Surg Neurol
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Controlled Clinical Trial
Intensive care unit robotic telepresence facilitates rapid physician response to unstable patients and decreased cost in neurointensive care.
The timely assessment and treatment of ICU patients is important for neurosurgeons and neurointensivists. We hypothesized that the use of RTP can improve physician rapid response to unstable ICU patients. ⋯ The use of RTP enabled rapid face-to-face attending physician response to ICU patients and resulted in decreased ICU cost and LOS.
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Neurosurgical emergencies constitute a significant proportion of workload of a tertiary neurosurgical service. Prompt diagnosis and emergent institution of definitive treatment are critical to reduce neurological mortality and morbidity. Diagnosis is highly dependent on accurate interpretation of scans by experienced clinicians. This expertise may not be readily available especially after office hours because many neurosurgical units are manned by middle-level neurosurgical staff with varying levels of experience in scan interpretation. Multimedia Messaging Service mobile phone technology offers a simple, cheap, quick, and effective solution to the problem of scan interpretation. An MMS takes only a few minutes to send and receive and allows senior doctors to view important images and make important clinical decisions to enhance patient management in an emergency situation. ⋯ The MMS technology is demonstrated to be a useful media for the transmission of high-quality images to assist in the diagnostic process and implementation of emergent clinical therapy. It is already in widespread use and can be seamlessly and rapidly implemented in the clinical arena to improve the quality of patient care.
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Clinical Trial
Efficacy and complications of patient-controlled analgesia treatment after spinal surgery.
Postoperative pain is one of the most common therapeutic problems in hospitals. Patient-controlled analgesia has gained popularity over the last decade in dealing with this problem. The goal of this article is to examine the effect of PCA in patients who underwent spinal fusion and to measure its effect on the different sexes and age groups. ⋯ We conclude that PCA is an effective and safe method with high satisfaction rate in postoperative pain control in patients who undergo spinal fusion.
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Minimally invasive surgery is a promising new tool in treatment of spinal disorders. Minimally invasive laminectomy provides an efficacious means of achieving lumbar decompression. Present single-tube approaches may entail significant facet injury. We explore the feasibility of a dual-tube minimally invasive laminectomy approach in a cadaver model. ⋯ We demonstrate that a dual-tube MIS technique can effectively complete lumbar decompressive laminectomy and foraminotomy procedures in a cadaver model, without significant facet injury. Minimally invasive surgery laminectomy techniques hold significant clinical promise.
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Recent studies show conscious perception is correlated with firing rate synchronization across multiple neuronal assemblies. This study explores the synchrony between multiple cortical surface sites as brain injury patients emerge from coma. ⋯ In frequencies from 1 to 30 Hz, synchrony between right parietal and temporal lobes, as well as bilateral occipital lobes, tends to be increased as patients emerge from comatose states. However, synchrony between most intrahemispheric cortical sites is decreased at higher GCS scores in most of the above frequency bands. Thus, brain injury patients demonstrate both increased and decreased cortical surface synchrony between different lobes during emergence from coma.