Sex Differences in Sex Hormone Profiles and Prediction of Consciousness Recovery After Severe Traumatic Brain Injury
Conclusion: These findings indicate that TBI differentially affects the levels of sex-steroid hormones in men and women patients. Plasma levels of testosterone could be a good candidate blood marker to predict recovery from unconsciousness after sTBI for male patients. Introduction Traumatic brain injury (TBI) is a major cause of death and disability worldwide and is increasing in incidence (1). Patients with acute severe TBI (sTBI) often develop severe disorders of consciousness, i.e., coma, minimally conscious state or vegetative state. Although many patients may regain consciousness during the 1-month post-TBI period, the minimal conscious state may also develop into a chronic and even permanent state (2). Early detection of consciousness in patients with TBI could predict subsequent recovery of neurological function since early recovery of consciousness is closely related to better long-term functional outcomes (3). However, there is an ongoing debate about the clinical assessment of consciousness, which relies on inferences obtained from observed responses to external stimuli. This clinical evaluation of consciousness may be erroneous in 40% of patients, since the responses of patients with severe brain damage may be very limited (4, 5). In addition, rehabilitative care will be limitedly accessible to those who are inaccurately identified as poor prognoses due to the lack of a tool for predicting consciousness recovery (6). Hence, it is crucial to find a biomarke...
ConclusionsFrailty assessment may be good value for money. However, limited availability of geriatric consultation services, may hinder implementation. Thus, the estimated benefits of frailty screening may not be achievable in practice.
We report the case of a 17-year-old patient with recurrent hemorrhagic pericardial effusion, who was diagnosed with primary pericardial fibrosarcoma. However, multiple radiological examinations, including CT and [18F] FDG/PET-CT, suggested the presence of fluid and no sign of tumor. Actually, when a patient presents with recurrent hemorrhagic pericardial effusions, pericardial tumors must be taken into account as part of the differential diagnosis.
We present two young patients (
Publication date: Available online 12 October 2019Source: Canadian Journal of CardiologyAuthor(s): Isabelle F. Vonder Muhll
We describe a contiguous gene deletion of the ATM locus in a multi-generation family of Italian descent with a strong family history of pancreatic cancer. A deletion of one copy of the entire ATM gene was identified by routine panel testing and further characterized by chromosomal microarray analysis. An 11q22.3 microdeletion of approximately 960kb was identified that is predicted to result in loss of 10 genes including ATM. The deletion was identified in two additional family members including a presymptomatic daughter and an affected sibling. A normal disomic complement of the 11q22.3 region was detected in a third famil...
Conclusions: The DC-TAV program is an ambitious, civilian-military, nationwide and long-term program, based on a harmonised standard of care and including multidimensional training. Further studies are required to assess its efficacy.
Publication date: Available online 12 October 2019Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): Arnaud Chaumeron, Jeremie Castanie, Louis Philippe Fortier, Patrick Basset, Sophie Bastide, Sandrine Alonso, Jean-Yves Lefrant, Philippe CuvillonABSTRACTBackground: Rapid sequence induction (RSI) is recommended in patients at risk of aspiration, but induced hemodynamic adverse events, including tachycardia. In elderly patients, this trial aimed to assess the impact of the addition of remifentanil during RSI on the occurrence of: tachycardia (primary outcome), hypertension (due to intubation) nor hypotension (rem...
Publication date: Available online 13 October 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Yuichi Ohgoshi, Yosuke Usui, Satoshi Terada, Yoshimasa Takeda, Aiji Ohtsuka
ConclusionsThis case series demonstrates that the use of a high frequency jet ventilator for cardiac MRI was feasible, safe, providing good quality cardiac imaging and avoiding anesthesia personnel to be inside the hazardous environment of MRI room. Future studies are needed to confirm its safety and efficiency in pediatric patients.ResumoJustificativa e objetivosA ressonância magnética (RM) cardíaca é uma técnica utilizada na avaliação de crianças com cardiopatias congênitas. A anestesia geral garante imobilidade, especialmente em pacientes não cooperador...
Publication date: Available online 12 October 2019Source: Anesthesiology ClinicsAuthor(s): Anne D. Cherry
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