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https://read.qxmd.com/read/30771300/determination-of-serum-neutrophil-gelatinase-associated-lipocalin-as-a-prognostic-biomarker-of-acute-spontaneous-intracerebral-hemorrhage
#1
Sheng Chen, Xia-Chan Chen, Xiao-Hui Lou, Song-Quan Qian, Zhan-Wei Ruan
BACKGROUND: Neutrophil gelatinase-associated lipocalin (NGAL) is currently known as an acute phase protein and implicated in acute brain injury. Herein, we sought to gauge serum NGAL level in patients after acute (<24 h) spontaneous intracerebral hemorrhage (ICH) and to investigate its relation to neurological outcome. METHODS: Serum NGAL levels were measured in 106 patients and 106 controls. National Institutes of Health Stroke Scale (NIHSS) score, Glasgow coma scale (GCS) score, ICH score and hematoma volume were recorded for assessing hemorrhagic severity...
February 13, 2019: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://read.qxmd.com/read/30764902/computed-tomography-with-intravenous-contrast-is-not-associated-with-development-of-acute-kidney-injury-in-severely-injured-pediatric-patients
#2
McGaha Paul K, Jeremy Johnson, Tabitha Garwe, Zoona Sarwar, Prasenjeet Motghare, William Daly, Robert Letton
Data for the incidence of acute kidney injury (AKI) related to intravenous contrast administration in the pediatric trauma population are limited. Obtaining a creatinine value before elective CT scans is a relatively accepted standard of care. We sought to determine whether there was any significant difference in the incidence of AKI between severely injured patients who received IV contrast and those who did not. We reviewed data from the trauma registry at our Level I pediatric trauma center. We limited the patients to severely injured pediatric traumas (<15 years old) directly transported from the scene of injury with a creatinine level measured on arrival...
January 1, 2019: American Surgeon
https://read.qxmd.com/read/30761404/impact-of-pituitary-dysfunction-on-cognitive-and-global-outcome-after-traumatic-brain-injury-and-aneurysmal-subarachnoid-haemorrhage
#3
Anna Tölli, Charlotte Höybye, Bo-Michael Bellander, Jörgen Borg
OBJECTIVE: To explore associations between pituitary dysfunction and clinical outcome at 12 months after traumatic brain injury and aneurysmal subarachnoid haemorrhage. METHODS: Prospective cohort study of 82 patients with traumatic brain injury and 45 with aneurysmal subarachnoid haemorrhage, included at 1 neurointensive care unit. Baseline data comprised age, sex, Glasgow Coma Scale (GCS) score, S100B and pupil light reactions. Hormone data were collected in the neurointensive care unit and 3, 6 and 12 months...
February 14, 2019: Journal of Rehabilitation Medicine
https://read.qxmd.com/read/30760357/computed-tomography-with-intravenous-contrast-is-not-associated-with-development-of-acute-kidney-injury-in-severely-injured-pediatric-patients
#4
McGaha Paul K, Jeremy Johnson, Tabitha Garwe, Zoona Sarwar, Prasenjeet Motghare, William Daly, Robert Letton
Data for the incidence of acute kidney injury (AKI) related to intravenous contrast administration in the pediatric trauma population are limited. Obtaining a creatinine value before elective CT scans is a relatively accepted standard of care. We sought to determine whether there was any significant difference in the incidence of AKI between severely injured patients who received IV contrast and those who did not. We reviewed data from the trauma registry at our Level I pediatric trauma center. We limited the patients to severely injured pediatric traumas (<15 years old) directly transported from the scene of injury with a creatinine level measured on arrival...
January 1, 2019: American Surgeon
https://read.qxmd.com/read/30760295/cerebral-metabolism-is-not-affected-by-moderate-hyperventilation-in-patients-with-traumatic-brain-injury
#5
Giovanna Brandi, Nino Stocchetti, Alberto Pagnamenta, Federica Stretti, Peter Steiger, Stephanie Klinzing
BACKGROUND: Hyperventilation-induced hypocapnia (HV) reduces elevated intracranial pressure (ICP), a dangerous and potentially fatal complication of traumatic brain injury (TBI). HV decreases the arteriolar diameter of intracranial vessels, raising the risk of cerebral ischemia. The aim of this study was to characterize the effects of moderate short-term HV in patients with severe TBI by using concomitant monitoring of cerebral metabolism, brain tissue oxygen tension (PbrO2 ), and cerebral hemodynamics with transcranial color-coded duplex sonography (TCCD)...
