Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 91
Filtrar
Mais filtros

Base de dados
País/Região como assunto
Tipo de documento
Intervalo de ano de publicação
1.
J Intensive Care Med ; 39(2): 159-169, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37605433

RESUMO

INTRODUCTION: Parents of children in the pediatric intensive care unit (PICU) experience substantial stress; a parent's perception of their child's illness severity, more than objective measures, predicts psychological outcomes. No tools exist to assess parents' real-time experiences. This pilot study evaluated the feasibility and acceptability of a text-based tool to measure parental experience. METHODS: Inclusion criteria included PICU stay >48 h, physician approval, smartphone access, and English-speaking caregiver. Eligible parents received a text-based baseline survey and surveys every other day while hospitalized regarding their mood/experiences and optional open-ended questions regarding stressors. They received post-discharge follow-up surveys at 1 week and 1, 3, and 6 months. Follow-up surveys assessed mood and symptoms of depression, anxiety, and post-traumatic stress. Interviews and surveys about the interface were conducted 1 week and 3 months following discharge. Feasibility was assessed by descriptive statistics (eg, response rates), and acceptability was assessed by descriptive statistics (survey results) and thematic analyses of interviews. RESULTS: Of 20 enrolled participants, the first 5 were excluded due to technical issues. Of the 15 included, results demonstrated feasibility and acceptability. Most participants (86%) completed all surveys during the PICU stay and continued to complete surveys at a high rate: 79%-94% 3 months post-discharge. All participants agreed that the system was easy to use and were satisfied with the system at discharge, and 91% remained satisfied 3 months post-discharge. Additionally, 76% reported comfort, and 69% reported benefit. From the interviews, participants lauded the system's convenience and applicability of content. Some proposed changes to improve ergonomics. Many suggested this interface could help teams better support families. CONCLUSIONS: A text-based interface for measuring experience in the PICU is feasible and acceptable to parents. Further research can explore how this could identify parents most at risk of adverse psychological sequelae and lead to earlier supportive interventions.


Assuntos
Assistência ao Convalescente , Envio de Mensagens de Texto , Criança , Humanos , Projetos Piloto , Estudos de Viabilidade , Alta do Paciente , Pais/psicologia , Unidades de Terapia Intensiva Pediátrica
2.
Psychol Med ; 53(5): 1906-1913, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-34802472

RESUMO

BACKGROUND: Evidence suggests a link between smaller hippocampal volume (HV) and post-traumatic stress disorder (PTSD). However, there has been little prospective research testing this question directly and it remains unclear whether smaller HV confers risk or is a consequence of traumatization and PTSD. METHODS: U.S. soldiers (N = 107) completed a battery of clinical assessments, including structural magnetic resonance imaging pre-deployment. Once deployed they completed monthly assessments of traumatic-stressors and symptoms. We hypothesized that smaller HV would potentiate the effects of traumatic stressors on PTSD symptoms in theater. Analyses evaluated whether total HV, lateral (right v. left) HV, or HV asymmetry (right - left) moderated the effects of stressor-exposure during deployment on PTSD symptoms. RESULTS: Findings revealed no interaction between total HV and average monthly traumatic-stressors on PTSD symptoms b = -0.028, p = 0.681 [95% confidence interval (CI) -0.167 to 0.100]. However, in the context of greater exposure to average monthly traumatic stressors, greater right HV was associated with fewer PTSD symptoms b = -0.467, p = 0.023 (95% CI -0.786 to -0.013), whereas greater left HV was unexpectedly associated with greater PTSD symptoms b = 0.435, p = 0.024 (95% CI 0.028-0.715). CONCLUSIONS: Our findings highlight the importance of considering the complex role of HV, in particular HV asymmetry, in predicting the emergence of PTSD symptoms in response to war-zone trauma.


