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Shifting paradigm in brain abscess management at tertiary care centre in Nepal

Neuroimmunology and Neuroinflammation 2018年第6期5卷 10-17页

作者： Prakash Kafle Mohan Raj Sharma Sushil Krishna Shilpakar Gopal Sedain Amit Pradhanang Ram Kumar Shrestha Binod Raj Bhandari christine groves Department of Neurosurgery Nobel Medical College Teaching HospitalBiratnagar56613Nepal Department of Neurosurgery Tribhuvan University Teaching HospitalKathmandu44613Nepal Department of Physical Medicine and Rehabilitation Indiana University School of MedicineIndianapolisIN46202USA

Aim: Brain abscess is a challenging clinical entity with substantial high case fatality rates despite significant advances in imaging techniques,laboratory modalities,surgical interventions,and antimicrobial treatment.Otogenic and cardiogenic sources are among the most common.Classic clinical presentation is seen in very few cases only.Burr hole with aspiration works well with good clinical outcomes.Control of primary source in cases of ear infection in the single setting results in good outcomes,reduces for additional surgery,and decreases the duration of hospital stay.Methods: This is prospective observational study conducted at Institute of Medicine,Tribhuvan University Teaching Hospital,Kathmandu,Nepal over the period of two and a half years(from September 2014 to March 2017).We analyzed the demographic profile,management strategies and outcome of these cases diagnosed with brain abscess using Microsoft Excel 2007.Results: A total of 51 cases were undertaken for surgical management.There were 35 males and 16 females with the male to female ratio of 2.18:1.The mean age of the study population was 16.76 years with age range from 4 months to 60 years.Otogenic source was the most common.Temporal lobe was the most common abscess location.Headache was the most common clinical presentation and was seen in 86.27%of the study population.All cases were initially managed with burrhole and aspiration of the abscess.Only 3.92%(n = 2)of cases subsequently required surgical excision of the abscess wall.Only 11.76%(n = 6)of the cases required multiple aspiration.Only 19.61%(n = 10)showed positive culture.Pseudomonas aeruginosa and E.coli were the most common organisms grown.Mortality rate among the study group was 3.92%.Conclusion: With the advent of modern technology in neuroimaging,mortality due to brain abscess has significantly decreased.Joint involvement of the otorhinolaryngology team and efforts in addressing the primary source have further helped in improving outcomes in cases of otogenic brain abscess.Hence,source c

关键词： Abscess otogenic brain abscess tubercular abscess

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Sharing Clinical Trial Data： A Proposal from the International Committee of Medical Journal Editors

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Chinese Medical Journal 2016年第2期129卷 127-128页

作者： Darren B Taichman Joyce Backus Christopher Baethge Howard Bauchner Peter W de Leeuw Jeffrey M Drazen John Fletcher Frank Frizelle Irish groves Abraham Haileamlak Astrid James christine Laine Larry Peiperl Anja Pinborg Peush Sahni Si-Nan Wu ICMJE Executive Deputy Editor Annals of Internal Medicine Library Operations National Library of Medicine German Medical Journal (Deutsches Arzteblatt) Editor-in-Chief Journal of the American Medical Association (JAMA) and the JAMA Network Editor-in-Chief The Dutch Medical Journal (Nederlands Tijdschrift voor Geneeskunde) Editor-in-Chief New England Journal of Medicine Editor-in-Chief Canadian Medical Association Journal Editor-in-Chief New Zealand Medical Journal Head of Research British Medical Journal Editor-in-Chief Ethiopian Journal of Health Sciences Deputv Editor The Lancet Editor-in-Chief Annals of Internal Medicine Chief Editor Public Library of Science (PLOS) Medicine Scientific Editor-ln-Chief Danish Medical Journal (Ugeskrift for Laeger) Representative and Past President World Association of Medical Editors Representative Chinese Medical Journal

The International Committee of Medical Journal Editors （ICMJE） believes that there is an ethical obligation to responsibly share data generated by interventional clinical trials because participants have put themselves at risk. In a growing consensus, many funders around the world - foundations, government agencies, and industry - now mandate data sharing. Here, we outline ICMJE＇s proposed requirements to help meet this obligation. We encourage feedback on the proposed requirements. Anyone can provide feedback at www. *** by April 18, 2016.

关键词： Clinical Trial Data International Committee of Medical Journal Editors Share

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