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601. Monitoring of Perfusion in Sepsis and Malaria

administration. Condition or disease Intervention/treatment Severe Sepsis Malaria Procedure: Lung Ultrasound examination Procedure: Compression ultrasonography (CUS) Procedure: Echocardiography Procedure: Inferior Vena Cava ultrasound Procedure: Passive leg raising test (PLR) Procedure: Orthogonal polarization spectral imaging (OPS) Procedure: Urine collection (Foley catheter) Procedure: Venous blood samplings Procedure: Electrocardiogram Procedure: GlycoCheck Detailed Description: This will be a single (...) provided by the National Library of Medicine related topics: resources: Groups and Cohorts Go to Group/Cohort Intervention/treatment Sepsis Procedure: Lung Ultrasound examination Use of lung ultrasound to detect pulmonary complications Procedure: Compression ultrasonography (CUS) CUS is a highly sensitive and specific modality used to recognize lower extremity deep venous thrombosis (DVT) Procedure: Echocardiography Echocardiogram can be (i) identify imminent life-threatening causes of hemodynamic

2018 Clinical Trials

602. Reproducibility of Lung Ultrasound in the Diagnosis of Acute Heart Failure in the ED

on the base of clinical exam, chest x-ray , brain natriuretic peptide (BNP) and echocardiographic findings. A patient lung comet score (LCS) was obtained by summing the number of comets in each of the scanned spaces. Then the probability of AHF was defined as : low probability (LCS<15) intermediate probability (15 30 ). Study Design Go to Layout table for study information Study Type : Observational Estimated Enrollment : 600 participants Observational Model: Case (...) admitted to the ED with acute dyspnea, with the final diagnosis of heart failure by the ICU team Criteria Inclusion Criteria: non traumatic dyspnea with the final diagnosis of heart failure Exclusion Criteria: coma, shock,Mechanical Ventilation, vasopressor drugs arrhythmia serious and sustained, pace maker severe mitral valve disease, severe pulmonary arterial hypertension renal failure with creatinine >350micromol/l Contacts and Locations Go to Information from the National Library of Medicine

2018 Clinical Trials

603. Comparison of The Effects of Thiazolidinediones(TZD), Sodium- Glucose Cotransporter 2 Inhibitors(SGLT2i) Alone and TZD / SGLT2i Combination Therapy on Non-alcoholic Fatty Liver Disease in Type 2 Diabetic Patients With Fatty Liver

: Diabetic patients other than type 2 diabetes, including type 1 diabetes and gestational diabetes Type 2 diabetic patients undergoing insulin therapy Patients who have taken TZD or SGLT2i drugs within the last 12 weeks or have had a history of severe side effects after taking the above drugs Patients with acute or chronic metabolic acidosis, including diabetic ketoacidosis with or without coma, and those with a history of ketone phosphatemia (within 6 months) Patients who meet the criteria for alcoholic (...) , myocardial infarction, transient ischemic attack, cerebrovascular disease, coronary artery bypass grafting, or coronary intervention) People with renal failure, chronic renal disease (estimated glomerular filtration rate <45 mL / min / 1.73 m2) or those who are difficult to use the medication due to dialysis Pregnant or lactating women A person who the examiner considers not eligible for clinical trials Contacts and Locations Go to Information from the National Library of Medicine To learn more about

2018 Clinical Trials

604. Cervico-vestibular Rehabilitation for Mild Traumatic Brain Injury

the patient will achieve the last step of this progression which means that the patient can safely return to play, the neuropsychologist and the kinesiologist will confirm the decision with a structured interview (neuropsychologist) and an aerobic test (kinesiologist). The clearance will be determined by the day for which 1) the symptoms will have resolved 2) the neurological, cervical spine and vestibular exams will be deemed normal by the treating physiotherapist 3) the subject returned to his normal (...) in the PCSS that started 72 hours or less after an impact; Having felt at least one or more cognitive symptoms that started 72 hours or less after an impact; Having abnormalities on one of the following test : the cervical physical examination (eg, tenderness/spasm on segmental testing, or reduced motion), the vestibular evaluation (eg, Dix hallpike test, vestibulo-ocular reflex test, or head thrust test) or the ocular motor evaluation (eg, convergence, smooth visual pursuits, or saccades). Exclusion

