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Florez-Perdomo WA, Reyes Bello JS, García-Ballestas E, Moscote-Salazar LR, Barthélemy EJ, Janjua T, Maurya VP, Agrawal A. "Aneurysmal Subarachnoid Hemorrhage and Cocaine Consumption: A Systematic Review and Metanalysis". World Neurosurg 2024; 184:241-252.e2. [PMID: 38072159 DOI: 10.1016/j.wneu.2023.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/04/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND The use of cocaine can lead to a variety of neurologic complications, including cerebral vasoconstriction, ischemia, aneurysm formation, and aneurysm rupture. A previous study has shown that cocaine use is associated with an increased risk of subarachnoid hemorrhage (SAH). This study conducted a systematic review and meta-analysis of observational studies to assess the association between cocaine use and the risk of poor neurological outcomes and mortality in patients with SAH. METHODS A systematic review and meta-analysis were performed following the meta-analysis of observational studies in epidemiology (MOOSE) declaration for systematic reviews and the Cochrane Manual of Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials (RCTs), nonrandomized clinical trials, and prospective and retrospective cohort studies that reported data about adults who suffered Aneurysmal Subarachnoid Hemorrhage (aSAH) after having consumed cocaine recreationally were included. Variables such as mortality, vasospasm, seizures, re-bleeding, and complications were analyzed. RESULTS After a thorough selection process, 14 studies involving 116,141 patients, of which 2227 had a history of cocaine consumption, were included in the analysis. There was a significant increase in overall unfavorable outcomes in aSAH patients with a history of cocaine use (OR 5.51 CI 95% [4.26-7.13] P = <0.0001; I2 = 78%), with higher mortality and poor neurologic outcomes. There were no significant differences in the risk of hydrocephalus, seizures, or re-bleeding. Cocaine use was found to increase the risk of vasospasm and overall complications. CONCLUSIONS This study insinuates that cocaine use is associated with worse clinical outcomes in aSAH patients. Despite the cocaine users did not exhibit a higher risk of certain complications such as hydrocephalus and seizures, they had an increased risk of vasospasm and overall complications. These findings highlight the importance of addressing the issue of cocaine consumption as a primary preventive measure to decrease the incidence of aSAH and improve patient outcomes.
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Affiliation(s)
- William Andres Florez-Perdomo
- Department of Neurocritical Care, Colombian Clinical Research Group in Neurocritical Care, Bogota, Colombia; Department of Research, European Stroke Organization (ESO), Basel, Switzerland.
| | - Juan Sebastian Reyes Bello
- Department of Neurocritical Care, Colombian Clinical Research Group in Neurocritical Care, Bogota, Colombia
| | - Ezequiel García-Ballestas
- Department of Neurocritical Care, Colombian Clinical Research Group in Neurocritical Care, Bogota, Colombia
| | | | - Ernest J Barthélemy
- Department of Neurosurgery, SUNY Downstate Health sciences University, Brooklin, New York, USA
| | - Tariq Janjua
- Department of Critical Care, Neurocritical Care Unit, Regions Hospital Saint Paul, Saint Paul, Minnessota, USA
| | - Ved Prakash Maurya
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Amit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, India
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Domínguez L, Rivas-Palacios C, Barbosa MM, Escobar MA, Puello Florez E, García-Ballestas E. Outcomes of endoscopic treatment for early correction of craniosynostosis in children: a 26-year single-center experience. J Neurosurg Pediatr 2023; 32:267-276. [PMID: 37310048 DOI: 10.3171/2023.4.peds22512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 04/21/2023] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Surgery is the cornerstone of craniosynostosis treatment. In this study, two widely accepted techniques are described: endoscope-assisted surgery (EAS) and open surgery (OS). The authors compared the perioperative and reconstructive outcomes of EAS and OS in children ≤ 6 months of age treated at the Napoleón Franco Pareja Children's Hospital (Cartagena, Colombia). METHODS According to the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement, patients with defined criteria who underwent surgery to correct craniosynostosis between June 1996 and June 2022 were retrospectively enrolled. Demographic data, perioperative outcomes, and follow-up were obtained from their medical records. Student t-tests were used for significance. Cronbach's α was used to assess agreement between estimated blood loss (EBL). Spearman's correlation coefficient and the coefficient of determination were used to establish associations between the results of interest, and the odds ratio was used to calculate the risk ratio of blood product transfusion. RESULTS A total of 74 patients met the inclusion criteria; 24 (32.4%) belonged to the OS group and 50 (67.6%) to the EAS group. There was a high interobserver agreement quantifying the EBL. The EBL, transfusion of blood products, surgical time, and hospital stay were shorter in the EAS group. Surgical time was positively correlated with EBL. There were no differences between the two groups in the percentage of cranial index correction at 12 months of follow-up. CONCLUSIONS Surgical correction of craniosynostosis in children aged ≤ 6 months by EAS was associated with a significant decrease in EBL, transfusion requirements, surgical time, and hospital stay compared with OS. The results of cranial deformity correction in patients with scaphocephaly and acrocephaly were equivalent in both study groups.
