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ObjectiveFew outcome data are available about posterior reversible encephalopathy syndrome (PRES). We studied 90-day functional outcomes and their determinants in patients with severe PRES.Design70 patients with severe PRES admitted to 24 ICUs in 2001–2010 were included in a retrospective cohort study. The main outcome measure was a Glasgow Outcome Scale (GOS) of 5 (good recovery) on day 90.Main ResultsConsciousness impairment was the most common clinical sign, occurring in 66 (94%) patients. Clinical seizures occurred in 57 (81%) patients. Median mean arterial pressure was 122 (105–143) mmHg on scene. Cerebral imaging abnormalities were bilateral (93%) and predominated in the parietal (93%) and occipital (86%) white matter. Median number of brain areas involved was 4 (3–5). Imaging abnormalities resolved in 43 (88%) patients. Ischaemic and/or haemorrhagic complications occurred in 7 (14%) patients. The most common causes were drug toxicity (44%) and hypertensive encephalopathy (41%). On day 90, 11 (16%) patients had died, 26 (37%) had marked functional impairments (GOS, 2 to 4), and 33 (56%) had a good recovery (GOS, 5). Factors independently associated with GOS<5 were highest glycaemia on day 1 (OR, 1.22; 95%CI, 1.02–1.45, p = 0.03) and time to causative-factor control (OR, 3.3; 95%CI, 1.04–10.46, p = 0.04), whereas GOS = 5 was associated with toxaemia of pregnancy (preeclampsia/eclampsia) (OR, 0.06; 95%CI, 0.01–0.38, p = 0.003).ConclusionsBy day 90 after admission for severe PRES, 44% of survivors had severe functional impairments. Highest glycaemia on day 1 and time to causative-factor control were strong early predictors of outcomes, suggesting areas for improvement.

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This paper identifies and addresses a significant weakness in the literature on mobility – the theorisation of mobility and power, and specifically, the consideration of mobility as an expression of power. It argues that the ‘mobilities turn’ has tended to draw a connection between mobility, autonomy and freedom, and in so doing has inadequately explored and theorised involuntary and coerced mobility. To illustrate this, the paper draws together two literatures that have thus far been poorly integrated, and that at first seem an unlikely pairing – the mobilities work that has exploded in scope and diversity over the past decade and that seeks to ‘undermine sedentarist theories’ in geography (Sheller M and Urry J 2006 The new mobilities paradigm Environment and Planning A 38 207–26, p 208), and the nascent field of ‘carceral geography’, a body of work beginning to coalesce around the spatialities of detention and imprisonment, but that, in its focus on spatial regulation, has thus far tended to overlook the mobilities inherent in carceral practices. The two are drawn together through consideration of an example of ‘disciplined mobility’– contemporary prisoner transport in the Russian Federation, which serves as an illustration both of punitive power expressed through mobility and of mobility in the carceral context. The paper then argues that future research in mobilities must consider more fully the disciplinary nature of mobility, and suggests that the concept of ‘disciplined mobility’ (after Packer J 2003 Disciplining mobility: governing and safety in Bratich J Z, Packer J and McCarthy C eds Foucault, cultural studies, and governmentality State University of New York Press, New York 135–63), may form a framework for such future research.

E 1 0 2 7What ' s known on the subject? and What does the study add?The pathophysiology of post-renal acute kidney injury (PR-AKI), i.e. caused by urinary tract obstruction, has been extensively studied in animal models but clinical studies on this subject are outdated, and/or have focused on the mechanisms of ' post-obstructive diuresis ' (POD), a potentially life-threatening polyuria that can develop after the release of obstruction.In severe PR-AKI, the risk of occurrence of POD is high. POD occurrence predicts renal recovery without the persistence of severe chronic kidney failure. In the present study, the occurrence of POD and the persistence of chronic renal sequelae could be predicted early from clinical variables at admission before the release of obstruction. OBJECTIVE• To identify predictors of post-obstructive diuresis (POD) occurrence or severe chronic renal failure (CRF) persistence after the release of urinary tract obstruction in the setting of post-renal acute kidney injury (PR-AKI). PATIENTS AND METHODS• Bi-centre retrospective observational study of all patients with PR-AKI treated in two intensive care units (ICUs) from 1998 to 2010.• Clinical, biological and imaging characteristics on admission and after the release of obstruction were analysed with univariate and, if possible, multivariate analysis to search for predictors of (i) occurrence of POD (diuresis > 4 L/day) after the release of obstruction; (ii) persistence of severe CRF (estimated glomerular fi ltration rate < 30 mL/ min/1.73 m 2 , including end-stage CRF) at 3 months. RESULTS• On admission, median (range) serum creatinine was 866 (247 -3119) μ mol/L.• POD occurred in 34 (63%) of the 54 analysable patients. On admission, higher serum creatinine (Odds ratio [ OR ] 1.002 per 1 μ mol/L, 95% confi dence interval [ CI ] 1.000 -1.004, P = 0.004), higher serum bicarbonate (OR 1.36 per 1 mmol/L, 95% CI 1.13 -1.65, P < 0.001), and urinary retention (OR 6.96, 95% CI 1.34 -36.23, P = 0.01) independently predicted POD occurrence.• Severe CRF persisted in seven (21%) of the 34 analysable patients, including two (6%) cases of end-stage CRF. Predictors of severe CRF persistence after univariate analysis were: lower blood haemoglobin ( P < 0.001) and lower serum bicarbonate ( P = 0.03) on admission, longer time from admission to the release of obstruction ( P = 0.01) and absence of POD ( P = 0.04) after the release of obstruction. CONCLUSIONS• In severe PR-AKI treated in ICU, POD occurrence was a frequent event that predicted renal recovery without severe CRF.• POD occurrence or severe CRF persistence could be predicted early from clinical and biological variables at admission before the release of obstruction. KEYWORDSacute kidney failure , chronic kidney failure , ureteric obstruction , critical illness , polyuria Study Type -Therapy (case series) Level of Evidence 4