Suspicion of penetrating cardiac injury: Curing or caring?

Identifying penetrating cardiac injury in hemodynamically stable patients can be challenging especially when the patient has no signs of cardiac tamponade and no pericardial effusion identified on transthoracic echocardiography. In this case report, we discuss both penetrating cardiac injuries diagnosis algorithm and treatment strategies. At present, it is difficult to refer to general guidelines transposable from one center to another.

Multidrug-Resistant Staphylococcus epidermidis Ventriculostomy-Related Infection Successfully Treated by Intravenous Ceftaroline after Failure of Daptomycin Treatment.

Background: Ventriculostomy-related infection with multidrug-negative strains are challenging to treat. We report the use of new antibiotics in such a case.

Case Description: We report the case of a neurosurgical intensive care unit patient who developed ventriculostomy-related infection with a multidrug-resistant Staphylococcus epidermidis.

Durability of antimicrobial activity of antibiotic-impregnated external ventricular drains: a prospective study.

Background: Antibiotic-impregnated external ventricular drains (AI-EVDs) have a debated efficacy in clinical studies.

Objectives: Our aim was to assess the durability of antimicrobial activity of AI-EVDs used in clinical settings.

Methods: From April 2017 to January 2018, all consecutive AI-EVDs (Bactiseal™) inserted in adult patients were prospectively included.

Breast Implants and Bilateral Tension Pneumothorax Following Blunt Chest Trauma.

A 38-year-old woman was admitted to our trauma centre with a complete left pneumothorax. The chest tube implementation procedure was aborted quickly because of a very difficult dissection (subcutaneous emphysema over two voluminous breast implants). The patient was transferred to the imaging room without chest tube insertion due to respiratory and haemodynamic stability.

Prediction of Early Intracranial Hypertension After Severe Traumatic Brain Injury: A Prospective Study.

Objective: This study aimed to assess the reliability of clinical features, noninvasive transcranial Doppler-related pulsatility index (PI) calculation, and optic nerve sheath diameter (ONSD) measured by ultrasound (US) and initial computed tomography (CT) scan (Marshall CT scan classification) in predicting the occurrence of early (<24 hours) high intracranial pressure (EHICP) (>20 mm Hg) after severe traumatic brain injury (TBI).

Methods: We conducted an observational prospective study in a level 1 trauma center. Patients were measured simultaneously for PI and US ONSD in the triage zone.

Natural history of ventriculostomy-related infection under appropriate treatment and risk factors of poor outcome: a retrospective study.

Objective: The authors aimed to describe the natural history of ventriculostomy-related infections (VRIs) under appropriate treatment and to assess risk factors for poor outcome.

Methods: All patients older than 18 years in whom an external ventricular drain (EVD) had been implanted and who had developed a VRI requiring treatment were included in this retrospective study. D0 was defined as the first day of antibiotic administration.

Multidrug-Resistant Acinetobacter baumannii Ventriculostomy-Related Infection, Treated by a Colistin, Tigecycline, and Intraventricular Fibrinolysis.

Background: Acinetobacter baumannii meningitis and ventriculitis are difficult issues, because of the low diffusion of antibiotics in the cerebrospinal fluid and bacterial multidrug resistance. The presence of an infected intraventricular hematoma, constituting an equivalent of undrained abscess, may promote biofilm formation and failure of medical treatment.

Case Description: In this case of ventriculostomy-related infection after ventricular hemorrhage, Acinetobacter baumannii was sensitive only to colistin and tigecycline.

The multistep road to ventilator-associated lung abscess: A retrospective study of S.aureus ventilator-associated pneumonia.

Object: We observed some cases of lung abscess (LA) in ICU patients suffering S.aureus ventilator-associated pneumonia (S.aureus-VAP).

A multi-faceted strategy to reduce ventilation-associated mortality in brain-injured patients. The BI-VILI project: a nationwide quality improvement project.

Purpose: We assessed outcomes in brain-injured patients after implementation of a multi-faceted approach to reduce respiratory complications in intensive care units.

Methods: Prospective nationwide before-after trial. Consecutive adults with acute brain injury requiring mechanical ventilation for ≥24 h in 20 French intensive care units (ICUs) were included.

Secondary Insults and Adverse Events During Intrahospital Transport of Severe Traumatic Brain-Injured Patients.

Background: Our aim was to assess the occurrence of secondary insults (SIs) or adverse events (AEs) during intrahospital transport (IHT) of severe traumatic brain injury (TBI) patients for head computed tomography (CT) scanning.

Methods: A prospective study based on severe TBI patients admitted from June 2011 through June 2013 in a level I trauma center. Patients received an IHT to perform a control CT scan in the first 3 days following trauma.

From the Skin to the Brain: Pathophysiology of Colonization and Infection of External Ventricular Drain, a Prospective Observational Study.

Ventriculostomy-related infection (VRI) is a serious complication of external ventricular drain (EVD) but its natural history is poorly studied. We prospectively tracked the bacteria pathways from skin towards ventricles to identify the infectious process resulting in ventriculostomy-related colonization (VRC), and VRI. We systematically sampled cerebrospinal fluid (CSF) on a daily basis and collected swabs from both the skin and stopcock every 3.

Clinical, biological, and microbiological pattern associated with ventriculostomy-related infection: a retrospective longitudinal study.

Background: Our aim was to describe the pattern of ventriculostomy-related infection (VRI) development using a dynamic approach.

Study Design: Retrospective longitudinal study.

Methods: We analyzed the files of 449 neurosurgical patients who underwent placement of external ventricular drain (EVD).

Spigelian hernia: CT findings and clinical relevance.

Objective: The purpose of our study was to evaluate the clinical relevance of preoperative CT in distinguishing between the two subtypes of spigelian hernia (SH).

Materials And Methods: We reviewed retrospectively the CT images of 35 patients. The patients were divided into two groups on the basis of the SH subtype: interstitial SH group (n = 15) and subcutaneous SH group (n = 20).

Certainty in categorical judgment of size.

The certainty of judgment (or self-confidence) has been traditionally studied in relation with the accuracy. However, from an observer's viewpoint, certainty may be more closely related to the consistency of judgment than to its accuracy: consistent judgments are objectively certain in the sense that any external observer can rely on these judgments to happen. The regions of certain vs.