February 13, 2019: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/30760289/is-there-an-association-between-female-gender-and-outcome-in-severe-trauma-a-multi-center-analysis-in-the-netherlands
#6
M Pape, G F Giannakópoulos, W P Zuidema, E S M de Lange-Klerk, E J Toor, M J R Edwards, M H J Verhofstad, T N Tromp, E M M van Lieshout, F W Bloemers, L M G Geeraedts
INTRODUCTION: Little evidence suggest that female gender is associated with a lower risk of mortality in severely injured patients, especially in premenopausal women. Previous clinical studies have shown contradictory results regarding protective effects of gender on outcome after severe trauma. The objective of this study was to determine the association between gender and outcome (mortality and Intensive Care Unit (ICU) admission) among severely injured patients in the Netherlands. METHODS: A retrospective multicentre study was performed including all polytrauma patients (Injury Severity Score (ISS) ≥16) admitted to the ED of three level 1 trauma centres, between January 1st, 2006 and December 31st, 2014...
February 13, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://read.qxmd.com/read/30760173/cerebral-autoregulation-guided-optimal-blood-pressure-in-sepsis-associated-encephalopathy-a-case-series
#7
Kathryn Rosenblatt, Keenan A Walker, Carrie Goodson, Elsa Olson, Dermot Maher, Charles H Brown, Paul Nyquist
BACKGROUND: Impaired cerebral autoregulation and cerebral hypoperfusion may play a critical role in the high morbidity and mortality in patients with sepsis-associated encephalopathy (SAE). Bedside assessment of cerebral autoregulation may help individualize hemodynamic targets that optimize brain perfusion. We hypothesize that near-infrared spectroscopy (NIRS)-derived cerebral oximetry can identify blood pressure ranges that enhance autoregulation in patients with SAE and that disturbances in autoregulation are associated with severity of encephalopathy...
February 13, 2019: Journal of Intensive Care Medicine
https://read.qxmd.com/read/30747681/supermassive-transfusion-a-15-year-single-center-experience-and-outcomes
#8
Alison J Yu, Kenji Inaba, Subarna Biswas, Luis Alejandro de Leon, Monica Wong, Elizabeth Benjamin, Lydia Lam, Demetrios Demetriades
The objective of this study was to determine the survival outcome associated with large-volume blood transfusion after trauma. This was a retrospective study at a Level I trauma center from January 2000 to December 2014 that included trauma patients who received ≥25 units packed red blood cell (pRBC) within the first 24 hours of hospital admission. Univariate and multivariable logistic regressions identified risk factors for mortality. Receiver operating characteristic curve analysis evaluated the ability of pRBC volume to predict mortality...
October 1, 2018: American Surgeon
https://read.qxmd.com/read/30747614/location-specific-differences-in-hematoma-volume-predict-outcomes-in-patients-with-spontaneous-intracerebral-hemorrhage
#9
Natasha Ironside, Ching-Jen Chen, Victoria Dreyer, Brandon Christophe, Thomas J Buell, Edward Sander Connolly
BACKGROUND AND OBJECTIVE: Functional outcome after spontaneous intracerebral hemorrhage (ICH) may vary depending on hematoma volume and location. We assessed the interaction between hematoma volume and location, and modified the original ICH score to include such an interaction. METHODS: Consecutive ICH patients were enrolled in the Intracerebral Hemorrhage Outcomes Project from 2009 to 2017. Inclusion criteria were age≥18 years, baseline modified Rankin Scale (mRS) score 0-2, neuroimaging, and follow-up...
February 12, 2019: International Journal of Stroke: Official Journal of the International Stroke Society
https://read.qxmd.com/read/30745195/safety-of-peripheral-line-administration-of-3-hypertonic-saline-and-mannitol-in-the-emergency-department
#10
Elhaam Mesghali, Scott Fitter, Khaled Bahjri, Kayvan Moussavi
BACKGROUND: Hypertonic saline (HTS) and mannitol are frequently utilized in the emergency department (ED) to manage elevations in intracranial pressure (ICP). OBJECTIVE: The objective of this study was to compare the incidence of extravasation injury when HTS or mannitol was administered via peripheral i.v. line (PIV). METHODS: This retrospective cohort study evaluated adult and pediatric patients given either 3% HTS or mannitol via PIV while in the ED...
February 8, 2019: Journal of Emergency Medicine
https://read.qxmd.com/read/30744682/comparison-of-minor-head-trauma-management-in-the-emergency-departments-of-a-united-states-and-italian-children-s-hospital
#11
Brittany M Stopa, Stefano Amoroso, Luca Ronfani, Elena Neri, Egidio Barbi, Lois K Lee
BACKGROUND: Pediatric head trauma management varies between emergency departments globally. Here we aim to compare the pediatric minor head trauma management between a US and Italian hospital. METHODS: We conducted a retrospective chart review of children 0-18 years old presenting after minor head trauma (Glasgow Coma Scale 14-15) from two emergency departments, in Boston, Massachusetts, United States and Trieste, Italy, between January and December 2013. Frequencies of demographic, clinical, and management characteristic were calculated...
