Base de dados : MEDLINE
Pesquisa : M01.526.485.810.910.750 [Categoria DeCS]
Referências encontradas : 150 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 15 ir para página                         

  1 / 150 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29370183
[Au] Autor:Xu Y; Shoamanesh A; Schulman S; Dowlatshahi D; Salman RA; Moldovan ID; Wells PS; AlKherayf F
[Ad] Endereço:Department of Medicine, University of Toronto, Toronto, Canada.
[Ti] Título:Oral anticoagulant re-initiation following intracerebral hemorrhage in non-valvular atrial fibrillation: Global survey of the practices of neurologists, neurosurgeons and thrombosis experts.
[So] Source:PLoS One;13(1):e0191137, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: While oral anticoagulants (OACs) are highly effective for ischemic stroke prevention in atrial fibrillation, intracerebral hemorrhage (ICH) remains the most feared complication of OAC. Clinical controversy remains regarding OAC resumption and its timing for ICH survivors with atrial fibrillation because the balance between risks and benefits has not been investigated in randomized trials. AIMS/HYPOTHESIS: To survey the practice of stroke neurologists, thrombosis experts and neurosurgeons on OAC re-initiation following OAC-associated ICH. METHODS: An online survey was distributed to members of the International Society for Thrombosis and Haemostasis, Canadian Stroke Consortium, NAVIGATE-ESUS trial investigators (Clinicatrials.gov identifier NCT02313909) and American Association of Neurological Surgeons. Demographic factors and 11 clinical scenarios were included. RESULTS: Two hundred twenty-eight participants from 38 countries completed the survey. Majority of participants were affiliated with academic centers, and >20% managed more than 15 OAC-associated ICH patients/year. Proportion of respondents suggesting OAC anticoagulant resumption varied from 30% (for cerebral amyloid angiopathy) to 98% (for traumatic ICH). Within this group, there was wide distribution in response for timing of resumption: 21.4% preferred to re-start OACs after 1-3 weeks of incident ICH, while 25.3% opted to start after 1-3 months. Neurosurgery respondents preferred earlier OAC resumption compared to stroke neurologists or thrombosis experts in 5 scenarios (p<0.05 by Kendall's tau). CONCLUSIONS: Wide variations in current practice exist among management of OAC-associated ICH, with decisions influenced by patient- and provider-related factors. As these variations likely reflect the lack of high quality evidence, randomized trials are direly needed in this population.
[Mh] Termos MeSH primário: Anticoagulantes/administração & dosagem
Fibrilação Atrial/complicações
Hemorragia Cerebral/complicações
Medicina
Trombose/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração Oral
Anticoagulantes/uso terapêutico
Esquema de Medicação
Seres Humanos
Neurologistas
Neurocirurgiões
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191137


  2 / 150 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29240838
[Au] Autor:Babu MA; Liau LM; Meyer FB
[Ad] Endereço:Department of Neurological Surgery, Jackson Memorial Hospital, Ryder Trauma Center, University of Miami, Miami, Florida, United States of America.
[Ti] Título:Recognized focused practice: Does sub-specialty designation offer value to the neurosurgeon?
[So] Source:PLoS One;12(12):e0189105, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Vehicles for life-long assessment such as Maintenance of Certification tend to focus on generalist neurosurgical knowledge. However, as neurosurgeons advance in their careers, they tend to narrow their practice and increase volumes in certain specific types of operations. Failing to test the type of procedures most relevant to the practitioner is a lost opportunity to improve the knowledge and practice of the individual neurosurgeon. In this study, we assess the neurosurgical community's appetite for designations of board-recognized Recognized Focused Practice (RFP). We administered a validated, online, confidential survey to 4,899 neurosurgeons (2,435 American Board of Neurological Surgery (ABNS) Diplomates participating in MOC, 1,440 Diplomates certified prior to 1999 (grandfathered), and 1,024 retired Diplomates). We received 1,449 responses overall (30% response rate). A plurality of respondents were in practice 11-15 years (18.5%), in private practice (40%) and participate in MOC (61%). 49% of respondents felt that a RFP designation would not be helpful. For the 30% who felt that RFP would be helpful, 61.3% felt that it would support recognition by their hospital or practice, it would motivate them to stay current on medical knowledge (53.4%), or it would help attract patients (46.4%;). The most popular suggestions for RFP were Spine (56.2%), Cerebrovascular (62.9%), Pediatrics (64.1%), and Functional/Stereotactic (52%). A plurality of neurosurgeons (35.7%) felt that RFP should recognize neurosurgeons with accredited and non-accredited fellowship experience and sub-specialty experience. Ultimately, Recognized Focused Practice may provide value to individual neurosurgeons, but the neurosurgical community shows tepid interest for pursuing this designation.
[Mh] Termos MeSH primário: Neurocirurgiões
[Mh] Termos MeSH secundário: Adulto
Idoso de 80 Anos ou mais
Seres Humanos
Meia-Idade
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189105