Assuntos
Militares , Transtornos de Estresse Pós-Traumáticos , Humanos , Transtornos de Estresse Pós-Traumáticos/diagnóstico por imagem , Estudos Prospectivos , Iraque , Guerra do Iraque 2003-2011
3.
J Neuroradiol ; 2023 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-37553050

RESUMO

BACKGROUND AND PURPOSE: Stent-assisted coil embolization of early branch aneurysms of the middle cerebral artery (MCA) can sometimes be challenging due to the small diameter and acute angle of the branches. This study aimed to analyze the treatment results and report the feasibility and outcomes of the distal stenting technique for these aneurysms. MATERIALS AND METHODS: The distal stenting technique was used for 15 wide-neck MCA aneurysms (females, 10; males, 5; mean age, 65.1 years) originating from the early branch between December 2018 and October 2021. The average sizes of the dome, depth, and neck of the aneurysms were 4.17 mm (range: 2.99-6.21 mm), 2.86 mm (range: 1.82-3.72 mm), and 3.42 mm (range: 2.44-4.32 mm), respectively. RESULTS: The average diameter of the stents was 4.0 mm (3.0 mm, 3; 4.0 mm, 6; 4.5 mm, 6). Stents were successfully deployed in all 15 aneurysms (100%). The average length of the procedure was 69 min (range: 45-117 min). On postoperative angiography, nine (60.0%) aneurysms were completely occluded, four (26.7%) had neck remnants, and two (13.3%) had contrast flow in the sac. During the procedure, vasospasm and thrombus formation occurred in one case each, but no neurological sequelae were observed. On follow-up digital subtraction angiography of the 10 aneurysms after an average of 13.7 months (range: 12-18 months), the branches were well preserved, and neck remnants were noted in four aneurysms (40.0%). No thromboembolic events occurred during the clinical follow-up. CONCLUSION: The distal stenting technique using an open-cell stent can be a good option for coil embolization of early branch MCA aneurysms.

4.
Molecules ; 26(10)2021 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-34070099

RESUMO

Wild ginseng has better pharmacological effects than cultivated ginseng. However, its industrialization is limited by the inability to grow wild ginseng on a large scale. Herein, we demonstrate how to optimize ginseng production through cultivation, and how to enhance the concentrations of specific ginsenosides through fermentation. In the study, we also evaluated the ability of fermented cultured wild ginseng root extract (HLJG0701-ß) to inhibit acetylcholinesterase (AChE), as well as its neuroprotective effects and antioxidant activity. In invitro tests, HLJG0701-ß inhibited AChE activity and exerted neuroprotective and antioxidant effects (showing increased catalyst activity but decreased reactive oxygen species concentration). In invivo tests, after HLJG0701-ß was orally administered at doses of 0, 125, 250, and 500 mg/kg in an animal model of memory impairment, behavioral evaluation (Morris water maze test and Y-maze task test) was performed. The levels of AChE, acetylcholine (ACh), blood catalase (CAT), and malondialdehyde (MDA) in brain tissues were measured. The results showed that HLJG0701-ß produced the best results at a dose of 250 mg/kg or more. The neuroprotective mechanism of HLJG0701-ß was determined to involve the inhibition of AChE activity and a decrease in oxidative stress. In summary, both invitro and invivo tests confirmed that HJG0701-ß administration can lead to memory improvement.


Assuntos
Antioxidantes/farmacologia , Fermentação , Fármacos Neuroprotetores/farmacologia , Panax/química , Extratos Vegetais/farmacologia , Raízes de Plantas/química , Acetilcolina/metabolismo , Acetilcolinesterase/metabolismo , Animais , Encéfalo/metabolismo , Catalase/sangue , Catalase/metabolismo , Inibidores da Colinesterase/farmacologia , Modelos Animais de Doenças , Feminino , Galactose , Ginsenosídeos/farmacologia , Masculino , Malondialdeído/sangue , Camundongos , Teste do Labirinto Aquático de Morris , Ovariectomia , Espécies Reativas de Oxigênio/metabolismo , Escopolamina
6.
Med Teach ; 41(5): 505-509, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-29378455

RESUMO

Medical students employ various study strategies to master large amounts of information during their medical education. Digital flashcards are an interactive, self-directed study stool that may improve knowledge retention by combining the principles of active recall and spaced-repetition. They may be studied during and beyond undergraduate medical education. However, making flashcards can be an onerous task. In this article, we describe twelve tips on how to establish and maintain a collaborative digital flashcard project based on the undergraduate medical curriculum.