February 11, 2019: Italian Journal of Pediatrics
https://read.qxmd.com/read/30743036/predictors-of-surgical-intervention-in-patients-with-spontaneous-intracerebral-hemorrhage
#12
Ching-Jen Chen, Dale Ding, Natasha Ironside, Thomas J Buell, Andrew M Southerland, Daniel Woo, Bradford B Worrall
OBJECTIVE: Despite no clear evidence from randomized trials, surgical intervention of spontaneous intracerebral hemorrhage (ICH) still occurs. We sought to describe the characteristics of patients undergoing surgical intervention in ICH. METHODS: Data from the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study were analyzed, and ICH patients were categorized into surgical intervention or nonoperative management groups. Patients with primary intraventricular hemorrhage (IVH) and those without data regarding the use of surgical intervention data were excluded...
December 18, 2018: World Neurosurgery
https://read.qxmd.com/read/30739747/efficacy-and-safety-of-minimally-invasive-surgery-with-thrombolysis-in-intracerebral-haemorrhage-evacuation-mistie-iii-a-randomised-controlled-open-label-blinded-endpoint-phase-3-trial
#13
Daniel F Hanley, Richard E Thompson, Michael Rosenblum, Gayane Yenokyan, Karen Lane, Nichol McBee, Steven W Mayo, Amanda J Bistran-Hall, Dheeraj Gandhi, W Andrew Mould, Natalie Ullman, Hasan Ali, J Ricardo Carhuapoma, Carlos S Kase, Kennedy R Lees, Jesse Dawson, Alastair Wilson, Joshua F Betz, Elizabeth A Sugar, Yi Hao, Radhika Avadhani, Jean-Louis Caron, Mark R Harrigan, Andrew P Carlson, Diederik Bulters, David LeDoux, Judy Huang, Cully Cobb, Gaurav Gupta, Ryan Kitagawa, Michael R Chicoine, Hiren Patel, Robert Dodd, Paul J Camarata, Stacey Wolfe, Agnieszka Stadnik, P Lynn Money, Patrick Mitchell, Rosario Sarabia, Sagi Harnof, Pal Barzo, Andreas Unterberg, Jeanne S Teitelbaum, Weimin Wang, Craig S Anderson, A David Mendelow, Barbara Gregson, Scott Janis, Paul Vespa, Wendy Ziai, Mario Zuccarello, Issam A Awad
BACKGROUND: Acute stroke due to supratentorial intracerebral haemorrhage is associated with high morbidity and mortality. Open craniotomy haematoma evacuation has not been found to have any benefit in large randomised trials. We assessed whether minimally invasive catheter evacuation followed by thrombolysis (MISTIE), with the aim of decreasing clot size to 15 mL or less, would improve functional outcome in patients with intracerebral haemorrhage. METHODS: MISTIE III was an open-label, blinded endpoint, phase 3 trial done at 78 hospitals in the USA, Canada, Europe, Australia, and Asia...
February 6, 2019: Lancet
https://read.qxmd.com/read/30734879/a-new-simplified-predictive-model-for-mortality-in-methicillin-resistant-staphylococcus-aureus-bacteremia
#14
Sarah C J Jorgensen, Abdalhamid M Lagnf, Sahil Bhatia, Michael J Rybak
Adjustment for confounding is important in observational methicillin-resistant Staphylococcus aureus bacteremia (MRSAB) studies due to the wide spectrum of disease severity and baseline health status that patients present with. The objectives of this study were to develop a simplified MRSAB-specific scoring model to estimate the risk of 30-day all-cause mortality and to compare its performance to the APACHE II and Pitt Bacteremia scores. Retrospective, singe-center, cohort study in adults with MRSAB 2008 to 2018...
February 8, 2019: European Journal of Clinical Microbiology & Infectious Diseases
https://read.qxmd.com/read/30734247/first-reported-human-case-of-meningitis-by-staphylococcus-condimenti
#15
Erika Zecca, Martina Costanzo, Alessandro Croce, Daniele Sola, Alice Pirovano, Erica Matino, Mario Pirisi
Staphylococcus condimenti (S. condimenti) is a coagulase-negative bacterium, generally regarded as not pathogenic. Indeed, S. condimenti owes its name to having been isolated from starter cultures of fermented sausage, as well as from fish and soy sauces. To the best of our knowledge, only two cases of human infection caused by this bacterium have been reported. Here, we present a case of meningitis by S. condimenti in a 65-year-old woman who was brought to hospital after having been found unconscious at home...
