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https://www.readbyqxmd.com/read/28526667/patient-centered-decision-support-formative-usability-evaluation-of-integrated-clinical-decision-support-with-a-patient-decision-aid-for-minor-head-injury-in-the-emergency-department
#1
Edward R Melnick, Erik P Hess, George Guo, Maggie Breslin, Kevin Lopez, Anthony J Pavlo, Fuad Abujarad, Seth M Powsner, Lori A Post
BACKGROUND: The Canadian Computed Tomography (CT) Head Rule, a clinical decision rule designed to safely reduce imaging in minor head injury, has been rigorously validated and implemented, and yet expected decreases in CT were unsuccessful. Recent work has identified empathic care as a key component in decreasing CT overuse. Health information technology can hinder the clinician-patient relationship. Patient-centered decision tools to support the clinician-patient relationship are needed to promote evidence-based decisions...
May 19, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28521349/postoperative-hematoma-requiring-recraniotomy-in-1149-consecutive-patients-with-intracranial-tumors
#2
Teruyoshi Kageji, Shinji Nagahiro, Yoshifumi Mizobuchi, Kohei Nakajima
BACKGROUND: The reported 30-day mortality rate after brain tumor surgery is 2.2% to 2.9%, with a postoperative hematoma (POH) as the most frequent cause of death. OBJECTIVE: To investigate the risk factors for a POH requiring a recraniotomy after brain tumor surgery in a large, contemporary, single-institution consecutive series. METHODS: We included 1149 patients who underwent surgery for intracranial tumors at the Tokushima University Hospital from 1997 to 2014...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28516078/subependymal-giant-cell-astrocytoma-presenting-with-tumoral-bleeding-a-case-report
#3
Jae-Young Kim, Tae-Young Jung, Kyung-Hwa Lee, Seul-Kee Kim
We report a rare case of subependymal giant cell astrocytoma (SEGA) associated with tumoral bleeding in a pediatric patient without tuberous sclerosis complex (TSC). A 10-year-old girl presented with a 2-week history of an increasingly aggravating headache. Brain magnetic resonance imaging revealed an approximately 3.6-cm, well-defined, heterogeneously enhancing mass with multistage hemorrhages on the right-sided foramen of Monro. The tumor was completely resected using a transcallosal approach. Intraoperatively, the mass presented as a gray-colored firm tumor associated with acute and subacute hemorrhages...
April 2017: Brain Tumor Research and Treatment
https://www.readbyqxmd.com/read/28502689/complicated-mild-traumatic-brain-injury-and-the-need-for-imaging-surveillance
#4
Martina Stippler, Jingyi Liu, Rouzbeh Motiei-Langroudi, Zoya Voronovich, Howard Yonas, Roger B Davis
OBJECTIVE: to evaluate the need for repeat head CT in patients with complicated mild traumatic brain injury (cmTBI) determined non-operative after the first head CT METHODS: 380 patients with mild TBI and a positive head CT not needing surgery were included. Changes between first and second head CT were categorized as decreased, increased or stable. RESULTS: Three patients required neurosurgical intervention (0.8%) after the second CT. There were no significant differences in demographics including age, gender, alcohol consumption, anticoagulation status, time between first and second CT, GCS at admission and discharge, and incidence of SAH, EDH, contusion or skull fractures between the operated and non-operated groups...
May 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28502562/grade-1-spetzler-and-martin-cerebral-ruptured-arteriovenous-malformations-treated-by-microsurgery-poor-functional-outcome-is-related-to-injury-from-haemorrhage
#5
R Aboukaïs, M Quidet, M Baroncini, P Bourgeois, X Leclerc, M Vinchon, J-P Lejeune
INTRODUCTION: Ruptured arteriovenous malformations (rAVM) are life-threatening diseases. OBJECTIVE: To evaluate the outcome of patients with grade 1 SPM rAVM after microsurgical treatment. MATERIALS AND METHOD: We retrospectively included 64 consecutive operated patients with a grade 1 SPM rAVM in our institution between 2002 and 2012. Complications related to the surgical procedure were recorded. All patients were re-evaluated 3months after treatment using the modified Rankin Scale score (mRS)...
