A COMPARISON OF ASSESSMENT, DIAGNOSIS AND TREATMENT OF PATIENTS WITH CEREBRAL VENOUS THROMBOSIS BEFORE AND AFTER INTRODUCTION OF A NEW POLICY AND GUIDELINE ACROSS GREATER MANCHESTER

2015 ◽  
Vol 86 (11) ◽  
pp. e4.103-e4
Author(s):  
James Keitley ◽  
Timothy Lavin ◽  
Martin Punter ◽  
Jason McMinn ◽  
Mark Kellett
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Diagnosis And Treatment ◽  
Clinical Assessments ◽  
Before And After ◽  
Valid Comparison ◽  
High Level ◽  
The Impact

BackgroundFrom June 2014, regional guidelines to transfer within 24 hours all radiologically confirmed cases of cerebral venous thrombosis (CVT) were implemented across Greater Manchester. This service review assesses the impact on assessment, diagnosis and treatment.MethodsWe prospectively recorded all CVT cases transferred into our unit between June 1st and November 30th 2014 (14 patients), and retrospectively reviewed the casenotes of patients admitted in 2012, 2013 and early 2014 (13 patients).ResultsMean number of days from diagnosis to transfer after guideline introduction was 0.4. More patients underwent fundoscopy (86% vs 77%), visual acuity (50% vs 27%), visual field (79% vs 69%) and otoscopy (29% vs 8%). Patients admitted to SRFT previously had shorter symptom to diagnosis, imaging, transfer, and treatment times.ConclusionsAfter guideline introduction we found a high level of compliance with time to transfer, with improvements in several aspects of clinical assessments. We expect that patients previously admitted to our centre were more unwell or already admitted for other reasons (e.g. neurosurgical) and therefore time from symptoms to diagnosis appears longer. We aim to extend the current evaluation to all patients in the region who weren't transferred to our centre to allow a more valid comparison.

Abstract TP189: Diagnosis and Treatment Trends of Cerebral Venous Thrombosis in a Large Observational Cohort

Stroke ◽  
2019 ◽  
Vol 50 (Suppl_1) ◽  
Author(s):  
Saif Bushnaq ◽  
Arvind Bambhroliya ◽  
Farhaan Vahidy ◽  
Amrou Sarraj ◽  
Sean Savitz ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Diagnosis And Treatment ◽  
Observational Cohort ◽  
Treatment Trends

scholarly journals A Therapeutic Educational Program in Oral Health for Persons with Schizophrenia: A Qualitative Feasibility Study

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Audrey Peteuil ◽  
Corinne Rat ◽  
Sahar Moussa-Badran ◽  
Maud Carpentier ◽  
Jean-François Pelletier ◽  
...  
Keyword(s):  
Oral Health ◽  
Educational Program ◽  
Periodontal Diseases ◽  
Level Of Evidence ◽  
Face To Face ◽  
Before And After ◽  
Health Quality ◽  
Persons With Schizophrenia ◽  
High Level ◽  
The Impact

Objective. The aim of this study was to test the feasibility of a therapeutic educational program in oral health (TEPOH) for persons with schizophrenia (PWS). Design. In a qualitative study, we explored the representation of oral health before and after a TEPOH. Clinical Setting: PWS are at greater risk of decayed and missing teeth and periodontal diseases. In a previous publication, we described the different steps in building a TEPOH by taking into account the experiences of PWS concerning oral health quality of life. This TEPOH aimed at promoting a global health approach. Participants: Voluntary PWS and their caregivers were recruited during face-to-face interviews at “Les Boisseaux” (a psychiatric outpatient centre) in Auxerre (France) and were included in the study between November and December 2016. Intervention: We explored the experiences of participants and their perceptions of oral health before and after the TEPOH with focus group meetings. Results. Four females and three males participated in the study, and the mean age was 29.4 ± 5. Before the TEPOH, the PWS produced 28 ideas about oral health perception and 37 after the TEPOH. After the TEPOH, elements relating to the determinants of oral health (smoking and poor diet) emerged. Conclusions. These results show an evolution in oral health representation, and after some adjustments to the TEPOH, the second step will be to test this program in a large sample to generate a high level of evidence of the impact of TEPOH in the long term.