Assuntos
Comportamento Cooperativo , Educação de Graduação em Medicina/métodos , Humanos , Relações Interpessoais , Aprendizagem , Software , Estudantes de Medicina
7.
Clin Psychol Psychother ; 26(6): 661-672, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31273851

RESUMO

For those who suffer with chronic and disruptive obsessive-compulsive disorder (OCD), who have not been sufficiently helped by outpatient treatments or medications, intensive residential treatment (IRT) is often the next best treatment option. To date, research of the predictors of treatment outcome in IRT for OCD are mixed and sometimes contradictory. Additionally, although comorbidity is common for patients in this setting, the inclusion of comorbidity as a potential predictor of outcome has been mostly lacking in research to date. The current study aimed to address these issues by utilizing optimal indices of treatment outcomes, while incorporating comorbidity into our analyses, in order to identify the predictors of treatment outcomes in the IRT for OCD setting. To this end, we analysed outcome data from 379 patients receiving IRT for OCD at the Rogers Memorial OCD Center between August 2012, and December 2017. Results indicated that the most important predictor of treatment outcome was obsession severity at admission. Specifically, higher obsession severity at admission predicted poorer treatment outcomes at discharge. Clinical implications and suggestions for future research were discussed in the manuscript.


Assuntos
Terapia Comportamental/métodos , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/terapia , Tratamento Domiciliar/métodos , Adulto , Feminino , Humanos , Masculino , Índice de Gravidade de Doença , Resultado do Tratamento
8.
J Exerc Sci Fit ; 17(1): 26-33, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30662511

RESUMO

BACKGROUND/OBJECTIVE: South Korea's 2018 Report Card on Physical Activity for Children and Youth is the second comprehensive evaluation of physical activity and the sources of influence based on the 10 core indicators provided by the Active Healthy Kids Global Alliance. It will serve as an advocacy tool to promote physical activity among children and youth. METHODS: Three national surveillance data (i.e., 2017 Korea Youth Risk Behavior Web-based Survey, 2016 Korea National Health and Nutrition Examination Survey, 2016 Physical Activity Promotion System) were used as main sources to evaluate the indicators. Descriptive statistics were performed to obtain prevalence estimates of physical activity-related indicators. In addition, expert opinions as well as the most recently available published or unpublished relevant sources were synthesized. RESULTS: South Korea's 2018 Report Card, compared to the 2016 Report Card, showed favourable changes in the Active Transportation (B+), Organized Sports Participation (C), Sedentary Behaviours (D), and School (D+) indicators, while unfavourable changes were shown in Overall Physical Activity (F) and Government (D). Physical Fitness was graded as D+. In parallel with the 2016 Report Card, Active Play, Family and Peers, and Community and Environment remain ungraded due to insufficient data. CONCLUSIONS: Successes as well as gaps and research needs were identified in the 2018 Report Card. Though some indicators have shown improvement, most children and youth continue to be insufficiently physically active with overall poor grades (Average of D+). To achieve substantial improvement in all grades in future Report Cards, more institutional and governmental support and investment is needed to promote physical activity. Furthermore, effort should be made to generate data pertaining to the indicators that were ungraded.

9.
Sensors (Basel) ; 18(9)2018 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-30205608

RESUMO

The objective of this study was to develop a noncontact, noninvasive, imaging system for monitoring the strain and deformation states of osseointegrated prostheses. The proposed sensing methodology comprised of two parts. First, a passive thin film was designed such that its electrical permittivity increases in tandem with applied tensile loading and decreases while unloading. It was found that patterning the thin films could enhance their dielectric property's sensitivity to strain. The film can be deposited onto prosthesis surfaces as an external coating prior to implant. Second, an electrical capacitance tomography (ECT) measurement technique and reconstruction algorithm were implemented to capture strain-induced changes in the dielectric property of nanocomposite-coated prosthesis phantoms when subjected to different loading scenarios. The preliminary results showed that ECT, when coupled with strain-sensitive nanocomposites, could quantify the strain-induced changes in the dielectric property of thin film-coated prosthesis phantoms. The results suggested that ECT coupled with embedded thin films could serve as a new noncontact strain sensing method for scenarios when tethered strain sensors cannot be used or instrumented, especially in the case of osseointegrated prostheses.


