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Haider SA, Pressman SM, Borna S, Gomez-Cabello CA, Sehgal A, Leibovich BC, Forte AJ. Evaluating Large Language Model (LLM) Performance on Established Breast Classification Systems. Diagnostics (Basel) 2024; 14:1491. [PMID: 39061628 PMCID: PMC11275570 DOI: 10.3390/diagnostics14141491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 06/25/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024] Open
Abstract
Medical researchers are increasingly utilizing advanced LLMs like ChatGPT-4 and Gemini to enhance diagnostic processes in the medical field. This research focuses on their ability to comprehend and apply complex medical classification systems for breast conditions, which can significantly aid plastic surgeons in making informed decisions for diagnosis and treatment, ultimately leading to improved patient outcomes. Fifty clinical scenarios were created to evaluate the classification accuracy of each LLM across five established breast-related classification systems. Scores from 0 to 2 were assigned to LLM responses to denote incorrect, partially correct, or completely correct classifications. Descriptive statistics were employed to compare the performances of ChatGPT-4 and Gemini. Gemini exhibited superior overall performance, achieving 98% accuracy compared to ChatGPT-4's 71%. While both models performed well in the Baker classification for capsular contracture and UTSW classification for gynecomastia, Gemini consistently outperformed ChatGPT-4 in other systems, such as the Fischer Grade Classification for gender-affirming mastectomy, Kajava Classification for ectopic breast tissue, and Regnault Classification for breast ptosis. With further development, integrating LLMs into plastic surgery practice will likely enhance diagnostic support and decision making.
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Affiliation(s)
- Syed Ali Haider
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL 32224, USA
| | | | - Sahar Borna
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL 32224, USA
| | | | - Ajai Sehgal
- Center for Digital Health, Mayo Clinic, Rochester, MN 55905, USA
| | - Bradley C. Leibovich
- Center for Digital Health, Mayo Clinic, Rochester, MN 55905, USA
- Department of Urology, Mayo Clinic, Rochester, MN 55905, USA
| | - Antonio Jorge Forte
- Division of Plastic Surgery, Mayo Clinic, Jacksonville, FL 32224, USA
- Center for Digital Health, Mayo Clinic, Rochester, MN 55905, USA
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De Jesus Encarnacion Ramirez M, Chmutin G, Nurmukhametov R, Soto GR, Kannan S, Piavchenko G, Nikolenko V, Efe IE, Romero AR, Mukengeshay JN, Simfukwe K, Mpoyi Cherubin T, Nicolosi F, Sharif S, Roa JC, Montemurro N. Integrating Augmented Reality in Spine Surgery: Redefining Precision with New Technologies. Brain Sci 2024; 14:645. [PMID: 39061386 PMCID: PMC11274952 DOI: 10.3390/brainsci14070645] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 06/04/2024] [Accepted: 06/11/2024] [Indexed: 07/28/2024] Open
Abstract
INTRODUCTION The integration of augmented reality (AR) in spine surgery marks a significant advancement, enhancing surgical precision and patient outcomes. AR provides immersive, three-dimensional visualizations of anatomical structures, facilitating meticulous planning and execution of spine surgeries. This technology not only improves spatial understanding and real-time navigation during procedures but also aims to reduce surgical invasiveness and operative times. Despite its potential, challenges such as model accuracy, user interface design, and the learning curve for new technology must be addressed. AR's application extends beyond the operating room, offering valuable tools for medical education and improving patient communication and satisfaction. MATERIAL AND METHODS A literature review was conducted by searching PubMed and Scopus databases using keywords related to augmented reality in spine surgery, covering publications from January 2020 to January 2024. RESULTS In total, 319 articles were identified through the initial search of the databases. After screening titles and abstracts, 11 articles in total were included in the qualitative synthesis. CONCLUSION Augmented reality (AR) is becoming a transformative force in spine surgery, enhancing precision, education, and outcomes despite hurdles like technical limitations and integration challenges. AR's immersive visualizations and educational innovations, coupled with its potential synergy with AI and machine learning, indicate a bright future for surgical care. Despite the existing obstacles, AR's impact on improving surgical accuracy and safety marks a significant leap forward in patient treatment and care.
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Affiliation(s)
| | - Gennady Chmutin
- Department of Neurosurgery, Russian People’s Friendship University, 117198 Moscow, Russia
| | - Renat Nurmukhametov
- Department of Neurosurgery, Russian People’s Friendship University, 117198 Moscow, Russia
| | - Gervith Reyes Soto
- Department of Head and Neck, Unidad de Neurociencias, Instituto Nacional de Cancerología, Mexico City 14080, Mexico
| | - Siddarth Kannan
- School of Medicine, University of Central Lancashire, Preston PR0 2AA, UK
| | - Gennadi Piavchenko
- Department of Human Anatomy and Histology, Sechenov University, 119911 Moscow, Russia
| | - Vladmir Nikolenko
- Department of Neurosurgery, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Ibrahim E. Efe
- Department of Neurosurgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10178 Berlin, Germany
| | | | | | - Keith Simfukwe
- Department of Neurosurgery, Russian People’s Friendship University, 117198 Moscow, Russia
| | | | - Federico Nicolosi
- Department of Medicine and Surgery, Neurosurgery, University of Milano-Bicocca, 20126 Milan, Italy
| | - Salman Sharif
- Department of Neurosurgery, Liaquat National Hospital and Medical College, Karachi 05444, Pakistan
| | - Juan Carlos Roa
- Department of Pathology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), 56100 Pisa, Italy
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Reyes Soto G, Murillo Ponce C, Catillo-Rangel C, Cacho Diaz B, Nurmukhametov R, Chmutin G, Natalaja Mukengeshay J, Mpoyi Tshiunza C, Ramirez MDJE, Montemurro N. Intraoperative Ultrasound: An Old but Ever New Technology for a More Personalized Approach to Brain Tumor Surgery. Cureus 2024; 16:e62278. [PMID: 39006708 PMCID: PMC11246190 DOI: 10.7759/cureus.62278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Although the use of transcranial ultrasound dates to the mid-20th century, the main purpose of this research work is to standardize its use in the resection of brain tumors. This is due to its wide availability, low cost, lack of contraindications, and absence of harmful effects for the patient and medical staff, along with the possibility of real-time verification of the complete resection of tumor lesions and minimization of vascular injuries or damage to adjacent structures. METHODS A retrospective study was conducted from June to December 2022. The study included eight patients (three men and five women) aged between 32 and 76 years. Histological examination revealed two high-grade gliomas, one low-grade glioma, and five metastatic lesions. RESULTS The low-grade glioma appeared as a homogeneously echogenic structure and easily distinguishable from brain parenchyma, whereas metastases and high-grade gliomas showed higher echogenicity, being identified as malignant lesions due to areas of low echogenicity necrosis and peritumoral edema identified as a hyperechogenic structure. CONCLUSIONS The use of intraoperative transcranial ultrasound constitutes an important tool for neurosurgeons during tumor resection. Although it is easy to use, intraoperative ultrasound requires a relatively short learning curve and a good understanding of the fundamentals of ultrasound. Its main advantage over neuronavigation is that it is not affected by the "brain shift" phenomenon that commonly occurs during tumor resection, since the ultrasound images are updated during surgery.
