8 research outputs found
Blunt Chest Trauma and Regional Anesthesia for Analgesia of Multitrauma Patients in French Intensive Care Units: A National Survey
No full textInternational audienceBACKGROUND: Chest injuries are associated with mortality among patients admitted to the intensive care unit (ICU) and require multimodal pain management strategies, including regional anesthesia (RA). We conducted a survey to determine the current practices of physicians working in ICUs regarding RA for the management of chest trauma in patients with multiple traumas. METHODS: An online questionnaire was sent to medical doctors (n = 1230) working in French ICUs, using the Société Française d’Anesthésie Réanimation (SFAR) mailing list of its members. The questionnaire addressed 3 categories: general characteristics, practical aspects of RA, and indications and contraindications. RESULTS: Among the 333 respondents (response rate = 27%), 78% and 40% of 156 respondents declared that they would consider using thoracic epidural analgesia (TEA) and thoracic paravertebral blockade (TPB), respectively. The main benefits declared for performing RA were the ability to have effective analgesia, a more effective cough, and early rehabilitation. For 70% of the respondents, trauma patients with a theoretical indication of RA did not receive TEA or TPB for the following reasons: the ICU had no experience of RA (62%), no anesthesiologist-intensivist working in the ICU (46%), contraindications (27%), ignorance of the SFAR guidelines (19%), and no RA protocol available (13%). In this survey, 95% of the respondents thought the prognosis of trauma patients could be influenced by the use of RA. CONCLUSIONS: While TEA and TPB are underused because of several limitations related to the patterns of injuries in multitrauma patients, lack of both experience and confidence in combination with the absence of available protocols appear to be the major restraining factors, even if physicians are aware that patients’ outcomes could be improved by RA. These results suggest the need to strengthen initial training and provide continuing education about RA in the ICU
Sedation versus general anaesthesia in endovascular therapy for anterior circulation acute ischaemic stroke: the multicentre randomised controlled AMETIS trial study protocol
No full textInternational audienceEndovascular thrombectomy is the standard of care for anterior circulation acute ischaemic stroke (AIS) secondary to emergent large vessel occlusion in patients who qualify. General anaesthesia (GA) or conscious sedation (CS) is usually required to ensure patient comfort and avoid agitation and movement during thrombectomy. However, the question of whether the use of GA or CS might influence functional outcome remains debated. Indeed, conflicting results exist between observational studies with better outcomes associated with CS and small monocentric randomised controlled trials favouring GA. Therefore, we aim to evaluate the effect of CS versus GA on functional outcome and periprocedural complications in endovascular mechanical thrombectomy for anterior circulation AIS.NCT03229148
Effect of an individualized versus standard blood pressure management during mechanical thrombectomy for anterior ischemic stroke: the DETERMINE randomized controlled trial
No full textAbstract
Background
Hypotension and blood pressure (BP) variability during endovascular therapy (EVT) for acute ischemic stroke (AIS) due to an anterior large vessel occlusion (LVO) is associated with worse outcomes. However, the optimal BP threshold during EVT is still unknown given the lack of randomized controlled evidence. We designed the DETERMINE trial to assess whether an individualized BP management during EVT could achieve better functional outcomes compared to a standard BP management.
Methods
The DETERMINE trial is a multicenter, prospective, randomized, controlled, open-label, blinded endpoint clinical trial (PROBE design). AIS patients with a proximal anterior LVO are randomly assigned, in a 1:1 ratio, to an experimental arm in which mean arterial pressure (MAP) is maintained within 10% of the first MAP measured before EVT, or a control arm in which systolic BP (SBP) is maintained within 140–180 mm Hg until reperfusion is achieved or artery closure in case of EVT failure. The primary outcome is the rate of favorable functional outcomes, defined by a modified Rankin Scale (mRS) between 0 and 2 at 90 days. Secondary outcomes include excellent outcome and ordinal analysis of the mRS at 90 days, early neurological improvement at 24 h (National Institutes of Health Stroke Scale), final infarct volume, symptomatic intracranial hemorrhage rates, and all-cause mortality at 90 days. Overall, 432 patients will be included.
Discussion
DETERMINE will assess the clinical relevance of an individualized BP management before reperfusion compared to the one size fits all approach currently recommended by international guidelines.
Trial registration
ClinicalTrials.gov, NCT04352296. Registered on 20th April 2020.
