Automated EEG-Based Brainwave Analysis for the Detection of Postoperative Delirium Does Not Result in a Shorter Length of Stay in Geriatric Hip Fracture Patients: A Multicentre Randomized Controlled Trial.

: Delirium in postoperative geriatric hip fracture patients is a serious and often preventable condition. If detected in time, it can be treated, but a delay in the diagnosis and initiation of treatment impairs outcomes. A novel approach to detect delirium is to use point-of-care electro-encephalogram (EEG) recording with automated analysis.

Long-term disease control of a non-operable neuroendocrine tumor of the lung with lanreotide: a case study.

Bronchopulmonary neuroendocrine tumors (NETs) are malignant tumors that represent approximately 20% of all lung cancers. The therapeutic option for advanced or metastatic bronchopulmonary NETs is mainly palliation of symptoms; options need to be individualized and, therefore, rely on the knowledge of multidisciplinary teams. Somatostatin analogs have been widely used in NETs for control of hormonal syndromes and are currently under evaluation for their antiproliferative activity.

Lessons to learn from EORTC study 08981: a feasibility study of induction chemoradiotherapy followed by surgical resection for stage IIIB non-small cell lung cancer.

The present EORTC phase II feasibility study in stage IIIB (T4-N3) NSCLC was conducted to investigate whether an induction regimen with concurrent chemoradiotherapy followed by surgery after restaging by re-mediastinoscopy and/or fluorodeoxyglucose-positron emission tomography (FDG-PET) was feasible in a multicenter setting. Unfortunately, the study closed prematurely because of poor accrual. The combination of more stringent selection criteria, the incorrect prevailing view of Ethical Boards that a tri-modality approach is too toxic, competing studies in the participating centers and the fact that patients with N3 disease could only be enrolled if a re-mediastinoscopy could be performed, underlie the low accrual.

Alpha-adrenergic contribution to the cardiovascular response to acute hypoxemia in the chick embryo.

Fetal responses to acute hypoxemia include bradycardia, increase in blood pressure, and peripheral vasoconstriction. Peripheral vasoconstriction contributes to the redistribution of the cardiac output away from ancillary vascular beds toward myocardial, cerebral, and adrenal circulations. We investigated the effect of alpha-adrenergic receptor blockade on this fetal response.

Unilateral fixed dilated pupil in a ventilated child with asthma.

An 11-year-old boy known to have asthma was referred to our intensive care unit (ICU) with progressive respiratory distress. He was sedated, paralysed, and intubated approximately 3 hours after arrival and nebulization with salbutamol and ipratropium was continued on the ventilator. About 16 hours later, he presented with transient unilateral fixed dilated pupils which resolved spontaneously without any neurological deficit.

Bone marrow content measured in radioimmune bone marrow scintigraphy: intra- and inter-observer variability.

The aim of this study was to assess the possible quantification of vertebral residual bone marrow content relative to the bone marrow content of a non-irradiated vertebra. This method is based on the vertebral count activity, measured using radioimmune bone marrow scintigraphy. First, however, we had to evaluate intra- and inter-observer variability.

Palliative effectiveness of radiation therapy in the treatment of superior vena cava syndrome.

A study was made of 34 patients concerning the palliation effect of radiation therapy in the treatment of superior vena cava syndrome (SVCS). They were seen between 1986-1993, at the Department of Radiotherapy in Middelheim General Hospital, Belgium, Antwerp. All patients had a syndrome of superior vena cava obstruction secondary to malignancy.

Radiotherapy for T2 and T3 carcinoma of the bladder: the influence of overall treatment time.

The influence of overall treatment time on local control rate was studied on a group of 147 patients with muscle invasive T2 or T3 transitional cell carcinoma of the urinary bladder. All patients received external radiotherapy at the Catharina Hospital, Eindhoven, The Netherlands between January 1974 and December 1984. Patients treated with overall treatment times shorter than 75 days (n = 92) were irradiated during a continuous course; all but one patient, with overall treatment times of 75 days or more (n = 55), received split-course radiotherapy.

Patterns of axillary lymph node metastasis in breast cancer.

The pattern of axillary lymph node involvement was analyzed in a review of 377 cases of T1-4 breast cancers. Clinical judgment of the axillary status proved to be wrong in approximately one-third of the cases. In univariate analysis, a strong correlation (P < .

Carcinoma of the urinary bladder: long-term results of interstitial radiotherapy.

Between January 1974 and December 1988, 46 patients with cancer of the urinary bladder, stages T1 or T2, and one patient with stage T3, were treated with an interstitial implant at the radiotherapy department of the Catharina Ziekenhuis at Eindhoven, The Netherlands. Prior to implantation, one patient received no external radiotherapy, all other 46 patients were treated by either a low dose (40 patients: 12 Gy median) or an intermediate dose (six patients: 38-40 Gy) of external radiotherapy. Loco-regional relapse was observed in 14/47 (30%) of the patients (1/14 also had distant metastases).

