Australasian Journal of Neuroscience最新文献_第8页

The Life and Trials of a Pseudomeningocoele 假性脑膜膨出的生活和试验

Australasian Journal of Neuroscience Pub Date : 2016-05-01 DOI: 10.21307/AJON-2017-124

Larissa Engel, Maira Manch

{"title":"The Life and Trials of a Pseudomeningocoele","authors":"Larissa Engel, Maira Manch","doi":"10.21307/AJON-2017-124","DOIUrl":"https://doi.org/10.21307/AJON-2017-124","url":null,"abstract":"Abstract This case study introduces Ms Z. It discusses her story and the nursing care of her journey with a diagnosis of a pseudomeningocele. This case study was developed using direct interviews with the patient, discussions with the patient’s surgeon, research articles, viewing scans, photos and using the patient’s clinical notes. The patient’s journey with the pseudomeningocele spans over a 20 year period with many up’s and downs throughout, resulting with what is hoped to be a better quality of life. Ms Z’s symptoms started at the age of sixteen. She experienced severe headaches when she coughed or laughed and was seen by a neurologist at the time but no clear diagnosis was made. Her symptoms continued and after multiple medical appointments, a diagnosis of Chiari Malformation was made. She had her first surgery in 2013 after which Ms Z reported her complications began to occur. She moved to New Zealand and started to get more unwell and presented to a rural emergency department (ED). She has undergone multiple procedures in New Zealand including long term intravenous (IV) antibiotics resulting from an infection previously undiagnosed. Nursing considerations will be discussed throughout the case study including peri and postoperative care for neurosurgical patients with pseudomeningoceles, complications to be aware of, and holistic support for patients - physical, emotional and psychological.","PeriodicalId":32533,"journal":{"name":"Australasian Journal of Neuroscience","volume":"66 1","pages":"33 - 37"},"PeriodicalIF":0.0,"publicationDate":"2016-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83180178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mild Traumatic Brain Injury: Adapting to Consequences 轻度创伤性脑损伤:适应后果

Australasian Journal of Neuroscience Pub Date : 2015-10-01 DOI: 10.21307/AJON-2017-115

Nutthita Petchprapai

{"title":"Mild Traumatic Brain Injury: Adapting to Consequences","authors":"Nutthita Petchprapai","doi":"10.21307/AJON-2017-115","DOIUrl":"https://doi.org/10.21307/AJON-2017-115","url":null,"abstract":"Abstract Mild traumatic brain injury (mTBI) affects more than 28,000 individuals annually in Thailand; however, little information about outcome after mTBI is known. This investigation aimed to explore consequences of mTBI among Thai adults who experienced mTBI in the previous 3-12 months. A sample of 135 adults was interviewed. Subjects were typically men, middle aged and approximately half were married. All completed the compulsory level of education in Thailand and were in the low income bracket. Subjects had Glasgow Coma Scores 14/15 at 30 minutes after injury and 15/15 (full score) after 3 days. Subjects reported low post-concussion symptoms scores and few depressive symptoms. All subjects worked or studied before the injury and almost of them returned to normal lives at the time of interview. However, 18% did experience moderately severe disability and 1.5% suffered severe disabilities. Future studies with longitudinal, comparison, or predictive methodology with reduced but relevant variables are suggested. Measures used in this study demonstrated reliability, supporting their use in Thailand. Providing health education and printed information regarding outcomes and disability after mTBI is recommended. Further study of the small but clinically important percentage of subjects who experience ongoing disability after mTBI is needed.","PeriodicalId":32533,"journal":{"name":"Australasian Journal of Neuroscience","volume":"2 1","pages":"12 - 19"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75948764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Enquiry into Practice: Management of Terminal Catastrophic Intracranial Haemorrhage in Palliative Care 实践探讨:临终灾难性颅内出血在姑息治疗中的处理

Australasian Journal of Neuroscience Pub Date : 2015-10-01 DOI: 10.21307/ajon-2017-116

Anna Smith

引用次数: 0

Timely Anticoagulant Thromboprophylaxis is Safe and Effective in the Care of Patients Suffering Traumatic Brain Injury 及时抗凝预防血栓在外伤性脑损伤患者的护理中是安全有效的

Australasian Journal of Neuroscience Pub Date : 2015-10-01 DOI: 10.21307/AJON-2017-118