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Affiliation(s)
- Leonardo Domínguez
- 1Department of Pediatric Neurosurgery, Napoleón Franco Pareja Children's Hospital (Child's House), Cartagena, Colombia
- 2Department of Neurosurgery, University of Cartagena, Colombia
| | - Claudio Rivas-Palacios
- 1Department of Pediatric Neurosurgery, Napoleón Franco Pareja Children's Hospital (Child's House), Cartagena, Colombia
- 2Department of Neurosurgery, University of Cartagena, Colombia
- 3Center of Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Colombia
| | - Mario M Barbosa
- 4Trauma and Emergency Epidemiology Research Group, University of Valle, Cali, Colombia
| | - Maria Andrea Escobar
- 5Faculty of Medicine, Rafael Nuñez University, Cartagena, Colombia
- 6Department of Arts and Humanities, International University of Valencia, Spain
| | - Elvira Puello Florez
- 1Department of Pediatric Neurosurgery, Napoleón Franco Pareja Children's Hospital (Child's House), Cartagena, Colombia
- 7Faculty of Medicine, University El Sinu, Cartagena, Colombia; and
| | - Ezequiel García-Ballestas
- 1Department of Pediatric Neurosurgery, Napoleón Franco Pareja Children's Hospital (Child's House), Cartagena, Colombia
- 3Center of Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Colombia
- 8Latinamerican Council of Neurocritical Care (CLaNI), Bogota, Colombia
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Florez WA, Martinez-Perez R, Deora H, Joaquim AF, García-Ballestas E, Quiñones-Ossa GA, Rivas-Palacios C, Agrawal A, Serrato SA, Jabbour P, Moscote-Salazar LR. An update of predictors of cerebral infarction after aneurysmal subarachnoid hemorrhage: systematic review and meta-analysis. J Neurosurg Sci 2023; 67:1-9. [PMID: 36112119 DOI: 10.23736/s0390-5616.22.05445-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Evidence about predictors of poor outcomes such as cerebral infarction (CI) after aneurysmal subarachnoid hemorrhage (aSAH) has not been fully elucidated. EVIDENCE ACQUISITION We performed a systematic review and meta-analysis on studies with adults with aSAH considering RCT and non-RCT, prospective, and retrospective cohort studies describing clinical, imaging as well as angiographic studies in patients with aSAH. EVIDENCE SYNTHESIS After reviewing the complete text, 11 studies were considered eligible, out of which four were ruled out. Degree of clinical severity was the most predictive factor with a higher degree at the presentation on different severity scales being associated with a statistically significant increasing the risk of suffering a CI following aSAH (OR 2.49 [95% CI 1.38-4.49] P=0.0003). Aneurysm size increased the risk of CI (OR 1.49 [95% CI 1.20-1.85] P=0.0003; I2=4%). In six studies analyzed, it was found that an important factor for the subsequent development of CI is vasospasm (OR 7.62 [2.19, 26.54], P=0.0001). CONCLUSIONS The development of vasospasm is a risk factor for CI development after aSAH. In our review, three factors were associated with an increased risk of CI: clinical severity at presentation, vasospasm, and aneurysm size. The major limitation of this meta-analysis is that included studies were conducted retrospectively or were post hoc analyses of a prospective trial.
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Affiliation(s)
- William A Florez
- Consejo Latinoamericano de Neurointensivismo- CLaNi, Cartagena, Colombia.,Faculty of Medicine, Universidad Surcolombiana, Neiva, Colombia
| | - Rafael Martinez-Perez
- Department of Neurosurgery, Wexner Medical Center, The Ohio State University, Columbus, OH, USA.,Division of Neurosurgery, Institute of Neurosciences, Austral University of Chile, Valdivia, Chile
| | - Harsh Deora
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Andrei F Joaquim
- Department of Neurosurgery. University of Campinas (UNICAMP), São Paulo, Brazil
| | - Ezequiel García-Ballestas
- Consejo Latinoamericano de Neurointensivismo- CLaNi, Cartagena, Colombia.,Centro De Investigaciones Biomédicas (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - Gabriel A Quiñones-Ossa
- Consejo Latinoamericano de Neurointensivismo- CLaNi, Cartagena, Colombia - .,Faculty of Medicine, El Bosque University, Bogotá, Colombia
| | - Claudio Rivas-Palacios
- Centro De Investigaciones Biomédicas (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - Amit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, India
| | | | - Pascal Jabbour
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Luis R Moscote-Salazar
- Consejo Latinoamericano de Neurointensivismo- CLaNi, Cartagena, Colombia.,Faculty of Medicine, Universidad Surcolombiana, Neiva, Colombia
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Bohorquez-Rivero JD, García-Ballestas E, Janjua T, Moscote-Salazar L. Liberal Versus Conservative Fluid Therapy in COVID-19 Patients: What is the Best Strategy for the Treatment of Critically ill Patients? J Transl Crit Care Med 2022. [PMCID: PMC9070581 DOI: 10.4103/jtccm.jtccm_1_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Paez-Nova M, Andaur K, García-Ballestas E, Bustos-Salazar D, Moscote-Salazar LR, Koller O, Valenzuela S. Primary intracranial smooth muscle tumor associated with Epstein-Barr virus in immunosuppressed children: two cases report and review of literature. Childs Nerv Syst 2021; 37:3923-3932. [PMID: 33884483 DOI: 10.1007/s00381-021-05173-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 04/15/2021] [Indexed: 11/29/2022]
Abstract
Primary intracranial smooth muscle tumors are rare. Most cases are related to Epstein-Barr virus proliferation in immunocompromised patients such as organ solid recipients. Only a few cases have been reported in pediatric patients. The clinical features are very variable depending mainly on the location and size of the smooth muscle tumor (SMT) and the pathogenesis is poorly understood. We describe two cases of intracranial SMT localized in the temporal lobe and associated with EBV in immunosuppressed children. A review of the literature associated with intracranial leiomyomas was also done.
