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[PMID]:28457510
[Au] Autor:Kanawaku Y; Hirakawa K; Koike K; Kanetake J; Ohno Y
[Ad] Endereço:Department of Legal Medicine, Nippon Medical School, 1-1-5 Sendagi Bunkyo-ku, Tokyo 113-8602, Japan. Electronic address: ykanawaku@nifty.com.
[Ti] Título:Pattern recognition analysis of proton nuclear magnetic resonance spectra of postmortem cerebrospinal fluid from rats with drug-induced seizure or coma.
[So] Source:Leg Med (Tokyo);25:52-58, 2017 Mar.
[Is] ISSN:1873-4162
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:Cerebrospinal fluid (CSF) is routinely subjected to gross evaluation in postmortem investigations; however, its use in chemical evaluations has not been fully realized. Analysis of nuclear magnetic resonance (NMR) spectra with pattern recognition methods was applied to CSF samples. Rats were treated with pentylenetetrazol (PTZ) to induce seizure or pentobarbital (PB) to induce coma, and postmortem CSF was collected after CO gas euthanization. Pattern recognition analysis of the NMR data was performed on individual postmortem CSF samples. The aim of this study was to determine if pattern recognition analysis of NMR data could be used to classify the rats according to their drug treatment. The applicability of NMR data with pattern recognition analysis using postmortem CSF was also assessed. Partial Least Squares-Discriminant Analysis (PLS-DA) score plots indicated that the PTZ, PB, and NS (control) groups were clustered and clearly separated. PLS-DA correlation loading plots showed respective spectral and category variances of 41% and 42% for factor 1, and 17% and 27% for factor 2. Thus, factors 1 and 2 together described 58% (41%+17%) and 69% (42%+27%) of the variation, respectively. NMR study of postmortem CSF has the potential to be utilized as both a novel forensic neurochemistry method and in the clinical setting.
[Mh] Termos MeSH primário: Líquido Cefalorraquidiano/efeitos dos fármacos
Coma/induzido quimicamente
Espectroscopia de Ressonância Magnética
Mudanças Depois da Morte
Convulsões/induzido quimicamente
[Mh] Termos MeSH secundário: Animais
Convulsivantes/toxicidade
Análise Discriminante
Hipnóticos e Sedativos/toxicidade
Metabolômica
Pentobarbital/toxicidade
Pentilenotetrazol/toxicidade
Ratos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Convulsants); 0 (Hypnotics and Sedatives); I4744080IR (Pentobarbital); WM5Z385K7T (Pentylenetetrazole)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE


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[PMID]:29443784
[Au] Autor:Namatame C; Sonoo T; Fukushima K; Naraba H; Hashimoto H; Nakamura K
[Ad] Endereço:Department of Emergency and Critical Care Medicine, Hitachi General Hospital, Johnan-cho, Hitachi, Ibaraki, Japan.
[Ti] Título:A thyroid storm patient with protracted disturbance of consciousness and reversible lesion in the splenium of corpus callosum: A case report.
[So] Source:Medicine (Baltimore);97(7):e9949, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Various neurological manifestations are observed in thyroid storm patients but protracted disturbance of consciousness is rare. PATIENT CONCERNS: A 58-year-old male was admitted to our hospital after a traffic accident. DIAGNOSES: Although awake on arrival, he fell into coma after admission. Based on the clinical symptoms and hyperthyroidism, the patient was diagnosed with thyroid storm (TS). INTERVENTIONS: Even after improvement of hyperthyroidism, disturbance of consciousness was protracted. Considering the possibility of immune-related etiology, methylprednisolone pulse was started. OUTCOMES: His consciousness level improved over a 3-month period, and he became able to walk with some assistance after 6 months. LESSONS: His condition was atypical of TS-associated encephalopathy because of the long clinical course. Reversible splenial lesion was visible using brain imaging. In some cases of TS, disturbance of consciousness can be protracted for several months, but it is reversible. Therefore, it is necessary to judge the long-term neurological outcome carefully.
