The Experts below are selected from a list of 324 Experts worldwide ranked by ideXlab platform
Ben Roitberg - One of the best experts on this subject based on the ideXlab platform.
-
Permanent cerebrospinal fluid diversion in subarachnoid hemorrhage: Influence of physician practice style.
Surgical neurology international, 2011Co-Authors: Domenic P. Esposito, Fernando D. Goldenberg, Jeffrey I. Frank, Agnieszka Ardelt, Ben RoitbergAbstract:Acute hydrocephalus (HCP) after aneurysmal subarachnoid hemorrhage (SAH) often persists. Our previous study described factors that singly and combined in a formula correlate with permanent CSF diversion. We now aimed to determine whether the same parameters are applicable at an institution with different HCP management practice. We reviewed records of 181 consecutive patients who presented with SAH and received an external ventricular drain (EVD) for acute HCP. After exclusion and inclusion criteria were met, 71 patients were analyzed. Data included admission Fisher and Hunt and Hess grades, aneurysm location, treatment modality, ventricle size, CSF cell counts and protein levels, length of stay (LOS) in the hospital, and the presence of craniectomy. Outcome measures were: (1) initial EVD challenge outcome; (2) Shunting within 3 months; and (3) LOS. Shunting correlated with Hunt and Hess grade, CSF protein, and the presence of craniectomy. The formula derived in our previous study demonstrated a weaker correlation with initial EVD challenge failure. Several parameters that correlated with Shunting in the previous study were instead associated with LOS in this study. The decision to shunt depends on management choices in the context of a disease process that may improve over time. Based on the treatment strategy, the Shunting rate may be lowered but LOS increased. Markers of disease severity in patients with HCP after SAH correlate with both shunt placement and LOS. This is the first study to directly evaluate the effect of different practice styles on the Shunting rate. Differences in HCP management practices should inform the design of prospective studies.
-
permanent cerebrospinal fluid diversion in subarachnoid hemorrhage influence of physician practice style
Surgical Neurology International, 2011Co-Authors: Domenic P. Esposito, Fernando D. Goldenberg, Jeffrey I. Frank, Agnieszka Ardelt, Ben RoitbergAbstract:BACKGROUND Acute hydrocephalus (HCP) after aneurysmal subarachnoid hemorrhage (SAH) often persists. Our previous study described factors that singly and combined in a formula correlate with permanent CSF diversion. We now aimed to determine whether the same parameters are applicable at an institution with different HCP management practice. METHODS We reviewed records of 181 consecutive patients who presented with SAH and received an external ventricular drain (EVD) for acute HCP. After exclusion and inclusion criteria were met, 71 patients were analyzed. Data included admission Fisher and Hunt and Hess grades, aneurysm location, treatment modality, ventricle size, CSF cell counts and protein levels, length of stay (LOS) in the hospital, and the presence of craniectomy. Outcome measures were: (1) initial EVD challenge outcome; (2) Shunting within 3 months; and (3) LOS. RESULTS Shunting correlated with Hunt and Hess grade, CSF protein, and the presence of craniectomy. The formula derived in our previous study demonstrated a weaker correlation with initial EVD challenge failure. Several parameters that correlated with Shunting in the previous study were instead associated with LOS in this study. CONCLUSIONS The decision to shunt depends on management choices in the context of a disease process that may improve over time. Based on the treatment strategy, the Shunting rate may be lowered but LOS increased. Markers of disease severity in patients with HCP after SAH correlate with both shunt placement and LOS. This is the first study to directly evaluate the effect of different practice styles on the Shunting rate. Differences in HCP management practices should inform the design of prospective studies.
Domenic P. Esposito - One of the best experts on this subject based on the ideXlab platform.
-
Permanent cerebrospinal fluid diversion in subarachnoid hemorrhage: Influence of physician practice style.
Surgical neurology international, 2011Co-Authors: Domenic P. Esposito, Fernando D. Goldenberg, Jeffrey I. Frank, Agnieszka Ardelt, Ben RoitbergAbstract:Acute hydrocephalus (HCP) after aneurysmal subarachnoid hemorrhage (SAH) often persists. Our previous study described factors that singly and combined in a formula correlate with permanent CSF diversion. We now aimed to determine whether the same parameters are applicable at an institution with different HCP management practice. We reviewed records of 181 consecutive patients who presented with SAH and received an external ventricular drain (EVD) for acute HCP. After exclusion and inclusion criteria were met, 71 patients were analyzed. Data included admission Fisher and Hunt and Hess grades, aneurysm location, treatment modality, ventricle size, CSF cell counts and protein levels, length of stay (LOS) in the hospital, and the presence of craniectomy. Outcome measures were: (1) initial EVD challenge outcome; (2) Shunting within 3 months; and (3) LOS. Shunting correlated with Hunt and Hess grade, CSF protein, and the presence of craniectomy. The formula derived in our previous study demonstrated a weaker correlation with initial EVD challenge failure. Several parameters that correlated with Shunting in the previous study were instead associated with LOS in this study. The decision to shunt depends on management choices in the context of a disease process that may improve over time. Based on the treatment strategy, the Shunting rate may be lowered but LOS increased. Markers of disease severity in patients with HCP after SAH correlate with both shunt placement and LOS. This is the first study to directly evaluate the effect of different practice styles on the Shunting rate. Differences in HCP management practices should inform the design of prospective studies.