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Affiliation(s)
- Maximiliano Paez-Nova
- Pediatric Neurosurgery Department, Dr. Asenjo Neurosurgical Institute, Santiago, Chile. .,Radioneurosurgery and Functional Neurosurgery Unit, Sheba Medical Center, Ramat Gan, Israel. .,Sheba Medical Center at Tel HaShomer, Tel Aviv University, Tel Aviv, Israel.
| | - Karem Andaur
- Pediatric Neurology Department, University of Santiago de Chile, Santiago, Chile
| | - Ezequiel García-Ballestas
- Latin American Council of Neurocritical Care-CLaNi, Cartagena, Colombia.,Center of Biomedical Research-CIB, Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - Diego Bustos-Salazar
- Center of Biomedical Research-CIB, Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - Luis Rafael Moscote-Salazar
- Latin American Council of Neurocritical Care-CLaNi, Cartagena, Colombia.,Center of Biomedical Research-CIB, Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - Osvaldo Koller
- Pediatric Neurosurgery Department, Dr. Asenjo Neurosurgical Institute, Santiago, Chile.,Pediatric Neurosurgery Department, Alemana Clinic, Santiago, Chile
| | - Sergio Valenzuela
- Pediatric Neurosurgery Department, Dr. Asenjo Neurosurgical Institute, Santiago, Chile.,Pediatric Neurosurgery Department, Alemana Clinic, Santiago, Chile
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Blanco-Teherán C, Quintana-Pájaro L, Narvaez-Rojas A, Martínez-Pérez R, García-Ballestas E, Moscote Salazar L, Prada-Soto S, Lozada-Martínez I. Evidence-based medicine in neurosurgery: why and how? J Neurosurg Sci 2021; 66:49-53. [PMID: 34342191 DOI: 10.23736/s0390-5616.21.05331-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Since its inception, medical training and practice are based primarily on the clinical experience provided by the mentors of each of the medical schools. In the 1990s, the first steps were taken for the construction of what we now know as evidence-based medicine. Evidence-based medicine is the set of studies, methods, and principles for the prevention of medical diseases, management guidelines, and algorithms used in sources of evidence. Neurosurgery based on evidence has emerged thanks to advances in neuroscience and information technology that allows the globalization of current scientific information. The results of important reviews on the levels of evidence in neurosurgery are low in percentages of high-quality evidence in this field of medicine. Based on the above, the objective of this manuscript is to describe the application of evidence in neurosurgery, the current state of the art in evidence-based medicine, and the steps needed to create evidence of the best quality in neurosurgery.
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Affiliation(s)
| | | | - Alexis Narvaez-Rojas
- Department of General Surgery, Carlos Roberto Huembes Hospital, National Autonomous University of Nicaragua, Managua, Nicaragua
| | | | | | - Luis Moscote Salazar
- Center for Biomedical Research, University of Cartagena, Cartagena, Colombia.,Medical and Surgical Research Center, University of Cartagena, Cartagena, Colombia.,Colombian Clinical Research Group in Neurocritical Care, University of Cartagena, Cartagena, Colombia.,Latin American Council of Neurocritical Care, Cartagena, Colombia
| | - Silvia Prada-Soto
- Medical and Surgical Research Center, University of Cartagena, Cartagena, Colombia
| | - Ivan Lozada-Martínez
- Medical and Surgical Research Center, University of Cartagena, Cartagena, Colombia - .,Colombian Clinical Research Group in Neurocritical Care, University of Cartagena, Cartagena, Colombia.,Latin American Council of Neurocritical Care, Cartagena, Colombia
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7
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Florez-Perdomo WA, García-Ballestas E, Martinez-Perez R, Agrawal A, Deora H, Joaquim AF, Quiñones-Ossa GA, Moscote-Salazar LR. Hemoglobin levels as a transfusion criterion in moderate to severe traumatic brain injury: a systematic review and meta-analysis. Br J Neurosurg 2021; 37:1-7. [PMID: 34148446 DOI: 10.1080/02688697.2021.1940850] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 06/07/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Several factors can influence the outcome of severe head injuries including the patient's hemoglobin levels. There has often been a dilemma regarding levels of hemoglobin at which red cell blood transfusion (RCBT) should be performed. OBJECTIVE To systematically review the literature to determine the usefulness of management protocols that have hemoglobin levels <10 g/dL vs <7 g/dL as an RCBT criterion. METHODS Following the PRISMA statement, the search was constructed using terms and descriptors of the Medical Subject Heading (MeSH), combined with Boolean operators. Full text of these articles was studied, and outcome measures at 3-6 months were considered for patients who were given a RCBT at <10 g/dL or at 7 g/dL hemoglobin levels. RESULTS A total of 4 articles were found suitable for inclusion in the meta-analysis. RCBT below 7 g/dL was not associated with an increased risk of mortality as compared to RCBT using the value of less than 10 g/dL. RCBT at lower levels of hemoglobin was also not associated with a poor neurological outcome (GOS 4-5) but rather RCBT at lower levels lead to better outcomes (GOS 1-3) and the association was significant. CONCLUSION Allogenic RCBT was associated with poorer neurological outcomes, within a wide range of reported differences in the hemoglobin threshold to decide for RCBT in TBI patients. Restrictive RCBT strategy may be useful in moderate to severe TBI cases although the risk of anemia-induced cerebral injury needs further investigation regarding the risks and complications inherent to RCBT.
