Shuo Yang, Q. Feng, Huidan Zhu, Zhihuan Zhou, Ji Zhang
Background: Neuroendoscopic transsphenoidal approach for resection of pituitary adenomas has the advantages of less damage, fewer complications, and a faster recovery than the traditional approach and has beening favored by neurosurgeons. However, there has no standard method of selecting suitable packing materials after the operation to relieve pain in patients and achieve the ideal hemostatic effect. We compared the postoperative complications and treatment effects of two different packing materials in patients with pituitary adenomas. Objective: To investigate the advantages and disadvantages of using a catheter balloon and iodoform gauze for hemostasis in patients undergoing pituitary tumor resection by neuroendoscopic transsphenoidal approach. Materials and Methods: We retrospectively analyzed these data of 48 cases treated with pituitary adenoma resection by the single nasal approach from January 2018 to October 2019 in Sun Yat-sen University Cancer Center. According to the type of sphenoid sinus packing material used, these patients were divided into balloon tamponade oppression group (24 cases) and tela iodoformum oppression group (24 cases), respectively. The balloon tamponade oppression group received catheter balloon tamponade oppression hemostasis, and the tela iodoformum oppression group underwent tela iodoformum oppression hemostasis. The outcomes and complications were compared between the two groups in which two kinds of sphenoid sinus packing materials were used for hemostasis after tumor resection by transnasal endoscopic approach. For the catheter balloon compression hemostasis method, on account of the plasticity of the balloon, the volume of water in the balloon can be adjusted according to the size of the patient’s own sphenoid cavity. The amount of bleeding and several complications in terms of discomfort during placement and removal of the packing material, rebleeding after removal of the packing, cerebrospinal fluid rhinorrhea and electrolyte disturbance are compared between the two groups. Results: 48 patients were enrolled. The two groups’ data of patients were similar in age structure, sex ratio, tumor size at baseline and so on. No complications, such as abscess formation, were found in both groups. The success rate in the compression with catheter balloon group was 100% (24 of 24 patients); and in the iodoform gauze group 83.33% (20 of 24 patients). A catheter balloon was more successful in stopping bleeding at early stage than iodoform gauze. There were no statistically significant differences in the hospitalization stay time, operating day to discharge day and tampon indwelling time (P > 0.05). There were also no significant differences in pairwise comparison between the catheter balloon group and iodoform gauze groups in the incidence of cerebrospinal fluid rhinorrhea or electrolyte disturbance between the two groups (P > 0.05). The incidence of headache in the catheter balloon group was statistically significantl
{"title":"Application and Care of Two Kinds of Sphenoid Sinus Packing Materials after Pituitary Tumor Resection with the Transnasal Endoscopic Approach","authors":"Shuo Yang, Q. Feng, Huidan Zhu, Zhihuan Zhou, Ji Zhang","doi":"10.4236/nm.2020.114015","DOIUrl":"https://doi.org/10.4236/nm.2020.114015","url":null,"abstract":"Background: Neuroendoscopic transsphenoidal approach for resection of pituitary adenomas has the advantages of less damage, fewer complications, and a faster recovery than the traditional approach and has beening favored by neurosurgeons. However, there has no standard method of selecting suitable packing materials after the operation to relieve pain in patients and achieve the ideal hemostatic effect. We compared the postoperative complications and treatment effects of two different packing materials in patients with pituitary adenomas. Objective: To investigate the advantages and disadvantages of using a catheter balloon and iodoform gauze for hemostasis in patients undergoing pituitary tumor resection by neuroendoscopic transsphenoidal approach. Materials and Methods: We retrospectively analyzed these data of 48 cases treated with pituitary adenoma resection by the single nasal approach from January 2018 to October 2019 in Sun Yat-sen University Cancer Center. According to the type of sphenoid sinus packing material used, these patients were divided into balloon tamponade oppression group (24 cases) and tela iodoformum oppression group (24 cases), respectively. The balloon tamponade oppression group received catheter