The Impact Of Eeg In The Diagnosis And Management Of Patients With Acute Impairment Of Consciousness [impacto Do Eeg No Diagnóstico E Conduta Dos Pacientes Com Alteração Aguda Do Estado Da Consciência]

Objectives: To assess the frequency of electroencephalogram (EEG) requests in the emergency room (ER) and intensive care unit (ICU) for patients with impairment of consciousness (IC) and its impact in the diagnosis and management. Methods: We followed patients who underwent routine EEG from ER and ICU with IC until discharge or death. Results: During the study, 1679 EEGs were performed, with 149 (8.9%) from ER and ICU. We included 65 patients and 94 EEGs to analyze. Epileptiform activity was present in 42 (44.7%). EEG results changed clinical management in 72.2% of patients. The main reason for EEG requisition was unexplained IC, representing 36.3% of all EEGs analyzed. Eleven (33%) of these had epileptiform activity. Conclusion: EEG is underused in the acute setting. The frequency of epileptiform activity was high in patients with unexplained IC. 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Incised valley paleoenvironments interpreted by seismic stratigraphic approach in Patos Lagoon, Southern Brazil

<div><p>ABSTRACT: The Rio Grande do Sul (RS) coastal plain area (33,000 km 2 ) had its physiography modified several times through the Quaternary, responding to allogenic and autogenic forcings. The Patos Lagoon covers a significant area of RS coastal plain (10,000 km 2 ), where incised valleys were identified in previous works. About 1,000 km of high resolution (3.5 kHz) seismic profiles, radiocarbon datings, Standard Penetration Test (SPT) and gravity cores were analyzed to interpret the paleoenvironmental evolution as preserved in incised valley infills. Seismic facies were recognized by seismic parameters. The sediment cores were used to ground-truth the seismic interpretations and help in the paleoenvironmental identification. Key surfaces were established to detail the stratigraphical framework, and seismic facies were grouped into four seismic units, which one classified in respective system tracts within three depositional sequences. The oldest preserved deposits are predominantly fluvial and estuarine facies, representing the falling stage and lowstand system tracts. The Holocene transgressive records are dominated by muddy material, mainly represented by estuarine facies with local variations. The transgression culminated in Late Holocene deposits of Patos Lagoon, representing the highstand system tract. The depositional pattern of the vertical succession was controlled by eustatic variations, while the autogenic forcing (paleogeography and sediment supply) modulated the local facies variation.</p></div