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https://www.readbyqxmd.com/read/29331194/-specificities-of-nursing-care-in-neurological-intensive-care
#1
REVIEW
Christelle Garijo, Flavien Chabert, Cécile Armonia, Perrine Boucheix
In the acute phase of the treatment of patients with brain injuries, the management of secondary brain injuries of systemic origin is a priority. A neurosurgical intensive care paramedical team shares their experience of the care delivered and the constant monitoring carried out to optimise, with the medical team, the patient's outcome and to innovate practices.
January 2018: Revue de L'infirmière
https://www.readbyqxmd.com/read/29328748/analysis-of-neuro-theatre-utilisation-and-reasons-for-cancellation-to-improve-efficiency-and-productivity
#2
Feras Sharouf, Asfand Baig Mirza, Vazira Moosajee, Sarah Plummer, Imran M Bhatti, Malik Zaben
In neurosurgery, much emphasis has recently been placed on theatre cancellation and time utilization as a key hospital management performance indicator. We sought to evaluate our unit's theatre throughput efficiency and identify the causes of elective surgery cancellations. We retrospectively audited all scheduled elective neurosurgical procedures over a period of nine months. Mean theatre utilization time was 47.0%. The common causes of cancellations were lack of theatre time (32%), non-availability of beds in recovery room (18...
April 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29325790/how-do-oral-and-maxillofacial-surgeons-manage-concussion
#3
D Hammond, R Welbury, G Sammons, E Toman, M Harland, S Rice
Craniofacial trauma results in distracting injuries that are easy to see, and as oral and maxillofacial surgeons (OMFS) we gravitate towards injuries that can be seen and are treatable surgically. However, we do tend not to involve ourselves (and may potentially overlook) injuries that are not obvious either visually or radiographically, and concussion is one such. We reviewed the records of 500 consecutive patients who presented with facial fractures at the Queen Elizabeth Hospital, Birmingham, to identify whether patients had been screened for concussion, and how they had been managed...
January 8, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29324173/the-risk-of-deterioration-in-gcs13-15-patients-with-traumatic-brain-injury-identified-by-computed-tomography-imaging-a-systematic-review-and-meta-analysis
#4
Carl Marincowitz, Fiona E Lecky, William Townend, Aditya Borakati, Andrea Fabbri, Trevor A Sheldon
The optimal management of mild traumatic brain injury (TBI) patients with injuries identified by computed tomography (CT) brain scan is unclear. Some guidelines recommend hospital admission for an observation period of at least 24 h. Others argue that selected lower-risk patients can be discharged from the Emergency Department (ED). The objective of our review and meta-analysis was to estimate the risk of death, neurosurgical intervention, and clinical deterioration in mild TBI patients with injuries identified by CT brain scan, and assess which patient factors affect the risk of these outcomes...
January 11, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29323806/spine-and-spinal-cord-injuries-after-falls-from-tree-stands-during-the-wisconsin-deer-hunting-season
#5
Kimberly Hamilton, Brandon Rocque, Nathaniel Brooks
BACKGROUND: Deer hunting is popular in much of the United States. In Wisconsin, use of tree stands for hunting is common. Spine surgeons at a Level 1 Trauma Center observed a high incidence of spine and spinal cord injury due to falls from tree stands while hunting. This study's purpose is to systematically characterize and classify those injuries. METHODS: We reviewed the University of Wisconsin Hospital and Clinics' trauma database for tree stand-related injuries from 1999 to 2013...
November 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29317368/interdisciplinary-care-model-independently-decreases-use-of-critical-care-services-after-corrective-surgery-for-adult-degenerative-scoliosis
#6
Owoicho Adogwa, Aladine A Elsamadicy, Amanda R Sergesketter, Michael Ongele, Victoria Vuong, Syed Khalid, Jessica Moreno, Joseph Cheng, Isaac O Karikari, Carlos A Bagley
OBJECTIVE: Interdisciplinary management of elderly patients requiring spine surgery has been shown to improve short and long-term outcomes. The aim of this study is to determine whether an interdisciplinary team approach mitigates use of intensive care unit (ICU) resources. METHODS: A unique co-management model for elderly patients undergoing lumbar fusion surgery was implemented at a major academic medical center. The Peri-operative Optimization of Senior Health Program(POSH) was launched with the aim of improving outcomes in elderly patients(>65-years-old) undergoing complex lumbar spine surgery...