balloon tamponade oppression hemostasis, and the tela iodoformum oppression group underwent tela iodoformum oppression hemostasis. The outcomes and complications were compared between the two groups in which two kinds of sphenoid sinus packing materials were used for hemostasis after tumor resection by transnasal endoscopic approach. For the catheter balloon compression hemostasis method, on account of the plasticity of the balloon, the volume of water in the balloon can be adjusted according to the size of the patient’s own sphenoid cavity. The amount of bleeding and several complications in terms of discomfort during placement and removal of the packing material, rebleeding after removal of the packing, cerebrospinal fluid rhinorrhea and electrolyte disturbance are compared between the two groups. Results: 48 patients were enrolled. The two groups’ data of patients were similar in age structure, sex ratio, tumor size at baseline and so on. No complications, such as abscess formation, were found in both groups. The success rate in the compression with catheter balloon group was 100% (24 of 24 patients); and in the iodoform gauze group 83.33% (20 of 24 patients). A catheter balloon was more successful in stopping bleeding at early stage than iodoform gauze. There were no statistically significant differences in the hospitalization stay time, operating day to discharge day and tampon indwelling time (P > 0.05). There were also no significant differences in pairwise comparison between the catheter balloon group and iodoform gauze groups in the incidence of cerebrospinal fluid rhinorrhea or electrolyte disturbance between the two groups (P > 0.05). The incidence of headache in the catheter balloon group was statistically significantl","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"14 1","pages":"130-141"},"PeriodicalIF":0.0,"publicationDate":"2020-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74558250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. S. Ahmed, M. Nada, Randa M. Amin, Omar Ali, M. H. Ibrahim
Background: Epilepsy is one of the most common neurological conditions with about 65 million people affected worldwide. It is also a common condition in children, where its prevalence is approximately 3.2 - 5.5/1000 in the developed world. Children with epilepsy (CWE) experience not only seizures but also multiple cognitive, behavioral, and emotional problems. ADHD is one of the more common comorbidities of childhood epilepsy. Objectives: To discuss the relationship between childhood epilepsy and comorbidities especially ADHD. Study Design: This is a prospective observational analytical cross-sectional study carried out on one hundred and fifteen patients at Ain Shams University and Nasr-city Health Insurance out-patient clinics, Cairo, Egypt fulfilling the inclusion criteria. Patients were selected by simple random sample. Results: ADHD is very common epilepsy comorbidity in Egyptian epileptic children with under-diagnosis and treatment. Conclusion: Frequent assessment for ADHD in epileptic children is mandatory for better quality of life.
{"title":"Comorbidity of Attention-Deficit/Hyperactivity Disorder (ADHD) in Children with Epilepsy, Egyptian Study","authors":"N. S. Ahmed, M. Nada, Randa M. Amin, Omar Ali, M. H. Ibrahim","doi":"10.4236/nm.2020.114014","DOIUrl":"https://doi.org/10.4236/nm.2020.114014","url":null,"abstract":"Background: Epilepsy is one of the most common neurological conditions with about 65 million people affected worldwide. It is also a common condition in children, where its prevalence is approximately 3.2 - 5.5/1000 in the developed world. Children with epilepsy (CWE) experience not only seizures but also multiple cognitive, behavioral, and emotional problems. ADHD is one of the more common comorbidities of childhood epilepsy. Objectives: To discuss the relationship between childhood epilepsy and comorbidities especially ADHD. Study Design: This is a prospective observational analytical cross-sectional study carried out on one hundred and fifteen patients at Ain Shams University and Nasr-city Health Insurance out-patient clinics, Cairo, Egypt fulfilling the inclusion criteria. Patients were selected by simple random sample. Results: ADHD is very common epilepsy comorbidity in Egyptian epileptic children with under-diagnosis and treatment. Conclusion: Frequent assessment for ADHD in epileptic children is mandatory for better quality of life.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88811525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Agbétou, A. Sowanou, Gérard Goudjinou, C. Adjien, D. Houinato, D. Gnonlonfoun