  3 / 150 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28155427
[Au] Autor:Guenther K
[Ad] Endereço:Department of History, Princeton University.
[Ti] Título:Between Clinic and Experiment: Wilder Penfield's Stimulation Reports and the Search for Mind, 1929-55.
[So] Source:Can Bull Med Hist;33(2):281-320, 2016.
[Is] ISSN:0823-2105
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:In medicine, the realm of the clinic and the realm of experimentation often overlap and conflict, and physicians have to develop practices to negotiate their differences. The work of Canadian neurosurgeon Wilder Penfield (1891-1976) is a case in point. Engaging closely with the nearly 5,000 pages of unpublished and hitherto unconsidered reports of electrical cortical stimulation that Penfield compiled between 1929 and 1955, I trace how Penfield's interest shifted from the production of hospital-based records designed to help him navigate the brains of individual patients to the construction of universal brain maps to aid his search for an ever-elusive "mind." Reading the developments of Penfield's operation records over time, I examine the particular ways in which Penfield straddled the individual and the universal while attempting to align his clinical and scientific interests, thereby exposing his techniques to standardize and normalize his brain maps.
[Mh] Termos MeSH primário: Mapeamento Encefálico/história
Estimulação Elétrica
História da Medicina
Neurocirurgiões/história
[Mh] Termos MeSH secundário: Pesquisa Biomédica/história
Encéfalo/fisiologia
Canadá
História do Século XX
Seres Humanos
Masculino
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171212
[Lr] Data última revisão:
171212
[Sb] Subgrupo de revista:QIS
[Da] Data de entrada para processamento:170204
[St] Status:MEDLINE
[do] DOI:10.3138/cbmh.33.2.148-27012015


  4 / 150 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:27776089
[Au] Autor:Tamber MS; Nikas D; Beier A; Baird LC; Bauer DF; Durham S; Klimo P; Lin AY; Mazzola C; McClung-Smith C; Mitchell L; Tyagi R; Flannery AM
[Ad] Endereço:*Department of Pediatric Neurological Surgery, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania; ‡Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois; §Advocate Children's Hospital, Oak Lawn, Illinois; ¶Division of Pediatric Neurosurgery, University of Florida Health Jacksonville, Jacksonville, Florida; ‖Department of Neurological Surgery, Oregon Health and Science University, Portland, Oregon; #Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; **Division of Neurosurgery, University of Vermont Medical Center, Burlington, Vermont; ‡‡Semmes-Murphey Neurologic & Spine Institute; Department of Neurosurgery, University of Tennessee Health Science Center; Le Bonheur Children's Hospital, Memphis, Tennessee; §§St. Louis Cleft-Craniofacial Center, SSM Health Cardinal Glennon Children's Hospital at Saint Louis University, Division of Plastic Surgery, Saint Louis University School of Medicine, St. Louis, Missouri; ¶¶Goryeb Children's Hospital of Atlantic Health Systems, Morristown, New Jersey; ‖‖Department of Neurosurgery, Palmetto Health University of South Carolina Medical Group, Columbia, South Carolina; ##Guidelines Department, Congress of Neurological Surgeons, Schaumburg, Illinois; ***Department of Surgery, Division of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey; ‡‡‡Kids Specialty Center, Women's & Children's Hospital, Lafayette, Louisiana.
[Ti] Título:Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on the Role of Cranial Molding Orthosis (Helmet) Therapy for Patients With Positional Plagiocephaly.
[So] Source:Neurosurgery;79(5):E632-E633, 2016 Nov.
[Is] ISSN:1524-4040
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: No evidence-based guidelines exist on the role of cranial-molding orthosis (helmet) therapy for patients with positional plagiocephaly. OBJECTIVE: To address the clinical question: "Does helmet therapy provide effective treatment for positional plagiocephaly?" and to make treatment recommendations based on the available evidence. METHODS: The US National Library of Medicine Medline database and the Cochrane Library were queried by using MeSH headings and key words relevant to the objective of this systematic review. Abstracts were reviewed, after which studies meeting the inclusion criteria were selected and graded according to their quality of evidence (Classes I-III). Evidentiary tables were constructed that summarized pertinent study results, and, based on the quality of the literature, recommendations were made (Levels I-III). RESULTS: Fifteen articles met criteria for inclusion into the evidence tables. There was 1 prospective randomized controlled trial (Class II), 5 prospective comparative studies (Class II), and 9 retrospective comparative studies (Class II). CONCLUSION: There is a fairly substantive body of nonrandomized evidence that demonstrates more significant and faster improvement of cranial shape in infants with positional plagiocephaly treated with a helmet in comparison with conservative therapy, especially if the deformity is severe, provided that helmet therapy is applied during the appropriate period of infancy. Specific criteria regarding the measurement and quantification of deformity and the most appropriate time window in infancy for treatment of positional plagiocephaly with a helmet remains elusive. In general, infants with a more severe presenting deformity and infants who are helmeted early in infancy tend to have more significant correction (and even normalization) of head shape. The full guidelines document can be located at https://www.cns.org/guidelines/guidelines-management-patients-positional-plagiocephaly/Chapter_5.
[Mh] Termos MeSH primário: Dispositivos de Proteção da Cabeça
Aparelhos Ortopédicos
Plagiocefalia não Sinostótica/terapia
[Mh] Termos MeSH secundário: Medicina Baseada em Evidências
Seres Humanos
Lactente
Neurocirurgiões/organização & administração
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


