scholarly journals Neurointerventional management of cerebrovascular trauma

2021 ◽  
pp. neurintsurg-2021-017923
Author(s):  
David C Lauzier ◽  
Arindam R Chatterjee ◽  
Akash P Kansagra
Keyword(s):  
High Risk ◽  
Patient Outcomes ◽  
Clinical Data ◽  
Penetrating Trauma ◽  
Diagnosis And Treatment ◽  
Optimal Management ◽  
Permanent Disability ◽  
Non Invasive ◽  
Cerebrovascular Trauma ◽  
Improve Patient

Traumatic cerebrovascular injuries following blunt or penetrating trauma are common and carry a high risk of permanent disability or death. Proper screening, diagnosis, and treatment of these lesions is essential to improve patient outcomes. Advances in imaging continue to improve the accuracy of non-invasive diagnosis of these injuries while new clinical data provide better evidence for optimal management, whether medical or invasive. Here, we review screening, diagnosis, and treatment of traumatic cerebrovascular injuries.

scholarly journals Cause Analysis and Diagnosis and Treatment of Intestinal Fistulas After Ultrasound-Guided Microwave Ablation of Abdominopelvic Lesions

2021 ◽  
Vol 8 ◽  
Author(s):  
Shuilian Tan ◽  
Xiaoling Yu ◽  
Zhigang Cheng ◽  
Jing Zhang ◽  
Jie Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
High Risk ◽  
Clinical Data ◽  
Microwave Ablation ◽  
Diagnosis And Treatment ◽  
Ultrasound Guided ◽  
Cause Analysis ◽  
High Risk Factors ◽  
Intestinal Fistulas

Objective: To determine the cause and high-risk factors for the development of intestinal fistulas (IFs) after ultrasound-guided microwave ablation (MA) of abdominopelvic lesions, and to identify effective prophylactic and therapeutic actions.Methods: Clinical data were collected from patients with an IF after ultrasound-guided MA of abdominopelvic lesions in our hospital from January 1, 2010 to December 31, 2018. The cause, diagnosis, and treatment of IFs in these patients were analyzed.Results: Among 8,969 patients who underwent ultrasound-guided MA of abdominopelvic lesions, eight patients developed IF after MA, Seven patients were discharged after being cured and one died.Conclusion: Abdominopelvic lesions are close to the intestines, so histories of surgery, radiotherapy, and abdominopelvic infection are high-risk factors for IF development after MA of these lesions. Surgical treatment should be provided as soon as an IF is identified.

Diagnosis and treatment impacts on wound care efficiency drivers: real-world analysis

2021 ◽  
Vol 30 (7) ◽  
pp. 534-542
Author(s):  
Christina Lindholm ◽  
Tim J Styche ◽  
Helen E Horton
Keyword(s):  
Patient Outcomes ◽  
Real World ◽  
Economic Burden ◽  
Wound Care ◽  
Diagnosis And Treatment ◽  
Wound Management ◽  
Care Pathways ◽  
Care Providers ◽  
Dressing Change ◽  
Improve Patient

Objective: The prevalence and economic burden of wounds are growing. Any wound has the potential to become hard-to-heal and require frequent care. Clinicians need to find ways to absorb demand on services without compromising outcomes. Drivers of wound care efficiency—time-to-heal, frequency of dressing change and the incidence of complications—can be evaluated to shape future wound management. A survey of wound care was conducted by clinicians from five centres in Sweden over a one-week period, during which clinicians documented every wound once. At the time of surveying, 49% of wounds were considered to be improving, infection incidence was 11.7% and dressings were changed a mean of 2.2 times per week, with highly exuding wounds changed 6.9 times per week. The data highlighted the importance of diagnosing patient and wound characteristics in selecting treatments and organising care. Recognised gaps in diagnoses potentially identify opportunities to influence healing, complication incidence and intensity of nursing, thus reducing demand on resources. In conclusion, this survey highlights opportunities to reduce the burdens these drivers present. Through improved diagnosis and alignment to recognised care pathways, there is potential to improve patient outcomes and alleviate the strains placed upon wound care providers.

