World Neurosurg
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The primary treatment for peripheral nerve tumors involves maximal surgical resection while preserving nerve function. Sodium fluorescein shows potential for enhancing the safety and efficacy of nerve tumor surgery. This review evaluates the advantages and limitations of sodium fluorescein in this context. ⋯ Sodium fluorescein shows promise as assisting tool in nerve tumor surgery by facilitating differentiation among the tumor, parent nerve, and surrounding soft tissue. However, multicenter randomized controlled trials are necessary to determine its effect on extent of resection rates, clinical outcomes, postoperative complication rates, and surgical duration in comparison to current standard of care.
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The shortcomings of business-like management systems in health care were exposed during the coronavirus disease 2019 pandemic when the need for flexibility and a rapid response to patients' needs became pressing. Almost all administrative decisions concerning the management of health care services have an ethical dimension. This research aims to investigate current debates on this subject and fill in the knowledge gaps. ⋯ Purely financial cost containment strategies in health care can be ineffective or even harmful. Therefore, nonfinancial control mechanisms must ensure adherence to personal and professional ethics, together with professionalism based on sound medical knowledge.
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The aim of this study was to assess the diagnostic yield of follow-up investigations in aneurysm-negative subarachnoid hemorrhage (SAH) patients. ⋯ The results of this study support the use of repeat DSA in patients with NPM-SAH; however, routine repeat DSA may not be indicated in PM-SAH patients. The routine use of MRI remains controversial.
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The presence of clear high-grade rotatory subluxation, in addition to an odontoid fracture, is a definite indication for surgery. However, the presence of a more subtle subluxation-Grades 1, 2, or 3-can often be overlooked, and as a result, prognostic associations with second cervical vertebrae (C2) fractures are rare. In light of this, we assessed the failure rate of conservative management in patients with both an odontoid fracture and a concurrent first and second cervical vertebrae (C1‒C2) rotatory subluxation. ⋯ In our series, C2 Alonzo fractures with a C1‒C2 rotatory subluxation had a 10-fold increased risk of secondary displacement and subsequent need for surgery. Further research on this association could improve the management of these conditions.