[Mh] Termos MeSH primário: Coma/etiologia
Corpo Caloso/diagnóstico por imagem
Crise Tireóidea/complicações
Crise Tireóidea/diagnóstico por imagem
[Mh] Termos MeSH secundário: Acidentes de Trânsito
Coma/diagnóstico por imagem
Glucocorticoides/uso terapêutico
Seres Humanos
Hipertireoidismo/complicações
Hipertireoidismo/tratamento farmacológico
Imagem por Ressonância Magnética
Masculino
Metilprednisolona/uso terapêutico
Meia-Idade
Crise Tireóidea/tratamento farmacológico
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids); X4W7ZR7023 (Methylprednisolone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009949


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[PMID]:28455458
[Au] Autor:Seyani C; Green P; Daniel L; Pegden A
[Ad] Endereço:Great Western Hospital, Swindon, UK.
[Ti] Título:An interesting case of opium tea toxicity.
[So] Source:BMJ Case Rep;2017, 2017 Apr 28.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:We present an unusual cause of respiratory arrest resulting from sole ingestion of home-brewed opium tea. A 64-year-old woman was found unresponsive and in respiratory arrest by a first responder. There were no obvious signs of regular recreational drug use. On presentation to the local district general hospital, the patient was in extremis, with severe physiological and biochemical derangements. A naloxone infusion was commenced and she later made a good recovery. It was subsequently discovered that she had brewed opium tea from opium buds she had picked from a nearby commercial poppy farm, a practice she had learnt while in Afghanistan.
[Mh] Termos MeSH primário: Transtornos Relacionados ao Uso de Opioides/diagnóstico
Ópio/toxicidade
Chá/toxicidade
[Mh] Termos MeSH secundário: Administração Intravenosa
Afeganistão
Coma/diagnóstico
Coma/etiologia
Feminino
Seres Humanos
Meia-Idade
Naloxona/administração & dosagem
Naloxona/uso terapêutico
Antagonistas de Entorpecentes/administração & dosagem
Antagonistas de Entorpecentes/uso terapêutico
Transtornos Relacionados ao Uso de Opioides/epidemiologia
Ópio/administração & dosagem
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Narcotic Antagonists); 0 (Tea); 36B82AMQ7N (Naloxone); 8008-60-4 (Opium)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE


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[PMID]:27776491
[Au] Autor:Salahuddin N; Mohamed A; Alharbi N; Ansari H; Zaza KJ; Marashly Q; Hussain I; Solaiman O; Wetterberg TV; Maghrabi K
[Ad] Endereço:Adult Critical Care Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, 11211, Saudi Arabia. nsalahuddin@kfsh.edu.sa.
[Ti] Título:The incidence of increased ICP in ICU patients with non-traumatic coma as diagnosed by ONSD and CT: a prospective cohort study.
[So] Source:BMC Anesthesiol;16(1):106, 2016 10 25.
[Is] ISSN:1471-2253
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Unexplained coma after critical illness can be multifactorial. We evaluated the diagnostic ability of bedside Optic Nerve Sheath Diameter [ONSD] as a screening test for non-traumatic radiographic cerebral edema. METHODS: In a prospective study, mixed medical-surgical intensive care units [ICU] patients with non-traumatic coma [GCS < 9] underwent bedside ultrasonographic ONSD measurements. Non-traumatic radiographic cerebral edema [NTRCE] was defined as > 5 mm midline shift, cisternal, sulcal effacement, or hydrocephalus on CT. RESULTS: NTRCE was identified in 31 of 102 patients [30.4 %]. The area under the ROC curve for detecting radiographic edema by ONSD was 0.785 [95 % CI 0.695-0.874, p <0.001]. ONSD diameter of 0.57 cm was found to be the best cutoff threshold with a sensitivity 84 % and specificity 71 %, AUC 0.785 [95 % CI 0.695-0.874, p <0.001]. Using ONSD as a bedside test increased the post-test odds ratio [OR] for NTRCE by 2.89 times [positive likelihood ratio], whereas post-test OR for NTRCE decreased markedly given a negative ONSD test [ONSD measurement less than 0.57 cm]; negative likelihood ratio 0.22. CONCLUSIONS: The use of ONSD as a bedside test in patients with non-traumatic coma has diagnostic value in identifying patients with non-traumatic radiographic cerebral edema.