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Sedation versus general anaesthesia in endovascular therapy for anterior circulation acute ischaemic stroke: the multicentre randomised controlled AMETIS trial study protocol
No full textIntroduction Endovascular thrombectomy is the standard of care for anterior circulation acute ischaemic stroke (AIS) secondary to emergent large vessel occlusion in patients who qualify. General anaesthesia (GA) or conscious sedation (CS) is usually required to ensure patient comfort and avoid agitation and movement during thrombectomy. However, the question of whether the use of GA or CS might influence functional outcome remains debated. Indeed, conflicting results exist between observational studies with better outcomes associated with CS and small monocentric randomised controlled trials favouring GA. Therefore, we aim to evaluate the effect of CS versus GA on functional outcome and periprocedural complications in endovascular mechanical thrombectomy for anterior circulation AIS.Methods and analysis Anesthesia Management in Endovascular Therapy for Ischemic Stroke (AMETIS) trial is an investigator initiated, multicentre, prospective, randomised controlled, two-arm trial. AMETIS trial will randomise 270 patients with anterior circulation AIS in a 1:1 ratio, stratified by centre, National Institutes of Health Stroke Scale (≤15 or >15) and association of intravenous thrombolysis or not to receive either CS or GA. The primary outcome is a composite of functional independence at 3 months and absence of perioperative complication occurring by day 7 after endovascular therapy for anterior circulation AIS. Functional independence is defined as a modified Rankin Scale score of 0–2 by day 90. Perioperative complications are defined as intervention-associated arterial perforation or dissection, pneumonia or myocardial infarction or cardiogenic acute pulmonary oedema or malignant stroke evolution occurring by day 7.Ethics and dissemination The AMETIS trial was approved by an independent ethics committee. Study began in august 2017. Results will be published in an international peer-reviewed medical journal.Trial registration number NCT03229148
Outcomes After Endovascular Therapy With Procedural Sedation vs General Anesthesia in Patients With Acute Ischemic Stroke
No full textInternational audienceImportance: General anesthesia and procedural sedation are common practice for mechanical thrombectomy in acute ischemic stroke. However, risks and benefits of each strategy are unclear.Objective: To determine whether general anesthesia or procedural sedation for anterior circulation large-vessel occlusion acute ischemic stroke thrombectomy are associated with a difference in periprocedural complications and 3-month functional outcome.Design, setting, and participants: This open-label, blinded end point randomized clinical trial was conducted between August 2017 and February 2020, with final follow-up in May 2020, at 10 centers in France. Adults with occlusion of the intracranial internal carotid artery and/or the proximal middle cerebral artery treated with thrombectomy were enrolled.Interventions: Patients were assigned to receive general anesthesia with tracheal intubation (n = 135) or procedural sedation (n = 138).Main outcomes and measures: The prespecified primary composite outcome was functional independence (a score of 0 to 2 on the modified Rankin Scale, which ranges from 0 [no neurologic disability] to 6 [death]) at 90 days and absence of major periprocedural complications (procedure-related serious adverse events, pneumonia, myocardial infarction, cardiogenic acute pulmonary edema, or malignant stroke) at 7 days.Results: Among 273 patients evaluable for the primary outcome in the modified intention-to-treat population, 142 (52.0%) were women, and the mean (SD) age was 71.6 (13.8) years. The primary outcome occurred in 38 of 135 patients (28.2%) assigned to general anesthesia and in 50 of 138 patients (36.2%) assigned to procedural sedation (absolute difference, 8.1 percentage points; 95% CI, -2.3 to 19.1; P = .15). At 90 days, the rate of patients achieving functional independence was 33.3% (45 of 135) with general anesthesia and 39.1% (54 of 138) with procedural sedation (relative risk, 1.18; 95% CI, 0.86-1.61; P = .32). The rate of patients without major periprocedural complications at 7 days was 65.9% (89 of 135) with general anesthesia and 67.4% (93 of 138) with procedural sedation (relative risk, 1.02; 95% CI, 0.86-1.21; P = .80).Conclusions and relevance: In patients treated with mechanical thrombectomy for anterior circulation acute ischemic stroke, general anesthesia and procedural sedation were associated with similar rates of functional independence and major periprocedural complications.Trial registration: ClinicalTrials.gov Identifier: NCT03229148
0002
No full textDAILY PALO.ALTO TIP FRIDAY; JANUARY 24,1919
UMITEO STATES WJLL MOW TRY '
EXPERIMENT OF PROHIBITION
Astonishing Action of an Individualistic People Witt) a Strong Sense
ef Personal Liberty Is Brought About by Lessons of the Great
War—Additional Legislation Planned to Enforce New
Uw-Wift "Wets" Contest?—Ratification Details.
TW trailed State* of America ha*
entared epos tb* treWMWdoos aorta! rt-
perimeoi ef natt.ut.-l pes bib* Uo* of
tb* mannfartur-". aata aad a** of ale*-
WBr drink*. Ther* wll he aaaadaal
tl*:* ta Uve the exprrtntat a fair t. *t
•lace the prohiMttaa I* by reostltg-
rtoaal aeMWdmeat. Tu all a]<f-Terence*
thta mandate by the America* people
against tbe wee of alcohol la latrnrtrd
to he abeotate aad r.n.l. Wr hav*
written It tato organic law—Into magna chorta—In tbe form of Ib* eight'
ernlh amendment to tbe ruo*11 teflon
ef tb* United States. .