The purpose of our study was to investigate etiologies of ischemic stroke in the neurology university clinic of CNHU-HKM, Cotonou. Method: It was a cross-sectional, prospective and analytical study carried out from 1st November 2014 to 31st August 2015 in the neurology university clinic of CNHU-HKM. We included all patients with stroke whose ischemic nature was confirmed through brain CT scan or magnetic resonance imaging. Data analysis was conducted with Census and Survey Processing System (CSPRO). We carried out bivariate then multivariate analysis in identifying associated factors. Threshold value is estimated at p
{"title":"Etiologies of Ischemic Stroke in Sub-Saharan Africa, Case of Benin","authors":"M. Agbétou, A. Sowanou, Gérard Goudjinou, C. Adjien, D. Houinato, D. Gnonlonfoun","doi":"10.4236/nm.2020.114012","DOIUrl":"https://doi.org/10.4236/nm.2020.114012","url":null,"abstract":"The purpose of our study was to investigate etiologies of ischemic stroke in the neurology university clinic of CNHU-HKM, Cotonou. Method: It was a cross-sectional, prospective and analytical study carried out from 1st November 2014 to 31st August 2015 in the neurology university clinic of CNHU-HKM. We included all patients with stroke whose ischemic nature was confirmed through brain CT scan or magnetic resonance imaging. Data analysis was conducted with Census and Survey Processing System (CSPRO). We carried out bivariate then multivariate analysis in identifying associated factors. Threshold value is estimated at p","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"128 1","pages":"100-107"},"PeriodicalIF":0.0,"publicationDate":"2020-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88100136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Parkinson’s disease (PD) is the second common neurodegenerative disease following Alzheimer’s disease. Multifactorial risk factors including environmental, nutritional and genetic factors may affect the frequency, risks, and genetic features of PD in different geographic and ethnic regions. Background: Our aim was to investigate the sociodemographic and disease characteristics, cognitive performances of patients with PD in Nusaybin, a southeastern city, and Hendek a northwestern city which have different geographical-cultural status, and to investigate the possible effects of regional differences on disease characteristics. Method: This retrospective study includes the data of patients with the diagnosis of PD who presented to outpatient Neurology clinics of Hendek State Hospital which is a city in the northwestern region of Turkey between April 2017 and June 2018 and patients who presented to the outpatient Neurology clinics of Nusaybin State Hospital, which is a city in the southeastern region of Turkey between October 2015 and January 2017. SPSS.23c (Statistical package for Windows) database was used for statistical analysis. Results: Our study included 114 cases with Parkinson’s disease in Hendek and 96 cases in Nusaybin.The majority of patients had idiopathic PD (IPD) in both provinces (96.9% in Hendek, and 92.1% in Nusaybin). Educational status of female patients was significantly lower in Nusaybin when compared with Hendek (9.3% and 63.3%, respectively). Family history for IPD was significantly higher in Hendek than Nusaybin (31.7% and 9.9%, respectively). There was a positive correlation between educational status and cognitive performances of the patients in both groups. Negative correlation was found between standardized mini mental test (s-mmt) scores and stage, severity of IPD in both groups. Conclusion: The socio-cultural status of our country decreases by going from west to east. Thus knowledge about PD, accessibility to the hospitals and health centers with the opportunity to get optimum treatments may show variabilities in between the regions. We believe that our study provides a comparison of patients with PD in two different regions of our country with different geographic, genetic characteristics, and development levels.
简介:帕金森病(PD)是继阿尔茨海默病之后第二常见的神经退行性疾病。包括环境、营养和遗传因素在内的多因素危险因素可能影响不同地理和民族地区PD的发生频率、风险和遗传特征。背景:我们的目的是调查东南城市Nusaybin和西北城市Hendek具有不同地理文化地位的PD患者的社会人口学和疾病特征、认知表现，并探讨区域差异对疾病特征的可能影响。方法:本回顾性研究包括2017年4月至2018年6月在土耳其西北部城市Hendek州立医院神经内科门诊就诊的PD患者和2015年10月至2017年1月在土耳其东南部城市Nusaybin州立医院神经内科门诊就诊的PD患者的数据。采用SPSS.23c (Statistical package for Windows)数据库进行统计分析。结果:我们的研究纳入了亨德克114例帕金森病患者和努赛宾96例帕金森病患者。两省的大多数患者患有特发性PD (IPD)(亨德克96.9%，努赛宾92.1%)。Nusaybin的女性患者受教育程度明显低于Hendek(分别为9.3%和63.3%)。Hendek的IPD家族史明显高于Nusaybin(分别为31.7%和9.9%)。两组患者的受教育程度与认知能力均呈正相关。标准化迷你智力测验(s-mmt)得分与两组IPD的分期、严重程度呈负相关。结论:我国社会文化地位由西向东下降。因此，关于PD的知识，医院和保健中心的可及性以及获得最佳治疗的机会可能在地区之间表现出差异。我们认为，我们的研究提供了一个比较的PD患者在我国两个不同的地区，具有不同的地理，遗传特征和发展水平。
