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Shah, Hiral Janak, und Khyati Kothary. „SUPERVISED EXERCISE VERSUS WORKOUT VIDEOS FOR WEIGHT REDUCTION IN ADULTS BETWEEN AGE GROUP OF 20-50 YEARS“. International Journal of Physiotherapy and Research 5, Nr. 6 (11.12.2017): 2534–40. http://dx.doi.org/10.16965/ijpr.2017.244.
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Gier, Amanda, Nicholas M. Edwards, Philip R. Khoury, Shelley Kirk, Christopher Kist und Robert Siegel. „Instructor-led versus Video-led Exercise: A Comparison of Intensity in Obese Youth“. International Journal of Kinesiology and Sports Science 6, Nr. 3 (31.07.2018): 12. http://dx.doi.org/10.7575/aiac.ijkss.v.6n.3p.12.
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Background: Exercise is a key component in treating childhood obesity. Group exercise sessions with a trained instructor are ideal, but most treatment programs cannot offer these often enough to meet physical activity guidelines. At-home options that provide a similar-intensity workout are needed. Objective: To determine if exercise videos are a feasible at-home option for obese youth to meet recommended physical activity guidelines for moderate-to-vigorous exercise. Methods: Obese youth attended a summer camp focused on weight management. Subjects wore accelerometers to assess physical activity levels at camp. During camp, all subjects completed four exercise activities: three separate exercise sessions led by exercise physiologists (EP), as well as an exercise video (EV). Each exercise session utilized a different format: high intensity interval training (HIIT), group games (GG) and yoga. The EV, created by the same EP, included aerobic exercise and yoga. Data was analyzed to determine intensity associated with each exercise session. Results: Data was obtained from 16 (50%) accelerometers (9 girls, 7 boys). There was no difference in sedentary (SED) minutes per hour between activities. HIIT and GG had more moderate-vigorous physical activity (MVPA) than yoga (p<0.0001 and p=0.01) and EV (p<0.0001 and p=0.01). There was no difference in MVPA between HIIT and GG. Conclusions: Obese children exercised at higher intensities during instructor-led HIIT and GG exercise sessions than yoga or EV sessions.
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Scott, Lorna M., David Scott, Sonja P. Bedic und Joseph Dowd. „The Effect of Associative and Dissociative Strategies on Rowing Ergometer Performance“. Sport Psychologist 13, Nr. 1 (März 1999): 57–68. http://dx.doi.org/10.1123/tsp.13.1.57.
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This study outlined the implementation and evaluation of one associative and two dissociative coping strategies on rowing ergometer performance. Participants were 9 novice varsity rowers who performed a 40-min ergometer workout in 10 separate experimental sessions. At each workout participants were requested to row as far as possible in 40 min. A multiple-baseline design was utilized, which after varying amounts of baseline permitted implementing an associative or dissociative strategy for each participant. These strategies included associative, dissociative-video, and dissociative-music. Results indicated that performance improved under all conditions for all participants but that the greatest gains were found in the associative condition.
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Mutz, Michael, Johannes Müller und Anne K. Reimers. „Use of Digital Media for Home-Based Sports Activities during the COVID-19 Pandemic: Results from the German SPOVID Survey“. International Journal of Environmental Research and Public Health 18, Nr. 9 (21.04.2021): 4409. http://dx.doi.org/10.3390/ijerph18094409.
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Health authorities recommend digital tools for home-based sport and exercise routines to stay active and healthy during the COVID-19 pandemic. The study investigates the prevalence, duration, most popular activities, and social selectivity of home-based digital sport and its contribution to overall levels of sporting activity during the pandemic. It is based on cross-sectional survey data (n = 1508), representing the population >14 years living in Germany. Data collection took place in October 2020, using computer-assisted web interviewing. Results show that overall, 23% of respondents used digital media for sports activities at least one time during the COVID-19 pandemic. Numbers increased during the lockdown and decreased afterwards. People engaged in a variety of fitness workouts, most frequently practiced with the help of publicly accessible fitness videos from video-sharing platforms. Digital sports practitioners are younger, better educated, and financially better off. Females are overrepresented. Individuals engaged in digital sports achieved 30 min/week more sports activity during the pandemic compared to individuals solely involved in offline sports. Hence, home-based digital sports activities were a popular means to stay active, particularly in the period of the lockdown. Strong social disparities indicate that the possible health benefits of digital sports only reach out to particular population groups.
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Rutkowska-Kucharska, Alicja, Katarzyna Wysocka, Sławomir Winiarski, Agnieszka Szpala und Małgorzata Sobera. „An Investigation into the Relation between the Technique of Movement and Overload in Step Aerobics“. Applied Bionics and Biomechanics 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/3954907.
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The aim of this research was to determine the features of a step workout technique which may be related to motor system overloading in step aerobics. Subjects participating in the research were instructors (n=15) and students (n=15) without any prior experience in step aerobics. Kinematic and kinetic data was collected with the use of the BTS SMART system comprised of 6 calibrated video cameras and two Kistler force plates. The subjects’ task was to perform basic steps. The following variables were analyzed: vertical, anteroposterior, and mediolateral ground reaction forces; foot flexion and abduction and adduction angles; knee joint flexion angle; and trunk flexion angle in the sagittal plane. The angle of a foot adduction recorded for the instructors was significantly smaller than that of the students. The knee joint angle while stepping up was significantly higher for the instructors compared to that for the students. Our research confirmed that foot dorsal flexion and adduction performed while stepping up increased load on the ankle joint. Both small and large angles of knee flexion while stepping up and down resulted in knee joint injuries. A small trunk flexion angle in the entire cycle of step workout shut down dorsal muscles, which stopped suppressing the load put on the spine.
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Schutte, Henrieke W., Robert P. Takes, Piet J. Slootweg, Marianne J. P. A. Arts, Jimmie Honings, Frank J. A. van den Hoogen, Henri A. M. Marres und Guido B. van den Broek. „Digital Video Laryngoscopy and Flexible Endoscopic Biopsies as an Alternative Diagnostic Workup in Laryngopharyngeal Cancer: A Prospective Clinical Study“. Annals of Otology, Rhinology & Laryngology 127, Nr. 11 (07.09.2018): 770–76. http://dx.doi.org/10.1177/0003489418793987.
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Objectives: An office-based workup strategy for patients with laryngopharyngeal lesions suspicious for carcinoma is analyzed. The feasibility of office-based transnasal flexible endoscopic biopsies under local anesthesia and the impact on the diagnostic workup are evaluated. Methods: This study is a prospective analysis of patients with laryngeal, oropharyngeal, and hypopharyngeal lesions suspicious for carcinoma. One hundred eighty-eight participants were divided into 2 groups. The first group underwent an office-based biopsy procedure under local anesthesia using a flexible digital video laryngoscope with instrument channel (n = 53), and the second group underwent a biopsy procedure under general anesthesia using rigid laryngopharyngoscopy (n = 135). Results: Office-based flexible endoscopic biopsies were tolerated well, and there were no complications. These biopsies were 92.5% successful in acquiring a definitive diagnosis. Costs were reduced. Diagnostic workup time and time until start of therapy were reduced to 2 days and 27 days, respectively. Conclusion: Office-based biopsy under local anesthesia using flexible digital video laryngoscopy is safe, cost-effective, and successful in providing a histopathological diagnosis. It reduces the diagnostic workup time significantly in patients with laryngeal, oropharyngeal, and hypopharyngeal cancer, while also reducing the necessity to subsequently perform a rigid laryngopharyngoscopy under general anesthesia.
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Finkelstein, Samantha, und Evan A. Suma. „Astrojumper: Motivating Exercise with an Immersive Virtual Reality Exergame“. Presence: Teleoperators and Virtual Environments 20, Nr. 1 (01.02.2011): 78–92. http://dx.doi.org/10.1162/pres_a_00036.
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We present the design and evaluation of Astrojumper, an immersive virtual reality exergame developed to motivate players to engage in rigorous, full-body exercise. We performed a user study with 30 people between the ages of 6 and 50 who played the game for 15 min. Regardless of differences in age, gender, activity level, and video game experience, participants rated Astrojumper extremely positively and experienced a significant increase in heart rate after gameplay. Additionally, we found that participants' ratings of perceived workout intensity positively correlated with their level of motivation. Overall, our results demonstrate that Astrojumper effectively motivates both children and adults to exercise through immersive virtual reality technology and a simple, yet engaging, game design.
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Sugimura, Yukiharu, Philipp Rellecke, Petra Reinecke, Artur Lichtenberg und Payam Akhyari. „Video-assisted minimally invasive resection of papillary fibroelastoma“. Asian Cardiovascular and Thoracic Annals 28, Nr. 3 (21.01.2020): 179–81. http://dx.doi.org/10.1177/0218492320901962.