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Affiliation(s)
- Gervith Reyes Soto
- Neurosurgical Oncology, Instituto Nacional de Cancerología, Mexico City, MEX
| | | | - Carlos Catillo-Rangel
- Neurosurgery, Hospital Regional 1ro de Octubre (ISSSTE or Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado), Mexico City, MEX
| | | | - Renat Nurmukhametov
- Neurosurgery, 2nd National Clinical Centre of Federal State Budgetary Research Institution (Russian Research Center of Surgery named after Academician B.V. Petrovsky), Moscow, RUS
| | - Gennady Chmutin
- Neurosurgery, Peoples' Friendship University of Russia (RUDN University), Moscow, RUS
| | | | | | | | - Nicola Montemurro
- Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP) University of Pisa, Pisa, ITA
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Reyes-Soto G, Carrillo-Hernández JF, Cacho-Díaz B, Ovalle CS, Castillo-Rangel C, Nurmukhametov R, Chmutin G, Ramirez MDJE, Montemurro N. Surgical treatment of orbital tumors in a single center: Analysis and results. Surg Neurol Int 2024; 15:122. [PMID: 38741993 PMCID: PMC11090600 DOI: 10.25259/sni_1016_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 03/15/2024] [Indexed: 05/16/2024] Open
Abstract
Background Orbital tumors, arising within the bony orbit and its contents, present diverse challenges due to their varied origins and complex anatomical context. These tumors, classified as primary, secondary, or metastatic, are further subdivided into intraconal and extraconal based on their relationship with the muscle cone. This classification significantly influences surgical approach and management. This study highlights surgical experiences with orbital tumors, underscoring the importance of tailored surgical approaches based on the lesion's site and its proximity to the optic nerve. Methods This retrospective study at the National Institute of Cancer's Head and Neck Department (2005-2014) analyzed 29 patients with orbital tumors treated with surgery, radiotherapy, chemotherapy, or combinations of them. Patient demographics, tumor characteristics, and treatment responses were evaluated using computed tomography (CT), magnetic resonance imaging, and positron emission tomography-CT imaging. Malignant tumors often required orbital exenteration and reconstruction, highlighting the study's commitment to advancing orbital tumor treatment. Results 29 patients (18 females and 11 males, age 18-88 years, mean 53.5 years) with orbital tumors exhibited symptoms such as decreased vision and exophthalmos. Tumors included primary lesions like choroidal melanoma and secondary types like epidermoid carcinoma. Treatments varied, involving a multidisciplinary team for surgical approaches like exenteration, with follow-up from 1 to 9 years. Radiotherapy and chemotherapy were used for specific cases. Conclusion Our study underscores the need for a multidisciplinary approach in treating orbital tumors, involving various surgical specialists and advanced technologies like neuronavigation for tailored treatment. The integration of surgery with radiotherapy and chemotherapy highlights the effectiveness of multidimensional treatment strategies.
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Affiliation(s)
- Gervith Reyes-Soto
- Department of Head and Neck, Unidad de Neurociencias, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Jose F. Carrillo-Hernández
- Department of Investigación Biomédica, Unidad de Investigación Biomédica en Cáncer, Laboratorio de Genómica, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Bernardo Cacho-Díaz
- Department of Head and Neck, Unidad de Neurociencias, Instituto Nacional de Cancerología, Mexico City, Mexico
| | | | - Carlos Castillo-Rangel
- Department of Neurosurgery, Servicio of the 1ro de Octubre Hospital of the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Instituto Politécnico Nacional, México City, Mexico
| | - Renat Nurmukhametov
- Department of Neurosurgery, Peoples’ Friendship University of Russia, Moscow, Russian Federation
| | - Gennady Chmutin
- Department of Neurosurgery, Peoples’ Friendship University of Russia, Moscow, Russian Federation
| | | | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
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Reyes Soto G, Cacho-Díaz B, Vilchis-Sámano H, Diaz-Sanabria I, Baeza-Velia B, Ayala-Garduño D, García-Ramos C, Rosales-Olivarez LM, Alpízar-Aguirre A, Mukengeshay JN, Reyes-Sánchez A, Ramirez MDJE, Montemurro N. Mexican Multicenter Experience of Metastatic Spinal Disease. Cureus 2024; 16:e58546. [PMID: 38957823 PMCID: PMC11218424 DOI: 10.7759/cureus.58546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 07/04/2024] Open
Abstract
Background Spinal metastatic disease is a silent progressive cancer complication with an increasing prevalence worldwide. The spine is the third most common site where solid tumors metastasize. Complications involved in spinal metastasis include root or spinal cord compression, progressing to a declining quality of life as patient autonomy reduces and pain increases. The main objective of this study is to report the incidence of patients and typology of spinal metastases in three reference centers in Mexico. Methodology Retrospective cohorts of patients diagnosed with spinal metastases from January 2010 to February 2017 at the National Cancer Institute, National Rehabilitation Institute, and the Traumatology and Orthopedics Hospital "Lomas Verdes" in Mexico City were analyzed. Results A total of 326 patients (56% males) with spinal metastases were reported. The mean age was 58.06 ± 14.05 years. The main sources of spinal metastases were tumors of unknown origin in 53 (16.25%) cases, breast cancer in 67 (20.5%) cases, prostate cancer in 59 (18%) cases, myeloma in 24 (7.4%) cases, and lung cancer in 23 (7.1%) cases. Conclusions The data obtained in this analysis delivers an updated standpoint on Mexico, providing the opportunity to distinguish the current data from global references. Collecting more epidemiological information for better recording of cancer and its associated complications, as well as further studies on them, is necessary.
