Csf Presentation 2009
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The document provides information on CSF Dynamics and their SinuShunt device for treating hydrocephalus. It discusses the shortcomings of traditional shunts, including numerous complications from overdrainage and short lifetimes. The SinuShunt aims to address these issues by draining cerebrospinal fluid from the brain ventricles directly into the transverse sinus, mimicking natural drainage and minimizing complications. Over 200 SinuShunts have been implanted with fewer reported complications compared to traditional shunts.
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Tunica Interna – innermost endothelium of simple squamous epithelium + basement membrane
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The document discusses the normal composition and characteristics of cerebrospinal fluid (CSF) as well as abnormalities that can indicate various medical conditions:
- CSF normally contains low levels of proteins, glucose, and cells while maintaining slightly acidic pH, clarity and specific gravity.
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- Classifications of facial nerve injuries including neuropraxia, axonotmesis, neurotmesis, and transection.
- The degeneration and regeneration processes after injury, including changes in the proximal and distal nerve segments and target muscles.
- Surgical techniques for nerve repair including fascicular repair, grafting, and principles such as achieving a tension-free repair.
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1) Post-operative visual acuity was excellent, with a mean of 20/28.
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3) Postoperative adverse events like iritis and corneal edema each affected around 1-2% of cases. No cases of endophthalmitis were reported.
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- Head extended
- Chin lifted
This aligns oral, pharyngeal and laryngeal axes
Improves laryngeal view during laryngoscopy
Allows for easier intubation
Maintains airway patency
Avoids need for in-line stabilization
Improves glottic visualization by up to 50% compared to neutral position
Standard position for intubation in children
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- Straight blade preferred for infants and children
- Curved blade for older children and adolescents
- External laryngeal manipulation may improve view
- Use just enough force to lift epiglottis off laryngeal inlet
- Do not force blade past glottis
- Su
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Macrocephaly is defined as a head circumference greater than 2 standard deviations above the mean for age and sex. It can be caused by increased skull size due to conditions like chronic anemia or increased brain size. Hydrocephalus, an excessive accumulation of cerebrospinal fluid in the brain ventricles, is another potential cause. Hydrocephalus can be obstructive due to blockages or non-obstructive if caused by increased fluid production or decreased absorption. Symptoms include irritability, poor feeding, lethargy and vomiting. Diagnosis involves medical history, physical exam, and brain imaging studies like CT or MRI scans. Treatment options include supportive care, medications to reduce fluid production, and surgical placement of a VP
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2) Diagnosis involves evaluating symptoms, imaging tests showing disproportionate ventricle enlargement, and tests like lumbar puncture to check CSF pressure and flow.
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Normal pressure hydrocephalus (NPH) is a condition where cerebrospinal fluid (CSF) absorption is reduced, causing increased pressure in the ventricles of the brain. It typically affects elderly individuals and presents as a triad of symptoms - impaired gait, urinary incontinence, and cognitive impairment. Diagnosis involves MRI or CT scans showing ventricle enlargement. Treatment is usually surgical placement of a shunt to drain CSF from the brain ventricles to the abdominal cavity or heart, which can improve symptoms. However, shunt surgery also carries risks of infection, obstruction, or over-drainage of CSF.
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Csf analysis presentation
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Endoscopic third ventriculostomy (ETV) is a procedure used to treat hydrocephalus, as an alternative to a shunt.
The procedure was attempted years ago, before shunts were invented. A man called Dandy performed it as an open operation in the early twentieth century. But basic endoscopic attempts with primitive endoscopes even preceded this. It was always a logical way to try and treat hydrocephalus. Modern equipment to carry out ETV didn’t exist until about twenty years ago, so it is only now that surgeons are able to review the procedure, and look at success rates and possible complications.Steam catheter
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- PFO Closure Device
- Implanted Baclofen Pump
- Pnuemobilia
- Common Bile Duct Stent
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A 52-year-old female presented with a clear watery nasal discharge that worsened with bending over or coughing. Clinical tests and imaging found a CSF leak from the right cribriform plate, likely caused by increased intracranial pressure eroding the bone. CSF leaks can be managed conservatively or surgically via an endoscopic approach, which has high success rates and minimal morbidity compared to intracranial or extracranial approaches.