January 6, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29304919/cranial-tumor-surgical-outcomes-at-a-high-volume-academic-referral-center
#7
Desmond A Brown, Benjamin T Himes, Brittny T Major, Benjamin F Mundell, Ravi Kumar, Bruce Kall, Fredric B Meyer, Michael J Link, Bruce E Pollock, John D Atkinson, Jamie J Van Gompel, W Richard Marsh, Giuseppe Lanzino, Mohamad Bydon, Ian F Parney
OBJECTIVE: To determine adverse event rates for adult cranial neuro-oncologic surgeries performed at a high-volume quaternary academic center and assess the impact of resident participation on perioperative complication rates. PATIENTS AND METHODS: All adult patients undergoing neurosurgical intervention for an intracranial neoplastic lesion between January 1, 2009, and December 31, 2013, were included. Cases were categorized as biopsy, extra-axial/skull base, intra-axial, or transsphenoidal...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29298475/neuropelveology-an-emerging-discipline-for-the-management-of-chronic-pelvic-pain
#8
REVIEW
Marc Possover, Karl-Erik Andersson, Axel Forman
Chronic pelvic pain (CPP) is a common condition involving multiple, organ-specific medical specialties, each with its own approach to diagnosis and treatment. Management requires knowledge of the interplay between pelvic organ function and neuro-functional anatomy, and of the neurologic and psychological aspects of CPP, but no current specialty fully encompasses this approach. Neuropelveology is an emerging discipline focusing on pathologies of the pelvic nervous system on a cross-disciplinary basis. It involves a neurological/neurosurgical approach, combining the knowledge required for a proper neurologic diagnosis, confirmation by transvaginal/transrectal examination of the pelvic nerves, and advanced laparoscopic surgery in selected cases of CPP...
December 2017: International Neurourology Journal
https://www.readbyqxmd.com/read/29297618/siop-podc-adapted-treatment-guidelines-for-low-grade-gliomas-in-low-and-middle-income-settings
#9
Laila Hessissen, Jeannette Parkes, Nisreen Amayiri, Naureen Mushtaq, Nongnuch Sirachainan, Yavuz Anacak, Dipayan Mitra, Anthony Figaji, Antoinette Schouten-van Meeteren, Michael Sullivan, Hester Burger, Alan Davidson, Eric Bouffet, Simon Bailey
Effective treatment of children with low grade glioma (LGG) requires a functioning multi-disciplinary team with adequate neurosurgical, neuroradiological, pathological, radiotherapy and chemotherapy facilities and personnel. In addition, the treating centre should have the capacity to manage a variety of LGG and treatment-associated complications. These requirements have made it difficult for many centers in low and middle-income countries (LMIC) to offer effective treatment and follow up. This article provides management recommendations for children with LGG according to the level of facilities available...
December 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29297142/bacterial-infections-of-the-central%C3%A2-nervous-system
#10
REVIEW
Renu Suthar, Naveen Sankhyan
Bacterial infections of the central nervous system (CNS) continue to be an important cause of morbidity and mortality in children. The spectrum of bacterial infection of CNS includes; focal or multifocal infections like brain abscesses or subdural empyema; or more generalized or diffuse infections like pyogenic meningitis or ventriculitis. Focal and generalized infections may co-exist in an individual patient. Prompt and adequate antibiotic therapy and occasionally neurosurgical interventions are the cornerstone of effective management...