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Affiliation(s)
| | - Ezequiel García-Ballestas
- Latin American Council of Neurocritical Care- CLaNi, Cartagena, Colombia
- Faculty of Medicine, Centro De Investigaciones Biomédicas (CIB), University of Cartagena, Cartagena, Colombia
| | - Rafael Martinez-Perez
- Department of Neurological Surgery, University of Colorado, Aurora, CO, USA
- Institute of Neurosciences, Division of Neurosurgery, Universidad Austral de Chile, Valdivia, Chile
| | - Amit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, India
| | - Harsh Deora
- Department of Neurosurgery, NIMHANS, Bangalore, India
| | - Andrei F Joaquim
- Department of Neurosurgery, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Gabriel A Quiñones-Ossa
- Latin American Council of Neurocritical Care- CLaNi, Cartagena, Colombia
- Faculty of Medicine, University El Bosque, Bogotá, Colombia
| | - Luis Rafael Moscote-Salazar
- Latin American Council of Neurocritical Care- CLaNi, Cartagena, Colombia
- Faculty of Medicine, Centro De Investigaciones Biomédicas (CIB), University of Cartagena, Cartagena, Colombia
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Aristizabal-Carmona BS, Lozada-Martinez ID, Torres-Llinás DM, Moscote-Salazar LR, García-Ballestas E, Agrawal A. Letter: Tirofiban Protocol Protects Against Delayed Cerebral Ischemia: A Case-Series Study. Neurosurgery 2021; 88:E453-E454. [PMID: 33555025 DOI: 10.1093/neuros/nyab002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 12/04/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- Brayan S Aristizabal-Carmona
- Autonomous University Foundation of the Americas Pereira Colombia.,Medical-Surgical Research Center School of Medicine University of Cartagena Cartagena Colombia
| | - Ivan D Lozada-Martinez
- Medical-Surgical Research Center School of Medicine University of Cartagena Cartagena Colombia.,Latin American Council of Neurocritical Care (CLaNi) Cartagena Colombia.,Colombian Clinical Research Group in Neurocritical Care School of Medicine University of Cartagena Cartagena Colombia
| | - Daniela M Torres-Llinás
- Medical-Surgical Research Center School of Medicine University of Cartagena Cartagena Colombia
| | - Luis R Moscote-Salazar
- Medical-Surgical Research Center School of Medicine University of Cartagena Cartagena Colombia.,Latin American Council of Neurocritical Care (CLaNi) Cartagena Colombia.,Colombian Clinical Research Group in Neurocritical Care School of Medicine University of Cartagena Cartagena Colombia
| | - Ezequiel García-Ballestas
- Latin American Council of Neurocritical Care (CLaNi) Cartagena Colombia.,Biomedical Research Center School of Medicine University of Cartagena Cartagena Colombia
| | - Amit Agrawal
- All India Institute of Medical Sciences Bhopal, India
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Herrera-Martinez MP, García-Ballestas E, Lozada-Martínez ID, Moscote-Salazar LR, Al-Dhahir M. Letter to the Editor. Traumatic axonal injury: causes and effects. J Neurosurg 2021:1. [PMID: 33962379 DOI: 10.3171/2021.1.jns204452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Mónica Patricia Herrera-Martinez
- 1Center of Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Colombia
- 3Latinamerican Council of Neurocritical Care (CLaNi), Cartagena, Colombia
| | - Ezequiel García-Ballestas
- 1Center of Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Colombia
- 3Latinamerican Council of Neurocritical Care (CLaNi), Cartagena, Colombia
| | - Ivan David Lozada-Martínez
- 2Medical-Surgical Research Center, University of Cartagena, Colombia
- 3Latinamerican Council of Neurocritical Care (CLaNi), Cartagena, Colombia
- 4Colombian Clinical Research Group in Neurocritical Care, University of Cartagena, Colombia; and
| | - Luis Rafael Moscote-Salazar
- 1Center of Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Colombia
- 2Medical-Surgical Research Center, University of Cartagena, Colombia
- 3Latinamerican Council of Neurocritical Care (CLaNi), Cartagena, Colombia
- 4Colombian Clinical Research Group in Neurocritical Care, University of Cartagena, Colombia; and
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Bohórquez-Rivero J, García-Ballestas E, Moscote-Salazar LR. Letter to the Editor: Role of Morality in Critical Care in COVID-19 Times. World Neurosurg 2021; 146:389-390. [PMID: 33607728 PMCID: PMC7884224 DOI: 10.1016/j.wneu.2020.11.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 11/28/2020] [Indexed: 11/03/2022]
Affiliation(s)
- José Bohórquez-Rivero
- Center for Biomedical Research, Faculty of Medicine, University of Sinú, Cartagena de Indias, Colombia.