2018 Clinical Trials

605. Comparison of Optical Quality With Different Placement of Refractive Multifocal Intraocular Lens

Co. Ltd., Gamagori, Japan) was used to evaluate postoperative mesopic and photopic pupil diameters and the quality of vision in each subject. Visual acuity was evaluated by MTF(modulation transfer function), SR(strehl ratio), intraocular total aberration, high order aberration, spherical aberration, coma aberration, trefoil aberration under 4mm pupil diameter. Contrast sensitivity [ Time Frame: 3 months postoperatively ] Contrast sensitivity measures were conducted uniocularly, under photopic (...) <1.5D Exclusion Criteria: patients with active ocular inflammation neuro-ophthalmic disease and macular disease previous corneal or intraocular surgery, corneal opacities or disease patients had surgical complications, pupillary trauma, inability to place the lens in the capsular bag IOL tilt or decentration deviated from intraoperative positioning difficulties with examinations and follow-up Contacts and Locations Go to Information from the National Library of Medicine To learn more about

2018 Clinical Trials

606. Is There a Benefit of Whole Body Computed Tomography (WBCT) for Patients With Only High Velocity Road Traffic Collision (RTC) Vittel Criteria?

Vittel criteria of gravity, normal clinical examination of the thorax, abdomen and pelvis and Glasgow Coma Scale (GCS) score of 15. Criteria Inclusion Criteria: Consecutives patients consulting the emergency department between August 1st 2016 and July 31th 2017 : Older than 18 y.o. WBCT performed, Victim of a high velocity RTC as defined by the presence of at least one criteria of the kinetics elements of the Vittel Criteria Normal physical exam of the chest, abdomen and pelvis, GCS score of 15 (...) . Identifier: NCT03679416 Recruitment Status : Completed First Posted : September 20, 2018 Last Update Posted : September 25, 2018 Sponsor: Rennes University Hospital Information provided by (Responsible Party): Rennes University Hospital Study Details Study Description Go to Brief Summary: For victims of high velocity RTC, with no other Vittel criteria of gravity, normal clinical examination of the thorax, abdomen and pelvis and Glasgow Coma Scale (GCS) score of 15 : Study of clinically

2018 Clinical Trials

607. Esmolol for the Treatment of Hypertension After Intracerebral Hemorrhage Study (ETHICHS)

Scale (NIHSS) and Glasgow Coma Scale [ Time Frame: from admission to discharge or 7th day ] Compare the variation in scores on the NIH Stroke Scale (NIHSS) and Glasgow Coma Scale (whichever comes first) between groups. MOCA scale [ Time Frame: in 90 ± 4 days ] To compare the cognitive performance assessed between the groups. Hematoma volume expansion and perihematoma volume of cerebral edema [ Time Frame: 24 ± 4 hours ] To compare the percentages of between admission tomography and control (...) between the examination performed in the first 72 ± 4 hours and the return after 90 ± 3 days) between the groups. Frequency of changes in the level of BNP [ Time Frame: at baseline times, 24 ± 4 and 72 ± 4 hours ] To compare the frequency of changes in the level of B-type natriuretic peptide (BNP) measured at baseline times, 24 ± 4 and 72 ± 4 hours between groups. Frequency of changes in baseline cardiac troponin levels [ Time Frame: 24 ± 4 and 72 ± 4 hours ] To compare the frequency of changes

2018 Clinical Trials

608. Retrospective analysis of alcohol testing in trauma team activation patients at a Canadian tertiary trauma centre. Full Text available with Trip Pro

, and to elucidate patient-level, injury-level and system-level factors associated with BAC testing.Retrospective cohort study.Tertiary trauma centre in Halifax, Canada.2306 trauma patients who required activation of the trauma team.The primary outcome was the rate of BAC testing among TTA patients. Trends in BAC testing over time and across patient and injury characteristics were described. Multivariable logistic regression examined patient-level, injury-level and system-level factors associated (...) with testing.Overall, 61% of TTA patients received BAC testing despite existence of a mandatory testing protocol. Rates of BAC testing rose steadily over the study period from 33% in 2000 to 85% in 2010. Testing varied considerably across patient-level, injury-level and system-level characteristics. Key factors associated with testing were male gender, younger age, lower Injury Severity Score, scene Glasgow Coma Scale score <9, direct transport to hospital and presentation between midnight and 09:00 hours

