neurologists

神经学家
  • 文章类型: Journal Article
    胎儿脑室增宽是产前通过神经影像学发现的最常见的胎儿神经系统疾病之一。胎儿脑室肥大等疾病不断发展的挑战涉及准确的诊断以及如何最好地提供有关预后的产前咨询以及婴儿的产后管理和护理。这篇叙述性综述的目的是讨论关于胎儿脑室增宽的文献,包括产后管理和神经发育结果,并为儿科神经科医生提供实践建议。
    Fetal cerebral ventriculomegaly is one of the most common fetal neurological disorders identified prenatally by neuroimaging. The challenges in the evolving landscape of conditions like fetal cerebral ventriculomegaly involve accurate diagnosis and how best to provide prenatal counseling regarding prognosis as well as postnatal management and care of the infant. The purpose of this narrative review is to discuss the literature on fetal ventriculomegaly, including postnatal management and neurodevelopmental outcome, and to provide practice recommendations for pediatric neurologists.
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  • 文章类型: Systematic Review
    背景:神经系统疾病由于其患病率和死亡率不断增加,仍然是全世界关注的问题,加上缺乏可用的治疗方法,在大多数情况下。探索与神经系统疾病发展相关的保护性和风险因素将有助于改进预防策略。然而,在基于人群的研究中确定神经学结果既复杂又昂贵。在研究中应用电子健康工具可能有助于降低成本和增加可访问性。本系统评价的目的是绘制现有的eHealth工具,评估流行病学研究的神经系统体征和/或症状。
    方法:四个搜索引擎(PubMed,WebofScience,Scopus&EBSCOHost)用于检索有关开发的文章,验证,或实施电子健康工具以评估神经系统体征和/或症状。总结了软件工具的临床和技术特性。由于数字高,这里只提供软件工具。
    结果:共检索到42种工具。这些捕获的体征和/或症状属于四个神经领域:认知功能,运动功能,颅神经,步态和协调。增加了第五类复合工具。大多数工具都是英文的,是为智能手机设备开发的,其余工具可作为基于Web的平台使用。不到一半的捕获工具经过了完全验证,只有大约一半在数据收集时仍处于活动状态。
    结论:所确定的工具通常由于语言障碍或缺乏适当的验证而存在局限性。大多数工具的维护和耐用性都很低。当前的制图工作为流行病学家提供了详细的指南,以确定最适合其研究的电子健康工具。
    背景:当前的研究由格罗宁根大学的博士学位资助。没有获得额外资金。
    BACKGROUND: Neurological disorders remain a worldwide concern due to their increasing prevalence and mortality, combined with the lack of available treatment, in most cases. Exploring protective and risk factors associated with the development of neurological disorders will allow for improving prevention strategies. However, ascertaining neurological outcomes in population-based studies can be both complex and costly. The application of eHealth tools in research may contribute to lowering the costs and increase accessibility. The aim of this systematic review is to map existing eHealth tools assessing neurological signs and/or symptoms for epidemiological research.
    METHODS: Four search engines (PubMed, Web of Science, Scopus & EBSCOHost) were used to retrieve articles on the development, validation, or implementation of eHealth tools to assess neurological signs and/or symptoms. The clinical and technical properties of the software tools were summarised. Due to high numbers, only software tools are presented here.
    RESULTS: A total of 42 tools were retrieved. These captured signs and/or symptoms belonging to four neurological domains: cognitive function, motor function, cranial nerves, and gait and coordination. An additional fifth category of composite tools was added. Most of the tools were available in English and were developed for smartphone device, with the remaining tools being available as web-based platforms. Less than half of the captured tools were fully validated, and only approximately half were still active at the time of data collection.
    CONCLUSIONS: The identified tools often presented limitations either due to language barriers or lack of proper validation. Maintenance and durability of most tools were low. The present mapping exercise offers a detailed guide for epidemiologists to identify the most appropriate eHealth tool for their research.
    BACKGROUND: The current study was funded by a PhD position at the University of Groningen. No additional funding was acquired.