| | - Ezequiel García-Ballestas
- Center for Biomedical Research, Faculty of Medicine, University of Cartagena, Cartagena de Indias, Colombia
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Herrera-Martinez MP, García-Ballestas E, Lozada-Martínez I, Moscote-Salazar L, Agrawal A, Janjua T. Commentary: Use of Point-of-Care Ultrasound (POCUS) by Neurosurgeons. Neurosurgery Open 2021. [DOI: 10.1093/neuopn/okab005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Mónica Patricia Herrera-Martinez
- Biomedical Research Center, School of Medicine, University of Cartagena, Cartagena, Colombia
- Latinamerican Council of Neurocritical Care (CLaNi), Cartagena, Colombia
| | - Ezequiel García-Ballestas
- Biomedical Research Center, School of Medicine, University of Cartagena, Cartagena, Colombia
- Latinamerican Council of Neurocritical Care (CLaNi), Cartagena, Colombia
| | - Ivan Lozada-Martínez
- Latinamerican Council of Neurocritical Care (CLaNi), Cartagena, Colombia
- Medical-Surgical Research Center, School of Medicine, University of Cartagena, Cartagena, Colombia
- Colombian Clinical Research Group in Neurocritical Care, University of Cartagena, Cartagena, Colombia
| | - Luis Moscote-Salazar
- Latinamerican Council of Neurocritical Care (CLaNi), Cartagena, Colombia
- Medical-Surgical Research Center, School of Medicine, University of Cartagena, Cartagena, Colombia
- Colombian Clinical Research Group in Neurocritical Care, University of Cartagena, Cartagena, Colombia
| | - Amit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, India
| | - Tariq Janjua
- Intensive Care, Regions Hospital, Saint Paul, Minnesota, USA
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García-Ballestas E, Florez-Perdomo WA, Starke RM, Joaquim AF, Agrawal A, Keni RR, Moscote-Salazar LR. Risk of Seizures after Endovascular Management of Ruptured Intracranial Aneurysms: A Systematic Review and Meta-analysis. J Epilepsy Res 2021; 10:55-61. [PMID: 33659196 PMCID: PMC7903045 DOI: 10.14581/jer.20009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/26/2020] [Accepted: 12/04/2020] [Indexed: 12/26/2022] Open
Abstract
Seizures in aneurysmal subarachnoid haemorrhage (aSAH) have been described secondary to SAH, changes in cortical function, vasospasm and as a result of treatment effects. Seizures are one of the important clinical determinants in neurological outcome of aSAH. Various studies support the notion of less risk of future seizures in endovascular treatment as compared to the microsurgical clipping, yet there is no conclusive evidence in favour or against the seizure occurrence in aSAH patients after endovascular treatment as compared to the microsurgical treatment. To carry out a systematic review and meta-analysis of the risk of seizures after endovascular management (coiling) of ruptured intracranial aneurysms. A literature search was performed in electronic database of PubMed, MEDLINE, Embase, and Scopus from inception to February 2020, using the terms Seizure, Intracranial aneurysms, embolization, with no constraints applied. Data were pooled using a random-effect model, results were abstracted as odds ratios (ORs) and 95% confidence interval (CI), and heterogeneity was reported as Chi-square. Five studies involving 3,077 patients were included in the meta-analysis. After endovascular management of aSAH, seizure risk was increased by a worse clinical severity (World Federation of Neurosurgery scale or Hunt and Hess) (OR, 3.34; 95% CI, 2.69–4.16; p<0.00001), severe vasospasm (OR, 2.20; 95% CI, 1.67–2.92; p<0.00001), cerebral infarction (OR, 5.19; 95% CI, 3.23–8.35; p<0.00001), and cerebral edema (OR, 1.79; 95% CI, 1.37–2.34; p<0.0000). Worse clinical severity, vasospasm, cerebral infarction and cerebral oedema are significant risk factors for the development of seizures after endovascular intervention in aSAH. The mechanism for this correlation is not clear.