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Cardiac papillary fibroelastoma is a rare cause of embolic events, especially seen in young patients. A 38-year-old woman with a transient ischemic attack underwent cardiac diagnostic workup. Transesophageal echocardiography and magnetic resonance imaging identified a tumor on the anterior leaflet of the mitral valve as the only potential source of embolization. Video-assisted minimally invasive resection of the tumor and reconstruction of the mitral valve were performed. Postoperative transthoracic echocardiography showed no residual tumor or mitral valve insufficiency. Histology identified a papillary fibroelastoma. The patient was discharged on the 9th postoperative day in good physical condition and without any postoperative limitations.
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Tang, Raymond S. Y., D. Nageshwar Reddy, Anthony Y. B. Teoh, Kelvin L. Y. Lam und Robert H. Hawes. „In vivo diagnosis of clonorchiasis during cholangioscopy for workup of suspected cholangiocarcinoma (with video)“. Gastrointestinal Endoscopy 80, Nr. 2 (August 2014): 344–45. http://dx.doi.org/10.1016/j.gie.2014.02.1027.
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Velagapudi, Ravi Kanth, und John P. Egan. „Thoracic Endometriosis: a Clinical Review and Update of Current and Evolving Diagnostic and Therapeutic Techniques“. Current Pulmonology Reports 10, Nr. 1 (09.02.2021): 22–29. http://dx.doi.org/10.1007/s13665-021-00269-z.
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Abstract Purpose of Review The goal of this review is to provide a comprehensive understanding of the pathophysiology, clinical presentation, diagnostic workup, and clinical management of thoracic endometriosis (TE), as well as highlight our personal experience with TE workup and management. Recent Findings TE can present in a wide range of clinical manifestations. Without high clinical suspicion, diagnosis can be delayed. Since no specific laboratory testing is available, diagnosis is often based on careful history taking, imaging, and direct visualization of endometrial lesions through video-assisted thoracoscopic surgery (VATS). Medical thoracoscopy (MT) may also be a useful tool in the diagnostic workup of TE. Summary The diagnosis and management of TE require a multidisciplinary approach and a high index of clinical suspicion. While VATS remains the gold standard for diagnosis, we share our experience using MT to diagnose and manage a case of TE-related hemothorax.
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Kondylis, Efstathios, Alexander C. Whiting, Stephen P. Harasimchuk, Juan Bulacio und William Bingaman. „Robot-Assisted Stereoelectroencephalography: 2-Dimensional Operative Video“. Operative Neurosurgery 21, Nr. 4 (15.06.2021): E371—E372. http://dx.doi.org/10.1093/ons/opab207.
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Abstract Invasive neuromonitoring is an important component of presurgical workup and seizure onset zone localization in patients with epilepsy being considered for surgical resection. In the United States, intraparenchymal stereoelectroencephalography (SEEG) electrodes have been replacing subdural grid electrodes for most cases, following a trend that has already matured in Europe. The use of robotic assistance has been shown to improve operative times and accuracy in SEEG electrode placement, as users benefit from the embedded planning software as well as the efficiency and accuracy of the robotic arm. The greatest barriers to implementation of this technology are the upfront cost and learning curve. This case-based surgeon's perspective operative video could benefit those considering incorporating robotic assistance for SEEG electrode placement. Those considering robotic assistance for pedicle screw placement and other budding applications may also benefit, as well as innovators looking for new applications. The patient consented for the procedure, video recording, and inclusion in subsequent publications.
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Orrange, Sharon Elizabeth, Leslie A. Saxon, Ahmet Baydur und P. Michael McFadden. „Unexplained cough: pericardial cyst innocent bystander or culprit?“ Chest Disease Reports 1, Nr. 1 (21.03.2011): 1. http://dx.doi.org/10.4081/cdr.2011.e1.
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Pericardial cysts are rare mediastinal cysts and an uncommon cause of cough. Patients are often asymptomatic but can present with cough, dyspnea and atypical chest pain. We describe the case of a 30 year old female with a 3 month history of unexplained cough. Extensive workup and empiric treatment for the standard causes of cough were unsuccessful. More detailed workup including bronchoscopy, endoscopy, pulmonary function testing and otolaryngology evaluation was normal. Computed tomographic (CT) scan and Magnetic resonance imaging (MRI) of the chest revealed a 5.8 cm pericardial cyst in the left cardiophrenic angle. Video assisted thorascopic surgery (VATS) was performed for removal of the cyst and the cough resolved completely postoperatively.
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Heywood, Leslie. „The CrossFit Sensorium: Visuality, Affect and Immersive Sport“. Paragraph 38, Nr. 1 (März 2015): 20–36. http://dx.doi.org/10.3366/para.2015.0144.
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By contrast to the competitive and participatory models of sport, the immersive model (Heywood 2006, 2008) shows greater potentiality as a healthful practice more distant from transcendent, technocratic aspects of other models, instead accepting the body's immanence as part of evolutionary history and the natural world. Because of the largely unconscious, evolutionarily based responses to one's environment, the environment in which a sporting activity takes place has a tangible impact on performance. As our most evolutionarily recent sense system, visuality is linked to the Social Engagement System (Porges 2011). The mediated experience of sport through visual culture might catalyse the Social Engagement System and the perception that the sporting activity is communal and welcoming. Particularly the subculture surrounding the sport of CrossFit, which spread almost entirely through website presence and the posting of videos of workouts on the mainsite, might be said to exemplify how growth in new sports is augmented by visuality and the formation of virtual communities that then become embodied.
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Gomez-Paz, Santiago, Yosuke Akamatsu, Mohamed M. Salem, Justin M. Moore, Christopher S. Ogilvy und Ajith J. Thomas. „Direct Transverse Sinus Cannulation for Coil Embolization of a Transverse-Sigmoid Sinus Dural Arteriovenous Fistula: 2-Dimensional Operative Video“. Operative Neurosurgery 20, Nr. 4 (30.01.2021): E288—E289. http://dx.doi.org/10.1093/ons/opaa455.
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Abstract A 65-yr-old male presented 2 mo after an episode of acute-onset headache associated with altered mental status. Imaging workup with cerebral angiography revealed a Cognard type IV right-sided transverse-sigmoid junction dural arteriovenous fistula (dAVF). The patient was treated with endovascular embolization of several pedicles from the middle meningeal (MMA) and occipital arteries. Residual filling and cortical venous reflux were noted on follow-up imaging. Therefore, definitive treatment of the persistent fistula was offered with a combined open and endovascular embolization approach.1 This would provide direct access into the sinus followed by embolization of the fistula. In the accompanying video, we present the case in detail and provide a discussion of the rational and treatment nuances associated with this approach. Patient consent was given prior to the procedure and consent and approval for this operative video were waived due to the retrospective nature of this manuscript and the anonymized video material.
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Basori, Ahmad Hoirul, und Alaa Omran Almagrabi. „Towards Racing Gamification with Natural Interface for post stroke Rehabilitation“. Computer Engineering and Applications Journal 6, Nr. 1 (07.04.2017): 21–28. http://dx.doi.org/10.18495/comengapp.v6i1.196.
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Stroke patient basically suffer from limited movement, they cannot control their balance very well, therefore the therapy that involve repetitive motion, harmonization and stability workout should be applied to them. The invention of Kinect has lead people to applied this device as a tool for recovering patient from stroke because its capability on tracking the skeletal of human body. Racing Game is very popular among the adults, elderly and even kids, the rule it’s quite simple and understandable. The combination between the racing game and natural interface will lead to innovative application which is potential to be used as home therapy for post stroke patient. User will be required to move some parts of their body such as both hand, arm, head and even shoulder. The body tracking is provided by depth camera that can capture and interpret human body gesture recognition to be used as interaction command. The human skeleton will be displayed onto screen to control the car in the game and the result of racing will be synchronized with user excitement which is recorded through Kinect video.
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Loof de Amorim, Bruno, Ricardo Chmelnitsky Wainberg, Juan Alberto Paz-Archila, Silvio Sarmento Lessa, Gabriela Miroslava Bustamante Vargas, Leonardo Favi Bocca, José Maria de Campos Filho, Christiane Monteiro de Siqueira Campos, Marcos Devanir Silva da Costa und Feres Chaddad-Neto. „Combined treatment for a hemispheric cerebellar AVM“. Neurosurgical Focus: Video 4, Nr. 1 (Januar 2021): V14. http://dx.doi.org/10.3171/2020.10.focvid2069.
