Blombach1165

ETLE.

The NUCOG differentiated cognitive profiles in patients with uncontrolled seizures due to different etiologies. Bilateral TLE and medication adversely affected cognitive performance, and overall patients with epilepsy performed worse than those with nonepileptic seizures. These results provide further evidence for sensitivity of the NUCOG for detecting cognitive impairment in patients with seizure disorders.

The NUCOG differentiated cognitive profiles in patients with uncontrolled seizures due to different etiologies. Bilateral TLE and medication adversely affected cognitive performance, and overall patients with epilepsy performed worse than those with nonepileptic seizures. These results provide further evidence for sensitivity of the NUCOG for detecting cognitive impairment in patients with seizure disorders.

The SUDEP and Seizure Safety Checklist ("Checklist") is a risk factors Checklist based around a person with epilepsy (PWE) demographics, seizure, physical, psychological, and lifestyle issues. The Checklist provides a cumulative picture of current risk when applied to a PWE. This study compares and contrasts risk factors of PWE in primary versus secondary care.

The Checklist was applied to all PWE registered in four primary care practices in central Cornwall UK (pop 120,000). Individual, modifiable, non-modifiable, and total risk factors and scores were compared between PWE open to secondary care and those not. Statistical tests were used to calculate significance of individual risk factors in primary or secondary care, to compare the total risk scores between care settings and to find the frequency differences of each risk factor between primary practices.

People with total and non-modifiable risk scores were higher in secondary care (both p < 0.001). However, modifiable risk scores were higher in primary care (p < 0.001). Psychiatric concerns were the most prevalent modifiable risk factor in primary care. There were significant differences in the risk profiles between all four primary care practices.

This study highlights that there is a lack of clarity on who is referred to secondary care and when. There needs to be an evidence-based system to allow for a bidirectional flow of PWE considering their fluctuating risk. The Checklist can be a decision support tool to enable this.

This study highlights that there is a lack of clarity on who is referred to secondary care and when. There needs to be an evidence-based system to allow for a bidirectional flow of PWE considering their fluctuating risk. The Checklist can be a decision support tool to enable this.This is a territory-wide study to investigate the impact of coronavirus disease 2019 (COVID-19) pandemic on Accident and Emergency Department (A&E) attendances and acute ward admissions for seizures. Adult patients who presented to the A&E with seizures from January 23, 2020 to March 24, 2020 (study period) were included and compared with parallel intervals from 2015 to 2019 (control periods). Preexisting time trend in control periods and potential changes during COVID-19 were analyzed by Poisson, negative and logistic regression models. Accident and Emergency Department attendances and ward admissions for seizures decreased significantly during the COVID-19 pandemic. A total of 319 and 230 recorded ward admissions and A&E attendances for seizures were identified during the study period in 2020, compared with 494 and 343 per annum, respectively in the control periods. The ratio of acute ward admission per A&E attendance for seizures did not change significantly. Intensive care utility and mortality rates remained stable. For some patients, delaying medical attention due to fear of nosocomial COVID-19 cross-infection may lead to severe or even life-threatening consequences. This change in medical help-seeking behavior calls for new medical care models to meet the service gap. Education to patients with epilepsy and their caregivers is of utmost importance during this pandemic.

Evaluation of the usefulness and the parental opinion about teleconsultation (TC) for rare pediatric epilepsies.

One-month prospective survey of consecutive TCs. All clinics on site have been turned into TC in the context of COVID-19 pandemic. The physicians quoted all TCs while the parents expressed their opinion though an invitation for an online questionnaire.

We included 151 TCs (145 patients) among the 259 epilepsy TCs done during the study period. The parental questionnaire has been answered 105 times. The physicians felt confident to organize a TC for the next visit of 74.8% of the children, but some limits were identified such as the absence of physical examination, weight, and psychomotor development evaluation. The physicians felt more confident for a new TC in older patients (9.5 ± 5.5 years versus 5.3 ± 4.3 years) and in stable patients (73.8% confident for instable, 82.8% for stable). Parents were satisfied with TC feeling that it answered health issues in a better manner than a clinic pinpointing the gain of time and the absence of travel. However, half of them would prefer a clinic for the next appointment.

Teleconsultation seems useful answering the patients' needs according to both physicians and families. Despite some limitations, it is most likely that TCs become a new part of the clinical activities in rare pediatric epilepsy centers.

Teleconsultation seems useful answering the patients' needs according to both physicians and families. Despite some limitations, it is most likely that TCs become a new part of the clinical activities in rare pediatric epilepsy centers.