The impact of financial safety act and corporate governance on the level of financial disclosure

2016 ◽  
Vol 58 (6) ◽  
pp. 618-633 ◽  
Author(s):  
Ali Ahmadi ◽  
Abdelfettah Bouri
Keyword(s):  
Corporate Governance ◽  
Design Methodology ◽  
Stock Exchange ◽  
Financial Disclosure ◽  
Content Type ◽  
Study Results ◽  
Before And After ◽  
The Subject ◽  
High Level ◽  
The Impact

Purpose This research paper aims to identify and measure the contribution of the financial safety act (FSA) regulation in improving the level of financial disclosure of listed Tunisian firms. To answer the problems of the subject, the authors tried to hold accountable several determinants of the level of financial disclosure relating to the particular characteristics of the firm, and the adoption of the recommendations envisaged by the FSA, as likely to have an impact on the level of financial disclosure of Tunisian firms. Design/methodology/approach With a sample composed by 20 companies during the period from 2003 to 2010 (160 observations), the contribution of the FSA regulation in improving the level of financial disclosure of listed Tunisian firms was identified and measured. After that, the levels of financial disclosure before and after the FSA were compared. Findings The study results confirm the positive and significant effect of the FSA on the level of financial disclosure. This impact seems to appear through the improvement of the disclosure level during the years which follow the adoption of the new regulation. The results of this study also show that firms with a high level of financial disclosure are those which have an independent board of directors, auditor BIG and joint audit. Originality/value This paper is devoted to evaluate the impact of the FSA n°2005-96 and corporate governance on the level of financial disclosure. The empirical study relates to a sample of 20 firms listed on the Tunis Stock Exchange observed over the period 2003-2010.

scholarly journals Evaluating the Rapid Emergence of Daptomycin Resistance in Corynebacterium: A Multi-Center Study

2021 ◽  
Author(s):  
Kaitlin F. Mitchell ◽  
Erin McElvania ◽  
Meghan A. Wallace ◽  
Lauren E. Droske ◽  
Amy E. Robertson ◽  
...  
Keyword(s):  
Antimicrobial Agents ◽  
Exposure Period ◽  
Corynebacterium Striatum ◽  
Before And After ◽  
Multi Center Study ◽  
High Level ◽  
The Impact ◽  
Repeated Subculture ◽  
Center Study

Background: Members of the genus Corynebacterium are increasingly recognized as pathobionts and can be very resistant to antimicrobial agents. Previous studies have demonstrated that Corynebacterium striatum can rapidly develop high-level daptomycin resistance (HLDR) (minimum inhibitory concentration [MIC] ≥256 μg/mL). Here we conducted a multi-center study to assay for this in vitro phenotype in diverse Corynebacterium species. Methods: Corynebacterium clinical isolates (n=157) from four medical centers were evaluated. MIC values to daptomycin, vancomycin, and telavancin were determined before and after overnight exposure to daptomycin to identify isolates able to rapidly develop daptomycin non-susceptibility. To investigate assay reproducibility, 18 isolates were evaluated at three study sites. In addition, stability of daptomycin non-susceptibility was tested using repeated subculture without selective pressure. The impact of different media brands was also investigated. Results: Daptomycin non-susceptibility emerged in 12 of 23 species evaluated in this study (C. afermentans, amycolatum, aurimucosum, bovis, jeikeium, macginleyi, pseudodiphtheriticum, resistens, simulans, striatum, tuberculostearicum, and ulcerans) and was detected in 50 of 157 (31.8%) isolates tested. All isolates displayed low (susceptible) MIC values to vancomycin and telavancin before and after daptomycin exposure. Repeated subculture demonstrated 2 of 9 isolates (22.2%) exhibiting HLDR reverted to a susceptible phenotype. Of 30 isolates tested on three media brands, 13 (43.3%) had differences in daptomycin MIC values between brands. Conclusions: Multiple Corynebacterium species can rapidly develop daptomycin non-susceptibility, including HLDR, after a short daptomycin exposure period.

scholarly journals Specific Polymorphism 4G/5G Gene for PAI-1 as a Possible Cause of Cerebral Venous Thrombosis: A Case Report