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Posterior fossa arteriovenous malformations (AVMs) can be a challenging disease, especially those large in size. AVMs can be treated with a combination of endovascular treatment and microsurgery. Here, the authors present the case of a 16-year-old female patient with progressive dizziness and episodic syncope. The workup of the patient showed a hemispheric cerebellar AVM, Spetzler-Martin grade IV. She underwent combined treatment (endovascular and microsurgery) with no complications and cure of the malformation.The video can be found here: https://youtu.be/rNw_Kyd76Mg
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Zenonos, Georgios, Eric Wang und Juan Fernandez-Miranda. „Endoscopic Endonasal Transoculomotor Triangle Approach for the Resection of a Pituitary Adenoma with Ambient Cistern Extension“. Journal of Neurological Surgery Part B: Skull Base 79, S 03 (14.02.2018): S283. http://dx.doi.org/10.1055/s-0038-1625942.
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Objectives The current video presents the nuances of the endoscopic endonasal transoculomotor triangle approach for the resection of a pituitary adenoma with extension into the ambient cistern. Design The video analyzes the presentation, preoperative workup and imaging, surgical steps and technical nuances of the surgery, the clinical outcome, and follow-up imaging. Setting The patient was treated by a skull base team consisting of a neurosurgeon and an ENT surgeon at a teaching academic institution. Participants The case refers to a 62-year-old female who presented with vision loss and headaches, and was found to have a pituitary adenoma with extension into the ambient cistern. Main Outcome Measures The main outcome measures consist of the reversal of the patient symptoms (headaches), the recurrence-free survival based on imaging, as well as the absence of any complications. Results The patient's headaches improved. There was no evidence of recurrence. Conclusions The endoscopic endonasal transoculomotor triangle approach is safe and effective for addressing pituitary tumors which extend into the ambient cistern.The link to the video can be found at: https://youtu.be/EBLwEWhohxY.
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Zenonos, Georgios, Carl Snyderman und Paul Gardner. „Endoscopic Endonasal Approach for a Suprasellar Craniopharyngioma“. Journal of Neurological Surgery Part B: Skull Base 79, S 03 (25.01.2018): S241—S242. http://dx.doi.org/10.1055/s-0038-1623522.
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Objectives The current video presents the nuances of an endoscopic endonasal approach to a suprasellar craniopharyngioma. Design The video analyzes the presentation, preoperative workup and imaging, surgical steps and technical nuances of the surgery, the clinical outcome, and follow-up imaging. Setting The patient was treated by a skull base team consisting of a neurosurgeon and an ENT surgeon, at a teaching academic institution. Participants The case refers to a 67-year-old man who presented with vision loss and headaches, and was found to have a suprasellar mass, with imaging characteristics consistent with a craniopharyngioma. Main Outcome Measures The main outcome measures consistent of the reversal of the patient symptoms (vision loss and headaches), the recurrence-free survival based on imaging, as well as the absence of any complications. Results The patient's vision improved after the surgery; at his last follow-up there was no evidence of recurrence on imaging. Conclusions The endoscopic endonasal approach is safe and effective in treating suprasellar craniopharyngiomas.The link to the video can be found at: https://youtu.be/p1VXbwnAWCo.
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Zenonos, Georgios, und Paul Gardner. „Interhemispheric, Translamina Terminalis Approach for the Resection of Suprasellar Cavernous Malformation“. Journal of Neurological Surgery Part B: Skull Base 79, S 03 (07.03.2018): S278. http://dx.doi.org/10.1055/s-0038-1624588.
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Objectives The current video presents the nuances of an interhemispheric, translamina terminalis approach for the resection of suprasellar cavernous malformation. Design The video analyzes the presentation, preoperative workup and imaging, surgical steps and technical nuances of the surgery, the clinical outcome, and follow-up imaging. Setting The patient was treated by a skull base team at a teaching academic institution. Participants The case refers to a 64-year-old female who presented with vision loss and confusion, and was found to have a suprasellar mass, with imaging characteristics consistent with a cavernous malformation of the third ventricle. Main Outcome Measures The main outcome measures consist of the reversal of the patient symptoms (vision loss and confusion), the recurrence-free survival based on imaging, as well as the absence of any complications. Results The patient's mental status improved slightly after surgery. There was no evidence of recurrence. Conclusions The interhemispheric, translamina terminalis approach is safe and effective for the resection of suprasellar cavernous malformations.The link to the video can be found at: https://youtu.be/z6RSAM_GnBA.
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Walterfang, Mark, Raju Yerra, Francesco Gaillard, Terence O’Brien, Ramon Mocellin und Dennis Velakoulis. „Complex visual hallucinations and occipital seizures“. Acta Neuropsychiatrica 19, Nr. 6 (Dezember 2007): 376–79. http://dx.doi.org/10.1111/j.1601-5215.2007.00238.x.
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Background:We describe the presentation of a young woman with long-standing complex partial seizures with occasional secondary generalization, who presented with complex visual hallucinations (CVHs) and delusions.Methods:Routine biological workup including magnetic resonance imaging revealed an area of significant left-sided occipital gliosis. Video telemetry monitoring revealed a left occipital focus for the origin of the electrographic seizure discharge.Conclusion:CVHs occur in a range of organic states, including epilepsy, and can be understood in terms of the underpinning neuroanatomy and neurotransmitter systems of the visual system.
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Schwab, Charles V., und Isaac J. Rempe. „Likelihood of Entanglement when Materials are Dropped Vertically onto a Rotating PTO Knuckle“. Journal of Agricultural Safety and Health 23, Nr. 4 (2017): 281–95. http://dx.doi.org/10.13031/jash.12562.
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Abstract. Power take-off (PTO) is a common method of transferring power from a tractor to a towed piece of machinery. The PTO is also a well-documented cause of severe and often permanent disabling injuries to farm operators. The physical conditions that cause entanglements are not well established. Several studies have explored the parameters of PTO entanglements as materials have been drawn across a rotating PTO knuckle to test for entanglement probability. The objective of this study was to determine probability of entanglement when materials are dropped vertically onto a PTO knuckle spinning at 540 rpm. A total of 360 randomized trials were conducted with ten replications for each of the six positions (center of yoke, edge of yoke rotating downward, edge of yoke rotating upward, center of cross, edge of cross rotating downward, and edge of cross rotating upward) and six different materials (woven cotton athletic shoe lace, cotton workboot lace, leather workboot lace, cotton twine, denim strip, and Tyvek strip). Not a single entanglement was recorded. Dramatic high-speed video imagery authenticated the material’s motion and path as it interacted with the rotating PTO knuckle. Keywords: Accident prevention, Farm safety, Probability, PTO, Safety.
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Pasanisi, Giovanni, Biagio Sassone, Jonathan Myers, Giorgio Chiaranda, Andrea Raisi, Rosario Lordi, Simona Mandini, Gianni Mazzoni und Giovanni Grazzi. „Modello di riabilitazione cardiologica teleguidata durante pandemia da COVID-19“. Cardiologia Ambulatoriale 28, Nr. 4 (Dezember 2020): 271–75. http://dx.doi.org/10.17473/1971-6818-2020-4-6.
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Background. The COVID-19 pandemic has induced many governments to promote national lockdowns. Despite a period of quarantine is the best option and recommendation to stop the rapid spread of infections, this may have collateral effects on other dimensions of the isolated patients’ physical and mental health. Physical activity is the major component of cardiac rehabilitation programs that have been abruptly discontinued. Aims. To counteract physical inactivity during the COVID-19 outbreak we propose an home cardiac rehabilitation program under telemonitoring guidance, the home-bAsed physiCal acTivity Intervention during cOvid-19 quaraNtine (ACTION) study, testing its feasibility. Methods and results. ACTION is an observational study in cardiac outpatients referred to an exercise-based cardiac rehabilita-tion program. A program consisting of aerobic recommendations combined with a selection of strength and balance exercises is recommended. Video tutorials providing details of the workouts will be sent to patients. Selected patients can be followed during the home-sessions via video connection using current smartphone applications. Conclusions. The ACTION study could provide applicable results for safe and effective exercise therapy in outpatients with car-diovascular disease, while preventing the COVID-19 outbreak from generating adverse health consequences due to acute cessa-tion of physical activity. Findings from the ACTION study can also be useful after the end of COVID-19 outbreak for patients who cannot participate in traditional center- or home-based cardiac rehabilitation programs.
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Sobko, I. N. „The preparation for the year main competition teams in basketball with hearing impairments with innovative technologies“. Physical education of students 18, Nr. 5 (28.10.2014): 30–37. http://dx.doi.org/10.15561/20755279.2014.0506.