The experiment I* a tretnendna* de-
partore from pr**vl«>u* tendencies of
tli-- American neopl*. W* ore an Individualistic p*Ofl.-t, with a Btraag *i'*ae
of pfi-Minal liberty. Vrl km- *r luir
set uut to regnlst* p-erenfcal bsblt. not
by statute, bat by <tm*tltsU<-n*l
amendment.
And the wooer of tb* passing of
thla t-aastitBlkmat amendment Is unite
aa i Heart-stile aa th* aaaeadasmt Itarrlf.
Artloa un th* erveateea pctvtoa*
amrnd-iM-a'* to th* Oa*»tltatU-*a ha*
tat ro Setwaea ata* aormtha and forty-
thrve men lh*. aa averag* of aheet two
yearn. Th* rr-*-utaik-<i provldlog for
thla eighteenth a-aendmenl waa paaaed
by (-ongrea* PecereWr IT. 1S1T, Oa
January 111. 1B1B. Hs nllScatloa by
th* slot re ta accomplished.
What has brought about Ibl* retlfl-
cation ao tjulrtelyT Obviously Ibe Ma*
ttooal Prohibition party hsa had prso
tlcalty nothing lo do wlih Ita sccote-
pllsfinietit. The answer evidently la
that tbe war has bronghl It shoal.
rriilili.liii.il la both an e-ninnmlr queo-
tt'ni end * moral question. Tb* war
art the .* Harries ii p-ruplr lo lon-hlng al
prohibition frvim both vlewpotata. Wr
got ercoe turned lo lb* ibouihl Ihst
grain wa* belter e*t*n *s ft--l than
swallowed ** lienor. Inaamacb s* w*
were-told iWt tn*a would «m lb*
idrnt of th* United Urate* end president *f Uw smote.
I certify thai this Joint re-tut at M-n
originated la th* senate.
JAMES M. HAKKlt. secretary.
TW HSllidiiuat wss paaaeg by tW
■easts ea Xagwat L 1917. aad paaaed
ay tW hotsa* on Dfcet-abee IT of tW
earn* jear. It waa paaaed hy IW sew-
sir with ihr bona* amendment* on
Dc*rembcr IS. TW vote In IW am
at* eras BS t" '-*■' and In tW heaao
as to us.
HaUHcatlaa by tW Stata*.
TW next step was ratlDcatlon of
this aiuaiiitaaani hy IW statu-* tbroagb
tbrir IcgislMiarv*. This called fur *f-
flrmailvr sctlon by thlrty-als aUte*
within Mvsa yrsrs. UlBalsoippt »n
tW Bret stSte to ratify, l-.tli senate
■ml Wear tahlng artloa Jansary **.
HUM. Tlir.-r otbtrr S-j-tbem aUIr*
follawrd la January—Virginia. Km-
twrhy. Booth Car..Hub Then csiik-
North Dakota. UtWr state* fottawvtl
la tW order named. Nebraska being
IW thirty tt-tb aad cwsapltrtiag tW
ralfflrattae.
. Weet virti. ia
CoUrseou. ,
M'a.tir f ion
tSMWa,
llit-Ntla.
Ni.itl. Carolina
TWy amy." Jaaaoryl*! ta Srr iTSsa
dec* a mart order was ***—***, tew*-
peeartly rwatratnlag Oo«. Wllitam D.
Otagsaas frtaw sifting tW rartBrattaa
of IW amnaWrnt. It-waa Indicated
thst similar ac-Uue might W Usee la
certain other' orate*. - !t was aald al
tW offer ot tW QsllfaralB Urepr
Orowtrs* •SMM-lallue Uml sech' artloa
ta possible ta IS otWr states. TW
stated, according ta thf asaoctaltaa.
are: Arkansas, Calends, alola*. Ne
vodo. Now Mexico, Oklahoma. Oregon.
IJiob, WaoMagtov. metier, and Nebraska.
la these stairs. It was Said, *U leg!*-
latlv* actions taa W. owler the law,
ithmu t.i thr people, aad tWt la
msny af tWm iW people W** 00 days
ts which i* take a refereadsm.