{"title":"A Glance into Regional Parkinson’s Disease Characteristics: What Differs from Northwest to Southeast of Turkey?","authors":"Saadet Sayan, Y. Değirmenci, D. Kotan","doi":"10.4236/nm.2020.113008","DOIUrl":"https://doi.org/10.4236/nm.2020.113008","url":null,"abstract":"Introduction: Parkinson’s disease (PD) is the second common neurodegenerative disease following Alzheimer’s disease. Multifactorial risk factors including environmental, nutritional and genetic factors may affect the frequency, risks, and genetic features of PD in different geographic and ethnic regions. Background: Our aim was to investigate the sociodemographic and disease characteristics, cognitive performances of patients with PD in Nusaybin, a southeastern city, and Hendek a northwestern city which have different geographical-cultural status, and to investigate the possible effects of regional differences on disease characteristics. Method: This retrospective study includes the data of patients with the diagnosis of PD who presented to outpatient Neurology clinics of Hendek State Hospital which is a city in the northwestern region of Turkey between April 2017 and June 2018 and patients who presented to the outpatient Neurology clinics of Nusaybin State Hospital, which is a city in the southeastern region of Turkey between October 2015 and January 2017. SPSS.23c (Statistical package for Windows) database was used for statistical analysis. Results: Our study included 114 cases with Parkinson’s disease in Hendek and 96 cases in Nusaybin.The majority of patients had idiopathic PD (IPD) in both provinces (96.9% in Hendek, and 92.1% in Nusaybin). Educational status of female patients was significantly lower in Nusaybin when compared with Hendek (9.3% and 63.3%, respectively). Family history for IPD was significantly higher in Hendek than Nusaybin (31.7% and 9.9%, respectively). There was a positive correlation between educational status and cognitive performances of the patients in both groups. Negative correlation was found between standardized mini mental test (s-mmt) scores and stage, severity of IPD in both groups. Conclusion: The socio-cultural status of our country decreases by going from west to east. Thus knowledge about PD, accessibility to the hospitals and health centers with the opportunity to get optimum treatments may show variabilities in between the regions. We believe that our study provides a comparison of patients with PD in two different regions of our country with different geographic, genetic characteristics, and development levels.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"53 1","pages":"63-73"},"PeriodicalIF":0.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74050771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Yangatimbi, Junior Koma Zobanga, Symphorien Shansy Grégbia, Josué Kinima, P. M’belesso
Introduction: Hemorrhagic strokes in the elderly constitute a diagnostic and therapeutic emergency and, by their frequency and severity, determine a public health problem. Goal of the Study: To elucidate knowledge and make our contribution to the study of this pathology (describe the epidemioclinical and evolutionary aspects of hemorrhagic cerebrovascular accidents in adults in Bangui). Methodology: It was a retrospective study with descriptive and analytical aims covering a period of two years (2) from January 2017 to December 2018, conducted in the Neurology department of the Sino-Central African Friendship University Hospital. Results: During the study, 255 patients were hospitalized for stroke, including 20 cases of AVCH, representing a hospital frequency of 7.8%. The average age was 60.05 years with extremes ranging from 50 to 78 years. The most represented age group was that of 50 to 60 years with a sex-ratio (M/F) of 1.2. Civil servants were more represented (35%) followed by housewives (25%). Alcohol was the main risk factor (95%) followed by hypertension (80%) and tobacco (40%). Most of the patients (75%) were admitted to the care facilities before 6 am (75%). Lethality was 35%. There was a significant statistical link between the Glasgow score and death (p = 0.007). In this series, 75% of the cases had sequelae dominated by hemiparesis (75%) and aphasia (25%). Conclusion: First study in the Central African Republic, with a high frequency, shows that the AVCH of the elderly poses a public health problem. Requires great mass awareness in order to reduce its mortality rate.