  5 / 150 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:27776088
[Au] Autor:Baird LC; Klimo P; Flannery AM; Bauer DF; Beier A; Durham S; Lin AY; McClung-Smith C; Mitchell L; Nikas D; Tamber MS; Tyagi R; Mazzola C
[Ad] Endereço:*Department of Neurological Surgery, Oregon Health and Science University, Portland, Oregon; ‡Semmes-Murphey Neurologic & Spine Institute; Department of Neurosurgery, University of Tennessee Health Science Center; Le Bonheur Children's Hospital; Memphis, Tennessee; §Kids Specialty Center, Women's & Children's Hospital, Lafayette, Louisiana; ¶Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; ∥Division of Pediatric Neurosurgery, University of Florida Health Jacksonville, Jacksonville, Florida; #Division of Neurosurgery, University of Vermont Medical Center, Burlington, Vermont; **St. Louis Cleft-Craniofacial Center, SSM Health Cardinal Glennon Children's Hospital at Saint Louis University, Division of Plastic Surgery, Saint Louis University School of Medicine, St. Louis, Missouri; ‡‡Department of Neurosurgery, Palmetto Health University of South Carolina Medical Group, Columbia, South Carolina; §§Guidelines Department, Congress of Neurological Surgeons, Schaumburg, Illinois; ¶¶Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois; ‖‖Advocate Children's Hospital, Oak Lawn, Illinois; ##Department of Pediatric Neurological Surgery, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania; ***Department of Surgery, Division of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey; ‡‡‡Goryeb Children's Hospital of Atlantic Health Systems Morristown, New Jersey.
[Ti] Título:Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline for the Management of Patients With Positional Plagiocephaly: The Role of Physical Therapy.
[So] Source:Neurosurgery;79(5):E630-E631, 2016 Nov.
[Is] ISSN:1524-4040
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Evidence-based guidelines are not currently available for the treatment of positional plagiocephaly and, in particular, for the use of physical therapy for treatment. OBJECTIVE: To answer the question: "does physical therapy provide effective treatment for positional plagiocephaly?" Treatment recommendations are created based on the available evidence. METHODS: The PubMed and the Cochrane Library were queried using MeSH headings and key words relevant to the objective of this systematic review. Abstracts were reviewed, after which studies meeting the inclusion criteria were selected and graded according to their quality of evidence (Classes I-III). Evidentiary tables were constructed that summarized pertinent study results, and recommendations were made based on the quality of the literature (Levels I-III). RESULTS: Three studies met criteria for inclusion. Two randomized, controlled trials (Class I and Class II) and 1 prospective study assessing plagiocephaly as a secondary outcome measure (Class III) were included. CONCLUSION: Within the limits of this systematic review, physical therapy is significantly more effective than repositioning education as a treatment for positional plagiocephaly. There is no significant difference between physical therapy and a positioning pillow as a treatment for positional plagiocephaly. However, given the American Academy of Pediatrics' recommendation against soft pillows in cribs to ensure a safe sleeping environment for infants, physical therapy must be recommended over the use of a positioning pillow. The full guidelines document can be located at https://www.cns.org/guidelines/guidelines-management-patients-positional-plagiocephaly/Chapter_4.
[Mh] Termos MeSH primário: Modalidades de Fisioterapia
Plagiocefalia não Sinostótica/terapia
[Mh] Termos MeSH secundário: Medicina Baseada em Evidências
Seres Humanos
Lactente
Neurocirurgiões/organização & administração
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


