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- 저자 : Tariq Janjua (검색결과 3 건)
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William A Florez,Ezequiel Garcia-Ballestas,Gabriel Alexander Quiñones-Ossa,Tariq Janjua,Subhas Konar,Amit Agrawal,Luis Rafael Moscote-Salazar 대한신경중재치료의학회 2021 Neurointervention Vol.16 No.3
Flow diverters have become a critical instrument for complex aneurysms treatment. However, limited data are currently available regarding short and long-term outcomes for the Silk flow diverter. The objective of the study is to determine neurological prognosis and mortality rates for the Silk flow diversion device used in intracranial aneurysms. A systematic review with meta-analysis was performed using databases. The following descriptors were used for the search: “SILK”, “Flow Diverter”, “Mortality”, and “Prognosis”. The following data were extracted: mortality, good functional outcome, Glasgow outcome scale, complete or near-complete occlusion rates, rate of retreatment, and complications (thromboembolic and hemorrhagic complications). A total of 14 studies were selected. Among the 14 studies, 13 were retrospective observational cohort studies and 1 was a prospective observational cohort study. The mortality rate was 2.84%. The clinical good outcomes rate was 93.3%. The poor outcome rate was 6.6%. The overall thromboembolic complication rate was 6.06% (95% confidence interval [CI] 0.00–6.37, P=0.12, I2=3.13%). The total hemorrhagic complication rate was 1.62% (95% CI 0.00–5.34, P=0.28, I2=1.56%). The complete aneurysm occlusion rate was 80.4% (95% CI 8.65–9.38, P<0.0001, I2=9.09%). The Silk diverter device has a good safety and efficacy profile for treating intracranial aneurysms with high complete occlusion rates.
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Utility of medical simulation in neurovascular critical care education
Sandra Mass-Ramírez,Hernán Vergara-Burgos,Carmen Sierra-Ochoa,Ivan David Lozada-Martinez,Luis Rafael Moscote-Salazar,Tariq Janjua,Md Moshiur Rahman,Sabrina Rahman,Yelson Alejandro Picón-Jaimes 대한신경집중치료학회 2021 대한신경집중치료학회지 Vol.14 No.1
Simulation has shown good results in medical scenarios in which the patient’s problem can be solved by following protocols previously established in clinical practice guidelines. Therefore, the implementation of simulation programs in neurocritical care improves the outcomes of patients at clinical centers because a properly trained professional will be able to provide the most effective care in the shortest time possible, safeguarding the patient’s life. Some learning and simulation models that can be included in medical education to improve neurocritical vascular care include task trainers, full-body mannequins, standardized patients, and computer-based simulation. Specifically, medical simulation in academic training programs in health sciences has a great impact on the development of specific skills, which could potentially reduce medical-legal and economic issues, improve care, and result in the management of clinical events. Simulation is established as an essential educational tool, allowing the instruction of knowledge from an interactive perspective and offering a broader vision when it comes to medical practice. The objective of this article is to present evidence related to the usefulness and impact of medical simulation in neurovascular critical care education.
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Brain-lung interaction: a vicious cycle in traumatic brain injury
Ariana Alejandra Chacón-Aponte,Érika Andrea Durán-Vargas,Jaime Adolfo Arévalo-Carrillo,Iván David Lozada-Martínez,Maria Paz Bolaño-Romero,Moscote-Salazar Luis Rafael,Pedro Grille,Janjua Tariq 대한중환자의학회 2022 Acute and Critical Care Vol.37 No.1
The brain-lung interaction can seriously affect patients with traumatic brain injury, triggering a vicious cycle that worsens patient prognosis. Although the mechanisms of the interaction are not fully elucidated, several hypotheses, notably the “blast injury” theory or “double hit” model, have been proposed and constitute the basis of its development and progression. The brain and lungs strongly interact via complex pathways from the brain to the lungs but also from the lungs to the brain. The main pulmonary disorders that occur after brain injuries are neurogenic pulmonary edema, acute respiratory distress syndrome, and ventilator-associated pneumonia, and the principal brain disorders after lung injuries include brain hypoxia and intracranial hypertension. All of these conditions are key considerations for management therapies after traumatic brain injury and need exceptional case-by-case monitoring to avoid neurological or pulmonary complications. This review aims to describe the history, pathophysiology, risk factors, characteristics, and complications of brain-lung and lung-brain interactions and the impact of different old and recent modalities of treatment in the context of traumatic brain injury.
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