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Mead posted an update 1 year ago
DOACs were not associated with elevated risk for hemorrhage, recurrent thrombosis or poor outcome when compared with traditional anticoagulation regimes. Prospective randomized trials are necessary to verify the non-inferiority of DOACs for long-term anticoagulation in postoperative pulmonary embolism after meningioma resection.
DOACs were not associated with elevated risk for hemorrhage, recurrent thrombosis or poor outcome when compared with traditional anticoagulation regimes. Prospective randomized trials are necessary to verify the non-inferiority of DOACs for long-term anticoagulation in postoperative pulmonary embolism after meningioma resection.
Impaired mood and quality of life was common in muscular dystrophies and play an important role in long-term management. Previous studies in dysferlinopathies mainly focused on the genotype-phenotypes correlations. Currently there are very few reports regarding the mental status, life quality and the correlated factors.
A total of 22 patients with dysferlinopathy was recruited and evaluated by 6-minute walking test (6MWT) and adapted-North Star Ambulatory Assessment (a-NSAA). Chinese version of SF-36, PHQ-9, and GAD-7 scale were used to evaluate the Quality of Life (QoL), depression and anxiety. Statistical analysis was applied to investigate the correlation between clinical variables and life quality or mental status.
SF-36 evaluation revealed multiple dimensional impairment in dysferlinopathy patients. Declined score in body pain (78.00 vs. Gambogic 91.23, p=0.0129) and mental health (56.00 vs.72.88, p=0.0493) were of note in female patients. Some patients suffered from depression (23%) and anxiety (23%) with a high score in PHQ-9/GAD-7. The 6MWT was well-correlated with the severity of depression and most scores in QoL except Body Pain and Role emotion.
The cross-sectional study revealed impaired mental status and life quality in dysferlinopathy, particularly in female patients. The life quality impairment is correlated with the clinical severity.
The cross-sectional study revealed impaired mental status and life quality in dysferlinopathy, particularly in female patients. The life quality impairment is correlated with the clinical severity.
To assess the relationship between sleep duration and risk of rupture of intracranial aneurysms (IAs).
According to our inclusion and exclusion criteria, 683 patients admitted to Beijing Tiantan Hospital were included in this study. There were 201 patients in the ruptured group and 482 patients in the unruptured group. Sleep duration was divided into three levels ≥8h (long), 6-8h (normal), ≤6h (short). Correlation between different sleep duration and rupture of IAs was evaluated by univariate and multivariate regression analysis.
The results of multivariate analysis demonstrated that there was a statistical difference between sleep duration of ≤6h and sleep duration ≥8h (OR=1.76, CI=[1.08-2.87], p=0.025). There was no statistically significant difference between the group with sleep duration of 6-8h and sleep duration of ≥8h (OR=1.04, CI=[0.65-1.67], p=0.857).
Short sleep duration (≤6h) may be related to the rupture of intracranial aneurysms. The reason for this correlation is not yet clear. We suspect that it may be caused by a series of physiological changes caused by reduced sleep.
Short sleep duration (≤6 h) may be related to the rupture of intracranial aneurysms. The reason for this correlation is not yet clear. We suspect that it may be caused by a series of physiological changes caused by reduced sleep.We sought to evaluate feasibility and cost-reduction potential of a pilot screening program involving neurosurgeon tele-consultation for inter-facility transfer decisions in TBI patients with GCS 14-15 and abnormal CT head at a community hospital. The authors performed a retrospective comparative analysis of two patient cohorts during the pilot at a large hospital system from 2015 to 2017. In “screened” patients (n = 85), images and examination were reviewed remotely by a neurosurgeon who made recommendations regarding transfer to a level 1 trauma center. In the “unscreened” group (n = 39), all patients were transferred. Baseline patient characteristics, outcomes, and costs were reviewed. Patient demographics were similar between cohorts. Traumatic subarachnoid hemorrhage was more common in screened patients (29.4% vs 12.8%, P = 0.02). The presence of midline shift >5 mm was comparable between groups. Among screened patients, 5 were transferred (5.8%) and one required evacuation of chronic subdural hematoma. In unscreened patients, 7 required evacuation of subdural hematoma. None of the screened patients who were not transferred deteriorated. Screened patients had significantly reduced average total cost compared to unscreened patients ($2,003 vs. $4,482, P = 0.03) despite similar lengths of stay (2.6 vs. 2.7 days, P = 0.85). In non-surgical patients, costs were less in the screened group ($2,025 vs. $2,939), although statistically insignificant (P = 0.38). In this pilot study, remote review of images and examination by a neurosurgeon was feasible to avoid unnecessary transfer of patients with traumatic intracranial hemorrhage and GCS 14-15. The true potential in cost-reduction will be realized in system-wide large-scale implementation.Stroke is the leading cause of disability among the elderly in the industrialized world. No more than 40% of stroke survivors walk independently, and only after receiving appropriate rehabilitation treatment; many stroke patients have also non-motor symptoms. The aim of this pilot study is to evaluate the effects of Ekso-training on non-motor outcomes, including gastrointestinal function and psychological well-being, in post stroke patients. We enrolled 30 post-stroke subjects, which were randomized into two groups in order of recruitment 15 patients were trained with the overground exoskeleton Ekso-GT (experimental group, EG), whereas 15 patients were submitted to a standard gait training (control group, CG). Both the groups underwent the same amount of physiotherapy. At the end of the training, only in the EG we observed a significant improvement in constipation, mood, and coping strategies, with regard to social support, as well as in the perception of quality of life (as per SF-12). According to these preliminary data, overground robotic gait training can be considered a valuable tool in improving non-motor symptoms, including constipation and behavioral disorders in patients with chronic stroke.