Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques最新文献_第2页

P.095 Role of selective neck dissections in the management of carotid body tumours P.095 颈部选择性切除术在颈动脉体肿瘤治疗中的作用

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques Pub Date : 2024-05-24 DOI: 10.1017/cjn.2024.200

G Francis, GE Pickett, S Taylor

{"title":"P.095 Role of selective neck dissections in the management of carotid body tumours","authors":"G Francis, GE Pickett, S Taylor","doi":"10.1017/cjn.2024.200","DOIUrl":"https://doi.org/10.1017/cjn.2024.200","url":null,"abstract":"Background: Carotid body tumours (CBT) are rare neoplasms of the paraganglia at the carotid bifurcation. Histopathologic analysis alone is insufficient to confirm malignancy, requiring metastases to non-neuroendocrine tissue including cervical lymph nodes for definitive diagnosis. The role of selective neck dissection (SND) during CBT surgeries in detecting malignancy and guiding subsequent management remains uncertain. Methods: A retrospective case series was performed on all patients undergoing CBT surgeries with SND between 2002 and 2022. Data collection included demographics, genetic and laboratory testing, imaging, intra- and post-operative complications, follow-up and histopathology. Results: Twenty-one patients underwent CBT resection with SND. Of these, 3 had carotid artery injuries, and 5 had nerve injuries. One patient experienced peri-operative embolic strokes, presumed related to tumour embolization. Three patients were found to have lymph node involvement, confirming malignancy. Malignancy was significantly associated with the risk of carotid injury (p = 0.04.) Conclusions: SND is a useful adjunct in detecting malignancy during CBT resection. The incidence of malignancy in CBT is low but not negligible and SND should be considered in patients with suspected malignancy or high-risk factors. This study’s 14% incidence of malignancy suggests there may be a rationale for considering universal implementation of SND during CBT resection.","PeriodicalId":9571,"journal":{"name":"Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101132","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

F.3 Multicentre prospective validation of integrated molecular classification of meningiomas and prediction of recurrence risk using DNA methylation F.3 脑膜瘤综合分子分类的多中心前瞻性验证以及利用DNA甲基化预测复发风险

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques Pub Date : 2024-05-24 DOI: 10.1017/cjn.2024.105

JZ Wang, V. Patil, A. Landry, C. Gui, A. Ajisebutu, C Wilson, A. Cohen Gadol, A. Rebchuk, S. Makarenko, S. Yip, K. Aldape, F. Nassiri, G. Zadeh

{"title":"F.3 Multicentre prospective validation of integrated molecular classification of meningiomas and prediction of recurrence risk using DNA methylation","authors":"JZ Wang, V. Patil, A. Landry, C. Gui, A. Ajisebutu, C Wilson, A. Cohen Gadol, A. Rebchuk, S. Makarenko, S. Yip, K. Aldape, F. Nassiri, G. Zadeh","doi":"10.1017/cjn.2024.105","DOIUrl":"https://doi.org/10.1017/cjn.2024.105","url":null,"abstract":"Background: Meningiomas have significant heterogeneity between patients, making prognostication challenging. For this study, we prospectively validate the prognostic capabilities of a DNA methylation-based predictor and multiomic molecular groups (MG) of meningiomas. Methods: DNA methylation profiles were generated using the Illumina EPICarray. MG were assigned as previously published. Performance of our methylation-based predictor and MG were compared with WHO grade using generalized boosted regression modeling by generating time-dependent receiver operating characteristic (ROC) curves and computing area under the ROC curves (AUCs) along with their 95% confidence interval using bootstrap resampling. Results: 295 meningiomas treated from 2018-2021 were included. Methylation-defined high-risk meningiomas had significantly poorer PFS and OS compared to low-risk cases (p<0.0001). Methylation risk increased with higher WHO grade and MG. Higher methylome risk (HR 4.89, 95%CI 2.02-11.82) and proliferative MG (HR 4.11, 95%CI 1.29-13.06) were associated with significantly worse PFS independent of WHO grade, extent of resection, and adjuvant RT. Both methylome-risk and MG classification predicted 3- and 5-year PFS and OS more accurately than WHO grade alone (ΔAUC=0.10-0.23). 42 cases were prescribed adjuvant RT prospectively although RT did not significantly improve PFS in high-risk cases (p=0.41). Conclusions: Molecular profiling outperforms conventional WHO grading for prognostication in an independent, prospectively collected cohort of meningiomas.","PeriodicalId":9571,"journal":{"name":"Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques","volume":"11 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099629","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

