Notes

Midwives' strategies for coping with boundaries to be able to supplying high quality maternal as well as neonatal treatment: any Glaserian based concept study.
Chronic subdural hematoma (CSDH) is an important health problem observed mostly in elderly population. Here, we aimed to describe and validate a simple modified technique of twist-drill craniostomy (TDC) using easily accessible tools for effective and safe bedside CSDH drainage.

A detailed description of the new modified TDC technique which allows for sequential drainage and irrigation under physiological conditions is provided. Clinical and radiological characteristics as well as surgical results of the patients undergoing this procedure are also presented.

A total of 55 patients (30 M, 25 F) underwent this modified TDC. Vorinostat Mean age was 61.7 ± 12.3 years. Medical comorbidities were common (76.4 %). Subdural hematoma was mostly unilateral (83.6 %). Maximum width of hematoma was 21 ± 4 mm on average (range 9-38 mm). In total, patients underwent 1.6 ± 0.9 subdural tappings on average (median 1, range 1-5). Repeat tappings were performed in 43.6 % of the patients. No mortality, serious morbidity or infectious existing procedures for patients with multiple co-morbidities and/or high anesthesia risk, in emergency conditions and busy neurosurgical centers.
The aim of this longitudinal study was to clarify whether significant alterations in structural connectivity occur over time in patients with newly diagnosed focal epilepsy of unknown origin.

A total of 40 patients with newly diagnosed focal epilepsy of unknown origin and with normal brain magnetic resonance imaging (MRI) on visual inspection were enrolled. All subjects underwent MRI twice involving three-dimensional volumetric T1-weighted imaging, which were suitable for structural volume analysis. Gray matter volumes were obtained using the FreeSurfer image analysis suite, and structural connectivity analyses were performed using Matlab-based BRain Analysis using graPH theory software.

The median interval between the two MRI scans was 18.5 months in patients with epilepsy. There was a general tendency toward decreased gray matter volumes on the second scan compared with the initial scan. However, the volumes of the right and left thalamus and brainstem on the second MRI scan had an increased tendency compared with those on the initial MRI scan. In measures of connectivity, there were significant differences between the two MRI scans. The mean clustering coefficient, global efficiency, local efficiency, and the small-worldness index were significantly increased, whereas the characteristic path length was decreased on the second MRI scan compared with the initial MRI scan.

The structural connectivity in patients with newly diagnosed focal epilepsy of unknown origin increases over time in the initial stage. These alterations and increases in structural connectivity may be related to underlying epileptogenicity in the initial stages of epilepsy.
The structural connectivity in patients with newly diagnosed focal epilepsy of unknown origin increases over time in the initial stage. These alterations and increases in structural connectivity may be related to underlying epileptogenicity in the initial stages of epilepsy.
Previous studies have suggested that diabetes mellitus (DM) could be a protective factor against amyotrophic lateral sclerosis (ALS) although the results are inconsistent. This study aimed to comprehensively investigate this relationship by identifying all available studies and summarizing their results.

A systematic review was conducted in MEDLINE and EMBASE database from inception to January 1st, 2020 to identify cohort studies and case-control studies that investigated the risk of development of ALS among patients with DM versus individuals without DM. Point estimates and standard errors from eligible studies were pooled together using the generic inverse variance method, as described by DerSimonian and Laird. Visualization of the funnel plot was used to assess for the presence of publication bias.

A total of 1683 articles were identified by the search strategy. After two rounds of review, three cohort studies and eight case-control studies fulfilled the inclusion criteria and were included in the meta-analysis. The risk of developing ALS was significantly lower among patients with DM than individuals without DM with the pooled relative risk of 0.68 (95 % CI, 0.55 - 0.84; I
81 %). The funnel plot was relatively symmetric and was not suggestive of the presence of publication bias.

A significantly decreased risk of ALS among patients with DM was observed in this meta-analysis.
A significantly decreased risk of ALS among patients with DM was observed in this meta-analysis.
Whilst modern awake intraoperative mapping has been widely accepted and implemented in the last decades in neuro-oncology, sparse reports have been published on the safety and efficiency of this approach in epilepsy surgery.

This article reports four cases with different locations of epileptogenic zones as examples of possible safe and efficient resections.

The results of the resections on seizure control were Engel 1 (no disabling seizures) in all cases and no patient experienced significant neurological deficits.

The discussion focuses on aspects of the future of epilepsy surgery in a hodotopical paradigm.
The discussion focuses on aspects of the future of epilepsy surgery in a hodotopical paradigm.
Platelets play a critical role in the inflammatory response, accompanied by microvascular endothelial dysfunction, underlying postoperative symptomatic cerebral hyperperfusion syndrome (PSCHS) after superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in moyamoya patients. We examined whether the preoperative platelet count can predict PSCHS after STA-MCA anastomosis in such patients.

In 160 adult moyamoya patients undergoing 186 STA-MCA anastomoses, preoperative (demographics, initial clinical manifestation, and Suzuki grade), intraoperative (surgical time, operative side, fluid balance, and maximum and minimum mean blood pressure before and after vessel anastomosis), immediate postoperative (APACHE 2 score), and laboratory (hemoglobin and C-reactive protein levels and white blood cell and platelet counts) data were collected retrospectively.

84 patients (90 sides, 48.4 %) developed PSCHS with a median(IQR) onset of postoperative day 1(0-3) and duration of 4(3-7) days. The preoperative (25.
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