B Maiya's research while affiliated with Cambridge University Hospitals NHS Foundation Trust and other places
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Publications (4)
In order to identify whether low-dose (1 microg) tetracosactide (Synacthen) testing may be preferable to high-dose (250 microg) testing in the diagnosis of adrenal insufficiency in traumatic brain injury (TBI), as suggested by studies in other forms of critical illness.
We retrospectively reviewed the results of modified tetracosactide tests (invol...
The objective was to study the anatomical changes in the pituitary gland following acute moderate or severe traumatic brain injury (TBI).
Retrospective, observational, case-control study.
Neurosciences Critical Care Unit of a university hospital.
Forty-one patients with moderate or severe TBI who underwent magnetic resonance imaging (MRI) during th...
Traumatic axonal injury (TAI) contributes significantly to mortality and morbidity following traumatic brain injury (TBI), but is poorly characterized by conventional imaging techniques. Diffusion tensor imaging (DTI) may provide better detection as well as insights into the mechanisms of white matter injury. DTI data from 33 patients with moderate...
Severe stridor of recent onset is a challenge to deal with because of the lack of investigations on which to base the management plan. We describe a case of an elderly lady who presented to us with a short history of severe stridor. We encountered unanticipated difficulties with tracheostomy under local anaesthesia as the thyroid was replaced by a...
Citations
... In a neurocritical care the use of just an increment to diagnose adrenal insufficiency would seem even more inappropriate although these tests have been applied and their use has even been reported in publications. 38 In patients who do not have septic shock the use of an increment has never been supported by randomised trials so its use is questionable outside this setting. Endocrinologists prefer to see an adequate peak after an ACTH test in this context. ...
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... There have also been reports of cases where an awake fiber-optic intubation is the preferred method to secure the airway in acute airway obstruction. 5 Predictors of failed intubation include cancer diagnosis, previous radiotherapy, and supraglottic lesions, which are indicative of the challenges of the head and neck patient population for airway management. 6 Tracheostomy does pose a risk to the patient with multiple complications, including postoperative bleeding, tracheitis, tube dislodgement, tracheoinnominate fistula, or tracheoesophageal fistula, all of which can be life-threatening. ...
... In the general population, many studies have examined white matter organization across the spectrum of TBI severity, both in the acute (< 3 month) and chronic (> 3 month) phases of injury. Changes in white matter organization have been documented as early as the day of injury 8,9 and often persist for many years. [10][11][12][13][14] Midline brain structures such as the corpus callosum are believed to be most susceptible to the shearing and rotational forces of traumatic brain injury. ...
... The gland lies in bony compartment of sella and is roofed by diaphragm sella making it vulnerable for injury in moderate and severe TBI. 13 Post-head injury ischemic event may lead to hypopituitarism. Hypophyseal-portal circulation supplies anterior lobe of pituitary through long portal vessels that run along infundibulum to anterior pituitary and can be damaged from hypertension/hypotension, mechanical forces and edema. ...