D.6 Neurological care and outcomes of pregnant patients with epilepsy in a Canadian tertiary care center (2014-2020) D.6 加拿大三级医疗中心癫痫孕妇的神经护理和治疗效果（2014-2020 年）

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques Pub Date : 2024-05-24 DOI: 10.1017/cjn.2024.97

S Chan, Y. Iyengar, J Snelgrove, J Hebert, E Bui

{"title":"D.6 Neurological care and outcomes of pregnant patients with epilepsy in a Canadian tertiary care center (2014-2020)","authors":"S Chan, Y. Iyengar, J Snelgrove, J Hebert, E Bui","doi":"10.1017/cjn.2024.97","DOIUrl":"https://doi.org/10.1017/cjn.2024.97","url":null,"abstract":"Background: Limited data exists on neurological care and outcomes of Canadian pregnant patients with epilepsy (PPWE). This study provides Canadian data to inform practice patterns and observed outcomes for PPWE at a tertiary care center. Methods: PPWE receiving care at the University Health Network (Toronto, Canada) epilepsy clinic from January 1, 2014 to November 20 2020 were retrospectively identified with demographics and neurological data and outcomes collected. Results: A total of 195 cases were identified, with a median maternal age of 32 years (SD 4.58), a median age at first seizure of 17 years (range 1 month – 36 years old), 52% were diagnosed with genetic generalized epilepsy and 50% endorsed 6 months of seizure freedom prior to conception. In pregnancy, 93% took ASM(s) with 77% receiving therapeutic drug monitoring (TDM) and drug dose adjustments reported in 69%. Most cases (73%) maintained a stable seizure frequency. Conclusions: This study provides new Canadian data on PPWE at a tertiary care center. PPWE are overall well controlled, more likely to have young adult onset, genetic generalized epilepsy with nearly all taking ASM(s) during pregnancy. While high rates of TDM and drug dose adjustments were observed, most experienced seizure stability in pregnancy.","PeriodicalId":9571,"journal":{"name":"Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques","volume":"2 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141098599","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

P.035 Cardiac screening in children with genetic epilepsy at risk for sudden unexpected death in epilepsy P.035 对有癫痫猝死风险的遗传性癫痫患儿进行心脏筛查

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques Pub Date : 2024-05-24 DOI: 10.1017/cjn.2024.142

J. Ezekian, A. Aschner, L. Zahavich, R. Hamilton, E. Donner, A. Bulic

{"title":"P.035 Cardiac screening in children with genetic epilepsy at risk for sudden unexpected death in epilepsy","authors":"J. Ezekian, A. Aschner, L. Zahavich, R. Hamilton, E. Donner, A. Bulic","doi":"10.1017/cjn.2024.142","DOIUrl":"https://doi.org/10.1017/cjn.2024.142","url":null,"abstract":"Background: People with epilepsy experience higher rates of cardiac arrhythmia and sudden death than the general population, with the highest risk in genetic epilepsies. Despite growing evidence of a possible cardiac contribution, routine cardiac screening for epilepsy patients is rarely performed. Methods: We performed a single center, retrospective review of patients with developmental epileptic encephalopathies caused by genetic variants expressed in the heart and brain. Clinical history, medications, age, and cardiac evaluation data were extracted. Results: Among 67 patients (56% female), 54 (81%) had at least one ECG. Twenty (37%) had an abnormal ECG. Forty-one had a repeat ECG: 8 showed persistent abnormalities, 7 resolution of abnormalities, and 7 a new abnormality. Five patients with an abnormality did not receive a follow up ECG. Two patients each had histories of cardiac arrest, syncope, and sudden death in a family member. Cardiac phenotypes differed in patients who experienced generalized tonic-clonic seizures and patients with epilepsy for 3+ years. Conclusions: Almost 1/3 of our high-risk epilepsy cohort had history of cardiac events or abnormalities on cardiac testing. Seizure type and epilepsy duration were associated with altered cardiac phenotypes. Since some findings were potentially clinically significant, routine cardiac screening of high-risk epilepsy patients may be warranted.","PeriodicalId":9571,"journal":{"name":"Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques","volume":"3 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141100776","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