Large-Cell Neuroendocrine Carcinoma: Controversies in Diagnosis and Treatment

2011 ◽  
Vol 9 (10) ◽  
pp. 1122-1129 ◽  
Author(s):  
Bonnie S. Glisson ◽  
Cesar A. Moran
Keyword(s):  
Patient Outcomes ◽  
Neuroendocrine Carcinoma ◽  
Treatment Guidelines ◽  
Large Cell ◽  
Large Cell Neuroendocrine Carcinoma ◽  
Diagnosis And Treatment ◽  
Prospective Data ◽  
Therapy Choice ◽  
Low Incidence ◽  
Improve Patient

The diagnosis and treatment of large cell neuroendocrine carcinoma are controversial, difficult, and clearly still evolving. Diagnosing this particular entity can be hampered by the limitations and restrictions imposed by its own definition in the current WHO classification. These complexities in the semantics of diagnostic criteria can puzzle not only the pathologist but also the treating physician, and lead to difficulties in choosing treatment for individual patients. Because of its low incidence (2%-3% of non-small cell carcinomas) and the difficulties in diagnosis, data regarding treatment outcomes are based on series in which the diagnosis is frequently made retrospectively in reclassification, the numbers of patients are small, and the determinants of therapy choice (e.g., treatment with or without adjuvant chemotherapy postresection) cannot be known. Thus, the evidence on which to base recommendations for stage-based treatment paradigms is flawed in many respects. This article discusses these difficult issues for pathologists and oncologists, offers a perspective regarding approaches in treatment, and suggests ways in which prospective data on this uncommon cancer can be gathered to inform treatment guidelines and improve patient outcomes.

scholarly journals Lyme Disease Training and Knowledge Translation Resources Available to Canadian Healthcare Professionals: A Gray Literature Review

2021 ◽  
Vol 12 ◽  
pp. 215013272110507
Author(s):  
Angela M. Coderre-Ball ◽  
Sania Sahi ◽  
Vanessa Anthonio ◽  
Madison Roberston ◽  
Rylan Egan
Keyword(s):  
Lyme Disease ◽  
Literature Review ◽  
Patient Outcomes ◽  
Healthcare Professionals ◽  
Diagnosis And Treatment ◽  
Gray Literature ◽  
Tick Borne Disease ◽  
Flow Charts ◽  
Improve Patient ◽  
Canadian Healthcare

Introduction: Lyme Disease (LD) is the most common tick-borne disease in North America. With the number of cases increasing yearly, Canadian healthcare professionals (HCP) rely on up-to-date and evidence-informed guidelines, instruction, and resources to effectively prevent, diagnose, and treat Lyme disease (LD). This review is the first of its kind to examine gray literature and analyze the diversity of recommendations provided to Canadian HCP about the prevention, diagnosis, and treatment of Lyme disease. Methods: A gray literature review consisting of 4 search strategies was conducted to retrieve materials targeted to Canadian HCP. Searches within targeted websites, targeted Google searches, and gray literature databases, and consultation with content experts were done to look for continuing medical education (CME) events, clinical flow charts, webinars, videos, and reference documents that discussed the prevention, diagnosis, and treatment of Lyme disease. Results: A total of 115 resources were included in this study. Recommendations surrounding prevention strategies were less varied between materials, whereas diagnosis and treatment recommendations were more varied. Our findings suggest that Canadian HCP are met with varying and sometimes contradictory recommendations for diagnosing and treating LD. Conclusions: Due to the increasing incidence of LD in Canada, there is a greater need for resource consistency. Providing this consistency may help mitigate LD burden, standardize approaches to prevention, diagnosis and treatment, and improve patient outcomes.

scholarly journals Pathologic analysis, diagnosis and treatment of adrenal myelolipoma

2014 ◽  
Vol 8 (9-10) ◽  
pp. 637 ◽  
Author(s):  
Heng-chuan Su ◽  
Wen-long Zhou ◽  
Xin Huang ◽  
Jun Dai ◽  
Bao-xing Huang ◽  
...  
Keyword(s):  
Clinical Data ◽  
Diagnosis And Treatment ◽  
Imaging Modalities ◽  
Adrenal Myelolipoma ◽  
Non Invasive ◽  
Pathologic Analysis

With the widespread use of non-invasive imaging modalities, the incidental detection of myelolipoma has become more common. We analyze the clinical data of 4 typical cases of unilateral adrenal myelolipomas, including 1 hormonally inactive patient and 3 hormonally active cases with hyperaldosteronemia, hypercortisolism and hyperandrogenemia. Obvious differences were found in the pathological sections. To our knowledge, this is the first article discussing the etiology of adrenal myelolipoma from pathologic analyses.