{"title":"Epidemioclinical and Progressive Aspects of the Adult Hemorrhagic Stroke in Bangui","authors":"E. Yangatimbi, Junior Koma Zobanga, Symphorien Shansy Grégbia, Josué Kinima, P. M’belesso","doi":"10.4236/nm.2020.113009","DOIUrl":"https://doi.org/10.4236/nm.2020.113009","url":null,"abstract":"Introduction: Hemorrhagic strokes in the elderly constitute a diagnostic and \u0000therapeutic emergency and, by their frequency and severity, determine a public \u0000health problem. Goal of the Study: To elucidate knowledge and make our \u0000contribution to the study of this pathology (describe the epidemioclinical and \u0000evolutionary aspects of hemorrhagic cerebrovascular accidents in adults in \u0000Bangui). Methodology: It was a retrospective study with descriptive and \u0000analytical aims covering a period of two years (2) from January 2017 to December \u00002018, conducted in the Neurology department of the Sino-Central \u0000African Friendship University Hospital. Results: During the study, 255 patients \u0000were hospitalized for stroke, including 20 cases of AVCH, representing \u0000a hospital frequency of 7.8%. The average age was 60.05 years with extremes \u0000ranging from 50 to 78 years. The most represented age group was that of 50 \u0000to 60 years with a sex-ratio (M/F) of 1.2. Civil servants were more represented \u0000(35%) followed by housewives (25%). Alcohol was the main risk factor (95%) \u0000followed by hypertension (80%) and tobacco (40%). Most of the patients \u0000(75%) were admitted to the care facilities before 6 am (75%). Lethality was \u000035%. There was a significant statistical link between the Glasgow score and \u0000death (p = 0.007). In this series, 75% of the cases had sequelae dominated by \u0000hemiparesis (75%) and aphasia (25%). Conclusion: First study in the Central \u0000African Republic, with a high frequency, shows that the AVCH of the elderly \u0000poses a public health problem. Requires great mass awareness in order to reduce \u0000its mortality rate.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74979360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Menat-Allah Mohamed Lashin, S. Khalil, T. Alloush, S. Anis, M. Fouad
Introduction: The neutrophil to lymphocyte ratio (NLR) can be used as a marker of subclinical inflammation, and may have a predictive power in prognosis and severity of atherosclerosis-related diseases. This study aimed to assess an association between the NLR, and clinical characteristics and one-month outcome in acute ischemic stroke (AIS). Subjects and Methods: This case-control observational prospective study included 75 patients admitted to stroke unit of Ain Shams University hospitals with AIS, sub grouped into 3 equal groups according to subtype of AIS, in addition to 25 healthy individuals. The demographic characteristics of the patients, complete blood picture test results at presentation, National Institutes of Health Stroke Scale (NIHSS) scores and modified Rankin Scale (mRS) scores were recorded. The clinical outcome was assessed by the NIHSS and mRS scores after one month. Results: The total leucocyte count was significantly higher in large artery atherosclerosis (P = 0.004) and cardioembolic (P = 0.020) stroke groups, unlike lacunar stroke group (P = 0.082), when compared to controls. The neutrophils count was higher (P < 0.001) and the lymphocyte count was lower (P < 0.001) among all the stroke groups compared to the control group. The NLR was higher among all the stroke groups compared to the control group (P < 0.001). The NLR at cutoff value more than 1.34 had predicted stroke with a sensitivity of 89.33% and specificity of 72% and accuracy reached 88.6%. There was non-significant association between NLR and each of NIHSS and mRS after one month from onset of AIS. Conclusion: NLR was significantly higher among AIS subtypes compared to controls, but not a good predictor for one month outcome.
{"title":"Neutrophil to Lymphocyte Ratio in Acute Ischemic Stroke","authors":"Menat-Allah Mohamed Lashin, S. Khalil, T. Alloush, S. Anis, M. Fouad","doi":"10.4236/nm.2020.112007","DOIUrl":"https://doi.org/10.4236/nm.2020.112007","url":null,"abstract":"Introduction: The neutrophil to lymphocyte ratio (NLR) can be used as a marker of subclinical inflammation, and may have a predictive power in prognosis and severity of atherosclerosis-related diseases. This study aimed to assess an association between the NLR, and clinical characteristics and one-month outcome in acute ischemic stroke (AIS). Subjects and Methods: This case-control observational prospective study included 75 patients admitted to stroke unit of Ain Shams University hospitals with AIS, sub grouped into 3 equal groups according to subtype of AIS, in addition to 25 healthy individuals. The demographic characteristics of the patients, complete blood picture test results at presentation, National Institutes of Health Stroke Scale (NIHSS) scores and modified Rankin Scale (mRS) scores were recorded. The clinical outcome was assessed by the NIHSS and mRS scores after one month. Results: The total leucocyte count was significantly higher in large artery atherosclerosis (P = 0.004) and cardioembolic (P = 0.020) stroke groups, unlike lacunar stroke group (P = 0.082), when compared to controls. The neutrophils count was higher (P < 0.001) and the lymphocyte count was lower (P < 0.001) among all the stroke groups compared to the control group. The NLR was higher among all the stroke groups compared to the control group (P < 0.001). The NLR at cutoff value more than 1.34 had predicted stroke with a sensitivity of 89.33% and specificity of 72% and accuracy reached 88.6%. There was non-significant association between NLR and each of NIHSS and mRS after one month from onset of AIS. Conclusion: NLR was significantly higher among AIS subtypes compared to controls, but not a good predictor for one month outcome.