Auditory event-related potentials as indicators of good prognosis in coma of non-anoxic etiology

The aim of this study is to evaluate whether auditory event-related potentials can predict the prognosis of recovery from coma resulting from different etiologies. The results of this study could then be used as an adjuvant test in helping the clinician evaluate patients in coma. We performed P300 auditory event-related potentials on 21 patients who developed a state of coma at our institution. We compared the results to the Glasgow coma scale at the onset of coma, on day 3, and day 21. We found that patients who developed coma secondary to cardiopulmonary arrest had no P300, and did not develop one, irrespective of their GCS, or their survival. Patients who developed coma from causes other than cardiopulmonary arrest who had a P300 at the onset of their coma, or developed one in the days that followed, ended up surviving their coma. On the other hand, patients in coma from non-cardiac causes who did not have, or developed a P300, did not survive their coma. We concluded that P300 had no prognostic value in coma secondary to anoxic brain injury, while it was an indicator of good prognosis if it was present in patients in coma from nonanoxic causes

Recanalization of the Chronically Occluded Internal Carotid Artery: Review of the Literature.

Introduction: We reviewed the literature on interventions for patients with medically refractory chronically occluded internal carotid artery (COICA) to assess the risks and/or benefits after recanalization via an endovascular technique (ET) or hybrid surgery (HS, i.e., ET plus carotid endarterectomy). Methods: A systematic search of the electronic databases was performed. Patients with COICA were classified into 4 different categories according to Hasan et al classification. Results: Eighteen studies satisfied the inclusion criteria. Only 6 studies involved an HS procedure. We identified 389 patients with COICA who underwent ET or HS; 91% were males. The overall perioperative complication rate was 10.1% (95% confidence interval [CI]: 7.4%-13.1%). For types A and B, the successful recanalization rate was 95.4% (95% CI: 86.5%-100%), with a 13.7% (95% CI: 2.3%-27.4%) complication rate. For type C, the success rate for ET was 45.7% (95% CI: 17.8%-70.7%), with a complication rate of 46.0% (95% CI: 20.0%-71.4%) for ET and for the HS technique 87.6% (95% CI: 80.9%-94.4%), with a complication rate of 14.0% (95% CI: 7.0%-21.8%). For type D, the success rate of recanalization was 29.8% (95% CI: 7.8%-52.8%), with a 29.8% (95% CI: 6.1%-56.3%) complication rate. Successful recanalization resulted in a symmetrical perfusion between both cerebral hemispheres, resolution of penumbra, normalization of the mean transit time, and improvement in Montreal Cognitive Assessment (MoCA) score (ΔMoCA = 9.80 points; P = 0.004). Conclusions: Type A and B occlusions benefit from ET, especially in the presence of a large penumbra. Type C occlusions can benefit from HS. Unfortunately, we did not identify an intervention to help patients with type D occlusions. A phase 2b randomized controlled trial is needed to confirm these findings

Indocyanine green elimination test in orthotopic liver recipients.

OBJECTIVE: To determine its predictive capability on graft quality and resultant clinical outcome, the indocyanine green (ICG) elimination test was performed by a spectrophotometric method and a noninvasive finger-piece method with 50 orthotopic liver transplantations. BACKGROUND: Early detection of poor-functioning hepatic grafts is one of the most important issues in liver transplantation, but no reliable methods exist. METHODS: The ICG test was performed after 50 orthotopic liver transplantations on postoperative days 1, 3, and 7. Indocyanine green elimination constants (K(ICG)) were measured by both a standard spectrophotometric analysis (K(ICG)-B) and by a finger-piece method (K(ICG)-F). The patients were followed for a minimum of 3 months after transplantation. Results of ICG tests were correlated with various clinical determinations. RESULTS: Twelve of the 50 grafts were lost within three months, of which 7 were related to graft failure. Multivariate analysis using the Cox proportional hazard model revealed that K(ICG) on postoperative day 1 was a better predictor of liver-related graft outcome than any of the conventional liver function tests. Furthermore, K(ICG) values showed significant correlation with the severity of preservation injury, longer intensive care unit (ICU) and hospital stay, prolonged liver dysfunction, and septic complications. Correlation of K(ICG) values by the spectrophotometric method with those by the finger-piece method was highly satisfactory in the grafts that had K(ICG)-B <0.15 min-1 (y = 0.868x -0.011, r = .955). CONCLUSION: The ICG elimination test, conducted spectrophotometrically or optically on the day after liver transplantation, is a reliable indicator of graft quality and subsequent graft outcome early after liver transplantation

