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https://www.readbyqxmd.com/read/29147893/high-elective-surgery-cancellation-rate-in-malawi-primarily-due-to-infrastructural-limitations
#1
Meghan Prin, Jessica Eaton, Onias Mtalimanja, Anthony Charles
BACKGROUND: The provision of safe and timely surgical care is essential to global health care. Low- and middle-income countries have a disproportionate share of the global surgical disease burden and struggle to provide care with the given resources. Surgery cancellation worldwide occurs for many reasons, which are likely to differ between high-income and low-income settings. We sought to evaluate the proportion of elective surgery that is cancelled and the associated reasons for cancellation at a tertiary hospital in Malawi...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29137094/a-novel-non-contrast-enhanced-mra-using-silent-scan-for-evaluation-of-brain-arteriovenous-malformation-a-case-report-and-review-of-literature
#2
Jin Il Moon, Hye Jin Baek, Kyeong Hwa Ryu, Hyun Park
RATIONALE: Brain arteriovenous malformations (AVMs) are congenital vascular abnormalities involving abnormal connections between arteries and veins. In clinical practice, imaging studies help evaluate feeding arteries, niduses, draining venous systems, and coexisting complications in patients with brain AVM. They also have an impact on decision-making regarding clinical management. We applied a novel non-contrast-enhanced MR angiography (MRA) technique, termed "silent MRA," for evaluating an incidental brain AVM...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29133178/lymphatic-vasculature-in-human-dural-superior-sagittal-sinus-implications-for-neurodegenerative-proteinopathies
#3
Naomi P Visanji, Anthony E Lang, David G Munoz
Recent reports have characterized functional lymphatic vessels, which drain both fluid and immune cells from the CSF to the deep cervical lymph nodes, lining the dural sinuses in mice. If conserved in the human brain these vessels could have profound implications for neuroinflammatory and neurodegenerative diseases. We provide evidence of the presence of lymphatic vessels in human dura obtained at autopsy, at the level of the superior sagittal sinus, in 4 individuals. Immunohistochemistry for the lymphatic vessel endothelial cell marker podoplanin revealed the widespread presence of multiple structures with a distinct lumen distributed throughout the superior sagittal sinus...
November 10, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/29131102/a-case-of-a-4-year-old-female-with-a-primary-spinal-malignancy-presenting-with-froin-s-syndrome
#4
Andrew T Hale, Gregory P Fricker, Travis W Crook
We report the case of a 4-year-old female with a primary extradural intramedullary atypical teratoid/rhabdoid tumor (AT/RT) leading to a middle cerebral artery (MCA) infarct and Froin's syndrome. She presented with a 6-pound weight loss over the previous week, as well as a decreased urinary output and an altered mental status. She underwent a brain MRI that revealed a left MCA infarct, mild ventriculomegaly, and bilateral internal carotid artery, M1, and A1 stenosis. An external ventricular drain (EVD) was placed due to increased intracranial pressure...
November 2, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29127332/outflow-of-cerebrospinal-fluid-is-predominantly-through-lymphatic-vessels-and-is-reduced-in-aged-mice
#5
Qiaoli Ma, Benjamin V Ineichen, Michael Detmar, Steven T Proulx
Cerebrospinal fluid (CSF) has been commonly accepted to drain through arachnoid projections from the subarachnoid space to the dural venous sinuses. However, a lymphatic component to CSF outflow has long been known. Here, we utilize lymphatic-reporter mice and high-resolution stereomicroscopy to characterize the anatomical routes and dynamics of outflow of CSF. After infusion into a lateral ventricle, tracers spread into the paravascular spaces of the pia mater and cortex of the brain. Tracers also rapidly reach lymph nodes using perineural routes through foramina in the skull...
November 10, 2017: Nature Communications
https://www.readbyqxmd.com/read/29123881/unexpected-complications-immediately-after-cranioplasty
#6
Akihito Kato, Hiroyuki Morishima, Goro Nagashima
Case: An 84-year-old man with subarachnoid hemorrhage underwent craniotomy and clipping with external decompression. Perfusion magnetic resonance imaging showed subclinical sinking skin flap syndrome, and he underwent cranioplasty on postoperative day 58. No problems occurred during the operation, but cerebral edema and hemorrhage were recognized on immediate postoperative computed tomography. Edema continued to progress, but edema and bleeding eventually improved without additional surgery...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29120564/developmental-venous-anomaly-serving-as-a-draining-vein-of-brain-arteriovenous-malformation
#7
Lukas Rasulić, Filip Vitošević, Krešimir Rotim, Svetlana Milošević Medenica, Dragoslav Nestorović
Developmental venous anomalies are cerebral vascular malformations that present normal venous drainage of cerebral tissue. With increased and accessible usage of modern diagnostic tools, they are now one of the most commonly diagnosed cerebral vascular malformations. Although developmental venous anomalies are considered to be benign lesions, association with arteriovenous malformation renders malignant potential to this combined pathology. In the case presented, these malformations were clinically silent and diagnosed accidentally, so they were not treated either with surgery, endovascular surgery or radiosurgery, considering the possible complications such as venous infarction of the brain, and because there was no obvious neurologic deficit related to this pathology...
