Search results for "Coma"

Il coma tossico

2007

Il coma tossico è una situazione clinica estremamente grave, non frequente, che riguarda diverse sostanze tossiche e che pone determinate problematiche riguardo la terapia specifica. Fra queste sostanze ricordiamo gli esteriorganofosforici, i metalli pesanti, l’etilen glicole, il monossido di carbonio etc. La terapia deve essere prima di supporto volta a stabilizzare i parametri cardiovascolari, respiratori e renali del paziente, quindi dopo bisogna eseguire un attenta anamnesi, un accurato esame obiettivo e i normali esami di laboratorio per individuare la sostanza tossica. Grande importanza riveste inoltre la conoscenza della farmacocinetica e quindi del volume di distribuzione, la modula…

Early prediction of coma recovery after cardiac arrest with blinded pupillometry

2017

Objectives Prognostication studies on comatose cardiac arrest (CA) patients are limited by lack of blinding, potentially causing overestimation of outcome predictors and self-fulfilling prophecy. Using a blinded approach, we analysed the value of quantitative automated pupillometry to predict neurological recovery after CA. Methods We examined a prospective cohort of 103 comatose adult patients who were unconscious 48 hours after CA and underwent repeated measurements of quantitative pupillary light reflex (PLR) using the Neurolight-Algiscan® device. Clinical examination, electroencephalography (EEG), somatosensory evoked potentials (SSEP) and serum neuron specific enolase (NSE) were perfor…

MR imaging of bilateral paramedian thalamic and mesencephalic infarcts: A case report

2010

We describe MR imaging of bilateral infarction of the paramedian portion of the mesencephalus and thalamus due to an occlusion of the Percheron artery. This entity is due to one of the anatomic variants of the perforating arteries supplying the thalamus and mesenchephalus. Clinically this kind of infarction presents with neurologic impairment as a disorder of consciousness, memory dysfunctions, various types of vertical gaze palsy and psychic changes, which need to be differentiated from delirium and coma. At MRI evaluation infarction of the paramedian portion of thalami and midbrain, with a “butterfly wings” pattern, was demonstrated as high signal intensity areas on FLAIR and FSE-T2W ima…

Assessing Prognosis Following Cardiopulmonary Resuscitation and Therapeutic Hypothermia

2013

SUMMARY Background: The prognosis of patients who are comatose after cardiopulmo nary resuscitation (CPR) is poor but can be improved by mild therapeutic hypothermia. We studied the question whether the known, reliable indicators of a poor prognosis after CPR are also valid for patients treated with CPR and hypothermia. Methods: This review is based on a selective search of the PubMed database for recent articles on the assessment of prognosis in persons who are comatose after CPR and therapeutic hypothermia. Results: On the basis of 21 clinical trials, 4 of which yielded level I evidence, 9 level II evidence, and 8 level III evidence, the following were identified as reliable indicators of…

Coma blisters. A key to neurological diagnosis

2020

Cerebral blood flow and cerebral death

1969

At present the diagnosis of cerebral death is based on the absence of manifestations of cerebral function (deep coma, wide pupils, absence of reflexes and spontaneous respiration, isoelectric EEG, etc.) during a variable period of time. However, the absence of vital signs of an organ, even for prolonged periods, is no proof of its death. The death of an organ can only be considered as proved by the demonstration that this organ has remained completely deprived of its blood flow during a period of time that surpasses its ability to survive circulatory arrest. In the case of the brain, the permanent absence of clearance of a radioactive tracer deposed within the brain is considered to demonst…

Effects of Repeating a Tactile Brain-Computer Interface on Patients with Disorder of Consciousness: A Hint of Recovery?

2019

Brain-computer interface (BCI) has been emerging as an assessment tool for patients with disorder of consciousness (DOC). With the advantages of high time resolution, low cost and portable design, EEG based BCI systems are especially suitable for bedside measurement. Recent studies showed the successful application of an EEG based BCI on DOC assessment and communication. However, the effect of repeated BCI measurement on this patient group is not clear. In this study, a tactile BCI paradigm was repeated 12 runs for 10 consecutive days on 5 DOC patients. Although the BCI performance varied among runs and days, every patient reached at least once the accuracy above 60%. Moreover, the Coma Rec…

DNA-DNA hybridization and ribotyping of Acidovorax delafieldii isolates from eels and aquatic environments

1992

Eleven strains of Acidovorax isolated from a freshwater lake and from healthy and diseased European eels in a hatchery were investigated by genotypic methods. DNA-DNA slot blot hybridization confirmed the identity of all strains as A. delafieldii. Isolates were heterogeneous in EcoR1 ribopatterns with four types recognizable. Most freshwater and healthy eel strains had the same ribotype but differed from the disease-associated strains. Typical ribopatterns of A. delafieldii contained 1·3, 1·5, and 3·2 kb fragments which provided useful additional taxonomic markers for species identification.

Bacteria from acidic to strongly alkaline insect midguts: Potential sources of extreme cellulolytic enzymes

2012

Abstract Bacterial isolates from the European Corn Borer (ECB) Ostrinia nubilalis and the coleopteran Colorado Potato Beetle (CPB) Leptinotarsa decemlineata midguts were identified and characterized. Twenty-four colonies, selected on solid media with cellulose as the sole carbon source and pH values ranging from 5 to 12, were identified through 16S sequencing as members of the genera Acinetobacter , Comamonas , Klebsiella , Microbacterium , Micrococcus and Sphingobacterium . A complete enzymatic characterization revealed widespread – albeit moderate – cellulase properties in all but one isolate and high xylanase activity in the four CPB isolates. Different enzymatic patterns in terms of opt…

Cupola

2004

La Cupola (o “Commissione”, come è stata indicata dai collaboratori di giustizia) indica la struttura di governo di Cosa Nostra. A partire dal 1987, le indagini sulla configurazione dell’organizzazione mafiosa siciliana riferiscono di un modello a struttura unitaria e verticistica, in grado di esercitare un controllo capillare sul territorio secondo criteri rispondenti al principio di suddivisione in aree geografiche. Al suo interno, le macro-unità sono rappresentate dalle cosiddette province, sulle quali governano i capi-provincia, riuniti in forma collegiale in un organo di coordinamento denominato regione o interprovinciale. Tra gli organi di governo su base provinciale, la più attiva e …