Dandy’s hemispherectomies: historical vignette

2021 ◽  
pp. 1-7
Author(s):  
Ignacio Jusue-Torres ◽  
Vikram C. Prabhu ◽  
G. Alexander Jones

To better understand Walter Dandy’s intentions and the historical context of his work on hemispherectomy, the authors reviewed his original 1928 publication. Gliomas were considered incurable at that time. Presuming that the loss of motor function denoted a lack of useful tissue in that hemisphere, he pioneered radical removal of the involved cerebral hemisphere. Of the 5 patients operated on by Dandy, 1 died within 48 hours of hemorrhage because of a displaced vascular clip; 1 died of pneumonia in 2 weeks; 2 died of tumor recurrence, at 3 months and 3.5 years, respectively; and a fifth patient was lost to follow-up beyond the 2nd postoperative week. The authors queried the Thomson Reuters Web of Science and Scopus. A total of 88 papers fulfilled inclusion criteria. Half of these papers (44/88) were published after 2012. Only 11% of papers (10/88) quoted Dandy’s paper accurately; half of them were published before 1997. Most publications (76% [67/88]) quoted Dandy incorrectly, all of them from 1997 and later. In the remaining 11 papers (13%), the accuracy of the quotes was unclear. The authors found a trend toward more accurate citation in earlier papers. Critically reviewing Dandy’s report, with an understanding of the historical context, allows a better understanding of his intentions and the value of his contribution.

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P33-P34
Author(s):  
Jeremy T. Reed ◽  
Shankar K. Sridhara ◽  
Scott E Brietzke

Objective Review and assess the current published literature regarding clinical outcomes of suction electrocautery adenoidectomy (ECA) in pediatric patients. Methods The MEDLINE database was systematically reviewed for articles reporting on the use of ECA. Inclusion criteria included English language, sample size greater than 5, and presentation of extractable data regarding pediatric outcomes with ECA. Random effects modeling was used to estimate summary outcomes. Results 9 studies met the inclusion criteria. There were 2 level 1b studies, 2 level 3b studies, and 5 level 4 studies. The mean sample size was 276 patients with a grand mean age of 6.0 years. Random effects modeling of summary estimates of intra-operative hemorrhage (4.1 cc vs. 24.0 cc 95% CI of difference = 16.5–23.1, p<0.001) and operative time (10.0 minutes vs. 11.9 minutes 95% CI of difference=0.82–2.90, p<0.001) favored ECA vs. traditional curette adenoidectomy. Subjective success was reported in 95.0% (95% CI=92.7–97.3%, p<0.001) of ECA patients with a grand mean of 5.8 months of postoperative follow-up and a grand mean lost to follow-up rate of 23.2%. Adenoid regrowth was evaluated objectively (endoscopy or X-ray) in only 116 of 2,132 (5.4%) total patients with an observed regrowth rate of 2.8% (95% CI=0–5.5%, p=0.052) with 846 total person years of follow-up. Conclusions The preponderance of evidence favors ECA versus curette adenoidectomy in terms of decreased intraoperative hemorrhage and decreased operative time. Long-term outcomes data for ECA are scarce, despite the fact that the procedure is likely performed hundreds of times each day, but suggest a low regrowth rate.


Author(s):  
Maria Silvia De Feo ◽  
Mariano Pontico ◽  
Viviana Frantellizzi ◽  
Ferdinando Corica ◽  
Flaminia De Cristofaro ◽  
...  

Abstract Purpose The remarkable amount of preclinical data achieved on 89Zr-PET imaging led to a significant clinical translation, concerning mainly immuno-PET applications. The aim of this systematic review is to provide a complete overview on clinical applications of 89Zr-PET imaging, using a systematic approach to identify and collect published studies performed in humans, sorted by field of application and specific disease subsections. Methods A systematic literature search of articles suiting the inclusion criteria was conducted on Pubmed, Scopus, Central, and Web Of Science databases, including papers published from January 1967 to November 2020. Eligible studies had to be performed on humans through PET imaging with 89Zr-labeled compounds. The methodological quality was assessed through the Quality Assessment of Diagnostic accuracy Studies-2 tool. Results A total of 821 articles were screened. 74 studies performed on humans were assessed for eligibility with the exclusion of further 18, thus 56 articles were ultimately selected for the qualitative analysis. Conclusions 89Zr has shown to be a powerful PET-imaging tool, in particular for radiolabeling antibodies in order to study antigen expression, biodistribution, anticancer treatment planning and follow-up. Other than oncologic applications, 89Zr-radiolabeled antibodies have been proposed for use in inflammatory and autoimmune disorders with interesting results. 89Zr-labeled nanoparticles represent groundbreaking radiopharmaceuticals with potential huge fields of application. To evaluate the clinical usefulness of 89Zr PET-imaging in different conditions and in real-world settings, and to widen its use in clinical practice, further translation of preclinical to clinical data is needed.


