The Experts below are selected from a list of 324 Experts worldwide ranked by ideXlab platform
Hai Jin - One of the best experts on this subject based on the ideXlab platform.
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therapeutic effect of gastrotomy on lung infection and dystrophy in patients with traumatic vagus Nerve Injury
Chinese Journal of Trauma, 2015Co-Authors: Chao Lin, Qiyong Mei, Kaiwei Han, Hai Jin, Shun Gong, Ning Liu, Haichen SunAbstract:Objective To examine the occurrence of traumatic lower Cranial Nerve Injury and the therapeutic effect of gastrostomy on vagus Nerve Injury. Methods Clinical data of 45 patients sustaining traumatic lower Cranial Nerve Injury were retrospectively analyzed. There were 32 males and 13 females, with the age of (34.5±8.8)years. Injury resulted from high falls in 22 patients, traffic accidents in 15 patients and other in 8 patients. Non-operative treatments, nutrition and hormone intervention, improving minicirculation, promoting blood circulation and removing stasis for instance, were performed for the patients with the Injury involving the glossopharyngeal Nerve (n=12), accessory Nerve (n=21) and hypoglossal Nerve (n=20). Vagus Nerve Injury was seen in 32 patients. Fifteen out of the 32 patients underwent gastrotomy and early enteral nutrition support and 17 transnasal gastric catheter indwelling and enteral nutrition support. Lung infection and dystrophy were evaluated after operation. Results Two patients had lung infection and one dystrophy after gastrotomy. In contrast, 9 patients had lung infection and one dystrophy after transnasal stomach intubation surgery (P<0.05). At follow-up, the complications were cured in gastrotomy group, but only 7 lung infection and 5 dystrophy were cured in indwelling catheter group. Conclusions Vagus Nerve Injury is most common in lower Cranial Nerve Injury and manifested with choking on water and dysphagia. Gastrostomy in combination with early enteral nutrition therapy is effective to improve the nutritional status and reduce lung infection in patients with traumatic vagus Nerve Injury. Key words: Cranial Nerve injuries; Traumatic brain injuries; Vagus Nerve; Gastrostomy
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Clinical treatment of traumatic brain Injury complicated by Cranial Nerve Injury.
Injury, 2010Co-Authors: Hai Jin, Sumin Wang, Lijun Hou, Chengguang Pan, Hui WangAbstract:Abstract Objective To discuss the epidemiology, diagnosis and surgical treatment of Cranial Nerve Injury following traumatic brain Injury (TBI) for the sake of raising the clinical treatment of this special category of TBI. Patients and methods A retrospective analysis was made of 312 patients with Cranial Nerve Injury among 3417 TBI patients, who were admitted for treatment in this hospital. Results A total of 312 patients (9.1%) involving either a single Nerve or multiple Nerves among the 12 pairs of Cranial Nerves were observed. The extent of Nerve Injury varied and involved the olfactory Nerve (66 cases), optic Nerve (78 cases), oculomotor Nerve (56 cases), trochlear Nerve (8 cases), trigeminal Nerve (4 cases), abducent Nerve (12 cases), facial Nerve (48 cases), acoustic Nerve (10 cases), glossopharyngeal Nerve (8 cases), vagus Nerve (6 cases), accessory Nerve (10 cases) and hypoglossal Nerve (6 cases). Imaging examination revealed skull fracture in 217 cases, complicated brain contusion in 232 cases, epidural haematoma in 194 cases, subarachnoid haemorrhage in 32 cases, nasal cerebrospinal fluid (CSF) leakage in 76 cases and ear CSF leakage in 8 cases. Of the 312 patients, 46 patients died; the mortality rate associated with low Cranial Nerve Injury was as high as 73.3%. Among the 266 surviving patients, 199 patients received conservative therapy and 67 patients received surgical therapy; the curative rates among these two groups were 61.3% (122 patients) and 86.6% (58 patients), respectively. Conclusion TBI-complicated Cranial Nerve Injury is subject to a high incidence rate, a high mortality rate and a high disability rate. Our findings suggest that the chance of recovery may be increased in cases where injuries are amenable to surgical decompression. It is necessary to study all 12 pairs of Cranial Nerves systematically. Clinically, it is necessary to standardise surgical indications, operation timing, surgical approaches and methods for the treatment of TBI-complicated Cranial Nerve Injury.
Benjamin Lok - One of the best experts on this subject based on the ideXlab platform.
