The Power of a Belief System: A Systematic Qualitative Synthesis of Spiritual Care for Patients with Brain Tumors.

: Diagnosis with a brain tumor is a critical event in the lives of patients and their families due to poor medical prognoses and complex clinical care. Spiritual care interventions have been known to have meaningful effects in morbid diagnoses and palliative medicine, but their role in the neuro-oncologic patient's experience is poorly understood. This systematic review explores the role of spirituality and its relevance to patient care in the diverse setting of brain tumors.

FactFinders for patient safety: Preventing potential procedure-related complications: Vasovagal reactions and spinal cord stimulator lead migration.

This series of FactFinders presents a brief summary of the evidence and outlines recommendations to improve our understanding and management of several potential procedure-related complications. Evidence in support of the following facts is presented. (1)  -- The overall incidence of vasovagal reactions (VVR) ranges from 1 to 8% during interventional pain procedures, though certain patient populations may be at greater risk.

FactFinders for patient safety: Motor stimulation testing in lumbar radiofrequency neurotomy and radiofrequency neurotomy in patients with posterior hardware.

This series of FactFinders presents a brief summary of the evidence and outlines recommendations regarding the use of motor stimulation testing in lumbar radiofrequency neurotomy and performance of radiofrequency neurotomy in patients with posterior spinal hardware. The evidence in support of the following facts is presented: (1) Motor stimulation does not inherently protect against unwanted damage to the spinal nerve, exiting spinal nerve root or its ventral ramus due to a lack of sensitivity of this test for identification of electrode contact or close proximity to sensorimotor nerves. Even when motor stimulation is performed, verification of correct electrode placement with multiplanar imaging including a minimum of true anterior-posterior and lateral fluoroscopic views is a recommended safeguard.

Quantifying cerebrospinal fluid dynamics: A review of human neuroimaging contributions to CSF physiology and neurodegenerative disease.

Cerebrospinal fluid (CSF), predominantly produced in the ventricles and circulating throughout the brain and spinal cord, is a key protective mechanism of the central nervous system (CNS). Physical cushioning, nutrient delivery, metabolic waste, including protein clearance, are key functions of the CSF in humans. CSF volume and flow dynamics regulate intracranial pressure and are fundamental to diagnosing disorders including normal pressure hydrocephalus, intracranial hypotension, CSF leaks, and possibly Alzheimer's disease (AD).

Factfinders for patient safety: Anticoagulant and antiplatelet agents and cervical medial branch procedures.

This series of FactFinders presents a brief summary of the evidence and outlines recommendations regarding the safety of anticoagulant and antiplatelet agents for cervical medial branch blocks and cervical medial branch radiofrequency neurotomy. The evidence in support of the following facts is presented: (1) In patients maintained on therapeutic anticoagulant (AC) and/or antiplatelet (AP) therapy, for whom cervical medial branch blocks (CMBBs) are being considered, there is strong evidence to guide decisions on continuing or discontinuing these AC/AP agents in preparation for the procedure. (2) Therapeutic anticoagulation (AC) and antiplatelet (APT) agents should be discontinued prior to cervical medial branch radiofrequency neurotomy (CMBRFN) due to serious hemorrhagic risks.