Assuntos
Osso e Ossos/metabolismo , Teste de Materiais/instrumentação , Teste de Materiais/métodos , Próteses e Implantes , Algoritmos , Capacitância Elétrica , Humanos , Nanocompostos , Imagens de Fantasmas , Tomografia
10.
Eat Weight Disord ; 20(3): 301-10, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25380978

RESUMO

AIMS: This study compared the effects of residential treatment on improving health-related quality of life (HRQOL) between males and females diagnosed with eating disorders (EDs) from admission to discharge and at follow-up. This study also analyzed the association between changes in HRQOL and changes in the severity of ED pathology, depression, and trait anxiety. METHODS: 145 consecutive patients (34 males and 111 females) admitted to a residential ED unit completed a panel of surveys at admission and discharge. The survey panel included the Eating Disorders Quality of Life Survey (EDQLS), the Eating Disorder Examination Questionnaire, the Quick Inventory of Depressive Symptomatology and the State-Trait Anxiety Inventory. An online follow-up survey was also conducted for the EDQLS. Mixed-factorial ANOVA was used to examine sex differences and changes in HRQOL between admission, discharge and post-treatment follow-up. Multiple regression analysis was used to investigate the relationship between sex, change in HRQOL, and changes in all other variables studied. RESULTS: By the end of residential treatment, both males and females had made similar statistically significant improvements in HRQOL from admission to discharge, which persisted after treatment. Greater decreases in ED pathology and trait anxiety significantly predicted greater increases in HRQOL during residential treatment while sex and changes in depression did not. CONCLUSION: The data show that residential treatment is an effective approach to improving HRQOL in both males and females with EDs. Greater improvements in trait anxiety and ED pathology contributed to greater improvement in HRQOL in these patients.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Qualidade de Vida/psicologia , Tratamento Domiciliar , Adolescente , Adulto , Ansiedade/psicologia , Depressão/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Índice de Gravidade de Doença , Fatores Sexuais , Resultado do Tratamento , Adulto Jovem
11.
Artigo em Inglês | MEDLINE | ID: mdl-38213113

RESUMO

While mechanical thrombectomy is known to be effective for distal medium vessel occlusion (DMVO) as well as large vessel occlusion, tortuous DMVO are predisposed to vessel injury during stent retriever thrombectomy. Furthermore, getting access to the thrombus may be difficult during suction thrombectomy using a dedicated suction catheter. Most studies describe DMVO treatment using stent retrievers and dedicated suction catheters, but there are limited studies reporting DMVO treated with suction thrombectomy using a microcatheter. Herein, we describe three cases of DMVO treated with suction thrombectomy that was performed using a microcatheter and subsequently showed good results. Therefore, suction thrombectomy using a microcatheter is a viable alternative treatment for tortuous DMVO.

12.
ACS Nano ; 18(17): 11404-11415, 2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38629449

RESUMO

High-performance and low operating voltage are becoming increasingly significant device parameters to meet the needs of future integrated circuit (IC) processors and ensure their energy-efficient use in upcoming mobile devices. In this study, we suggest a hybrid dual-gate switching device consisting of the vertically stacked junction and metal-insulator-semiconductor (MIS) gate structure, named J-MISFET. It shows excellent device performances of low operating voltage (<0.5 V), drain current ON/OFF ratio (∼4.7 × 105), negligible hysteresis window (<0.5 mV), and near-ideal subthreshold slope (SS) (60 mV/dec), making it suitable for low-power switching operation. Furthermore, we investigated the switchable NAND/NOR logic gate operations and the photoresponse characteristics of the J-MISFET under the small supply voltage (0.5 V). To advance the applications further, we successfully demonstrated an integrated optoelectronic security logic system comprising 2-electric inputs (for encrypted data) and 1-photonic input signal (for password key) as a hardware security device for data protection. Thus, we believe that our J-MISFET, with its heterogeneous hybrid gate structures, will illuminate the path toward future device configurations for next-generation low-power electronics and multifunctional security logic systems in a data-driven society.