February 7, 2019: Infection
https://read.qxmd.com/read/30725141/acute-kidney-injury-in-trauma-patients-admitted-to-the-icu-a-systematic-review-and-meta-analysis
#16
REVIEW
Signe Søvik, Marie Susanna Isachsen, Kine Marie Nordhuus, Christine Kooy Tveiten, Torsten Eken, Kjetil Sunde, Kjetil Gundro Brurberg, Sigrid Beitland
PURPOSE: To perform a systematic review and meta-analysis of acute kidney injury (AKI) in trauma patients admitted to the intensive care unit (ICU). METHODS: We conducted a systematic literature search of studies on AKI according to RIFLE, AKIN, or KDIGO criteria in trauma patients admitted to the ICU (PROSPERO CRD42017060420). We searched PubMed, Cochrane Database of Systematic Reviews, UpToDate, and NICE through 3 December 2018. Data were collected on incidence of AKI, risk factors, renal replacement therapy (RRT), renal recovery, length of stay (LOS), and mortality...
February 6, 2019: Intensive Care Medicine
https://read.qxmd.com/read/30725101/development-and-validation-of-a-prediction-model-for-prehospital-triage-of-trauma-patients
#17
Eveline A J van Rein, Rogier van der Sluijs, Frank J Voskens, Koen W W Lansink, R Marijn Houwert, Rob A Lichtveld, Mariska A de Jongh, Marcel G W Dijkgraaf, Howard R Champion, Frank J P Beeres, Luke P H Leenen, Mark van Heijl
Importance: Prehospital trauma triage protocols are used worldwide to get the right patient to the right hospital and thereby improve the chance of survival and avert lifelong disabilities. The American College of Surgeons Committee on Trauma set target levels for undertriage rates of less than 5%. None of the existing triage protocols has been able to achieve this target in isolation. Objective: To develop and validate a new prehospital trauma triage protocol to improve current triage rates...
February 6, 2019: JAMA Surgery
https://read.qxmd.com/read/30721773/improving-survival-with-tranexamic-acid-in-cerebral-contusions-or-traumatic-subarachnoid-hemorrhage-univariate-and-multivariate-analysis-on-independent-factors-associated-with-lower-mortality
#18
David Yuen Chung Chan, Anderson Chun On Tsang, Lai Fung Li, Kevin King Fai Cheng, Frederick Chun Pong Tsang, Benedict Beng Teck Taw, Jenny Kan Suen Pu, Wilson Wai Shing Ho, Wai Man Lui, Gilberto Ka Kit Leung
BACKGROUND: Fall with head injury is an epidemic challenge especially with the aging population. Contributing factors for mortality included the development of cerebral contusions and delayed traumatic intracerebral hematoma. Currently, there is no established treatment for these conditions. OBJECT: This study aimed to investigate the impact of independent factors on the mortality rate of traumatic brain injury with contusions or traumatic subarachnoid hemorrhage...
February 2, 2019: World Neurosurgery
https://read.qxmd.com/read/30721540/multi-centre-study-found-that-strict-adherence-to-guidelines-led-to-computed-tomography-scans-being-overused-in-children-with-minor-head-injuries
#19
Nicky Niele, Marlies van Houten, Bart Boersma, Maarten Biezeveld, Matthijs Douma, Katja Heitink, Gavin W Ten Tusscher, Ellen Tromp, J B van Goudoever, Frans B Plötz
AIM: Our primary aim was to calculate the head computed tomography (CT) scan rate in children with a minor head injury (MHI) when the Dutch National guidelines were followed in clinical practice. The secondary aim was to determine the incidence of CT abnormalities and the guideline predictors associated with traumatic abnormalities. METHODS: We performed a multi-centre, prospective observational cross-sectional study in the emergency departments of six hospitals in The Netherlands between 1 April 2015 and 31 December 2016...
February 5, 2019: Acta Paediatrica
https://read.qxmd.com/read/30717052/neutrophil-to-lymphocyte-ratio-as-an-independent-predictor-for-unfavorable-functional-outcome-in-aneurysmal-subarachnoid-hemorrhage
#20
Antje Giede-Jeppe, Jonathan Reichl, Maximilian I Sprügel, Hannes Lücking, Philip Hoelter, Ilker Y Eyüpoglu, Joji B Kuramatsu, Hagen B Huttner, Stefan T Gerner
OBJECTIVEStroke-associated immunosuppression and inflammation are increasingly recognized as factors triggering infections and thus potentially influencing outcome after stroke. Several studies have demonstrated that elevated neutrophil-to-lymphocyte ratio (NLR) is a significant predictor of adverse outcomes for patients with ischemic stroke or intracerebral hemorrhage. Thus far, in patients with subarachnoid hemorrhage the association between NLR and outcome is insufficiently established. The authors sought to investigate the association between NLR on admission and functional outcome in aneurysmal subarachnoid hemorrhage (aSAH)...
February 1, 2019: Journal of Neurosurgery
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