Clinical features, etiologies, and outcomes of central nervous system infections in intensive care: A multicentric retrospective study in a large Brazilian metropolitan area.

Purpose: The goal of this study was to investigate severe central nervous system infections (CNSI) in adults admitted to the intensive care unit (ICU). We analyzed the clinical presentation, causes, and outcomes of these infections, while also identifying factors linked to higher in-hospital mortality rates.

Materials And Methods: We conducted a retrospective multicenter study in Rio de Janeiro, Brazil, from 2012 to 2019.

Experience of a neurology service during the 2016 Olympic and Paralympic Games.

Background: We analyzed the utilization of acute neurologic care during the 2016 Olympic and Paralympic Games in Rio de Janeiro.

Methods: We conducted a retrospective analysis of data collected during the games.

Results: Sixty-three neurologic evaluations were performed in patients from the Olympic Family (OF), 22 of these involving athletes from 19 countries.

Highly active antiretroviral therapy for critically ill HIV patients: A systematic review and meta-analysis.

Introduction: It is unclear whether the treatment of an HIV infection with highly active antiretroviral therapy (HAART) affects intensive care unit (ICU) outcomes. In this paper, we report the results of a systematic review and meta-analysis performed to summarize the effects of HAART on the prognosis of critically ill HIV positive patients.

Materials And Methods: A bibliographic search was performed in 3 databases (PubMed, Web of Science and Scopus) to identify articles that investigated the use of HAART during ICU admissions for short- and long-term mortality or survival.

Resumption of Anticoagulation After Intracranial Hemorrhage.

Anticoagulation is a vital therapy in a number of different disease processes, and is strongly recommended for the prevention of stroke in patients with atrial fibrillation and/or with mechanical prosthetic heart valves. Studies involving patients on oral anticoagulants (OACs) have revealed that ICH can occur eight times more frequently in this population, with an annual estimated incidence of 0.25 to 1.

Neurologic Complications Associated With the Zika Virus in Brazilian Adults.

Importance: There are no prospective cohort studies assessing the incidence and spectrum of neurologic manifestations secondary to Zika virus (ZIKV) infection in adults.

Objective: To evaluate the rates of acute ZIKV infection among patients hospitalized with Guillain-Barré syndrome (GBS), meningoencephalitis, or transverse myelitis.

Design, Setting, And Participants: A prospective, observational cohort study was conducted at a tertiary referral center for neurological diseases in Rio de Janeiro, Brazil, between December 5, 2015, and May 10, 2016, among consecutive hospitalized adults (>18 years of age) with new-onset acute parainfectious or neuroinflammatory disease.

Guillain-Barré syndrome and Zika virus outbreaks.

Purpose Of Review: Arboviruses have been associated with central and peripheral nervous system injuries, in special the flaviviruses. Guillain-Barré syndrome (GBS), transverse myelitis, meningoencephalitis, ophthalmological manifestations, and other neurological complications have been recently associated to Zika virus (ZIKV) infection. In this review, we aim to analyze the epidemiological aspects, possible pathophysiology, and what we have learned about the clinical and laboratory findings, as well as treatment of patients with ZIKV-associated neurological complications.

Fatal case of co-infection with dengue virus and during a dengue epidemic in the state of Rio de Janeiro, Brazil.

Introduction: Dengue and meningococcal disease are caused by two different agents: a flavivirus and a Gram-negative bacterium, respectively. The first symptoms of both diseases can be indistinct and a rapid and accurate diagnosis is crucial, considering that both diseases are associated with high morbidity and mortality, representing a major public-health problem in Brazil.

Case Presentation: We report a fatal case of co-infection of dengue virus (DENV) and in a 54-year-old patient.

Hematologic counts as predictors of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

Purpose: Aneurysmal subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality, but currently no single clinical method or ancillary test can reliably predict which subset of patients will develop delayed cerebral ischemia (DCI). The aim of this study was to find hematologic derangements and clinical factors present during the first 7 days after bleeding that could help identify patients at risk for development of DCI.

Materials And Methods: Databank analysis of patients with SAH admitted between 2010 and 2012 in a single center.

Worldwide barriers to organ donation.

Importance: The disparity between patients awaiting organ transplantation and organ availability increases each year. As a consequence, organ trafficking has emerged and developed into a multibillion-dollar-a-year industry.

Objective: To identify and address barriers to organ donation in the United States and globally.

Intracerebral hemorrhage: new challenges and steps forward.

Intracerebral hemorrhage (ICH) is a significant cause of morbidity and mortality. With the aging population, increased use of anticoagulants, and changing racial and ethnic landscape of the United States, the incidence of ICH will increase over the next decade. Improvements in preventative strategies to treat hypertension and atrial fibrillation are necessary to change the trajectory of this increase.

Intracerebral hemorrhage in patients receiving oral anticoagulation therapy.

Intracerebral hemorrhage (ICH) in patients with oral anticoagulation therapy is an increasingly prevalent problem in large part due to the aging population and the increased use of anticoagulants for patients at high risk of thrombosis. Warfarin has been virtually the only outpatient anticoagulant choice until fairly recently. The development of subcutaneously injected heparinoids, and more recently, of direct thrombin inhibitors, has made the treatment and prognostication of ICH in anticoagulated patients more difficult.

Residency Training: the role of neurocritical care in resident education.

Neurology is traditionally recognized as primarily an outpatient or consultative specialty, usually attracting candidates whose main focus may not necessarily be the management of complex critically ill patients or the performance of invasive procedures. However, the advent of modern mechanical ventilation and, more recently, effective therapies for the treatment of acute ischemic stroke and other neurologic catastrophes is bringing about a paradigm shift, with neurologists increasingly assuming a more aggressive attitude and rapid response to frequently disabling and often fatal pathologies.