March 2017: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29114344/an-examination-of-eyal-hurst-s-2008-framework-for-promoting-retention-in-resource-poor-settings-through-locally-relevant-training-a-case-study-for-the-university-of-guyana-surgical-training-program
#8
Anupa J Prashad, Brian H Cameron, Meghan McConnell, Madan Rambaran, Lawrence E M Grierson
Background: Eyal and Hurst proposed that locally relevant medical education can offset the prevalence of physician "brain drain" in resource-poor regions of the world, and presented a framework of the ethical and pragmatic benefits and concerns posed by these initiatives. The present study explored the framework's utility through a case study of the University of Guyana Diploma in Surgery (UGDS) program. Methods: The framework's utility was evaluated using a case study design that included review and analysis of documents and semi-structured interviews with graduates, trainees, faculty members, and policy makers associated with the UGDS program...
April 2017: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/29114315/intracranial-hypotension-associated-cerebral-swelling-following-cranioplasty-report-of-two-cases
#9
Masashi Nomura, Takahiro Ota, Mitsugu Ishizawa, Shinsuke Yoshida, Takayuki Hara
Cranioplasty is a comparatively simple neurosurgical procedure, and fatal complications are rare. This report describes two cases of critical brain swelling after otherwise uneventful cranioplasty. Both cases had subarachnoid hemorrhage and extremely similar clinical courses. They underwent decompressive craniotomy and clipping in the acute phase and had cranioplasty in the chronic phase, resulting in serious cerebral swelling and death. Deep venous sinus thrombosis was revealed in the autopsy for one case...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29110778/more-than-a-drainage-fluid-the-role-of-csf-in-signaling-in-the-brain-and-other-effects-on-brain-tissue
#10
Sebastian Illes
Current progress in neuroscience demonstrates that the brain is not an isolated organ and is influenced by the systemic environment and extracerebral processes within the body. In view of this new concept, blood and cerebrospinal fluid (CSF) are important body fluids linking extracerebral and intracerebral processes. For decades, substantial evidence has been accumulated indicating that CSF modulates brain states and influences behavior as well as cognition. This chapter provides an overview of how CSF directly modulates the function of different types of brain cells, such as neurons, neural stem cells, and CSF-contacting cells...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29101073/malignant-cerebral-swelling-after-a-cranioplasty-a-case-report-and-literature-review
#11
Liang Shen, Yue Zhou, Jie Xu, Zhongzhou Su
BACKGROUND: Cranioplasty is considered a low-risk operation in the field of neurosurgery following decompression craniectomy (DC). Well-known complications after cranioplasty, such as infection, seizure, and titanium plate exposure, may not threaten the lives of patients. Unfortunately, there are many fatal complications that are under reported. In this study, we report a case and perform a literature review to introduce malignant cerebral swelling, which is regarded as a devastating complication...
October 28, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29093495/application-of-multimodal-navigation-together-with-fluorescein-angiography-in-microsurgical-treatment-of-cerebral-arteriovenous-malformations
#12
Shiyu Feng, Yanyang Zhang, Zhenghui Sun, Chen Wu, Zhe Xue, Yudong Ma, Jinli Jiang
This study aimed to explore the clinical applications of multimodal navigation combined with indocyanine green (ICG) fluorescein angiography in microsurgical treatment of cerebral arteriovenous malformations (AVMs). We retrospectively collected 52 patients with AVMs. Assisted by anatomic image, we reestablished three-dimensional structure using preoperative functional magnetic resonance imaging (fMRI) and Diffusion tensor imaging (DTI). The operation for lesion resection was finished under the assistance of neuro-navigation...
November 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29069919/stereotactic-biopsy-of-cerebellar-lesions-straight-versus-oblique-frame-positioning
#13
Johanna Quick-Weller, Nina Brawanski, Nazife Dinc, Bedjahn Behmanesh, Sara Kammerer, Daniel Dubinski, Volker Seifert, Gerhard Marquardt, Lutz Weise
OBJECTIVE: Biospies of brain lesions with unknown entity are an everyday procedure among many neurosurgical departments. Biopsies can be performed frame-guided or frameless. However, cerebellar lesions are a special entity with a more complex approach. All biopsies in this study were performed stereotactically frame guided. Therefore, only biopsies of cerebellar lesions were included in this study. We compared whether the frame was attached straight versus oblique and we focused on diagnostic yield and complication rate...
October 26, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29063222/the-brain-drain-myth-retention-of-specialist-surgical-graduates-in-east-central-and-southern-africa-1974-2013
#14
Adam Gyedu
No abstract text is available yet for this article.
