Assuntos
Tomada de Decisão Clínica/métodos , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Medicina Baseada em Evidências/métodos , Guias como Assunto , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Betacoronavirus , COVID-19 , Humanos , SARS-CoV-2RESUMO
As a result of national guidance in the UK, the number of computed tomography brains performed in patients with minor head injury has increased significantly. The aim of this survey was to establish the requirement for general anaesthesia and tracheal intubation in the management of emergency department patients requiring an urgent computed tomography of the brain. About 300 consecutive scans in emergency department patients were reviewed. The majority (>90%) did not require anaesthetic airway management despite an overall acute scan diagnosis rate of around 25% and 30 day mortality of 10%.
Assuntos
Anestesia Geral/estatística & dados numéricos , Lesões Encefálicas/diagnóstico por imagem , Intubação Intratraqueal/estatística & dados numéricos , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Procedimentos Desnecessários , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Manuseio das Vias Aéreas/métodos , Lesões Encefálicas/mortalidade , Lesões Encefálicas/terapia , Pré-Escolar , Estudos Transversais , Serviço Hospitalar de Emergência , Escala de Coma de Glasgow , Mortalidade Hospitalar/tendências , Humanos , Lactente , Recém-Nascido , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Traumatismo Múltiplo/diagnóstico por imagem , Traumatismo Múltiplo/terapia , Medição de Risco , Reino Unido , Adulto JovemRESUMO
State-of-the-art medical care of the victims of current conflicts is generating large quantities of quality clinical data as a by-product. Observational research based on these data is beginning to have a profound influence on the clinical management of both military and civilian trauma patients. Computational modelling based on these datasets may offer the ability to investigate clinical treatment strategies that are practically, ethically or scientifically impossible to investigate on the front line. This article reviews the potential of this novel technology to aid development of treatment for blast lung and other unresolved medical scenarios.
Assuntos
Traumatismos por Explosões/fisiopatologia , Biologia Computacional/métodos , Modelos Biológicos , Síndrome do Desconforto Respiratório/fisiopatologia , Simulação por Computador , HumanosRESUMO
Previous research demonstrated a relationship between preoperative memory measured by the Wechsler Memory Scale-Revised (WMS-R) and postsurgical memory change in patients who underwent left (LATL), but not right (RATL) anterior temporal lobectomy. The current study replicated previous efforts using the Wechsler Memory Scale-Third Edition (WMS-III) in a larger sample. The WMS-III was administered to 161 patients with medically intractable epilepsy prior to and approximately 6 months following LATL or RATL. Correlations between presurgical memory on WMS-III indices and memory change following surgery were calculated for each group. Significant negative relationships were found between pre- and postsurgical memory scores in patients who underwent LATL on all WMS-III measures (r=-0.31 to -0.43). Significant negative correlations were observed in patients who underwent RATL only on visual memory measures (r=-0.24 to -0.44). Findings support previous conclusions using the WMS-R showing that patients who undergo LATL with higher presurgical memory ability are at greater risk for memory decline following temporal resection than patients with lower presurgical memory scores.