Author(s):  
J Han ◽  
AL Hebb ◽  
SA Imran ◽  
DB Clarke

Background: Post-operative delayed hormone dysfunction (DHD) in patients with nonfunctioning pituitary adenomas (NFPA) is highly variable and is predicted based on limited evidence. This study was undertaken to assess the likelihood of developing new DHD and its relation to the extent of tumor resection and recurrence. Methods: Four hundred fifty-five prospectively collected patient files were reviewed from our Program’s database. Inclusion criteria: NFPA; underwent surgery; and minimum follow-up of two years. Tumor recurrence was correlated with DHD (starting one year post-operatively) based on standardized annual imaging and hormone testing. Results: Eighty-nine patients met our inclusion criteria: 39 males and 50 females; mean follow-up was 4.3yrs (ranging from 2 to 11yrs). With no post-op residual tumor, the probability of developing DHD was only 7% by six years; no patient in this group developed DHD after three years of follow-up. In contrast, by six years, the probability of DHD was 33% in patients with residual stable tumor, and 54% in those with tumor recurrence/growth. Conclusions: By six years, approximately one third of patients with incomplete resection, and over half with tumor regrowth, will likely develop DHD. In contrast, the risk of DHD with complete tumor resection is <10% and, when seen, occurs within three years of surgery.


Neurosurgery ◽  
1984 ◽  
Vol 14 (2) ◽  
pp. 204-210 ◽  
Author(s):  
Helen S. L. Chan ◽  
Laurence E. Becker ◽  
Harold J. Hoffman ◽  
Robin P. Humphreys ◽  
Bruce E. Hendrick ◽  
...  

Abstract Seven of fourteen children with spinal cord ependymoma had myxopapillary tumors of the filum terminale. These tumors made up 15.9% of all primary spinal neuroectodermal tumors in children (44 cases) seen during a 62-year period (1919 to 1981). Their clinical presentation, radiological features, pathological findings, treatment, and outcome are reported. Six of the seven patients were known to be alive at the time of writing. The seventh patient was lost to follow-up after 3 years without tumor recurrence. Of 5 patients whose primary mode of treatment was operation alone, 3 had intraspinal or intracranial recurrences. Despite tumor recurrences, 2 patients were long term survivors after further operation and irradiation, whereas the third patient recently received craniospinal irradiation for intracranial tumor recurrence. The 2 patients who did not have tumor recurrence after operation alone had been followed for 3 and 7 years, respectively. Two children with subtotal tumor resection and spinal irradiation had no recurrences at 1 and 17 years, respectively. Our data suggest that this unusual subtype of spinal ependymoma is not uncommon during childhood and has a good prognosis. All patients with this tumor require prolonged follow-up for tumor recurrence after operation and irradiation.


2020 ◽  
Vol 30 (3) ◽  
Author(s):  
Farzad Gohardehi ◽  
Hesam Seyedin ◽  
Shandiz Moslehi