  6 / 150 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28799840
[Au] Autor:Martin JE; Bookland M; Moote D; Cebulla C
[Ad] Endereço:Division of Neurosurgery, Department of Surgery, Connecticut Children's Medical Center; and.
[Ti] Título:Standardized method for the measurement of Grabb's line and clival-canal angle.
[So] Source:J Neurosurg Pediatr;20(4):352-356, 2017 Oct.
[Is] ISSN:1933-0715
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE Grabb's line-the perpendicular distance from the basion-C2 line (pB-C2)-is a widely used radiographic measurement with significant clinical implications in patients with a complex Chiari malformation. Rigorous demonstration of the reproducibility of this measurement has not previously been reported. The authors report a standardized measurement technique with excellent inter- and intrarater reliability on T1-weighted sagittal MRI. METHODS The authors developed a standardized measurement technique that included specifications of midline slice selection, landmark and reference line definitions, and measurement technique on T1-weighted sagittal images. Twenty MR images were reviewed by 2 pediatric neurosurgeons, 1 pediatric radiologist, and 1 undergraduate student. Measurements were performed using the technique specified on 2 separate occasions. Intrarater and interrater reliabilities were calculated using the intraclass correlation coefficient. RESULTS A combined interrater reliability of 0.879 was achieved for the pB-C2, and 0.916 for the clival-canal angle, another measure of interest in patients with complex Chiari malformations. Intrarater reliability for these measurements exceeded 0.858 for all 4 reviewers. CONCLUSIONS Grabb's line-the pB-C2-can be measured with excellent reliability using a standardized measurement protocol. Individual clinicians and collaborative databases should consider using validated measurement techniques to guide clinical decision making in patients with craniocervical junction pathology.
[Mh] Termos MeSH primário: Malformação de Arnold-Chiari/diagnóstico por imagem
Fossa Craniana Posterior/diagnóstico por imagem
Imagem por Ressonância Magnética/métodos
Imagem por Ressonância Magnética/normas
Canal Vertebral/diagnóstico por imagem
[Mh] Termos MeSH secundário: Malformação de Arnold-Chiari/cirurgia
Vértebras Cervicais/diagnóstico por imagem
Fossa Craniana Posterior/cirurgia
Seres Humanos
Neurocirurgiões/psicologia
Variações Dependentes do Observador
Processo Odontoide/diagnóstico por imagem
Processo Odontoide/cirurgia
Valores de Referência
Canal Vertebral/cirurgia
Estudantes/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170812
[St] Status:MEDLINE
[do] DOI:10.3171/2017.5.PEDS17181


  7 / 150 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28727832
[Au] Autor:Alotaibi NM; Ibrahim GM; Wang J; Guha D; Mamdani M; Schweizer TA; Macdonald RL
[Ad] Endereço:Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
[Ti] Título:Neurosurgeon academic impact is associated with clinical outcomes after clipping of ruptured intracranial aneurysms.
[So] Source:PLoS One;12(7):e0181521, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Surgeon-dependent factors such as experience and volume are associated with patient outcomes. However, it is unknown whether a surgeon's research productivity could be related to outcomes. The main aim of this study is to investigate the association between the surgeon's academic productivity and clinical outcomes following neurosurgical clipping of ruptured aneurysms. METHODS: We performed a post-hoc analysis of 3567 patients who underwent clipping of ruptured intracranial aneurysms in the randomized trials of tirilazad mesylate from 1990 to 1997. These trials included 162 centers and 156 surgeons from 21 countries. Primary and secondary outcomes were: Glasgow outcome scale score and mortality, respectively. Total publications, H-index, and graduate degrees were used as academic indicators for each surgeon. The association between outcomes and academic factors were assessed using a hierarchical logistic regression analysis, adjusting for patient covariates. RESULTS: Academic profiles were available for 147 surgeons, treating a total of 3307 patients. Most surgeons were from the USA (62, 42%), Canada (18, 12%), and Germany (15, 10%). On univariate analysis, the H-index correlated with better functional outcomes and lower mortality rates. In the multivariate model, patients under the care of surgeons with higher H-indices demonstrated improved neurological outcomes (p = 0.01) compared to surgeons with lower H-indices, without any significant difference in mortality. None of the other academic indicators were significantly associated with outcomes. CONCLUSION: Although prognostication following surgery for ruptured intracranial aneurysms primarily depends on clinical and radiological factors, the academic impact of the operating neurosurgeon may explain some heterogeneity in surgical outcomes.
[Mh] Termos MeSH primário: Aneurisma Roto/cirurgia
Bibliometria
Aneurisma Intracraniano/cirurgia
Neurocirurgiões
Procedimentos Neurocirúrgicos
Editoração
[Mh] Termos MeSH secundário: Aneurisma Roto/tratamento farmacológico
Aneurisma Roto/mortalidade
Escolaridade
Feminino
Escala de Resultado de Glasgow
Seres Humanos
Aneurisma Intracraniano/tratamento farmacológico
Aneurisma Intracraniano/mortalidade
Modelos Logísticos
Masculino
Meia-Idade
Análise Multivariada
Fármacos Neuroprotetores/uso terapêutico
Neurocirurgiões/educação
Pregnatrienos/uso terapêutico
Ensaios Clínicos Controlados Aleatórios como Assunto
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Neuroprotective Agents); 0 (Pregnatrienes); YD064E883I (tirilazad)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0181521