[Mh] Termos MeSH primário: Edema Encefálico/fisiopatologia
Coma/diagnóstico por imagem
Hipertensão Intracraniana/epidemiologia
Pressão Intracraniana/fisiologia
Nervo Óptico/diagnóstico por imagem
[Mh] Termos MeSH secundário: Edema Encefálico/complicações
Edema Encefálico/epidemiologia
Coma/fisiopatologia
Feminino
Seres Humanos
Incidência
Unidades de Terapia Intensiva
Hipertensão Intracraniana/complicações
Hipertensão Intracraniana/diagnóstico por imagem
Masculino
Meia-Idade
Estudos Prospectivos
Arábia Saudita/epidemiologia
Tomografia Computadorizada por Raios X
Ultrassonografia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171204
[Lr] Data última revisão:
171204
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


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[PMID]:28957432
[Au] Autor:Modi HR; Wang Q; Gd S; Sherman D; Greenwald E; Savonenko AV; Geocadin RG; Thakor NV
[Ad] Endereço:Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
[Ti] Título:Intranasal post-cardiac arrest treatment with orexin-A facilitates arousal from coma and ameliorates neuroinflammation.
[So] Source:PLoS One;12(9):e0182707, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cardiac arrest (CA) entails significant risks of coma resulting in poor neurological and behavioral outcomes after resuscitation. Significant subsequent morbidity and mortality in post-CA patients are largely due to the cerebral and cardiac dysfunction that accompanies prolonged whole-body ischemia post-CA syndrome (PCAS). PCAS results in strong inflammatory responses including neuroinflammation response leading to poor outcome. Currently, there are no proven neuroprotective therapies to improve post-CA outcomes apart from therapeutic hypothermia. Furthermore, there are no acceptable approaches to promote cortical or cognitive arousal following successful return of spontaneous circulation (ROSC). Hypothalamic orexinergic pathway is responsible for arousal and it is negatively affected by neuroinflammation. However, whether activation of the orexinergic pathway can curtail neuroinflammation is unknown. We hypothesize that targeting the orexinergic pathway via intranasal orexin-A (ORXA) treatment will enhance arousal from coma and decrease the production of proinflammatory cytokines resulting in improved functional outcome after resuscitation. We used a highly validated CA rat model to determine the effects of intranasal ORXA treatment 30-minute post resuscitation. At 4hrs post-CA, the mRNA levels of proinflammatory markers (IL1ß, iNOS, TNF-α, GFAP, CD11b) and orexin receptors (ORX1R and ORX2R) were examined in different brain regions. CA dramatically increased proinflammatory markers in all brain regions particularly in the prefrontal cortex, hippocampus and hypothalamus. Post-CA intranasal ORXA treatment significantly ameliorated the CA-induced neuroinflammatory markers in the hypothalamus. ORXA administration increased production of orexin receptors (ORX1R and ORX2R) particularly in hypothalamus. In addition, ORXA also resulted in early arousal as measured by quantitative electroencephalogram (EEG) markers, and recovery of the associated behavioral neurologic deficit scale score (NDS). Our results indicate that intranasal delivery of ORXA post-CA has an anti-inflammatory effect and accelerates cortical EEG and behavioral recovery. Beneficial outcomes from intranasal ORXA treatment lay the groundwork for therapeutic clinical approach to treating post-CA coma.