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This study analyzed over 21,000 office-based cataract surgeries performed between 2011-2014 to evaluate safety and effectiveness outcomes. Key findings include:
1) Post-operative visual acuity was excellent, with a mean of 20/28.
2) Intraoperative complications like capsule tears and vitreous loss occurred in 0.55% and 0.34% of cases respectively.
3) Postoperative adverse events like iritis and corneal edema each affected around 1-2% of cases. No cases of endophthalmitis were reported.
Second surgeries were required in 0.70% of cases within 6 months. The study found office-based cataract
Pediatric Airway Anatomy Physiology and Management.ppt
- Head extended
- Chin lifted
This aligns oral, pharyngeal and laryngeal axes
Improves laryngeal view during laryngoscopy
Allows for easier intubation
Maintains airway patency
Avoids need for in-line stabilization
Improves glottic visualization by up to 50% compared to neutral position
Standard position for intubation in children
Laryngoscopy
- Straight blade preferred for infants and children
- Curved blade for older children and adolescents
- External laryngeal manipulation may improve view
- Use just enough force to lift epiglottis off laryngeal inlet
- Do not force blade past glottis
- Su
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Thoracoscopic drainage was performed on 12 patients with hydatid cysts of the lung. The patients were 7 males and 5 females ranging in age from 11 to 64 years old. Thoracoscopic drainage was successfully completed in 9 patients (75%) with a mean hospital stay of 5 days. In one case (8%), air leakage continued beyond 7 days and in two patients (16.6%) the procedure had to be converted to an open operation due to inaccessibility of the cyst and uncontrollable air leakage. No recurrences were detected in the 7 patients that were able to be followed up after surgery. Thoracoscopic drainage can be used to successfully manage selected patients with peripherally located and/or ruptured
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Pediatric cardiac interventions have advanced significantly, with balloon angioplasties and devices now used routinely to treat conditions like atrial septal defects, ventricular septal defects, and patent ductus arteriosus. Newer interventions still in clinical trials include muscular VSD and perimembranous VSD device closure, flow restrictor implantation as an alternative to pulmonary artery banding, and components of the Norwood procedure in the catheterization lab. While short term outcomes are encouraging for many procedures, long term data is still needed to fully evaluate safety and efficacy. Continued innovation holds promise for more pediatric heart conditions to be treated using minimally invasive techniques.
EFFECT OF TRANS-SEPTAL SUTURE TECHNIQUE VERSUS NASAL PACKING AFTER SEPTOPLASTY
EFFECT OF TRANS-SEPTAL SUTURE TECHNIQUE VERSUS NASAL PACKING AFTER SEPTOPLASTYInternational Journal of Technical Research & Application
Background: Septoplasty is a common surgical
procedure performed by otolaryngologists for the correction of
deviated nasal septum. This surgery may be associated with
numerous complications. To minimize these complications,
otolaryngologists frequently pack both nasal cavities with
different types of nasal packing. Despite all its advantages,
nasal packing is also associated with some disadvantages. To
avoid these issues, many surgeons use suturing techniques to
obviate the need for packing after surgery.
Objective: To determine the efficacy and safety of trans-septal
suture technique in preventing complications and decreasing
morbidity after septoplasty in comparison with nasal packing.
Patients and methods: Prospective comparative study. This
study was conducted in the department of Otolaryngology -
Head and Neck Surgery, Rizgary Teaching Hospital - Erbil,
from the 6th of May 2014 to the 30th of November 2014.
A total of 60 patients aged 18-45 years, undergoing septoplasty,
were included in the study. Before surgery, patients were
randomly divided into two equal groups. Group (A) with transseptal
suture technique was compared with group (B) in which
nasal packing with Merocel was done. Postoperative morbidity
in terms of pain, bleeding, postnasal drip, sleep disturbance,
dysphagia, headache and epiphora along with postoperative
complications including septal hematoma, septal perforation,
crustation and synechiae formation were assessed over a follow
up period of four weeks.