December 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29038829/the-brain-drain-myth-retention-of-specialist-surgical-graduates-in-east-central-and-southern-africa-1974-2013
#15
Avril Hutch, Abebe Bekele, Eric O'Flynn, Andrew Ndonga, Sean Tierney, Jane Fualal, Christopher Samkange, Krikor Erzingatsian
BACKGROUND: This study assesses the retention of specialist surgical graduates from training programmes across eight countries in East, Central and Southern Africa from 1974 to 2013. It addresses the gap in existing data by analysing retention rates of surgical graduates by comparing graduating institution to current location. Data were assessed by country, region, specialty and gender with a view to informing national and regional healthcare and education strategies. METHODS: Twenty-five institutions train surgeons in the ten countries covered by the College of Surgeons of East, Central and Southern Africa (COSECSA)-24 Universities and the College itself...
December 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29036806/pritumumab-the-first-therapeutic-antibody-for-glioma-patients
#16
Ivan Babic, Elmar Nurmemmedov, Venkata M Yenugonda, Tiffany Juarez, Natsuko Nomura, Sandeep C Pingle, Mark C Glassy, Santosh Kesari
Immunotherapy is now at the forefront of cancer therapeutic development. Gliomas are a particularly aggressive form of brain cancer for which immunotherapy may hold promise. Pritumumab (also known in the literature as CLNH11, CLN-IgG, and ACA-11) was the first monoclonal antibody tested in cancer patients. Pritumumab is a natural human monoclonal antibody developed from a B lymphocyte isolated from a regional draining lymph node of a patient with cervical carcinoma. The antibody binds ecto-domain vimentin on the surface of cancer cells...
September 1, 2017: Human Antibodies
https://www.readbyqxmd.com/read/29021222/the-perivascular-pathways-for-influx-of-cerebrospinal-fluid-are-most-efficient-in-the-midbrain
#17
Howard Dobson, Matthew MacGregor Sharp, Richard Cumpsty, Theodore P Criswell, Tyler Wellman, Ciara Finucane, Jenna M Sullivan, Roy O Weller, Ajay Verma, Roxana O Carare
Although there are no conventional lymphatic vessels in the brain, fluid and solutes drain along basement membranes of cerebral capillaries and arteries towards the subarachnoid space and cervical lymph nodes. Convective influx/glymphatic entry of the cerebrospinal fluid (CSF) into the brain parenchyma occurs along the pial-glial basement membranes of arteries. This project tested the hypotheses that pial-glial basement membranes of arteries are thicker in the midbrain, allowing more glymphatic entry of CSF...
October 11, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/29019892/bright-sinus-appearance-on-arterial-spin-labeling-mr-imaging-aids-to-identify-cerebral-venous-thrombosis
#18
Ji Hee Kang, Tae Jin Yun, Roh-Eul Yoo, Byung-Woo Yoon, A Leum Lee, Koung Mi Kang, Seung Hong Choi, Ji-Hoon Kim, Chul-Ho Sohn, Moon Hee Han
Cerebral venous thrombosis is a potentially lethal disease. Early diagnosis is essential to improve its prognosis. However, its early diagnosis based on conventional imaging modalities remains a challenge in clinical settings. The purpose of this study was to evaluate whether bright sinus appearance on arterial spin-labeling perfusion-weighted image (ASL-PWI) could help identify cerebral venous thrombosis.ASL-PWI of 13 patients who were confirmed as cerebral venous thrombosis based on neurologic symptoms and computed tomography (CT) or magnetic resonance (MR) venography (with/without cerebral angiography) were retrospectively analyzed for the presence or absence of the following: bright signal in dural sinus termed "bright sinus appearance"; and hypoperfusion in brain parenchyma drained by thrombosed sinus...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29017546/is-there-a-doctor-in-the-house-availability-of-israeli-physicians-to-the-workforce
#19
Pamela Kuflik Horowitz, Annarosa Anat Shemesh, Tuvia Horev
BACKGROUND: Israeli policymakers have expressed serious concerns about being able to meet the growing demand for physician services. For this reason, the Israel Ministry of Health (MoH) undertook studies based on 2008 and then 2012 data to obtain an accurate assessment of the size, specialty mix, demographic and geographic composition of the physician workforce. This paper highlights the findings from these studies about the number and percentage of licensed physicians in Israel who were not available, were only partially available, or were about to leave the Israeli healthcare workforce...
May 30, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28978605/cognitive-aids-a-must-for-procedures-performed-by-multidisciplinary-sedation-teams-outside-the-operation-room
#20
Susanne Eberl, Lena Koers, Maartje Van Haperen, Benedikt Preckel
The human brain might not perform optimally during stressful situations. Cognitive aids can help in such situations to carry out all necessary treatment steps in a correct order. We present the case of a severe anaphylactic reaction during a percutaneous radiological intervention to drain an echinococcosis cyst on the radiology suite outside the operation room (OR), in which cognitive aids were successfully used to optimise patient care by a multidisciplinary team. Cognitive aids do not replace experience and skills of the individual caregivers, but can be invaluable tools for multidisciplinary teams dealing with crisis situations outside the OR...
October 4, 2017: BMJ Case Reports
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