Publications by authors named "J T Scoville"
Background And Objectives: Low-birth weight, premature infants often have severe intraventricular hemorrhage (IVH), which can result in posthemorrhagic hydrocephalus (PHH), sometimes requiring cerebrospinal fluid diversion. Initial temporizing management of PHH includes placement of a ventriculosubgaleal shunt (VSGS) or ventricular access device (VAD). Studies have found similar permanent shunt conversion rates between VSGS and VAD but were limited by sample scope and size.
View Article and Find Full Text PDFBackground: Depressed skull fractures in infants often present as "ping-pong ball" fractures with inward buckling of the calvarium, secondary to trauma. Management varies widely, and few concrete guidelines exist in the literature to guide decision-making when choosing a methodology for fracture elevation. The authors present two cases of attempted depressed skull fracture elevation with traction on a percutaneously placed bone fiducial screw, followed by a review of the literature, in order to further investigate the factors considered when selecting an intervention.
View Article and Find Full Text PDFBackground: We examined the cost-effectiveness of providing systematic smoking cessation interventions to oncology patients at point-of-care.
Methods: A decision analytic model was completed from the healthcare payer's perspective and included all incident cancer cases involving patients who smoke in New Brunswick, Canada (n = 1040), cancer site stratifications, and risks of mortality, continued smoking, and cancer treatment failure over one year. Usual care (no cessation support) was compared to the standard Ottawa Model for Smoking Cessation (OMSC) intervention, and to OMSC plus unlimited cost-free stop smoking medication (OMSC + SSM), including nicotine replacement therapy, varenicline, or bupropion.
Article Synopsis
- * A case study of a 12-year-old girl with refractory cerebral vasospasm from Streptococcus pneumoniae meningitis successfully utilized intrathecal nicardipine through an external ventricular drain, resulting in significant clinical improvement.
- * While vasospasm is rare in pediatric cases, this study highlights the potential effectiveness of intraventricular nicardipine, a treatment previously validated in adults, showing promise for children experiencing severe vasospasm.
Article Synopsis
- Middle meningeal artery embolization (MMAE) is being recognized as an effective treatment for non-acute subdural hematomas (NASHs), but its impact on coagulopathic patients needs further investigation.
- In a study analyzing 537 patients undergoing MMAE from 2019 to 2023, researchers found that coagulopathy significantly increases the likelihood of needing additional surgical intervention post-treatment.
- Specifically, patients with coagulopathy required rescue surgery at rates almost three times higher than those without coagulopathy, suggesting that anticoagulant and antiplatelet use may worsen outcomes.