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74093902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Madane, M. Issa, A. Hamidou, Mariko Mahamane, Beye Seydina Alioune, Dembele Alaji Seidou, Coulibaly Mahamadoun, Ouattara Kassoum, Kaloga Mahamane Asseye, S. Koita, Ebongue Sandrine, D. Mahamane
A cerebrole is a patient with a neurological deficit of central origin; these patients very often present disorders of the ion concentration, hence the need for hospitalization in intensive care. The aim of our study was to study hydro-electrolyte disorders in brain-damaged patients, to describe the clinical aspects, to identify the contributing factors and to determine the prognosis of these patients in the intensive care unit of gabriel toure teaching hospital. Material and Methods: It was a prospective cross-sectional study, descriptive of a period of 11 months going from June 2015 to April 2016 in the intensive care unit of CHU Gabriel TOURE we included all the cerebral patients admitted in intensive care in which hydro-ionic disorders have detected on arrival or during hospitalization. Data were collected through transfer sheets, a survey sheet and medical records. Data entry and analysis were done respectively on SPSS software (version 19) and Microsoft Word Starter 2010 software. Results: During our study, out of 450 hospitalization patients, we identified 110 brain-damaged patients and 75 patients were retained in our study, i.e. a prevalence of 16.6%. Male was predominant with 72% with a sex ratio of 2.5 the age group 20 - 50 years was majority with 45.3%, the average age was 38.49 years. The majority of patients (58.7%) were admitted from the emergency department. The most common reason for admission was impairment of consciousness in 94.7% (Table 1) of cases and the Glasgow admission score was less than or equal to 8 in 58.7% (Table 1) of patients. Hydro-electrolyte disturbances were present in 93.3% of patients on admission. Hyponatremia was the most common disorder with 56% (42 cases). Followed by hyperkalaemia 10.7% (8 cases), hypernatremia 9.3% (7 cases), at hypocalcemia 9.3% (7 cases), associated disorders 8% (6 cases). Brain CT was performed in 52% of the patients. In our study, malaria was the most common etiology of ionic disorders with 36%. Of the patients who died, 80% had developed hyponatremia after 5 days in hospital, and the overall lethality was 73.3%. Conclusion: Hydro-electrolyte disorders are frequent in the intensive care setting and their management must be rapid in order to reduce morbidity and mortality.
脑病是指中枢源性神经功能缺损的患者;这些患者经常出现离子浓度紊乱，因此需要在重症监护室住院治疗。本研究的目的是研究加布里埃尔图尔教学医院重症监护室脑损伤患者的水电解质紊乱，描述临床方面，确定影响因素，并确定这些患者的预后。材料与方法:这是一项前瞻性横断面研究，描述了2015年6月至2016年4月在CHU Gabriel TOURE重症监护室进行的为期11个月的研究。我们纳入了所有在到达或住院期间检测到氢离子障碍的重症监护室脑患者。通过转让表、调查表和医疗记录收集数据。数据录入和分析分别使用SPSS软件(version 19)和Microsoft Word Starter 2010软件。结果:在我们的研究中，在450例住院患者中，我们发现110例脑损伤患者，75例患者被保留在我们的研究中，患病率为16.6%。男性居多，占72%，性别比为2.5;年龄以20 ~ 50岁为主，占45.3%，平均年龄38.49岁。大多数患者(58.7%)来自急诊科。入院最常见的原因是意识障碍，占94.7%(表1)，58.7%(表1)患者的格拉斯哥入院评分小于或等于8分。93.3%的患者入院时存在水电解质紊乱。低钠血症是最常见的疾病，占56%(42例)。其次是高钾血症10.7%(8例)，高钠血症9.3%(7例)，低钙血症9.3%(7例)，相关疾病8%(6例)。52%的患者行脑CT检查。在我们的研究中，疟疾是离子失调最常见的病因，占36%。死亡患者中80%在住院5天后发生低钠血症，总病死率为73.3%。结论:水电解质紊乱是重症监护室的常见疾病，必须迅速处理，以降低发病率和死亡率。
{"title":"Hydroelectrolytic Disorders in Cerebroleted Patients in the Intensive Care Unit of Gabriel Touré Teaching Hospital","authors":"D. Madane, M. Issa, A. Hamidou, Mariko Mahamane, Beye Seydina Alioune, Dembele Alaji Seidou, Coulibaly Mahamadoun, Ouattara Kassoum, Kaloga Mahamane Asseye, S. Koita, Ebongue Sandrine, D. Mahamane","doi":"10.4236/nm.2020.112006","DOIUrl":"https://doi.org/10.4236/nm.2020.112006","url":null,"abstract":"A cerebrole is a patient with a neurological deficit of central origin; these patients very often present disorders of the ion concentration, hence the need for hospitalization in intensive care. The aim of our study was to study hydro-electrolyte disorders in brain-damaged patients, to describe the clinical aspects, to identify the contributing factors and to determine the prognosis of these patients in the intensive care unit of gabriel toure teaching hospital. Material and Methods: It was a prospective cross-sectional study, descriptive of a period of 11 months going from June 2015 to April 2016 in the intensive care unit of CHU Gabriel TOURE we included all the cerebral patients admitted in intensive care