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FOUR Score Coma Exam

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61. Neurological Outcomes After In-Hospital Cardiac Arrest

score is classified according to the point. Good neurological outcome is defined as CPC 1-2 and poor is CPC 3-5. CPC score will be evaluated by neurological examination and the results of other exam. Neurological examination: Neurologist will perform directly until the point of CPC score 1 is confirmed. mental status: ACDU score, FOUR score and Glasgow Coma Scale brain stem reflex: Light reflexes by pupillometer(the NeurOptics® NPi™-100 (Neuroptics Inc., Irvine, CA, USA)) and corneal reflexes motor (...) following cardiac arrest. CPC score is classified according to the point. Good neurological outcome is defined as CPC 1-2 and poor is CPC 3-5. CPC score will be evaluated by neurological examination and the results of other exam. Neurological examination: Neurologist will perform directly until the point of CPC score 1 is confirmed. mental status: ACDU score, FOUR score and Glasgow Coma Scale brain stem reflex: Light reflexes by pupillometer(the NeurOptics® NPi™-100 (Neuroptics Inc., Irvine, CA, USA

2016 Clinical Trials

62. Neuroimaging and Neuropsychological Outcomes in Urea Cycle Disorders

, impairments, and diet history; a physical exam; a full neurological exam; and cognitive and motor testing. During this visit, participants will undergo imaging studies and additional cognitive and motor testing over a 1-2-day period. This will include standard MRI studies and four sessions consisting of functional MRI (fMRI) (CNMC only), diffusion tensor imaging, and 1H magnetic resonance spectroscopy. For the fMRI study, participants perform various motor and behavioral tasks while in the imaging scanner (...) that the diffusion of water is isotropic and unrestricted, or equally restricted, in all directions and with 1 meaning that diffusion occurs along only one axis and is fully restricted along all other directions. Scores closer to 1 are associated with intact white matter while scores closer to 0 are associated with white matter damage. Secondary Outcome Measures : Change in behavioral testing results [ Time Frame: baseline and 2 year follow up ] correlation of the findings from neuroimaging with cognitive

2016 Clinical Trials

63. Stellate Ganglion Blockade in Post-Menopausal Women

-Delay Free Recall, Short-Delay Cued Recall, Long Delay Free Recall, Long Delay Cued Recall, Card Rotation Tests, Finding As, Letter, Semantic and Phonemic Fluency, Logical Memory Subtest of Wechsler Memory Scale (WMS-R/LM-R) Part 1 and (WMS-R/LM-R) Part 2, Mini-Mental State Exam (MMSE), Memory Functioning Questionnaire (MFQ),Closing Question at baseline, 12 weeks (3 months) and 24 weeks (6 months) Composite changes from baseline of scores of measures of mood [ Time Frame: Up to 24 weeks (6 months (...) treatment. safety labs within 30 days of SGB intervention Exclusion Criteria: conditions that preclude SGB or sham intervention (e.g., anatomic abnormalities of the anterior neck or cervical spine ; goiter, cardiac/pulmonary compromise; contralateral (left-sided) phrenic nerve paralysis or diaphragmatic paresis; history of seizure, coma, or stroke; history of neurologic deficit to the brachial plexus or an abnormal brachial plexus neurologic exam; history of Zenker's diverticulum; acute illness

2016 Clinical Trials

64. Family Practice Notebook Updates 2017

not decrease resource use, admissions (surgery, gi) before Abdominal MRI in children is preferred first strategy is faster and more cost-effective, despite being inconclusive in 25% of cases (psych, exam, er) Head imaging is not required for new onset without focal neurologic deficit (expert opinion) Acute psychiatric symptoms in alert adults do not mandate routine lab testing No risk assessment tool can identify those safe for discharge (neuro, cv) Consider even in minor NIH stroke scores <5 Large vessel (...) (e.g. , cerebellar artery) may have low NIH Stroke Score particularly underestimates deficits from cerebellar strokes CTA Head and Neck identifies large vessel and can help inform decision V. Updates: September 2017 (ortho, peds) Evaluation includes , gait exam, limb asymmetry as well as , may be caused by , , may be caused by , and Angular variations include and ing (cv, procedure, ) Stress testing is uncommonly indicated in asymptomatic patients aside from vascular surgery preop, vigorous

2018 FP Notebook

65. Should I Have Meniscus Surgery?

tear or a flap tear — those are the tears tend to remain bothersome. If after four, five, six weeks, you still have the same degree of discomfort and quality of life issues, then you might be a good candidate for surgery, which we call an arthroscopy. Physical therapy can help those of you whose knees feel unstable or weak, and it can help those of you with significant swelling to gain back your motion, stability and strength. Therapy can be beneficial before surgery (pre-habilitation), instead