2017 ◽  
Vol 18 (2) ◽  
pp. 169-173
Author(s):  
Tatjana Boskovic Matic ◽  
Aleksandar Gavrilovic ◽  
Snezana Simovic ◽  
Dejan Aleksic ◽  
Katarina Vesic ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Plasminogen Activator ◽  
Cerebral Venous Thrombosis ◽  
Sinus Thrombosis ◽  
Plasminogen Activator Inhibitor ◽  
Plasminogen Activator Inhibitor 1 ◽  
Sagittal Sinus ◽  
Clinical Center ◽  
The Impact ◽  
Activator Inhibitor

AbstractThrombosis of veins and venous sinus (CVT) is the rare cerebral vascular disorder which makes less than 1% of all strokes. Thrombosis of veins and venous sinuses is picturesquely called “мајоr neurological forger” since it is characterized by very varied clinical picture. Among the various causes of CVT, which can be of infective or non-infective nature, the congenital hyper coagulations especially stand out, diagnosis is based on highly sophisticated diagnostic tests.We present the case of a female patient, 36 years old, who was hospitalized at the Clinic for Neurology in Clinical Center because of the diffuse headache she had for the last few days, with milder right-sided hemiparesis and one generalized tonic-clonic epileptic seizure. With nuclear magnetic resonance (MR/2D venography) the thrombosis of the upper and lower sagittal sinuses is confirmed. By appropriate laboratory tests, as well as by confirmatory immunological and genetic analyses, the impact of the most of the factors is excluded which can contribute to the occurrence of venous thrombosis. The only pathological findings which indicated the possible congenital thrombophilia as the cause of the sagittal sinus thrombosis was the determination of the specific polymorphism of the 4G/5G gene for plasminogen activator inhibitor 1.According to our knowledge, this is the first decribed case of the possible impact of the specific polymorphism of the 4G/5G gene for plasminogen activator inhibitor of 1 on the development of cerebral venous thrombosis.

scholarly journals 819. How effective is alcohol flush and drying cycle of automatic endoscope reprocessor (AER): Stripped Endoscope (SE) model

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S452-S452
Author(s):  
Mohamed Yassin ◽  
Heather Dixon ◽  
Michelle Nerandzic ◽  
Curtis Donskey
Keyword(s):  
Visual Inspection ◽  
Compressed Air ◽  
Usual Practice ◽  
Essential Step ◽  
Limited Efficacy ◽  
Disinfection Process ◽  
Before And After ◽  
High Level ◽  
The Impact ◽  
Water Borne

Abstract Background Endoscopic designs are more ergonomic and technically sophisticated than ever. Endoscope transmitted infections continues despite scrutiny and optimization of disinfection processes. Effective endoscopic dryness has been largely overlooked, even though it is paramount for prevention of water-borne pathogens accumulating after high level disinfection (HDL). Additionally, complete dryness is required to achieve sterilization. The aim of this study is to evaluate the dryness of the endoscopes after routine a routine disinfection process. Methods Three endoscopes were stripped from their outer sheaths to allow for visual inspection of the inside channels. SE were processed as per usual practice. After HLD in an automatic endoscope reprocessor (AER) that included an alcohol flush and drying cycle, SE were hung and observed for any water within the channels. SE were flushed with filtered compressed air. Dryness was monitored visually and by feeling for the impact of water spray at the distal tip of SE. Dryness of the channels before and after air flush was observed for the three SE for three trials each. Results All the SE were grossly wet after HLD despite the AER’s alcohol flush and drying cycle. Hanging vertically had no effect on the narrow diameter channels. Applying compressed air to each channel was effective for drying the channels based on visual inspection and water emission from the distal tip of the SE. The filtered compressed air had a flow rate of 20 L/minute for an average of 2 minutes to assure complete dryness. The nozzle for applying the filtered compressed air was ill-fitting to the openings of the cylinders and ports on the control handle, making it difficult to get a good seal for applying the filtered compressed air. Conclusion The AER’s drying cycle was not effective for drying endoscope channels. Vertical hanging had limited efficacy on endoscopic dryness. The application of filtered compressed air to individual channels was effective for drying the channels. This SE model was useful and direct for assessing the degree of moisture inside the channels. The application of filtered compressed air should be an essential step in endoscopic reprocessing regardless of the need for sterilization. Disclosures All Authors: No reported disclosures

scholarly journals The Impact of Cataract Surgery on Contrast Visual Acuity and Retinal Sensitivity in Patients with Retinitis Pigmentosa

