Ocular Dipping in Creutzfeldt-Jakob Disease

Sierra-Hidalgo, Fernando; Llamas, Sara; Gonzalo, Juan Francisco; Sánchez, Carmen

doi:10.3988/jcn.2014.10.2.162

Cited by 6 publications

(8 citation statements)

References 15 publications

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“…In our prior work performed during the same time period as this study, we used the same definition to examine the incidence of and time spent in BIRs in both of our medicine units. 19 We found that 63% to 81% of patients in both units received BIRs. As a result, we assumed all nursing staff, attending physicians, and housestaff physicians had experienced this process, and their responses to this survey were contextualized in these experiences.…”

Section: Study Settingmentioning

confidence: 72%

“…For the purposes of this study, we specifically defined BIRs as: “encounters that include the team of providers, at least 2 physicians plus a nurse or other care provider, discussing the case at the patient's bedside.” In our prior work performed during the same time period as this study, we used the same definition to examine the incidence of and time spent in BIRs in both of our medicine units . We found that 63% to 81% of patients in both units received BIRs.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Bedside interprofessional rounds: Perceptions of benefits and barriers by internal medicine nursing staff, attending physicians, and housestaff physicians

Gonzalo

Kuperman

Lehman

et al. 2014

Journal of Hospital Medicine

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BACKGROUND Interprofessional collaboration improves the quality of care, but integration into workflow is challenging. Although a shared conceptualization regarding bedside interprofessional rounds may enhance implementation, little work has investigated providers' perceptions of this activity. OBJECTIVE To evaluate the perceptions of nurses, attending physicians, and housestaff physicians regarding the benefits/barriers to bedside interprofessional rounds. DESIGN AND PARTICIPANTS Observational, cross‐sectional survey of hospital‐based medicine nurses, attending physicians, and housestaff physicians. Descriptive, nonparametric Wilcoxon rank sum and nonparametric correlation were used. MAIN MEASURES Bedside interprofessional rounds were defined as “encounters including 2 physicians plus a nurse or other care provider discussing the case at the patient's bedside.” Eighteen items related to “benefits” and 21 items related to “barriers” associated with bedside interprofessional rounds. RESULTS Of 171 surveys sent, 149 were completed (87%). Highest‐ranked benefits were related to communication/coordination, including “improves communication between nurses‐physicians;” lowest‐ranked benefits were related to efficiency, process, and outcomes, including “decreases length‐of‐stay” and “improves timeliness of consultations.” Nurses reported most favorable ratings for all items (P < 0.05). Rank order for 3 provider groups showed high correlation (r = 0.92, P < 0.001). Highest‐ranked barriers were related to time, including “nursing staff have limited time;” lowest‐ranked barriers were related to provider‐ and patient‐related factors, including “patient lack of comfort.” Rank order of barriers among all groups showed moderate correlation (r = 0.62–0.82). CONCLUSIONS Although nurses perceived greater benefit for bedside interprofessional rounds than physicians, all providers perceived coordination/teamwork benefits higher than outcomes. To the extent the results are generalizable, these findings lay the foundation for facilitating meaningful patient‐centered interprofessional collaboration. Journal of Hospital Medicine 2014;9:646–651. © 2014 Society of Hospital Medicine

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Section: Study Settingmentioning

confidence: 72%

Section: Methodsmentioning

confidence: 99%

Bedside interprofessional rounds: Perceptions of benefits and barriers by internal medicine nursing staff, attending physicians, and housestaff physicians

Gonzalo

Kuperman

Lehman

et al. 2014

Journal of Hospital Medicine

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“…128,130 Although not commonly reported, ocular dipping can also be a characteristic ocular abnormality. 131,132 Disordered fixation with saccadic intrusions in the setting of severe insomnia can be a useful early diagnostic clue of FFI. 133 Gerstmann-Sträussler-Scheinker disease also presents with abnormal eye movements in the early stages such as pathologic nystagmus, impaired visual tracking, impaired VOR, and gaze-evoked nystagmus.…”

Section: Prion Diseasementioning

confidence: 99%

“…Vertical supranuclear ophthalmoplegia in CJD can resemble PSP 128,130 . Although not commonly reported, ocular dipping can also be a characteristic ocular abnormality 131,132 . Disordered fixation with saccadic intrusions in the setting of severe insomnia can be a useful early diagnostic clue of FFI 133 .…”

Section: Eye Movements In Myoclonusmentioning

confidence: 99%

Eye Movement Disorders in Movement Disorders

Kassavetis

Kaski

Anderson

et al. 2022

Movement Disord Clin Pract

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Oculomotor assessment is an essential element of the neurological clinical examination and is particularly important when evaluating patients with movements disorders. Most of the brain is involved in oculomotor control, and thus many neurological conditions present with oculomotor abnormalities. Each of the different classes of eye movements and their features can provide important information that can facilitate differential diagnosis. This educational review presents a clinical approach to eye movement abnormalities that are commonly seen in parkinsonism, ataxia, dystonia, myoclonus, tremor, and chorea. In parkinsonism, subtle signs such as prominent square wave jerks, impaired vertical optokinetic nystagmus, and/or the “round the houses” sign suggest early progressive supranuclear gaze palsy before vertical gaze is restricted. In ataxia, nystagmus is common, but other findings such as oculomotor apraxia, supranuclear gaze palsy, impaired fixation, or saccadic pursuit can contribute to diagnoses such as ataxia with oculomotor apraxia, Niemann‐Pick type C, or ataxia telangiectasia. Opsoclonus myoclonus and oculopalatal myoclonus present with characteristic phenomenology and are usually easy to identify. The oculomotor exam is usually unremarkable in isolated dystonia, but oculogyric crisis is a medical emergency and should be recognized and treated in a timely manner. Gaze impersistence in a patient with chorea suggests Huntington's disease, but in a patient with dystonia or tremor, Wilson's disease is more likely. Finally, functional eye movements can reinforce the clinical impression of a functional movement disorder.

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“…3 Ocular dipping is most commonly reported in the setting of severe anoxic brain injury with associated diffuse cortical and lenticular pathology, but it has also been described in prolonged status epilepticus and prion disease. 1,2,4 The prognosis for patients displaying ocular dipping is variable. Interestingly, either a return of consciousness or pentobarbital may abolish ocular dipping.…”

mentioning

confidence: 99%