Articles: cations.
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Intensive care medicine · Dec 2014
Prognostication in comatose survivors of cardiac arrest: An advisory statement from the European Resuscitation Council and the European Society of Intensive Care Medicine.
To review and update the evidence on predictors of poor outcome (death, persistent vegetative state or severe neurological disability) in adult comatose survivors of cardiac arrest, either treated or not treated with controlled temperature, to identify knowledge gaps and to suggest a reliable prognostication strategy. ⋯ Evidence from a total of 73 studies was reviewed. The quality of evidence was low or very low for almost all studies. In patients who are comatose with absent or extensor motor response at ≥ 72 h from arrest, either treated or not treated with controlled temperature, bilateral absence of either pupillary and corneal reflexes or N20 wave of short-latency somatosensory evoked potentials were identified as the most robust predictors. Early status myoclonus, elevated values of neuron-specific enolase at 48-72 h from arrest, unreactive malignant EEG patterns after rewarming, and presence of diffuse signs of postanoxic injury on either computed tomography or magnetic resonance imaging were identified as useful but less robust predictors. Prolonged observation and repeated assessments should be considered when results of initial assessment are inconclusive. Although no specific combination of predictors is sufficiently supported by available evidence, a multimodal prognostication approach is recommended in all patients.
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To describe the social, clinical and use-patterns characteristics of medicinal marijuana use among patients with epilepsy (PWEs). ⋯ PWEs using medicinal marijuana have a common profile. They are usually young single men with drug-resistant epilepsy and psychiatric comorbidity. Most used marijuana before formal prescription and all believe the drug was effective on their seizure control. Because of the concurrent use of other antiseizure medications, it is complex to estimate the actual effect of marijuana.
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Journal of hypertension · Nov 2014
Review Meta AnalysisEffect of exposure to PM2.5 on blood pressure: a systematic review and meta-analysis.
Comprehensive studies have confirmed that particulate matter air pollution could trigger myocardial infarction, heart failure and reduce heart rate variability; however, its effect on blood pressure (BP) remains controversial. Therefore, we did a systematic review and meta-analysis to investigate the association and its magnitude between exposure to PM2.5 and BP. ⋯ Exposure to PM2.5 had a statistically significant impact on BP and the magnitude of this effect may have substantially clinical implication.
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Adv Skin Wound Care · Nov 2014
A novel hand-shaped suprathel simplifies the treatment of partial-thickness burns.
The standard therapy to treat superficial partial-thickness burns of the hand involves the application of skin substitutes such as Suprathel (PolyMedics Innovations GmbH, Denkendorf, Germany), which reduce pain significantly, thus allowing a fast mobilization and leading to a quicker restoration of function. The aim of this study was to simplify the application of Suprathel by using new precut hand-shaped bandages. ⋯ The use of the new Hand-Suprathel increases efficiency because of its convenient and faster application, as well as by reducing material waste.
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The role of regional anaesthesia in cleft lip surgery in the developing world is not well documented. ⋯ Regional anaesthesia for cleft lip surgery in patients >14 years of age was well tolerated and associated with few complications. It is a safe and effective option when used as the sole anaesthetic modality for cheiloplasty in the developing world.