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Affiliation(s)
- Ezequiel García-Ballestas
- Latin American Council of Neurocritical Care, Cartagena, Colombia.,Center of Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Bolívar, Colombia
| | - William A Florez-Perdomo
- Latin American Council of Neurocritical Care, Cartagena, Colombia.,Faculty of Medicine, Surcolombian University, Neiva, Colombia
| | - Robert M Starke
- Department of Neurosurgery & Neuroradiology, University of Miami & Jackson Memorial Hospital, Miami, FL, USA
| | | | - Amit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Saket Nagar, Nellore, India
| | | | - Luis-Rafael Moscote-Salazar
- Latin American Council of Neurocritical Care, Cartagena, Colombia.,Center of Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Bolívar, Colombia
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Herrera-Martinez MP, García-Ballestas E, Lozada-Martinez I, Torres-Llinás D, Moscote-Salazar L. Letter to the Editor. Creating the conditions for gender equality to end sexual harassment in neurosurgery. J Neurosurg 2021:1-2. [PMID: 33545683 DOI: 10.3171/2020.12.jns204261] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Mónica Patricia Herrera-Martinez
- 1Center of Biomedical Research, University of Cartagena, Colombia
- 2Latin American Council of Neurocritical Care (CLaNi), Cartagena, Colombia
| | - Ezequiel García-Ballestas
- 1Center of Biomedical Research, University of Cartagena, Colombia
- 2Latin American Council of Neurocritical Care (CLaNi), Cartagena, Colombia
| | - Ivan Lozada-Martinez
- 2Latin American Council of Neurocritical Care (CLaNi), Cartagena, Colombia
- 3Medical-Surgical Research Center, University of Cartagena, Colombia
- 4Colombian Clinical Research Group in Neurocritical Care, University of Cartagena, Colombia
| | | | - Luis Moscote-Salazar
- 1Center of Biomedical Research, University of Cartagena, Colombia
- 2Latin American Council of Neurocritical Care (CLaNi), Cartagena, Colombia
- 3Medical-Surgical Research Center, University of Cartagena, Colombia
- 4Colombian Clinical Research Group in Neurocritical Care, University of Cartagena, Colombia
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Padilla-Zambrano HS, García-Ballestas E, Quiñones-Ossa GA, Sibaja-Perez AE, Agrawal A, Moscote-Salazar LR, Menéndez-González M. The Prion-like Properties of Amyloid-beta Peptide and Tau: Is there Any Risk of Transmitting Alzheimer's Disease During Neurosurgical Interventions? Curr Alzheimer Res 2021; 17:781-789. [PMID: 33280597 DOI: 10.2174/1567205017666201204164220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 10/10/2020] [Accepted: 10/13/2020] [Indexed: 11/22/2022]
Abstract
Recent studies have recognized similarities between the peptides involved in the neuropathology of Alzheimer's disease and prions. The Tau protein and the Amyloid β peptide represent the theoretical pillars of Alzheimer's disease development. It is probable that there is a shared mechanism for the transmission of these substances and the prion diseases development; this presumption is based on the presentation of several cases of individuals without risk factors who developed dementia decades after a neurosurgical procedure. This article aims to present the role of Aβ and Tau, which underlie the pathophysiologic mechanisms involved in the AD and their similarities with the prion diseases infective mechanisms by means of the presentation of the available evidence at molecular (in-vitro), animal, and human levels that support the controversy on whether these diseases might be transmitted in neurosurgical interventions, which may constitute a wide public health issue.
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Affiliation(s)
- Huber S Padilla-Zambrano
- Center for Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - Ezequiel García-Ballestas
- Center for Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | | | - Andrés E Sibaja-Perez
- Center for Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - Amit Agrawal
- Department of Neurosurgery, Narayana Medical College, Nellore, Andhra Pradesh, India
| | - Luis R Moscote-Salazar
- Neurosurgeon-Critical Care, Center for Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Cartagena de Indias, Bolivar, Colombia
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15
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Florez-Perdomo WA, García-Ballestas E, Moscote-Salazar LR, Konar SK, Raj S, Chouksey P, Shrivastava A, Mishra R, Agrawal A. Heart Rate Variability as a Predictor of Mortality in Traumatic Brain Injury: A Systematic Review and Meta-Analysis. World Neurosurg 2021; 148:80-89. [PMID: 33412317 DOI: 10.1016/j.wneu.2020.12.132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To systematically review the medical literature to determine the utility of heart rate variability in predicting mortality for moderate to severe traumatic brain injury. METHODS A search for randomized controlled trials, nonrandomized trials, and prospective and retrospective cohort studies was carried out using PubMed, SCOPUS, Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE. Reference lists of included studies were also searched to identify potentially eligible studies. RESULTS Five articles comprising 542 patients met inclusion criteria. Heart rate variability as low-frequency/high-frequency ratio (area under the curve [AUC] receiver operating characteristic [ROC]) for predicting mortality was found to be statistically significant (AUC ROC 0.810, P < 0.001) with high heterogeneity (I2 = 61.98%, P = 0.032). Meta-analysis of low-frequency/high-frequency ratio, High frequency peak, and total power were statistically significant for predicting mortality. Odd's ratio for predicting mortality for LF/HF ratio, HF peak, and TP were 16.17, 19.09, 22.59 respectively. High-frequency peak in predicting mortality showed an AUC ROC of 0.986 (P ≤ 0.001) with a low level of heterogeneity. Total power (TP) showed an AUC ROC of 0.93 (P < 0.001) in predicting mortality with a high level of heterogeneity (I2 = 83.16%, P = 0.002). Funnel plot analysis to assess the presence of publication bias for TP showed a high level of heterogeneity and asymmetry among studies. CONCLUSIONS This meta-analysis predicted high mortality based on odds ratio for variables low-frequency/high-frequency ratio, high-frequency peak, and TP. However, the statistical analysis was weakened owing to the high level of heterogeneity in the included studies. Further research is needed to generate high-quality recommendations regarding heart rate variability as a predictor of mortality after traumatic brain injury.