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Affiliation(s)
- Gervith Reyes Soto
- Neurosurgical Oncology, Mexico National Cancer Institute, Mexico City, MEX
| | - Bernardo Cacho-Díaz
- Head and Neck Surgery Department, Instituto Nacional de Cancerología, Mexico City, MEX
| | - Hugo Vilchis-Sámano
- Spine Surgery, Hospital de Traumatología y Ortopedia "Lomas Verdes", Mexico City, MEX
| | - Ignacio Diaz-Sanabria
- Spine Surgery, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico City, MEX
| | - Beatriz Baeza-Velia
- Spine Surgery, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico City, MEX
| | - David Ayala-Garduño
- Spine Surgery, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico City, MEX
| | - Carla García-Ramos
- Spine Surgery, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico City, MEX
| | | | - Armando Alpízar-Aguirre
- Spine Surgery, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico City, MEX
| | | | - Alejandro Reyes-Sánchez
- Spine Surgery, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico City, MEX
| | | | - Nicola Montemurro
- Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), Pisa, ITA
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Wang CC, Hu TM, Lin YJ, Chen CL, Hsu YC, Kao CL. Use of noninvasive brain stimulation and neurorehabilitation devices to enhance poststroke recovery: review of the current evidence and pitfalls. J Int Med Res 2024; 52:3000605241238066. [PMID: 38603599 PMCID: PMC11010770 DOI: 10.1177/03000605241238066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 02/22/2024] [Indexed: 04/13/2024] Open
Abstract
Neurorehabilitation devices and technologies are crucial for enhancing stroke recovery. These include noninvasive brain stimulation devices that provide repetitive transcranial magnetic stimulation or transcranial direct current stimulation, which can remodulate an injured brain. Technologies such as robotics, virtual reality, and telerehabilitation are suitable add-ons or complements to physical therapy. However, the appropriate application of these devices and technologies, which target specific deficits and stages, for stroke therapy must be clarified. Accordingly, a literature review was conducted to evaluate the theoretical and practical evidence on the use of neurorehabilitation devices and technologies for stroke therapy. This narrative review provides a practical guide for the use of neurorehabilitation devices and describes the implications of use and potential integration of these devices into healthcare.
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Affiliation(s)
- Chien-Chih Wang
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- Department of Physical Medicine and Rehabilitation, School of Medicine, National Yang Ming Chao Tung University, Taipei, Taiwan, ROC
- Intelligent Long Term Medical Care Research Center, Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
| | - Tsung-Ming Hu
- Department of Future Studies and LOHAS Industry, Fo Guang University, Yilan, Taiwan, ROC
- Department of Psychiatry, Taipei Veterans General Hospital Yuli Branch, Hualien, Taiwan, ROC
| | - Yung-Jie Lin
- Department of Family Medicine, Taipei Veterans General Hospital Yuli Branch, Hualien, Taiwan, ROC
| | - Chien-Lung Chen
- Taipei Hospital, Ministry of Health and Welfare, Taipei, Taiwan, ROC
- National Yang Ming Chao Tung University, Institute of Hospital and Health Care Administration, Taipei Taiwan, ROC
| | - Yu-Chuan Hsu
- Department of Nursing, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chung-Lan Kao
- Department of Physical Medicine and Rehabilitation, School of Medicine, National Yang Ming Chao Tung University, Taipei, Taiwan, ROC
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, National Yang Ming Chao Tung University, Taipei, Taiwan, ROC
- Center For Intelligent Drug Systems and Smart Bio-devices (IDS2B), National Chiao Tung University, Hsinchu, Taiwan, ROC
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Ramirez MDJE, Montemurro N, Musa G, Chmutin GE, Nurmukhametov R, Rosario AR, Barza JL, Kaprovoy S, Konovalov N, Kudriavtsev D, Mukengeshay JN, Kalangu KK, Kachinga S, Sufianov A, Simfukwe K, Baeza-Antón L, Kutty RK, El-Ghandour NMF, Garozzo D. On the balance beam: facing the challenges of neurosurgical education in the third millennium. Surg Neurol Int 2024; 15:102. [PMID: 38628530 PMCID: PMC11021083 DOI: 10.25259/sni_1014_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/26/2024] [Indexed: 04/19/2024] Open
Abstract
Background Neurosurgery is one of the most complex and challenging areas of medicine, and it requires an ongoing commitment to education and expertise. Preparing young neurosurgeons with comprehensive education that can allow them to achieve high professional standards is a pivotal aspect of our profession. Methods This paper aims to analyze the current scenario in neurosurgical training identifying innovative methods that can guarantee the highest level of proficiency in our specialty. Results Given the inherent high-stakes nature of neurosurgical procedures, there is a significant burden of responsibility in ensuring that neurosurgical training is of the highest caliber, capable of producing practitioners who possess not just theoretical knowledge but also practical skills and well-tuned judgment. Conclusion Providing high-quality training is one of the major challenges that the neurosurgical community has to face nowadays, especially in low- and middle-income countries; one of the main issues to implementing neurosurgery worldwide is that the majority of African countries and many areas in Southeast Asia still have few neurosurgeons who encounter enormous daily difficulties to guarantee the appropriate neurosurgical care to their population.
