World Neurosurg
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Randomized Controlled Trial
The effects of supplemental dexmedetomidine anesthesia on intracranial aneurysm patients undergoing intracranial interventional embolization.
Intracranial aneurysm (IA) has been identified in approximately 0.4%-3% of the population and associated with 3%-10% mortality. IA is the major factor attributing to spontaneous subarachnoid hemorrhage. We aim to investigate that whether employing dexmedetomidine (DEX), an α2 adrenergic receptor agonist, as a supplementation could impact the outcomes of patients with intracranial interventional embolization. ⋯ Our study demonstrated that employing DEX as supplementation during anesthesia could effectively reduce surgical stress and improve cognitive function, ultimately improving patients' recovery from intracranial interventional embolization.
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Observational Study
Sacroiliac Joint Fusion - A Shift Towards Variant Anatomy and Clinical Implications.
To investigate impact of patient factors and sacroiliac joint (SIJ) anatomical structure on SIJ fusion outcomes. ⋯ A pathological SIJ has a significantly higher prevalence of variant joint anatomy. There appears to be a trend toward differences in surgical outcomes based on SIJ anatomy. Future research with larger sample sizes is necessary to confirm these differences.
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Clinical follow-up data of pediatric patients with cerebral arteriovenous malformations (AVMs) are limited. This study investigated the characteristics of AVMs in children and analyzed the clinical outcomes of multimodality therapy in pediatric patients with AVMs at a single center. ⋯ In pediatric patients, AVMs were more likely to present with intracranial hemorrhage than that in adults. Hemorrhagic presentation in children was associated with a small nidus, exclusively deep drainage, and deep AVM location. Pediatric patients with ruptured AVMs had significantly higher risks of follow-up hemorrhage than those with unruptured AVMs. Our clinical results suggest that nonconservative treatment is better for pediatric patients with AVMs.
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An extensive spinal epidural abscess is a devasting infection of the multiple-level epidural space. Emergent surgical decompression is required to remove the abscess and decompress the affected spinal cord. This study evaluated the efficacy of unilateral laminotomy for bilateral decompression (ULBD) in the treatment of extensive spinal epidural abscesses. ⋯ As a minimally invasive technique, ULBD is a safe and effective treatment for extensive spinal epidural abscesses in critically ill patients. Moreover, the use of an ultrasonic bone curette not only safely accelerates over-the-top decompression but also flushes the epidural abscess with copious amount of cold saline.
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The use of Fourier transform infrared spectroscopy to identify the peritumoral tissue of gliomas proves the potential of this technique to distinguish normal brain tissues from glioma tissues. However, due to the heterogeneity of gliomas, it is difficult to characterize the representative spectra of normal brain tissues and glioma tissues. The linear spectra of major cellular components, such as microglia, astrocytes, and glioma cells, were obtained to quantify the biochemical changes between healthy cells and tumor cells, and provide supporting data for the final distinction between tumor and normal brain tissue. ⋯ We conclude that an improved understanding of both similarities and differences in the cellular components of astrocytes, microglia, and glioma cells can help us better understand the heterogeneity of gliomas. We suggest that targeting cellular metabolism (protein, lipid, and nuclear acids) is helpful to distinguish between normal brain tissue and glioma tissue, which has broad application prospects.