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IVA - Exploring Gender Biases with Virtual Patients for High Stakes Interpersonal Skills Training
Intelligent Virtual Agents, 2014Co-Authors: Diego J. Rivera-gutierrez, Juan C Cendan, Regis Kopper, Andrea Kleinsmith, Glen R. Finney, Benjamin LokAbstract:The use of virtual characters in a variety of research areas is widespread. One such area is healthcare. The study presented in this paper leveraged virtual patients to examine whether virtual patients are more likely to be correctly diagnosed due to gender and skin tone. Medical students at the University of Florida College of Medicine interacted with six virtual patients across two sessions. The six virtual patients comprised various combinations of gender and skin tone. Each virtual patient presented with a different Cranial Nerve Injury. The results indicate a significant difference in correct diagnosis according to patient gender for one of the cases. In that case, female patients were correctly diagnosed more frequently than their male counterpart. The description of that case required that the virtual patient present with a visible bruise on the forehead. We hypothesize the results obtained could be due to a transfer of a real world gender bias.
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simulation of a virtual patient with Cranial Nerve Injury augments physician learner concern for patient safety
Bio-Algorithms and Med-Systems, 2010Co-Authors: Aaron Kotranza, Juan C Cendan, Kyle Johnsen, Benjamin LokAbstract:Recent technological developments concerning Web 2.0 have enabled the use of three-dimensional virtual platforms for educational purposes. In this paper, focus is placed on the modifi cation of an OpenSimulator based 3D environment for its reuse in a different fi eld of medical education; developments are presented alongside the associated effort to reconstruct and repurpose this environment so as to fi t medical specialties of different clinical skills. The aim of this study was to present repurposing aspects of a learning environment modifi cation and adaption to the needs of various medical specialties, in an attempt to reuse – and therefore share – learning content between different medical areas. Initially, a 3-Dimensional environment was created using the OpenSim platform for use in cardiology. Then, the virtual environment was modifi ed so as to be oriented to the needs of psychiatry. The reconstruction of the educational environment and context and the reformation of the educational clinical scenario offer the possibility of reusability of this content which can be tailored to the needs of each medical fi eld. * Corresponding author; Address: Lab of Medical Informatics, P.O. Box 323, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki Greece, tel:+302310999310, fax:+302310999263, email: bamidis@med.auth.gr BIO-ALGORITHMS AND MED-SYSTEMS JOURNAL EDITED BY MEDICAL COLLEGE – JAGIELLONIAN UNIVERSITY Vol. 6, No. 11, 2010, p. 9–13
Hon-man Liu - One of the best experts on this subject based on the ideXlab platform.
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Carotid angioplasty with or without stenting versus carotid endarterectomy for carotid artery stenosis: A meta-analysis
Journal of the Neurological Sciences, 2008Co-Authors: Jiann-shing Jeng, Hon-man LiuAbstract:Carotid angioplasty with or without stent placement (CAS) has emerged as an alternative to carotid endarterectomy (CEA) for revascularization of severe carotid artery stenosis in patients with high risk for surgery. This meta-analysis compared the efficacy and safety of both treatments from data for previous randomized trials. We did a literature search using Medline, PubMed, Cochrane database, and relevant articles for randomized trials comparing CAS with CEA. A meta-analysis using both random-effects and fixed-effects models compared outcome events of death, stroke, myocardial infarction, and Cranial Nerve Injury at 30 days, 6 months, or 1 year after procedure. A total of nine trials involving 3138 patients (1564, CEA; 1574, CAS) with symptomatic or asymptomatic stenosis were included for analysis. By random-effects model, there was no significant difference of event rates between treatments for any stroke (odds ratio for CAS [95% confidence interval], 1.46 [0.91-2.36]), death or any stroke (1.37 [0.90-2.10]), or death, any stroke, or myocardial infarction (1.02 [0.49-2.11]) at 30-day, and death and any stroke at 6 months (1.50 [0.69-3.23]) or 1 year (1.25 [0.59-2.63]). But, there were significantly higher 30-day event rates after CAS than CEA for death or any stroke (1.37 [1.04-1.81]) by fix-effects model, accompanied with significant heterogeneity (p=0.04). Risk of Cranial Nerve Injury was much lower in CAS than in CEA (0.12 [0.05-0.29]). Except for lower risk of Cranial Nerve Injury, CAS is neither safer nor associated with a better short-term outcome as compared to CEA in treating carotid artery stenosis.
Stefano Michelagnoli - One of the best experts on this subject based on the ideXlab platform.
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Cranial Nerve Injury is associated with dual antiplatelet therapy use and cervical hematoma after carotid endarterectomy.