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Affiliation(s)
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - Gerald Musa
- Department of Neurological Diseases and Neurosurgery, Peoples Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - Gennady E. Chmutin
- Department of Neurosurgery, Peoples’ Friendship University of Russia, Moscow, Russian Federation
| | - Renat Nurmukhametov
- Department of Neurosurgery, Peoples’ Friendship University of Russia, Moscow, Russian Federation
| | - Andreina Rosario Rosario
- Department of Neurosurgery, Autonomous University of Santo Domingo, Santo Domingo, Dominican Republic
| | - Jesus Lafuente Barza
- Department of Neurosurgery, Spine Center Hospital del Mar, Sagrat Cor University Hospital, Barcelona, Spain
| | - Stanislav Kaprovoy
- Department of Neurosurgery, N.N. Burdenko National Medical Research Center of Neurosurgery, Moscow, Russian Federation
| | - Nikolay Konovalov
- Department of Neurosurgery, N.N. Burdenko National Medical Research Center of Neurosurgery, Moscow, Russian Federation
| | - Dmitry Kudriavtsev
- Department of Neurosurgery, Podolsk Regional Hospital, Moscow, Russian Federation
| | | | - Kazadi Kelvin Kalangu
- Department of Neurosurgery, University of Zimbabwe, College of Health Sciences, Zimbabwe
| | - Sichizya Kachinga
- Department of Neurosurgery, University Teaching Hospital, Lusaka, Zambia
| | - Albert Sufianov
- Department of Neurosurgery, Peoples’ Friendship University of Russia, Moscow, Russian Federation
- Federal Centre of Neurosurgery, Tyumen, Russia
- Department of Neurosurgery, State Medical University (Sechenov University), Moscow, Russia
| | - Keith Simfukwe
- Department of Neurosurgery, Peoples’ Friendship University of Russia, Moscow, Russian Federation
| | - Laura Baeza-Antón
- Department of Neurological Surgery, Weill Cornell Medicine/NewYork Presbyterian Hospital, New York, United States
| | - Raja K. Kutty
- Department of Neurosurgery, Government Medical College, Thiruvananthapuram, Kerala, India
| | | | - Debora Garozzo
- Department of Neurosurgery, Mediclinic Parkview Hospital, Dubai, United Arab Emirates
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Montemurro N. Clinical and surgical outcome of endoscopic third ventriculostomy (ETV) and ventriculoperitoneal shunt (VPS) in patients with Long-Standing Overt Ventriculomegaly in Adults (LOVA): a systematic review. Neurol Res 2024; 46:81-88. [PMID: 37722694 DOI: 10.1080/01616412.2023.2257461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 07/19/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVES The optimal surgical procedure for long-standing overt ventriculomegaly in adults (LOVA) remains controversial. METHODS A systematic search of three databases was performed for studies published between January 1999 and March 2022. This systematic review included 12 studies with a total of 318 patients with LOVA surgically treated. PRISMA guidelines were followed. RESULTS Gait disturbance (74.8%) and headache (59.7%) were the most common clinical presentation. Overall, the rate of postoperative clinical improvement at the last follow-up was 83.6% (95% CI 78.1-86.1). A lower rate of postoperative clinical improvement or halt of progression of presenting symptoms was observed after ETV (211/257 = 82.1% 95% CI 76.2-85.1%) compared with VPS (55/61 = 90.2% 95% CI 80.3-96.1%). Overall, surgical and postoperative complications were reported in 22/297 patients (7.5% 95% CI 4.4-20%) (11 studies). A higher rate of surgical complications was observed in patients treated with VPS (19.7% 95 CI 5.9-46.7%), compared with patients treated with ETV (4.3% 95% CI 2.1-10.9%). The overall rate of second surgery due to failure of first surgical approach (ETV or VPS) was 46/275 (16.7%). DISCUSSION This meta-analysis confirmed the efficacy of EVT and VPS in symptomatic patients with LOVA, reporting a roughly 84% of postoperative clinical improvement or halt of progression of symptoms. A higher rate of surgical complications was observed in patients treated with VPS compared with patients treated with ETV. In addition, roughly 18% of patients treated with ETV required a further VPS. These findings should be considered when advising LOVA patients regarding the management of hydrocephalus.
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Affiliation(s)
- Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), Pisa, Italy
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Torres CSO, Mora AE, Campero A, Cherian I, Sufianov A, Sanchez EF, Ramirez ME, Pena IR, Nurmukhametov R, Beltrán MA, Juarez ED, Cobos AM, Lafuente-Baraza J, Baldoncini M, Luzzi S, Montemurro N. Enhancing microsurgical skills in neurosurgery residents of low-income countries: A comprehensive guide. Surg Neurol Int 2023; 14:437. [PMID: 38213434 PMCID: PMC10783688 DOI: 10.25259/sni_791_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/23/2023] [Indexed: 01/13/2024] Open
Abstract
Background The main objectives of this paper are to outline the essential tools, instruments, and equipment needed to set up a functional microsurgery laboratory that is affordable for low-income hospitals and to identify cost-effective alternatives for acquiring microsurgical equipment, such as refurbished or donated instruments, collaborating with medical device manufacturers for discounted rates, or exploring local suppliers. Methods Step-by-step instructions were provided on setting up the microsurgery laboratory, including recommendations for the layout, ergonomic considerations, lighting, and sterilization processes while ensuring cost-effectiveness, as well as comprehensive training protocols and a curriculum specifically tailored to enhance microsurgical skills in neurosurgery residents. Results We explored cost-effective options for obtaining microsurgery simulators and utilizing open-source or low-cost virtual training platforms. We also included guidelines for regular equipment maintenance, instrument sterilization, and establishing protocols for infection control to ensure a safe and hygienic learning environment. To foster collaboration between low-income hospitals and external organizations or institutions that can provide support, resources, or mentorship, this paper shows strategies for networking, knowledge exchange, and establishing partnerships to enhance microsurgical training opportunities further. We evaluated the impact and effectiveness of the low-cost microsurgery laboratory by assessing the impact and effectiveness of the established microsurgery laboratory in improving the microsurgical skills of neurosurgery residents. About microsutures and microanastomosis, after three weeks of training, residents showed improvement in "surgical time" for ten separate simple stitches (30.06 vs. 8.65 min) and ten continuous single stitches (19.84 vs. 6.51 min). Similarly, there was an increase in the "good quality" of the stitches and the suture pattern from 36.36% to 63.63%. Conclusion By achieving these objectives, this guide aims to empower low-income hospitals and neurosurgery residents with the necessary resources and knowledge to establish and operate an affordable microsurgery laboratory, ultimately enhancing the quality of microsurgical training and patient care in low-income countries.
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Affiliation(s)
| | | | - Alvaro Campero
- Department of Neurosurgery, Hospital Padilla de Tucuman, Tucuman, San Miguel de Tucuman, Argentina
| | - Iype Cherian
- Institute of Neurosciences, Krishna Vishwa Vidyapeeth, Karad, Maharashtra, India
| | - Albert Sufianov
- Department of Neurosurgery, Federal Center of Neurosurgery, Tyumen
| | | | | | - Issael Ramirez Pena
- Department of Neurosurgery, The Royal Melbourne Hospital, Melbourne, Australia
| | | | | | - Eduardo Diaz Juarez
- Department of Neurosurgery, National University of Mexico Hospital General, Durango
| | | | | | - Matias Baldoncini
- Department of Neurosurgery, San Fernando Hospital, Belgrano, San Fernando, Argentina
| | - Sabino Luzzi
- Department of Neurosurgery, University of Pavia, Pavia
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
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10
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Nurmukhametov R, Medetbek A, Ramirez ME, Afsar A, Sharif S, Montemurro N. Factors affecting return to work following endoscopic lumbar foraminal stenosis surgery: A single-center series. Surg Neurol Int 2023; 14:408. [PMID: 38053695 PMCID: PMC10695345 DOI: 10.25259/sni_659_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023] Open
Abstract
Background This study evaluates the factors affecting the return to work of endoscopic surgery for lumbar foraminal stenosis (LFS), including symptoms, functional status, complications, and reoperation rates. Methods The authors' retrospective cohort study included 100 consecutive patients (50 males and 50 females) diagnosed with LFS who underwent endoscopic surgery at Trotsky National Research Center of Surgery between January 2018 and December 2021. Results There were no significant differences in age and preoperative visual analog scale and Oswestry disability index scores between the male and female groups, time to return to work for different patient groups after undergoing endoscopic lumbar foraminotomy (ELF). However, patients with more severe stenosis and comorbidities may take longer to recover. Confounding factors were patient age, preoperative physical function, and job requirements. Conclusion This study confirms that study ELF can effectively improve symptoms associated with lumbar radiculopathy, as well as back pain, and improve patients' quality of life. Comorbidity, smoking status, and complications prolong the time to return to work following ELF surgery compared to healthy subjects.
