Using a mobile app for self-management could make it easier for patients to get insight into their blood pressure patterns. However, little is known about the availability, quality, and features of ...mobile apps targeting blood pressure.
The goal of the research was to determine the availability, functionality, and quality of mobile apps that could be used for blood pressure monitoring purposes.
A systematic app search was performed based on the standards for systematic reviews. We searched the Dutch official app stores for Android and iOS platforms using predefined keywords and included all English and Dutch mobile apps targeting blood pressure. Two independent assessors determined eligibility and quality of the apps using the 5-point Mobile App Rating Scale (MARS). Quality scores of the apps with and without 17 a priori selected characteristics were compared using independent sample t tests.
A total of 184 apps (104 Android, 80 iOS) met the inclusion criteria. The mean overall MARS score was 2.63 (95% CI 2.55-2.71) for Android and 2.64 (95% CI 2.56-2.71) for iOS. The apps Bloeddruk (4.1) and AMICOMED BP (3.6) had the highest quality scores on the Android and iOS platforms, respectively. Of the app characteristics recorded, only pricing, in-app advertisements, and local data storage were not associated with the quality scores. In only 3.8% (7/184) of the apps, involvement of medical experts in its development was mentioned, whereas none of the apps was formally evaluated with results published in a peer-reviewed journal.
This study provides an overview of the best apps currently available in the app stores and important key features for self-management that can be used by health care providers and patients with hypertension to identify a suitable app targeting blood pressure monitoring. However, the majority of the apps targeting blood pressure monitoring were of poor quality. Therefore, it is important to involve medical experts in the developmental stage of health-related mobile apps to improve the quality of these apps.
•Yolk sac tumor (YST) is a rare cancer that affects young people. Symptoms include visual problems, seizures, and paralysis. Treatment options include surgery, chemotherapy (CT), and radiation ...therapy (RT).•A man with seminoma and liver metastases had seizures and was found to have a lesion on the left frontal lobe. The tumor was removed through craniotomy surgery and identified as a pure-YST. Adjuvant RT and CT led to remission and the patient is symptom-free after two years.•Tumors were commonly found in the pineal region, cerebral lobes, and sellar region. Male and female patients had different overall survival but not among different tumor locations. There was no significant difference in overall survival between the two histological subtypes.•The study found that complete tumor resection along with radiation and chemotherapy is the best option for managing brain tumors. Females have a better prognosis. The patients were followed for an average of 28 months, with a median overall survival of 13 months.
Purpose
The literature concerning the use of balloon kyphoplasty (BKP) for pure traumatic fractures is unclear. We report our experience about the treatment of a specific subgroup of traumatic ...vertebral fractures (AOSpine type A) with BKP through a retrospective analysis.
Methods
Sixty-one patients affected by AOSpine type A traumatic fractures of the thoracolumbar spine underwent BKP at our institution (2004–2008): 26 males and 35 females; mean age 52 ± 15 (18–75) years. At 6–12 and 60 months follow-up examinations, vertebral height restoration, sagittal spinal alignment and pain were recorded.
Results
Kyphoplasty proved to be a safe method to treat these fractures preserving a relative correct spinal sagittal balance with recovery of the morphology of the fractured vertebra, vertebral height and the angle of kyphosis.
Conclusions
BKP used for traumatic fractures significantly alleviates pain, does not cause notable complications and enables patients to return to their normal lives in a short time.
Hemostasis in neurosurgery is of utmost importance. Bleeding management is one of the crucial steps of each neurosurgical procedure. Several strategies, namely thermal, mechanical, electric, and ...chemical, have been advocated to face blood loss within the surgical field. Over time, countless hemostatic agents and devices have been proposed. Furthermore, the ever-growing recent technological innovation has made available several novel and interesting tools. Pursuant to their impact on surgical practice, we perceived the imperative to update our previous disclosure paper. Therefore, we reviewed the literature and analyzed technical data sheets of each product in order to provide an updated and comprehensive overview in regard to chemical properties, mechanisms of action, use, complications, tricks, and pitfalls of topical hemostatic agents.