13.
WMJ ; 123(2): 99-105, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38718237

RESUMO

INTRODUCTION: More young adults (age 18-24 years) in rural areas versus urban areas use electronic nicotine delivery systems (ENDS) - also known as e-cigarettes. Little is known about young adults' perceptions toward ENDS use and cessation. The objective of this study was to examine barriers and facilitators to ENDS use cessation among young adults living in rural areas, as well as their perceptions about ENDS use and cessation and to determine implications for future cessation studies. METHODS: We administered cross-sectional online surveys to young adults living in rural Midwestern counties. A total of 100 individuals responded to the surveys. Descriptive statistics were used to report their perceptions of ENDS use as well as barriers and facilitators to ENDS use cessation. The content analysis method was used to analyze the answers to an open-ended question regarding perceptions about the ENDS use cessation in the context of rural areas. RESULTS: Barriers to ENDS use cessation included perceived advantages to ENDS use, high nicotine dependence, and the perception that ENDS use was less harmful cigarettes. Facilitators to ENDS use cessation included cost of ENDS use, perceived harm, and high confidence in ability to quit. Participants' perceptions about ENDS use cessation in the context of rural areas were conceptualized under the themes of (1) exposure to and initiation of ENDS use, (2) continuation of ENDS use, and (3) prevention and cessation of ENDS use. CONCLUSIONS: Health care providers, tobacco control researchers, and public health advocates should be aware of barriers and facilitators to ENDS use cessation among young adults for future cessation intervention studies relevant specifically to rural areas.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , População Rural , Humanos , Feminino , Masculino , Estudos Transversais , Inquéritos e Questionários , Adulto Jovem , Adolescente , Abandono do Hábito de Fumar/métodos , Wisconsin , Adulto
14.
J Addict Nurs ; 34(3): E74-E78, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37669347

RESUMO

ABSTRACT: Tobacco use is a leading cause of cancer, cardiovascular and respiratory disease, and preventable death in the United States. The brains of individuals with nicotine dependence are characterized by damaged mesolimbic pathways in the medial portion of the limbic and frontal lobes, creating positive reinforcing mechanisms. Transcranial direct current stimulation (tDCS) targets this neuroadaptation to improve smokers' nicotine-related outcomes, such as craving and smoking behavior, by depolarizing or hyperpolarizing the neurons of the brain. Recent literature reported promising outcomes in smokers after tDCS treatment interventions. tDCS has great potential for clinical nursing research for tobacco control given its multiple methodological advantages and few disadvantages. Nurse researchers can consider individualized and home-based tDCS interventions for community-based tobacco control research and may need to consider objective outcome measures (e.g., cotinine in urine) and addiction-related cognitive variables (e.g., self-regulation). Users of electronic nicotine delivery systems also need to be considered as participants in tDCS interventions. Additional considerations for nursing research are discussed.


Assuntos
Tabagismo , Estimulação Transcraniana por Corrente Contínua , Humanos , Nicotina , Tabagismo/terapia , Tabagismo/psicologia , Fumar/psicologia , Fumantes
15.
West J Nurs Res ; 45(11): 980-985, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37646373

RESUMO

Electronic nicotine delivery system (ENDS) use continues to grow in rural areas of the United States. In particular, young adults (18-24 years) in rural areas are a hard-to-reach population in regard to understanding the growing ENDS use trend. The purpose of this article was to describe recruitment strategies that were used for a series of ENDS-relevant projects for young adults in rural areas, report recruitment yields from these strategies, and provide methodological considerations to aid researchers in improving recruitment. We used descriptive statistical methods to characterize recruitment yields (responses to screening vs initial invites, and number of individuals who fully met eligibility criteria vs responses to screening) from 2 ENDS studies that focused on 3 main recruitment strategies, including student directories, leadership offices (eg, Student Affairs), and regional tobacco control support networks (eg, Area Health Education Centers) for reaching young adults in rural communities. The recruitment yield rates varied and ranged from 2% to 14% depending on strategy with leadership offices resulting in the highest recruitment yield. Methodological considerations by strategy are described in detail. Results of this study can be used to inform tailored recruitment strategies to increase the representation of rural young adults in ENDS or other tobacco research.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Abandono do Hábito de Fumar , Vaping , Humanos , Adulto Jovem , População Rural , Estados Unidos , Sujeitos da Pesquisa
16.
Sci Rep ; 13(1): 14886, 2023 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-37689766