May 11, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28493801/imaging-of-hydatid-disease-with-a-focus-on-extrahepatic-involvement
#6
Eugenio Zalaquett, Christine Menias, Francisco Garrido, Matías Vargas, José Francisco Olivares, Daniel Campos, Natalia Pinochet, Antonio Luna, Nirvikar Dahiya, Álvaro Huete
Hydatid disease (HD) is a parasitic infection caused by the larvae of a tapeworm that is endemic to many regions around the world-South America, Africa, and Asia, in particular. Humans are infected as intermediate hosts in the parasite's life cycle; thus, HD can be seen in persons living in areas where animal husbandry is practiced. However, owing to the varied patterns of migration and immigration during the past several decades, HD can be diagnosed in individuals living anywhere. The liver is the most common organ involved, with hepatic HD accounting for the majority of published cases...
May 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28490156/multiloculated-hydrocephalus-open-craniotomy-or-endoscopy
#7
REVIEW
Yun Ho Lee, Young Sub Kwon, Kook Hee Yang
Multiloculated hydrocephalus (MLH) is a condition in which patients have multiple, separate abnormal cerebrospinal fluid collections with no communication between them. Despite technical advancements in pediatric neurosurgery, neurological outcomes are poor in these patients and the approach to this pathology remains problematic especially given individual anatomic complexity and cerebrospinal fluid (CSF) hydrodynamics. A uniform surgical strategy has not yet been developed. Current treatment options for MLH are microsurgical fenestration of separate compartments by open craniotomy or endoscopy, shunt surgery in which multiple catheters are placed in the compartments, and combinations of these modalities...
May 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28486839/brugada-syndrome-and-the-story-of-dave
#8
Samira Kashinath Dhamapurkar, Barbara A Wilson, Anita Rose, Gerhard Florschutz
Brugada syndrome (BrS) is a little known genetic condition that causes severe disturbances in cardiac rhythm and may result in sudden unexpected cardiac death in an apparently healthy person. The heart structure is typically normal but there are problems with electrical activity. The syndrome is named after Spanish brothers who are cardiologists, Pedro and Josep Brugada. BrS is the major cause of sudden unexplained death syndrome (SUDS), also known as sudden arrhythmic death syndrome (SADS). Following a description of the syndrome, including its prevalence and incidence, how it is diagnosed and how it can be treated, we consider those who survive a cardiac arrest and what problems they may face...
May 10, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28486159/trends-of-thromboprophylaxis-and-complications-after-major-lower-limb-orthopaedic-surgeries-in-korea-national-health-insurance-claim-data
#9
Sunyoung Kim, Hongyup Ahn, Soon-Ae Shin, Jong-Heon Park, Chang Won Won
BACKGROUND: In Western countries, prophylaxis for venous thromboembolism (VTE) following major lower limb orthopaedic surgeries is recommended. However, that has not been the case in Asian countries, where the reported incidence of postoperative VTE has been low. The present study examined trends in VTE prophylaxis prescriptions and related complications following major lower limb orthopaedic surgeries in South Korea. DESIGN/PARTICIPANTS: Using claim data from the National Health Insurance Corporation, 263,664 patients aged 65years or older who underwent major orthopaedic surgeries (total hip arthroplasty [THA], total knee arthroplasty [TKA], or hip fracture surgery [HFS]) between 2008 and 2012 were included...