P.005 Eptinezumab demonstrated efficacy regardless of prior preventive migraine treatment failure: post hoc DELIVER analyses P.005 无论之前的偏头痛预防性治疗是否失败，Eptinezumab 都能显示出疗效：DELIVER 事后分析

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques Pub Date : 2024-05-24 DOI: 10.1017/cjn.2024.113

P Pozo-Rosich, M Ashina, SJ Tepper, S. Jensen, L Pickering Boserup, M Krog Josiassen, B Sperling, JK Bougie, J. Miron

{"title":"P.005 Eptinezumab demonstrated efficacy regardless of prior preventive migraine treatment failure: post hoc DELIVER analyses","authors":"P Pozo-Rosich, M Ashina, SJ Tepper, S. Jensen, L Pickering Boserup, M Krog Josiassen, B Sperling, JK Bougie, J. Miron","doi":"10.1017/cjn.2024.113","DOIUrl":"https://doi.org/10.1017/cjn.2024.113","url":null,"abstract":"Background: This post hoc analysis evaluated the efficacy of eptinezumab vs placebo across 24 weeks of treatment in the placebo-controlled period of the DELIVER study in subgroups defined by prior treatment failure. Methods: DELIVER (NCT04418765) randomized adults with migraine to eptinezumab 100 mg, 300 mg, or placebo intravenous infusion every 12 weeks. Eligible patients needed documented evidence of 2–4 prior preventive treatment failures within the past 10 years. This post hoc analysis focused on subgroups of patients with prior treatment failure on topiramate, beta blockers, amitriptyline, and/or flunarizine. Results: The full analysis set included 890 patients: 633 previously failed topiramate, 538 failed beta blockers, 508 failed amitriptyline, and 333 failed flunarizine; within each subgroup, most patients had 2 prior treatment failures (51–56%). Across Weeks 1–12 in all subgroups, patients treated with eptinezumab experienced greater reductions from baseline in MMDs than those receiving placebo, with larger reductions observed over Weeks 13–24. Similarly, ≥50% MRRs were higher with eptinezumab than with placebo and increased following a second infusion. Conclusions: Eptinezumab demonstrated greater reductions in MMDs compared with placebo across all subgroups of prior preventive treatment failure, with evidence to suggest that a second dose provides additional benefit.","PeriodicalId":9571,"journal":{"name":"Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques","volume":"7 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101222","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

P.052 Utility of amyotrophic lateral sclerosis functional rating scale (ALSFRS) bulbar subscores for predicting need for gastrostomy tube P.052 肌萎缩性脊髓侧索硬化症功能评定量表（ALSFRS）球部亚评分对预测胃造瘘管需求的实用性

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques Pub Date : 2024-05-24 DOI: 10.1017/cjn.2024.159

T. Perera, J. Greenfield, G. Jewett

{"title":"P.052 Utility of amyotrophic lateral sclerosis functional rating scale (ALSFRS) bulbar subscores for predicting need for gastrostomy tube","authors":"T. Perera, J. Greenfield, G. Jewett","doi":"10.1017/cjn.2024.159","DOIUrl":"https://doi.org/10.1017/cjn.2024.159","url":null,"abstract":"Background: We evaluated the utility of the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS) in predicting risk of gastrostomy tube (G-tube) insertion in patients with ALS. Methods: We conducted a retrospective study using the Pooled Resource Open-Access ALS Clinical Trials Database. People with ALS, at least two ALSFRS scores, and baseline swallowing subscore >1 were included. G-tube outcome was defined as reaching a swallowing subscore ≤1. Predictors were ALSFRS bulbar subscores (swallowing, speech, salivation). Survival analyses estimated median time to outcome and cumulative probability of outcome within 91 days. Individuals were censored at last ALSFRS score. Results: We included 6,943 participants. Median [95% CI] time to G-tube insertion was 245 [228, 285], 562 [547, 621], and 1,268 [980, 1,926] for baseline swallowing subscores of 2, 3, and 4, respectively. Probability of G-tube insertion was associated with baseline swallowing, speech, and salivation subscores (log-rank test p < 0.0001). For patients who transitioned to a swallowing subscore of 2 or 3, 18.1% [95% CI 16.1, 20.3] and 1.9% [95% CI 1.3, 2.7] required G-tube insertion within 91 days of score transition. Conclusions: ALSFRS bulbar subscores may identify patients at risk of G-tube insertion. Probability of G-tube insertion within 91 days is low if swallowing subscore ≥3.","PeriodicalId":9571,"journal":{"name":"Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques","volume":"39 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141102275","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

