Neurosurgery at UT Southwestern Medical Center: 1956–2020

2021 ◽  
Vol 135 (6) ◽  
pp. 1849-1856
Author(s):  
Christopher L. Taylor
Keyword(s):  
Training Program ◽  
Surgical Outcomes ◽  
Medical Center ◽  
Pediatric Neurosurgery ◽  
Veterans Affairs ◽  
University Hospital ◽  
Fertile Ground ◽  
History Of Neurosurgery ◽  
National Organizations ◽  
History Of

The history of neurosurgery at UT Southwestern Medical Center in Dallas, Texas, is reviewed. Kemp Clark, MD, started the academic neurosurgical practice at Parkland Hospital in 1956. Clark developed a robust training program that required the resident to operate early. In 1972, the Dallas Veterans Affairs Hospital was added to the training program. Duke Samson, MD, became chair in 1988. He emphasized technical excellence and honest reporting of surgical outcomes. In 1989, Zale Lipshy University Hospital opened and became a center for neurosurgical care, and Hunt Batjer, MD, became chair in 2012. The program expanded significantly. Along with principles established by his predecessors, Batjer emphasized the need for all neurosurgeons to engage the community and to be active in policy leadership through local and national organizations. During his tenure, the pediatric neurosurgery group at Children’s Medical Center Dallas was integrated with the department, and a multidisciplinary spine service was developed. In 2014, the Peter O’Donnell Jr. Brain Institute was established, and the William P. Clements Jr. University Hospital opened. For 64 years, UT Southwestern Medical Center has been fertile ground for academic neurosurgery, with a strong emphasis on excellence in patient care.

Utility of Anakinra in Acute Crystalline Diseases: A Retrospective Study Comparing a University Hospital with a Veterans Affairs Medical Center

2018 ◽  
Vol 46 (7) ◽  
pp. 748-750 ◽  
Author(s):  
Julianna Desmarais ◽  
Cong-Qiu Chu
Keyword(s):  
Retrospective Study ◽  
Adverse Effects ◽  
Medical Center ◽  
Veterans Affairs ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Acute Gout ◽  
Efficacy And Safety ◽  
Inpatient Management ◽  
Gout Flares

Objective.To evaluate the efficacy and safety of anakinra in inpatient management of acute gout and pseudogout.Methods.Hospitalized patients with acute gout (n = 77) or pseudogout (n = 11) or both (n = 3) were analyzed for response to anakinra and adverse effects.Results.Half of all patients had comorbidities limiting the treatment choice. Anakinra was well tolerated, and 92% of gout flares and 79% of pseudogout flares responded to treatment.Conclusion.Anakinra is an effective and safe treatment for acute gout and pseudogout in hospitalized patients, particularly in those with comorbidities.

scholarly journals Presentation, diagnostic assessment and surgical outcomes in primary hyperparathyroidism: a single centre’s experience

2018 ◽  
Vol 7 (10) ◽  
pp. 1105-1115 ◽  
Author(s):  
Laura J Reid ◽  
Bala Muthukrishnan ◽  
Dilip Patel ◽  
Mike S Crane ◽  
Murat Akyol ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Clinical Features ◽  
Surgical Outcomes ◽  
Imaging Modality ◽  
Evidence Base ◽  
University Hospital ◽  
Clearance Ratio ◽  
Curative Surgery ◽  
History Of ◽  
Surgical Failure