While tW om--oi!n.etit ander Ita -***>
vltrlueo d*e* ooi biro*nc**'»ffertlve un
III oo* jeer from IW date Of Ita rail-
Aeatloa. It seems ItarlJ i.i the cum
if) will be-rume permanently dry -laly
1 ant. .This I* the ttatr oa •- hli h ihr
Map ghowing In Whit* First M Slate* Ratifying g|ght**«tth *Am*agert*nt.
w»r. -Vr aaw what IW enforced ae-
brtriy of military se-rrtce did physical*
ly, mentally and morally for young
mm wto Wd indulged In liquor In
peace tlmee.
gome of our allle* got Into tW war
ta a hum b*c*u*e tWy Wd-to—Bed-
glnm and franc* ta safe thrlr Uvea,
Orsst Britain to save Ita national turn-
or. America look It* time—a htng Um*
—«ad gradually worked llself up tn
thr drtertiifnation tO 8ght. [ViabtlM*
mocb coosidrratloa of prohlbllloa waa
a part of thta slow prnceao. So tWt
whoa tW opportaalty cam* tW si*tee
of tW Colon went over IW tap )a»t
aboat as IW Aiaerican mriM *nd
doa.tbWy* did In tW .Argoaee.
Text ef Amendment.
rot-owing Is IW fall lest of IW prohibition smendoent oa which atatr
tagtataiare* are voting:
JOINT K£SOLUT10N WIOPOSISO
AN AMKNDUCVr TO THK CONSTITUTION OF TOE UNITED BtATEB.
BcHsolved by IW senata and bou*e
Of r**pr***ntaHv** of tW Culled
Stairs of America. In rongre** assent-
Med. two-thirds of each Was* concurring therein. IWt iW foltewtng *m-*od-
mrot t* tW C*n*tltuttoa W. and here*
by Is. pfDposed to iW stale* ta be-
coesr valid as a part ot tW Cone-til o-
tk* when rallSed by lb* legtalalare*
ot th* several state- a* provided by
tW C-aMlt-bttaa:
Sectloa 1—-After ooe y*-*r fmmtbe
retlficatloa af this inkir tW none-
facture. salt- or transport a I ion of l>r
taxlcatltrg liquor* wllbtu. Ibe Impor-
totlfjo tWrrot Inm. or IW «zpari*riMi
thereof fraan tW L'nlted titalra snd
su trrritory snb>ect tu IW jorisdlrtluti
thereof for beverage pwpoeee ts hereby prohibited.'
! (taction 3—Tbe congress and IW
severs! stalra- Wv* roocnrreni power to mforcr this article by appropri-
ste Icgtalattss-.
Sectloa S—Thl* article sWII W in-
oprratlve unleM lt sbsll Wve Wen
ratified a* ea ainrodawnl ta tW (W
stltntloo by tbe legiOatore* of tW are-
rral.atate* aa peoeldrd la tW Coaart-
tnllr.n wltbln -rtm years frma llie
, data of Ihe sabmlmloa Wreof to IW
atatas by tW coagr»«a.
CS-Un> CL.\HK. speaker of IW
Woae of repreWntorlvea.
THOMAS UARSHALL tlr* pr*w-
*j--f i«l n «r iiiiet- pmhlblllon recently
roactrd by' t-angr«M go** Into rffi-rt.
1'hnt taw preli-Oli tW lii»tillf»Ctiln*
and sale of•Intoslraiita for beverage
purpose-* and irmalne in fort* until
Ihe drmoUUullou nf the nallon'* war
ertnle* la romidrietl. Doabtl*** tWl
emergency war-time nn-**ar* -will W
effective over tW aevrral monlW IWl
will etapae after July 1 until IW coo-
alltollonal bone dry art. now adopted.
beea-mee effective.
A*.Ji*jcn*i Dry teglslaHen.
Dsrlsg Uw Ttot followiac rattflca-
tlun congiiaa and tW several stale*
wtll W called cj-.it to p**s t. -ficutiuo
lo eaferc* th* ame«-tttsi-Qi ahd lo gre-
vtd* penaliir* for vtolatlaoB. It ta
proWble a large force of ag*eia ander tW direction of the rofa-miaalcrarT
uf lataroe! rerenar will Wv* to W sp-
polntsd to enforce tW law. Each atat*
will har* to provide mat-hlnsry for
tW enfurcrrorni of tW law la addltloa lo the machinery provided by iW
federal government.
ll Is likely Ibis additional legislation
wlU h* pwdie-d threegh aa fast as tW
dry* can poab IL In *ome parts of
iW cventry st least they parpoee lo
take fan adrantage ef their victory.
For example. In Illinois ■ forecast
of IW Asll-Beloon leagu* la thl*: la
addltloa lo tW "march aad r-rlswr*
art' an art rigidly restrict ing tW ban-
diaaff of ttgwor for ~r**Lrtnal. au»
fartnritijr. *mcram-**ntal and artenUftr
parpoeee; lagtatatioa coverlag dortan'
trrescrtpttaaa. which must W Iworri
by ■ Waa fid* pfayslcioa In writing
'lat.d. dtogiMM-lns tb* lllnrse and Ibr.
purpoae of-It* n*r; sli railroad rtr-J
ord* . of Uqnor aUpn-eata mu*t i- ,
kept; drastic legtalatloa regvlatlnv
asta by dniggtats. with heavy peewit)
for violation.
