- Short-term outcomes following posterior cervical fusion among octogenarians with cervical spondylotic myelopathy: a NSQIP database analysis. [Journal Article]
- SJSpine J 2018 Feb 14
- CONCLUSIONS: Compared to patients aged 60-69 and 70-79, octogenarian patients with CSM were significantly more likely to be discharged to a location other than home following PCF. After controlling for patient comorbidities and demographics, 80-89 year old CSM patients undergoing PCF did not differ in other outcomes when compared to the other age cohorts. These results can improve preoperative risk counseling and surgical decision-making.
- Risk factors for platelet transfusion in glioblastoma surgery. [Journal Article]
- JCJ Clin Neurosci 2018 Feb 13
- The objectives of this study are to identify risk factors for and to evaluate clinical outcomes of platelet transfusion in glioblastoma surgery. The medical records of adult patients who underwent cr...
The objectives of this study are to identify risk factors for and to evaluate clinical outcomes of platelet transfusion in glioblastoma surgery. The medical records of adult patients who underwent craniotomy for glioblastoma resection at a single academic medical center were retrospectively reviewed. We stratified patients into 2 groups: those who were transfused at least 1 unit of platelets intraoperatively or postoperatively (no more than 7 days after surgery), and those who were not transfused with platelets. Through the use of a 1:3 matched cohort analysis, we compared complications, length of stay, discharge disposition, and mortality, across groups. One hundred and five consecutive adult patients were included in this study. Thirteen patients (12.38%) received platelet transfusions. Prior antiplatelet therapy (odds ratio [OR] 8.21, 95% confidence interval [CI]: 2.36-28.58), preoperative platelet count less than 200,000 cells/µL (OR 8.46, 95% CI: 2.16-33.22), and longer operative times (OR 1.73, 95% CI: 1.10-2.72) were significant risk factors for platelet transfusion. There were no significant differences in the outcomes of interest in the matched cohort analysis.
- Post-IV thrombolytic headache and hemorrhagic transformation risk in acute ischemic stroke. [Journal Article]
- NCNeurol Clin Pract 2016; 6(1):22-28
- Background: Headache during or soon after administration of IV tissue plasminogen activator (tPA) in patients with acute ischemic stroke (AIS) is a concern for hemorrhagic transfo...
Background: Headache during or soon after administration of IV tissue plasminogen activator (tPA) in patients with acute ischemic stroke (AIS) is a concern for hemorrhagic transformation (HT). However, no data are available regarding the incidence of HT in these patients or the prognostic indication of these headaches. We examine the importance of tPA-associated headaches among AIS patients in terms of HT rates and clinical outcomes.Methods:AIS patients treated with IV tPA at a comprehensive stroke center between January 2007 and November 2012 were retrospectively reviewed for documented tPA-associated headache in the first 24 hours post-tPA. We compared the headache and nonheadache groups for differences in various clinical and radiologic outcomes.Results:Of the 193 patients, 63 (32.6%) had tPA-associated headache. Headache patients (HP) were younger than nonheadache patients (NHP) (mean ± SD, 59.5 ± 17.4 years vs 69.9 ± 15.5 years,p< 0.0001), and 53% of HP were men, compared to 49.2% of NHP (p= 0.537). Comorbid conditions did not differ between the 2 groups. There were no statistical differences between HP and NHP in admission NIH Stroke Scale (NIHSS) score (11.2 ± 5.7 vs 11.5 ± 5.5,p= 0.646), NIHSS score at 24 hours (6.5 ± 5.7 vs 7.4 ± 6.9,p= 0.466), NIHSS score at discharge (6.7 ± 10.1 vs 8.1 ± 11.6,p= 0.448), HT (12.7% vs 18.4%,p= 0.3), cervical artery dissection (4.7% vs 5.38%,p= 0.764), length of hospitalization (6.29 ± 5 days vs 6.35 ± 4.7 days,p= 0.935), and disposition.Conclusion:tPA-associated headache does not predict increased risk of HT and has no other prognostic importance in patients with AIS. Prospective studies with a larger cohort may be needed to further explore this relationship.