Objective Primary hyperparathyroidism (PHPT) is a common reason for referral to endocrinology but the evidence base guiding assessment is limited. We evaluated the clinical presentation, assessment and subsequent management in PHPT. Design Retrospective cohort study. Patients PHPT assessed between 2006 and 2014 (n = 611) in a university hospital. Measurements Symptoms, clinical features, biochemistry, neck radiology and surgical outcomes. Results Fatigue (23.8%), polyuria (15.6%) and polydipsia (14.9%) were associated with PHPT biochemistry. Bone fracture was present in 16.4% but was not associated with biochemistry. A history of nephrolithiasis (10.0%) was associated only with younger age (P = 0.006) and male gender (P = 0.037). Thiazide diuretic discontinuation was not associated with any subsequent change in calcium (P = 0.514). Urine calcium creatinine clearance ratio (CCCR) was <0.01 in 18.2% of patients with confirmed PHPT. Older age (P < 0.001) and lower PTH (P = 0.043) were associated with failure to locate an adenoma on ultrasound (44.0% of scans). When an adenoma was identified on ultrasound the lateralisation was correct in 94.5%. Non-curative surgery occurred in 8.2% and was greater in those requiring more than one neck imaging modality (OR 2.42, P = 0.035). Conclusions Clinical features associated with PHPT are not strongly related to biochemistry. Thiazide cessation does not appear to attenuate hypercalcaemia. PHPT remains the likeliest diagnosis in the presence of low CCCR. Ultrasound is highly discriminant when an adenoma is identified but surgical failure is more likely when more than one imaging modality is required.

The history of neurosurgery at the University of Nebraska Medical Center

2021 ◽  
pp. 1-7
Author(s):  
Erin J. Torell ◽  
Tyler S. Pistone ◽  
Andrew P. Gard
Keyword(s):  
Patient Care ◽  
Private Practice ◽  
Medical Center ◽  
Resident Training ◽  
Nebraska Medical ◽  
Harvey Cushing ◽  
Lecture Series ◽  
History Of Neurosurgery ◽  
History Of ◽  
The University

The Department of Neurosurgery at the University of Nebraska Medical Center has grown considerably from one neurosurgeon in 1923 into a first-class department with diverse subspecialty care and innovative faculty. Founding neurosurgeon Dr. J. Jay Keegan, a student of Harvey Cushing, instituted a legacy of clinical and research excellence that he passed on to his successors. The department created a lecture series to honor Keegan’s pioneering techniques and impact in the field, featuring prominent neurosurgeons from across the country. Keegan’s successors, such as Dr. Lyal Leibrock, grew the department through a unique partnership with private practice. The current faculty has continued the tradition of exceptional resident training and innovative patient care.

History of CT Scan Studies in Aphasia—1970s to 1990s

2018 ◽  
Author(s):  
Margaret A. Naesser ◽  
Carole L. Palumbo ◽  
Paula I. Martin
Keyword(s):  
Ct Scan ◽  
Medical Center ◽  
Veterans Affairs ◽  
Hemispheric Dominance ◽  
Ct Scans ◽  
Lesion Site ◽  
Language Therapy ◽  
Boston University ◽  
History Of ◽  
Language Areas

This chapter summarizes early computed tomography (CT) scan studies in stroke patients with aphasia from the 1970s through the 1990s. Studies took place at the Boston University Aphasia Research Center located at the Boston Veterans Affairs Medical Center. Earliest studies associated classical aphasia syndromes with lesions located in cortical language areas on CT scans. In the 1980s, studies reported that chronic aphasia could be associated with subcortical lesion only; emphasis was on lesion in white matter pathways. In the 1990s, studies showed that lesion sites on CT scans performed after 2 months poststroke could be predictive for recovery of auditory language comprehension, and meaningful nonfluent speech at 1 year poststroke. Lesion site patterns were identified for different outcome levels following specific language therapy programs. Some rare aphasia cases are included: left-handers with separate hemispheric dominance locations for speech versus comprehension in the same person; and a unilateral, word deafness case.

scholarly journals Eosinophilia in Patients with End Stage Renal Disease Undergoing Hemodialysis

2021 ◽  
Vol 27 (2) ◽  
pp. 67-70
Author(s):  
Kyoung Ha Kim ◽  
Tae Ik Chang ◽  
Seug Yun Yoon ◽  
Min-Young Lee ◽  
Namsu Lee ◽  
...  
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Medical Records ◽  
Medical Center ◽  
Parasite Infection ◽  
University Hospital ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage ◽  
Specific Symptoms