The jlrys presumably wffl aot roo
Sne tbetr efforts to'-rnfoTdng Uie lew.
TWy Will daebtf*** take tW qseeil.-n
into pontics of sll kind* aad amW ll
sn loaur. TWy annonac*. for Irwtoac*.
la Cblrego tWl tWy ■ ill ash si! candidate* fnr major tn declare Ibrru-
aetre* oa IW strict ttrtotrtmeat ot
dry Irsi.iatlr.n. TWy win make It an
it.ii*. in tbe apring rempalga *ad will
• •[•••"*• any a!d--rmsi*lr caadldale who
doe* twit tor rW msrfc.
Will tM Weu Contortf
Will ih* mita . -iii. .i n>- ii-s.in, af
tW'wb<il« pfocretllns ttom Ib* start?
TW dry siiJe ot thl* legal prwpool-
ttaa 1* thas set f.. th by tW Antt-S*
leea league:
-Arti.i* V «f tW tetlrral Coostltu-
uoa pfwvlde* thst tW legtstatsr* er
* stats contention to tW only body
which can ratify aa anveodmeal te IW
Oeostltuttaa. cWwrea* Is given IW
power t<. say which one aWll Wee thi
authority. Onogrea* Wd cboeeo |W
out* Ivgtalstare* ea tW Wdta* te rati
fy tW federal prohibition ameadment.
A atat* tafareadam therefor* weald
W Illegal and vi i.i."
TW Antl-HaliK.il League of America
Ws proWbly Wd more to do with
bringing nWut prohlblUt-B iWs any
atWr oo* ogeocy. ll wmo fooa-tlcd In
llSJd and ta Bonpartlsea aod ana***.*-
larlan Its porpo** I* tW ritrrmlna-
ll..ii .4 tb* Wvrragr llfi_..r tralTlr. |(.
I* a c-oanitua of tW iVntl-Wleoa
Wage* of tW District of CXrfumbia.
tW Ann Sa:u.-i Uagnr of Ohio and t.*.
ether nalluasl, out* sad local, tern-
peranc* bodies. It has WancW* ta
sll Mate*. It i- nperteeVl* Wv* a*
artier part la providing legt-alatton for
IW eoforr-rmeai uf prtihltritluo under
tW el* lit mill! aiomdint-nt.
ll la pimail.lr IWt tW wata may also
eltai-k IW Irgallly of tW acttaa of
cniign**. By wot* tb* view is held
that tW a men ill n ent was not properly
submitted to the *ial--* hy o.iigrc";
ihut ll was s.i..[it..I by tm. U.ir-la'uf •
quorum i.r.-*nii and Voting, when-a-
according to IW Cmiiiui.-ii ll ahtml'i
Wt* Wen Sd^jgteU Uy t*-> thlnls of oli
smben *fc-rt*d. If tW i-t-Mlgtliin
Bubmittlag tW amm-lmcm wer* th U
dertsred uneoartllviloaal It woeM lr*<t
tu mucb quest lout ag, far virtually al
of Ibe ■meodmeat* to IW COnstligtlot.
Wve beea adopted by a im>-thlf.L
tot* of tW mrmbers prrecot ratlin
than a t»•- thtnU vete of all ii«*ml-ri<
elected t* rongre so.
Amsndm-wita of tW Past
TW Orsi national prohlbllloa
atuenduirui «aa proposed by Ssaatur
II. W. Htatr ot New lUupshlre. as
early'ss lRTd. II provided for.* tW
pmhlbllloa nf (W uanutaciur-^-tale,
Wporialloa snd eipoiiallou of spirit-
oua dlalllled liquor for beverage pur
poses. Me Introduced theb a Mil mm*
ilmre bt-lwretl lIRtf'Snd 1W*I: In IM*.
he rhangrd il to Include all slrofci.Ile
Ug-MS
Woaliir Ji.l.it D. Works of f-gtUor-
nla intr.-lii...-.! Into the senate IB VM4
a bill pruvldln< for IW prohlMUea of
splritotis nqoora. rsriadlng *lotO snd
beer*, lt recrtved no *-;|[- rt frmao
IW natlnna! pmhlUtloa advocate*.
la-errmWr IB. 1103. Congreaamu
lleWoo ot AtaWm* introduced- tW
fab-utl* "Hi.lifc.i, rrw.lutli.n~ Tbe
original mteilulloo placed tbe mfhrce-
iii. nt of thi- law In tbe hand* at tW
national goventneggj but li wa* eo
amrndr.1 a* to dlil'It- ihe r. -.imii" 11, lilt y Ww-i-ii Ibe State nnd fnli-ral *%
f-riiinrnt.. In order lo secure tW sap
pari uf certain advornle* of "State**
right*." The origin*) resoltillmr'wa*
amended eight time* by Hob*oa*blm-
self and was Bnslly voi*d no Decern-
Wr **K H'll. recelvlni 1PT tntrs. 238
Wing necessary to carry Ihroagh IW
h.in*e It never came to a vet* in
the **B*fe.