April 26, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28484542/incidental-bleeding-meningioma
#10
Robert Sinurat, Jusuf D Banjarnahor
The authors present the case of a 46-year-old woman who was admitted to their institution after suffering acute intratumoral hemorrhage. There was no history and evidence of neoplasms, trauma, seizures and coagulopathy in the patient. Surgery was performed for evacuation of the hematoma and tumor excision after brain CT scan. Post operative results her neurologic function recovered completely. The pathology reports revealed angioblastic meningioma. The key to make an early and accurate diagnosis is good radiological examination, and definitive surgery can bring a more favorable outcome, lowering the morbidity and mortality rate...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28484523/radiosurgery-in-treatment-of-cerebral-arteriovenous-malformation-mid-term-results-of-388-cases-from-a-single-center
#11
Mohammad Ali Bitaraf, Ramon Katoozpour, Mazyar Azar, Mohsen Nouri, Seyed Abolghasem Mortazavi, Abbas Amirjamshidi
BACKGROUND AND OBJECTIVES: The purpose of this study is to evaluate the outcome and risks of radiosurgery for patients with arteriovenous malformations (AVM) of the brain all treated in a single center in the 3(rd) world with all its limitations. MATERIALS AND METHODS: We performed a retrospective analysis of 388 patients with AVM treated with radiosurgery during an 8-year period. Factors associated with increased chance of AVM obliteration or hemorrhages during the follow-up period were analyzed...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28481989/left-atrioventricular-valve-replacement-in-a-patient-with-hereditary-haemorrhagic-telangiectasia
#12
Yasunori Iida, Naritaka Kimura, Akinori Hirano, Hideyuki Shimizu
Hereditary haemorrhagic telangiectasia, or Osler-Rendu-Weber disease, is characterized by multiple arteriovenous malformations and telangiectasia which develop in the brain, lungs or liver. We report the case of a patient who had severe left atrioventricular valve regurgitation with atrial fibrillation after atrioventricular septal defect repair in her childhood and was diagnosed as having hereditary haemorrhagic telangiectasia by chance. The patient underwent successful left atrioventricular valve replacement and maze operation...
May 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28470655/-elevated-intraocular-pressure-induces-cellular-responses-in-the-retinal-capillaries
#13
Katrin Brockhaus, Harutyun Melkonyan, Verena Prokosch, Solon Thanos
Background In the early diagnosis of clinical glaucoma, peripapillary bleedings were almost pathognomonic for a capillary insult. In the perfusion diagnostics, it is predominantly accepted that perfusion imbalances and IOP-induced changes occur and play a crucial role. Biomechanical peculiarities of the optic nerve head and cellular responses to astrocytes are also likely involved. Material and Methods We present in vivo and ex vivo models of IOP-elevation to enhance the resolution of examining cellular and molecular changes and to understand the mechanisms of capillary changes due to IOP-elevation...
May 3, 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28467584/the-geriatric-polytrauma-risk-profile-and-prognostic-factors
#14
Holger Rupprecht, Hans Jürgen Heppner, Kristina Wohlfart, Alp Türkoglu
BACKGROUND: In the German population, the percentage of elderly patients is increasing, and consequently there are more elderly patients among trauma cases, and particularly cases of polytrauma. The aim of this study was to present clinical results and a risk profile for geriatric polytrauma patients. METHODS: Review of 140 geriatric (over 65 years of age) polytrauma patients who received prehospital treatment was performed. Severity of trauma was retrospectively assessed with Hannover Polytrauma Score (HPTS)...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28465218/structure-toxicity-relationship-of-cefoperazone-and-its-impurities-to-developing-zebrafish-by-transcriptome-and-raman-analysis
#15
Ying Han, Jianqin Qian, Jingpu Zhang, Changqin Hu, Chen Wang
Cefoperazone (CFP) is a potent antibacterial agent that is widely used for the treatment of bacterial infections. Previously, we found that both the C-7 and C-3 substituents of CFP are toxic functional groups, and two groups could affect gene expression in zebrafish embryos, thereby resulting in variable abnormal phenotypes. (6R, 7S)-cefoperazone (7S-CFP) is the 7-epimer of CFP and 1-methyl-1H-tetrazole-5-thiol (MTT) is the C-3 substituent of CFP. Both molecules are impurities isolated from CFP that can induce adverse effects...
April 29, 2017: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/28463214/-clinical-predictors-of-hemorrhagic-transformation-in-non-lacunar-ischemic-stroke
#16
Natalia R Balian, Claudia B Alonzo, María Cristina Zurrú, Laura Brescacin, Santiago G Pigretti, Pedro E Colla Machado, Gabriel D Waisman, Edgardo Cristiano
Hemorrhagic transformation is a complex phenomenon where brain tissue bleeds, which could be associated or not to an increase in the neurological deficit after the acute ischemic stroke. The aim of our study was to evaluate clinical predictors of hemorrhagic transformation in patients with non-lacunar ischemic stroke. We performed a prospective analysis of the clinical records and images of patients with non-lacunar ischemic stroke. Demographics, vascular risk factors, previous medications and the information of the event in patients with and without hemorrhagic transformation were here compared...
