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Baohua Yue, Ron Brendel, Amelia Lukitsch, Thomas Prentice, Brian Doty
BACKGROUND: Commercial baclofen formulations used with infusion pumps are available at therapeutic concentrations of 0.5-2.0 mg/mL. However, patients who receive higher daily doses of baclofen may benefit from products with greater baclofen concentrations since their refill frequency would be reduced (up to a maximum of 180 days). We evaluated baclofen solubility, baclofen 3 mg/mL intrathecal (IT) formulation stability, and chemical and physical compatibility with Medtronic SynchroMed(®) II and Codman Medstream(®) programmable IT infusion pumps...
October 21, 2016: Neuromodulation: Journal of the International Neuromodulation Society
Daniel F Hanley, Richard E Thompson, John Muschelli, Michael Rosenblum, Nichol McBee, Karen Lane, Amanda J Bistran-Hall, Steven W Mayo, Penelope Keyl, Dheeraj Gandhi, Tim C Morgan, Natalie Ullman, W Andrew Mould, J Ricardo Carhuapoma, Carlos Kase, Wendy Ziai, Carol B Thompson, Gayane Yenokyan, Emily Huang, William C Broaddus, R Scott Graham, E Francois Aldrich, Robert Dodd, Cristanne Wijman, Jean-Louis Caron, Judy Huang, Paul Camarata, A David Mendelow, Barbara Gregson, Scott Janis, Paul Vespa, Neil Martin, Issam Awad, Mario Zuccarello
BACKGROUND: Craniotomy, according to the results from trials, does not improve functional outcome after intracerebral haemorrhage. Whether minimally invasive catheter evacuation followed by thrombolysis for clot removal is safe and can achieve a good functional outcome is not known. We investigated the safety and efficacy of alteplase, a recombinant tissue plasminogen activator, in combination with minimally invasive surgery (MIS) in patients with intracerebral haemorrhage. METHODS: MISTIE was an open-label, phase 2 trial that was done in 26 hospitals in the USA, Canada, the UK, and Germany...
November 2016: Lancet Neurology
Jane Halliday, Ian Kamaly
BACKGROUND: Neuronavigation, the ability to perform real-time intra-operative guidance during cranial and/or spinal surgery, has increased both accuracy and safety in neurosurgery [2]. Cranial navigation of existing surgical instruments using Brainlab requires the use of an instrument adapter and clamp, which in our experience renders an endoscope 'top-heavy', difficult to manipulate, and the process of registration of the adapter quite time-consuming. METHODS: A Brainlab Disposable Stylet was used to navigate fenestration of an entrapped temporal horn in a pediatric case...
October 14, 2016: Acta Neurochirurgica
Kunxue Deng, Xun Ye, Yaya Yang, Man Liu, Ali Ayyad, Yuanli Zhao, Yuyu Yuan, Jizong Zhao, Tao Xu
BACKGROUND: Numerous dura substitutes are commercially available, but no absorbable synthetic dura repair product has been used for both onlay and suture applications. OBJECTIVE: The safety and effectiveness of a new absorbable synthetic substitute composed of Poly-L-lactide microfibers as onlay dural graft were evaluated. METHODS: Physical properties and performance of the microfibrous synthetic dural substitute implanted as an onlay or suturable grafts were compared with these commercial products, including CODMAN ETHISORB™ Dura Patch and DuraGen™ Dural Graft Matrix, in a canine duraplasty model...
September 2016: Neurological Research
İdiris Altun, Zafer Yüksel, Tufan Mert
AIM: To investigate whether programmable CSF shunts are influenced by exposure to the magnetic field and to compare the effects of magnetic field in 4 different brands of programmable CSF shunts. MATERIAL AND METHODS: This experimental study was performed in the laboratory using a novel design of magnetic field. Four types of programmable CSF shunts (Miethke®, Medtronic®, Sophysa® and Codman®Hakim®) were exposed to the magnetic field generated by an apparatus consisting of Helmholtz coil for 5 minutes...
April 25, 2016: Turkish Neurosurgery
Merter Yalcinkaya, Osman Lapcin, Yavuz Arikan, Osman Emre Aycan, Devrim Ozer, Yavuz Selim Kabukcuoglu
Aneurysmal bone cyst originating from the surface of the bone, either within the cortex or subperiosteally, is an uncommon anatomic subtype. This article reports the clinical and radiologic evaluations and treatment outcomes of 10 patients with surface aneurysmal bone cysts that were surgically treated between 1982 and 2014. Mean age at the time of surgery was 22.4 years (range, 11-44 years). According to Capanna's radiographic evaluation criteria, 6 of the lesions were classified as type V and 4 were classified as type IV...