[Mh] Termos MeSH primário: Nível de Alerta
Encéfalo/patologia
Coma/tratamento farmacológico
Coma/fisiopatologia
Inflamação/tratamento farmacológico
Orexinas/administração & dosagem
Orexinas/uso terapêutico
[Mh] Termos MeSH secundário: Administração Intranasal
Animais
Nível de Alerta/efeitos dos fármacos
Comportamento Animal/efeitos dos fármacos
Biomarcadores/metabolismo
Encéfalo/efeitos dos fármacos
Encéfalo/fisiopatologia
Coma/complicações
Eletroencefalografia
Ritmo Gama/efeitos dos fármacos
Parada Cardíaca/fisiopatologia
Hemodinâmica/efeitos dos fármacos
Inflamação/complicações
Inflamação/patologia
Masculino
Receptores de Orexina/genética
Receptores de Orexina/metabolismo
Orexinas/farmacologia
RNA Mensageiro/genética
RNA Mensageiro/metabolismo
Ratos Wistar
Ressuscitação
Cloreto de Sódio/administração & dosagem
Cloreto de Sódio/farmacologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Orexin Receptors); 0 (Orexins); 0 (RNA, Messenger); 451W47IQ8X (Sodium Chloride)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170929
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0182707


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[PMID]:28906367
[Au] Autor:Huang HS; Hsu CC; Ye JC; Su SB; Huang CC; Lin HJ
[Ad] Endereço:aDepartment of Emergency Medicine bDepartment of Occupational Medicine, Chi-Mei Medical Center cDepartment of Biotechnology, Southern Taiwan University of Science and Technology dBachelor Program of Senior Service eDepartment of Leisure, Recreation, and Tourism Management, Southern Taiwan University of Science and Technology fDepartment of Medical Research, Chi-Mei Medical Center, Liouying gDepartment of Environmental and Occupational Health, College of Medicine, National Cheng Kung University hDepartment of Geriatrics and Gerontology, Chi-Mei Medical Center iDepartment of Emergency Medicine, Taipei Medical University, Taipei, Taiwan.
[Ti] Título:Predicting the mortality in geriatric patients with dengue fever.
[So] Source:Medicine (Baltimore);96(37):e7878, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Geriatric patients have high mortality for dengue fever (DF); however, there is no adequate method to predict mortality in geriatric patients. Therefore, we conducted this study to develop a tool in an attempt to address this issue.We conducted a retrospective case-control study in a tertiary medical center during the DF outbreak in Taiwan in 2015. All the geriatric patients (aged ≥65 years) who visited the study hospital between September 1, 2015, and December 31, 2015, were recruited into this study. Variables included demographic data, vital signs, symptoms and signs, comorbidities, living status, laboratory data, and 30-day mortality. We investigated independent mortality predictors by univariate analysis and multivariate logistic regression analysis and then combined these predictors to predict the mortality.A total of 627 geriatric DF patients were recruited, with a mortality rate of 4.3% (27 deaths and 600 survivals). The following 4 independent mortality predictors were identified: severe coma [Glasgow Coma Scale: ≤8; adjusted odds ratio (AOR): 11.36; 95% confidence interval (CI): 1.89-68.19], bedridden (AOR: 10.46; 95% CI: 1.58-69.16), severe hepatitis (aspartate aminotransferase >1000 U/L; AOR: 96.08; 95% CI: 14.11-654.40), and renal failure (serum creatinine >2 mg/dL; AOR: 6.03; 95% CI: 1.50-24.24). When we combined the predictors, we found that the sensitivity, specificity, positive predictive value, and negative predictive value for patients with 1 or more predictors were 70.37%, 88.17%, 21.11%, and 98.51%, respectively. For patients with 2 or more predictors, the respective values were 33.33%, 99.44%, 57.14%, and 98.51%.We developed a new method to help decision making. Among geriatric patients with none of the predictors, the survival rate was 98.51%, and among those with 2 or more predictors, the mortality rate was 57.14%. This method is simple and useful, especially in an outbreak.
