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Guidelines for Seizure Prophylaxis in Patients Hospitalized with Nontraumatic Intracerebral Hemorrhage: A Clinical Practice Guideline for Health Care Professionals from the Neurocritical Care Society.
Neurocrit Care
December 2024
Department of Clinical Pharmacology, University of Tennessee Health Science Center College of Pharmacy, Knoxville, TN, USA.
Background: There is practice heterogeneity in the use, type, and duration of prophylactic antiseizure medications (ASM) in patients hospitalized with acute nontraumatic intracerebral hemorrhage (ICH).
Methods: We conducted a systematic review and meta-analysis assessing ASM primary prophylaxis in adults hospitalized with acute nontraumatic ICH. The following population, intervention, comparison, and outcome (PICO) questions were assessed: (1) Should ASM versus no ASM be used in patients with acute ICH with no history of clinical or electrographic seizures? (2) If an ASM is used, should levetiracetam (LEV) or phenytoin/fosphenytoin (PHT/fPHT) be preferentially used? and (3) If an ASM is used, should a long (> 7 days) versus short (≤ 7 days) duration of prophylaxis be used? The main outcomes assessed were early seizure (≤ 14 days), late seizures (> 14 days), adverse events, mortality, and functional and cognitive outcomes.
Background: Nontraumatic acute abdominal pain is a common presentation in emergency settings, often requiring surgical intervention. This study aimed to explore the clinical presentations, surgical management, and outcomes in patients with nontraumatic acute abdominal pain, providing insights for improving management strategies.
Methods: This observational study was conducted at a tertiary care hospital in North India and included 433 patients who underwent elective and emergency abdominal surgeries from June 2021 to May 2023.
A 79-year-old man undergoing treatment with warfarin for atrial fibrillation and hemodialysis for renal failure was transferred to our hospital for rehabilitation. During a maintenance hemodialysis session, blood pressure was shown to be elevated and an intramural duodenal hematoma suddenly occurred. After 3 days, the hematoma had enlarged and angiographic embolization was performed, with complete resolution noted after 2 months.
View Article and Find Full Text PDFGENITAL HERPES ZOSTER - AN UNUSUAL BUT IMPORTANT CAUSE OF ACUTE NONTRAUMATIC VULVAR ULCERS.
Am J Obstet Gynecol
December 2024
Department of Obstetrics and Gynecology, Gaia/Espinho Local Health Unit; CINTESIS - Center for Health Technology and Services Research, University of Port; Department of Medical Sciences, University of Aveiro.
Asymmetric, Bilateral Nontraumatic Subperiosteal Orbital Hematomas in an Anticoagulated Patient Following Anesthesia in Prone Positioning.
Ophthalmic Plast Reconstr Surg
December 2024
Department of Ophthalmology.
The authors report a case of nontraumatic orbital subperiosteal hematoma after general anesthesia with patient in the prone position. The patient, who was on aspirin, clopidogrel, and subcutaneous heparin, presented immediately after sacral ulcer debridement with acute bilateral vision loss and periorbital edema. While the OD improved with conservative management, the OS continued to have 20/200 vision, decreased color vision, afferent pupillary defect, and extraocular movement limitation after lateral canthotomy and cantholysis.
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