There are few reports in the literature of tuberculous brain abscess. Tuberculous brain abscess usually occurs in an immunocompromised host. Almost all previously documented cases have involved ...acquired immune deficiency syndrome. We encountered a 53-year-old right-handed immunocompetent male who was initially suspected of having a cerebrovascular accident due to acute-onset right hemiparesis and paresthesia. A tentative diagnosis of brain tumor versus brain abscess was made on imaging studies. The patient was finally diagnosed with a tuberculous brain abscess based upon deterioration on imaging and a positive tuberculosis culture. The tuberculous brain abscess was located in the left parietal lobe, which resulted in Gerstmann's syndrome and right-sided apraxia. Stereotactic surgery was performed. He was also given antituberculosis chemotherapy and comprehensive rehabilitation. Considerable improvement was noted after rehabilitation. The patient even returned to a normal life and work. Our case demonstrates that an aggressive intensive inpatient rehabilitation program combined with stereotactic surgery and effective antituberculosis therapy play an important role in improving the outcome for patients with tuberculous brain abscess, Gerstmann's syndrome, and right-sided apraxia.
Immigration has expanded dramatically in both traditional and emerging receiving nations. This worldwide boom has profoundly altered urban areas as new arrivals have transformed inner cities and ...suburbs alike into bastions of new ethnic economic activity. Examining the essential role of space in assisting and modifying ethnic business activity, this book considers how ethnic economies are reshaping the urban landscape in the United States, Britain, Australia, Canada, Germany, and Italy. Each chapter explores the significance of urban space and local context in the development of an ethnic economy and how, in turn, ethnic economies have helped to recreate urban neighborhoods. With its international scope and rich case studies, this book will be invaluable for scholars and students alike in the fields of ethnic studies, urban studies, economic development, geography, and sociology.
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Introduction:
The combination of local impedance (LI), a direct measure of electrical resistance at the catheter tip, and contact force (CF) may facilitate treatment of atrial ...fibrillation (AF). This trial is designed to examine the safety and effectiveness of a novel RF catheter that allows measurement of both LI and CF.
Hypothesis:
Demonstrate the safety and effectiveness of a novel radiofrequency catheter with LI and CF for treatment of drug refractory, recurrent, symptomatic Paroxysmal AF (PAF).
Methods:
NEwTON AF is a multi-center, global, prospective, single arm study. Patients received index treatment for PAF with the study catheter. The present 6-month endpoint analysis was prospectively planned.
Results:
The study treated 299 patients at 45 sites in North America, Europe, and Asia. Patients were 39.5% female with a mean age of 62yrs (±12), and had a mean LVEF of 59% and an LA diameter of 3.9cm. Procedure time, LA dwell, and fluoroscopy times were 166, 136, and 15 minutes, respectively. High-power short-duration (HSPD, 45-50W) was exclusively used in 210 cases, which had notably shorter procedure times than the 82 cases that used conventional power, 148 vs 208 min, respectively. Acute procedural success was observed in 98.3% of cases. As of 6 months, freedom from documented recurrence of any atrial arrhythmia was 79.9% (Figure). Recurrence in relation to LI shows that pts with a 20Ω LI drop (in at least 60% of lesions) had better 6m outcomes (84.2% vs 73.3, p=0.04). The freedom from safety event rate at 30d was 96.0%; events included pericarditis (6), access complications (2), pulmonary edema (2), embolism (2), cerebrovascular accident (1), tamponade (1). Pericarditis was higher in pts with a history of COVID at enrollment, 16.3% vs 5.9%, p=0.025.
Conclusions:
This data suggests that patient outcomes and safety for this novel catheter are promising. Further data from this study, including 12m outcomes, and detailed analysis of local impedance data are forthcoming.
The right atrial appendage atrial tachycardia (RAA AT) has been previously reported as a rare site in focal AT. We report a patient with a history of a right pneumonectomy who underwent catheter ...ablation of the AT originating from the RAA. This RAA AT showed unusual P‐wave morphology compared with previous reports. We describe the RAA AT following right pneumonectomy using a NavX system (St. Jude Medical, St. Paul, MN, USA). (PACE 2010; e46–e48)
Background/Purpose Accurate length-of-stay (LOS) estimates have an impact on medical costs for stroke patients. Most studies have reported only descriptive sample means or have provided ...linear-model-based estimates for LOS. This study calculated point and interval estimates by treating hospital discharge as an event, and utilizing the proportional hazards (PH) model to provide the estimation of hospital stay for first-ever stroke patients in a rehabilitation department of a clinical center. Methods Pairwise analysis for correlations between age, sex, comorbidity status, modified Barthel index (MBI) and functional independence measure (FIM) was performed. These explanatory variables are used in the K-sample comparisons, the c2 test for association, the PH regression analysis, and log-transformed linear (LTL) regression. Results The PH model gave a prediction on estimated mean LOS, with an absolute bias of 0.85 days, by combining MBI and FIM into a single variable, or a bias of 1.15 days and 1.16 days with MBI and FIM variables, respectively. The LTL-based estimation generated a bias of 5.91 days. The PH model has relatively shorter confidence intervals than those obtained by sample-mean and LTL methods. Conclusion We recommend using the PH model for predicting mean LOS when the PH assumption for patients with different clinical characteristics is satisfied. However, the proposed method only applies to rehabilitating stroke patients.
