World Neurosurg
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Review Meta Analysis
Physiologic Growth Hormone Replacement Therapy and Craniopharyngioma Recurrence in Pediatric Patients: A Meta-Analysis.
A systematic review and meta-analysis were conducted to examine the effect of growth hormone-replacement therapy (GHRT) on the recurrence of craniopharyngioma in children. ⋯ This meta-analysis demonstrated a lower recurrence rate of craniopharyngioma among children treated with GHRT than those who were not.
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Comparative Study
Intradural spinal tumors - a review of post-operative outcomes comparing intramedullary and extramedullary tumors from a single institution's experience.
Intradural spinal tumors are rare and can be classified into extramedullary or intramedullary. They commonly present with symptoms such as intractable back pain or neurologic deficits. We retrospectively reviewed 91 cases of intradural spinal tumors that underwent surgery in our institution from 2011 to 2016 and assessed their clinical outcomes. ⋯ We achieved gross total resection in the majority of patients with both extramedullary and intramedullary tumors (65.4% vs. 70%, P = 0.91). Patients younger than 65 years (odds ratio [OR] 4.40, confidence interval [CI] 0.72-26.9, P = 0.11) and those who had complete resection of tumor (OR 2.92, CI 0.61-14.0, P = 0.18) were associated with higher odds of improved clinical outcomes, but the results were not statistically significant. The use of intraoperative neurophysiologic monitoring was not associated with improved neurologic outcomes compared with cases where it was not used (OR 0.56, CI 0.10-3.05, P = 0.50).
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Commercially available fibrin glue (Com-FG), which is used commonly worldwide, is produced with pooled human plasma from multiple donors. However, it has added bovine aprotinin, which involves the risk of infection, allogenic immunity, and allergic reactions. We evaluate the efficacy, reliability, and safety of completely autologous fibrin glue (CAFG). ⋯ CAFG effectively provides hemostatic, adhesive, and safety performance. The timing and three-dimensional shape of CAFG-soaked oxidized regenerated cellulose and/or polyglycolic acid sheets solidification can be controlled with slow fibrin formation. The cost to prepare CAFG is similar compared with Com-FG products, and it can therefore be easily used at most institutions.