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Purpose : develop and prove experimentally comprehensive training program on the Ukrainian national team basketball with hearing impairment in the annual cycle for the major competitions. Material : The study involved 12 basketball hearing impaired 20-25 years old - female players team of Ukraine on basketball. Also analyzed the test results and competitive activity 12 basketball players with hearing impairments - Lithuanian team players. Results : We showed the need for a qualitative change in the training process through the development and application of innovative technologies. This allows a greater level of communication between the coach and athletes to intensify training process. Developed and experimentally substantiated comprehensive training program for the Ukrainian national team. In technical training device used light. This increased mobility, agility, activity and intensity workouts. In tactical training improved situational and planned change tactical drawing game using copyright protection of video tutorials with animated illustrations. Conclusions : A positive impact of the developed system for basketball training result in major competitions.
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Gomez-Paz, Santiago, Yosuke Akamatsu, Mohamed M. Salem, Justin M. Moore, Ajith J. Thomas und Christopher S. Ogilvy. „Transvenous Coil Embolization of a Transverse-Sigmoid Sinus Dural Arteriovenous Fistula: 2-Dimensional Operative Video“. Operative Neurosurgery 20, Nr. 4 (30.01.2021): E290—E291. http://dx.doi.org/10.1093/ons/opaa454.
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Abstract This case is a 66-yr-old woman with a 2-mo history of left-sided tinnitus. Workup with magnetic resonance angiography showed early opacification of the left sigmoid sinus and internal jugular vein as well as asymmetric and abundant opacification of the left external carotid artery branches, suspicious for a dural arteriovenous fistula (dAVF). Diagnosis was confirmed with cerebral angiography, consistent with a left-sided Cognard type I dAVF.1 Initial treatment attempt was made with transarterial 6% ethylene-vinyl alcohol copolymer (Onyx 18) embolization of feeders from the occipital and middle meningeal arteries. However, embolization was not curative and there was a recurrence of a highly bothersome tinnitus 3 wk following treatment. Angiography redemonstrated the transverse sinus dAVF with new recruitment arising from several feeders, including the left external carotid artery, middle meningeal artery, and superficial temporal artery, now Cognard type IIa. Definitive treatment through a transvenous coil embolization provided permanent obliteration of the fistula without recrudescence of symptoms on follow-up. In this video, the authors discuss the nuances of treating a dAVF via a transvenous embolization. Patient consent was given prior to the procedure, and consent and approval for this operative video were waived because of the retrospective nature of this manuscript and the anonymized video material.
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Rahme, Rudy J., Karl R. Abi-Aad, Ahmad Kareem Almekkawi, Devi P. Patra und Bernard R. Bendok. „Endovascular Embolization of a Lateral Sacral Fistula: 2-Dimensional Operative Video“. Operative Neurosurgery 19, Nr. 3 (14.03.2020): E313. http://dx.doi.org/10.1093/ons/opaa020.
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Abstract Spinal dural arteriovenous fistulas are the most common vascular malformations of the spine. They are localized in the sacral spine in 5% to 14% of the cases. They can be fed by the median or the lateral sacral arteries. These lesions present with nonspecific symptoms such as radiculopathy and/or myelopathy, which often leads to a delay in diagnosis. In this video, we present the case of a 65-yr-old gentleman with a lateral sacral dural arteriovenous fistula. The patient was referred to our institution after the outside facility workup was nondiagnostic. He presented with spastic paraparesis and bilateral radiculopathy. After patient informed consent was obtained, we performed a spinal diagnostic angiogram with catheterization and angiography of the internal iliac artery, which revealed the fistula. Onyx (Medtronic, Dublin, Ireland) embolization was performed, which led to a complete occlusion of the fistula. The patient had complete neurological recovery, and at 2-yr follow-up, imaging remained negative for a fistula. In this video, we discuss the nuances and key points related to the epidemiology, diagnosis, and treatment of lateral sacral fistulas.1-3
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Sattur, Mithun G., Karl R. Abi-Aad, Fucheng Tian, Matthew E. Welz, Barrett Anderies und Bernard R. Bendok. „Treatment Strategy of a Patient With a Brain Arteriovenous Malformation and Cranial Dural Fistula: 2-Dimensional Operative Video“. Operative Neurosurgery 16, Nr. 5 (06.09.2018): 636. http://dx.doi.org/10.1093/ons/opy208.
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Abstract We present the case of a 56-yr-old right-handed male, after informed consent was obtained, who presented with acute confusion and agitation, on the background of a remote history of an uncomplicated resection of a left parietal grade 2 glioma. Imaging revealed a large, acute right temporal intracerebral hemorrhage (ICH). Standard vascular workup for the cause of the ICH included catheter angiography. No direct cause of the hemorrhage was revealed; however, a high grade parasagittal dural arteriovenous fistula (DAVF) with cortical venous reflux was noted close to the prior craniotomy site. The venous reflux was towards the left hemisphere, but it was hypothesized that similar reflux on the right side may have been present and was not presently evident due to thrombosis. The DAVF was embolized by endovascular means, followed by evacuation of the hematoma. Follow-up angiogram 7 mo later revealed a high-flow, right superior temporal cortical arteriovenous malformation (AVM). The DAVF unfortunately had also progressed. Endovascular occlusion of both lesions was attempted but was not successful. Subsequently, microsurgical resection for both the vascular malformations was performed with careful pre- and intraoperative planning to obtain a successful clinical and angiographic result. In this video, we summarize diagnostic and therapeutic nuances that have broad implications for the workup of ICH and the strategic management of a unique scenario involving a brain AVM and high-grade cranial dural fistula in the same patient. Prior to each procedure, informed consent was obtained from the patient, which includes consent for publication.
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Hendricks, Benjamin K., und Robert F. Spetzler. „Microsurgical Clipping of an Unruptured Basilar Apex Aneurysm: 2-Dimensional Operative Video“. Operative Neurosurgery 19, Nr. 4 (18.05.2020): E391—E392. http://dx.doi.org/10.1093/ons/opaa135.
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Abstract Aneurysms of the basilar artery apex are generally at an increased risk of rupture compared with aneurysms in other locations, and the risk of rupture increases with increasing aneurysm size. Therefore, these lesions necessitate treatment to decrease the risk of rupture. The location, size, and directionality of dome projection influence the difficulty of microsurgical treatment. The patient presented with an incidental basilar apex aneurysm identified on workup for headaches. The aneurysm projected superoposteriorly into the interpeduncular cistern. The surgical approach involved a wide exposure of the basilar apex complex and meticulous identification and preservation of P1 perforators during clip applications. It was imperative to visualize all perforators on both sides of the clip prior to application, given the severe morbidity associated with a perforator infarct. The patient tolerated the procedure well and remained neurologically intact after the operation. This video is an exemplary demonstration of basilar apex aneurysm clip application for an incidentally discovered aneurysm. The patient gave informed consent for surgery and video recording. Institutional review board approval was deemed unnecessary. Used with permission from Barrow Neurological Institute, Phoenix, Arizona.
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Ceccato, Guilherme H. W., Rodolfo F. M. da Rocha, Duarte N. C. Cândido, Wladimir O. Melo, Marcio S. Rassi und Luis A. B. Borba. „Microsurgical resection of foramen magnum meningioma through a transcondylar approach: three-dimensional operative video“. Neurosurgical Focus: Video 1, Nr. 2 (Oktober 2019): V3. http://dx.doi.org/10.3171/2019.10.focusvid.19465.
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Foramen magnum (FM) meningiomas are challenging lesions. We present the case of a 38-year-old female with neck pain, dysphonia, and slight twelfth nerve palsy. Imaging workup was highly suggestive of an FM meningioma, and microsurgical resection with the aid of intraoperative neurophysiological monitoring was indicated. A transcondylar approach was employed, the vertebral artery was mobilized, and the tumor was completely removed. Postoperative MRI demonstrated complete resection. There were no signs of cervical instability. The patient presented with improvement of her symptoms and no new neurological deficit on follow-up. FM meningiomas can be successfully resected using a transcondylar approach, since it increases the exposure of the ventral FM, allowing the surgeon to work parallel to the skull base and flush with the tumor’s attachment. Informed consent was obtained from the patient for publication of this operative video.The video can be found here: https://youtu.be/itfUOB-6zM0.
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Duaa, BM, A. Ye, S. Doesburg, H. Otsubo und A. Ochi. „A multi-modality approach to identifying primary generalized epilepsy that can mimic focal epilepsy“. Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 42, S1 (Mai 2015): S22. http://dx.doi.org/10.1017/cjn.2015.114.