Journal of vascular surgery, 2016Co-Authors: Emiliano Chisci, Clara Pigozzi, Leonardo Ercolini, Thomas F. Rehring, Serena Colon, Alessandra Borgheresi, Luciana Tramacere, Stefano MichelagnoliAbstract:Objective To determine predictors of Cranial Nerve Injury (CNI) after carotid endarterectomy (CEA). Methods Consecutive CEAs performed over a 5-year period were enrolled in this study. Outcomes analyzed included 30-day major adverse event rate (composite of stroke, death, and myocardial infarction), death, stroke, disabling stroke, myocardial infarction, cervical hematoma and CNI rate, reoperation, and hospital readmission at 30 days. Results There were 1258 CEAs were included in the study, 1168 (93%) were performed using an eversion technique. Patients with symptoms comprised 27% of the cohort (n = 340). At 30 days, there were no deaths, 23 major adverse events (1.8%), 11 strokes (0.9%: nine minor, two major), 12 myocardial infarctions (0.9%), 41 cervical hematomas (3.3%), 9 reoperations (0.7%) and 10 hospital readmissions (0.8%). Median duration of stay was 1 day (interquartile range, 1-2 days). CNI rate at discharge was 2.3% (n = 29). Two patients (9%) had more than one Cranial Nerve affected. The marginal mandibular branch of the facial Nerve was most frequently involved (n = 16; 52%), followed by the hypoglossal (n = 9; 29%), the vagus (n = 4; 13%), and the spinal accessory Nerve (n = 2; 6%). Horner's syndrome, consistent with an Injury to the cervical sympathetic chain, occurred in 13 patients (1%) who had a true Cranial Nerve affected as well. The vast majority (94%) of these CNIs and all Horner's syndrome neurapraxias were transient; only the two accessory lesions persisted at their follow-up visit (median, 32 months; range, 8-72 months). Significant predictors for CNI included diabetes (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.0-6.2; P = .048), cervical hematoma (OR, 41.7; 95% CI, 13.8-125.4; P P = .002). Conclusions CNI is predominantly a transient complication, but is associated significantly with dual antiplatelet therapy use and the occurrence of a postoperative cervical hematoma. Scrupulous attention to hemostasis might reduce the incidence of CNI.
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IF16. Cranial Nerve Injury Is Significantly Associated With Dual Antiplatelet Therapy Usage and Neck Hematoma Occurrence Following Carotid Endarterectomy
Journal of Vascular Surgery, 2015Co-Authors: Emiliano Chisci, Clara Pigozzi, Leonardo Ercolini, Pierfrancesco Frosini, Nicola Troisi, Stefano MichelagnoliAbstract:Cranial Nerve Injury Is Significantly Associated With Dual Antiplatelet Therapy Usage and Neck Hematoma Occurrence Following Carotid Endarterectomy Emiliano Chisci, Clara Pigozzi, Leonardo Ercolini, Pierfrancesco Frosini, Nicola Troisi, Stefano Michelagnoli. Department of Surgery, Vascular and Endovascular Surgery Unit “San Giovanni di Dio” Hospital, Florence, Italy; Azienda Sanitaria di Firenze, Vascular Endovascular Surgery Unit, Florence, Italy
Jim Mathew - One of the best experts on this subject based on the ideXlab platform.
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A Prospective Study on the Incidence and Outcome of Cranial Nerve Injuries in Patients with Traumatic Brain Injuries
Indian Journal of Neurotrauma, 2021Co-Authors: Noufal Basheer, Jenimol C. Varghese, Rojan Kuruvilla, Jacob P. Alappat, Jim MathewAbstract:Background Posttraumatic Cranial Nerve injuries are not uncommon and can occur by shearing forces, rapid acceleration/deceleration, or Injury to the skull base. The incidence of Cranial Nerve Injury in craniocerebral trauma varies between 5 and 23 percent in various literature. Methodology A prospective study was conducted on the incidence and outcome of Cranial Nerve injuries (CNI) in 256 consecutive cases of traumatic brain injuries (TBI). Patients over the age of 5 years with a follow-up of 6 months in the period from September 2017 to November 2018 in our institution were sampled. Results A total of 256 patients were included in our study. The incidence of CNI in TBI patients was 14.8% (38 patients). Facial Nerve was the most common Cranial Nerve to be involved, followed by olfactory Nerve and vestibulocochlear Nerve. Cranial Nerve Injury was more common in patients with severe head Injury (p Conclusions CNI are a major cause of morbidity in TBI patients. All patients admitted with TBI should be examined meticulously for CNI on follow-up.