2017: Medicina
https://www.readbyqxmd.com/read/28458385/recent-trends-in-neuro-endovascular-treatment-for-acute-ischemic-stroke-cerebral-aneurysms-carotid-stenosis-and-brain-arteriovenous-malformations
#17
Yuji Matsumaru, Eiichi Ishikawa, Tetsuya Yamamoto, Akira Matsumura
The efficacy of mechanical thrombectomy with stent retrievers for emergent large vessel occlusion has been proved by randomized trials. Mechanical thrombectomy is increasingly being adopted in Japan since stent retrievers were first approved in 2014. An urgent clinical task is to offer structured systems of care to provide this treatment in a timely fashion to all patients with emergent large vessel occlusion. Treatment with flow-diverting stents is currently a preferred treatment option worldwide for large and giant unruptured aneurysms...
May 1, 2017: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/28457980/reversal-of-trauma-induced-coagulopathy-using-first-line-coagulation-factor-concentrates-or-fresh-frozen-plasma-retic-a-single-centre-parallel-group-open-label-randomised-trial
#18
Petra Innerhofer, Dietmar Fries, Markus Mittermayr, Nicole Innerhofer, Daniel von Langen, Tobias Hell, Gottfried Gruber, Stefan Schmid, Barbara Friesenecker, Ingo H Lorenz, Mathias Ströhle, Verena Rastner, Susanne Trübsbach, Helmut Raab, Benedikt Treml, Dieter Wally, Benjamin Treichl, Agnes Mayer, Christof Kranewitter, Elgar Oswald
BACKGROUND: Effective treatment of trauma-induced coagulopathy is important; however, the optimal therapy is still not known. We aimed to compare the efficacy of first-line therapy using fresh frozen plasma (FFP) or coagulation factor concentrates (CFC) for the reversal of trauma-induced coagulopathy, the arising transfusion requirements, and consequently the development of multiple organ failure. METHODS: This single-centre, parallel-group, open-label, randomised trial was done at the Level 1 Trauma Center in Innsbruck Medical University Hospital (Innsbruck, Austria)...
April 27, 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28455691/long-lasting-cerebral-vasospasm-microthrombosis-apoptosis-and-paravascular-alterations-associated-with-neurological-deficits-in-a-mouse-model-of-subarachnoid-hemorrhage
#19
Mohamad El Amki, Martine Dubois, Antoine Lefevre-Scelles, Nicolas Magne, Mélanie Roussel, Thomas Clavier, Pierre-Olivier Guichet, Emmanuel Gérardin, Vincent Compère, Hélène Castel
Subarachnoid hemorrhage (SAH) is a devastating disease with high mortality and morbidity. Long-term cognitive and sensorimotor deficits are serious complications following SAH but still not well explained and described in mouse preclinical models. The aim of our study is to characterize a well-mastered SAH murine model and to establish developing pathological mechanisms leading to cognitive and motor deficits, allowing identification of specific targets involved in these long-term troubles. We hereby demonstrate that the double blood injection model of SAH induced long-lasting large cerebral artery vasospasm (CVS), microthrombosis formation and cerebral brain damage including defect in potential paravascular diffusion...
April 28, 2017: Molecular Neurobiology
https://www.readbyqxmd.com/read/28454992/accuracy-of-varioguide-frameless-stereotactic-system-against-frame-based-stereotaxy-prospective-randomized-single-centre-study
#20
Ondrej Bradac, Anna Steklacova, Katerina Nebrenska, Jiri Vrana, Patricia de Lacy, Vladimir Benes
INTRODUCTION: Frameless stereotactic brain biopsy systems became widely used nowadays. Varioguide is a relatively novel frameless system. Its accuracy was studied in laboratory setting, but has not yet been studied in the clinical setting. The purpose of this study was to determine its accuracy and diagnostic yield and to compare this with frame-based stereotaxy. MATERIAL AND METHODS: Overall 53 patients (33M and 20F,age 60±15y) were enrolled into this prospective randomized single-centre study...
April 25, 2017: World Neurosurgery
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