Results: Out of 60 patients, 37 patients were males (61.7%)
and 23 patients were females (38.3%). Patients with nasal
packing had significantly more postoperative pain (P<0.05)><0.05). There was no significant difference between
the two groups with respect to nasal bleeding, septal
hematoma, septal perforation, crustation and synechiae
formation.
Conclusion: Septoplasty can be safely performed using transseptal
suturing technique without nasal packing.
International Journal of Rhinology & Otolaryngology
Endoscopic techniques have been widely adopted in sinus and skull base surgery replacing the traditional intracranial/extracranial approaches. However, one of the most common complication is an iatrogenic Cerebrospinal Fluid (CSF) leak, which places the patient at risk for meningitis, pneumocephalus and brain herniation. The instant intraoperative CSF leak diagnosis and consequent repair is crucial to avoid these complications. Traditionally, intrathecal fl uorescein injection was utilized to aid in the diagnosis. However, this technique is not FDA approved and encompasses major drawbacks (seizure, lower extremity paresis, cranial nerve palsies and patient discomfort).The purpose of this case series is to introduce a new diagnostic paradigm using topical fl uorescein strips “FLUORETS”. It has shown promising prospects due to its safety, accuracy and sensitivity in identifying CSF leaks.
Vasküler Nöroşirürjide Gelecek
Prof.Dr. Nihat Egemen'den vasküler nöroşirürjide gelecek hakkında bilgiler içeriyor.
http://www.nihategemen.com
Oxygénation Nasale Humidifiée à Haut Débit - Optiflow aux urgences COMUN 2018
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Quelle est la place de l'Optiflow aux urgences ?
Où en est-on des études cliniques ?
Peut-on traiter les patients des urgences comme ceux de réanimation avec l'oxygénation haut-débit ?
De nouvelles perspectives avec l'Optiflow ?Keidan Presentation 2016 + video
This document discusses a prototype technology called CoVa that uses capnography to detect increased carbon dioxide levels after injecting sodium bicarbonate intravenously. This allows clinicians to confirm correct placement of intravenous catheters. The technology has been tested on 200 patients in a phase 3 clinical trial with statistically significant results. It could help prevent complications from malpositioned catheters like extravasation and infiltration, which are common problems that result in high costs to hospitals. Regulatory approval pathways are straightforward and initial development costs are estimated at $500,000 over 2 years to start sales.
JOURNAL CLUB abi.pptx
This study compared the efficacy of a topical tranexamic acid pack versus a hot saline pack for hemorrhage control following adenoidectomy. 180 patients were randomly assigned to receive one of the two packs or no pack following surgery. Results found that the tranexamic acid pack was more effective, achieving hemostasis faster with fewer additional procedures compared to the hot saline pack. There was also less postoperative bleeding in the tranexamic acid group. The study concluded that a topical tranexamic acid pack is more effective for post-adenoidectomy hemostasis than a hot saline pack.
41st publication jamdsr - 1st name
This document discusses avascular necrosis of the maxilla, a rare complication of Le Fort I orthognathic surgery. It occurs in less than 1% of cases when blood flow to the maxilla is compromised during surgery. Risk factors include rupture of the descending palatine artery, postoperative vascular thrombosis, stripping of palatal soft tissues, and patient factors like anatomical irregularities or vascular anomalies. Treatment aims to prevent secondary infection and promote healing through measures like antibiotics, hyperbaric oxygen therapy, and bone grafting. The case report presented analyzes factors that may have increased risk of avascular necrosis in one patient with sickle cell trait who developed the complication.
26th Publication - JAMDSR - 1st Name.pdf
26.Tiwari RV, Prathigudupu RS, Mathew P, Roy B, Sehrawat K, Pareek P, Tiwari H A Review on one rare complication “Avascular Necrosis of Maxilla” after Le Fort I Orthognathic Surgery. J Adv Med Dent Scie Res 2018;6(7):23-30.