T1 and T2 carcinoma of the urinary bladder: long term results with external, preoperative, or interstitial radiotherapy.

Between January 1974 and December 1984, 273 consecutive patients with cancer of the urinary bladder, Stages T1 or T2, any N, M0, were referred to the radiotherapy department of the Catharina Hospital at Eindhoven, The Netherlands and 265 were treated in a non-randomized fashion according to one of the three following schedules: 137 patients (67 T1, 70 T2) received radiotherapy only; 96 (44 T1, 52 T2) had preoperative radiotherapy followed by cystectomy and diversion according to the Bricker technique in 94/96; 32 patients (13 T1, 19 T2) had low total dose (12 Gy median) external radiotherapy followed by an interstitial cesium implant. The external radiotherapy fields included the pelvic structures. Total dose was 64 Gy median in the radiotherapy-only group and 40 Gy median in the preoperative irradiated group.

Incompletely resected rectum, recto-sigmoid, or sigmoid carcinoma: results of postoperative radiotherapy and prognostic factors.

Postoperative radiotherapy was given in 40 patients with gross or microscopic pathologically proven residual disease after surgical resection of rectum, recto-sigmoid, or sigmoid carcinoma. The radiotherapy target volume included the pelvis with (9 patients) or without (31 patients) the perineum. Median total dose of radiation was 50 Gy (range 30-60).

Bilateral horizontal gaze paralysis due to pontine hemorrhage. A case report.

In a case of bilateral horizontal gaze paralysis, vertical gaze was clinically intact but eye movement recordings demonstrated a transient reduction of vertical saccadic velocities. Horizontal caloric vestibulo-ocular responses were absent. CT scanning and NMR imaging showed a hematoma in the median pontine tegmentum.

The influence of physostigmine on visual-vestibular interaction in hereditary ataxias.

Visual suppression of caloric nystagmus was studied in five patients with hereditary ataxia before and after administration of physostigmine. All patients had an initial abnormal ocular fixation index that improved after physostigmine was given. The data indicate that there is a partly reversible disturbance of visual-vestibular interaction in patients with hereditary ataxia, caused by an impairment of a central cholinergic mechanism.

Cerebrospinal fluid glutamine levels and EEG findings in patients with hepatic encephalopathy.

The cerebrospinal fluid glutamine level was determined and an electro-encephalogram was made at roughly the same time in 41 patients on 55 occasions. A modified electro-encephalographic grading for practical use was introduced, because the classical electroencephalographic grading described by PARSONS-SMITH et al. (1957) does not apply to patients in deep coma.

Cutaneous silent period in masseter muscles: a clinical and electrodiagnostic evaluation.

In 35 normal subjects electromyographic silent periods were constantly evoked bilaterally in the masseter muscles during maximal contraction after unilateral electrical stimulation over the infraorbital or mental nerve. Findings in this study and data obtained in 30 patients suffering from trigeminal (26) and facial (four) nerve lesions suggest that the silent period evoked according to our methods is cutaneous in origin. The trigeminal sensory root forms the afferent limb of the silent period reflex.

[Volitional postural dyskinesia with hypertrophic neuropathy].

Two cases of voluntary postural dyskinesia with hypertrophic neuropathy are reported. Electron-microscope studies revealed in one case a hypertrophic neuropathy with onion bulb formation, in the other axonal degeneration. The findings are compared with those of Pierre Marie-Boveri disease, of Roussy-Lévy disease and with the case of Salisachs and Lapresle (1973).

Jaw reflexes and masseter electromyograms in mesencephalic and pontine lesions: an electrodiagnostic study.

Jaw reflexes and masseter electromyograms were studied in five patients with mesencephalic and 11 patients with pontine lesions, vascular or tumorous in nature. In the former group jaw reflexes were abnormal, being delayed or absent, whereas masseter electromyograms were normal. In the latter group, both jaw reflexes and masseter EMG, showing denervation, were abnormal in six and both normal in five cases.

[Mixed neuropathies in rheumatoid arthritis. Motor and sensory nerve conduction velocities].

Nerve conduction studies and analysis of the sensory action potential (110 nerves investigated) demons treated abnormalities in 15 to 20 patients with rheumatoid arthritis. It is concluded that moderate, often subclinical peripheral neuropathy is a common complication in rheumatoid arthritis.

Jaw and blind reflexes in trigeminal nerve lesions. An electrodiagnostic study.

Eighteen patients with intracranial trigeminal nerve lesions were investigated electrodiagnostically. The trigeminal motor root function was studied on the basis of the jaw reflex and masseter myograms and was disturbed in all cases. The jaw reflexes were abnormal in 16 and the masseter myograms in eight cases.

Electromyographic and reflex study in idiopathic and symptomatic trigeminal neuralgias: latency of the jaw and blink reflexes.

Recorded jaw reflexes were studied in 51 normal subjects. In addition, the blink and jaw reflexes combined with masseteric electromyography were recorded in 17 unselected patients with facial pain. Six of these patients, including two without neurological anomalies, showed electrodiagnostic anomalies.