P.136 Implementation of BC Children’s Hospital’s intraventricular hemorrhage of prematurity management pathway: a quality improvement analysis P.136 不列颠哥伦比亚省儿童医院早产儿脑室内出血管理路径的实施：质量改进分析

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques Pub Date : 2024-05-24 DOI: 10.1017/cjn.2024.237

MW Elder, A. Weir, I. Watson, F. Haji, A. Singhal, M. Tamber

{"title":"P.136 Implementation of BC Children’s Hospital’s intraventricular hemorrhage of prematurity management pathway: a quality improvement analysis","authors":"MW Elder, A. Weir, I. Watson, F. Haji, A. Singhal, M. Tamber","doi":"10.1017/cjn.2024.237","DOIUrl":"https://doi.org/10.1017/cjn.2024.237","url":null,"abstract":"Background: Early placement of a ventricular access device (VAD) may decrease the need for permanent CSF diversion and improve cognitive outcomes in premature infants with intraventricular hemorrhage. In 2019, BC Children’s Hospital implemented a multidisciplinary early intervention pathway for these infants. This study evaluated process and compliance measures related to protocol implementation. Methods: A retrospective quality improvement chart review of enrolled infants was performed. Select measures included time to neurosurgery consult and intervention, compliance with VAD tapping and ultrasound protocols, overall ultrasound resource use, and complications. Results: Sixteen patients were included. Median time to VAD insertion was 6 days (IQR 4-9.5), greater than the 3-day target. Transfer time from peripheral NICUs and access to OR time were found to be important reasons for delay. Patients received a median 92.2% (IQR 85.1-100%) of the ultrasounds required by protocol, with a median of 36.5 (IQR 29-43.25) ultrasounds per patient. VAD tapping was 88.8% (IQR 75.6-94.8%) compliant; most protocol deviations were indicated taps not performed due to technical difficulties. Conclusions: Compliance with the new protocol was satisfactory. Areas for improvement include continued education at peripheral NICU sites to minimize transfer delays, improved access to the OR, and maintenance of technical skills amongst our NICU partners.","PeriodicalId":9571,"journal":{"name":"Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques","volume":"35 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141102459","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

P.073 Spontaneous fluctuation of contrast enhancement in adult pilocytic astrocytoma and other low-grade brain tumors P.073 成年朝体细胞星形细胞瘤和其他低级别脑肿瘤中对比度增强的自发性波动

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques Pub Date : 2024-05-24 DOI: 10.1017/cjn.2024.179

T. Rohringer, SK Ong, AF Gao, P. Alcaide-Leon

{"title":"P.073 Spontaneous fluctuation of contrast enhancement in adult pilocytic astrocytoma and other low-grade brain tumors","authors":"T. Rohringer, SK Ong, AF Gao, P. Alcaide-Leon","doi":"10.1017/cjn.2024.179","DOIUrl":"https://doi.org/10.1017/cjn.2024.179","url":null,"abstract":"Background: Pilocytic astrocytoma and other circumscribed low-grade brain tumors can exhibit spontaneous enhancement changes despite stable size and clinical status. We aimed to describe this phenomenon in adults. Methods: We performed a retrospective review of our MRI database (2011-2021) to identify cases with enhancement changes in otherwise stable tumors. We searched for reports containing: “pilocytic”, “pilomyxoid”, “RGNT”, “rosette”, “glioneuronal”, “DNET”, and “dysembryoplastic”. Exclusion criteria included WHO grade 3/4 tumors, patients <19 years, equivocal diagnostic findings, and no serial MRIs. We reviewed 238 patients. Results: We identified 12 adult patients with the desired phenomenon: 6 pilocytic astrocytoma, 1 pilomyxoid astrocytoma, 2 rosette-forming glioneuronal tumor, 1 unverified low-grade glioma, and 2 cases without biopsy. Seven were untreated, while five were residual or recurrent tumors. Six showed a pattern of new/increasing and subsequent decreasing/disappearing enhancement over 1-4 years. One exhibited spontaneous regression of enhancement over 1 year. Five showed repeating cycles of increasing and decreasing enhancement over longer monitoring periods of 7-15 years, with mean duration of increasing enhancement prior to decline of 21.4 months (SD 5.9). Conclusions: Spontaneous contrast enhancement fluctuation in adult pilocytic astrocytoma and other circumscribed low-grade brain tumors can occur, and on its own should not be misconstrued as evidence of tumor progression/regression.","PeriodicalId":9571,"journal":{"name":"Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099961","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