January 3, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29290044/aggressive-somatotrophinomas-lacking-clinical-symptoms-neurosurgical-management
#11
Mario Giordano, Amir Samii, Rudolf Fahlbusch
We report our experience about somatotrophinomas without clinical manifestation of acromegaly having radiological- and surgical-verified invasion of the cavernous sinus. We present the clinical, radiological and hormonal status of three patients affected by invasive GH-secreting pituitary adenomas without clinical signs and symptoms of acromegaly with elevation of serum IGF-1 from a series of 142 pituitary adenomas operated in our institute with the aid of intraoperative magnetic resonance imaging (MRI). Total tumor removal was possible in two of the three cases; the patients show normal hormonal status and no recurrence at long-term follow-up...
December 30, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/29288902/diagnostic-evaluation-and-surgical-management-of-pediatric-insular-epilepsy-utilizing-magnetoencephalography-and-invasive-eeg-monitoring
#12
Raheel Ahmed, Hiroshi Otsubo, Carter Snead, Elizabeth Donner, Elysa Widjaja, Ayako Ochi, James M Drake, James T Rutka
INTRODUCTION: The diagnosis and surgical management of pediatric patients with insular epilepsy is challenging due to variable and indistinct seizure semiology arising within the insular cortex. In addition, surgical approaches are associated with potential morbidity given the regional neurosurgical and vascular anatomy. Our institutional experience in evaluation and surgical management of insular epilepsy patients is presented. Diagnostic evaluation, surgical treatment and seizures outcomes are highlighted...
December 20, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29288841/management-of-severe-traumatic-brain-injury-first-24-hours
#13
Thomas Geeraerts, Lionel Velly, Lamine Abdennour, Karim Asehnoune, Gérard Audibert, Pierre Bouzat, Nicolas Bruder, Romain Carrillon, Vincent Cottenceau, François Cotton, Sonia Courtil-Teyssedre, Claire Dahyot-Fizelier, Frédéric Dailler, Jean-Stéphane David, Nicolas Engrand, Dominique Fletcher, Gilles Francony, Laurent Gergelé, Carole Ichai, Etienne Javouhey, Pierre-Etienne Leblanc, Thomas Lieutaud, Philippe Meyer, Sébastien Mirek, Gilles Orliaguet, François Proust, Hervé Quintard, Catherine Ract, Mohamed Srairi, Karim Tazarourte, Bernard Vigué, Jean-François Payen
The latest French Guidelines for the management in the first 24hours of patients with severe traumatic brain injury (TBI) were published in 1998. Due to recent changes (intracerebral monitoring, cerebral perfusion pressure management, treatment of raised intracranial pressure), an update was required. Our objective has been to specify the significant developments since 1998. These guidelines were conducted by a group of experts for the French Society of Anesthesia and Intensive Care Medicine (Société Francaise d'Anesthésie Réanimation (SFAR)) in partnership with the Association de Neuro-Anesthésie-Réanimation de Langue Française (ANARLF), the Société Française de Neurochirurgie (SFN), the Groupe Francophone de Réanimation et d'Urgences Pédiatriques (GFRUP) and the Association des Anesthésistes-Réanimateurs Pédiatriques d'Expression Française (ADARPEF)...
December 27, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29285407/designing-a-pain-management-protocol-for-craniotomy-a-narrative-review-and-consideration-of-promising-practices
#14
REVIEW
Susana Vacas, Barbara Van de Wiele
Background: Craniotomy is a relatively common surgical procedure with a high incidence of postoperative pain. Development of standardized pain management and enhanced recovery after surgery (ERAS) protocols are necessary and crucial to optimize outcomes and patient satisfaction and reduce health care costs. Methods: This work is based upon a literature search of published manuscripts (between 1996 and 2017) from Pubmed, Cochrane Central Register, and Google Scholar...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29283150/a-multidisciplinary-approach-to-sphenoid-wing-dysplasia-presenting-with-pulsatile-proptosis-in-neurofibromatosis-type-1-a-rare-case-report
#15
S Prathibha, Vandana Parasar, S Yasmin, V V Seetha Pramila
Neurofibromatosis (NF) with sphenoid wing dysplasia is a rare clinical entity. Herewith, we present a case of NF with sphenoid wing dysplasia which presented with pulsatile progressive proptosis. Other ocular symptoms or visual disturbances were absent. Diagnosis of the condition was not easy and the management was a challenging task which needed multidisciplinary approach as there were ocular, neurological, orthopedic, and dermatological manifestations. With neurosurgical intervention, reconstruction of the sphenoid wing was possible...