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Affiliation(s)
- William Andres Florez-Perdomo
- Medicina General-Universidad Surcolombiana, Medico Investigador Concejo Latinoamericano de Neurointensivismo-CLaNi, Clinica Sahagún IPS SA, Córdoba, Colombia
| | - Ezequiel García-Ballestas
- Center for Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | | | - Subhas K Konar
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Sumit Raj
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, India
| | - Pradeep Chouksey
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, India
| | - Adesh Shrivastava
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, India
| | - Rakesh Mishra
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, India
| | - Amit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, India.
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Vasquez H, García-Ballestas E, Moscote-Salazar LR, Serrato SA, Florez Perdomo WA, Agrawal A. Multilocular hydrocephalus. roneuro 2020. [DOI: 10.33962/roneuro-2020-086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Multilocular hydrocephalus is an entity that occurs relatively frequently in neurosurgical practice. We are present an editorial letter with a mini-review of the pathophysiology, surgical, and medical treatment.
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Florez WA, García-Ballestas E, Maeda F, Joaquim A, Pavlov O, Moscote-Salazar LR, Tsimpas A, Martinez-Perez R. Relationship between aspirin use and subarachnoid hemorrhage: A systematic Review and meta-analysis. Clin Neurol Neurosurg 2020; 200:106320. [PMID: 33268193 DOI: 10.1016/j.clineuro.2020.106320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Aspirin has been associated with a decreasing risk of subarachnoid hemorrhage due to its anti-inflammatory mechanism of action and potential protective properties against aneurysm growth. OBJECTIVE To determine the association between aneurysmal subarachnoid hemorrhage and aspirin use. METHODS A systematic review of the literature and a meta-analysis were performed across the PubMed database. The following keywords were used: "aspirin, acetylsalicylic acid, 2-acetyloxy-benzoic acid, ruptured intracranial aneurysm, aneurysmal subarachnoid hemorrhage, spontaneous subarachnoid hemorrhage, intracerebral hemorrhage, spontaneous aneurysmal hemorrhage, spontaneous intracerebral bleeding". Studies that were performed with animals or analyzed patients with traumatic brain injury were excluded. A total of five studies were included in our meta-analysis, with a total of 19,222 patients evaluated. Statistical analysis was performed to determine the association between the use of aspirin and the risk of subarachnoid hemorrhage. RESULTS Aspirin use reduce the risk of subarachnoid hemorrhage (odds ratio [OR] 0.51, 95 % confidence interval [CI] 0.34-0.76). CONCLUSION Although some previous studies suggested that aspirin may potentially reduce the risk of subarachnoid hemorrhage, our meta-analysis found an association between the reduction of risk of aneurysmal subarachnoid hemorrhage.
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Affiliation(s)
- William A Florez
- Latinoamerican Council of Neurocritical Care, Cartagena, Colombia; Faculty of Health, Programa Medicina, Universidad Surcolombiana, Neiva, Huila, Colombia.
| | - Ezequiel García-Ballestas
- Latinoamerican Council of Neurocritical Care, Cartagena, Colombia; Centro De Investigaciones Biomédicas (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - Fernando Maeda
- Department of Neurosurgery, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Andrei Joaquim
- Department of Neurosurgery, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | - Orlin Pavlov
- Departament of Neurosurgery, Klinikum Fulda gAG, Fulda, Germany
| | - Luis Rafael Moscote-Salazar
- Latinoamerican Council of Neurocritical Care, Cartagena, Colombia; Centro De Investigaciones Biomédicas (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - Asterios Tsimpas
- Section of Neurosurgery, Department of Surgery, Advocate Illinois Masonic Medical Center, Chicago, IL, USA
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Bohórquez-Rivero J, García-Ballestas E, Moscote-Salazar LR. Letter to the Editor: "The Neurosurgeon and Medical Professionalism During the COVID-19 Pandemic". World Neurosurg 2020; 142:559-560. [PMID: 32987599 PMCID: PMC7510435 DOI: 10.1016/j.wneu.2020.06.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 06/27/2020] [Indexed: 12/04/2022]
Affiliation(s)
- José Bohórquez-Rivero
- Center for Biomedical Research (CIB), Faculty of Medicine, University of Sinú, Cartagena de Indias, Colombia.