The use of the endoscope (fiberscope) to assist the microsurgical clipping of cerebral aneurysm was first reported by Fischer and Mustafa in 1994. The rigid endoscope has been increasingly used ...during aneurysm surgery in which structures around the aneurysm can be detected with high quality imaging. Our 3 years of its use now allows us to assess the endoscope's efficacy and limits in standard surgery with a pterional approach in aneurysms of the anterior circulation. The endoscope can carry out a supportive role in planning surgical manoeuvres and in verifying whether clipping has been performed correctly or not. In our view, among the aneurysms of the anterior circulation, the endoscope is particularly useful in those of the internal carotid and the anterior communicating arteries. In many cases of these aneurysms the posterior communicating artery, choroidal artery or one of the distal cerebral arteries is hidden behind the aneurysm dome. Dome retraction is often required in order to see these vascular structures with the microscope. Thus an endoscope with a 30 degrees view angle becomes very useful. The concealed areas are identified without retraction, which prevents the possibility of the aneurysm being ruptured and also reduces the use of temporary clipping. From its early use as a supportive measure that is sometimes useful in surgery for "easy" aneurysms, the endoscope has now become almost indispensable for the "difficult" aneurysms, including the large and giant ones before and after clipping. Thus, the endoscope should be kept ready for use in the operating theatre for any eventuality.
We assess the advantages and disadvantages of the use of the endoscope in the microsurgical treatment of intracranial aneurysms.
During our 3 years of experience, 52 patients with 48 ruptured and 10 unruptured aneurysms of the anterior circulation (including 6 cases of two-fold aneurysms) underwent clipping with endoscope support through a pterional approach. All ruptured aneurysms produced a Hunt and Hess Grade I or II subarachnoid haemorrhage. The endoscope was inserted before and after clipping in order to observe the conditions surrounding the aneurysm and to receive immediate confirmation that clipping had been performed correctly.
In all cases general anatomy visualization was provided by the endoscope, and the correct clip positioning and vessel conditions were easily checked. In 4 cases the endoscope showed that the clip had been positioned incorrectly. Additional clipping was performed in these cases: in 2 cases the clip was re-applied correctly and in another case a clip was added. Only the fourth patient with a large communicating artery died (1.9%) of cerebral infarction. This was due to post-clipping stenosis of one distal cerebral artery in which it was not possible to re-position the clip correctly because of the presence of arteriosclerotic calcific plaque near the aneurysm neck. In 3 cases there was an intraoperative ruptured aneurysm dome that was not caused by the endoscope insertion. No further complications were caused by the endoscope.
In certain cases endoscopic-assisted microsurgery is an exceptional aid to the surgeon and must become part of the operating theatre equipment and kept on hand ready for use. The endoscope is, in our opinion, particularly useful in certain aneurysm localisations (internal carotid artery-anterior communicating artery ICA-ACOMA).
Diatraea saccharalis (Fabricius) has cryptonephridial type Malphigian tubules (MT). This type of MT is characterized by the penetration of the distal part of the MT into the external walls of the ...rectum, which is usually lined with a perinephral membrane. The MT is divided into three differentiated regions: proximal, middle and distal. In this study, our objective was to compare the nuclear activities of each one of the three regions of the D. saccharalis MT by using a nuclear basophilic technique and critical electrolyte concentration with a toluidine blue stain at pH 4.0. This method allows differentiation of DNA/protein complexes in in situ and in vitro chromatin. MT chromatin structure in D. saccharalis is variable. Fifth instars have a more decondensed chromatin than fourth instars. The distal tubule region was the most decondensed region of the MT. Our data show an elevated genetic activity of the MT in the pre-metamorphosis period. The distal region of the MT has the highest observed activity, which may be associated with the re-absorption of useful components and the excretion of waste materials.
Myxopapillary ependymomas represent the most frequent type of ependymomas found at the conus medullaris-cauda equina-terminal filum level. In this article the authors describe the clinical ...presentation, radiographic findings, operative details, and pathological features of a patient with a concomitant presentations of a thoracic spinal cord myxopapillary ependymoma and a filum terminale myxopapillary ependymoma. A 16-year-old man presented to the Neurosurgery Department of the S. Maria delle Grazie Hospital (Naples, Italy) with an increased weakness of both the legs with great difficulties with walking and with bowel and bladder dysfunction. In a few minutes he becomes paraplegic. Magnetic resonance (MR) imaging revealed two ependymomas: the first one was localized in the middle thoracic part of the spinal cord and, the second one was localized in the cauda at sacral level. Two operations were performed for gross total resection of the masses. The first operation was performed at thoracic level and the second one was performed at the sacral level after two months. The examination demonstrated in both cases a myxopapillary ependymoma. The patient experienced complete resolution of her preoperative symptoms. This article reports an unusual case of a concomitant presentations of a thoracic spinal cord myxopapillary ependymoma and a filum terminale myxopapillary ependymoma myxopapillary. To the best of the authors' knowledge, this association has not yet been reported. This raises the interesting question of a possible associative or causative relationship between these pathologies. The authors considered dissemination to be the spread of tumor along the neuraxis to a location separate from the primary site. They do not believe that the lesion at the cauda level was a drop metastase. As the entire spinal cord and the brain were imaged, and as the tumor in the thoracic spinal cord area was we well capsulated, a disseminated ependymoma was confidently excluded.
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