- New, Immunomodulatory, Oral Nutrition Formula for Use Prior to Surgery in Patients With Head and Neck Cancer: An Exploratory Study. [Journal Article]
- JJJPEN J Parenter Enteral Nutr 2018; 42(2):371-379
- CONCLUSIONS: The new formula can be safely prescribed as part of the preoperative treatment of patients with head and neck cancer and might reduce the problem of postoperative infection.
- Independent suboesophageal neuronal innervation of the defense gland and longitudinal muscles in the stick insect (Peruphasma schultei) prothorax. [Journal Article]
- ASArthropod Struct Dev 2018 Feb 10
- This study investigates the neuroanatomy of the defense gland and a related muscle in the stick insect Peruphasma schultei with axonal tracing and histological sections. The gland is innervated by th...
This study investigates the neuroanatomy of the defense gland and a related muscle in the stick insect Peruphasma schultei with axonal tracing and histological sections. The gland is innervated by three neurons through the Nervus anterior of the suboesophageal ganglion (SOG), the ipsilateral neuron (ILN), the contralateral neuron (CLN) and the prothoracic intersegmental neuron (PIN). The ILN has a large soma which is typical for motoneurons that cause fast contraction of large muscles and its dendrites are located in motor-sensory and sensory neuropile areas of the SOG. The CLN might be involved in the coordination of bilateral or unilateral discharge as its neurites are closely associated to the ILN of the contralateral gland. Close to the ejaculatory duct of the gland lies a dorsal longitudinal neck muscle, muscle pronoto-occipitalis (Idlm2), which is likely indirectly involved in gland discharge by controlling neck movements and therefore the direction of discharge. This muscle is innervated by three ventral median neurons (VMN). Thus, three neuron types (ILN, CLN, and PIN) innervate the gland muscle directly, and the VMNs could aid secretion indirectly. The cytoanatomy of motorneurons innervating the defense gland and neck muscle are discussed regarding the structure and functions of the neuropile in the SOG. As basis for the neuroanatomical study on the defense gland we assembled a map of the SOG in Phasmatodea.
- Adjustment of antidiabetic treatment regimens on discharge from the emergency department: effect on 90-day outcomes in patients admitted to a short-stay unit. [Journal Article]
- EEmergencias 2018; 30(1):14-20
- CONCLUSIONS: Helmet removal was completed in an average of 70 seconds with flexion and rotation mainly toward the side where the professional supporting the head was positioned.
- The difficulty of predicting clinical outcome after intended submaximal resection of large vestibular Schwannomas. [Journal Article]
- JCJ Clin Neurosci 2018 Feb 08
- CONCLUSIONS: Intended submaximal resection provides satisfactory neurological outcome for patients with large VS. Risk factors for postoperative neurological deterioration remain unclear.
- Early childhood undernutrition increases risk of hearing loss in young adulthood in rural Nepal. [Journal Article]
- AJAm J Clin Nutr 2018 Feb 07
- CONCLUSIONS: Early childhood undernutrition is a modifiable risk factor for early adulthood hearing loss.
- A comparison of symptoms and quality of life before and after nasal septoplasty and radiofrequency therapy of the inferior turbinate. [Journal Article]
- BEBMC Ear Nose Throat Disord 2018; 18:2
- CONCLUSIONS: Surgical treatment of nasal obstruction led to less symptoms and better HQOL for all three patient groups. Comparing the postoperative scores between the patient groups we find that all groups reached the same level of HQOL. Regarding symptoms, the patients who underwent septoplasty combined with RFIT reported postoperatively less nasal obstruction than patients who underwent RFIT alone which may indicate that a combined procedure of septoplasty and RFIT is better than RFIT alone to treat nasal obstruction. Furthermore, revision cases, patients with sleep apnea and asthma patients seem to have poorer outcome after surgery than other patients. Both disease specific and general QOL instruments add valuable information for identifying factors influencing outcome.
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- Correlation of Clinical and Radiological Outcome After Anterior Cervical Discectomy and Fusion With a Polyetheretherketone Cage. [Journal Article]
- JCJ Clin Med Res 2018; 10(3):268-276
- CONCLUSIONS: In our study, reduction of cervical lordosis and sagittal ROM did not appear to significantly influence on patients' self-reported disability. Such findings further highlight the greater role of pain level over the mechanical limitations of ACDF with a PEEK cage on patients' own perceived recovery.