| | - Ezequiel García-Ballestas
- Center for Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Cartagena de Indias, Colombia
| | - Luis Rafael Moscote-Salazar
- Center for Biomedical Research (CIB), Faculty of Medicine, University of Cartagena, Cartagena de Indias, Colombia
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García-Ballestas E, Moscote-Salazar LR, Joaquim A, Agrawal A. Global warming, neurosurgery and neurocritical care. roneuro 2020. [DOI: 10.33962/roneuro-2020-076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The changing temperatures are making an impact on health-related mortality outcomes with many studies on the role of temperature and mortality risks in cardiovascular and respiratory illnesses. Global warming a real phenomenon, progressing rapidly and producing changes in the ecosystem and have economic, social and public health implications.
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Abdul Azeez MM, Moscote-Salazar LR, Alcala-Cerra G, García-Ballestas E, Bustos-Salazar D, Satyarthee GD, Agrawal A. Emergency Management of Traumatic Spinal Cord Injuries. Indian Journal of Neurotrauma 2020. [DOI: 10.1055/s-0040-1713556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AbstractSpinal cord trauma constitutes one of the main causes of mortality and morbidity in young adults around the world, with an estimated 2 to 3 new cases for every 100,000 population. Road traffic accidents, falls from high heights, sports injuries, and violent actions are common causes of spinal cord injuries. There is no “gold standard” for the diagnosis of spinal cord traumatic injuries; however, the rational use of conventional radiologic test, computed tomography scan, and magnetic resonance imaging (MRI) will allow to identify almost all clinically relevant injuries. MRI is recommended according to surgeon’s criteria, who after evaluating the specific characteristics of the injury will determine its usefulness. Therapeutic strategies need to be directed to maintain airway, breathing and circulation, maintenance of mean arterial pressure prevention of hypotension, and assessment of other associated injuries. Intensive treatment must be focused on the prevention and management of ventilatory and cardiovascular abnormalities related to muscle weakness and loss of autonomic innervation.
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Affiliation(s)
| | - Luis Rafael Moscote-Salazar
- Consejo Latinoamericano de Neurointensivismo- CLaNi, Cartagena, Colombia
- Centro De Investigaciones Biomédicas (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - Gabriel Alcala-Cerra
- Centro De Investigaciones Biomédicas (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - Ezequiel García-Ballestas
- Consejo Latinoamericano de Neurointensivismo- CLaNi, Cartagena, Colombia
- Centro De Investigaciones Biomédicas (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - Diego Bustos-Salazar
- Centro De Investigaciones Biomédicas (CIB), Faculty of Medicine, University of Cartagena, Cartagena, Colombia
| | - Guru Dutta Satyarthee
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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21
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García-Ballestas E, Martinez-Perez R, Agrawal A, Moscote-Salazar LR. Letter: Transesophageal Echocardiography-Guided Ventriculoatrial Shunt Insertion. Oper Neurosurg (Hagerstown) 2020; 19:E333. [PMID: 32585690 DOI: 10.1093/ons/opaa182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ezequiel García-Ballestas
- Consejo Latinoamericano de Neurointensivismo- CLaNi Cartagena, Colombia.,Centro De Investigaciones Biomédicas (CIB) Faculty of Medicine - University of Cartagena Cartagena, Colombia
| | - Rafael Martinez-Perez
- Department of Neurosurgery Wexner Medical Center The Ohio State University Columbus, Ohio.,Institute of Neurosciences Division of Neurosurgery Universidad Austral de Chile Valdivia, Chile
| | - Amit Agrawal
- Department of Neurosurgery All India Institute of Medical Sciences Saket Nagar, Bhopal Madhya Pradesh, India
| | - Luis-Rafael Moscote-Salazar
- Consejo Latinoamericano de Neurointensivismo- CLaNi Cartagena, Colombia.,Centro De Investigaciones Biomédicas (CIB) Faculty of Medicine - University of Cartagena Cartagena, Colombia
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Martinez-Perez R, Dutta-Satyarthee G, García-Ballestas E, Agrawal A, Moscote-Salazar LR. Letter to the Editor. Is aspirin a new silver bullet for reducing the growth of intracranial aneurysms? J Neurosurg 2020; 133:1-2. [PMID: 32114537 DOI: 10.3171/2020.1.jns2049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Rafael Martinez-Perez
- 1Institute of Neurosciences, Universidad Austral de Chile, Valdivia, Chile
- 2Wexner Medical Center, The Ohio State University, Columbus, OH
| | | | | | - Amit Agrawal
- 5All India Institute of Medical Sciences, Madhya Pradesh, India
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Agrawal A, García-Ballestas E, Durango-Espinosa Y, Mendoza-Flórez R, Moscote-Salazar L, Keni R, Deora H. The puzzle of spontaneous versus traumatic subarachnoid hemorrhage. Apollo Med 2019. [DOI: 10.4103/am.am_22_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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