2018 BMJ open

609. Characterization & Treatment of Chronic Pain After Moderate to Severe TBI

multi-site, cross sectional, observational study designed to examine chronic pain and pain treatment after moderate to severe TBI. Condition or disease Traumatic Brain Injury Pain Detailed Description: The aims of this study are to: 1) Determine chronic pain classification (musculoskeletal, headache, central/neuropathic), prevalence, location, duration, and associations with demographic, injury severity, current level of functioning and comorbidities in participants followed in ten Centers (...) ) Identify treatment practices by clinicians who treat comorbid TBI and chronic pain to determine gaps in availability/accessibility of guideline level treatment, highlighting underserved populations where applicable. Results from this study will provide a more detailed picture of the problem of chronic pain after TBI by examining the types of pain that occur after TBI, which may be multiple types of pain for a subset of individuals, as well as the frequency of comorbid conditions. Identifying extreme

2018 Clinical Trials

610. Synek Score to Predict Poor Neurological Outcome Post Resuscitated Cardiac Arrest

clinical examination, biomarkers and electroencephalography (Guidelines ESICM 2015). Early standard electroencephalography (EEG) is currently recommended and some features, notably absence of reactivity, status epilepticus or burst suppression after rewarming are strongly predictive of poor outcome. But those features require a precise analyze of the EEG usually performed by specialist. EEG patterns can be simplified and classified in five grades according to the Synek classification, ranging from (...) dominant reactive alpha activity (grade 1) to isoelectric encephalogram (grade 5). Grade 1 and two are considering as good prognostic, grade 3 as intermediate and grade 4 to five as poor prognostic. Nevertheless, few data are available on the performance of this classification since generalization of TTM use. We hypothesize that a multimodal strategy combining clinical examination, NSE concentration and the Synek score would bring a high degree of prediction. We aimed to assess the performances

2018 Clinical Trials

611. Staphylococcus aureus meningitis in adults: A comparative cohort study of infections caused by methicillin-resistant and methicillin-susceptible strains. (Abstract)

Staphylococcus aureus meningitis in adults: A comparative cohort study of infections caused by methicillin-resistant and methicillin-susceptible strains. Staphylococcus aureus meningitis is an uncommon nosocomial infection usually associated with neurosurgical procedures, but spontaneous infections may occasionally appear.To compare the features of meningitis caused by meticillin-resistant (MRSA) and meticillin-susceptible (MSSA) S. aureus and examine the prognostic factors for mortality (...) was given to 118 (34%) patients. Overall 30-day mortality rate was 23%. On multivariate analysis, mortality was associated with severe sepsis or shock (odds ratio (OR) 9.9, 95% confidence interval (CI) 4.5-22.0, P < 0.001), spontaneous meningitis (OR 4.2, 95% CI 1.9-9.1, P < 0.001), McCabe-Jackson score rapidly or ultimately fatal (OR 2.8, 95% CI 1.4-5.4, P = 0.002), MRSA infection (OR 2.6, 95% CI 1.3-5.3, P = 0.006), and coma (OR 2.6, 95% CI 1.1-6.1, P < 0.029). In postoperative cases, mortality

2018 Journal of Hospital Infection

612. Traumatic Minor Intracranial Hemorrhage: Management by Non-neurosurgeon Consultants in a Regional Trauma Center is Safe and Effective. (Abstract)

Traumatic Minor Intracranial Hemorrhage: Management by Non-neurosurgeon Consultants in a Regional Trauma Center is Safe and Effective. There is debate concerning the need for specialist neurosurgical transfer of patients presenting to Level II trauma centers with a minimal head injury (Glasgow Coma Scale ≥13) and a small non-progressive intracranial bleeding (ICB).A retrospective chart analysis was performed assessing the outcomes of adult patients presenting with a minor traumatic ICB (...) on initial CT scan (minimal subarachnoid hemorrhage; small-width subdural hematoma without shift; punctate cerebral contusion). Patients with extradural hematomas and those patients on antiplatelet or anticoagulant therapy were excluded from the protocol.Overall 291 cases were assessed (mean age 69.9 years) with 75% of cases presenting after a fall. There was deterioration of neurological status in 11 patients (3.8%) with 8 hospital transfers and 5 with an abnormal neurological examination (NE). Two

2018 World Journal of Surgery

613. Effects of Liraglutide on the Cognitive Function in Patients With Type 2 Diabetes Mellitus

from performance on the following measures: (1)Digit Span Test(DST);(2) Rey Auditory Verbal Learning(RAVL);(3) Long-Delay Free Recall(LDFR);(4) Trail Making Test(TMT);(5) Animal Naming Test(ANT);(6) Clock Drawing Test(CDT);(7)Minimum Mental State Examination(MMSE);(8)Memory and executive screening(MES);(8)functional near-infrared spectroscopy. Secondary Outcome Measures : Changes of systolic blood pressure and diastolic blood pressure [ Time Frame: Baseline,4weeks,8weeks,12weeks(End of Trial (...) 。 Exclusion Criteria: Type 2 diabetes with acute diabetic complications. Type 1 diabetes. Other diseases affecting cognitive function (congenital dementia,brain trauma,severe heart dysfunction,severe kidney dysfunction,severe lung dysfunction,epilepsy,severe hypoglycemic coma,cerebrovascular disease,ischemic heart disease,etc). Alcohol abuse,mental illness and psychoactive substance abuse. History of thyroid disease. Any surgical or medical conditions that significantly influence absorption, distribution

2018 Clinical Trials

614. Optical and visual quality after small-incision lenticule extraction. Full Text available with Trip Pro

Optical and visual quality after small-incision lenticule extraction. To examine the relationship between corneal higher-order aberrations (HOAs), scatter, and residual refraction with visual symptoms and visual acuity after small-incision lenticule extraction (SMILE) for myopia and astigmatism.University Eye Clinic, Aarhus, Denmark.Prospective case series.Eyes had small-incision lenticule extraction for myopia or myopic astigmatism. Examinations were performed preoperatively and 1 day, 7 days (...) ) and coma by 0.1 ± 0.1 μm (P < .001); spherical aberration did not change significantly. The severity of self-reported visual symptoms decreased postoperatively. Scatter, corneal HOAs, and residual refraction were not correlated with the degree of visual symptoms. On linear regression analysis, residual refraction was a significant predictor of UDVA (1 day: adjusted R2 = 0.16, P = .02; 3 months: adjusted R2 = 0.55, P < .001). Scatter and corneal HOAs were not associated with postoperative UDVA.Despite

2018 Journal of cataract and refractive surgery

615. Disagreement Between Clinicians and Score in Decision-Making Capacity of Critically Ill Patients. (Abstract)

Disagreement Between Clinicians and Score in Decision-Making Capacity of Critically Ill Patients. To compare the assessment of decision-making capacity of ICU patients by attending clinicians (physicians, nurses, and residents) with a capacity score measured by the Mini-Mental Status Examination, completed by Aid to Capacity Evaluation if necessary. The primary outcome was agreement between physicians' assessments and the score. Secondary outcomes were agreement between nurses' or residents (...) decision-making capacity (n = 92/206 [45%]) than score (n = 34/206 [17%]; absolute difference 28% [95% CI, 20-37%]; p = 0.001). There was a high disagreement between assessments of all clinicians and score (Kappa coefficient 0.39 [95% CI, 0.29-0.50] for physicians; 0.39 [95% CI, 0.27-0.52] for nurses; and 0.46 [95% CI, 0.35-0.58] for residents). The main factor associated with disagreement was a Glasgow Coma Scale score between 10 and 15 (odds ratio, 2.92 [1.18-7.19], p = 0.02 for physicians; 4.97

2018 Critical Care Medicine

616. Risk Factors for Compartment Syndrome in Pediatric Trauma Patients. (Abstract)

Risk Factors for Compartment Syndrome in Pediatric Trauma Patients. This study aimed to identify risk factors for compartment syndrome (CS) in pediatric trauma populations.We included patients younger than 19 years treated at trauma centers contributing to the National Trauma Data Bank between 2009 and 2012. Multivariable logistic regression was used to examine the association between risk factors and the development of CS. The final model adjusted for age, sex, race, number of comorbidities (...) , Glascow Coma Scale, Injury Severity Score, mechanism of injury, and fracture of the lower limb.A total of 341,238 patients were eligible for analysis, and 896 patients developed CS (0.3%). In adjusted regression models, older patients had significantly higher odds of CS compared with patients 1 years or younger (odds ratio [OR], 3.29 [95% confidence interval [CI], 1.29-8.37; 2-6 years]; OR, 7.55 [95% CI, 3.08-18.55 [7-12 years]; OR, 10.34 [95% CI, 4.26-25.09 [13-18 years]). Male patients had

2018 Pediatric Emergency Care

617. Costal Margin Tenderness and the Risk for Intra-abdominal Injuries in Children with Blunt Abdominal Trauma. Full Text available with Trip Pro

Costal Margin Tenderness and the Risk for Intra-abdominal Injuries in Children with Blunt Abdominal Trauma. The risk of radiation exposure from computed tomography (CT) imaging in children is well recognized. Patient history and physical examination findings, including costal margin tenderness (CMT), influence a physician's decision to image a child with blunt torso trauma. The objective of this study was to determine the importance of CMT for identifying children with intraabdominal injuries (...) adjusted odds of IAI in children presenting with isolated and nonisolated CMT. Risk differences were calculated to estimate the risk of IAI independently attributable to CMT in the setting of isolated PECARN risk factors. Finally, CT use among exposure groups was estimated to quantify potentially avoidable imaging.Among 9,174 children with Glasgow Coma Scale scores of 14 or 15 who sustained blunt torso trauma, 1,267 (13.8%) had CMT. Among those with CMT, 177 (14.0%) had isolated CMT and 1,090 (86.0

2018 Academic Emergency Medicine

618. Clinical Value of Dorsal Medulla Oblongata Involvement Detected with Conventional MRI for Prediction of Outcome in Children with Enterovirus 71-related Brainstem Encephalitis. (Abstract)

in children with enterovirus 71-related brainstem encephalitis (EBE) by using conventional magnetic resonance imaging (MRI) and to evaluate the value of dorsal medulla oblongata involvement in outcome prediction.Forty-six children with EBE were enrolled in the study. All subjects underwent a 1.5 Tesla MRI examination of the brain. The disease distribution and clinical data were collected. Dichotomized outcomes (good vs. poor) at longer than 6 months were available for 28 patients. Logistic regression (...) outcome group. Logistic regression analysis showed that dorsal medulla oblongata involvement was the most significant single variable in outcome prediction (predictive accuracy, 90.5%), followed by multiple area involvement, age and initial Glasgow Coma Scale score.Dorsal medulla oblongata involvement on conventional MRI correlated significantly with poor outcomes in EBE children, improved outcome prediction when compared with other clinical and disease location variables, and was most predictive when

2018 Pediatric Infectious Dsease Journal

619. Clinical Outcomes of SMILE With a Triple Centration Technique and Corneal Wavefront-Guided Transepithelial PRK in High Astigmatism. Full Text available with Trip Pro

patients) that received treatment for myopia with high astigmatism (≥ 2.50 diopters) using SMILE with a triple centration technique (SMILE group; 45 eyes) and corneal wavefront-guided transepithelial PRK (transepithelial PRK group; 44 eyes). Visual acuity measurement, manifest refraction, slit-lamp examination, autokeratometry, corneal topography, and evaluation of corneal wavefront aberration were performed preoperatively and at 1, 3, and 6 months after surgery. The safety, efficacy, vector parameters (...) , respectively). Whereas the transepithelial PRK group exhibited increased corneal spherical aberration and significantly reduced corneal coma and trefoil, no changes in aberrometric values were noted in the SMILE group.Both SMILE with a triple centration technique and corneal wavefront-guided transepithelial PRK are effective and provide predictable outcomes for the correction of high myopic astigmatism, although slight undercorrection was observed in the SMILE group. The triple centration technique

2018 Journal of Refractive Surgery

620. Correlates of patterns of health values of African Americans living with HIV/AIDS: Implications for advance care planning and HIV palliative care. Full Text available with Trip Pro

Americans living with HIV/AIDS and to examine correlates of these values.Data were from the first 325 participants in the AFFIRM Care study, which enrolled adults living with HIV/AIDS in Baltimore, Maryland, who had histories of illicit drug use. Respondents were asked whether (yes/no) they thought any of six health states would be worse than death: severe unremitting pain, total dependency on others, irreversible coma, being on mechanical ventilation, nursing home residence, and severe dementia. Latent (...) class analysis was used to group individuals by their pattern of responses, interpretable as preference for aggressive (life-sustaining) or nonaggressive (palliative) end-of-life care. Latent class regression analysis was used to examine associations between class membership and background, health status, and social variables.We found statistical support for a three-class latent class analysis model: 1) the nonaggressive treatment class, comprising 43% of cases, in which members perceived that every

2018 Journal of pain and symptom management

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