2016 Howard J. Luks, MD blog

66. Newly Diagnosed with Hepatitis B? Acute or Chronic? Learning the HBV Basics…

of sickness last 2013 on my medical exam for a job here in the Philippines. I had my second Opinion but the result is the same. I never had a test since then. Please reply. Thank you. Hello: There is no cure yet for hepatitis B, however there are two very effective antivirals -– entecavir and tenofovir (Viread) and its TAF formulation that was recently approved by FDA –- that quickly reduce your viral load (HBV DNA) and your risk of liver damage if you should ever need treatment. To find out the latest

2016 hepbblog

67. Family Practice Notebook Updates 2017

not decrease resource use, admissions (surgery, gi) before Abdominal MRI in children is preferred first strategy is faster and more cost-effective, despite being inconclusive in 25% of cases (psych, exam, er) Head imaging is not required for new onset without focal neurologic deficit (expert opinion) Acute psychiatric symptoms in alert adults do not mandate routine lab testing No risk assessment tool can identify those safe for discharge (neuro, cv) Consider even in minor NIH stroke scores <5 Large vessel (...) (e.g. , cerebellar artery) may have low NIH Stroke Score particularly underestimates deficits from cerebellar strokes CTA Head and Neck identifies large vessel and can help inform decision V. Updates: September 2017 (ortho, peds) Evaluation includes , gait exam, limb asymmetry as well as , may be caused by , , may be caused by , and Angular variations include and ing (cv, procedure, ) Stress testing is uncommonly indicated in asymptomatic patients aside from vascular surgery preop, vigorous

2018 FP Notebook

68. Patient Dignity (Formerly: Patient Modesty): Volume 92

, tacit agreement – no females were allowed. This would be strictly for men and men felt safe in these situations. I don’t think naked military induction exams really became standard until WW1. That’s not to say it didn’t occur during the Crimean War, the American Civil War or the Franco-Prussian War. We’d have to research that. But before “modern” warfare, governments were more interested in bodies in any condition to man the front lines. Doctor’s examining naked bodies didn’t really begin seriously (...) TO THE EXTENT THAT NONE OF YOU CAN TRULY APPRECIATE. PT At , said... Dr. Bernstein, I looked at Volume 12. There were more women participating back then and that was an excellent discussion about the pelvic exams in exchange for birth control. I hope that isn't still as mandatory as it was then. The discussion was as well a bit more focused on patients simply being modest and/or uncomfortable with opposite gender intimate care without going into staff misbehavior or unprofessional behavior as being

2018 Bioethics Discussion Blog

69. Patient Modesty: Volume 90

" in ways totally different than the "patient satisfaction" scoring by Ganey. Very interesting and fits with what has been written on this Patient Modesty thread. ..Maurice. At , Anonymous said... Hello, Please read the article (url below) about the lack of informed consent - another blow to patient dignity/ self-determination. http://blogs.einstein.yu.edu/minnesota-case-demonstrates-continuing-erosion-of-informed-consent/?utm_source=The+Doctor%27s+Tablet&utm_campaign=0a4cc73c66-RSS+Subscribers (...) by a dietitian. Because a lot of patients are diabetic, so it’s important. Billy bob is brought by ambulance to the hospital and admitted and he is found to have a high blood sugar of over 600. Technically, he should be in a coma. Billy bob dosen’t like the hospital food cause it tastes bland so Billy Bob orders a pizza from the local Pizza Hut and has it delivered to his room, his favorite, anchovies, pepporini, double cheese and mushrooms. But Billy Bob is non-compliant with the physicians orders regarding

2018 Bioethics Discussion Blog

70. Patient Modesty: Volume 91

nurses always let their male patients lie nude longer than really needs too. It is at this time that I am going to give a bigger picture of the more common privacy violations that occur in hospitals. Definition of flashing: Female nurses open up their male patients gowns to expose the patient’s genitals when other female staff enter the male patients’s room. Location, neuro icu, micu, any intensive care unit whereby male patients are comatose by barb induced comas. This unnecessary exposure in the 70