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Gen Miura ◽  
Takayuki Baba ◽  
Tomoaki Tatsumi ◽  
Hirotaka Yokouchi ◽  
Shuichi Yamamoto
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Cataract Surgery ◽  
Contrast Sensitivity ◽  
Retinal Sensitivity ◽  
Zone Length ◽  
Ellipsoid Zone ◽  
Postoperative Visual Acuity ◽  
Before And After ◽  
The Impact

Purpose. To determine the effects of cataract surgery on contrast visual acuity and retinal sensitivity in patients with retinitis pigmentosa. Methods. Retinal sensitivity and contrast visual acuity were determined by microperimetry (MAIA) and contrast sensitivity acuity tester (CAT-CP), respectively, before and after cataract surgery. The significance of the correlations between visual acuity, retinal sensitivity, contrast visual acuity, improvements after surgery, and macular structure before and after cataract surgery was determined. Results. Retinal sensitivity and contrast visual acuity were significantly improved after cataract surgery. The correlations among postoperative visual acuity, postoperative retinal sensitivities, and preoperative ellipsoid zone length were significant. The postoperative retinal sensitivity of the central 10° and the ellipsoid zone length was particularly significantly correlated. Preoperative contrast visual acuity and the amount of improvement and preoperative retinal sensitivity and the amount of improvement were significantly negatively correlated. The contrast visual acuity under both the 100% and 10% photopic and mesopic conditions improved significantly after cataract surgery. Conclusions. Cataract surgery in retinitis pigmentosa patients with preserved ellipsoid zones significantly improved retinal sensitivity and contrast visual acuity. Cataract surgery can be expected to improve retinal sensitivity and contrast visual acuity under various conditions, even if preoperative visual parameters are low, as long as the ellipsoid zone is preserved.

Cerebral Venous Thrombosis: The Problem of Timely Diagnosis and Treatment (P07.028)

Neurology ◽  
2012 ◽  
Vol 78 (Meeting Abstracts 1) ◽  
pp. P07.028-P07.028
Author(s):  
B. Bonakdarpour ◽  
T. Lin ◽  
K. Denski ◽  
S. Putta ◽  
B. Coull
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Diagnosis And Treatment ◽  
Timely Diagnosis

Diagnosis and treatment of cerebral venous thrombosis

2012 ◽  
Vol 10 (12) ◽  
pp. 1545-1553 ◽  
Author(s):  
Christian Weimar ◽  
Florian Masuhr ◽  
Karim Hajjar
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Diagnosis And Treatment

scholarly journals New Insights on Diagnosis and Treatment of Cerebral Venous Thrombosis – A Narrative Review

2021 ◽  
Vol 3 (2) ◽  
pp. 17-20
Author(s):  
Thomas Gabriel Schreiner
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Randomized Clinical Trials ◽  
Acute Stage ◽  
Diagnosis And Treatment ◽  
Future Research ◽  
Symptomatic Therapy ◽  
Invasive Treatment ◽  
Research Directions ◽  
Future Research Directions

Cerebral venous thrombosis (CVT), although accounting for only 0.5-1% of all strokes, remains a potentially fatal neurological emergency, which must be promptly diagnosed and treated. Consisting of two parts, this review aims to highlight the most important data from recent years regarding diagnosis and treatment of CVT, illustrating both the current modern therapeutic approach and the future research directions in the field. Regarding the clinical diagnosis, the neurologist may sometimes have difficulties in recognizing this pathology, given the diverse clinical picture of the acute stage of CVT that can mimic various neurological disorders. In addition, although most risk factors (procoagulation status, infections, trauma, systemic diseases) are known and can be easily detected, in a significant percentage of cases the etiology remains uncertain. For paraclinical diagnosis, among the imaging investigations essential to support the diagnosis, CT angiography and MRI venography are reliable alternatives to digital subtraction angiography which represent the gold standard nowadays. In terms of treatment, international guidelines provide general directions for anticoagulation, with low molecular weight heparin being highly recommended. Regarding invasive treatment methods (thrombolysis, thrombectomy) that could be used in severe cases where anticoagulation has been shown to be insufficient, as well as symptomatic therapy, the evidence is often insufficient, new randomized clinical trials with large cohorts of patients being required.

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