  8 / 150 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28665241
[Au] Autor:Kraemer MR; Sandoval-Garcia C; Bragg T; Iskandar BJ
[Ad] Endereço:Department of Neurosurgery, University of Wisconsin Hospitals and Clinics, Madison, Wisconsin.
[Ti] Título:Shunt-dependent hydrocephalus: management style among members of the American Society of Pediatric Neurosurgeons.
[So] Source:J Neurosurg Pediatr;20(3):216-224, 2017 Sep.
[Is] ISSN:1933-0715
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE The authors conducted a survey to evaluate differences in the understanding and management of shunt-dependent hydrocephalus among members of the American Society of Pediatric Neurosurgeons (ASPN). METHODS Surveys were sent to all 204 active ASPN members in September 2014. One hundred thirty responses were received, representing a 64% response rate. Respondents were asked 13 multiple-choice and free-response questions regarding 4 fundamental problems encountered in shunted-hydrocephalus management: shunt malfunction, chronic cerebrospinal fluid (CSF) overdrainage, chronic headaches, and slit ventricle syndrome (SVS). RESULTS Respondents agreed that shunt malfunction occurs most often as the result of ventricular catheter obstruction. Despite contrary evidence in the literature, most respondents (66%) also believed that choroid plexus is the tissue most often found in obstructed proximal catheters. However, free-text responses revealed that the respondents' understanding of the underlying pathophysiology of shunt obstruction was highly variable and included growth, migration, or adherence of choroid plexus, CSF debris, catheter position, inflammatory processes, and CSF overdrainage. Most respondents considered chronic CSF overdrainage to be a rare complication of shunting in their practice and reported wide variation in treatment protocols. Moreover, despite a lack of evidence in the literature, most respondents attributed chronic headaches in shunt patients to medical reasons (for example, migraines, tension). Accordingly, most respondents managed headaches with reassurance and/or referral to pain clinics. Lastly, there were variable opinions on the etiology of slit ventricle syndrome (SVS), which included early shunting, chronic overdrainage, and/or loss of brain compliance. Beyond shunt revision, respondents reported divergent SVS treatment preferences. CONCLUSIONS The survey shows that there is wide variability in the understanding and management of shunt-dependent hydrocephalus and its complications. Such discrepancies appear to be derived partly from inconsistent familiarity with existing literature but especially from a paucity of high-quality publications.
[Mh] Termos MeSH primário: Derivações do Líquido Cefalorraquidiano
Hidrocefalia/etiologia
Hidrocefalia/terapia
[Mh] Termos MeSH secundário: Criança
Falha de Equipamento
Transtornos da Cefaleia Secundários/etiologia
Transtornos da Cefaleia Secundários/terapia
Seres Humanos
Neurocirurgiões
Pediatras
Síndrome do Ventrículo Colabado/etiologia
Síndrome do Ventrículo Colabado/terapia
Sociedades Médicas
Inquéritos e Questionários
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171115
[Lr] Data última revisão:
171115
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170701
[St] Status:MEDLINE
[do] DOI:10.3171/2017.2.PEDS16265