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Introduction: Evaluating the suitability for surgery in patients with epilepsy requires determining if the epilepsy is focal or generalized. Presurgical workups can indicate focal epilepsy in certain cases of generalized epilepsy (GE). The purpose of this study was to identify distinctive features which characterize patients with primary GE that mimics focal epilepsy. Method: We retrospectively identified 19 children with generalized interictal discharges during scalp video-EEG (SVEEG) and underwent invasive monitoring and/or epilepsy surgery. Two children did not undergo resective surgery due to final diagnosis of primary GE (Group A). Seventeen children underwent a resective surgery (Group B). Scalp video-EEG, MEG, MRI, and intracranial video EEG (IVEEG) were reviewed. Results: On (SVEEG), the frequency of generalized spike-and-waves (GSW) was 3Hz in Group A and 1.5-2.5Hz in Group B. Group A had only absence seizures , whereas 80% in Group B had multiple types of seizures. Both groups had lateralized MEG dipoles. One patient in Group A had a focal MRI abnormality. In Group A, IVEEG showed GSW of 3 Hz frequency with inconsistent leading. In Group B, IVEEG showed consistent localization of ictal and interictal high frequency oscillations. Conclusion: Children with generalized 3 Hz spike-and-waves and only absence seizures may be a contraindication of resective surgery even though some presurgical workup shows focality.
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Zenonos, Georgios, Eric Wang und Juan Fernandez-Miranda. „Infrasellar Endoscopic Endonasal Approach for a Pituitary Adenoma Extending into the Third Ventricle, with Anterior Displacement of the Pituitary Gland“. Journal of Neurological Surgery Part B: Skull Base 79, S 02 (16.01.2018): S233—S234. http://dx.doi.org/10.1055/s-0037-1620261.
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Objectives The current video presents the nuances of the infrasellar endoscopic endonasal approach for a pituitary adenoma extending into the third ventricle, with anterior displacement of the pituitary gland. Design The video analyzes the presentation, preoperative workup and imaging, surgical steps and technical nuances of the surgery, the clinical outcome, and follow-up imaging. Setting The patient was treated by a skull base team consisting of a neurosurgeon and an ENT surgeon at a teaching academic institution. Participants The case refers to 73-year-old female patient who was found to have a sellar mass after failure of vision to improve with cataract surgery. She also reported a several-month history of progressive loss of vision along with daily retro-orbital headaches. The adenoma extended into the clivus as well as in the retrosellar and suprasellar regions, eroding into the floor of the third ventricle. The normal gland was displaced anteriorly. Main Outcome Measures The main outcome measures consisted of reversal of patient symptoms (headaches and visual disturbance), recurrence-free survival based on imaging, as well as absence of any complications. Results The patient's headaches and visual fields improved. There was no evidence of recurrence. Conclusion The infrasellar endoscopic endonasal approach is safe and effective for pituitary adenomas extending into the third ventricle, with anterior displacement of the pituitary gland.The link to the video can be found at: https://youtu.be/zp_06mEyRvY.
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Shah, Ashish H., Anthony C. Wang und Jacques J. Morcos. „Lateral parietal arteriovenous malformation with feeding artery aneurysm“. Neurosurgical Focus 43, videosuppl1 (Juli 2017): V8. http://dx.doi.org/10.3171/2017.7.focusvid.17108.
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Superficial arteriovenous malformations (AVMs) with favorable Spetzler-Martin grading are amenable to primary surgical resection. Careful preoperative workup including preoperative angiograms is essential to identify feeding artery aneurysms and deep venous drainage. The authors present a 37-year-old female who presented with a Spetzler-Martin Grade II right parietal superficial AVM with a 5-mm feeding artery aneurysm from the posterior cerebral artery. Given the risk of hemorrhage, the AVM was resected completely without any complications. On subsequent postoperative angiograms, the feeding artery aneurysm diminished in caliber. Feeding artery aneurysms may regress spontaneously after resection of an AVM due to flow-related changes.The video can be found here: https://youtu.be/PpwODc9iI3g.
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Wagner, Kathryn M., Visish M. Srinivasan und Peter Kan. „Techniques of Onyx Embolization of Arteriovenous Malformation: 2-Dimensional Operative Video“. Operative Neurosurgery 20, Nr. 6 (24.03.2021): E430. http://dx.doi.org/10.1093/ons/opab061.
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Abstract Advances in endovascular techniques and tools have allowed for treatment of complex arteriovenous malformations (AVMs), which historically may have posed unacceptable risk for open surgical resection. Endovascular treatment may be employed as an adjunct to surgical resection or as definitive therapy. Improvements in embolization materials have made endovascular AVM treatment safer for patients and useful across a variety of lesions. While many techniques are employed for transarterial AVM embolization, the essential tenets apply to all procedures: (1) great care should be taken to cannulate only vessels directly supplying the lesion, and not en passage vessels, prior to injecting embolisate; (2) embolisate should travel into the nidus, but not into the draining veins; (3) embolistate reflux proximal to the microcatheter should be avoided. There are several techniques that accomplish these goals, including the plug and push method, or using a balloon to prevent embolisate reflux. We use controlled injection of liquid Onyx (Medtronic), with increasing pressure over multiple injections pushing the embolisate forward into the AVM. This is repeated in multiple feeding vessels to decrease or eliminate supply to the AVM. Here, we present a 36-yr-old female with a right parietal AVM discovered on workup of headaches. After informed consent was obtained, she underwent preoperative embolization using this technique prior to uncomplicated surgical resection. The video shows the endovascular Onyx embolization of multiple feeding vessels over staged treatment.
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Huffman, Lynn C., Michael F. Reed und John A. Howington. „Video-Assisted Thoracoscopic Splanchnicectomy for Pain Control in Chronic Pancreatitis“. Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 1, Nr. 4 (Juni 2006): 171–74. http://dx.doi.org/10.1097/01.imi.0000220917.68537.2f.
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Background Management of pain in patients with chronic pancreatitis can be frustrating. The authors retrospectively evaluated their experience with video-assisted thoracoscopic surgery (VATS) for pain secondary to chronic pancreatitis. Methods From September 1999 to August 2004, 16 patients underwent VATS for pain associated with chronic pancreatitis. Data were collected retrospectively. Results Eight patients were female and 8 were male. Their ages ranged from 17 to 81 years, with a mean age of 40 years. There were 22 VATS splanchnicectomies performed: 7 right, 10 left, and 5 bilateral. The average operative time was 75 minutes for right VATS splanchnicectomy, 86 minutes for left VATS splanchnicectomy, and 88 minutes for bilateral VATS splanchnicectomies. The average length of stay (LOS) was 2.6 days after right VATS splanchnicectomy, 2.2 days after left VATS splanchnicectomy, and 1 day after bilateral VATS splanchnicectomies. Two cases were nonelective and not included in the determination of LOS. No postoperative complications occurred in any of the patients admitted for elective operations. Postoperative mortality was zero. Complete resolution of pain occurred in 4 patients (25%): 1 right splanchnicectomy, 1 left splanchnicectomy, and 2 bilateral splanchnicectomies. Total pancreatectomy with islet cell transplant was subsequently performed in 5 patients (31%), who improved but then had recurrent pain. Continued chronic pain managed with nonsteroidal antiinflammatory drugs and narcotic analgesics was the result in 7 patients (44%) Conclusions Video-assisted thoracoscopic splanchnicectomy surgery may alleviate pain in patients with chronic pancreatitis. It can be performed with minimal morbidity and mortality, and has been safe and useful in the workup, evaluation, and management of pain associated with chronic pancreatitis.
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Mahboob, Hafiz B., Kazi H. Kaokaf und Jeremy M. Gonda. „Creutzfeldt-Jakob Disease Presenting as Expressive Aphasia and Nonconvulsive Status Epilepticus“. Case Reports in Critical Care 2018 (2018): 1–9. http://dx.doi.org/10.1155/2018/5053175.
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Creutzfeldt-Jakob disease (CJD), the most common form of human prion diseases, is a fatal condition with a mortality rate reaching 85% within one year of clinical presentation. CJD is characterized by rapidly progressive neurological deterioration in combination with typical electroencephalography (EEG) and magnetic resonance imaging (MRI) findings and positive cerebrospinal spinal fluid (CSF) analysis for 14-3-3 proteins. Unfortunately, CJD can have atypical clinical and radiological presentation in approximately 10% of cases, thus making the diagnosis often challenging. We report a rare clinical presentation of sporadic CJD (sCJD) with combination of both expressive aphasia and nonconvulsive status epilepticus. This patient presented with slurred speech, confusion, myoclonus, headaches, and vertigo and succumbed to his disease within ten weeks of initial onset of his symptoms. He had a normal initial diagnostic workup, but subsequent workup initiated due to persistent clinical deterioration revealed CJD with typical MRI, EEG, and CSF findings. Other causes of rapidly progressive dementia and encephalopathy were ruled out. Though a rare condition, we recommend consideration of CJD on patients with expressive aphasia, progressive unexplained neurocognitive decline, and refractory epileptiform activity seen on EEG. Frequent reimaging (MRI, video EEGs) and CSF examination might help diagnose this fatal condition earlier.
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Steinberger, Jeremy, Dominic Nistal, Leslie Schlachter, Anthony Costa, Holly Oemke und Joshua B. Bederson. „A Virtual-Reality, 360-Degree Fly-Through of an Arteriovenous Malformation Resection: 2-Dimensional Operative Video“. Operative Neurosurgery 18, Nr. 1 (15.04.2019): E11. http://dx.doi.org/10.1093/ons/opz062.
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Abstract The application of navigation integrated virtual reality (VR) in neurosurgery is an emerging paradigm that may offer improved situational awareness for the surgeon. Here, we present a case of a complex arteriovenous malformation (AVM) with complex venous drainage and observe how VR impacted structural delineation during approach, resection, and overall strategic planning. The patient was a 30-yr-old female with no past medical history who presented with headaches and a generalized tonic clonic seizure. Workup included computed tomography, computed tomography angiography, magnetic resonance imaging, magnetic resonance angiography, and magnetic resonance venography; a high flow right frontal AVM was found. The AVM was safely resected using navigation integrated with VR; careful arterial devascularization preceded resection of the draining veins and then the AVM nidus. Postoperative scans confirmed complete resection of the AVM. This case outlines the application of a current state-of-the-art VR platform to assist the craniotomy for resection of an AVM.
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Mangussi-Gomes, João, Eduardo Vellutini, Huy Truong, Felix Pahl und Aldo Stamm. „Endoscopic Endonasal Transplanum Transtuberculum Approach for the Resection of a Large Suprasellar Craniopharyngioma“. Journal of Neurological Surgery Part B: Skull Base 79, S 03 (28.02.2018): S249—S250. http://dx.doi.org/10.1055/s-0038-1625940.
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Objectives To demonstrate an endoscopic endonasal transplanum transtuberculum approach for the resection of a large suprasellar craniopharyngioma. Design Single-case-based operative video. Setting Tertiary center with dedicated skull base team. Participants A 72-year-old male patient diagnosed with a suprasellar craniopharyngioma. Main Outcomes Measured Surgical resection of the tumor and preservation of the normal surrounding neurovascular structures. Results A 72-year-old male patient presented with a 1-year history of progressive bitemporal visual loss. He also referred symptoms suggestive of hypogonadism. Neurological examination was unremarkable and endocrine workup demonstrated mildly elevated prolactin levels. Magnetic resonance images demonstrated a large solid-cystic suprasellar lesion, consistent with the diagnosis of craniopharyngioma. The lesion was retrochiasmatic, compressed the optic chiasm, and extended into the interpeduncular cistern (Fig. 1). Because of that, the patient underwent an endoscopic endonasal transplanum transtuberculum approach.1 2 3 The nasal stage consisted of a transnasal transseptal approach, with complete preservation of the patient's left nasal cavity.4 The cystic component of the tumor was decompressed and its solid part was resected. It was possible to preserve the surrounding normal neurovascular structures (Fig. 2). Skull base reconstruction was performed with a dural substitute, a fascia lata graft, and a right nasoseptal flap (Video 1). The patient did well after surgery and referred complete visual improvement. However, he also presented pan-hypopituitarism on long-term follow-up. Conclusions The endoscopic endonasal route is a good alternative for the resection of suprasellar lesions. It permits tumor resection and preservation of the surrounding neurovascular structures while avoiding external incisions and brain retraction.The link to the video can be found at: https://youtu.be/zmgxQe8w-JQ.
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Essayed, Walid I. B. N., Emad Aboud und Ossama Al-Mefty. „Pineal Region Hemangioblastoma Resection Through Paramedian Supracerebellar Approach: 2-Dimensional Operative Video“. Operative Neurosurgery 21, Nr. 1 (30.04.2021): E34—E35. http://dx.doi.org/10.1093/ons/opab104.
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Abstract Pineal region tumors remain challenging lesions to safely resect because of their central location.1 Patients frequently present with symptoms associated with hydrocephalus and brainstem compression.2 Local anatomy, primarily the tentorium angle and venous anatomy, plays a central role in the selection of the approach.3 The paramedian supracerebellar approach pioneered by Yaşargil in 19844 allows to access the pineal region through a less steep angle while avoiding the central thickened arachnoid and midline cerebellar and vermian veins.3 Although the author strongly prefers the advantageous three-quarter concord position, this early case was performed in a sitting position, which requires a bubble test to rule out the presence of a persistent foramen ovale. The preoperative pineal differential diagnosis should be exhaustive, including blood and cerebrospinal fluid (CSF) tumor markers in suitable cases. Hemangioblastomas are seldom found or expected in the pineal area, and the surgeon must be alarmed by their typical “cherry nodule” appearance.2,5 Their recognition prior to resection is paramount in avoiding excessive blood loss from tumor entry. Similar to arteriovenous malformations, hemangioblastoma surgical tenets include en bloc resection and preservation of the main draining veins until the last steps of the resection. Von Hippel-Lindau (VHL) syndrome genetic workup is necessary is similar patients, as more than 25% of hemangioblastomas are associated with VHL tumor suppressor gene mutations in chromosome 3.2 The patient consented to the surgery and use of her photography. Image at 2:41 from Ueyama et al, Bridging veins on the tentorial surface of the cerebellum: a microsurgical anatomic study and operative considerations, Neurosurgery, 1998, 43(5),3 used with permission from the Congress of Neurological Surgeons.
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Ogudo, Kingsley A., Dahj Muwawa Jean Nestor, Osamah Ibrahim Khalaf und Hamed Daei Kasmaei. „A Device Performance and Data Analytics Concept for Smartphones’ IoT Services and Machine-Type Communication in Cellular Networks“. Symmetry 11, Nr. 4 (24.04.2019): 593. http://dx.doi.org/10.3390/sym11040593.
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With the advancement of new technologies, the number of connected devices, the amount of data generated, and the need to build an intelligently connected network of things to improve and enrich the human ecosystem open new doors to modifications and adaptations of current cellular network infrastructures. While more focus is given to low power wide area (LPWA) applications and devices, a significant challenge is the definition of Internet of Things (IoT) use cases and the value generation of applications on already existing IoT devices. Smartphones and related devices are currently manufactured with a wide range of smart sensors such as accelerometers, video sensors, compasses, gyros, proximity sensors, fingerprint sensors, temperature sensors, and biometric sensors used for various purposes. Many of these sensors can be automatically expanded to monitor a user’s daily activities (e.g., fitness workouts), locations, movements, and real-time body temperatures. Mobile network operators (MNOs) play a substantial role in providing IoT communications platforms, as they manage traffic flow in the network. In this paper, we discuss the global concept of IoT and machine-type communication (MTC), and we conduct device performance analytics based on data traffic collected from a cellular network. The experiment equips service providers with a model and framework to monitor device performance in a network.
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Cerdán-de-las-Heras, Jose, Fernanda Balbino, Anders Løkke, Daniel Catalán-Matamoros, Ole Hilberg und Elisabeth Bendstrup. „Tele-Rehabilitation Program in Idiopathic Pulmonary Fibrosis—A Single-Center Randomized Trial“. International Journal of Environmental Research and Public Health 18, Nr. 19 (23.09.2021): 10016. http://dx.doi.org/10.3390/ijerph181910016.
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We investigated the usefulness and effectiveness of tele-rehabilitation on exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). A randomized study was carried out, including stable patients with IPF for 3 months of tele-rehabilitation: video and chat consultations with a physiotherapist and workout sessions with a virtual physiotherapist agent (VAPA). Moreover, 6-min walk test distance (6MWTD), forced vital capacity (FVC), diffusion capacity for carbon monoxide (DLCO), 7 days pedometry, Saint George Respiratory Questionnaire for interstitial lung disease, The King’s Brief Interstitial Lung Disease Questionnaire, and General Anxiety Disorder 7 Questionnaire were tested before and after 3 months of tele-rehabilitation, as well as after 3 and 6 months follow-up. Patient satisfaction and adherence were also measured for tele-rehabilitation with VAPA. Twenty-nine patients aged 70.9 ± 8.6 years, male 72.4%, FVC% 83.5 ± 17.7, DLCO% 50.6 ± 13.0, 6MWTD 468.4 ± 14.8 were included. Fifteen patients were randomized to tele-rehabilitation with VAPA and 14 to the control group. Differences in 6MWTD between groups were at baseline (+10 m (p = 0.11)) and after 3 (+39.5 m (p = 0.03)), 6 (+34.3 m (p = 0.02)), and 9 months (+40.5 m (p = 0.15)) follow-up. No difference was observed in pedometry and quality of life. Adherence was above 63%. Patient satisfaction was high. Tele-rehabilitation with VAPA appears to be useful in patients with IPF. Exercise capacity was better at follow up at 3 and 6 months compared with the control group. There was no change in quality of life or pedometry. Adherence and patient satisfaction were all high.