With modelling and simulation (or in silico) techniques, patient-specific optimization algorithms represent promising tools to support the surgical decision-making process, particularly in 3D correction of adolescent idiopathic scoliosis, where the best intraoperative instrumentation strategy and the correction goals are debated.

1080 biomechanical intraoperative simulations of a representative pediatric thoracic curve were run according to a full-factorial design approach. Widely accepted instrumentation configurations (5 screw patterns, 4 upper and 3 lower instrumented vertebrae, 6 rod curvatures and 3 rod stiffnesses) were analyzed, assuming concave rod rotation and en bloc derotation as main correction maneuvers. Results in terms of 3D correction and mobility were rated using an objective function for thoracic scoliosis also including surgeon-dependent correction objectives. An extensive sensitivity analysis on correction objectives was performed.

Multiple optimal strategies were identified, dependithe considered thoracic case. Multiple clinically equivalent strategies may be used, as supported by the variety of considered correction objectives. The current approach could be translated to any scoliotic curves, including surgeon preferences in terms of instrumentation parameters, intraoperative correction maneuvers and correction objectives.

The number of people managing chronic conditions is growing with the rapidly aging population. Visits to the emergency department are steadily rising, but little is known about the rationale of those seeking emergent care.

The goal of this study was to better understand, from the patients' perspective, the reasons for seeking care in an emergency department setting.

A qualitative descriptive design was used to interview aging adults with at least two chronic conditions who made three or more visits to the emergency department within a year.

The eight-person sample was 88% female and 75% white, with an average age of 54years.

Participant interviews were conducted with a semistructured interview guide. Conventional content analysis was used to examine words and phrases in professionally transcribed documents. Qualitative methods for testing and confirming conclusions were performed.

We discovered that aging adults visit the emergency department to seek relief from unrelenting pain and to overcome barriers to receiving treatment for pain in ambulatory settings. Participants reported feeling judged when seeking emergency department care for pain management.

Participants described emergency department care as the only option in response to several barriers to healthcare access. Most commonly, emergency department care was sought when relief from persistent or acute pain was required. One way to reduce strain on EDs from pain-related visits is to manage patients with persistent pain more proactively in their community environment.

Participants described emergency department care as the only option in response to several barriers to healthcare access. Most commonly, emergency department care was sought when relief from persistent or acute pain was required. One way to reduce strain on EDs from pain-related visits is to manage patients with persistent pain more proactively in their community environment.

Psychological interventions are effective at ameliorating the experience of pain in conditions such as rheumatoid arthritis and chronic back pain. However, their effect on diabetic peripheral neuropathy (DPN) pain has yet to be established AIM To assess the effectiveness of psychological interventions on pain and related outcomes in adults with DPN.

Systematic review.

Community, hospital in-patient and out-patient.

Adults with diabetic peripheral neuropathy.

Medline, Embase, PsychInfo, and CINAHL databases together with grey literature and trial registers were searched. A meta-analysis and narrative synthesis of included studies were undertaken.

Nine studies were selected from 1610 citations. Anacardic Acid in vitro At short-term follow-up psychological therapies showed a large effect on pain severity (SMD=-0.94, 95%CI [-1.50, -0.37], p=.001), a small effect on pain interference (SMD=-0.39, 95%CI [-0.73, -0.05], p=.02), and a moderate effect on depressive symptoms (SMD=-0.58, 95%CI [-0.95, -0.21], p=.002). Quality of lifpments.

Unidimensional size is commonly used to risk stratify pancreatic cysts (PCs) despite inconsistent performance. The current study aimed to determine if unidimensional size, demonstrated by maximum axial diameter (MAD), is an appropriate surrogate measurement for volume and surface area.

Patients with cross-sectional imaging of PCs from 2012 to 2013 were identified. Cyst MAD, volume, and surface area were measured using quantitative imaging software. Non-pseudocystic PCs >1cm were selected for inclusion to assess MAD correlation with volume and surface area. Cysts imaged twice >1 year apart were selected to evaluate volumetric growth rate.

In total, 195 cysts were included. Overall, MAD was strongly correlated with volume (r=0.83) and surface area (r=0.93). However, cysts 1-2cm and 2-3cm were weakly correlated with volume and surface area r=0.78, 0.57 and 0.82, 0.61, respectively. Cyst volumes and surface areas varied widely within unidimensional size groups with 51% and 40% of volumes and surface areas overlapping unidimensional size groups, respectively. Estimated changes in volume poorly predicted measured changes in volume with 42% of cysts having >100% absolute percent difference.

Pancreatic cyst volume and surface area may be useful adjunct measurements to risk stratify patients and surveil cyst changes and deserves further study.

Pancreatic cyst volume and surface area may be useful adjunct measurements to risk stratify patients and surveil cyst changes and deserves further study.