■When De** Prehlbitkn Prohibit?
Neaator Morris tthepfiard of Triaa,
author of the ameadment. WIlS-IWI
nwti.er.ai proMhftlaa-wUl go ii.t.. eJTrcl
Stanford Calendar
dar j
S Ms.—Baretsas Heard, ta an llloa-
trstad lecture, "My Hoom ta th* rield
Ot Hooor." la th* A*.*mbly Hall. Ad
miiaiou tree.
OFFICIAL NOTICKS
■taatord tlalTerslty Medical School
Thirty ****nih course ot popular
let-lure*, to W given In Lane Hall, oa
tW nortb aide of Secranwato street.
gear Webster. Baa rranclaco. Oeneral sehject. -LaiiMs of tW Great
War:
Jaaaary Ss—WWt IW Wsr Hoi
Toagkt Us la KsgsrU to Uw Food -Sap-
ply of lb* Peepll, by Prot bl. JaBo.
ot tW t'atvereity of California.
rehraery f—WWt tW War lias
Taught Is la Begard to the Control at
Venereal Dtsegaas, by Dr. Lewis Mich-
*l*on oT tW Btato Board ot Health.
Kebruory Sl—WWt th* War Hu
Tasghl Vs la itagotd to tW Physical
CondlUon of Our Young Man. hy Dr.
I'hlllp Halo Hereon. -
March 7—Tbe Children'* Year; a
Itaconatructloa Pregrsra. hy Dr. Ade-
Isi.e Drown
Marvb Sl—TW Control of Epld*m-
1-*. ky lw. William C. Hasalar of th*
(U* mactaca Board of Haollb.
Twssdey av*nl*g Mttting*
Jaa. 2»-LectS-re by Clark W. li.tb-
PALOIttTOCAtDBWtft
FrMe-Atdth
Bogstaore Tribe. No lit. I O R. U.
■ Ul Meet at Fraternity Hell rviday
evening January II Degree work.
Important bustues* K*fr**hm*nta. v
MEXICAN BIBBL CAPTURIO
BV THK OOVBNNMBNT
IB, An*.**!,. r,,.D
MEXICO CITY. Jaa. at --The Wsr
Dapartment hoa announced th* cap
tare et Igascle Morelee Earsgooo. former tedmal general, WW W* be. n
Operating agalnal th* govern aunt in
tW atat* ot Nuevo Woo. Th* prta-
oa*r. wW wa* captared at a reach ta
N*evo t-eoo. W* been token te Moo-
terey for trial. Zarogoaa defended
Tamp4co wader the Ha*rt* regies*
agalaat lha ronatltntloaaliata under
General Pablo Ocmtals*. He *err*a<
d*r*d. si.ugttt amnrety, than fled to tW
{Dotted Blair-*, later returning to
M*alco snd operating ta roajeaclton
with Juan Almaaan lis la of sd*
vsacsd ag*. HI* capture ceased wn*
eiclimnent In Montarey, where he is
well known and has msny relative*.
itusttttttt ituMitsastttt
Ramona Cafeteria
MRS.A.HURD,!
NOW OPEN
Corner Unirersity Ava* asd Ramon* St, Up Stain
Opp. 1st National Bank. Service I!: 30 a. m. to § p. ra.
Thoouo Walton StoAfard Art Oa!1*ry
TW Art (loilsry la op«n lo tW public, without thorg*. during tW fODOW-
tag boon: IS **m to S pja. dally, in-
eluding Sunday.
Eihlblttoo ef Joseph I-eiineU's war
lithographs on the food and teal in
dusirl**. oloslag February S, ISlt.
Exhibition fit Eaatara art school
work In tolor Ahd design; closing February I, lilt.
B-Lhlbltloa ot tw.ui) tour drasrlngs
by Luetan Jeoaa We*lr*llag "TW Boat
of Praac* ■ Closing Kobruary 10, 1111.
HAWAIIAN JAPANBU
BtCOMINO AMIRICANIZIO
HONOUILU. Jaa. 34.—Th* Nlppa
JUL on* of tb* Japan**** dally n*w*.
paper* published bere. Is printing
new* Heme of **p*rtol Interest la both
Japan*** and English, partlcalarty
Special rat.ir--.rama Irom Ihe Orient
Th* lanovstloa la coa*id*r*d oa fresh
evidence of th* rapid Amaricaalaatloa
of th* Japans** ta Hawaii. Tli* Nlppa
Jljl is tW flrat Japan*** pspar ta iW
territory lo publish news in English.
Ccnatar s/orris gheppsrd.