[Mh] Termos MeSH primário: Dengue/diagnóstico
Dengue/mortalidade
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estudos de Casos e Controles
Coma/complicações
Coma/mortalidade
Dengue/complicações
Feminino
Escala de Coma de Glasgow
Hepatite/complicações
Hepatite/mortalidade
Seres Humanos
Modelos Logísticos
Masculino
Análise Multivariada
Razão de Chances
Insuficiência Renal/complicações
Insuficiência Renal/mortalidade
Estudos Retrospectivos
Sensibilidade e Especificidade
Análise de Sobrevida
Taiwan
Centros de Atenção Terciária
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007878


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[PMID]:28888275
[Au] Autor:Ameloot K; De Deyne C; Ferdinande B; Dupont M; Palmers PJ; Petit T; Eertmans W; Moonen C; Belmans A; Lemmens R; Dens J; Janssens S
[Ad] Endereço:Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium; Department of Cardiology, University Hospitals Leuven, Leuven, Belgium. Electronic address: koen.ameloot@uzleuven.be.
[Ti] Título:Mean arterial pressure of 65 mm Hg versus 85-100 mm Hg in comatose survivors after cardiac arrest: Rationale and study design of the Neuroprotect post-cardiac arrest trial.
[So] Source:Am Heart J;191:91-98, 2017 Sep.
[Is] ISSN:1097-6744
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Post-cardiac arrest (CA) patients admitted to the intensive care unit (ICU) have a poor prognosis, with estimated survival rates of around 30%-50%. On admission, these patients have a large cerebral penumbra at risk for additional damage in case of suboptimal brain oxygenation during their stay in the ICU. The aim of the Neuroprotect post-CA trial is to investigate whether forcing mean arterial blood pressure (MAP) and mixed venous oxygen saturation (SVO ) in a specific range (MAP 85-100 mm Hg, SVO 65%-75%) with additional pharmacological support (goal-directed hemodynamic optimization) may better salvage the penumbra, reduce cerebral ischemia, and improve functional outcome when compared with current standard of care (MAP 65 mm Hg). DESIGN: The Neuroprotect post-CA trial (NCT02541591) is a multicenter, randomized, parallel-group, open-label, assessor-blinded, monitored, and investigator-driven clinical trial. The trial will be conducted in 2 tertiary care hospitals in Belgium (UZ Leuven and ZOL-Genk). A total of 112 eligible patients will be randomly assigned in a 1:1 ratio to goal-directed hemodynamic optimization or standard care strategy by an interactive voice response system. Patients will be stratified according to the presence of an initial shockable rhythm. Adult patients (≥18 years) resuscitated from out-of-hospital CA of a presumed cardiac cause who are unconscious upon hospital admission are eligible for inclusion. Patients can be included irrespective of their presenting heart rhythm but need to have a sustained return of spontaneous circulation. Trial interventions will take 36 hours starting from ICU admission. The primary outcome is the extent of cerebral ischemia as quantified by the apparent diffusion coefficient on diffusion-weighted magnetic resonance imaging to be performed at day 4-5 post-CA. Secondary outcomes include surrogate biomarkers of brain injury (neuron specific enolase) at day 1-5, neuropsychological and functional testing at hospital discharge, a Short Form-36 health questionnaire at 180 days, and outcome as assessed with cerebral performance category scores at ICU discharge and at 180 days. CONCLUSIONS: The Neuroprotect post-CA trial will investigate whether a more aggressive hemodynamic strategy to obtain a MAP 85-100 mm Hg and SVO 65%-75% reduces brain ischemia and improves outcome when compared with standard treatment (MAP 65 mm Hg) in comatose post-CA survivors.