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Affiliation(s)
- Renat Nurmukhametov
- Department of Spinal Surgery, Petrovsky National Research Centre of Surgery, Moscow, Russian Federation
| | - Abakirov Medetbek
- Department of Spinal Surgery, Petrovsky National Research Centre of Surgery, Moscow, Russian Federation
| | - Manuel Encarnacion Ramirez
- Department of Neurosurgery, Russian People’s Friendship University, United Nations Educational, Scientific and Cultural Organization (UNESCO), Digital Anatomy, Moscow, Russian Federation
| | - Afifa Afsar
- Department of Neurosurgery, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Salman Sharif
- Department of Neurosurgery, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
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11
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Montemurro N, Trilli I, Bordea IR, Ferrara E, Francesco MD, Caccamo F, Malcangi G, Rapone B. Are Whiplash-Associated Disorders and Temporomandibular Disorders in a Trauma Related Cause and Effect Relationship? A Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1482. [PMID: 37629772 PMCID: PMC10456620 DOI: 10.3390/medicina59081482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
Background: Whiplash is associated with a wide variety of clinical manifestations, including headache, neck pain, cervical rigidity, shoulder and back pain, paresthesia, vertigo, and temporomandibular disorders (TMDs). Previous studies reported that TMDs are more common in individuals with chronic whiplash-associated disorders (WAD) than in the general population; however, the pathophysiology and mechanism of this relationship are still not well understood. Methods: A PubMed and Ovid EMBASE review was performed to identify all studies addressing the trauma related cause and effect relationship between WAD and TMDs from January 2003 to March 2023. Results: After screening for eligibility and inclusion criteria, a total of 16 articles met the selection criteria. The various included studies discussed different aspects of the association between WDA and TMDs, including changes in the coordination and amplitude of jaw opening, the severity of the associated symptoms/signs in cases of WAD, the degree of fatigue and psychological stress, difficulty in feeding, cervical and myofascial pain, changes in the MRI signal at various muscle points, muscle tenderness, and quality of life. Conclusions: In this review, we summarized the clinical evidence of any trauma related cause and effect relationship between whiplash and TMDs. An accurate screening of the previous literature showed that, in conclusion, the relationship between whiplash and TMDs is still unclear.
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Affiliation(s)
- Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), University of Pisa, 56100 Pisa, Italy;
| | - Irma Trilli
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (I.T.); (G.M.); (B.R.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dental Medicine, University of Medicine and Pharmacy ‘Iuliu Hatieganu’, 400012 Cluj-Napoca, Romania
| | - Elisabetta Ferrara
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio, 66100 Chieti, Italy;
| | - Maurizio De Francesco
- Department of Neurosciences, Institute of Clinical Dentistry, University of Padua, 35128 Padua, Italy;
| | | | - Giuseppina Malcangi
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (I.T.); (G.M.); (B.R.)
| | - Biagio Rapone
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (I.T.); (G.M.); (B.R.)
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12
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Uhl JF, Sufianov A, Ruiz C, Iakimov Y, Mogorron HJ, Encarnacion Ramirez M, Prat G, Lorea B, Baldoncini M, Goncharov E, Ramirez I, Céspedes JRC, Nurmukhametov R, Montemurro N. The Use of 3D Printed Models for Surgical Simulation of Cranioplasty in Craniosynostosis as Training and Education. Brain Sci 2023; 13:894. [PMID: 37371373 DOI: 10.3390/brainsci13060894] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/22/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The advance in imaging techniques is useful for 3D models and printing leading to a real revolution in many surgical specialties, in particular, neurosurgery. METHODS We report on a clinical study on the use of 3D printed models to perform cranioplasty in patients with craniosynostosis. The participants were recruited from various medical institutions and were divided into two groups: Group A (n = 5) received traditional surgical education (including cadaveric specimens) but without using 3D printed models, while Group B (n = 5) received training using 3D printed models. RESULTS Group B surgeons had the opportunity to plan different techniques and to simulate the cranioplasty. Group B surgeons reported that models provided a realistic and controlled environment for practicing surgical techniques, allowed for repetitive practice, and helped in visualizing the anatomy and pathology of craniosynostosis. CONCLUSION 3D printed models can provide a realistic and controlled environment for neurosurgeons to develop their surgical skills in a safe and efficient manner. The ability to practice on 3D printed models before performing the actual surgery on patients may potentially improve the surgeons' confidence and competence in performing complex craniosynostosis surgeries.
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Affiliation(s)
- Jean Francois Uhl
- Anatomy Department, Paris University and UNESCO Chair of Digital Anatomy, 75100 Paris, France
| | - Albert Sufianov
- Federal Center of Neurosurgery, Sechenov University, 119435 Moscow, Russia
| | - Camillo Ruiz
- Laboratorio de Investigaciones Morfológicas Aplicadas, Universidad Nacional de La Plata, La Plata B1900, Argentina
| | - Yuri Iakimov
- Federal Center of Neurosurgery, Sechenov University, 119435 Moscow, Russia
| | - Huerta Jose Mogorron
- Anatomy Department, Paris University and UNESCO Chair of Digital Anatomy, 75100 Paris, France
| | | | - Guillermo Prat
- Laboratorio de Investigaciones Morfológicas Aplicadas, Universidad Nacional de La Plata, La Plata B1900, Argentina
| | - Barbara Lorea
- Laboratorio de Investigaciones Morfológicas Aplicadas, Universidad Nacional de La Plata, La Plata B1900, Argentina
| | - Matias Baldoncini
- Laboratory of Microsurgical Neuroanatomy, Second Chair of Gross Anatomy, School of Medicine, University of Buenos Aires, Buenos Aires B1406, Argentina
| | - Evgeniy Goncharov
- Traumatology and Orthopedics Center, Central Clinical Hospital of the Russian Academy of Sciences, 103272 Moscow, Russia
| | - Issael Ramirez
- Neurosurgery Department, The Royal Melbourne Hospital, Melbourne 3000, Australia
| | | | - Renat Nurmukhametov
- Neurological Surgery, Peoples Friendship University of Russia, 103274 Moscow, Russia
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), University of Pisa, 56100 Pisa, Italy
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13
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Andreucci-Annunziata P, Mellado A, Vega-Muñoz A. Telesupervision in Psychotherapy: A Bibliometric and Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16366. [PMID: 36498438 PMCID: PMC9735903 DOI: 10.3390/ijerph192316366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/25/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: This systematic review supported by a bibliometric analysis identified quantitative and qualitative empirical studies that allowed us to respond to the objective of identifying and discussing the scope and limitations of the clinical-psychotherapeutic supervision in virtual modality or telesupervision. (2) Methods: The articles were selected according to the Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the eligibility criteria proposed by the PICOS strategy (population, interventions, comparators, outcomes, and study design) based on 396 records of scientifically identified articles in the Journal Citation Report databases of the Web of Science. (3) Results: The literature review stages allowed the selection of three articles, which were added three others that were already included in a previous review, to enrich the analysis and discussion. The results of the present review highlighted aspects of nonverbal communication, alliance, comfort, preference, trust, and construction of professional identity, among others, both considering only the telesupervision format and comparing it with traditional face-to-face supervision. (4) Conclusions: The contributions that these results are providing to the understanding of the scope and limitations of the practice of telesupervision are discussed, also considering its interference in the construction of the professional identity of supervisors and supervisees.
