfunction as a frequent accompaniment in human and animal model events of sudden unexpected death in epilepsy (SUDEP). This review aims to provide an overview of the scientific evidence behind the currently accepted risk factors and working hypotheses regarding SUDEP pathophysiology. RECENT FINDINGS: Epidemiological analysis of public health burden of SUDEP has shown that it rates second only to stroke in the years of potential life lost...
April 2015: Current Opinion in Neurology
Mika Rockholt, Carlos Cervera
A previously healthy 48-year-old man was admitted to the hospital after a sudden fever and loss of consciousness. He had no history of recent travel outside Spain. Cranial computed tomography revealed dilatation of the ventricular system and diffuse cerebral edema, which had caused collapse of the..
October 9, 2014: New England Journal of Medicine
Jason J Chang, Nerses Sanossian
BACKGROUND: Intracerebral hemorrhage is associated with poor clinical outcome and high mortality. Research and treatment modalities have focused on the expansion of the primary hematoma through blood pressure control and activation of coagulation factors. However, clinical trials have failed to show decreased rates of death or disability in intracerebral hemorrhage following hospital initiation of blood pressure control. However, as clinical deterioration often occurs immediately after onset, pre-hospital initiation of blood pressure control may be more ideal...
November 14, 2013: Journal of Neurological Disorders
Jennifer R Tomasone, Kathleen A Martin Ginis, Wayland Pulkkinen, Andrei Krassioukov
CONTEXT/OBJECTIVE: Despite availability of clinical practice guidelines (CPGs), gaps in autonomic dysreflexia (AD) knowledge and practice persist. A free, online educational module, the "ABCs of AD", was developed to improve knowledge of the AD-CPGs among emergency healthcare personnel. We examine short-term changes in paramedic and nurse trainees' knowledge of, and social cognitions towards using, the AD-CPGs following module completion. DESIGN: Pre-post. METHODS: Thirty-four paramedic and nurse trainees from two training programs in Canada completed measures immediately before and after viewing the online "ABCs of AD" module...
September 2014: Journal of Spinal Cord Medicine
Nichole Bosson, Genevieve Santillanes, Amy H Kaji, Andrea Fang, Tasha Fernando, Margaret Huang, Jumie Lee, Marianne Gausche-Hill
STUDY OBJECTIVE: Apnea is a known complication of pediatric seizures, but patient factors that predispose children are unclear. We seek to quantify the risk of apnea attributable to midazolam and identify additional risk factors for apnea in children transported by paramedics for out-of-hospital seizure. METHODS: This is a 2-year retrospective study of pediatric patients transported by paramedics to 2 tertiary care centers. Patients were younger than 15 years and transported by paramedics to the pediatric emergency department (ED) for seizure...
March 2014: Annals of Emergency Medicine
Anna Maria Malfitano, Giuseppe Marasco, Maria Chiara Proto, Chiara Laezza, Patrizia Gazzerro, Maurizio Bifulco
Statins have, at present, the potential to provide a new therapeutic target for various neurological diseases. It is well established that statins reduce cholesterol levels and prevent coronary heart disease. Moreover, evidence suggest that statins have additional properties such as endothelial protection via action on the nitric oxide synthase system as well as antioxidant, anti-inflammatory and anti-platelet effects. These properties might have potential therapeutic implication not only in stroke but also in neurological disorders such as Alzheimer disease, Parkinson's disease, multiple sclerosis and primary brain tumors...
October 2014: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Jonathan A Edlow, Alejandro Rabinstein, Stephen J Traub, Eelco F M Wijdicks
Because coma has many causes, physicians must develop a structured, algorithmic approach to diagnose and treat reversible causes rapidly. The three main mechanisms of coma are structural brain lesions, diffuse neuronal dysfunction, and, rarely, psychiatric causes. The first priority is to stabilise the patient by treatment of life-threatening conditions, then to use the history, physical examination, and laboratory findings to identify structural causes and diagnose treatable disorders. Some patients have a clear diagnosis...
December 6, 2014: Lancet
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