RESUMO

Cerebrospinal fluid (CSF) leakage after endoscopic skull base surgery remains a challenge despite multilayer reconstruction including nasoseptal flap (NSF) has become a standard technique. Injectable hydroxyapatite (HXA) has shown promising results to prevent CSF leakage. This study aimed to validate the efficacy of HXA-based skull base reconstruction performed by less-experienced neurosurgeons who had short-term clinical experiences as independent surgeons. Between March 2018 and November 2022, 41 patients who experienced intraoperative high-flow CSF leakage following endoscopic endonasal surgery at two independent tertiary institutions were enrolled. Skull base reconstruction was performed using conventional multilayer techniques combined with or without HXA. The primary outcome was postoperative CSF leakage. The surgical steps and nuances were described in detail. The most common pathology was craniopharyngioma. Injectable HXA was used in 22 patients (HXA group) and conventional techniques were performed in 19 patients (control group). The HXA group achieved a significantly lower incidence of postoperative CSF leakage than the control group (0% vs. 26.3%, p = 0.016). No HXA-related complications were observed. The use of injectable HXA in skull base reconstruction was highly effective and safe. This technique and its favorable results might be readily reproduced by less-experienced neurosurgeons.


Assuntos
Neoplasias Hipofisárias , Cirurgiões , Humanos , Base do Crânio/cirurgia , Vazamento de Líquido Cefalorraquidiano , Durapatita , Neoplasias Hipofisárias/cirurgia
17.
J Korean Neurosurg Soc ; 66(4): 446-455, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36325752

RESUMO

OBJECTIVE: Chronic subdural hematoma (CSDH) is a common neurosurgical disease and generally treated with burr-hole surgery alone. Tranexamic acid (TXA) is an antifibrinolytic agent that potentially reduces recurrence rates and the residual hematoma volume. However, the role of postoperative TXA medication remains unclear to date. This study aimed to verify the effectiveness of adjunctive TXA in the view of early hematoma resolution. METHODS: Between January 2018 and September 2021, patients with CSDH who underwent burr-hole trephination in a single tertiary institute were reviewed. The study population was divided into three groups, TXA, non-TXA, and antithrombotics (AT) groups, according to the medical history of cardio-cerebrovascular disease and TXA administration. The primary endpoint was CSDH recurrence, defined as re-appearance or re-accumulation of CSDH requiring neurosurgical interventions. The secondary outcome was CSDH resolution, defined as complete or near-complete resorption of the CSDH. The CSDH resolution time and serial changes of hematoma thickness were also investigated. RESULTS: A total of 240 patients was included in the analysis consisting of 185 male and 55 female, with a median age of 74 years. During the median imaging follow-up period of 75 days, 222 patients were reached to the primary or secondary endpoint. TXA was administered as an adjunctive therapy in 41 patients (TXA group, 16.9%) while 114 patients were included in the non-TXA group (47.9%) and 85 were in the AT group. The recurrence rate was the lowest in the TXA group (2.4%), followed by non-TXA (7.0%) and AT (8.2%) groups. However, there was no statistical significance due to the small number of patients with recurrence. CSDH resolution was achieved in 206 patients, and the median estimated time to resolution was significantly faster in the TXA group (p<0.001). Adjunctive TXA administration was a significant positive factor for achieving CSDH resolution (p<0.001). The hematoma thickness was comparable among the three groups at the initial time and after surgery. However, CSDH thickness in the TXA group decreased abruptly in a month and showed a significant difference from that in the other groups (p<0.001). There was no TXA-related adverse event. CONCLUSION: The adjunctive use of TXA after CSDH surgery significantly facilitated the resorption of residual CSDH and resulted in the early CSDH resolution. Adjunctive TXA may be an effective treatment option to reduce recurrence by enhancing CSDH resolution in the selective patients.

