Articles: cations.
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Over the past decade, stenting of lateral sinus stenosis has been used to treat idiopathic intracranial hypertension. Two types of stenoses have been identified: extrinsic and intrinsic. ⋯ Irrespective of the type of stenosis, stenting of lateral sinus stenoses is an effective treatment for intracranial hypertension symptoms. At our institution, this treatment has replaced draining of cerebrospinal fluid when treatment with acetazolamide has proved to be ineffective.
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After a 4-year planning period, a joint Ethiopian/Norwegian training program in neurosurgery was started in June 2006. The collaborating partners were Addis Ababa University; Department of Surgery, Tikur Anbessa Specialized Hospital; University of Bergen; Haukeland University Hospital; and Myungsung Christian Medical Center, a Korean missionary hospital in Addis Ababa, Ethiopia. ⋯ This article gives an account of the strategies underlying the program planning, the history of the program, and on the experience gained by it. Finally, ethical problems and challenges encountered in the program are discussed.
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Clinical Trial
Transection of the omohyoid muscle as an aid during vagal nerve stimulator implantation.
Exposure of the carotid sheath during vagus nerve stimulator (VNS) implantation is usually straightforward but can be difficult for patients with a large body habitus. In addition, the exposure must be done with care if the surgeon wants to keep the vagus nerve in situ without using retractors that might impair access. ⋯ Omohyoid transection provides excellent exposure of the carotid sheath during VNS implantation.
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Patients with aneurysmal subarachnoid hemorrhage (aSAH) are susceptible to various medical complications, including ventriculostomy-associated infections (VAIs) in those who undergo external ventricular drain (EVD) placement. Many preventative strategies for VAIs have been used during the last 20 years, but their overall effect is unknown. Using the Nationwide (National) Inpatient Sample, we examined trends in VAI rates and mortality during a recent 12-year period in the aSAH population. ⋯ Despite numerous VAI-preventative strategies, the national VAI rate in aSAH patients has not changed; however, a reduction in mortality is suggested. Further studies are needed to determine how best to reduce VAIs, and to identify factors influencing observed trends in VAI and mortality.
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Minerva anestesiologica · Mar 2017
Altered liver function in patients undergoing veno-arterial extracorporeal membrane oxygenation (ECMO) therapy.
Multiple organ dysfunction can occur in patients undergoing Veno-arterial Extra Corporal Membrane Oxygenation (VA-ECMO); however, liver function has not been well studied in this setting. ⋯ A substantial proportion of patients needing VA-ECMO have early ELE, which usually improves over days. The prognostic implications are not evident.