The Morbidity of Trauma Nephrectomy

2009 ◽  
Vol 75 (11) ◽  
pp. 1112-1117
Author(s):  
Norma M. Edwards ◽  
Jeffrey A. Claridge ◽  
Raquel M. Forsythe ◽  
Jordan A. Weinberg ◽  
Martin A. Croce ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Trauma Registry ◽  
Penetrating Trauma ◽  
Mortality Rates ◽  
Infectious Complications ◽  
Complication Rates ◽  
Severely Injured ◽  
Prognostic Information ◽  
Improve Patient ◽  
Overall Mortality

Mortality has been shown to be high in patients after trauma nephrectomy (TN). However, there are little data regarding morbidity in survivors. The objective of this study was to determine the morbidity rates associated with TN with attention directed to renal failure (RF) and formation of intra-abdominal abscess (IAA). Patients who underwent TN over a 9-year period (1996 to 2004) were identified from the trauma registry. Records were reviewed for all complications after TN in patients surviving at least 48 hours. Eighty-nine patients were identified with TN; 61 per cent resulted after penetrating trauma. Overall mortality was 34 per cent. Seventy-one patients survived greater than 48 hours; 51 (72%) experienced at least one morbidity. There was no difference in morbidity rates between patients undergoing blunt trauma and those undergoing penetrating trama. Patients with morbidities were significantly older, more severely injured, and had higher mortality rates and longer hospital courses. Infectious complications were seen in 52 per cent, respiratory in 48 per cent, gastrointestinal in 30 per cent, coagulopathy in 25 per cent, and RF and IAA were each seen in 14 per cent of patients. Patients undergoing TN are severely injured with significant morbidity. The results from this study allow us to establish benchmarks to assess complication rates for patients who undergo TN, which can provide prognostic information and goals to improve patient outcomes.

scholarly journals Serum Midkine: Emerging Biomarker for Detection and Prognosis of Non-small Lung Cancer

2021 ◽  
Author(s):  
Louisa Stern ◽  
Erik Mueller ◽  
Eugen Bellon ◽  
Matthias Reeh ◽  
Rainer Grotelueschen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Patient Outcomes ◽  
Operating Characteristic ◽  
Outcome Prediction ◽  
Characteristic Curve ◽  
Screening Tools ◽  
Non Invasive ◽  
Nsclc Patients ◽  
Improve Patient

Abstract Lung cancer continues to be the leading cause for cancer-related deaths in men and women worldwide. Sufficient screening tools enabling early diagnosis are essential to improve patient outcomes. The aim of this study was to evaluate serum midkine (S-MK) both as a diagnostic and prognostic biomarker in non-small cell lung cancer (NSCLC). This single-center analysis included 59 NSCLC patients counting 30 squamous cell cancers and 29 adenocarcinomas. Preoperative S-MK concentration was determined using ELISA. Patients were followed up to five years. S-MK was found to be significantly overexpressed in patients with NSCLC compared to healthy controls (p < 0.001). The discriminative power of S-MK to differentiate NSCLC subjects from controls was fairly high with an area under the receiver operating characteristic curve of 0.83 (p < 0.001). Optimal sensitivity of 92 % and reasonable specificity of 68% was reached at a threshold of 416 pg/ml S-MK. Patients with high S-MK concentration showed a significantly shorter overall survival compared to patients with low S-MK expression (p < 0.05). In conclusion, S-MK is overexpressed in patients with NSCLC and serves as an independent prognostic factor for overall survival. S-MK may thus be considered as an additional non-invasive biomarker not only for NSCLC screening but also for outcome prediction.

scholarly journals The Management of Psychomotor Agitation Associated with Schizophrenia or Bipolar Disorder: A Brief Review

2021 ◽  
Vol 18 (8) ◽  
pp. 4368
Author(s):  
Maurizio Pompili ◽  
Giuseppe Ducci ◽  
Alessandro Galluzzo ◽  
Gianluca Rosso ◽  
Claudia Palumbo ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Patient Outcomes ◽  
Healthcare Staff ◽  
Pharmacological Interventions ◽  
Psychomotor Agitation ◽  
Non Invasive ◽  
Proper Training ◽  
Improve Patient ◽  
Future Management

The early and correct assessment of psychomotor agitation (PMA) is essential to ensure prompt intervention by healthcare professionals to improve the patient’s condition, protect healthcare staff, and facilitate future management. Proper training for recognizing and managing agitation in all care settings is desirable to improve patient outcomes. The best approach is one that is ethical, non-invasive, and respectful of the patient’s dignity. When deemed necessary, pharmacological interventions must be administered rapidly and avoid producing an excessive state of sedation, except in cases of severe and imminent danger to the patient or others. The purpose of this brief review is to raise awareness about best practices for the management of PMA in emergency care situations and consider the role of new pharmacological interventions in patients with agitation associated with bipolar disorder or schizophrenia.

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