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Ali, Muhammad Sajawal, Vijaya Sivalingam Ramalingam, George Haasler und Kenneth Presberg. „Pleuroparenchymal fibroelastosis (PPFE) treated with lung transplantation and review of the literature“. BMJ Case Reports 12, Nr. 4 (April 2019): e229402. http://dx.doi.org/10.1136/bcr-2019-229402.
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A 26-year-old woman presented with a 15-year history of non-progressive dyspnoea. Chest imaging showed bilateral apical pleural and parenchymal scarring, pleural thickening and bronchiectasis. Pulmonary function tests showed a moderate restrictive defect. Non-invasive workup was non-revealing; therefore, the patient was referred for video-assisted thoracic surgery and lung biopsy. Histopathology revealed pleural thickening and, subpleural parenchymal fibrosis and elastic tissue deposition. Lung parenchyma further away from the pleura was well preserved. Based on these findings, the patient was diagnosed with pleuroparenchymal fibroelastosis (PPFE). Since PPFE is a progressive disorder without effective medical therapies, and given our patient’s worsening symptoms, she underwent bilateral lung transplantation. It has been almost 4 years since the lung transplantation, our patient continues to do well. To the best of our knowledge, to date, this is the longest follow-up reported for a PPFE patient undergoing lung transplantation.
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Housley, Steven B., Aaron Hoffman und Adnan H. Siddiqui. „Ventriculoperitoneal shunt placement with ultrasound guidance and laparoscopic assistance: 2-dimensional instructional video“. Surgical Neurology International 11 (25.04.2020): 82. http://dx.doi.org/10.25259/sni_8_2020.
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Background: Postoperative communicating hydrocephalus has been described in the literature commonly associated with treatment of ruptured intracranial aneurysms; however, it is also reported to occur following other intracranial interventions such as meningioma resection and decompressive hemicraniectomy. In 2011, Burkhardt et al. reported the incidence of postoperative hydrocephalus following skull base meningioma resection was twice as high as resection of meningiomas in other regions.[1] They found that age and increased length of surgery were associated with higher rates of postoperative hydrocephalus. Our patient, a 76-year-old man, initially presented with the left-hand paresthesias and numbness before the revelation of a large sphenoid planum meningioma on workup imaging. He underwent surgical resection due to developing cranial nerve deficits and personality changes in an extensive procedure that required approximately 8 h to complete. His postoperative course, given the factors above, included the development of hydrocephalus. Case Description: He was taken to the operating room for ventriculoperitoneal shunt placement, as displayed in this video case report, which highlights our surgical and sterile techniques, intraoperative ultrasound to ensure appropriate ventricular placement, and a single-port laparoscopic technique for direct visualization of placement of the abdominal catheter. After shunt placement, his course was complicated by a small tract hemorrhage, which resolved without further treatment. He was observed to have an improvement in mental function that occurred over the following 2–3 days before being discharged to an outpatient rehabilitation facility for continued care. Conclusion: Ventriculoperitoneal shunt placement is an effective and safe procedure for the treatment of postoperative communicating hydrocephalus when performed with appropriate techniques as displayed in the associated video case report. The patient gave informed consent for surgery and video recording. Institutional Review Board approval was deemed unnecessary.
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Tovar-Spinoza, Zulma S., Ayako Ochi, James T. Rutka, Cristina Go und Hiroshi Otsubo. „The role of magnetoencephalography in epilepsy surgery“. Neurosurgical Focus 25, Nr. 3 (September 2008): E16. http://dx.doi.org/10.3171/foc/2008/25/9/e16.
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Epilepsy surgery requires the precise localization of the epileptogenic zone and the anatomical localization of eloquent cortex so that these areas can be preserved during cortical resection. Magnetoencephalography (MEG) is a technique that maps interictal magnetic dipole sources onto MR imaging to produce a magnetic source image. Magneto-encephalographic spike sources can be used to localize the epileptogenic zone and be part of the workup of the patient for epilepsy surgery in conjunction with data derived from an analysis of seizure semiology, scalp video electroencephalography, PET, functional MR imaging, and neuropsychological testing. In addition, magnetoencephalographic spike sources can be linked to neuronavigation platforms for use in the neurosurgical field. Finally, paradigms have been developed so that MEG can be used to identify functional areas of the cerebral cortex including the somatosensory, motor, language, and visual evoked fields. The authors review the basic principles of MEG and the utility of MEG for presurgical planning as well as intra-operative mapping and discuss future applications of MEG technology.
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Özdemirci, Fahrettin, Özlem (Gökkurt) Bayram und Mehmet Altay Ünal. „ERM Implementation and Future Directions at Ankara University“. International Journal of Knowledge Society Research 4, Nr. 1 (Januar 2013): 1–11. http://dx.doi.org/10.4018/jksr.2013010101.
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In the study, the matter how the records management systems will adapt to this new process in a rapid way in a period, in which the transformations of public institutions into e-Government has been accelerated, is evaluated with a development that can be a sample especially for the universities. “Modelling of Transition Process of Electronic Records Management and Archiving System in Universities Project (e-BEYAS)” is a project carried out in Ankara University. Through the “e-Records Management and Archiving System (e-BEYAS), which gave its name to the software in which the model is applied, communication within the institution, information/records share inter institutions, and archiving of electronic records can be realized in a reliable medium; integration to the applications on sharing information/records inter institutions on e-Government channels can be provided. For this purpose, system usage scenarios have been created in order to produce, register, preserve, archive, access and report the records and documents safely in an appropriate model for institutional structure in Ankara University. Thus, after completing the workouts, the system will be not only mobile signature (m-signature) supported with its substructure providing the adaptation to mobile life, but also they can support the e-mail, SMS, integration, audio and video applications that can access the system through smart devices.
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Salfity, Hai, und Betty C. Tong. „VATS and Minimally Invasive Resection in Early-Stage NSCLC“. Seminars in Respiratory and Critical Care Medicine 41, Nr. 03 (25.05.2020): 335–45. http://dx.doi.org/10.1055/s-0039-3401991.
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AbstractLung carcinoma widely affects men and women in the sixth and seventh decades of life. Thorough workup with radiographic imaging, pathologic diagnosis, and cardiopulmonary functional assessment is key to successful treatment. Accurate staging is essential for both assessing prognosis and directing therapy. Early-stage lung cancer is most often treated with anatomic lobectomy; locally advanced cancers may require induction or adjuvant therapies. Any nonnodal metastases will require definitive systemic therapy. Traditionally, surgery was performed with a posterolateral thoracotomy incision, division of the hilar vessels, removal of affected lung parenchyma, and a complete mediastinal and hilar lymph node dissection for accurate pathologic staging. In recent years, however, video-assisted thoracoscopic (VATS) or other minimally invasive approaches have emerged as the standard of care for early-stage disease. Compared with standard thoracotomy, VATS lobectomy offers improved postoperative outcomes as well as potential survival benefit. Thoracoscopic lobectomy is also cost-effective. This article focuses on the technique, outcomes, adaptation, and evolution of thoracoscopic lobectomy and other minimally invasive techniques in the treatment of lung cancer.
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Mansouri, Alireza, Aria Fallah und Taufik A. Valiante. „Determining Surgical Candidacy in Temporal Lobe Epilepsy“. Epilepsy Research and Treatment 2012 (21.02.2012): 1–16. http://dx.doi.org/10.1155/2012/706917.
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Temporal lobe epilepsy (TLE) is the most common form of adult epilepsy that is amenable to surgical treatment. In the carefully selected patient, excellent seizure outcome can be achieved with minimal or no side effects from surgery. This may result in improved psychosocial functioning, achieving higher education, and maintaining or gaining employment. The objective of this paper is to discuss the surgical selection process of a patient with TLE. We define what constitutes a patient that has medically refractory TLE, describe the typical history and physical examination, and distinguish between mesial TLE and neocortical TLE. We then review the role of routine (ambulatory/sleep-deprived electroencephalography (EEG), video EEG, magnetic resonance imaging (MRI), neuropsychological testing, and Wada testing) and ancillary preoperative testing (positron emission tomography, single-photon emission computed tomography (SPECT), subtraction ictal SPECT correlated to MRI (SISCOM), magnetoencephalography, magnetic resonance spectroscopy, and functional MRI) in selecting surgical candidates. We describe the surgical options for resective epilepsy surgery in TLE and its commonly associated risks while highlighting some of the controversies. Lastly, we present teaching cases to illustrate the presurgical workup of patients with medically refractory TLE.
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Czihal, Michael, Christian Lottspeich, Anton Köhler, Ilaria Prearo, Ulrich Hoffmann, Siegfried G. Priglinger und Marc J. Mackert. „Transocular sonography in acute arterial occlusions of the eye in elderly patients: Diagnostic value of the spot sign“. PLOS ONE 16, Nr. 2 (12.02.2021): e0247072. http://dx.doi.org/10.1371/journal.pone.0247072.