[Mh] Termos MeSH primário: Pressão Arterial/fisiologia
Reanimação Cardiopulmonar/métodos
Coma/fisiopatologia
Unidades de Terapia Intensiva
Parada Cardíaca Extra-Hospitalar/complicações
[Mh] Termos MeSH secundário: Bélgica/epidemiologia
Encéfalo/patologia
Coma/etiologia
Coma/mortalidade
Imagem de Difusão por Ressonância Magnética
Feminino
Seres Humanos
Masculino
Parada Cardíaca Extra-Hospitalar/mortalidade
Parada Cardíaca Extra-Hospitalar/terapia
Prognóstico
Método Simples-Cego
Taxa de Sobrevida/tendências
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170911
[St] Status:MEDLINE


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[PMID]:28844532
[Au] Autor:Mezuki S; Shono Y; Akahoshi T; Hisanaga K; Saeki H; Nakashima Y; Momii K; Maki J; Tokuda K; Maehara Y
[Ad] Endereço:Emergency and Critical Care Center, Kyushu University Hospital, Fukuoka, Japan.
[Ti] Título:Esophageal perforation due to blunt chest trauma: Difficult diagnosis because of coexisting severe disturbance of consciousness.
[So] Source:Am J Emerg Med;35(11):1790.e3-1790.e5, 2017 Nov.
[Is] ISSN:1532-8171
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Esophageal perforation due to blunt trauma is a rare clinical condition, and the diagnosis is often difficult because patients have few specific symptoms. Delayed diagnosis may result in a fatal clinical course due to mediastinitis and subsequent sepsis. In this article, we describe a 26-year-old man with esophageal perforation due to blunt chest trauma resulting from a motor vehicle accident. Because a severe disturbance of consciousness masked the patient's trauma-induced thoracic symptoms, we required 11h to diagnose the esophageal perforation. Therefore, the patient developed septic shock due to mediastinitis. However, his subsequent clinical course was good because of prompt combined therapy involving surgical repair and medical treatment after the diagnosis.
[Mh] Termos MeSH primário: Acidentes de Trânsito
Perfuração Esofágica/etiologia
Mediastinite/etiologia
Choque Séptico/etiologia
Traumatismos Torácicos/complicações
Ferimentos não Penetrantes/complicações
[Mh] Termos MeSH secundário: Adulto
Coma/complicações
Diagnóstico Tardio
Perfuração Esofágica/diagnóstico
Perfuração Esofágica/cirurgia
Esofagoscopia
Escala de Coma de Glasgow
Hemotórax/diagnóstico por imagem
Hemotórax/etiologia
Seres Humanos
Masculino
Enfisema Mediastínico/diagnóstico por imagem
Enfisema Mediastínico/etiologia
Mediastinite/diagnóstico por imagem
Pneumotórax/complicações
Pneumotórax/diagnóstico por imagem
Radiografia Torácica
Enfisema Subcutâneo/diagnóstico por imagem
Enfisema Subcutâneo/etiologia
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170829
[St] Status:MEDLINE


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[PMID]:28767605
[Au] Autor:Fang YQ; Zhan RC; Jia W; Zhang BQ; Wang JJ
[Ad] Endereço:aDepartment of Neurology bDepartment of Neurosurgery cDepartment of Gastroenterology, Qianfoshan Hospital, Shandong University, Jinan dWeifang Medical University, Weifang, Shandong, China.
[Ti] Título:A case report of intraventricular tigecycline therapy for intracranial infection with extremely drug resistant Acinetobacter baumannii.
[So] Source:Medicine (Baltimore);96(31):e7703, 2017 Aug.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Intracranial infection with Acinetobacter baumannii is a tough problem due to the presence of multiresistance and drugs poor penetration through the blood brain barrier (BBB). Tigecycline is effective to cure A baumannii, but it can only be used intravenously which is also difficult to pass BBB. So, it will be a breakthrough if intraventricular (IVT) tigecycline is used in the clinical therapy. However, this treatment has been reported quite rarely until now. PATIENT CONCERNS: We described a case of a 50-year-old male worker whose clinical futures were high fever and cerebral rigidity after neurosurgery. DIAGNOSES: Intracranial infection with extensive drug resistant (XDR) A baumannii. INTERVENTIONS: The patient was treated with IVT tigecycline. OUTCOMES: The symptoms of intracranial infection disappeared. The temperature of this patient decreased to normal and cerebral rigidity disappeared. The cerebrospinal fluid culture became negative, with normal levels of white blood cell, glucose and chlorine. LESSONS: IVT tigecycline therapy maybe effective to intracranial infection with XDR A baumannii. However, more studies will further demonstrate the therapeutic values of IVT tigecycline to intracranial infection, and not only restricted to A baumannii infections.