B.5 Video-based prehospital teletriage for acute stroke: primary results from a regional pilot-study B.5 基于视频的急性中风院前远程会诊：地区试点研究的主要结果

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques Pub Date : 2024-05-24 DOI: 10.1017/cjn.2024.84

G. Jacquin, O. Bereznyakova, N. Daneault, Y. Deschaintre, C. Odier, A. Poppe, L. Gioia

{"title":"B.5 Video-based prehospital teletriage for acute stroke: primary results from a regional pilot-study","authors":"G. Jacquin, O. Bereznyakova, N. Daneault, Y. Deschaintre, C. Odier, A. Poppe, L. Gioia","doi":"10.1017/cjn.2024.84","DOIUrl":"https://doi.org/10.1017/cjn.2024.84","url":null,"abstract":"Background: Only limited data exist on the potential benefit of prehospital video-based teletriage for patients with acute stroke. Methods: During a 6-month period, all patients from a defined geographical catchment area with a 911 call for acute stroke were screened by the paramedic team on site. Those with known symptom onset of <6h underwent video-based teletriage for transfer to either the closest tertiary (for suspected LVO occlusion) or to the closest secondary stroke centers. Patients referred for thrombectomy by same the secondary stroke centers without teletriage during the same period served as control. Results: Overall, 33 patients were teletriaged and 23 (70%) were bypassed to the tertiary center. Of the latter, 13 (median NIHSS 19) underwent thrombectomy (+/- iv thrombolysis). During the same period, 22 patients (median NIHSS 17) were referred for thrombectomy without teletriage. The median time from 911 to thrombectomy was 129 [IQR 51] min after teletriage, as compared to 196 [74] min in controls (p=0.015). The median NIHSS at 24h was 6 in the teletriage group versus 14.5 in controls (p=0.07). Conclusions: Video-based prehospital teletriage for acute stroke is feasible, reliably identifies patients without LVO stroke and significantly improves the delay between stroke alert and thrombectomy in eligible LVO stroke patients.","PeriodicalId":9571,"journal":{"name":"Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques","volume":"9 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099273","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

P.016 Re-norming medical education: centering patient experience and diverse bodies in Lumbar Puncture (LP) instruction P.016 重新规范医学教育：在腰椎穿刺术（LP）教学中以患者体验和多样化身体为中心

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques Pub Date : 2024-05-24 DOI: 10.1017/cjn.2024.124

E. Lin, W. Koopman, D. Dilkes, C. Casserly

{"title":"P.016 Re-norming medical education: centering patient experience and diverse bodies in Lumbar Puncture (LP) instruction","authors":"E. Lin, W. Koopman, D. Dilkes, C. Casserly","doi":"10.1017/cjn.2024.124","DOIUrl":"https://doi.org/10.1017/cjn.2024.124","url":null,"abstract":"Background: Medical curricula are often created with limited patient and student input and underrepresent certain body types. Traditional medical education often prepares learners to perform procedures, such as lumbar punctures (LPs), on a young white able-bodied 70kg male. When approaching diverse patients, this educational gap can lead to medical learners’ lack of confidence, skill, and knowledge, resulting in poor patient experiences. Methods: This co-design project involves patient and student input. We interviewed five patients who underwent LPs and explored their experience through a trauma-informed approach. To visualize landmarking across body types, we recruited nine volunteers of diverse body sizes, ages, tattoos, and skin colour (Fitzpatrick Scale). Incorporating patient narratives, as well as videos and photographs showing landmarking on diverse bodies, we crafted an online LP instructional module. Focus groups of 6-10 students will be held to collect student perception of the effectiveness of the module. Results: Our learning module and related media will be built into Western University’s Undergraduate Medical Education curriculum, available under a Creative Commons license through the Western Health Education Media Library. Conclusions: Integrating patient experience and student feedback, we are developing a comprehensive educational tool to better equip medical learners to deliver patient-centered LPs across diverse body types.","PeriodicalId":9571,"journal":{"name":"Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques","volume":"10 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141098658","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