-
permanent cerebrospinal fluid diversion in subarachnoid hemorrhage influence of physician practice style
Surgical Neurology International, 2011Co-Authors: Domenic P. Esposito, Fernando D. Goldenberg, Jeffrey I. Frank, Agnieszka Ardelt, Ben RoitbergAbstract:BACKGROUND Acute hydrocephalus (HCP) after aneurysmal subarachnoid hemorrhage (SAH) often persists. Our previous study described factors that singly and combined in a formula correlate with permanent CSF diversion. We now aimed to determine whether the same parameters are applicable at an institution with different HCP management practice. METHODS We reviewed records of 181 consecutive patients who presented with SAH and received an external ventricular drain (EVD) for acute HCP. After exclusion and inclusion criteria were met, 71 patients were analyzed. Data included admission Fisher and Hunt and Hess grades, aneurysm location, treatment modality, ventricle size, CSF cell counts and protein levels, length of stay (LOS) in the hospital, and the presence of craniectomy. Outcome measures were: (1) initial EVD challenge outcome; (2) Shunting within 3 months; and (3) LOS. RESULTS Shunting correlated with Hunt and Hess grade, CSF protein, and the presence of craniectomy. The formula derived in our previous study demonstrated a weaker correlation with initial EVD challenge failure. Several parameters that correlated with Shunting in the previous study were instead associated with LOS in this study. CONCLUSIONS The decision to shunt depends on management choices in the context of a disease process that may improve over time. Based on the treatment strategy, the Shunting rate may be lowered but LOS increased. Markers of disease severity in patients with HCP after SAH correlate with both shunt placement and LOS. This is the first study to directly evaluate the effect of different practice styles on the Shunting rate. Differences in HCP management practices should inform the design of prospective studies.
Angus R Silver - One of the best experts on this subject based on the ideXlab platform.
-
Shunting inhibition modulates neuronal gain during synaptic excitation
Neuron, 2003Co-Authors: Simon J Mitchell, Angus R SilverAbstract:Neuronal gain control is important for processing information in the brain. Shunting inhibition is not thought to control gain since it shifts input-output relationships during tonic excitation rather than changing their slope. Here we show that tonic inhibition reduces the gain and shifts the offset of cerebellar granule cell input-output relationships during frequency-dependent excitation with synaptic conductance waveforms. Shunting inhibition scales subthreshold voltage, increasing the excitation frequency required to attain a particular firing rate. This reduces gain because frequency-dependent increases in input variability, which couple mean subthreshold voltage to firing rate, boost voltage fluctuations during inhibition. Moreover, synaptic time course and the number of inputs also influence gain changes by setting excitation variability. Our results suggest that Shunting inhibition can multiplicatively scale rate-coded information in neurons with high-variability synaptic inputs.
Fernando D. Goldenberg - One of the best experts on this subject based on the ideXlab platform.
-
Permanent cerebrospinal fluid diversion in subarachnoid hemorrhage: Influence of physician practice style.
Surgical neurology international, 2011Co-Authors: Domenic P. Esposito, Fernando D. Goldenberg, Jeffrey I. Frank, Agnieszka Ardelt, Ben RoitbergAbstract:Acute hydrocephalus (HCP) after aneurysmal subarachnoid hemorrhage (SAH) often persists. Our previous study described factors that singly and combined in a formula correlate with permanent CSF diversion. We now aimed to determine whether the same parameters are applicable at an institution with different HCP management practice. We reviewed records of 181 consecutive patients who presented with SAH and received an external ventricular drain (EVD) for acute HCP. After exclusion and inclusion criteria were met, 71 patients were analyzed. Data included admission Fisher and Hunt and Hess grades, aneurysm location, treatment modality, ventricle size, CSF cell counts and protein levels, length of stay (LOS) in the hospital, and the presence of craniectomy. Outcome measures were: (1) initial EVD challenge outcome; (2) Shunting within 3 months; and (3) LOS. Shunting correlated with Hunt and Hess grade, CSF protein, and the presence of craniectomy. The formula derived in our previous study demonstrated a weaker correlation with initial EVD challenge failure. Several parameters that correlated with Shunting in the previous study were instead associated with LOS in this study. The decision to shunt depends on management choices in the context of a disease process that may improve over time. Based on the treatment strategy, the Shunting rate may be lowered but LOS increased. Markers of disease severity in patients with HCP after SAH correlate with both shunt placement and LOS. This is the first study to directly evaluate the effect of different practice styles on the Shunting rate. Differences in HCP management practices should inform the design of prospective studies.