Plasma Soluble Human Elastin Fragments as an Intra-Aneurysmal Localized Biomarker for Ruptured Intracranial Aneurysm

Background—Fragmentation of the tunica media is a hallmark of intracranial aneurysm formation, often leading to aneurysmal progression and subsequent rupture. The objective of this study is to determine the plasma level of elastin fragments in the lumen of ruptured versus unruptured human intracranial aneurysms. Methods and Results—One hundred consecutive patients with/without ruptured saccular intracranial aneurysms undergoing endovascular coiling or stent-assisted coiling were recruited. Blood samples were collected from the lumen of intracranial aneurysm using a microcatheter. The tip of the microcatheter was placed inside the aneurysm’s sac in close proximity to the inner wall of the dome. Plasma levels of elastin fragments were measured using an ELISA-based method. Mean plasma level of soluble human elastin fragments was significantly greater in ruptured aneurysms when compared with nonruptured aneurysms (102.0±15.5 versus 39.3±9.6 ng/mL; P\u3c0.001). Mean plasma level of soluble human elastin fragments did not have significant correlation with age, sex, size, or aneurysm location. Conclusions—The present study revealed that a significantly higher concentration of soluble human elastin fragments in the lumen of ruptured intracranial aneurysms when compared with nonruptured ones. © 2018 The Authors

Increasing mortality in the United States from cholangiocarcinoma: an analysis of the National Center for Health Statistics Database

CCA Mortality Rate by Year among Asians; raw data file with query terms. (TXT 6 kb

Do Multinational enterprises push up wages of domestic firms in the Italian Manufacturing sector?

This paper analyzes the effects of foreign direct investment on wages paid by domestic firms in the Italian manufacturing sector over the period 2002–2007. In particular, the authors investigate the im-pact of multinational enterprises on wages paid by local firms which operate in the same industry, known and horizontal wage spillovers, or have linkages with multinational enterprises in both downstream and upstream industries, known as vertical wage spillovers. By using a large panel dataset, consisting of 551,000 observations, the authors find evidence of wage spillovers only at inter-industry level and, more specifically, for those firms who supply their goods to multinational enterprises, described as backward wage spillovers. Moreover, findings suggest that the wage spillover effect is strongly affected by the technological gap between local and foreign firms: only workers employed in domestic firms with a low-medium technological absorptive capacity seem to benefit from the presence of multinational enterprises in terms of higher wages

Responding to Climate Change: The Economy and Economics - Part of the Problem and Solution

The Climate Change Starter’s Guide provides an introduction and overview for education planners and practitioners on the wide range of issues relating to climate change and climate change education, including causes, impacts, mitigation and adaptation strategies, as well as some broad political and economic principles. The aim of this guide is to serve as a starting point for mainstreaming climate change education into school curricula. It has been created to enable education planners and practitioners to understand the issues at hand, to review and analyse their relevance to particular national and local contexts, and to facilitate the development of education policies, curricula, programmes and lesson plans. The guide covers four major thematic areas: 1. the science of climate change, which explains the causes and observed changes; 2. the social and human aspects of climate change including gender, health, migration, poverty and ethics; 3. policy responses to climate change including measures for mitigation and adaptation; and 4. education approaches including education for sustainable development, disaster reduction and sustainable lifestyles. A selection of key resources in the form of publication titles or websites for further reading is provided after each of the thematic sections

Large area quantitative analysis of nanostructured thin-films

Proposed and verified method offers an unique quantitative large scale nanostructures' evaluation.This is the accepted manuscript. The final version is available at http://pubs.rsc.org/en/Content/ArticleLanding/2015/RA/c4ra16018e#!divAbstract