Automated seizure detection systems and their effectiveness for each type of seizure.

Epilepsy affects almost 1% of the population and most of the approximately 20-30% of patients with refractory epilepsy have one or more seizures per month. Seizure detection devices allow an objective assessment of seizure frequency and a treatment tailored to the individual patient. A rapid recognition and treatment of seizures through closed-loop systems could potentially decrease morbidity and mortality in epilepsy. However, no single detection device can detect all seizure types. Therefore, the choice of a seizure detection device should consider the patient-specific seizure semiologies. This review of the literature evaluates seizure detection devices and their effectiveness for different seizure types. Our aim is to summarize current evidence, offer suggestions on how to select the most suitable seizure detection device for each patient and provide guidance to physicians, families and researchers when choosing or designing seizure detection devices. Further, this review will guide future prospective validation studies.

Delayed presentation of splenic trauma following colonoscopy.

Splenic trauma is a rare complication of colonoscopy, and diagnosis of such an injury is often delayed and made only at laparotomy. Although computerized tomography may be helpful, a knowledge of this complication is the best tool to aid in early diagnosis. In this article, a case of splenic trauma is presented that was associated with a flexible fiberoptic colonoscopy and required an urgent splenectomy five days after the procedure.

Aspergillus empyema.

Aspergillus empyema occurred in a 69-year-old man six years after pneumonectomy. Exposed silk suture at the bronchial stump acted as a nidus and permitted extension of infection into the pleural space. Resolution was achieved by drainage and removal of the silk suture. The pathogenesis and management of Aspergillus empyema are reassessed in light of these findings.