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Purpose To characterize the diagnostic yield of the spot sign in the diagnostic workup of acute arterial occlusions of the eye in elderly patients. Methods Clinical characteristics of consecutive patients aged ≥ 50 years with acute central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO) or anterior ischemic optic neuropathy (AION) were recorded. Videos of transocular sonography were assessed for the presence of the spot sign by two blinded readers. Group comparisons were made between CRAO-patients with and without the spot sign. Two experienced cardiovascular physicians allocated CRAO-cases to a presumed aetiology, without and with knowledge on the presence/absence of the spot sign. Results One-hundred-twenty-three patients were included, 46 of whom suffered from CRAO. A spot sign was seen in 32 of 46 of patients with CRAO and in 7 of 23 patients with BRAO. Interobserver agreement was excellent (Cohen`s kappa 0.98). CRAO-patients with the spot sign significantly more frequently had a medical history of cardiovascular disease (62.8 vs. 21.4%, p = 0.03) and left heart valve pathologies (51.9 vs. 10%, p = 0.03). The spot sign was not found in any of the three patients with CRAO secondary to cranial giant cell arteritis. The assumed CRAO aetiology differed in 37% of cases between two cardiovascular physicians, regardless whether transocular sonography findings were known or not. Conclusion The spot sign is a simple sonographic finding with excellent interobserver agreement, which proofs the embolic nature of CRAO, but does not allow exact attribution of the underlying aetiology.
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Chen, Jasper J., Devendra S. Thakur, Krzysztof A. Bujarski, Barbara C. Jobst, Erik J. Kobylarz und Vijay M. Thadani. „Quality Improvement Opportunities in Caring for Patients with Nonepileptic Seizures“. Case Reports in Psychiatry 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/201575.
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Background. Patients with nonepileptic seizures (NES) are challenging to treat for myriad reasons. Often patients may be misdiagnosed with having epilepsy and then may suffer unintended consequences of treatment side effects with antiepileptic medication. In addition, patients may be maligned by health care providers due to a lack of ownership by both psychiatrists and neurologists and a dearth of dedicated professionals who are able to effectively treat and reduce severity and frequency of symptoms.Aims of Case Report. Many psychiatrists and neurologists are unaware of the extent of the barriers to care faced by patients with NES (PWNES) and the degree of perception of maltreatment or lack of therapeutic alliance at various stages of their care, including medical workup, video-EEG monitoring, and follow-up plans. We present the case of a patient with NES who experienced numerous barriers as well as incoordination to her care despite being offered a breadth of resources and discuss the quality improvement opportunities that may exist to improve care of patients with NES.Conclusion. No known literature has documented the extensive barriers to care of PWNES in parallel to quality improvement opportunities for improving their care. We endeavor to contribute to the overall formulation and development of a clinical care pathway for PWNES.
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Geertsema, Evelien E., Gerhard H. Visser, Demetrios N. Velis, Steven P. Claus, Maeike Zijlmans und Stiliyan N. Kalitzin. „Automated Seizure Onset Zone Approximation Based on Nonharmonic High-Frequency Oscillations in Human Interictal Intracranial EEGs“. International Journal of Neural Systems 25, Nr. 05 (17.06.2015): 1550015. http://dx.doi.org/10.1142/s012906571550015x.
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A novel automated algorithm is proposed to approximate the seizure onset zone (SOZ), while providing reproducible output. The SOZ, a surrogate marker for the epileptogenic zone (EZ), was approximated from intracranial electroencephalograms (iEEG) of nine people with temporal lobe epilepsy (TLE), using three methods: (1) Total ripple length (TRL): Manually segmented high-frequency oscillations, (2) Rippleness (R): Area under the curve (AUC) of the autocorrelation functions envelope, and (3) Autoregressive model residual variation (ARR, novel algorithm): Time-variation of residuals from autoregressive models of iEEG windows. TRL, R, and ARR results were compared in terms of separability, using Kolmogorov–Smirnov tests, and performance, using receiver operating characteristic (ROC) curves, to the gold standard for SOZ delineation: visual observation of ictal video-iEEGs. TRL, R, and ARR can distinguish signals from iEEG channels located within the SOZ from those outside it (p < 0.01). The ROC AUC was 0.82 for ARR, while it was 0.79 for TRL, and 0.64 for R. ARR outperforms TRL and R, and may be applied to identify channels in the SOZ automatically in interictal iEEGs of people with TLE. ARR, interpreted as evidence for nonharmonicity of high-frequency EEG components, could provide a new way to delineate the EZ, thus contributing to presurgical workup.
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Bower, Regina S., Elaine C. Wirrell, Laurence J. Eckel, Lily C. Wong-Kisiel, Katherine C. Nickels und Nicholas M. Wetjen. „Repeat resective surgery in complex pediatric refractory epilepsy: lessons learned“. Journal of Neurosurgery: Pediatrics 16, Nr. 1 (Juli 2015): 94–100. http://dx.doi.org/10.3171/2014.12.peds14150.
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OBJECT Resection can sometimes offer the best chance of meaningful seizure reduction in children with medically intractable epilepsy. However, when surgery fails to achieve the desired outcome, reoperation may be an option. The authors sought to investigate outcomes following resective reoperation in pediatric patients with refractory epilepsy, excluding tumoral epilepsies. Differences in preoperative workup between surgeries are analyzed to identify factors influencing outcomes and complications in this complex group. METHODS Medical records were reviewed for all pediatric patients undergoing a repeat resective surgery for refractory epilepsy at the authors' institution between 2005 and 2012. Tumor and vascular etiologies were excluded. Preoperative evaluation and outcomes were analyzed for each surgery and compared. RESULTS Ten patients met all inclusion criteria. The median age at seizure onset was 4.5 months. Preoperative MRI revealed no lesion in 30%. Nonspecific gliosis and cortical dysplasia were the most common pathologies. The majority of preoperative workups included MRI, video-electroencephalography (EEG), and SISCOM. Intracranial EEG was performed for 60% for the first presurgical evaluation and 70% for the second evaluation. The goal of surgery was palliative in 4 patients with widespread cortical dysplasia. The final Engel outcome was Class I in 50%. The rate of favorable outcome (Engel Class I–II) was 70%. The complication rate for the initial surgery was 10%. However, the rate increased to 50% with the second surgery, and 3 of these 5 complications were pseudomeningoceles requiring shunt placement (2 of the 3 patients underwent hemispherotomy). CONCLUSIONS Resective reoperation for pediatric refractory epilepsy has a high rate of favorable outcome and should be considered in appropriate candidates, even as a palliative measure. Intracranial EEG monitoring should be considered on initial workup in cases where the results of imaging or EEG studies are ambiguous or conflicting. Epilepsy secondary to cortical dysplasia, especially if the dysplasia is not seen clearly on MRI, can be difficult to cure surgically. Therefore, in these cases, as large a resection as can be safely accomplished should be done, particularly when the goal is palliative. The rate of complications, particularly pseudomeningocele ultimately requiring shunt placement, is much higher following reoperation, and patients should be counseled accordingly.
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Smith-Singares, Eduardo, und Abdul Saied. „Traumatic Thoracic Duct Transection managed with Left Thoracoscopy: A Case Report and Review of Literature“. Panamerican Journal of Trauma, Critical Care & Emergency Surgery 2, Nr. 2 (2013): 97–99. http://dx.doi.org/10.5005/jp-journals-10030-1068.
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ABSTRACT Context Chylothorax is an uncommon complication after penetrating trauma to the chest and the neck. Only 25% of all chylothorax cases are related to penetrating trauma. We report such a case on a transmediastinal stab wound, managed by video-assisted thoracic surgery. Case report A 48-year-old male presented to our level I trauma center after sustaining a stab wound to the right chest. Initial workup revealed a left side pneumothorax. After chest tube placement 700 ml of blood and milky fluid were recovered. The patient was managed initially with TPN, without success. On day 3, he was taken to the OR for a left VATS. The thoracic duct was dissected and the injury identified and controlled with hemoclips. The intervention was successful and the patient was discharged on POD #4. Discussion Chylothorax are classified and managed according to the daily output of the fistula. While low output chylothorax are more frequent, more likely related to malignancy of the mediastinum and lymph nodes, and more likely to close with nonsurgical management; traumatic chylothorax are generally high output and more likely to require surgical intervention. The different approaches to this difficult pathology are reviewed. How to cite this article Smith-Singares E, Saied A. Traumatic Thoracic Duct Transection managed with Left Thoracoscopy: A Case Report and Review of Literature. Panam J Trauma Critical Care Emerg Surg 2013;2(2):97-99.