World Neurosurg
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Malignant glioma progresses rapidly and shows poor prognosis, but clinically applicable blood plasma-based biochemical tumor markers remain lacking. This study aimed to develop a diagnostic system using probe electrospray ionization mass spectrometry (PESI-MS) and a machine-learning logistic regression model to detect plasma changes at various time points in a murine glioma model. ⋯ These results indicate that PESI-MS combined with machine learning-based diagnostics in blood plasma could be a promising approach to accurate detection of malignant glioma.
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Moyamoya disease (MMD) is a rare cerebrovascular disorder marked by internal carotid artery narrowing, collateral neovascularization, and symptomatic cerebral ischemia. Select patients can benefit from direct bypass (superficial temporal artery [STA]-proximal middle [MCA] bypass) by restoring blood flow to hypoperfused territories. Symptomatic contralateral stroke (CS) following STA-MCA bypass is a devastating, poorly understood complication. We investigate clinical and radiographic risk factors influencing CS incidence after bypass surgery. ⋯ Patients with CS following bypass had significantly higher preoperative SBP, postoperative SBP goals below their average preoperative SBP, and longer time from symptom onset to surgery compared to patients without CS. Patient-specific postoperative SBP management and timely surgical revascularization are crucial for preventing CS in patients with MMD undergoing STA-MCA bypass.
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Negative pressure wound therapy (NPWT) has been used for postsurgical wound management across various disciplines, including spinal surgery. However, its efficacy in reducing wound infection rates after posterior thoracolumbar spine surgery remains uncertain. ⋯ NPWT significantly reduced infection rates in patients with multiple comorbidities, suggesting its potential benefit in managing wound infections in this subgroup. This finding is particularly relevant for an urban, minority patient population, highlighting the importance of tailored wound care strategies.
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To compare the efficacy and safety of unilateral biportal endoscopic lumbar interbody fusion (UBE-LIF) and endoscopic lumbar interbody fusion (Endo-LIF) in the treatment of lumbar degenerative diseases in lumbar degenerative diseases. ⋯ Postoperative pain and safety were comparable between the two endoscopic procedures.The UBE-LIF procedure was shorter, whereas the Endo-LIF had less total blood loss and a shorter recovery time.