January 2018: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29276597/urinary-perforation-in-spina-bifida-neurosurgical-and-infectious-consequences
#16
Deborah Callanan, Timothy Phillips, Micam Tullous
As the number of medically complex children increases, pediatricians and emergency physicians face challenges in evaluating complications from devices placed to treat their underlying conditions. We present a child with spina bifida who developed a perforation of his vesicostomy leading to peritonitis, septic shock, and urgent externalization of his ventriculoperitoneal shunt. Multiple consultants may need to be promptly involved in the management of children with underlying medical problems. Because procedural complications are often reported only in the surgical specialty literature, pediatricians and emergency physicians should seek information from their patients' specialists about potential problems...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29274454/the-prevalence-of-cerebral-vascular-abnormalities-detected-in-various-diagnostic-subgroups-of-spontaneous-subarachnoid-hemorrhage-in-the-modern-era
#17
Ming Y Chong, Sean C Martin, Isaac Phang, E J St George, Nigel Suttner, Mario K Teo
OBJECTIVE: To determine the prevalence of cerebral vascular abnormalities in various diagnostic subgroups of spontaneous subarachnoid hemorrhage (SAH) in a regional neurosurgical center in the modern era. METHODS: Prospective data collection of 609 consecutive patients with spontaneous SAH in a 3-year period (August 2010 to August 2013) was carried out. Patients were divided into three diagnostic subgroups: computed tomography (CT) positive for SAH; CT negative but positive cerebrospinal fluid (CSF) examination by spectrophotometry for SAH; CT negative for SAH and inconclusive CSF examination...
December 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29251702/safety-and-efficacy-of-brain-injury-guidelines-at-a-level-iii-trauma-center
#18
Grace E Martin, Christopher P Carroll, Zach J Plummer, D A Millar, Timothy A Pritts, Amy T Makley, Bellal A Joseph, Laura B Ngwenya, Michael D Goodman
BACKGROUND: Patients with mild-to-moderate traumatic brain injury (TBI) are often primarily managed by emergency medicine and trauma/acute care physicians. The Brain Injury Guidelines (BIG) were developed at an ACS-accredited level 1 trauma center to triage mild-to-moderate TBI patients and help identify patients who warrant neurosurgical consultation. The BIG have not been validated at a level III trauma center. We hypothesized that BIG criteria can be safely adapted to an ACS-accredited level III trauma center to guide transfers to a higher echelon of care...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29249272/successful-spinal-anaesthesia-in-a-patient-with-a-tarlov-cyst
#19
N Pfund, A Oh, A Cyna
Perineural (Tarlov) cysts are cerebrospinal fluid-containing perineural sacs that are usually located in the sacral spine. While often asymptomatic, they can cause progressive neurological symptoms including pain, paraesthesia and weakness. We present a case of a 24-year-old patient who had uneventful spinal anaesthesia at the L3-4 level for an elective caesarean section. Prior to her procedure, she had reported a two-year history of intermittent back pain and lower-limb paraesthesia, secondary to an S1 segment perineural cyst...
December 14, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29248624/association-of-surgeons-in-training-conference-bournemouth-2017
#20
EDITORIAL
A P Williams, R L Harries, H M Mohan
The Association of Surgeons in Training (ASiT) is a professional body and registered charity working to promote excellence in surgical training for the benefit of junior doctors and patients alike. The Association provides support at both regional and national levels throughout the United Kingdom and Republic of Ireland. Originally founded in 1976, ASiT is independent of the National Health Service (NHS), Surgical Royal Colleges, and specialty associations. The 2017 Annual Conference in Bournemouth brought together over 700 delegates for a diverse educational weekend with numerous expert guest speakers...
December 14, 2017: International Journal of Surgery
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