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  • 文章类型: Review
    目的:外展神经麻痹的病因在研究中显示出很大的差异性。这项研究旨在通过从转诊的大学医院的所有科室招募患者来确定孤立的外展神经麻痹的临床特征和潜在病因。
    方法:我们回顾了在首尔国立大学Bundang医院所有科室确诊为孤立外展神经麻痹的807例患者的医疗记录,城南,大韩民国,从2003年到2020年。我们还比较了病因与先前研究中合并的患者的比例。
    结果:最常见的病因是微血管(n=296,36.7%),其次是特发性(n=143,17.7%),肿瘤(n=115,14.3%),血管异常(n=82,10.2%),炎症(n=76,9.4%),和创伤性(n=35,4.3%)。患者大多由眼科医生管理(n=576,71.4%),其次是神经科医生(n=479,59.4%),急诊医师(n=278,34.4%),神经外科医生(n=191,23.7%),和其他(n=72,8.9%)。根据患者的年龄和性别以及管理中涉及的专业,病因的比例显着不同(p<0.001)。与以前报告的汇总数据相比,目前的研究表明,微血管原因的患病率较高,但创伤性和肿瘤性原因的发生率较低。
    结论:先前关于孤立的外展神经麻痹的病因学分布的研究结果应考虑招募患者的人口统计学特征和所涉及的特殊性来解释。
    The etiologies of abducens nerve palsy have shown a large variability among studies. This study aimed to establish the clinical features and underlying etiologies of isolated abducens nerve palsy by recruiting patients from all departments in a referral-based university hospital.
    We reviewed the medical records of 807 patients with a confirmed diagnosis of isolated abducens nerve palsy at all departments of Seoul National University Bundang Hospital, Seongnam, Republic of Korea, from 2003 to 2020. We also compared the proportion of etiology with that of the patients pooled from the previous studies.
    The most common etiology was microvascular (n = 296, 36.7%), followed by idiopathic (n = 143, 17.7%), neoplastic (n = 115, 14.3%), vascular anomalies (n = 82, 10.2%), inflammatory (n = 76, 9.4%), and traumatic (n = 35, 4.3%). Patients were mostly managed by ophthalmologists (n = 576, 71.4%), followed by neurologists (n = 479, 59.4%), emergency physicians (n = 278, 34.4%), neurosurgeons (n = 191, 23.7%), and others (n = 72, 8.9%). The proportion of etiology significantly differed according to the age and sex of the patients and the specialties involved in the management (p < 0.001). Compared to the pooled data from the previous reports, the current study showed a higher prevalence of microvascular cause but a lower occurrence of traumatic and neoplastic causes.
    The results of previous studies on etiologic distribution of isolated abducens nerve palsy should be interpreted with consideration of the demographic features of patients recruited and the specialties involved.
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  • 文章类型: Journal Article
    人工智能(AI)和称为机器学习(ML)的AI流行分支越来越多地用于医学和医学研究。这篇综述概述了AI和ML(AI/ML),包括常用术语的定义。我们讨论了AI的历史,并提供了AI/ML如何应用于儿科神经病学的实例。例子包括神经肿瘤学成像,自闭症诊断,从图表中诊断,癫痫,脑瘫,和新生儿神经病学。诸如监督学习之类的主题,无监督学习,并讨论了强化学习。
    Artificial intelligence (AI) and a popular branch of AI known as machine learning (ML) are increasingly being utilized in medicine and to inform medical research. This review provides an overview of AI and ML (AI/ML), including definitions of common terms. We discuss the history of AI and provide instances of how AI/ML can be applied to pediatric neurology. Examples include imaging in neuro-oncology, autism diagnosis, diagnosis from charts, epilepsy, cerebral palsy, and neonatal neurology. Topics such as supervised learning, unsupervised learning, and reinforcement learning are discussed.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    Autoimmune encephalitis is an increasingly recognized entity in children. When treated promptly, favorable outcomes are seen in a majority of pediatric patients. However, recognition of autoimmune encephalitis in young patients is challenging. Once autoimmune encephalitis is suspected, additional difficulties exist regarding timing of treatment initiation and duration of treatment, as evidence to guide management of these patients is emerging. Here, we review available literature regarding pediatric autoimmune encephalitis and present our institution\'s comprehensive approach to the evaluation and management of the disease. These guidelines were developed through an iterative process involving both pediatric neurologists and rheumatologists.