  9 / 150 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28625903
[Au] Autor:Nater A; Murray JC; Martin AR; Nouri A; Tetreault L; Fehlings MG
[Ad] Endereço:Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
[Ti] Título:The Need for Clinical Practice Guidelines in Assessing and Managing Perioperative Neurologic Deficit: Results from a Survey of the AOSpine International Community.
[So] Source:World Neurosurg;105:720-727, 2017 Sep.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: There is no standardized approach to assess and manage perioperative neurologic deficit (PND) in patients undergoing spinal surgery. This survey aimed to evaluate the awareness and usage of clinical practice guidelines (CPGs) as well as investigate how surgeons performing spine surgeries feel about and manage PND and how they perceive the value of developing CPGs for the management of PND. METHODS: An invitation to participate was sent to the AOSpine International community. Questions were related to the awareness, usage of CPGs, and demographics. Results from the entire sample and subgroups were analyzed. RESULTS: Of 770 respondents, 659 (85.6%) reported being aware of the existence of guideline(s), and among those, 578 (87.7%) acknowledged using guideline(s). Overall, 58.8% of surgeons reported not feeling comfortable managing a patient who wakes up quadriplegic after an uneventful multilevel posterior cervical decompression with instrumented fusion. Although 22.9% would consider an immediate return to the operating room, the other 77.1% favored conducting some kind of investigation/medical intervention first, such as performing magnetic resonance imaging (85.9%), administrating high-dose corticosteroids (50.2%), or increasing the mean arterial pressure (44.7%). Overall, 90.6% of surgeons believed that CPGs for the management of PND would be useful and 94.4% would be either likely or extremely likely to use these CPGs in their clinical practice. CONCLUSIONS: Most respondents are aware and routinely use CPGs in their practice. Most surgeons performing spine surgeries reported not feeling comfortable managing PND. However, they highly value the creation and are likely to use CPGs in its management.
[Mh] Termos MeSH primário: Internacionalidade
Doenças do Sistema Nervoso/terapia
Neurocirurgiões/normas
Assistência Perioperatória/normas
Guias de Prática Clínica como Assunto/normas
Inquéritos e Questionários
[Mh] Termos MeSH secundário: Estudos Transversais
Gerenciamento Clínico
Feminino
Seres Humanos
Masculino
Doenças do Sistema Nervoso/diagnóstico
Doenças do Sistema Nervoso/epidemiologia
Assistência Perioperatória/métodos
Projetos Piloto
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170620
[St] Status:MEDLINE


  10 / 150 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28599906
[Au] Autor:Chung SB; Ryu J; Chung Y; Lee SH; Choi SK
[Ad] Endereço:Department of Neurosurgery, National Medical Center, Seoul, Korea.
[Ti] Título:An Affordable Microsurgical Training System for a Beginning Neurosurgeon: How to Realize the Self-Training Laboratory.
[So] Source:World Neurosurg;105:369-374, 2017 Sep.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To provide detailed information about how to realize a self-training laboratory with cost-effective microsurgical instruments, especially pertinent for the novice trainee. METHODS: Our training model is designed to allow the practice of the microsurgery skills in an efficient and cost-effective manner. A used stereoscopic microscope is prepared for microsurgical training. A sufficient working distance for microsurgical practice is obtained by attaching an auxiliary objective lens. The minimum instrument list includes 2 jeweler's forceps, iris scissors, and alligator clips. The iris scissors and alligator clip provide good alternatives to micro-scissors and microvascular clamp. RESULTS: The short time needed to set up the microscope and suture the gauze with micro-forceps makes the training model suitable for daily practice. It takes about 15 minutes to suture 10 neighboring fibers of the gauze with 10-0 nylon; thus, training can be completed more quickly. CONCLUSIONS: We have developed an inexpensive and efficient micro-anastomosis training system using a stereoscopic microscope and minimal micro-instruments. Especially useful for novice trainees, this system provides high accessibility for microsurgical training.
[Mh] Termos MeSH primário: Neurocirurgiões/educação
Neurocirurgiões/psicologia
Procedimentos Neurocirúrgicos/educação
Procedimentos Neurocirúrgicos/métodos
[Mh] Termos MeSH secundário: Anastomose Cirúrgica/educação
Anastomose Cirúrgica/instrumentação
Anastomose Cirúrgica/métodos
Feminino
Seres Humanos
Laboratórios
Masculino
Procedimentos Neurocirúrgicos/instrumentação
Instrumentos Cirúrgicos
Suturas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170611
[St] Status:MEDLINE



página 1 de 15 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde