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OBJECTIVE To study the impact of severe head injury on both basal pituitary hormone secretion and the response to exogenous synthetic hypothalamic releasing factors (TRH and GHRH) in order to evaluate sequential changes in the central control of hypophyseal secretion in the days following head injury. DESIGN Prospective clinical study PATIENTS 21(More)
OBJECTIVE To evaluate the effect of severe head injury on both the secretion of basal pituitary hormones and the response to exogenous synthetic hypothalamic releasing factors administration. DESIGN Prospective, clinical study. SETTING General intensive care unit in a university teaching hospital, Italy. PATIENTS Comatose, head-injured patients (n =(More)
OBJECTIVE AND IMPORTANCE A traumatic carotid-cavernous sinus fistula (CCF) is rarely diagnosed early and may sometimes be missed until clinical signs and symptoms appear. The continuous monitoring of cerebral venous oxygen saturation may reveal the presence of a CCF by means of a fiberoptic catheter that records very high oxygen saturation values when(More)
Sir: A 24 year-old boy was brought to the ED with head injury after a motorcycle accident. On his arrival, he was alert, and his GCS was 14 (V5, M5, E4). A head CT scan was performed, and a small (max width 0.9 cm) temporal epidural hematoma was observed. Since its small dimension, it was not scheduled for surgery, and a new CT scan after 4 h was planned.(More)
Many patients in the ICU receive mechanical ventilation and require sedative medications. Anxiolysis, hypnosis, and amnesia can be considered the primary objects of sedative therapy. Intravenous benzodiazepines are the drugs most commonly used for sedation in ICU. Proper choice and use of benzodiazepines is based on knowledge of the pharmacology and is an(More)
A previously healthy 71-y-old male developed acute upper airway obstruction caused by a Stenotrophomonas maltophilia infection of the mucocutaneous and soft tissue of the neck. Ventilator support was provided via a small-calibre endotracheal tube. Stenotrophomonas was susceptible only to levofloxacin and cotrimoxazole. Antibiotic therapy rapidly improved(More)
OBJECTIVE To assess the agreement between computed tomography and transcranial sonography in patients after decompressive craniectomy. DESIGN Prospective study. SETTING The medical intensive care unit of a university-affiliated teaching hospital. PATIENTS Thirty head-injured patients consecutively admitted to the intensive care unit of "A. Gemelli"(More)
Extracorporeal liver devices have gained great attention as a complementary approach to liver transplantation in patients with acute on chronic liver failure. Among others, Molecular Adsorbent Recycling System (MARS) is a hemodiafiltration against albumin able to remove low molecular weight toxins. We aimed to validate the use of MARS in patients presenting(More)