2018 Bioethics Discussion Blog

71. Cataract Surgery Guidelines

2000;77:13-24. 2. Lundstrom M, Stenevi U, Thorburn W. Quality of life after first- and second-eye cataract surgery: five- year data collected by the Swedish National Cataract Register. J Cataract Refract Surg 2001;27:1553-9. 3. Javitt JC, Brenner MH, Curbow B, et al. Outcomes of cataract surgery. Improvement in visual acuity and subjective visual function after surgery in the first, second, and both eyes. Arch Ophthalmol 1993;111:686-91. 4. Castells X, Comas M, Alonso J, et al. In a randomized (...) to the adult eye) ? Potential for amblyopia ? Long life span after cataract removal These facts must be taken into account and their impact understood by any surgeon undertaking cataract surgery in children. 6.7 Evaluation History Should include history of pregnancy and family history III IV ARCHIVED see NICE cataracty surgery guidelines 201728 Examination Should include examination of the child and a dilated exam of the lenses of both parents Investigations Neonates with bilateral cataracts and no family

2010 Royal College of Ophthalmologists

72. Addyi - Flibanserin

flibanserin was co-administered with both ethanol concentrations. The hypotensive effect of the interaction can be profound – in four male subjects (17%, 4/23) receiving low dose ethanol, the magnitude of the systolic blood pressure reductions ranged from about 28 to 54 mmHg and the magnitude of the diastolic blood pressure reductions ranged from about 24 to 46 mmHg. All four subjects received medical intervention. One of these subjects also experienced syncope; his blood pressure at the time of the event (...) that potentially contribute to the metabolism of flibanserin.” CDTL comment: Four combined cases of syncope and severe hypotension were observed in Studies 511.111 and SPR-12-01. The magnitude of increase in flibanserin exposure when used in combination with strong or moderate CYP3A4 inhibitors could lead to many such adverse events if flibanserin is made available. Even if the use of strong or moderate CYP3A4 is contraindicated, existing automatic screening systems in pharmacies may not eliminate concomitant

2015 FDA - Drug Approval Package

73. Management of Stroke Rehabilitation

to care • Utilization of healthcare Version 2.0 VA/DoD Clinical Practice Guideline for the October, 2010 Management of Stroke Rehabilitation Introduction Page - 4 Effective rehabilitation improves functional outcome. An indicator for improvement is the positive change in the Functional Independence Measures (FIM TM ) (UDS MR for1997, 1998) score over a period of time in the post- acute care period. Within the Veterans Health Administration (VHA) this measure is captured in the Functional Status (...) management of risk factors and co-morbidities is essential to ensure survival. OUTCOME MEASURES 1. Effective rehabilitation improves functional outcome. An indicator for improvement is the positive change in the Functional Independence Measures (FIM TM ) score over a period of time in the post-acute care period. Within the Veterans Health Administration (VHA) this measure is captured in the Functional Status and Outcomes Database for rehabilitation. All stroke patients should be entered into the database

2010 VA/DoD Clinical Practice Guidelines

74. Thoracic Aortic Disease: Guidelines For the Diagnosis and Management of Patients With

resonance imaging (MR), or in some cases, echocardiographic exam- ination is the only method to detect thoracic aortic diseases and determine risk for future complications (see Section 4). • Radiologic imaging technologies have improved in terms of accuracy of detection of thoracic aortic disease. How- ever, as the use of these technologies has increased, so also has the potential risk associated with repeated radiation exposure, as well as contrast medium–related toxicity. Whether these technologies

2010 American College of Cardiology

75. Blunt Cerebrovascular Injury

with any neurologic abnormality that is unexplained by a diagnosed injury should be evaluated for BCVI. 2. Blunt trauma patients presenting with epistaxis from a suspected arterial source after trauma should be evaluated for BCVI. Level III: 1. Asymptomatic patients with significant blunt head trauma as defined below are at significantly increased risk for BCVI and screening should be considered. Risk factors are as follows: * Glasgow Coma Scale score ≤8; * Petrous bone fracture; * Diffuse axonal (...) factors for blunt carotid arterial injury (BCAI). These were (1) Glasgow Coma Scale score <6; (2) petrous fracture; (3) diffuse axonal injury; and (4) LeFort II or III fracture. Patients who had any of the above risk factors had a risk of 41% for BCAI. This risk increased to 93% in the presence of all 4 factors. The only risk factor for blunt vertebral artery injury (BVAI) was presence of cervical spine fracture. However, 20% of patients diagnosed with BCVI selected for screening by the criteria

2010 Eastern Association for the Surgery of Trauma

76. CPG on the comprehensive care of people with Alzheimer's Disease and other Dementias

(Barcelona) M.ª Pilar Cañabate González, social worker, Fundació ACE, Institut Català de Neurociències Aplicades (Barcelona) Montserrat Coma Solé, general practitioner, Les Planes Primary Health Centre, Sant Joan Despí (Barcelona) Josep Lluís Conde Sala, psychologist, University of Barcelona Maria-Dolors Estrada Sabadell, public health and preventivist physician, Agència d’Informació, Avaluació i Qualitat en Salut (AIAQS) (Barcelona) It has been 5 years since the publication of this Clinical Practice