Objective: Eosinophilia in patients on hemodialysis has already been reported. It has been associated with allergy to dialyzers and exaggerated activation of complement during hemodialysis. Its etiology, however, remains unknown. In addition, there are not enough studies on eosinophilia in patients on hemodialysis in Korea. Therefore, we performed this retrospective study to find out the prevalence and possible etiologic factors of blood eosinophilia in patients undergoing hemodialysis.Methods: Between January 2013 to December 2015, the patients hospitalized for hemodialysis at Soonchunhyang University Hospital and National Health Insurance Service Medical Center (Ilsan Hospital) were included in this study. Eosinophilia was defined when absolute eosinophil count was greater than 500/μL, respectively. We retrospectively reviewed the medical records of patients about parasite infection, other malignancies, and history of kidney transplantation.Results: Of the 2,155 patients hospitalized for hemodialysis at two centers, 1,057 patients (49%) were found to have eosinophilia. We investigated 1,199 patients’ information (Soonchunhyang University Hospital) by the medical records. Two hundred two patients (16.8%) had no identifiable and/or possible causes. Only two patients complained of symptoms such as itching. Steroids were administered to control symptoms, and both patients had normal eosinophil levels, and steroids were discontinued. Other patients did not complain of specific symptoms associated with eosinophilia and did not take medication such as steroids. Eosinophilia was improved in 49% of patients without special treatments.Conclusion: We found that the eosinophil counts in patients with end stage renal disease on hemodialysis were frequently elevated. However, in most cases, eosinophilia was not clinically relevant.

Methicillin-ResistantStaphylococcus aureusOutbreak at a Veterans' Affairs Medical Center: Importance of Carriage of the Organism by Hospital Personnel

1990 ◽  
Vol 11 (6) ◽  
pp. 291-296 ◽  
Author(s):  
Annette C. Reboli ◽  
Joseph F. John ◽  
Christel G. Platt ◽  
J. Robert Cantey
Keyword(s):  
Infection Control ◽  
Healthcare Workers ◽  
Medical Center ◽  
Veterans Affairs ◽  
Control Measures ◽  
University Hospital ◽  
Contact Tracing ◽  
Hospital Personnel ◽  
Surgical Resident ◽  
Number Of Patients

AbstractThe reported prevalence of nasal carriage of methicillin-resistantStaphylococcus aureus (MRSA) by hospital personnel averages 2.5%. From August 1985 to September 1987, 155 patients at our Veterans' Affairs Medical Center (VAMC) were colonized or infected with MRSA. In December 1986, only two (2.1%) of 94 healthcare workers were identified as nasal carriers. Prompted by a sharp increase in the number of patients with MRSA in early 1987, contact tracing identified 450 employees, of whom 36 (8%) were nasal carriers. Thirty-five percent of surgical residents (7 of 20) were nasal carriers. Prior to being identified as a nasal carrier, one surgical resident was associated with the inter-hospital spread of the VAMC MRSA strain to the burn unit of the affiliated university hospital. Three family members of two employee carriers were also found to harbor the epidemic strain. All 36 carriers were decolonized with various antimicrobial combinations. Vigorous infection control measures were effective in controlling the epidemic. The frequency of MRSA carriage by hospital personnel at our medical center during the epidemic proved higher than previously appreciated. Thus, healthcare workers may comprise a sizable MRSA reservoir. During an MRSA epidemic, infection control should attempt to identify and decolonize this hospital reservoir, as these individuals can disseminate MRSA both within the hospital as well as into the community.

scholarly journals Incidence and Risk Factors of Surgical Site Infection Following Pediatric Neurosurgery

2020 ◽  
Vol 41 (S1) ◽  
pp. s293-s293
Author(s):  
Corinne Bergeron ◽  
Pamela Doyon-Plourde ◽  
Chantal Veronneau ◽  
Caroline Quach
Keyword(s):  
Risk Factors ◽  
Antibiotic Therapy ◽  
Previous History ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Pediatric Neurosurgery ◽  
Cerebrospinal Fluid Leak ◽  
Number Of Patients ◽  
History Of Neurosurgery ◽  
History Of