in which hydro-ionic disorders have detected on arrival or during hospitalization. Data were collected through transfer sheets, a survey sheet and medical records. Data entry and analysis were done respectively on SPSS software (version 19) and Microsoft Word Starter 2010 software. Results: During our study, out of 450 hospitalization patients, we identified 110 brain-damaged patients and 75 patients were retained in our study, i.e. a prevalence of 16.6%. Male was predominant with 72% with a sex ratio of 2.5 the age group 20 - 50 years was majority with 45.3%, the average age was 38.49 years. The majority of patients (58.7%) were admitted from the emergency department. The most common reason for admission was impairment of consciousness in 94.7% (Table 1) of cases and the Glasgow admission score was less than or equal to 8 in 58.7% (Table 1) of patients. Hydro-electrolyte disturbances were present in 93.3% of patients on admission. Hyponatremia was the most common disorder with 56% (42 cases). Followed by hyperkalaemia 10.7% (8 cases), hypernatremia 9.3% (7 cases), at hypocalcemia 9.3% (7 cases), associated disorders 8% (6 cases). Brain CT was performed in 52% of the patients. In our study, malaria was the most common etiology of ionic disorders with 36%. Of the patients who died, 80% had developed hyponatremia after 5 days in hospital, and the overall lethality was 73.3%. Conclusion: Hydro-electrolyte disorders are frequent in the intensive care setting and their management must be rapid in order to reduce morbidity and mortality.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84725732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ghadeer Al-Shabeeb, Fatimah Al Zawad, Osama Basheir
Intravenous thrombolysis remains the gold standard in the management of acute ischemic stroke if the patient presents within the window period. Endovascular thrombectomy is another line of therapy in selected cases. Nonetheless, one of the most devastating complications of IV thrombolysis is intracranial hemorrhage (ICH); in such cases, the previous history of ICH is considered a potential contraindication to thrombolysis. Evidence regarding the safety of thrombolysis administration in patients with a previous history of ICH is scarce. We encountered a patient with acute ischemic stroke with a past history of hypertensive ICH. A 59-year-old female, presented with complete right-sided body weakness, global aphasia and gaze preference. A computed tomography (CT) brain perfusion scan revealed a mismatch suggestive of left middle cerebral artery (MCA) ischemic stroke. The patient received intravenous thrombolysis and showed significant clinical improvement with no subsequent complications or ICH. In reporting this case, we aim to provide evidence supporting the safety of thrombolytic therapy in selected cases with a previous history of ICH when no alternative line of management is available.
{"title":"Management of Acute Ischemic Stroke in a Patient with a Past History of Intracranial Hemorrhage","authors":"Ghadeer Al-Shabeeb, Fatimah Al Zawad, Osama Basheir","doi":"10.4236/nm.2020.111004","DOIUrl":"https://doi.org/10.4236/nm.2020.111004","url":null,"abstract":"Intravenous thrombolysis remains the gold standard in the management of acute ischemic stroke if the patient presents within the window period. Endovascular thrombectomy is another line of therapy in selected cases. Nonetheless, one of the most devastating complications of IV thrombolysis is intracranial hemorrhage (ICH); in such cases, the previous history of ICH is considered a potential contraindication to thrombolysis. Evidence regarding the safety of thrombolysis administration in patients with a previous history of ICH is scarce. We encountered a patient with acute ischemic stroke with a past history of hypertensive ICH. A 59-year-old female, presented with complete right-sided body weakness, global aphasia and gaze preference. A computed tomography (CT) brain perfusion scan revealed a mismatch suggestive of left middle cerebral artery (MCA) ischemic stroke. The patient received intravenous thrombolysis and showed significant clinical improvement with no subsequent complications or ICH. In reporting this case, we aim to provide evidence supporting the safety of thrombolytic therapy in selected cases with a previous history of ICH when no alternative line of management is available.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89882413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The article considers the biological nature and origins of emotional stress. Emotional stress is primarily formed within the mental activity of the brain in the form of pronounced negative emotions. The “Dynamic Theory of Emo-tions” characterizes the development of a continuous negative emotional state in conflicting behavioral situations when the subject is unable to satisfy its strong dominant need for a long time. The emotional stress is represented as having a dual nature, i.e. a biologically negative pathogenetic effect on health, but a positive impact on the adaptation of individuals, self-preservation of life, and evolutionary change in species.