18.
J Neurointerv Surg ; 2023 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-38129111

RESUMO

BACKGROUND: Contrast-induced encephalopathy (CIE) following endovascular interventions is a rare but serious complication. This study aimed to investigate the risk factors of contrast leakage (CL) and CIE in patients who underwent coil embolization of unruptured intracranial aneurysms (UIAs). METHODS: Patients with UIAs who underwent coil embolization at a single tertiary institute between January 2019 and January 2022 were enrolled retrospectively. CL was defined as cortical or subcortical contrast enhancement with effacement of the cortical sulci. CIE was defined as the new onset of neurological deficits associated with CL. Following the procedure, all patients underwent CT scans, and MRI scans were performed on those with symptoms. Patient and procedural risk factors were investigated. RESULTS: In total, 459 patients were analyzed. The median procedure time and contrast dose were 69 min and 96 mL, respectively. CL was evident in 35 patients. In the multivariate analysis, hypertension, large aneurysm, longer procedure time, and greater contrast dose were associated with CL. CIE was diagnosed in 19 patients, and the risk factors included large aneurysm, longer procedure time, and greater contrast dose. The procedure time was predictive of both CL (P<0.001) and CIE (P=0.01). The optimal cut-off value for procedure time was 81.5 min. All CIE patients recovered completely within 8-96 hours. CONCLUSIONS: A large aneurysm and prolonged procedure time may increase the patient's risk of CL and CIE due to increased contrast exposure. Patients who underwent a procedure that exceeded 1.5 hours necessitate post-procedure evaluation and monitoring.

19.
Artigo em Inglês | MEDLINE | ID: mdl-35682303

RESUMO

Excoriation (skin-picking) disorder (SPD) is a psychiatric condition with variable clinical presentation. We developed the Diagnostic Interview for Skin Picking Problems (DISP), a semi-structured interview designed to assess (1) DSM-5 criteria for SPD and (2) several clinical features of SPD, including the frequency and duration of picking episodes, and the proportion of time devoted to picking at different body areas. The DISP was administered along with other measures to 120 college students (88% women, average age = 22 years) with suspected skin picking problems (based on their responses to a screening survey). The results showed that the DISP had good inter-rater reliability, test-retest reliability over 1-5 months, and convergent/divergent validity. We also found that participants displayed divergent clinical characteristics depending on the pattern of frequency, duration, and body location of picking episodes (e.g., those who primarily picked at the fingers had a unique clinical presentation). Overall, the findings provide preliminary support for the psychometric properties and clinical utility of DISP. The results also underscore the importance of accurately assessing frequency, duration, and body location of picking episodes.


Assuntos
Transtornos Mentais , Comportamento Autodestrutivo , Adulto , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes , Comportamento Autodestrutivo/psicologia , Pele , Inquéritos e Questionários , Adulto Jovem
20.
World Neurosurg ; 164: e280-e289, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35526813

RESUMO

BACKGROUND: Gamma Knife radiosurgery (GKS) is a promising treatment option for meningioma. However, the incidence of peritumoral edema (PTE) following GKS has been reported to be 7%-38%. This study aimed to develop a predictive model for post-GKS PTE using a deep neural network (DNN) algorithm. METHODS: Patients treated with GKS for meningioma between November 2012 and February 2020 at a single tertiary center were reviewed. The primary outcome was newly developed or aggravated PTE after GKS. Clinical data, including radiosurgical parameters, were collected, and imaging data obtained at the time of GKS were incorporated into the model using a 50-layered residual neural network, ResNet50. Consequently, the model efficiency was evaluated considering the accuracy and area under the receiver operating curve (AUC) values. RESULTS: A total of 202 patients were included in this study. The median tumor volume was 2.3 mL, and the median prescription dose was 13 Gy. PTE was observed before GKS in 22 patients. Post-GKS PTE was evident in 28 patients (13.9%), which further evolved to radiation necrosis in 5 patients. The accuracy and AUC values of the hybrid data model based on both clinical and imaging data were 0.725 and 0.701, respectively. The performance of the hybrid data model was superior to that of the other models based on clinical or image data only. CONCLUSIONS: The DNN-based model using both clinical and imaging data exhibited fair results in predicting post-GKS PTE in meningioma treatment. Predictive models using imaging data may be helpful in prognostic research.


Assuntos
Neoplasias Meníngeas , Meningioma , Radiocirurgia , Edema/etiologia , Seguimentos , Humanos , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/radioterapia , Neoplasias Meníngeas/cirurgia , Meningioma/diagnóstico por imagem , Meningioma/etiologia , Meningioma/radioterapia , Redes Neurais de Computação , Radiocirurgia/efeitos adversos , Radiocirurgia/métodos , Estudos Retrospectivos , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
Detalhe da pesquisa