Clinical Application of Brain Plasticity in Neurosurgery.

Brain plasticity is an ongoing process of reorganization not only on the macroscopic level but also from underlying changes at the cellular and molecular levels of neurons. This evolution has not yet been fully understood. The objective of this paper is to review and understand neuroplasticity through the review of literature, imaging, and intraoperative evidence.

A Cultural Shift Away from Cognitive-behavioral Empathy.

Empathy in medicine is often neglected due to various constraints imposed on the physician. Despite empathy being proven as beneficial to the patient health and outcomes, patients remain unsatisfied with the healthcare system and usually, in turn, their physicians. To instill empathetic patient-physician relationships, medical training has for some time focused on cognitive-behavioral empathy.

Resident Perspective on Feedback and Barriers for Use as an Educational Tool.

Background Feedback in physician graduate medical education is not clearly defined. Some parties may view questioning as a form of feedback, others the conversations over lunch, some the comments in the operating room (OR), and still others the written evaluation at planned meetings. The lack of clarity in defining what constitutes feedback is concerning when this is considered a fundamental means of education to enhance practices and care for patients.

Trending serial CSF samples to guide treatment of refractory coccidioidal meningitis with intrathecal liposomal amphotericin.

Intrathecal amphotericin B deoxycholate (AmB-d) can be prescribed as an adjunct to systemic therapy for severe or recalcitrant cases coccidioidal meningitis. Recently intravenous (IV) Liposomal amphotericin B (L-AmB) has been recommended as monotherapy therapy for refractory coccidioidal meningitis based on its advantages over (AmB-d), however, its intrathecal use has not been reported. Moreover, there is nothing in the literature quantifying clinical improvement with objective laboratory data in human patients.

Retrospective Analysis of Ventriculitis in External Ventricular Drains.

Background: Nosocomial EVD-related ventriculitis is a major complication and a significant cause of morbidity and mortality in critically ill neurological patients. Questions remain about best management of EVDs. The purpose of this study is to compare our incidence of ventriculitis to studies using different catheters and/or antibiotic coverage schemes and determine whether c-EVD with prolonged antibiotics given for the duration of drain placement is inferior to ac-EVD with pp-abx or ac-EVD with prolonged antibiotics for prevention of ventriculitis.

Stroke risk and tamoxifen therapy for breast cancer.

Background: Tamoxifen, which is used widely to treat, and increasingly to prevent, breast cancer, has been associated with increased risk of stroke. We assessed the impact of tamoxifen treatment for breast cancer on the risk of stroke, considering dose, duration, and recency of use of tamoxifen and known stroke risk factors.

Methods: We conducted a nested case-control study of stroke after breast cancer among female Los Angeles County residents enrolled in a large health maintenance organization when diagnosed with breast cancer between January 1, 1980, and July 1, 2000.

The acute cerebrovascular event: surgical and other interventional therapies.

Over the next decade, more early and aggressive treatments will become available for acute stroke. As EPs have been forced to push their skills and knowledge significantly further with the advent of time-sensitive interventions for myocardial ischemia, a similar sophistication will undoubtedly emerge in the management of acute stroke. Certain components of the neurological examination will likely assume a new significance and, as with the renewed focus on the nature of ST segment change on the ECG in ACS, there will be new attention to early imaging findings in stroke.