BACKGROUND: Non-communicable diseases (NCD) such as hypertension (HTN) and diabetes mellitus (DM) have been one of the major health problems in the world. The aim of this study was to evaluate the prevalence rate of DM and HTN following natural and man-made disasters that impose significant economic and psychological burdens on human communities.METHODS: In this systematic and meta-analysis review, all crosssectional studies that at least one of their objectives was to measure the prevalence of HTN or DM in individuals affected by natural and man-made disasters were included. Literature review was done in international databases including PubMed, Scopus and Web of Science, from database inception to February 17, 2019. The extracted data included the bibliographic characteristics of the article, the age of the participants, number of participants, gender, sample size, outcome, duration of the follow-up, and prevalence of DM and HTN. Data were analyzed by STATA software (version11) and random effect method and the I2 index were used to investigate heterogeneity between the articles.RESULTS: A total of 16 articles met the inclusion criteria. Based on the quality assessment, 11 papers were categorized as moderate and 5 paper were categorized as high quality. The prevalence of HTN and DM in disaster-exposed populations were 47.35 (CI 95%: 38.53-56.17) and 13.56 (CI 95%: 10.12-17.01), respectively.CONCLUSION: The results of this study show a high prevalence of HTN and DM in survivors of major disasters, which is higher in comparison to the general population. 


2021 ◽  
Vol 7 ◽  
Author(s):  
Yibo Zhang ◽  
Feitian Li ◽  
Chunfu Dai ◽  
Wuqing Wang

Purpose: The presence of endolymphatic hydrops (EH) in patients with intralabyrinthine schwannomas (ILSs) is poorly understood. This study aims to determine whether there is a correlation between endolymphatic hydrops and clinical presentations of ILS.Methods: Data from nine patients with ILSs were retrospectively reviewed between 2007 and 2020. Temporal bone MRI with intratympanic or intravenous injection of gadolinium was applied to detect ILSs and EH.Results: 3D real inversion recovery (IR) sequence MRI of the temporal bone confirmed ipsilateral EH in four patients (4/6). All four patients with EH on MRI presented with vertigo similar to Meniere's disease. Among these patients with EH, one patient with EH in the cochlea showed moderate sensorineural hearing loss, while three patients with EH in both the vestibule and cochlea showed profound hearing loss. MRI demonstrated a transmacular tumor (TMA) in one patient, intravestibular (IV) in four patients, and vestibulocochlear (VC) in four patients. Two IV cases showed moderated hearing loss, while the TMA and VC cases showed profound hearing loss. Transotic resection of the tumor was applied in five patients; translabyrinthine resection was applied in one patient; two patients were under observation; and one patient was given intratympanic injection of gentamicin (ITG). During follow-up, all of the treated patients reported relief of vertigo, and postoperative MRI was performed in two patients, which showed no tumor recurrence. The two patients under observation showed no deterioration of hearing loss or vertigo. One patient was lost to follow-up.Conclusion: EH concurrent with ILSs has been underestimated previously. With the extensive application of temporal bone MRI paradigms, such as 3D-real IR sequence MRI, more cases of potential EH in patients with ILS will be identified. The severity of hearing loss may be associated with the location of the tumor and the degree of EH.


Author(s):  
Sohrab Almasi ◽  
Farkhondeh Asadi

COVID-19 has created major health-related, economic, and social challenges in societies, and its high contagion has dramatically altered access to healthcare. COVID-19 management can be improved by the use of telehealth. This study aimed to examine different telehealth technologies in the management of COVID-19 disease in the domains of surveillance, diagnosis, screening, treatment, monitoring, tracking, and follow-up and investigate the challenges to the application of telehealth in COVID-19 management. This scoping review was conducted based on Arksey and O’Malley's framework. Searches were performed in Web of Science, PubMed, and Scopus databases to examine the evidence on the effectiveness of telehealth in COVID-19 management. Eventually, 36 articles were selected based on the inclusion criteria. The majority of these studies (33%) were conducted in China. Most services offered via telehealth focused on surveillance, tracking, and follow-up, in that order. Moreover, the most frequently used technologies were social networks, web-based apps, and mobile apps, respectively. The use of telehealth in COVID-19 disease management plays a key role in surveillance, diagnosis, screening, treatment, monitoring, tracking, and follow-up.


2021 ◽  
Vol 9 (10) ◽  
pp. 2016
Author(s):  
Mariachiara Ippolito ◽  
Barbara Simone ◽  
Carlotta Filisina ◽  
Francesca Romana Catalanotto ◽  
Giulia Catalisano ◽  
...  

