ISSN:1070-5295    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1070-5295    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1070-5295    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Despite advances in understanding the epidemiology and pathophys-iology of cerebrovascular disease, stroke remains the third leading cause of death in the United States. Although hypertension is the most important treatable risk factor for stroke, recent epidemiologic studies have found elevated cholesterol, oral contraceptive use, alcohol abuse, and cardiac defects to be independent risk factors for stroke. Recently published clinical trials add to our ability to prevent and treat stroke. Aspirin remains the most commonly used antiplatelet agent affording reductions of about one third in nonfatal stroke in patients at high risk. Ticlopidine has been shown to have a slight benefit over aspirin in preventing stroke and transient ischemic attack, but this drug has more adverse effects. In pooled data from five clinical trials, warfarin was found to be superior to aspirin in preventing stroke in patients with atrial fibrillation. Early clinical trials with neuroprotective and thrombolytic therapies have shown promise, but large prospective randomized trials are still in progress. The indications for carotid endarterectomy continue to be defined; however, surgical intervention appears to benefit both symptomatic and asymptomatic patients with high-grade carotid stenosis.

ISSN:1070-5295    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Scientific advances in our understanding of the basic pathophysiology of traumatic brain injury have significantly improved the ability to monitor relevant variables in patients with acute head injury. Improvements in noninvasive and invasive cerebral monitoring, particularly cerebral oxygenation monitoring, have allowed early identification and treatment of neurologic deterioration. Cerebral monitoring has also provided an invaluable means of evaluating intensive care management and pharmacologic therapy and of predicting neurologic outcome. The most exciting advances have occurred in the development of neuroprotective therapies. For the first time, clinical trials have demonstrated a significant improvement in neurologic outcome after traumatic brain injury.

ISSN:1070-5295    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Interest in both experimental and clinical aspects of status epilepticus is increasing; this is reflected by the number of papers published in the scientific and medical literature during the past year. Understanding of basic mechanisms of status epilepticus has advanced, including a possible role of failure of adenosine-mediated inhibition in the initiation of status epilepticus and ofN-methyl-D-aspartate and non-N-methyl-D-aspartate excitatory receptors in the maintenance of status epilepticus. The role of status epilepticus in the induction of mossy fiber sprouting and chronic epilepsy and their mechanistic relationship to one another has been explored but still needs to be fully elucidated. A variety of drugs for the treatment of status epilepticus and of status epilepticus-induced neuronal damage have been studied in experimental and clinical paradigms. Several large studies have provided additional information regarding the classification, etiology, and epidemiology of status epilepticus. The combination of experimental and clinical studies of status epilepticus should provide the basis for major advances in our understanding of the pathophysiology and treatment of status epilepticus over the next several years.

ISSN:1070-5295    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Recent clinical studies and review articles concerning the epidemiology, clinical features, and antibiotic and adjunctive therapy of bacterial meningitis and brain abscess are presented. The type and frequency of complications that may occur during the course of bacterial meningitis are reported, and their intensive care management is discussed. The role of the polymerase chain reaction in viral diseases of the central nervous system is briefly presented, and further areas of research are mentioned.

ISSN:1070-5295    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Considerable confusion and controversy exist regarding the definition, diagnosis, prognosis, and treatment of patients in a vegetative state. Uncertainty regarding terminology, diagnostic criteria, the meaning of the termpersistent, and the ethical issues surrounding the withdrawal of artificial nutrition and hydration persist. Over the past year the findings of a multisociety task force were reported, which sought to establish uniform diagnostic criteria and review all available prognostic data. Although the findings of the task force clarify diagnosis, the introduction of the termpermanent vegetative statemay be easily confused with persistent vegetative state. Attitudes regarding treatment of patients determined to be in an irreversible vegetative state are changing. The expectation that long-term care is the standard of care has recently been challenged.

ISSN:1070-5295    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Gastrointestinal complications often develop in the critically ill. This section ofCurrent Opinion in Critical Carefocuses on the digestive tract, liver, and pancreas of those admitted to the ICU. These patients also suffer from multiple organ dysfunction, in which the gut seems to play a major role.

ISSN:1070-5295    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Stress ulceration has been studied in various high-risk populations. This review presents recent studies about risk factors for the development of stress-related mucosal damage and compares different treatments for prophylaxis and therapy of stress-related mucosal damage and stress ulcer bleeding.

ISSN:1070-5295    

出版商:OVID    

年代:1995

数据来源: OVID