{"title":"Emotional Stress: The Dialectics of Nature","authors":"E. Yumatov","doi":"10.4236/nm.2020.111003","DOIUrl":"https://doi.org/10.4236/nm.2020.111003","url":null,"abstract":"The article considers the biological nature and origins of emotional stress. Emotional stress is primarily formed within the mental activity of the brain in the form of pronounced negative emotions. The “Dynamic Theory of Emo-tions” characterizes the development of a continuous negative emotional state in conflicting behavioral situations when the subject is unable to satisfy its strong dominant need for a long time. The emotional stress is represented as having a dual nature, i.e. a biologically negative pathogenetic effect on health, but a positive impact on the adaptation of individuals, self-preservation of life, and evolutionary change in species.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89142183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Boukassa, H. Ekouele-Mbaki, Olivier Brice Ngackosso, S. Bambino
Background: Intracranial suppurations (ICS) due to banal germs are medical-surgical emergencies, despite their little removed frequency. Represented by abscesses and empyemas, their management has been improved by the combined contributions of new diagnostic and therapeutic methods. Objective: Appreciate the management of intracranial suppurations banal germ in our service. Material and methods: A retrospective study of 41 cases of intra-cranial suppurations was conducted at Brazzaville University Hospital, from January 2007 to June 2019. Diagnostic, therapeutic and evolution aspects have been studied. Results: They are divided into 24 empyemas, 8 abscesses and 9 associations abscess-empyema. The average age was 20.2 years old in general. The male predominance is noted in all groups. The sex ratio is 3.1 for all of these intracranial suppurations (ICS). They frequently complicated Oto-Rhino-Laryngology (ORL) infections (41.4%). The clinic was mostly represented by the Bergman’s triad 51.2%, followed by headache 14.6% and seizures 12.2%. The lesions were predominant in supratentorial 97.5%. Frontal location was found in 67.4%. Germs were isolated in 29.4% of samples. There were 5 Streptococci, 3 Staphylococci and 2 Gram-negative Bacilli. The medico-surgical treatment indicated in 80.5% combined often probabilistic tri-antibiotherapy with the evacuation of the pus by the trepano-puncture. Evolution under this treatment was marked by healing in 90.2%. The lethality was 9.7%. Conclusion: The pursuit of the improvement of these infections requires the adequate treatment of their gateways, most of them loco-regional.
{"title":"Intracranial Suppuration at the Brazzaville Academic Hospital","authors":"L. Boukassa, H. Ekouele-Mbaki, Olivier Brice Ngackosso, S. Bambino","doi":"10.4236/nm.2020.111005","DOIUrl":"https://doi.org/10.4236/nm.2020.111005","url":null,"abstract":"Background: Intracranial suppurations (ICS) due to banal germs are medical-surgical emergencies, despite their little removed frequency. Represented by abscesses and empyemas, their management has been improved by the combined contributions of new diagnostic and therapeutic methods. Objective: Appreciate the management of intracranial suppurations banal germ in our service. Material and methods: A retrospective study of 41 cases of intra-cranial suppurations was conducted at Brazzaville University Hospital, from January 2007 to June 2019. Diagnostic, therapeutic and evolution aspects have been studied. Results: They are divided into 24 empyemas, 8 abscesses and 9 associations abscess-empyema. The average age was 20.2 years old in general. The male predominance is noted in all groups. The sex ratio is 3.1 for all of these intracranial suppurations (ICS). They frequently complicated Oto-Rhino-Laryngology (ORL) infections (41.4%). The clinic was mostly represented by the Bergman’s triad 51.2%, followed by headache 14.6% and seizures 12.2%. The lesions were predominant in supratentorial 97.5%. Frontal location was found in 67.4%. Germs were isolated in 29.4% of samples. There were 5 Streptococci, 3 Staphylococci and 2 Gram-negative Bacilli. The medico-surgical treatment indicated in 80.5% combined often probabilistic tri-antibiotherapy with the evacuation of the pus by the trepano-puncture. Evolution under this treatment was marked by healing in 90.2%. The lethality was 9.7%. Conclusion: The pursuit of the improvement of these infections requires the adequate treatment of their gateways, most of them loco-regional.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79253491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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