Background: Little is known about the occurrence of bloodstream infections in hospitalized patients with COVID-19 and the related clinical consequences. The aim of this systematic review and meta-analysis was to estimate the pooled occurrence of BSIs among hospitalized patients with COVID-19 and mortality of this patient population. Methods: A systematic search was performed on PubMed, EMBASE, and Web of Science from inception to 19 April 2021. The primary outcome was the occurrence of BSIs among hospitalized patients with COVID-19. The secondary outcome was mortality at the longest available follow-up. Results: Forty-six studies met the inclusion criteria, with a total of 42,694 patients evaluated. The estimated occurrence of BSIs was 7.3% (95% CI 4.7–1.1%) among hospitalized patients with COVID-19, with a mortality rate of 41% (95% CI 30%–52.8%). The subgroup analysis conducted on patients admitted to ICU provided an estimated occurrence of 29.6% (95% CI 21.7%–38.8%). A higher occurrence of BSI was observed in patients with COVID-19, in comparison with patients without COVID-19 (OR 2.77; 95% CI 1.53–5.02; p < 0.001). Conclusions: Our analysis estimated the occurrence of BSIs among hospitalized patients with COVID-19 at around 7%. A four-times higher occurrence was estimated among patients admitted to ICU.


2021 ◽  

Background & Objectives: Due to the outbreak of COVID-19, applying telehealth and telemedicine to prevent the spread of disease is inevitable. Therefore, this study aimed to investigate the application of telehealth and telemedicine in the human coronavirus epidemic. Materials and Methods: The systematic search was conducted in Medline (through PubMed), Scopus, and ISI Web of Science to identify relevant studies published until June 10, 2020. Inclusion criteria included studies in which telemedicine and telehealth were utilized as healthcare services in COVID-19, SARS, or MERS epidemics. This review was performed according to PRISMA guidelines. Results: A total of 598 articles were identified after removing duplicates. After the systematic screening, 18 studies were met our criteria. The analysis showed that only one study was related to SARS, and the rest were on COVID-19 disease. Teleconsultation and televisit had a high percentage (55.6%) among other types of telemedicine services. The most mentioned obstacles were access to suitable technologies and lack of assessment or follow-up to achieve outcomes. Conclusion: The results showed that telehealth and telemedicine could have advantages such as preventing the spread of COVID-19, reducing the healthcare burden, and maintaining appropriate patient care. In addition to these benefits, several limitations and obstacles, including organizational, technological, and patient-related barriers, may be encountered, so it is better to consider the necessary arrangements before implementing telemedicine.


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Shadi Yaghi ◽  
Adam de Havenon ◽  
Erica Scher ◽  
Andrew Chang ◽  
Alexandra Kvernland ◽  
...  

Introduction: Previous studies have shown an elevated risk of MI (MI) in patients with symptomatic intracranial atherosclerotic disease (sICAD), but the mediators of increased risk of MI or death in these patients remain uncertain. We aim to determine risk factors associated with MI or death in patients with symptomatic ICAD. Methods: Patients enrolled in SAMMPRIS had sICAD and were randomized to aggressive medical management (AMM) vs. stenting and AMM. The primary outcome of this post-hoc analysis is MI or vascular death within 2 years of follow-up. We excluded patients who were lost to follow up, had a stroke during follow up, had non-vascular death or death within 30 days of stenting. Patients meeting the inclusion criteria were divided into two groups: those with vs. those without the primary outcome. We used binary logistic regression to determine predictors of incident MI or death within 2 years. Results: Of the 451 patients enrolled in SAMMPRIS, 350 patients met the inclusion criteria (reasons for exclusion: 4 deaths occurring within 30 days of stenting, 63 with ischemic stroke, 6 with symptomatic hemorrhage, 7 patients with non-cardiovascular death within 2 years, and 21 lost to follow up). At 2 years, 17 patients (4.9%) had MI/death; 10 patients had MI and 7 had cardiovascular deaths. In a multivariable model, factors associated with MI/death were: history of coronary artery disease (adjusted OR 3.19, 95% CI 1.14 - 8.93, p = 0.027) and systolic blood pressure (adjusted OR per 10 mm increase 1.20, 95% CI 0.98 - 1.44, p = 0.080). This risk was abut 24% with both predictors present and 2.8% with them absent (Figure). Conclusion: Higher systolic blood pressure and pre-existing cardiovascular disease were independently associated with incident MI or vascular death in patients with sICAD, despite medical management. Further studies are needed to confirm this association and test interventions to reduce this risk.


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