September 1, 2016: Orthopedics
S Talibi, A Tarnaris, S A Shaw
BACKGROUND: The introduction of antibiotic-impregnated catheters (AICs) has significantly reduced external ventricular drain (EVD) infection rates, inhibiting in particular Gram-positive microbial infection. There is a theoretical increased risk of selection of resistant and Gram-negative microorganisms. The aim of this study is to look at the impact of the introduction of AICs on microorganism susceptibility of infected EVDs and to determine whether the use of such devices results in shift from Gram-positive to Gram-negative microorganisms...
October 2016: British Journal of Neurosurgery
Joel Howell, John Ayanian
No abstract text is available yet for this article.
October 2016: Journal of Health Services Research & Policy
Melissa C Werndle, Samira Saadoun, Isaac Phang, Marek Czosnyka, Georgios Varsos, Zofia Czosnyka, Peter Smielewski, Ali Jamous, B Anthony Bell, Argyro Zoumprouli, Marios C Papadopoulos
Intracranial pressure (ICP) is routinely measured in patients with severe traumatic brain injury (TBI). We describe a novel technique that allowed us to monitor intraspinal pressure (ISP) at the injury site in 14 patients who had severe acute traumatic spinal cord injury (TSCI), analogous to monitoring ICP after brain injury. A Codman probe was inserted subdurally to measure the pressure of the injured spinal cord compressed against the surrounding dura. Our key finding is that it is feasible and safe to monitor ISP for up to a week in patients after TSCI, starting within 72 h of the injury...
2016: Acta Neurochirurgica. Supplement
Mi Ok Kim, Audrey Adji, Michael F O'Rourke, Alberto P Avolio, Peter Smielewski, John D Pickard, Marek Czosnyka
While intracranial pressure (ICP), arterial pressure and transcranial middle cerebral artery flow velocity (MCAFV) are often monitored in unconscious patients following stroke or head injury, the value of waveform indices has not been fully established. We retrospectively analysed the data of eight adults (aged 19-36 years) with closed head injury who had spontaneous and repeated episodes of elevated ICP (i.e. "plateau waves"). MCAFV was measured using transcranial Doppler, ICP using a Codman catheter and radial artery pressure using cannulation...
2016: Acta Neurochirurgica. Supplement
Gustavo Henrique Frigieri Vilela, Brenno Cabella, Sérgio Mascarenhas, Marek Czosnyka, Peter Smielewski, Celeste Dias, Danilo Augusto Cardim, Yvonne Maria Mascarenhas, Charles Chenwei Wang, Rodrigo Andrade, Koji Tanaka, Luiza Silva Lopes, Benedicto Oscar Colli
In this chapter we present in vivo experiments with a new minimally invasive method of monitoring intracranial pressure (ICP). Strain gauge deformation sensors are externally glued onto the exposed skull. The signal from these sensors is amplified, filtered, and sent to a computer with appropriate software for analysis and data storage. Saline infusions into the spinal channel of rats were performed to produce ICP changes, and minimally invasive ICP and direct Codman intraparenchymal ICP were simultaneously acquired in six animals...
2016: Acta Neurochirurgica. Supplement
John E Kuhn
The concept of measuring the outcomes of treatment in health care was promoted by Ernest Amory Codman in the early 1900s, but, until recently, his ideas were generally ignored. The forces that have advanced outcome measurement to the forefront of health care include the shift in payers for health care from the patient to large insurance companies or government agencies, the movement toward assessing the care of populations not individuals, and the effort to find value (or cost-effective treatments) amid rising healthcare costs...
2016: Instructional Course Lectures
Shaw Bronner, Emma Codman, Dana Hash-Campbell, Sheyi Ojofeitimi
The aerobic demands of today's dance repertoire warrant understanding of the current cardiorespiratory fitness of dancers. The purpose of this study was to compare aerobic fitness levels of professional and pre-professional modern dancers and determine change over time. A retrospective analysis of four groups, two professional, and two pre-professional, was conducted in preseason annual screens, occurring before the professional dancers' rehearsal period and the students' academic training. Resting (HRrest), peak (HRpeak), and recovery (HRrecov) heart rate, and blood pressure (BP) were compared in 577 dancers, using an accelerated 3-minute step test...