Kandace Micallef

{"title":"Timely Anticoagulant Thromboprophylaxis is Safe and Effective in the Care of Patients Suffering Traumatic Brain Injury","authors":"Kandace Micallef","doi":"10.21307/AJON-2017-118","DOIUrl":"https://doi.org/10.21307/AJON-2017-118","url":null,"abstract":"Abstract Despite the high prevalence and associated morbidity of Venous Thromboembolism (VTE) development, thromboprophylaxis in the neurosurgical setting remains a source of contention due to concerns of iatrogenic haemorrhage progression associated with anticoagulant thromboprophylaxis. Opinions of ideal time to initiate chemical prophylaxis for VTE within the neurosurgical community vary between clinicians. It is nevertheless rarely disputed that timely and appropriate prophylaxis of VTE reduces morbidity. This review aims to determine the safety and efficacy of chemical VTE prophylaxis within the neurosurgical setting. The consequences of VTE can be devastating and patients with neurotrauma are amongst those at greatest risk. With this in mind, the neuroscience nurse must be meticulously conscientious for the prevention of VTE in the neurosurgical setting. The neurosurgical nurse has a close affiliation to the patient, is often the first to observe the clinical signs and symptoms associated with VTE, is responsible for implementing prevention strategies and assisting with treatment for those who unfortunately develop a Deep Vein Thrombosis or Pulmonary Embolism (PE).","PeriodicalId":32533,"journal":{"name":"Australasian Journal of Neuroscience","volume":"28 1","pages":"30 - 35"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90525384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Neurological Integrated Care Pathway 神经系统综合护理途径

Australasian Journal of Neuroscience Pub Date : 2015-10-01 DOI: 10.21307/AJON-2017-117

K. McCoy, H. Chan

{"title":"A Neurological Integrated Care Pathway","authors":"K. McCoy, H. Chan","doi":"10.21307/AJON-2017-117","DOIUrl":"https://doi.org/10.21307/AJON-2017-117","url":null,"abstract":"Abstract Objective To assess the feasibility of service integration for neurological care. Design Observation study Participants A total of 104 admissions for 92 neurological patients treated in a major region hospital and suitable for discharge home were eligible for participation. Intervention A neurological integrated care pathway (NICP) was trialled at a major regional hospital between July 2012 and June 2013. Objective data included patients, gender, age, diagnosis, length of hospital stay, referral dates, discharge dates, dates when patients were seen by the community neurological liaison nurse, and readmissions were collated for analyses. Outcome measures Targeted outcomes included the estimated service impact on the hospital in terms of reduced length of hospital stay and decreased readmissions and increased referral rate to community neurological support service, and quality of patient care. Results The trial saw an increase in efficiency and standard of care despite growth in patient numbers. The CNLN attended to 104 recorded referrals (more than 17 times the number of referrals in 2011), all within 7 days of their referral date (a 77.4% decrease compared to 2011 where patients were attended to up to 31 days). In addition, the average length of hospital stay had decreased significantly from 26 days in 2011 to 9 days (a 65.4% decrease) with a low rate of re-admission (approximately 11.5%). Conclusion The NICP improved service efficiency for both the hospital system and the community neurological support service, with high levels of patient satisfaction. In this case the NICP achieved best value from existing resources and provided a viable model of service delivery for chronic neurological conditions.","PeriodicalId":32533,"journal":{"name":"Australasian Journal of Neuroscience","volume":"17 1","pages":"25 - 29"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78565181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Yesterday, Today & Tomorrow: Best Practice for CSF Sampling of an EVD to Minimise Patient Risk 昨天，今天和明天:埃博拉病毒病脑脊液取样的最佳做法，以尽量减少患者风险

Australasian Journal of Neuroscience Pub Date : 2015-10-01 DOI: 10.21307/AJON-2017-114