-
permanent cerebrospinal fluid diversion in subarachnoid hemorrhage influence of physician practice style
Surgical Neurology International, 2011Co-Authors: Domenic P. Esposito, Fernando D. Goldenberg, Jeffrey I. Frank, Agnieszka Ardelt, Ben RoitbergAbstract:BACKGROUND Acute hydrocephalus (HCP) after aneurysmal subarachnoid hemorrhage (SAH) often persists. Our previous study described factors that singly and combined in a formula correlate with permanent CSF diversion. We now aimed to determine whether the same parameters are applicable at an institution with different HCP management practice. METHODS We reviewed records of 181 consecutive patients who presented with SAH and received an external ventricular drain (EVD) for acute HCP. After exclusion and inclusion criteria were met, 71 patients were analyzed. Data included admission Fisher and Hunt and Hess grades, aneurysm location, treatment modality, ventricle size, CSF cell counts and protein levels, length of stay (LOS) in the hospital, and the presence of craniectomy. Outcome measures were: (1) initial EVD challenge outcome; (2) Shunting within 3 months; and (3) LOS. RESULTS Shunting correlated with Hunt and Hess grade, CSF protein, and the presence of craniectomy. The formula derived in our previous study demonstrated a weaker correlation with initial EVD challenge failure. Several parameters that correlated with Shunting in the previous study were instead associated with LOS in this study. CONCLUSIONS The decision to shunt depends on management choices in the context of a disease process that may improve over time. Based on the treatment strategy, the Shunting rate may be lowered but LOS increased. Markers of disease severity in patients with HCP after SAH correlate with both shunt placement and LOS. This is the first study to directly evaluate the effect of different practice styles on the Shunting rate. Differences in HCP management practices should inform the design of prospective studies.
Jeffrey I. Frank - One of the best experts on this subject based on the ideXlab platform.
-
Permanent cerebrospinal fluid diversion in subarachnoid hemorrhage: Influence of physician practice style.
Surgical neurology international, 2011Co-Authors: Domenic P. Esposito, Fernando D. Goldenberg, Jeffrey I. Frank, Agnieszka Ardelt, Ben RoitbergAbstract:Acute hydrocephalus (HCP) after aneurysmal subarachnoid hemorrhage (SAH) often persists. Our previous study described factors that singly and combined in a formula correlate with permanent CSF diversion. We now aimed to determine whether the same parameters are applicable at an institution with different HCP management practice. We reviewed records of 181 consecutive patients who presented with SAH and received an external ventricular drain (EVD) for acute HCP. After exclusion and inclusion criteria were met, 71 patients were analyzed. Data included admission Fisher and Hunt and Hess grades, aneurysm location, treatment modality, ventricle size, CSF cell counts and protein levels, length of stay (LOS) in the hospital, and the presence of craniectomy. Outcome measures were: (1) initial EVD challenge outcome; (2) Shunting within 3 months; and (3) LOS. Shunting correlated with Hunt and Hess grade, CSF protein, and the presence of craniectomy. The formula derived in our previous study demonstrated a weaker correlation with initial EVD challenge failure. Several parameters that correlated with Shunting in the previous study were instead associated with LOS in this study. The decision to shunt depends on management choices in the context of a disease process that may improve over time. Based on the treatment strategy, the Shunting rate may be lowered but LOS increased. Markers of disease severity in patients with HCP after SAH correlate with both shunt placement and LOS. This is the first study to directly evaluate the effect of different practice styles on the Shunting rate. Differences in HCP management practices should inform the design of prospective studies.
-
permanent cerebrospinal fluid diversion in subarachnoid hemorrhage influence of physician practice style
Surgical Neurology International, 2011Co-Authors: Domenic P. Esposito, Fernando D. Goldenberg, Jeffrey I. Frank, Agnieszka Ardelt, Ben RoitbergAbstract:BACKGROUND Acute hydrocephalus (HCP) after aneurysmal subarachnoid hemorrhage (SAH) often persists. Our previous study described factors that singly and combined in a formula correlate with permanent CSF diversion. We now aimed to determine whether the same parameters are applicable at an institution with different HCP management practice. METHODS We reviewed records of 181 consecutive patients who presented with SAH and received an external ventricular drain (EVD) for acute HCP. After exclusion and inclusion criteria were met, 71 patients were analyzed. Data included admission Fisher and Hunt and Hess grades, aneurysm location, treatment modality, ventricle size, CSF cell counts and protein levels, length of stay (LOS) in the hospital, and the presence of craniectomy. Outcome measures were: (1) initial EVD challenge outcome; (2) Shunting within 3 months; and (3) LOS. RESULTS Shunting correlated with Hunt and Hess grade, CSF protein, and the presence of craniectomy. The formula derived in our previous study demonstrated a weaker correlation with initial EVD challenge failure. Several parameters that correlated with Shunting in the previous study were instead associated with LOS in this study. CONCLUSIONS The decision to shunt depends on management choices in the context of a disease process that may improve over time. Based on the treatment strategy, the Shunting rate may be lowered but LOS increased. Markers of disease severity in patients with HCP after SAH correlate with both shunt placement and LOS. This is the first study to directly evaluate the effect of different practice styles on the Shunting rate. Differences in HCP management practices should inform the design of prospective studies.