2010 GuiaSalud

77. CPG on the Diagnosis, Treatment and Prevention of Tuberculosis

, Preventative Medicine and Public Health Physician, It has been 5 years since the publication of this Clinical Practice Guideline and it is subject to updating. CLINICAL PRACTICE GUIDELINE IN THE SNHS 12 Hospital General Universitario de Elche, Alicante Arturo Noguerado Asensio, Internal Medicine Physician, Hospital de Cantoblanco-La Paz, Madrid David Rigau Comas, Specialist Physician, Clinical Pharmacology, Iberoamerican Cochrane Centre; Hospital de la Santa Creu i Sant Pau, Barcelona Joan Roca Martínez (...) , Documentalist, Iberoamerican Cochrane Centre; Hospital de la Santa Creu i Sant Pau,Barcelona Rafael Vidal Pla, Pulmonologist, Hospital Vall d’Hebron, Barcelona Coordination David Rigau Comas, Rigau Comas, Specialist Physician, Clinical Pharmacology Iberoamerican Cochrane Centre; Hospital de la Santa Creu i Sant Pau, Barcelona Pablo Alonso Coello, Family and Community Medicine Physician Iberoamerican Cochrane Centre; Hospital de la Santa Creu i Sant Pau, Barcelona External Review External Review José Antonio

2010 GuiaSalud

78. Assessment and Treatment of Individuals with History of TBI and PTSD

- traumatic amnesia lasting >24 hr up to permanently, or Glasgow Coma score as low as 3 Focal neurologic signs Usually none or transient Frequently present Neuroimaging with CT or MRI Usually negative Diagnostic Natural History Full recovery is usual; there is lack of consensus on the natural history of concussion and post-concussive symptoms Natural history and recovery are directly related to the severity of the injury and functional neuroanatomy Case definitions and specificity of injury sequelae Case (...) will be disseminated broadly throughout V A and will: inform V A clinical policy, develop clinical practice guidelines, set directions for future research to address gaps in knowledge, identify the evidence to support V A performance measures, and rationalize drug formulary decisions. HSR&D provides funding for four ESP Centers. Each Center has an active and publicly acknowledged V A affiliation and also serves as an Evidence Based Practice Center (EPC) supported by the Agency for Healthcare Research and Quality

2009 Veterans Affairs Evidence-based Synthesis Program Reports

79. Nasopharyngeal Cancer, Childhood

with nasopharyngeal carcinoma present with advanced disease (stage III/IV or T3/T4).[ , ] Population-based studies have reported that patients younger than 20 years had a higher incidence of advanced-stage disease than did adult patients.[ , ] However, less than 10% of children and adolescents with nasopharyngeal carcinoma presented with distant metastases at diagnosis.[ - ] Prognosis The overall survival of children and adolescents with nasopharyngeal carcinoma has improved over the last four decades; with state (...) cytokeratin expression.[ ] Sixty-six samples of olfactory neuroblastoma and tumor samples from other cancers, including alveolar rhabdomyosarcoma and sinonasal adenocarcinoma, were obtained from nine medical centers and analyzed by genome-wide DNA methylation profiling, copy number analysis, immunohistochemistry, and next-generation panel sequencing. Unsupervised hierarchal clustering analysis of DNA methylation data identified the following four distinct clusters:[ ] The largest cluster, which comprised

2012 PDQ - NCI's Comprehensive Cancer Database

80. Multiple Endocrine Neoplasia, Childhood

with nasopharyngeal carcinoma present with advanced disease (stage III/IV or T3/T4).[ , ] Population-based studies have reported that patients younger than 20 years had a higher incidence of advanced-stage disease than did adult patients.[ , ] However, less than 10% of children and adolescents with nasopharyngeal carcinoma presented with distant metastases at diagnosis.[ - ] Prognosis The overall survival of children and adolescents with nasopharyngeal carcinoma has improved over the last four decades; with state (...) cytokeratin expression.[ ] Sixty-six samples of olfactory neuroblastoma and tumor samples from other cancers, including alveolar rhabdomyosarcoma and sinonasal adenocarcinoma, were obtained from nine medical centers and analyzed by genome-wide DNA methylation profiling, copy number analysis, immunohistochemistry, and next-generation panel sequencing. Unsupervised hierarchal clustering analysis of DNA methylation data identified the following four distinct clusters:[ ] The largest cluster, which comprised

2012 PDQ - NCI's Comprehensive Cancer Database

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