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Affiliation(s)
- Paola Andreucci-Annunziata
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330507, Chile
| | - Augusto Mellado
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330507, Chile
| | - Alejandro Vega-Muñoz
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330507, Chile
- Escuela de Doctorado, Universidad Rovira i Virgili, 43007 Tarragona, Spain
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14
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Kamecka K, Foti C, Gawiński Ł, Matejun M, Rybarczyk-Szwajkowska A, Kiljański M, Krochmalski M, Kozłowski R, Marczak M. Telemedicine Technologies Selection for the Posthospital Patient Care Process after Total Hip Arthroplasty. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11521. [PMID: 36141791 PMCID: PMC9517262 DOI: 10.3390/ijerph191811521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
For many years, the importance of using telematic technologies in medicine has been growing, especially in the period of the coronavirus pandemic, when direct contact and supervision of medical personnel over the patient is difficult. The existing possibilities of modern information and communication technologies (ICTs) are not fully used. The aim of the study is to identify the telemedicine technologies that can be used in future implementation projects of the posthospital patient care process after total hip arthroplasty (THA). The literature search is reported according to PRISMA 2020. The search strategy included databases and gray literature. In total, 28 articles (EMBASE, PubMed, PEDro) and 24 records from gray literature (Google Search and Technology presentations) were included in the research. This multi-source study analyzes the possibilities of using different technologies useful in the patient care process. The conducted research resulted in defining visual and wearable types of telemedicine technologies for the original posthospital patient care process after THA. As the needs of stakeholders in the posthospital patient care process after THA differ, the awareness of appropriate technologies selection, information flow, and its management importance are prerequisites for effective posthospital patient care with the use of telemedicine technologies.
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Affiliation(s)
- Karolina Kamecka
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland
| | - Calogero Foti
- Physical and Rehabilitation Medicine, Clinical Sciences and Translational Medicine Department, Tor Vergata University, 00133 Rome, Italy
| | - Łukasz Gawiński
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland
| | - Marek Matejun
- Department of Entrepreneurship and Industrial Policy, Faculty of Management, University of Lodz, 90-237 Lodz, Poland
| | | | - Marek Kiljański
- Polish Association of Physiotherapy Specialists, 95-200 Pabianice, Poland
- Medical Magnus Clinic, 90-552 Lodz, Poland
| | - Marek Krochmalski
- Medical Magnus Clinic, 90-552 Lodz, Poland
- Polish Muscles, Ligaments and Tendons Society, 90-552 Lodz, Poland
| | - Remigiusz Kozłowski
- Center of Security Technologies in Logistics, Faculty of Management, University of Lodz, 90-237 Lodz, Poland
| | - Michał Marczak
- Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-131 Lodz, Poland
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15
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Huo X, Wang K, Song L, Yang Y, Zhu S, Ma J, Tian K, Fan Y, Wang L, Wu Z. Bibliometric analysis of publication trends in chordoma research (1992−2021). INTERDISCIPLINARY NEUROSURGERY 2022. [DOI: 10.1016/j.inat.2022.101589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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16
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Długosz P, Liszka D, Bastrakova A, Yuzva L. Health Problems of Students during Distance Learning in Central and Eastern Europe: A Cross-Sectional Study of Poland and Ukraine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10074. [PMID: 36011708 PMCID: PMC9407955 DOI: 10.3390/ijerph191610074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/20/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has significantly disrupted the functioning of society. Issues of deteriorating health were among the main problems resulting from restrictions such as self-isolation, social distancing, and remote education. The aim of this research was to attempt to probe the psychophysical condition of students after more than a year of remote education. The survey method (CAPI) was used to collect the data on a representative sample of 1000 students in Poland and 1022 in Ukraine. The research sample was selected in a randomly stratified manner, taking into account such characteristics as: gender, age, and place of residence. The results of the research showed that 44% of Polish and 50% of Ukrainian students experienced health problems. The burden of remote education mainly contributed to the reduction of physical fitness. Young Poles more often paid attention to the deterioration of mental well-being, and Ukrainians to the deterioration of their physical condition. Based on the conducted analyses, it was also established that health problems appeared more often among the females, students with lower social support and with lower trust levels. The main risk factors were Internet addiction, secondary effects of the pandemic, and negative remote education experiences. Research has shown that remote education and problems that arise in students' households during the pandemic may have significantly contributed to the deterioration of their psychophysical condition.
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Affiliation(s)
- Piotr Długosz
- Faculty of Social Sciences, Pedagogical University of Krakow, 30-084 Krakow, Poland
| | - Damian Liszka
- Faculty of Social Sciences, Pedagogical University of Krakow, 30-084 Krakow, Poland
| | - Anastasiia Bastrakova
- Department of Sociology, Kyiv International Institute of Sociology, 04070 Kyiv, Ukraine
| | - Luydmila Yuzva
- Department of Sociology, Taras Shevchenko National University of Kyiv, 01033 Kyiv, Ukraine
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17
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New Targets and New Technologies in the Treatment of Parkinson’s Disease: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148799. [PMID: 35886651 PMCID: PMC9321220 DOI: 10.3390/ijerph19148799] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 02/06/2023]
Abstract
Parkinson’s disease (PD) is a progressive neurodegenerative disease, whose main neuropathological finding is pars compacta degeneration due to the accumulation of Lewy bodies and Lewy neurites, and subsequent dopamine depletion. This leads to an increase in the activity of the subthalamic nucleus (STN) and the internal globus pallidus (GPi). Understanding functional anatomy is the key to understanding and developing new targets and new technologies that could potentially improve motor and non-motor symptoms in PD. Currently, the classical targets are insufficient to improve the entire wide spectrum of symptoms in PD (especially non-dopaminergic ones) and none are free of the side effects which are not only associated with the procedure, but with the targets themselves. The objective of this narrative review is to show new targets in DBS surgery as well as new technologies that are under study and have shown promising results to date. The aim is to give an overview of these new targets, as well as their limitations, and describe the current studies in this research field in order to review ongoing research that will probably become effective and routine treatments for PD in the near future.
