Curēus
-
The International Consensus Definition for Sepsis and Septic Shock Task Force has recently developed new methods to determine whether a patient is at risk for end organ failure after he has been suspected to have sepsis. One of the newest measures developed is a quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA), and it is used to identify patients who are at risk of sepsis outside the intensive care unit. The systemic inflammatory response syndrome (SIRS) score has previously been the standard for determining a patient's sepsis risk and prognosis for future mortality. With the development of these new tools, it is imperative to compare qSOFA to SIRS in order to determine which method is best and under which circumstances. We conclude that according to evidence currently available, qSOFA has limited use for patients in the intensive care unit at the time of evaluation for predicting mortality and organ dysfunction. Furthermore, qSOFA outranks SIRS for patients in the emergency department except for SIRS delivering positive results more quickly.
-
The objective of this review is to analyze the evidence supporting selective dorsal rhizotomy (SDR) for the treatment of spastic cerebral palsy (CP). We reviewed 85 outcome studies from 12 countries between 1990 and 2017. The published results are overwhelmingly supportive of SDR, and 39 studies form a basis for this review. ⋯ The outcomes of SDR specific to spastic quadriplegia require further investigation because of the relatively small patient population with quadriplegia. Lastly, we found that SDR can prevent or reverse premature aging in adolescents and adults with spastic diplegia. In conclusion, the evidence supporting the efficacy of SDR is strong, and SDR is a well-established option for spasticity management in spastic CP.