China
Africa
Explore chapters and articles related to this topic
Medical Tourism And Well-Being: Trends and Strategies
Published in Frederick J. DeMicco, Ali A. Poorani, Medical Travel Brand Management, 2023
Frederick J. DeMicco, M. Cetron, O. Davies
In other countries, the public health system is overburdened, and needed care can be delayed, particularly for difficult, uncommon, or expensive procedures. In Britain, regulations require the National Health Service to provide surgery no more than 18 weeks after diagnosis. In 2016, more than 193,000 patients waited longer every month. (At that, this is a substantial improvement over the experience reported in the first edition of this text, published in 2006). In Canada, the waiting list for neurosurgery in 2016 averaged 47 weeks after referral by a general practitioner. Esoteric procedures can take even longer. Waiting times of three months or more are common for stem-cell transplants needed for more than 80 diseases, including several blood cancers. In one well-publicized case from 2016, an 18-year-old girl with acute myeloid leukemia died while waiting for a transplant 8 months after learning that several matching donors were available. Until May 2017, cancer patients who had relapsed after chemotherapy were barred from stem-cell transplants that might have saved their lives.
Two Years and Counting
Published in Stijn Geerinck, Reconstructing Identity After Brain Injury, 2022
The week after the meeting with the medical examiner, I had a follow-up consultation with the neurosurgeon. I felt the tension rise in my body but managed to stay relatively calm in anticipation of the moment. The most recent scans were scrutinised and the position and condition of my shunt were verified. There were no indications of additional complications. The shunt was still in its correct position and there were no signs of recent epileptic activity in the scans. It seemed that the brain damage was under control and that significant improvements were being made. I wouldn’t have to abandon hope of a normal life! The realisation cleared a lot of space in my brain. I left the hospital with a broad (albeit half-sided) grin and felt a stream of new energy that I used to take on extra work at home. I had long conversations with my children and vacuum-cleaned forgotten corners, just because I could.
Epidural and Intrathecal Analgesia
Published in Pamela E. Macintyre, Stephan A. Schug, Acute Pain Management, 2021
Pamela E. Macintyre, Stephan A. Schug
The first step in the diagnosis is immediate discontinuation of the epidural infusion without removing the epidural catheter. No resolution of the neurological symptoms in response to this should trigger immediate magnetic resonance imaging (MRI) and urgent specialist surgical consultation (for example, neurosurgeon or spinal surgeon), as potential recovery depends on time-contingent diagnosis and treatment.
Cochlear implants and deep brain stimulators
Published in Cochlear Implants International, 2023
Zachary A. Kons, Kathryn L. Holloway, Daniel H. Coelho
Though all published reports have focused on implanting DBS in patients with preexisting CI, predictable challenges may also arise for patients with preexisting DBS. Preoperative imaging with computed tomography (CT) may be acquired with a DBS in place, though the extension wires may cause hyperdense artifact partially obstructing the mastoid. For patients with chronic ear disease or poorly aerated mastoid air cells, this may cause challenges when drilling the mastoid cavity and necessitate a more careful search for typical landmarks. Although MRI is not strictly required before every CI implantation, complex cases may necessitate MRI for improved visualization of the anatomy. Certain DBS models for Medtronic Inc. (Minneapolis, MN), Boston Scientific (Natick, MA), and Abbott Neuromodulation (Austin, TX) have been granted FDA approval for MRI, (Medtronic, 2015; Neuromodulation, 2022; Scientific). However, these guidelines are rapidly changing and should be reviewed before scheduling imaging. Neurosurgery should be consulted preoperatively for surgical planning.
Fatal cerebral hemorrhage in a patient with thrombotic thrombocytopenic purpura with a normal platelet count during treatment with caplacizumab
Published in Platelets, 2022
Kim Ditzel, Dirk Jan Mons, Rob Fijnheer
After 15 days of plasmapheresis in total and 5 days of caplacizumab, her platelet count recovered to >150 10^9/l (Figure 1). After 2 days of adequate platelet count, the plasmapheresis was stopped and the caplacizumab was planned to continue for a total of 30 days. She was ready to be discharged 12 days after the start of caplacizumab. Unfortunately, the night before planned discharge, she woke up with a left-sided hemiparesis. A CT-scan showed a massive intracerebral hemorrhage with midline shift and signs of brain herniation. There were no signs of underlying cerebrovascular abnormality. Her platelet count at the time was 606 10^9/l and no coagulation abnormalities were shown. She was given 4000 international units of Haemate-P, a vWF/factor VIII concentrate, to counter the iatrogenic decreased activity of vWF. No platelets were given, since her platelet count was normal and there was no platelet dysfunction. The neurologist consulted with a neurosurgeon, but there were no further therapeutic options. All supportive therapy was stopped and she died a few hours later.
Coexistence of TERT C228T mutation and MALAT1 dysregulation in primary glioblastoma: new prognostic and therapeutic targets
Published in Neurological Research, 2021
Secil Ak Aksoy, Melis Mutlu, Berrin Tunca, Hasan Kocaeli, Mevlut Ozgur Taskapilioglu, Ahmet Bekar, Cagla Tekin, Omer Gokay Argadal, Muhammet Nafi Civan, İsmail Seckin Kaya, Pınar Eser Ocak, Sahsine Tolunay
Total 76 patients diagnosed with primary adult GB between 2005 and 2016 and 9 diagnosed with primary pediatric GB between 2005 and 2017 in the Department of Neurosurgery of Uludağ University Hospital were enrolled. Tumor tissue samples were obtained via surgical resection before radiation or chemotherapy treatment. Surgical procedures were performed by neurosurgeons in the Department of Neurosurgery using a microscope (Zeiss OPMI Pentero Carl Zeiss Inc., Oberkochen, Germany). Resection materials of 85 adult and pediatric primary GB patients were paraffinized at the Bursa Uludağ University Pathology Department and classified as per the WHO criteria. Five brain tissues that were removed to reach the tissue during the operations of epilepsy patients and evaluated as normal by the pathology department were used as controls. Patients who had only stereotactic biopsy died within the first 30 d after surgical resection because of different reasons, whose pathology preparations were unsuitable for genetic and epigenetic studies, and those with familial cases and concurrent malignancies were excluded from the study. All the materials included in this study were approved by the Bursa Uludag University Ethics Committee (ethics number 2017–13/98 and 2018–14/29). Pediatric and adult GB patients were evaluated as per their follow-up period until September 2020.