Background: Neurosurgeries are at high risk of surgical site infections (SSI), a complication associated with increased morbidity, mortality, and cost. Our aim was to measure SSI incidence and risk factors following pediatric neurosurgery at CHU Sainte-Justine, the provincial center for pediatric craniofacial surgery in Québec, Canada. Methods: Retrospective cohort study of all patients with elective neurosurgery performed at CHUSJ between October 2014 and October 2018. Medical records were reviewed to compare demographics, clinical presentations, and outcomes of patients. SSIs occurring within 30 days of a procedure without implant and up to 90 days with implant, were identified. SSI incidence was measured in patient years, and risk factors were assessed using univariate logistic regressions. Results: In total, 379 patients were included with an overall SSI incidence of 3.96 patient years. We found a higher SSI incidence in 2014–2015 compared to 2016–2018 (1.82 vs 4.83 patient years). The median age was 3.90 years, and cases seemed younger than controls (1.45 vs 4.15 years). No difference between groups was found for sex, body mass index, prematurity, and length of hospitalization. The proportion of deep SSIs was greater than superficial SSIs (53.3% vs 46.7%). Cases were more likely to present with a more severe ASA score, previous history of neurosurgery, neurological conditions, and pulmonary conditions than controls: OR, 3.90 (95% CI, 1.36–11.49); OR, 2.59 (95% CI, 0.88–7.40); OR, 2.77 (95% CI, 0.98–8.41), and OR, 3.21 (95% CI, 0.86–9.94), respectively. Among patients with history of neurosurgery, a higher proportion of cases experienced a cerebrospinal fluid leak (28.6% vs 2.2%). Most patients (85.8%) received preoperative prophylactic antibiotic. Of those, 49.3% were considered appropriate based on antibiotic and timing of administration. When antibiotic dosage was also considered, the number of patients who received an appropriate antibiotic therapy decreased radically. Conclusions: Patients with comorbidities, especially neurological and pulmonary conditions, are at higher risk of SSI after neurosurgery. We are currently working on a detailed analysis to explain the increase in SSI incidence after 2016. Finally, prophylactic antibiotic therapy needs to be improved and its impact on SSI rates needs to be monitored.Funding: NoneDisclosures: None

Barnes Hospital and the Washington University Medical Center

1992 ◽  
Vol 77 (2) ◽  
pp. 318-320 ◽  
Author(s):  
Henry G. Schwartz
Keyword(s):  
Medical Center ◽  
Content Type ◽  
Medical College ◽  
Harvey Cushing ◽  
History Of Neurosurgery ◽  
History Of ◽  
Neurological Surgery ◽  
The University ◽  
Washington University ◽  
New Location

✓ The author documents the development of the Medical School at Washington University since 1891, when the St. Louis Medical College was first included as part of the University. In 1909, Robert Brookings, President of the Corporation of Washington University, acquired a large endowment and moved the clinical and hospital facilities to a new location, enabled by the estate of Robert Barnes. Harvey Cushing was offered the chair of surgery but eventually decided in favor of Harvard University in 1910. Dr. Ernest Sachs was recruited to Washington University by Dr. Fred Murphy, and in 1919 became the first ever Professor of Neurological Surgery. The history of neurosurgery and those who served it at the Washington University Medical Center and Barnes Hospital is recounted.

Development of a Prediction Rule for Methicillin-ResistantStaphylococcus aureusand Vancomycin-ResistantEnterococcusCarriage in a Veterans Affairs Medical Center Population

2008 ◽  
Vol 29 (10) ◽  
pp. 969-971 ◽  
Author(s):  
Stefan Riedel ◽  
Diana Von Stein ◽  
Kelly Richardson ◽  
Joann Page ◽  
Sara Miller ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Hospital Admission ◽  
Medical Center ◽  
Prediction Rule ◽  
Veterans Affairs ◽  
Methicillin Resistant ◽  
History Of ◽  
Vancomycin Resistant

A history of hospital admission in the prior year was the most sensitive predictor of methicillin-resistantStaphylococcus aureusor vancomycin-resistantEnterococcuscolonization at admission to a Veterans Affairs Medical Center (VAMC) but missed more than one-third of carriers and required screening more than one-half of admitted patients.

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