1,720,981 research outputs found
A point-of-care evaluation after visual loss following paraclinoid aneurysm repair: the role of sonographic and pupillometer assessment
Full text linkVisual complications represent common deficits following surgical or endovascular repair of paraclinoid aneurysms. Different etiologies should be investigated to prevent devastating consequences. Herein we present a point-of-care evaluation to investigate sudden visual loss after coiling of paraclinoid aneurysms. A 20-year-old male was admitted for a sudden headache. Head computed tomography showed a subarachnoid hemorrhage and subsequent angiography revealed a 9-mm left supraclinoid aneurysm of the internal carotid artery treated with endovascular coil embolization. Thirty minutes after intensive care unit admission, the patient reported a left amaurosis. To exclude secondary etiologies, an immediate evaluation with point-of-care devices (color-doppler and B-mode ultrasound and automated pupillometry) was performed. Sonographic evaluations were negative for ischemic/thrombotic events and neurologic pupil index within physiological ranges provide evidence of third cranial nerve responsiveness. The symptomatology resolved progressively over 120 minutes with low-dose steroid therapy, 30° head-of-bed elevation, and blood pressure management. Visual deficits can occur after endovascular procedure and should be investigated. Suspected visual loss is a neurological emergency that deserves a prompt evaluation. Ultrasound and automated pupillometry have proved to be an effective, rapid, reliable, and non-invasive combination for a clinical decision-making strategy in the management of post-procedural acute visual deficits
Statins in Subarachnoid Hemorrhage to Prevent Delayed Cerebral Ischemia: Old Drugs for New Strategies?
No full textSubarachnoid hemorrhage (SAH) caused by a ruptured
cerebral aneurysm is probably the most devastating event
that can afect the brain. It is a predominantly medical
condition, which, after the initial intervention that stops
the bleeding (clipping or coiling), can go on to an important sequela of complications. Te tools available to the
intensivist physician are relatively few. Undoubtedly, the
most fearsome complication is delayed cerebral ischemia
(DCI), defned as the occurrence of focal neurological
defcits or loss of at least 2 points on the Glasgow Coma
Scale not attributable to other causes
Neurogenic Fever after Subarachnoid Hemorrhage in Animal Models: A Systematic Review
Full text linkThe observation of neurogenic fever resulting from subarachnoid hemorrhage (SAH) in
animal models is a useful tool for the interpretation of its pathophysiology in humans, which is still a
major challenge in the management of neurocritical patients. This systematic review aims to identify
the prognostic factors and pathophysiological elements that determine the onset of neurogenic fever
and its severity in animal models. In addition, our study aims to analyze which pharmacological
treatments are most effective. All the articles available in Pubmed, Embase, and the Biological
Science Collection until August 2021 concerning in vivo experimental studies on SAH animal models,
including full texts and abstracts written in English and Italian, were considered. The risk of bias
was assessed with SYRCLE’s Risk of Bias tool. In total, 81 records were retrieved; after excluding
duplicates, 76 records were potentially relevant. A total of 64 articles was excluded after title and
abstract screening. The remaining 12 studies were evaluated as full texts, and 6 other studies were
excluded (SAH-induced animal studies without a body temperature assessment). In one study,
body temperature was measured after SAH induction, but the authors did not report temperature
recording. Therefore, only five studies met the search criteria. The high methodological heterogeneity
(different animal species, different temperature measurement methods, and different methods of
the induction of bleeding) prevented meta-analysis. Synthesis methodology without meta-analysis
(SWiM) was used for data analysis. The total number of animals used as controls was 87 (23 rabbits,
32 mice, and 32 rats), while there were 130 animals used as interventions (54 rabbits, 44 mice, and
32 rats). The presence of blood in the subarachnoid space, particularly red blood cells, is responsible
for neurogenic fever; the role of hemoglobin is unclear. The mechanism is apparently not mediated
by prostaglandins. The autonomic nervous system innervating brown adipose tissue is undoubtedly
implicated in the onset of neurogenic fever. The activation of the central adenosine-1 receptor is
effective in controlling the temperature of animals with neurogenic fever (by inhibiting thermogenesis
of brown adipose tissue)
Correlation between hypo-pituitarism and poor cognitive function using neuropsychological tests after aneurysmal subarachnoid haemorrhage: A pilot study
No full textHypopituitarism seems to be rather common following aneurysmal subarachnoid haemorrhage (aSAH), even though its real prevalence remains unclear and the effects on six-month patient functional outcomes are debatable. This study correlated hypopituitarism after aSAH and cognitive performances using neuropsychological tests
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
The CLOSED protocol to assess optic nerve sheath diameter using color-Doppler: a comparison study in a cohort of idiopathic normal pressure hydrocephalus patients
Full text linkBACKGROUND: Sonographic assessment of the optic nerve sheath diameter represents a promising non-invasive technique for estimation of the intracranial pressure. A wide inter-observer variability, along with a lack of a standardized protocol for the optic nerve sheath diameter measurements, could lead to over- or under-estimation. The present study was aimed at evaluating feasibility of color-Doppler for better delineating optic nerve sheath borders, comparing it to B-mode imaging, using the magnetic resonance measurements as a comparison. METHODS: Optic nerve sheath diameters were evaluated using magnetic resonance by an expert radiologist in a cohort of patients with suspected idiopathic normal pressure hydrocephalus. Magnetic resonance findings were evaluated twice. In the first half of this cohort, optic nerve sheath diameters were measured using B-mode only, in the second half applying color-Doppler. Measurements obtained using these two techniques were compared to magnetic resonance imaging measurements. The Bland–Altman analysis and concordance correlation coefficient were computed to quantify the strength of agreement between the two magnetic resonance assessments. Box plots and average (± SD) were used to compare assessments by sonographic and magnetic resonance methods. RESULTS: Fifty patients were included. MRI assessment showed a moderate concordance correlation coefficient. Optic nerve sheath diameters measured applying color-Doppler were lower (p < 0.001) and less scattered compared to B-mode assessment, which approached more to magnetic resonance measurements. CONCLUSIONS: In this cohort of patients, magnetic resonance showed high intra-rater variability in optic nerve sheath diameter assessments. Optic nerve sheath diameter assessments using color-Doppler yielded lower and less scattered diameters compared to B-mode only
- …