R. Crane, Nicole M. King

{"title":"Yesterday, Today & Tomorrow: Best Practice for CSF Sampling of an EVD to Minimise Patient Risk","authors":"R. Crane, Nicole M. King","doi":"10.21307/AJON-2017-114","DOIUrl":"https://doi.org/10.21307/AJON-2017-114","url":null,"abstract":"Abstract Managing raised intracranial pressure (ICP) with the use of an external ventricular drain (EVD) is a common occurrence in a neurosurgical setting. A central role of the neuroscience nurse in managing that EVD is to monitor the patient for signs and symptoms of infection otherwise known as ventriculitis. Cerebrospinal fluid (CSF) sampling from an EVD has historically been completed as a daily routine specimen to monitor for any signs of infection. However, in more recent times there has been evidence to suggest that specimens should only be collected when infection or ventriculitis is suspected to minimise the interruption of the closed system. Different practices have been identified related to the frequency of sampling, the best solution for decontamination of the sampling site/port and preferable port for obtaining the specimen. Our aim was to complete an integrative literature review. Medline Complete and CINAHL were searched and articles were screened. Nine articles were used to form the integrated review. The main findings were collated and found that daily sampling is no longer recommended. The proximal port was the most popular choice for sampling. Decontaminating solutions used for accessing an EVD varied with no evidence to support the choice of solution. Findings of the majority of papers were focussed on sampling frequency and other associated ways to minimise infection rather than choice of sampling site or the use of specific decontaminating solutions.","PeriodicalId":32533,"journal":{"name":"Australasian Journal of Neuroscience","volume":"48 1","pages":"7 - 11"},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87979576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Central Pontine Myelinolysis: A Case Study 桥脑中央髓鞘溶解一例研究

Australasian Journal of Neuroscience Pub Date : 2015-05-01 DOI: 10.21307/ajon-2017-108

L. Arrowsmith, C. Tolar

{"title":"Central Pontine Myelinolysis: A Case Study","authors":"L. Arrowsmith, C. Tolar","doi":"10.21307/ajon-2017-108","DOIUrl":"https://doi.org/10.21307/ajon-2017-108","url":null,"abstract":"Abstract Central Pontine Myelinolysis (CPM) commonly presents as a complication of treatment in patients with profound life threatening hyponatraemia. It occurs when the sodium level is corrected too rapidly. Hyponatraemia should never be corrected at a rate greater than 8-10mmol/L of sodium per day. Rapid correction causes extracellular tonicity and will continue to drive water out of the brain’s cells leading to cellular dysfunction. Frequent clinical signs include dysphagia, dysarthria, diplopia and acute para/quadraparesis. Patients can also experience locked in syndrome, where cognitive function is intact but all muscles are paralysed with the exception of eye blinking. CPM gets its name as it occurs when cell dysfunction causes destruction of the myelin sheath of nerve cells in the brain stem, more specifically the pons. It is associated with poor prognosis and prevention is of primary importance. Freddy is a 35 year old freelance graphic designer, fitness instructor and ultra-marathon runner. In October 2011 he competed in the Sahara Marathon in Morocco, a 6 day 255km ultra-marathon. At the end of the third day Freddy was found collapsed and vomiting. He was confused and was suffering severe leg cramps. The next morning Freddy suffered a single convulsive episode and was subsequently transferred to a hospital in Egypt.","PeriodicalId":32533,"journal":{"name":"Australasian Journal of Neuroscience","volume":"15 1","pages":"15 - 19"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77801636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The lived experience of adults with myasthenia gravis: A phenomenological study 成人重症肌无力的生活经验:现象学研究

Australasian Journal of Neuroscience Pub Date : 2015-05-01 DOI: 10.21307/AJON-2017-112

Trudy Keer-Keer

{"title":"The lived experience of adults with myasthenia gravis: A phenomenological study","authors":"Trudy Keer-Keer","doi":"10.21307/AJON-2017-112","DOIUrl":"https://doi.org/10.21307/AJON-2017-112","url":null,"abstract":"Abstract Myasthenia gravis (MG) is a disorder of the neuromuscular junction (NMJ) that causes fatigue and fluctuating muscle weakness (Hickey, 2009). The physiology of this disease is well understood and there are numerous medically focused articles that outline historical data, randomized controlled trials of treatment options and unusual case studies. The nursing literature about MG is limited and dated. The aim of this study was to examine and understand the lived experiences of adults with MG. An interpretive phenomenological approach has been used that applies the research methodology of van Manen (1990). Seven people living with MG were interviewed and their experiences of the disease recorded. Questions were broadly worded about various topics related to MG and were guided by individual experiences. Thematic analysis revealed that MG affects every aspect of a person’s ‘lifeworld’: their sense of time, body, space and their relationships with others. The findings of this study highlight three main themes embedded in the data that a person with MG experiences: living with uncertainty, living with weakness and living with change. These experiences have been interpreted and discussed to gain a deep understanding of the meaning of the disease. This study raises awareness of MG for neuroscience nurses and provides a unique view of this disease.","PeriodicalId":32533,"journal":{"name":"Australasian Journal of Neuroscience","volume":"1 1","pages":"40 - 46"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80810472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Effectiveness of the Sitting Position Without Back Support 没有背部支撑的坐姿的有效性