March 2016: Journal of Dance Medicine & Science
S M I Zaidi, A Nassimizadeh, A Warfield, A P Johnson, S K Ahmed
The Codman ETHISORB Dura Patch is a synthetic, absorbable material whose absorption is complete within approximately 90 days. We report the first case of an unabsorbed Codman Dura patch, in which a patient was presented with nasal obstruction and epistaxis 8 years after pituitary surgery for Cushing's disease.
January 13, 2016: British Journal of Neurosurgery
Chengjun Li, Yu Cong, Xiaozhou Liu, Xing Zhou, Guangxin Zhou, Meng Lu, Xin Shi, Sujia Wu
Despite significant advances in the diagnosis and treatment of osteosarcoma in recent years, overall survival has remained low for over 2 decades. The standard diagnosis of osteosarcoma requires a combination of clinical presentation, radiologic studies, and pathologic tissue evaluation. A typical Codman's triangle in radiologic evaluation is vital in making correct diagnosis for middle or late stage of osteosarcoma. However, there is an actual demand for novel molecular markers with high sensitivity and stability for the diagnosis of early events of osteosarcoma and also the probability of recurrence and metastasis...
2016: Frontiers in Bioscience (Landmark Edition)
David Skarda, Doug Barnhart
From the time of Earnest Codman until recently, measuring and improving quality has variably been viewed as a supportive group in the hospital, or an irritating "fringe" movement in health care. A more thoughtful view of quality improvement (QI) is that it is a central tenet of surgical professionalism, and really what we signed up for when we accepted the responsibility of healing patients using surgery as our methodology. The following article uses a patient safety event to highlight the successful use of a well-known method of improving care, while engaging trainees in the principles of physician engagement, accountability, and professionalism...
December 2015: Seminars in Pediatric Surgery
Isaac Phang, Marius Mada, Angelos G Kolias, Virginia F J Newcombe, Rikin A Trivedi, Adrian Carpenter, Rob C Hawkes, Marios C Papadopoulos
STUDY DESIGN: Laboratory and human study. OBJECTIVE: To test the Codman Microsensor Transducer (CMT) in a cervical gel phantom. To test the CMT inserted to monitor intraspinal pressure in a patient with spinal cord injury. SUMMARY OF BACKGROUND DATA: We recently introduced the technique of intraspinal pressure monitoring using the CMT to guide management of traumatic spinal cord injury [Werndle et al. Crit Care Med 2014;42:646]. This is analogous to intracranial pressure monitoring to guide management of patients with traumatic brain injury...
May 2016: Spine
Francesco Iannaccone, Matthieu De Beule, Sander De Bock, Imramsjah M J Van der Bom, Matthew J Gounis, Ajay K Wakhloo, Matthieu Boone, Benedict Verhegghe, Patrick Segers
Clinical studies have demonstrated the efficacy of stent supported coiling for intra-cranial aneurysm treatment. Despite encouraging outcomes, some matters are yet to be addressed. In particular closed stent designs are influenced by the delivery technique and may suffer from under-expansion, with the typical effect of "hugging" the inner curvature of the vessel which seems related to adverse events. In this study we propose a novel finite element (FE) environment to study potential failure able to reproduce the microcatheter "pull-back" delivery technique...
February 2016: Annals of Biomedical Engineering
Jody Filippo Capitanio, Alice Venier, Lucio Aniello Mazzeo, Lina Raffaella Barzaghi, Stefania Acerno, Pietro Mortini
BACKGROUND: Exposure to magnetic fields may alter the settings of programmable ventriculoperitoneal shunt valves or even cause permanent damages to these devices. There is little information about this topic, none on live patients. OBJECTIVE: To investigate the effects of 1.5-tesla magnetic resonance imaging (MRI) on Hakim-Codman (HC) pressure programmable valves implanted in our hospital. METHODS: A single-center prospective study to assess the rate of perturbations of HC programmable valve implanted...
April 2016: World Neurosurgery
Dan Farahmand, Terje Sæhle, Per Kristian Eide, Magnus Tisell, Per Hellström, Carsten Wikkelsö
OBJECTIVE: The study aim was to examine the effect of gradually reducing the opening pressure on symptoms and signs in the shunt treatment of idiopathic normal pressure hydrocephalus (iNPH). METHODS: In this prospective double-blinded, randomized, controlled, double-center study on patients with iNPH, a ventriculoperitoneal shunt with an adjustable Codman Medos Valve was implanted in 68 patients randomized into 2 groups. In 1 group (the 20-4 group) the valve setting was initially set to 20 cm H2O and gradually reduced to 4 cm H2O over the course of the 6-month study period...
February 2016: Journal of Neurosurgery
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