Jonnsrj IA, 'id), eerilflrallon and tn-
aonncrmrot of rstlflcstlon being merely
a matter of form. It la ae«dle*a to say
tWt tW wets do not accept Ihls view
and ibat effort to delay tW fmaat
proceedings will W made*, preliminary ta contesting tW legality *t the
rMin.alli.,1
Al say mir, li is formally *n-
anoaced tWl sorb a.ooatret will W
Orade. ll la lit. iy that Ihe wets relv
more rm tW refrreodaw propooltUo
than un IW queetloo of votes.
PRACTICE WAR TIME ECONOMY and save coal by
partially banking your furnace fire with fine coal
COARSE SCREENINGS 10 PER TON, any quantity
235
We O. HORABIN
Arc. HumeP.A.60
Hobson s...
For High Class
BAKERY GOODS
PWn* ISO 101 ____ Ave.
A reword ot 110 00 win W paid for
Lh* arrest aad eoavtattao of say*o*
foend stealing TW Time* from lh*
pramts** of oor ssWcrlWca
SPtCIAL NOTICES
Plaaaa laa*d."ail lastramaota r»
pelted. K. BoWmktrg A Boa. ph ST.
1-lSdt
• • a
.'allvj-s Baherr Is op*n tor bualnea*.
IU Hamilton Are, next to puetofflre
llill -
• • *
ITao* In scleaUftc mind training will
m**l Tbaredsy *v*ohig (In place of
th* usual Wedneeday) at T:lu la room
It. IM Uel-rerelty Av* Opon to tb*
"Ur; ISS-tt
PENINSUU RAPID
TOANS1T CO.
A ,*.*•,*-,**, •*■**, Bet*.,.
San Francisco .
. a asd an
Peninsula Points
irosTneouKP
L_**e Prje Ati* A. M*i r j|. t H. » ■
* 11- *.l. •!■». * 11. • 11- 1*111. MU
l*_}i_ ■*•*■* " '■■ "'*
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luii-t *i IS Nsaakas tM M.t sue, *:**.
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Tie), fiit. Sill, In. Sill, s II. »1J. »:)t.
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l.Vi ten*, mu. J'li*
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NOTICI OF ANNUAL MggTINO OF
STOCKHOLDERS OF CAgTIL-
LEJA SCHOOL
NOTICB .IB IIRRKBT OlVKN tnoi
an annual meeting of alockboldare of
CABTlleLKJA BCHOOL. S corpora*
lion, for the election of Director* to
pgfgg tor lb* ensuing year and until
their anccrtaaor* or* etacted and qualify, and tor th* tranaactlon of sach
other bnalaea* sa'asay com* Wfore
lh* m**Ung, will ba held upon Tne*.
day, IW -Hh doy Ot February. A O.
ltll. at tW War of f:» o'clock pm
of said day at ib* olflee of aald cor<
poratlon, ftoom No. t. at No. ISIS Bry
oat Btreei. la lh* Town of Palo Alto,
Coanty of flout* Clara. State of (tall.
tank.
VLOBJtNCC C. BTEARNB,
Becretary of Caetlll*}a School.
Dated: January Sl, 1I1S.
Ml to H
ISABEL L, CHARLES
NOTARY PUBUC
VINiMG BLDG.
LM.S1M0NSEN
PUBLIC ACCOUNTANT
«i Twehy Bldg. a*s* i
Hotel Larkin
PALO ALTO
atmoFSAt. fia4
T0U HAVE NOT teen the
rope-making machines?
Then you have lost good
time. Phone and learn.
FREE! FREE!
FREE! FREE!
Buttermilk
With tach pound of Butter we will fire jron FREE ONE
QUART «< ear DELICIOUS FRESH BUTrERMlLK.
We Bisk* our own Butter—thtt'i why it it to f**d
TRY OUR ICE CREAM
( ■■,"■■, „■'■'■■■■■ 'l"J.'l— wr1 r s i, --B. -„, ' IIIMUS
University Creamery
PhoneSt
209 Univeriity Ave. Free Dt£ttrit.
Tiaiet Want Adi bring joorl retultt at all timet.
Great
Everything Reduced
OUR ENTIRE STOCK OF
Ladies9 Underwear
Cannot be deicribed ether thas te ity that it it the la^jeit anil moit complete
ttock on the peniniula.
AU. AT PRICES UNUSUALLY CHEAP
KnMng Yarns...
All itandard brandt in a wide range of colon
At Wpr. ct. reduction of the listed prices
ALL REMNANTS THROUGHOUT THE SCORE AT 1-3 OFF REGULAR PRICES
Extra Special...
