Objective: A survey was implemented for early assessment of pandemic-related practice processes and quality improvement (QI). Background: In response to the public health measures in Hawaii to curtail the coronavirus 2019 pandemic, Hawaii Pacific Neuroscience (HPN) adapted their patient care to ensure continuity of neurological treatment. Methods: The telephone survey was conducted on patients seen at HPN during the period of April 22, 2020-May 18, 2020 to address four areas related to patients' outpatient experience: delivery of care, general well-being, experience with telemedicine, and disease-specific questions. Dr. Patricia Borman for their contributions to the survey.
Surgical margin status is one of the strongest prognosticators in predicting patient outcomes in head and neck cancer, yet head and neck surgeons continue to face challenges in the accurate detection of these margins with the current standard of care. Novel intraoperative imaging modalities have demonstrated great promise for potentially increasing the accuracy and efficiency in surgical margin delineation. In this current study, we collated and analyzed various intraoperative imaging modalities utilized in head and neck cancer to evaluate their use in discriminating malignant from healthy tissues. The authors conducted a systematic database search through PubMed/Medline, Web of Science, and EBSCOhost (CINAHL). Study screening and data extraction were performed and verified by the authors, and more studies were added through handsearching. Here, intraoperative imaging modalities are described, including optical coherence tomography, narrow band imaging, autofluorescence, and fluorescent-tagged probe techniques. Available sensitivities and specificities in delineating cancerous from healthy tissues ranged from 83.0% to 100.0% and 79.2% to 100.0%, respectively, across the different imaging modalities. Many of these initial studies are in small sample sizes, with methodological differences that preclude more extensive quantitative comparison. Thus, there is impetus for future larger studies examining and comparing the efficacy of these intraoperative imaging technologies.
Background Alzheimer’s disease (AD) is progressive neurodegenerative disease and is the most common cause of dementia in the elderly. Currently, patients are diagnosed based on memory loss through mental status exams, supportive imaging, and/or laboratory tests. Even though there are no biomarkers or tests available for preclinical patients, the Apolipoprotein E (ApoE) polymorphic alleles indicate if a patient is at high (e4 allele), neutral (e3 allele), or low risk (e2 allele). In this study, we use electroencephalogram (EEG) analysis in preclinical participants at high genetic risk for AD to determine if there are characteristic EEG changes and/or patterns that may predict progression to AD at the preclinical stage. Method Participants ages 64 to 78 were selected from Hawaii Pacific Neuroscience’s patient database. Selected participants had a Mini‐Mental Status Exam score of no lower than 28. Participants were asymptomatic at the time of the study. Each participant also had a genotype study to determine their ApoE genotype (11 participants were e3e3; 3 participants were e3e4; 2 participants were e4e4; 1 participant was e2e4). An EEG was conducted to determine any apparent trends via visual analysis. Result Of the 18 participants who had received EEGs, 6 (33%) displayed evidence of abnormal focal temporal slowing of some kind. 4 of the 6 (e3e3, e3e3, e3e4, e3e4) displayed focal left temporal slowing, and 2 of the 6 displayed bilateral temporal slowing (e4e4, e3e3), of which one was independent (e4e4). The remaining 12 patients did not display any abnormalities in their EEG study. Of the 11 e3e3 genotype participants, 3 (27%) displayed abnormal slowing. Of the 3 e3e4 genotype participants, 2 (67%) displayed abnormal slowing. Of the 2 e4e4 genotype participants, 1 (50%) displayed abnormal slowing. Conclusion This study suggests that EEGs may be a potential predictive test for the onset of AD in high‐risk patients, particularly with the ApoE4 allele. Future studies may follow the progression of EEGs in this patient population to determine if our EEG data correlates with future onset of cognitive symptoms. If proven to be successful, EEGs may be an additional, noninvasive tool to detect possible AD before progression to permanent memory loss.
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