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18
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Spinal Vascular Shunts: Single-Center Series and Review of the Literature of Their Classification. Neurol Int 2022; 14:581-599. [PMID: 35893282 PMCID: PMC9326594 DOI: 10.3390/neurolint14030047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 02/04/2023] Open
Abstract
Spinal arteriovenous shunts (sAVSs) are an uncommon disease, constituting 3 to 4% of intradural lesions; 70% of these lesions are spinal arteriovenous fistulas (sAVFs), whereas spinal arteriovenous malformations (sAVMs) are rarer. Both share the problem of their classification due to the heterogeneity of their angioarchitecture. The aim of this study is to report a series of sAVSs treated in the neurosurgery department of the Hospital Nacional Guillermo Almenara during the 2018–2020 period and to present an overview of the current literature on sAVS classification. We reviewed all medical records of patients diagnosed with sAVFs and sAVMs during the 2018–2020 period, and then we analyzed images with Horos v4.0.0, illustrated some cases with Clip Studio Paint v1.10.5, and performed a descriptive statistical analysis with SPSS v25. Twelve patients were included in this study, eight of which were women (67%) and four of which were men (33%); the age range was from 3 to 74 years. Eight sAVSs were sAVFs, whereas four were sAVMs. The most frequent clinical manifestation was chronic myelopathy in seven patients (58%). Of those treated only by embolization, seven (70%) resulted in complete occlusion (five sAVFs and two sAVMs), while three (30%) remained with a residual lesion. At last follow-up, five patients (42%) improved clinically, and the seven remaining (58%) maintained the same neurological state. sAVSs require a detailed study of their angioarchitecture for proper management. The endovascular treatment is safe with acceptable cure rates. The surgical option should not be set aside.
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19
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Jabbar R, Jankowski J, Pawełczyk A, Szmyd B, Solek J, Pierzak O, Wojdyn M, Radek M. Cervical Paraspinal Chordoma: A Literature Review with a Novel Case Report. J Clin Med 2022; 11:jcm11144117. [PMID: 35887879 PMCID: PMC9325254 DOI: 10.3390/jcm11144117] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 02/01/2023] Open
Abstract
Chordomas are rare malignant neoplasms, accounting for 1–4% of all primary bone tumors. Most spinal chordomas occur in the sacrococcygeal region and the base of the skull; however, 6% of chordomas are observed in the cervical spine. In these cases, the lesion is mainly located in the midline. These tumors slowly grow before becoming symptomatic and encase the surrounding vascular and nerve structures. Patients with advanced chordoma have a poor prognosis due to local recurrence with infiltration and destruction of adjacent bone and tissues. Systemic chemotherapy options have not been fully effective in these tumors, especially for recurrent chordomas. Thus, new combinations of currently available targeted molecular and biological therapies with radiotherapy have been proposed as potential treatment modalities. Here, the present paper describes the case of a 41-year-old male with a C2–C4 chordoma located paravertebrally, who underwent surgical resection with a debulking procedure for a cervical chordoma. Computed tomography angiography revealed a paraspinal mass with bone remodeling and the MRI showed a paravertebral mass penetrating to the spinal canal with a widening of the intervertebral C2–C3 foramen. Initially, the tumor was diagnosed as schwannoma based on its localization and imaging features; however, the histopathology specimen confirmed the diagnosis of chordoma. This case study highlights the effectivity of radical surgical resection as a mainstay treatment for chordomas, discusses neuroimaging, diagnosis, and the use of currently available targeted therapies and forthcoming treatment strategies, as alternative treatment options for chordoma.
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Affiliation(s)
- Redwan Jabbar
- Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, 90-549 Lodz, Poland; (R.J.); (J.J.); (A.P.); (B.S.); (O.P.); (M.W.)
| | - Jakub Jankowski
- Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, 90-549 Lodz, Poland; (R.J.); (J.J.); (A.P.); (B.S.); (O.P.); (M.W.)
| | - Agnieszka Pawełczyk
- Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, 90-549 Lodz, Poland; (R.J.); (J.J.); (A.P.); (B.S.); (O.P.); (M.W.)
| | - Bartosz Szmyd
- Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, 90-549 Lodz, Poland; (R.J.); (J.J.); (A.P.); (B.S.); (O.P.); (M.W.)
| | - Julia Solek
- Department of Pathology, Chair of Oncology, Medical University of Lodz, 92-213 Lodz, Poland;
| | - Olaf Pierzak
- Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, 90-549 Lodz, Poland; (R.J.); (J.J.); (A.P.); (B.S.); (O.P.); (M.W.)
| | - Maciej Wojdyn
- Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, 90-549 Lodz, Poland; (R.J.); (J.J.); (A.P.); (B.S.); (O.P.); (M.W.)
| | - Maciej Radek
- Department of Neurosurgery, Spine and Peripheral Nerve Surgery, Medical University of Lodz, 90-549 Lodz, Poland; (R.J.); (J.J.); (A.P.); (B.S.); (O.P.); (M.W.)
- Correspondence:
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20
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Chaurasia B, Chavda V, Lu B, Garg K, Montemurro N. Cognitive deficits and memory impairments after COVID-19 (Covishield) vaccination. Brain Behav Immun Health 2022; 22:100463. [PMID: 35496775 PMCID: PMC9034829 DOI: 10.1016/j.bbih.2022.100463] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/12/2022] [Accepted: 04/20/2022] [Indexed: 12/11/2022] Open
Abstract
Vaccination is an essential public health strategy to control the 2019 Coronavirus (COVID-19) pandemic. While the benefits of the COVID-19 vaccines far outweigh the risks, side effects continue to be reported in the literature. We report a 65-year-old man who developed cognitive deficits and memory impairments following his first dose of Oxford AstraZeneca vaccine (Covishield). The onset of acute cognitive deficits and memory impairments could be another complication to COVID-19 vaccination that physicians and neurologists need to be warned to. Monitoring the safety of COVID-19 vaccines and describing side effects associated with them is essential to improve safety profiles and enhance public trust.
