Traumatic brain injury caused by "balconing".

The term "balconing" refers to the practice of jumping from hotel balconies or roofs to swimming pools, or between hotel balconies. This activity is performed by young vacationists in certain European touristic locations, and it is perceived as a recreational practice. The activity generates a small but constant flow of patients with fall-related severe brain and systemic injuries. Our institution is a reference hospital for severe trauma in a geographic zone where "balconing" activity takes place. We have retrospectively reviewed the medical records of patients sustaining "balconing"-related injuries. Salient features regarding epidemiology, neurosurgical injuries, systemic injuries, and outcome are described. With this series of cases, we aim to present "balconing" as a cause of traumatic brain injury and polytrauma in a defined population, and to express the concern this group of patients generate.

Real-time continuous glucose monitoring in an intensive care unit: better accuracy in patients with septic shock.

OBJECTIVE: This study assessed the accuracy of real-time continuous glucose monitoring system (RTCGMS) devices in an intensive care unit (ICU) to determine whether the septic status of the patient has any influence on the accuracy of the RTCGMS. SUBJECTS AND METHODS: In total, 41 patients on insulin therapy were included. Patients were monitored for 72 h using RTCGMS. Arterial blood glucose (ABG) samples were obtained following the protocol established in the ICU. The results were evaluated using paired values (excluding those used for calibration) with the performance assessed using numerical accuracy. Nonparametric tests were used to determine statistically significant differences in accuracy. RESULTS: In total, 956 ABG/RTCGMS pairs were analyzed. The overall median relative absolute difference (RAD) was 13.5%, and the International Organization for Standardization (ISO) criteria were 68.1%. The median RADs reported for patients with septic shock, with sepsis, and without sepsis were 11.2%, 14.3%, and 16.3%, respectively (P<0.05). Measurements meeting the ISO criteria were 74.5%, 65.6%, and 63.7% for patients with septic shock, with sepsis, and without sepsis, respectively (P<0.05). CONCLUSIONS: The results showed that the septic status of patients influenced the accuracy of the RTCGMS in the ICU. Accuracy was significantly better in patients with septic shock in comparison with the other patient cohorts.