scholarly journals A questioner survey regarding recognition and clinical practice of neurocritical care

2022 ◽  
Vol 29 (1) ◽  
pp. 55-60
Author(s):  
Author(s):  
Patrick M. Kochanek ◽  
Rachel P. Berger

A variety of biomarkers of brain injury are being developed in neurocritical care to study secondary injury pathways or aid in diagnostic, prognostic, and/or theragnostic applications. This chapter focuses largely on brain injury biomarkers that can be detected in serum or cerebrospinal fluid samples from patients with acute critical brain injury of various causes. Much of the work has been carried using biomarkers of proteins that are relatively unique to the brain, and that reflect damage to important cellular constituents such as neurons, astroycytes, or axons. Novel approaches that employ a panel of markers or novel analytic methods such as trajectory analysis may optimize the utility of these biomarkers in clinical practice. We anticipate that there will soon be one or more protein biomarkers of brain injury available for clinical use.


2020 ◽  
Author(s):  
Thiago Russo ◽  
Gabriela Ocamoto ◽  
Rafaella Zambetta ◽  
Gustavo Vilela ◽  
Cintya Hayashi ◽  
...  

Abstract Background: Monitoring patients with acute brain injury is crucial in neurocritical care. Intracranial compliance (ICC) has been studied to complement the interpretation of intracranial pressure (ICP) and help the neurocritical care team to anticipate brain function deterioration. ICC has been found to be related to compensatory mechanisms that maintain the stability of ICP (e.g., the higher the compensation, the higher the compliance of intracranial content to adapt to changes in volume and pressure). However, ICC has not been properly translated to clinical practice and has remained a critical technology gap in clinical neuroscience. The objective of this study is to establish a protocol for a scoping review to map the key concepts of ICC in the literature. In addition, this study is designed to characterize the relationship between ICC and ICP, as well as systematically describe the outcomes that are used to assess ICC, considering both the invasive and noninvasive methods.Methods: The scoping review protocol will be conducted according to the Joanna Briggs Institute’s recommendation. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews will be followed. Animals and humans are considered as the population to be investigated. No age criteria or health condition will be considered. ICC, as well as the relationship between ICC and ICP, will be considered as a core concept in this review. Information will be screened based on the context of neurocritical care. Several databases (PubMed, CINAHL, Web of Science, EMBASE, Epistemonikos, Grey Literature Report, clinical trial registries, and Cochrane Clinical Trials) will be searched to identify literature using a combination of keywords and descriptors, and there will be no restriction on the time frame. Data will be extracted systematically by the research team and the results will be summarized.Discussion: No systematic review has mapped the concepts of ICC and its relationship with ICP. Providing the key concepts of ICC and the methods of assessment might show its possible applications in clinical practice and the gaps in research.Systematic review registration: Currently, scoping review protocols are not eligible for registration in the International Prospective Register of Systematic Review database.


2020 ◽  
Vol 48 (5) ◽  
pp. 2295-2305
Author(s):  
Jiawei Zhang ◽  
Dandan Li ◽  
Rui Zhang ◽  
Peng Gao ◽  
Rongxue Peng ◽  
...  

The role of miR-21 in the pathogenesis of various liver diseases, together with the possibility of detecting microRNA in the circulation, makes miR-21 a potential biomarker for noninvasive detection. In this review, we summarize the potential utility of extracellular miR-21 in the clinical management of hepatic disease patients and compared it with the current clinical practice. MiR-21 shows screening and prognostic value for liver cancer. In liver cirrhosis, miR-21 may serve as a biomarker for the differentiating diagnosis and prognosis. MiR-21 is also a potential biomarker for the severity of hepatitis. We elucidate the disease condition under which miR-21 testing can reach the expected performance. Though miR-21 is a key regulator of liver diseases, microRNAs coordinate with each other in the complex regulatory network. As a result, the performance of miR-21 is better when combined with other microRNAs or classical biomarkers under certain clinical circumstances.


2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.


2019 ◽  
Vol 4 (2) ◽  
pp. 322-324
Author(s):  
Thomas F. Burke

Purpose The purpose of this article was to describe a model for “hybrid speech telecoaching” developed for a Fortune 100 organization and offer a “thought starter” on how clinicians might think of applying these corporate strategies within future clinical practice. Conclusion The author contends in this article that corporate telecommunications and best practices gleaned from software development engineering teams can lend credibility to e-mail, messaging apps, phone calls, or other emerging technology as viable means of hybrid telepractice delivery models and offer ideas about the future of more scalable speech-language pathology services.


2020 ◽  
Vol 29 (2) ◽  
pp. 688-704
Author(s):  
Katrina Fulcher-Rood ◽  
Anny Castilla-Earls ◽  
Jeff Higginbotham

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.


2014 ◽  
Vol 23 (2) ◽  
pp. 65-74 ◽  
Author(s):  
Gail Van Tatenhove

Language sample analysis is considered one of the best methods of evaluating expressive language production in speaking children. However, the practice of language sample collection and analysis is complicated for speech-language pathologists working with children who use augmentative and alternative communication (AAC) devices. This article identifies six issues regarding use of language sample collection and analysis in clinical practice with children who use AAC devices. The purpose of this article is to encourage speech-language pathologists practicing in the area of AAC to utilize language sample collection and analysis as part of ongoing AAC assessment.


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