Australasian Journal of Neuroscience Pub Date : 2015-05-01 DOI: 10.21307/ajon-2017-111

Nobuko Okubo

{"title":"Effectiveness of the Sitting Position Without Back Support","authors":"Nobuko Okubo","doi":"10.21307/ajon-2017-111","DOIUrl":"https://doi.org/10.21307/ajon-2017-111","url":null,"abstract":"Abstract Purpose In the field of neuroscience nursing in Japan, the “sitting position without back support” (SB) has promoted earlier ambulation, improved level of consciousness, and prevented disuse syndrome in patients with disturbance of consciousness and impaired mobility. This research was conducted with the aim of examining if respiratory function improved using SB on acute patients on ventilation in ICU. Method The research design involved daily administration of SB to 10 participants in a controlled trial to compare respiratory function before, during, and after implementation. The measurement indexes were respiratory functions such as tidal volume and lung compliance value and the number of incidences that occurred during implementation, and tools such as APACHE II were used to measure deteriorations of physical condition. Analysis used non-parametric and parametric methods and an alpha level of 0.05 was used for all statistical tests. Results Tidal volume and lung compliance value during SB implementation significantly increased, compared to before and after implementation. There were no incidents such as decannulation during implementation, and APACHE II scores were seen to significantly drop after the commencement of SB until discharge from ICU. However, a decline in pulse rate and blood pressure were seen during implementation of SB (4.8%). Conclusion The sitting position without back support administered to acutely ill patients on a ventilator was effective in improving respiratory function. In the future, there is a need to create a nurse’s assessment guide for implementation of SB and test the SB on a larger population.","PeriodicalId":32533,"journal":{"name":"Australasian Journal of Neuroscience","volume":"17 1","pages":"31 - 39"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90894081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Importance of a Multidisciplinary Team Approach for Optimizing Pituitary Surgery Outcomes 多学科团队方法对优化垂体手术结果的重要性

Australasian Journal of Neuroscience Pub Date : 2015-05-01 DOI: 10.21307/AJON-2017-110

Amy A. Eisenberg, N. Mclaughlin, P. Cohan, C. Griffiths, G. Barkhoudarian, D. Kelly

{"title":"Importance of a Multidisciplinary Team Approach for Optimizing Pituitary Surgery Outcomes","authors":"Amy A. Eisenberg, N. Mclaughlin, P. Cohan, C. Griffiths, G. Barkhoudarian, D. Kelly","doi":"10.21307/AJON-2017-110","DOIUrl":"https://doi.org/10.21307/AJON-2017-110","url":null,"abstract":"Abstract Pituitary tumors including pituitary adenomas and related lesions such as craniopharyngiomas and Rathke’s cleft cysts present with a wide range of hormonal and neurological signs and symptoms resulting in a variety of referral pathways. A multidisciplinary approach to the diagnostic evaluation and treatment plan is essential to optimise outcomes. The patient is seen by each member of the team, including neurosurgeon, endocrinologist, head & neck surgeon, nurse practitioner and in some instances neuro-ophthalmologist, oncologist, radiation oncologist and interventional neuroradiologist. Appropriate investigations are undertaken and a further meeting arranged at which all opinions are discussed. A reasoned treatment regimen is recommended, taking into consideration the patient’s wishes and overall medical condition. This manuscript describes the team approach currently employed in the Brain Tumor Center and Pituitary Disorders Program at Providence Saint John’s Health Center & John Wayne Cancer Institute. When referring pituitary patients to this centre, health care professionals and patients alike are experiencing the positive benefits received from a patient-centred, multidisciplinary approach.","PeriodicalId":32533,"journal":{"name":"Australasian Journal of Neuroscience","volume":"32 1","pages":"24 - 30"},"PeriodicalIF":0.0,"publicationDate":"2015-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74915750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0