World Neurosurg
-
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.
-
Deep-seated brainstem cavernous malformations (BSCMs) pose a particular challenge for brainstem entry intraoperatively and their treatment can require comprehensive application of neuronavigation, electrophysiological brainstem mapping and monitoring, and full knowledge of safe brainstem entry zones. In the present report, we have introduced a supplementary technical trick for localizing a hidden tiny lesion inside the brainstem when a developmental venous anomaly (DVA) is present on the brainstem surface. ⋯ The presented method could help surgeons trace deep-seated BSCMs with minimal brainstem parenchyma impairment, avoiding unnecessary aggressive exploration.
-
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.
-
Lumbar Spine MRI Use for Low Back Pain (OP-8) is calculated by dividing the number of patients who received lumbar magnetic resonance imaging (MRI-L) before receiving alternative treatments (e.g., physical therapy) by the total number of patients receiving MRI-L in the outpatient setting at a given institution. Since the passage of the Post-Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), OP-8 scores became tied to hospital finances. This study aims to determine how MACRA has impacted OP-8 scores since its implementation. We also aim to investigate how regional designation, profit status (for-profit, government, and nonprofit), and hospital setting (critical access, non-critical access) affect OP-8 scores. ⋯ The implementation of MACRA seems to have been unsuccessful in altering practice patterns, given the minimal change in OP-8 scores over the last 4 years. Furthermore, institutional factors are clearly correlated with a lack of adherence to magnetic resonance imaging guidelines. Given these findings, there is a need to modify health policies.
-
Sevoflurane (Sev) is a rapidly acting, potent inhalation anesthetic with rapid uptake and elimination. But many studies have shown that Sev could result in cognition dysfunction in adolescent or aging patients. Now, therapeutic targeting with IL-17A antibody has shown a promising effect on Sev-induced cognition impairment. In the study we report that P300 inhibition could act as an alternative approach to decrease IL-17A activity. ⋯ These data show that P300 will potentially be a new drug target for the therapy of cognition impairment caused by Sev.