Mechanical Ventilation
This document discusses various aspects of mechanical ventilation and weaning patients off ventilators. It addresses the problems associated with prolonged intubation versus premature extubation. It emphasizes the nurse's responsibility to monitor patients' readiness for weaning and to gradually decrease mechanical support. The document also discusses definitions of weaning success and ensuring patients are weaned at the appropriate time.
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- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
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The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
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Endocrine Therapy
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Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
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Combination Therapies
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Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
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These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
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Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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Csf Presentation 2009
- 1. Page Company Presentation CSF Dynamics
- 2. Introduction Key persons behind CSFDynamics A/S Page MD, Dr.med.sci., University of Aarhus (1976), Specialist in Neurosurgery (1979). Currently employed as Chief Surgeon and Medical Director at PrivatHospitalet Danmark (1992-). Previously Dr. Børgesen was employed as chief neurosurgeon at the University Clinic of Neurosurgery at Rigshospitalet (1988-02), consultant at Arbejdsskadestyrelsen (1987-99), assistant neurologist at Sikringsstyrelsen (1986-87), consultant at the department of neurosurgery at KAS Glostrup (1984-87), consultant at the department of neurosurgery at Borgaspitalin in Iceland (1982-82). Dr. Børgesen is author and co-author of 86 scientific articles Svend Erik Børgesen Niels Agerlin MD from the University of Copenhagen (1986), Ph.D. from the University of Copenhagen (1993). Currently employed as Chief Neurosurgeon at the Neurosurgical dept. at KAS Glostrup (2002-). Previously employed as senior resident physician at the Neurosurgical dept. at KAS Glostrup (1997-01), resident physician and senior resident physician at the Neurosurgical dept. and Neurological dept. at Rigshospitalet (1988-96)
- 3. Introduction History of the SinuShunt Page Year Event 1993 The first animal experiment on dogs took place. 1994-95 Dr. Børgesen finished the first technical development of the SinuShunt and prepared the shunt ready for patenting. 26 Sep. 1996 An APCT application was filed for the USA, all of Europe, Japan, Hong Kong, Canada and Australia. 1997 The first SinuShunts were implanted. 1997-99 Clinical development and testing of the SinuShunt. 2000 The SinuShunt and the first results were presented at a neurosurgery world congress in Sydney. The interest was overwhelming. At that congress, the first contacts were made with university hospitals in Europe which wanted to participate in the future testing. The development started of a new shunt for treatment of hydrocephalus for infants and young children. At the same time the shunt for treatment of AD was developed. 2001 CSFDynamics entered into a production agreement with Medical Rubber AB in Sweden, a family-owned company established in 1973. The company, which is ISO 9002 and EN 46002 certified and has clean room facilities (class 10,000), currently produces the SinuShunt. 2002 The SinuShunt achieved the CE approval. Pilot testing and clinical studies continued in selected university hospitals in Europe. Jun. 2003 Dr. Børgesen received the Pudenz Award for 2002 for “Excellence in Cerebrospinal Fluid Physiology”. The award was given to Dr. Børgesen for “his many contributions over the years to the understanding of factors underlying the clinical physiology of hydrocephalus and his recent innovative studies utilizing the ventriculo-cranial venous sinus methodology for treatment of this condition”. End of 2003 Approx. 200 SinuShunts were implanted in selected hospitals 2007/2009 Development of a new and improved sinus-tube.
- 4. Introduction The SinuShunt Page
- 5. Introduction Illustration of the SinuShunt principle Page
- 6. Introduction The SinuShunt vs. traditional shunts Page SinuShunt Traditional shunts
- 19. Hydrocephalus Technical details of the shunting principle Page Traditional shunts SinuShunt Traditional valves have large intervals for the intracranial pressure The SinuShunt does not have any interval for the intracranial pressure ÷
- 24. Hydrocephalus Implanting the SinuShunt Page 1) Connector 2) Valves 3) Pre-chamber 4) Resistance tube 5) Drain for the transverse sinus Incision marks Position of the transverse sinus
- 37. Alzheimer’s Disease Physics of the MiniShunt Page Traditional shunts High pressure differential requires much higher resistance MiniShunt Low pressure differential enables much larger outflow with no overdrainage risk
Editor's Notes
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