Introduction: Intracranial pressure (ICP) monitoring is commonly used in investigating the aetiology of chronic paediatric neurological conditions. A series of high-amplitude spikes has been observed in overnight ICP recordings of some children, many of whom have hydrocephalus or craniosynostosis.
Research Question: This clinical evaluation aimed to define the spike pattern, describe the patient group in which it is most likely to occur, and conduct high-resolution waveform analysis.
Material And Methods: ICP waveforms from 40 patients aged 0-5 years (inclusive), recorded between 2017 and 2021 at the Royal Hospital for Children Glasgow, were retrospectively analysed. The pattern was defined through visual inspection of regions of interest by two reviewers. Patients were stratified using demographic and clinical data. R software was used to perform regression and high-resolution waveform analyses.
Results: The spike pattern was defined as the presence of 2 consecutive spikes with an amplitude of at least 8 mmHg, with a gap of at least 30 min between spikes. In the adjusted Poisson regression, age was significantly associated with the number of spikes (IRR 0.8, 95% CI 0.70 to 0.92, p-value 0.001).
Discussion And Conclusion: Younger age was significantly associated with an increased number of spikes in this cohort. Investigation of clinical consequences of the spikes is warranted.
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http://dx.doi.org/10.1016/j.bas.2024.102859 | DOI Listing |
J Eval Clin Pract
February 2025
Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, Jordan.
Background: Chronic respiratory disorders such as asthma and chronic obstructive pulmonary disease (COPD) may deteriorate into acute exacerbations requiring hospitalization. Assessing the predictors of prolonged hospital stays could help identify potential interventions to reduce the burden on patients and healthcare systems.
Aim: This study aimed to identify the risk factors attributed to prolonged hospital stays among patients admitted with acute exacerbations of chronic respiratory disorders in Jordan.
Neurosurgery
February 2025
Global Neurosciences Institute, Philadelphia , Pennsylvania , USA.
Background And Objectives: Despite growing interest in how patient frailty affects outcomes (eg, in neuro-oncology), its role after transsphenoidal surgery for Cushing disease (CD) remains unclear. We evaluated the effect of frailty on CD outcomes using the Registry of Adenomas of the Pituitary and Related Disorders (RAPID) data set from a collaboration of US academic pituitary centers.
Methods: Data on consecutive surgically treated patients with CD (2011-2023) were compiled using the 11-factor modified frailty index.
JAMA Cardiol
January 2025
Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois.
Importance: Lung ultrasound (LUS) aids in the diagnosis of patients with dyspnea, including those with cardiogenic pulmonary edema, but requires technical proficiency for image acquisition. Previous research has demonstrated the effectiveness of artificial intelligence (AI) in guiding novice users to acquire high-quality cardiac ultrasound images, suggesting its potential for broader use in LUS.
Objective: To evaluate the ability of AI to guide acquisition of diagnostic-quality LUS images by trained health care professionals (THCPs).
JAMA Surg
January 2025
Population Health Research Institute, Hamilton, Ontario, Canada.
Importance: Perioperative bleeding is common in general surgery. The POISE-3 (Perioperative Ischemic Evaluation-3) trial demonstrated efficacy of prophylactic tranexamic acid (TXA) compared with placebo in preventing major bleeding without increasing vascular outcomes in noncardiac surgery.
Objective: To determine the safety and efficacy of prophylactic TXA, specifically in general surgery.
Am J Speech Lang Pathol
January 2025
Department of Therapy Services, University of Virginia Health System, Charlottesville.
Purpose: Research has shown that prolonged endotracheal intubation can increase risk of aspiration following extubation. This study examined the relationship between swallowing and intubation among patients with COVID-19. We investigated the association between the duration of intubation and time until an oral diet was safely initiated and the correlation between the length of intubation and reduced sensation with aspiration as seen on flexible endoscopic evaluation of swallowing (FEES)/videofluoroscopic swallowing study (VFSS).
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