World Neurosurg
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International medical graduates (IMGs) comprise ∼25% of physicians in the United States. Differences in promotion rates from assistant to associate to full professorship based on medical school location have been understudied. We aim to stratify odds of professional advancement by 3 categories: IMG with U.S. residency, IMG with international residency, and U.S. medical with U.S. residency training. ⋯ Time out of residency and Scopus h-index were associated with higher academic rank regardless of career level. Attending medical school internationally with U.S. residency was associated with lower odds of associate professorship promotion over 10 years. There was no relationship between IMG and full professorship promotion. IMGs who attended residency internationally did not have lower promotion rates. These findings suggest it may be harder for IMGs to earn promotion from assistant to associate professor in neurosurgery.
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One of the most common reasons for poor patient outcomes and revision surgery in spinal fusion is hardware failure. Screw loosening or pullout occurs in up to one-quarter of all cases. It is known that even small screw-rod misalignments can cause significant mechanical overloads during rod fixation, which can result in hardware failure. To address this crucial surgical step, a novel augmented reality-assisted software was developed to generate custom rod templates that are precisely adapted to the individual patient. ⋯ The augmented reality-assisted software is intended to give surgeons access to patient-specific intraoperative real-time data, helping them in bending rods that are more precisely adapted to the individual patient compared with the freehand technique.
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Successful thrombectomy improves functional outcome in tandem occlusions with a large ischemic core.
Emergent stenting in tandem occlusions and mechanical thrombectomy (MT) of acute ischemic stroke related to large vessel occlusion (LVO-AIS) with a large core are tested independently. We aim to assess the impact of reperfusion with MT in patients with LVO-AIS with a large core and a tandem occlusion and to compare the safety of reperfusion between large core with tandem and nontandem occlusions in current practice. ⋯ Successful reperfusion was associated with a higher rate of favorable outcome in large core LVO-AIS with a tandem occlusion, with a safety profile similar to nontandem occlusion.
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Case Reports
ISOLATED INTRAVENTRICULAR NEUROCYSTICERCOSIS: AN ATYPICAL PRESENTATION OF A COLLOID CYST.
Neurocysticercosis is a condition characterized by the presence of Taenia solium (larval stage: Cysticercus cellulosae) in the brain and is classified as a tropical disease. Although it was previously uncommon in Europe, the number of cases has been increasing over the past decade. ⋯ Anatomopathologic analysis confirmed the presence of a C. cellulosae larva. It is crucial not to overlook or misdiagnose isolated intraventricular neurocysticercosis because it can lead to complications such as delayed diagnosis and dissemination of the cyst.
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In patients undergoing surgery for spinal metastasis, we sought to: (1) describe patterns of palliative care consultation, (2) evaluate the factors that trigger palliative care consultation, and (3) determine the association of palliative care consultation on longer-term outcomes. ⋯ Only 1 in 6 patients received palliative care consultation. Patients receiving same-stay palliative care consultation had more advanced local and systemic disease burden. Increased utilization of palliative care consultation in patients with spine metastasis is needed.