[Mh] Termos MeSH primário: Infecções por Acinetobacter/tratamento farmacológico
Acinetobacter baumannii
Antibacterianos/administração & dosagem
Infecções do Sistema Nervoso Central/tratamento farmacológico
Minociclina/análogos & derivados
Infecção da Ferida Cirúrgica/tratamento farmacológico
[Mh] Termos MeSH secundário: Infecções por Acinetobacter/complicações
Infecções por Acinetobacter/etiologia
Infecções do Sistema Nervoso Central/etiologia
Coma/complicações
Farmacorresistência Bacteriana Múltipla
Seres Humanos
Injeções Intraventriculares
Masculino
Meia-Idade
Minociclina/administração & dosagem
Procedimentos Neurocirúrgicos
Infecção da Ferida Cirúrgica/complicações
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 70JE2N95KR (tigecycline); FYY3R43WGO (Minocycline)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007703


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[PMID]:28753456
[Au] Autor:Ruijter BJ; Hofmeijer J; Meijer HGE; van Putten MJAM
[Ad] Endereço:Clinical Neurophysiology, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Hallenweg 15, 7522NB Enschede, The Netherlands. Electronic address: b.j.ruijter@utwente.nl.
[Ti] Título:Synaptic damage underlies EEG abnormalities in postanoxic encephalopathy: A computational study.
[So] Source:Clin Neurophysiol;128(9):1682-1695, 2017 Sep.
[Is] ISSN:1872-8952
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: In postanoxic coma, EEG patterns indicate the severity of encephalopathy and typically evolve in time. We aim to improve the understanding of pathophysiological mechanisms underlying these EEG abnormalities. METHODS: We used a mean field model comprising excitatory and inhibitory neurons, local synaptic connections, and input from thalamic afferents. Anoxic damage is modeled as aggravated short-term synaptic depression, with gradual recovery over many hours. Additionally, excitatory neurotransmission is potentiated, scaling with the severity of anoxic encephalopathy. Simulations were compared with continuous EEG recordings of 155 comatose patients after cardiac arrest. RESULTS: The simulations agree well with six common categories of EEG rhythms in postanoxic encephalopathy, including typical transitions in time. Plausible results were only obtained if excitatory synapses were more severely affected by short-term synaptic depression than inhibitory synapses. CONCLUSIONS: In postanoxic encephalopathy, the evolution of EEG patterns presumably results from gradual improvement of complete synaptic failure, where excitatory synapses are more severely affected than inhibitory synapses. The range of EEG patterns depends on the excitation-inhibition imbalance, probably resulting from long-term potentiation of excitatory neurotransmission. SIGNIFICANCE: Our study is the first to relate microscopic synaptic dynamics in anoxic brain injury to both typical EEG observations and their evolution in time.
[Mh] Termos MeSH primário: Coma/fisiopatologia
Eletroencefalografia/tendências
Parada Cardíaca/fisiopatologia
Hipóxia Encefálica/fisiopatologia
Redes Neurais (Computação)
Sinapses/fisiologia
[Mh] Termos MeSH secundário: Idoso
Coma/diagnóstico
Coma/epidemiologia
Feminino
Parada Cardíaca/diagnóstico
Parada Cardíaca/epidemiologia
Seres Humanos
Hipóxia Encefálica/diagnóstico
Hipóxia Encefálica/epidemiologia
Potenciação de Longa Duração/fisiologia
Masculino
Potenciais da Membrana/fisiologia
Meia-Idade
Países Baixos/epidemiologia
Transmissão Sináptica/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170831
[Lr] Data última revisão:
170831
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170729
[St] Status:MEDLINE



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