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  • 文章类型: Journal Article
    BACKGROUND: Driving is a complex task requiring the integrity and the cooperation of cognition, motor, and somatosensory skills, all of which are impacted by neurological diseases.
    OBJECTIVE: Identification of neurologist\'s role when assessing fitness to drive of cognitively impaired individuals.
    METHODS: We performed a systematic review of the guidelines/recommendations (G/Rs) regarding the evaluation of driving fitness of patients with mild cognitive impairment (MCI) and/or dementia. Emphasis was put on the neurological and neuropsychological aspects of the evaluation.
    RESULTS: Eighteen G/Rs were included in the review (9 national guidelines, 5 recommendation papers, 3 consensus statements, and 1 position paper). All G/Rs referred to drivers with dementia and 9/18 referred to drivers with MCI. A common approach among G/Rs is the initial trichotomization of patients in safe to drive, unsafe to drive, and undetermined cases, which are referred to a second-line evaluator. First-line evaluators are general practitioners in 10/18 G/Rs; second-line evaluators are neurologists in 7/18 G/Rs. Specific neuropsychological tests are proposed in 11/18 G/Rs and relative cut-off values in 7/18. The most commonly used tests are the MMSE, TMT, and CDT. A thorough neurological examination is proposed in only 1/18 G/R.
    CONCLUSIONS: Although extensive multi-disciplinary research has provided useful information for driving behavior of cognitively impaired individuals, we are still far from a widely accepted approach of driving ability evaluation in this increasing population. A comprehensive assessment from a multi-disciplinary team in which the neurologist plays a critical role seems to be required, although this has not yet been implemented in any G/Rs.
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  • 文章类型: Journal Article
    Background: Decisions based on erroneous assessments may result in unrealistic patient and family expectations, suboptimal advice, incorrect treatment, or costly medical errors. Regret is a common emotion in daily life that involves counterfactual thinking when considering alternative choices. Limited information is available on care-related regret affecting healthcare professionals managing patients with multiple sclerosis (MS). Methods: We reviewed identified gaps in the literature by searching for the combination of the following keywords in Pubmed: \"regret and decision,\" \"regret and physicians,\" and \"regret and nurses.\" An expert panel of neurologists, a nurse, a psychiatrist, a pharmacist, and a psychometrics specialist participated in the study design. Care-related regret will be assessed by a behavioral battery including the standardized questionnaire Regret Intensity Scale (RIS-10) and 15 new specific items. Six items will evaluate regret in the most common social domains affecting individuals (financial, driving, sports-recreation, work, own health, and confidence in people). Another nine items will explore past and recent regret experiences in common situations experienced by healthcare professionals caring for patients with MS. We will also assess concomitant behavioral characteristics of healthcare professionals that could be associated with regret: coping strategies, life satisfaction, mood, positive social behaviors, occupational burnout, and tolerance to uncertainty. Planned Outcomes: This is the first comprehensive and standardized protocol to assess care-related regret and associated behavioral factors among healthcare professionals managing MS. These results will allow to understand and ameliorate regret in healthcare professionals. Spanish National Register (SL42129-20/598-E).
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  • 文章类型: Journal Article
    This review is intended to help physicians guide patients to optimal management of post-stroke aphasia. We review literature on post-stroke aphasia treatment, focusing on: (1) when and for whom language therapy is most effective, (2) the variety of approaches that can be effective for different individuals, and (3) the extent to which behavioral therapy might be augmented by non-invasive brain stimulation and/or medications.
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  • 文章类型: Journal Article
    Diseases of the retina are common and numerous, with causes ranging over inherited, inflammatory, vascular, infectious, neoplastic, traumatic, toxic, and idiopathic etiologies. A key issue in the diagnosis of retinal disease is the duration of symptoms, which can be acute, chronic, or acute presentations of chronic disease. Clinical examination with direct ophthalmoscopy or, even better, biomicroscopy with a slit lamp and condensing lens, is a key component of diagnosis, which can be enhanced through investigational methods such as fluorescein angiography, optical coherence tomography, or electroretinography. Consideration of the history, visual acuity and visual field, and fundoscopic findings is usually sufficient to determine whether patients need referral on an emergency, urgent, or routine basis. Emphasis is given to vascular disease, age-related macular degeneration, diabetic retinopathy, genetic eye disease, and retinal detachment.
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