Monday, Tueaday and Wednesday
1000 YARDS OF COTTON CREPE, VOILE, MADRAS, POPLIN, SWISS, SILK
MULL, ETC., VALUES UP TO 11.50 YARD, WILL BE PUT ON SALE MONDAY
At the ridiculous price of 19c a Yard
GINGHAMS
OUR ENORMOUS STOCK COMPRISING 500 PATTERNS, REPRESENTING A
VALUE OF 110,000, WILL BE ON SALE. THE MANUFACTURER'S PRICE IS
37 Vie, THE REGULAR RETAIL PRICE 50 AND 55c'A YARD.
Our Price for 3 days 29c Yard
en^ fetore
Men'a Cotton Derby Ribbed
Underwear
MADE OF FINE COTTON Y-ARN. COLORS ECRU AND GREY.
REGULAR VALUE OUR SALE PRICE $1.00 A GARMENT
Men'. Store
Univeriity Ave.
and High St.
Phone 458-R
Women't Store
Llnivei-tity Ave.
and Emerson
Phone 458-W
SOLE AOtNTt
Rte.lt,n Caraata Ka,e*r Un.trw.ar and Qtavea
Warner'. Car***, Ledi.a" Kama Journal ".tt.re.
Royal Worceet.r Corral, Celt.-, Wo.,* Name* ana! Initial*
■en Tan Coraat, Hand tmareldee*,. Pleatin
Intracranial pressure monitoring with and without brain tissue oxygen pressure monitoring for severe traumatic brain injury in France (OXY-TC): an open-label, randomised controlled superiority trial
No full textInternational audienceBackground: Optimisation of brain oxygenation might improve neurological outcome after traumatic brain injury. The OXY-TC trial explored the superiority of a strategy combining intracranial pressure and brain tissue oxygen pressure (PbtO2) monitoring over a strategy of intracranial pressure monitoring only to reduce the proportion of patients with poor neurological outcome at 6 months.Methods: We did an open-label, randomised controlled superiority trial at 25 French tertiary referral centres. Within 16 h of brain injury, patients with severe traumatic brain injury (aged 18-75 years) were randomly assigned via a website to be managed during the first 5 days of admission to the intensive care unit either by intracranial pressure monitoring only or by both intracranial pressure and PbtO2 monitoring. Randomisation was stratified by age and centre. The study was open label due to the visibility of the intervention, but the statisticians and outcome assessors were masked to group allocation. The therapeutic objectives were to maintain intracranial pressure of 20 mm Hg or lower, and to keep PbtO2 (for those in the dual-monitoring group) above 20 mm Hg, at all times. The primary outcome was the proportion of patients with an extended Glasgow Outcome Scale (GOSE) score of 1-4 (death to upper severe disability) at 6 months after injury. The primary analysis was reported in the modified intention-to-treat population, which comprised all randomly assigned patients except those who withdrew consent or had protocol violations. This trial is registered with ClinicalTrials.gov, NCT02754063, and is completed.Findings: Between June 15, 2016, and April 17, 2021, 318 patients were randomly assigned to receive either intracranial pressure monitoring only (n=160) or both intracranial pressure and PbtO2 monitoring (n=158). 27 individuals with protocol violations were not included in the modified intention-to-treat analysis. Thus, the primary outcome was analysed for 144 patients in the intracranial pressure only group and 147 patients in the intracranial pressure and PbtO2 group. Compared with intracranial pressure monitoring only, intracranial pressure and PbtO2 monitoring did not reduce the proportion of patients with GOSE score 1-4 (51% [95% CI 43-60] in the intracranial pressure monitoring only group vs 52% [43-60] in the intracranial pressure and PbtO2 monitoring group; odds ratio 1·0 [95% CI 0·6-1·7]; p=0·95). Two (1%) of 144 participants in the intracranial pressure only group and 12 (8%) of 147 participants in the intracranial pressure and PbtO2 group had catheter dysfunction (p=0.011). Six patients (4%) in the intracranial pressure and PbtO2 group had an intracrebral haematoma related to the catheter, compared with none in the intracranial pressure only group (p=0.030). No significant difference in deaths was found between the two groups at 12 months after injury. At 12 months, 33 deaths had occurred in the intracranial pressure group: 25 (76%) were attributable to the brain trauma, six (18%) were end-of-life decisions, and two (6%) due to sepsis. 34 deaths had occured in the intracranial pressure and PbtO2 group at 12 months: 25 (74%) were attributable to the brain trauma, six (18%) were end-of-life decisions, one (3%) due to pulmonary embolism, one (3%) due to haemorrhagic shock, and one (3%) due to cardiac arrest.Interpretation: After severe non-penetrating traumatic brain injury, intracranial pressure and PbtO2 monitoring did not reduce the proportion of patients with poor neurological outcome at 6 months. Technical failures related to intracerebral catheter and intracerebral haematoma were more frequent in the intracranial pressure and PbtO2 group. Further research is needed to assess whether a targeted approach to multimodal brain monitoring could be useful in subgroups of patients with severe traumatic brain injury-eg, those with high intracranial pressure on admission
