Brain retraction injury: systematic literature review
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History is of one of the many disciplines that is considered as science, and which allows past events to be studied.This allows us to know about past facts, accompany their evolution, the origin of many concepts and terms, as well as errors and myths, allowing a comprehensive understanding of the present and learning to improve the future.The importance of history is such that it ends up determining the culture of many countries and also frames scientific disciplines.The great advances in knowledge of neurological function and its brain localization began in the nineteenth century.It is only recently that head injuries are classified by their neurological deficit rather than the type of skull fracture.This is not surprising, since most head injuries were treated by general surgeons who knew little about neurological examination.Although the illustrations in the early sixteenth century showed the anisocoria, this condition was not mentioned until three centuries later, when Jonathan Hutchinson first reported a dilated pupil on the same side as an intracranial clot, and pointed out that it was due to the compression of the third cranial nerve.
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Abstract Purpose: The neurological status of glioblastoma (GBM) patients rapidly deteriorates. We recently demonstrated that early diagnosis and surgery within three weeks from the initial symptoms are associated with improved survival. While GBM is a semi-urgent disease, the prehospital behaviors and clinical outcomes of GBM patients are poorly understood. We aimed to disclose how prehospital patient behavior influences the clinical outcomes of GBM patients. Methods: IDH-wildtype GBM patients treated at our institution between January 2010 and December 2019 were reviewed. Patients were divided into two groups: neurosurgeon and non-neurosurgeon groups, based on the primary doctor whom patients sought for an initial evaluation. Patient demographics and prognoses were examined. Results: Of 170 patients, 109 and 61 were classified into the neurosurgeon and non-neurosurgeon groups, respectively. The median age of neurosurgeon group was significantly younger than the non-neurosurgeon group (61 vs. 69 years old, P = 0.019) and in better performance status (preoperative KPS scores ≥ 80: 72.5% vs. 55.7%, P = 0.027). The neurosurgeon group exhibited a significantly shorter duration from the first hospital visit to the first surgery than the non-neurosurgeon group (18 vs. 29 days, P < 0.0001). Furthermore, the overall survival of the neurosurgeon group was significantly more prolonged than that of the non-neurosurgeon group (22.9 vs. 14.0 months, P = 0.038). Conclusion: Seeking an initial evaluation by a neurosurgeon was associated with prolonged survival in GBM patients. A short duration from the first hospital visit to the first surgery is essential in enhancing GBM patient prognosis.
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Comparison of search strategies in systematic reviews of adverse effects to other systematic reviews
Abstract Background Research indicates that the methods used to identify data for systematic reviews of adverse effects may need to differ from other systematic reviews. Objectives To compare search methods in systematic reviews of adverse effects with other reviews. Methods The search methodologies in 849 systematic reviews of adverse effects were compared with other reviews. Results Poor reporting of search strategies is apparent in both systematic reviews of adverse effects and other types of systematic reviews. Systematic reviews of adverse effects are less likely to restrict their searches to MEDLINE or include only randomised controlled trials ( RCT s). The use of other databases is largely dependent on the topic area and the year the review was conducted, with more databases searched in more recent reviews. Adverse effects search terms are used by 72% of reviews and despite recommendations only two reviews report using floating subheadings. Conclusions The poor reporting of search strategies in systematic reviews is universal, as is the dominance of searching MEDLINE . However, reviews of adverse effects are more likely to include a range of study designs (not just RCT s) and search beyond MEDLINE .
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This chapter contains section titled: Abstract Background Search strategy Mechanisms of traumatic brain injury Classification of mild traumatic brain injury Ancillary investigations Biochemical markers of traumatic brain injury Clinical observation Rules for bed rest Follow-up Conclusions
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