Abstract Background It is unclear whether atrial fibrillation (AF) adversely influences the clinical course of patients with hepatocellular carcinoma (HCC). Methods During the period from January 1, ...2001 to December 31, 2010, 476 patients (mean ± SD age 60.3 ± 12.9 years) diagnosed with HCC were retrospectively enrolled in our study. The HCC stage, treatment, baseline characteristics, underlying cardiovascular diseases, and corresponding drug treatment were systematically reviewed. The primary endpoint was death from any cause. Results AF was associated with a significantly reduced survival time in patients with HCC (AF vs. non-AF patients mean ± SD survival time 470.1 ± 89.6 days vs. 1161.2 ± 32.6 days, log-rank p < 0.001; probability of survival 0.20, 95% confidence interval 0.10–0.38, p < 0.001). After adjustment for sex and age, AF was still associated with poorer survival times (hazard ratio 4.131, 95% confidence interval 2.134–5.733, p < 0.001). The causes of death among 22 patients with both HCC and AF included 11 cases of hepatic failure, four cases of ruptured tumor, and two cases of bleeding from esophageal varices. None of these patients with AF used warfarin. Seven bleeding events related to HCC were noted, but none of these patients developed a major thromboembolism. The mean ± SD follow-up period was 645 ± 468 days. Conclusion Patients with HCC had a significantly reduced survival time with the comorbidity of AF. Tumor rupture was relatively common among patients with both HCC and AF. The anticoagulation treatment of AF in patients with HCC deviated from the current guidelines without an increase in thromboembolic events.
This study aimed to evaluate whether CHADS(2) and CHA(2)DS(2)-VASc scores are useful for risk stratification in patients after catheter ablation of atrial fibrillation (AF).
AF is associated with ...increased risk of cardiovascular events. However, limited data are available on the predictors of adverse events in patients with AF after catheter ablation.
A total of 565 patients with AF who underwent catheter ablation were enrolled in the study. The clinical endpoint was occurrence of thromboembolic events (ischemic stroke, transient ischemic attack, peripheral embolism, or pulmonary embolisms) or death during follow-up after catheter ablation.
During a follow-up of 39.2 ± 22.6 months, 27 patients (4.8%) experienced adverse events. Both the CHADS(2) and CHA(2)DS(2)-VASc scores were useful predictors of events in separate multivariate models. The areas under the receiver-operator characteristic curves based on the CHADS(2) and CHA(2)DS(2)-VASc scores in predicting events were 0.785 and 0.830, respectively. Although the difference did not reach statistical significance (p = 0.116), the CHA(2)DS(2)-VASc score could be used to further stratify the patients with CHADS(2) scores of 0 or 1 into 2 groups with different event rates (7.1% vs. 1.1%, p = 0.003) at a cutoff value of 2.
The CHADS(2) and CHA(2)DS(2)-VASc scores are useful predictors of adverse events after catheter ablation of AF.
Purpose - This paper aims to present a novel embedded-internet robot system based on an internet robot agent and the brain-computer interface (BCI) scheme.Design methodology approach - A highly ...flexible and well-integrated embedded ethernet robot (eRobot) was designed with enhanced mobility. In the eRobot, a circuit core module called a tiny network bridge (TNB) is designed to reduce robotic system cost and increase its mobility and developmental flexibility. The TNB enables users to control eRobot motion via embedded ethernet technology. Through electroencephalogram (EEG) feedback training, the command translation unit (CTU) and alertness level detection unit (ADU) allow the eRobot to perform specific motions (for example, lying down or standing up) to reflect alertness levels of the user, and move forward, turn left or right following the user's command.Findings - After a short training period, subjects could achieve at least 70 percent accuracy in the CTU game testing. And the error rate of ADU, estimated from the results of classifying 496 labeled EEG epochs, was approximately 10.7 percent. Combining an encoding procedure, the commands issued from the CTU could prevent the robot from performing undesired actions.Originality value - The eRobot could reflect some physiological human states and be controlled by users with our economical design and only two bipolar EEG channels adopted. Thus, users could make the EEG-based eRobot agent his or her representative. Based on the proposed EEG-based eRobot system, a robot with increased sophistication will be developed in the future for use by disabled patients.
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