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Affiliation(s)
- Bipin Chaurasia
- Department of Neurosurgery, Bhawani Hospital and Research Centre, Birgunj, Nepal
| | - Vishal Chavda
- Department of Pathology, Stanford School of Medicine, Stanford University Medical Center, USA
| | - Bingwei Lu
- Department of Pathology, Stanford School of Medicine, Stanford University Medical Center, USA
| | - Kanwaljeet Garg
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), University of Pisa, Pisa, Italy
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21
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Montemurro N, Condino S, Carbone M, Cattari N, D’Amato R, Cutolo F, Ferrari V. Brain Tumor and Augmented Reality: New Technologies for the Future. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6347. [PMID: 35627884 PMCID: PMC9141435 DOI: 10.3390/ijerph19106347] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/22/2022] [Indexed: 12/26/2022]
Abstract
In recent years, huge progress has been made in the management of brain tumors, due to the availability of imaging devices, which provide fundamental anatomical and pathological information not only for diagnostic purposes [...].
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Affiliation(s)
- Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), University of Pisa, 56100 Pisa, Italy
| | - Sara Condino
- Department of Information Engineering, University of Pisa, 56100 Pisa, Italy; (S.C.); (R.D.); (F.C.); (V.F.)
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy; (M.C.); (N.C.)
| | - Marina Carbone
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy; (M.C.); (N.C.)
| | - Nadia Cattari
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy; (M.C.); (N.C.)
- Department of Translational Research, University of Pisa, 56100 Pisa, Italy
| | - Renzo D’Amato
- Department of Information Engineering, University of Pisa, 56100 Pisa, Italy; (S.C.); (R.D.); (F.C.); (V.F.)
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy; (M.C.); (N.C.)
| | - Fabrizio Cutolo
- Department of Information Engineering, University of Pisa, 56100 Pisa, Italy; (S.C.); (R.D.); (F.C.); (V.F.)
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy; (M.C.); (N.C.)
| | - Vincenzo Ferrari
- Department of Information Engineering, University of Pisa, 56100 Pisa, Italy; (S.C.); (R.D.); (F.C.); (V.F.)
- EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy; (M.C.); (N.C.)
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22
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Ischemic Stroke and SARS-CoV-2 Infection: The Bidirectional Pathology and Risk Morbidities. Neurol Int 2022; 14:391-405. [PMID: 35645351 PMCID: PMC9149929 DOI: 10.3390/neurolint14020032] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/16/2022] [Accepted: 04/22/2022] [Indexed: 12/12/2022] Open
Abstract
Stroke is a fatal morbidity that needs emergency medical admission and immediate medical attention. COVID-19 ischemic brain damage is closely associated with common neurological symptoms, which are extremely difficult to treat medically, and risk factors. We performed literature research about COVID-19 and ischemia in PubMed, MEDLINE, and Scopus for this current narrative review. We discovered parallel manifestations of SARS-CoV-19 infection and brain ischemia risk factors. In published papers, we discovered a similar but complex pathophysiology of SARS-CoV-2 infection and stroke pathology. A patient with other systemic co-morbidities, such as diabetes, hypertension, or any respiratory disease, has a fatal combination in intensive care management when infected with SARS-CoV-19. Furthermore, due to their shared risk factors, COVID-19 and stroke are a lethal combination for medical management to treat. In this review, we discuss shared pathophysiology, adjuvant risk factors, challenges, and advancements in stroke-associated COVID-19 therapeutics.
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Hassan SUN, Zahra A, Parveen N, Khatoon F, Bangi NA, Hosseinzadeh H. Quality of Life and Adherence to Healthcare Services During the COVID-19 Pandemic: A Cross-Sectional Analysis. Patient Prefer Adherence 2022; 16:2533-2542. [PMID: 36147381 PMCID: PMC9488595 DOI: 10.2147/ppa.s378245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 08/26/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To determine the relationship of various domains of quality of life (QoL) with healthcare adherence during the COVID-19 pandemic in Saudi Arabia. METHODS The study sample comprised 795 participants among which 203 had a current diagnosis of any major NCDs, including cardiovascular diseases, diabetes mellitus, asthma, chronic pulmonary diseases, and chronic psychiatric illnesses and a control group of 592 participants who had no NCD. Participants completed an online survey questionnaire which obtained data on socio-demographic variables, types of NCDs, and healthcare adherence during the year 2020, the period during which Saudi Arabia underwent the first two waves of the COVID-19 pandemic. World Health Organization Quality of Life (WHOQOL-BREF) assessed the QoL in four domains physical, psychological, social and environmental and used standard scores in the analysis. GraphPad Prism 5 and SPSS 25V were employed for the statistical analysis. Bar graphs and frequency distribution tables present descriptive data. Bivariate and multivariate logistic regression analyses were computed to determine the significance of the relationship between QoL and healthcare adherence. RESULTS Almost equal proportions of participants with NCDs (n=109/203; 54%) and without NCDs (n=327/592; 55%) demonstrated nonadherence to their regular healthcare during the COVID-19 pandemic (χ2=0.14; p=0.71). Patients with NCDs experienced lower quality of life in the psychological, social and environmental domains of QoL (p<0.05). Results from the multivariate regression analysis showed that female gender (AOR=1.52; p<0.05) psychological QoL (AOR=1.99; p<0.05), social QoL (AOR=1.98; p<0.05) and environmental QoL (AOR=1.95; p<0.05) significantly relate with adherence to healthcare. CONCLUSION Psychological, social and environmental may influence healthcare adherence among patients with NCDs during pandemics and should be focused on while devising future healthcare policy and interventions.
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Affiliation(s)
- Sehar-un-Nisa Hassan
- Department of Public Health, College of Public Health and Health Informatics, University of Ha’il, Ha’il, 81451, Saudi Arabia
| | - Aqeela Zahra
- Department of Family and Community Medicine, College of Medicine, University of Ha’il, Ha’il, 81451, Saudi Arabia
- Correspondence: Aqeela Zahra, Department of Family and Community Medicine, College of Medicine, University of Ha’il, Ha’il, 81451, Saudi Arabia, Tel +966583675414, Email
| | - Nuzhat Parveen
- Department of Obstetrics and Gynecology, College of Medicine, University of Ha’il, Ha’il, 81451, Saudi Arabia
| | - Fahmida Khatoon
- Department of Family and Community Medicine, College of Medicine, University of Ha’il, Ha’il, 81451, Saudi Arabia
| | - Naseer Ahmad Bangi
- Department of Respiratory Therapy, College of Medical Rehabilitation Sciences, Taibah University, Madinah, 42353, Saudi Arabia
| | - Hassan Hosseinzadeh
- School of Haelth and Society, University of Wollongong, Wollongong, NSW, Australia
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