World Neurosurg
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Craniopharyngiomas (CPs) are benign, dysontogenetic tumors associated with complex endocrinologic and neurologic symptoms and high morbidity. The aim of this study is to elucidate modifiable effectors of health-related quality of life (HrQoL) of adult patients with CP following neurosurgical intervention using standardized instruments as well as descriptive analysis. ⋯ The global HrQoL of our cohort showed a substantial reduction compared with a healthy reference population. Postoperative hyposmia and ageusia is found in patients with the lowest postoperative HrQoL who otherwise had no new significant endocrinologic or neurologic complications. As these symptoms are not regularly accounted for in the HrQoL instruments used in this study, further analysis is needed to determine the possible significance of this complication in CP surgery, and it may affect the choice of surgical approach as well as the information patients receive before consenting to surgery.
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Diabetes mellitus (DM) has been identified as a risk factor for poorer outcomes following anterior cervical discectomy and fusion (ACDF). This study aims to evaluate the impact DM has on achievement of MCID (minimum clinically important difference) following ACDF. ⋯ Although moderate intergroup differences in MCID achievement were demonstrated, the results of this study suggest that patients may realize similar benefits of ACDF surgery regardless of DM status.
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The current study aimed to assess the risk factors and preventive measures for valve inversion after lumboperitoneal shunt (LPS) construction. ⋯ The distance between the valve and spinous process was found to be significantly correlated with valve reversal. However, the condition can be prevented by fixing the tube at the nuchal ligament.
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Lumbar disc arthroplasty (LDA) has emerged as a motion-sparing alternative to lumbar fusion. Although LDA may be amenable to the ambulatory surgical setting, to date no study has identified the factors predisposing patients to extended hospital stay. ⋯ Complications following elective single-level LDA are relatively rare, with few extended hospitalizations being attributable to any specific complication. Risk factors for prolonged LOS appear to be related to diagnosis and surgical time rather than to modifiable preoperative comorbidities. Conversely, unplanned reoperations within 30 days are associated with optimizable perioperative factors such as smoking, diabetes, and surgical site infection.
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The purpose of this study was to characterize the impact of household income disparities in the survival of patients with non-small cell lung cancer (NSCLC) presenting with brain metastasis on a population-based level. ⋯ This population-based study suggests that living in higher median household income counties is associated with increased survival time and reduced risk of mortality for patients with NSCLC who have brain metastases present at diagnosis, independent of other factors. These findings underscore the importance of ensuring adequate and easy access to care for all patients, irrespective of their economic background.