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Abstract
BACKGROUND Hypothyroidism is a very common disease that requires life-long treatment. In our study, we analyze the quality of the YouTube videos concerning hypothyroidism as a "source of health information" for the patients, and the (possible) correlation between video quality and video popularity. METHODS We included 96 YouTube videos obtained by using the following search terms: "hypothyroidism," "Hashimoto's disease," "thyroid insufficiency," and "low thyroid hormone." We evaluated video quality by using the DISCERN criteria, and video popularity by using the Video Power Index. RESULTS The mean DISCERN Score for both raters was 1.995, indicating poor YouTube videos' quality. Sixty-eight videos achieved a high score in the video power index (VPI). The mean popularity score for videos with misleading information was higher than the mean score for all evaluated videos. CONCLUSIONS The overall quality of YouTube videos regarding hypothyroidism was poor. Videos frequently lack the source of information presented. Besides, content is often incomplete, and sometimes includes misleading statements. Physicians dealing with hypothyroid patients should be aware of the possibility that information and instruction they give to patients could be "modulated" by the availability of both low quality and popular alternative "sources of medical knowledge."
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Affiliation(s)
| | | | | | - Giuseppe Fanciulli
- Unit of Endocrinology, Department of Medical, Surgical and Experimental Sciences, University of Sassari, AOU of Sassari, Sassari, Italy
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Antkowiak L, Stogowski P, Klepinowski T, Balinski T, Mado H, Sumislawski P, Niedbala M, Rucinska M, Nowaczyk Z, Rogalska M, Kocur D, Kasperczuk A, Sordyl R, Kloc W, Kaspera W, Kammler G, Sagan L, Rudnik A, Tabakow P, Westphal M, Mandera M. External validation of the Chicago Chiari Outcome Scale in adults with Chiari malformation type I. Neurosurg Focus 2023; 54:E3. [PMID: 36857789 DOI: 10.3171/2022.12.focus22625] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 10/30/2022] [Accepted: 12/29/2022] [Indexed: 03/03/2023]
Abstract
OBJECTIVE The Chicago Chiari Outcome Scale (CCOS) serves as a standardized clinical outcome evaluation tool among patients with Chiari malformation type I (CM-I). While the reliability of this scale has been proven for pediatric patients, the literature lacks CCOS validation when used solely in adults. Therefore, this study aimed to determine the validity of the CCOS in an external cohort of adult patients. METHODS The authors retrospectively analyzed the medical records of symptomatic patients with CM-I who underwent posterior fossa decompression between 2010 and 2018 in six neurosurgical departments. Each patient was clinically assessed at the latest available follow-up. Gestalt outcome was determined as improved, unchanged, or worsened compared with the preoperative clinical state. Additionally, the CCOS score was calculated for each patient based on the detailed clinical data. To verify the ability of the CCOS to determine clinical improvement, the area under the receiver operating characteristic (AUROC) curve was evaluated. A logistic regression analysis using all four components of the CCOS (pain symptoms, nonpain symptoms, functionality, and complications) was performed to establish predictors of the improved outcome. RESULTS Seventy-five individuals with a mean age of 42 ± 15.32 years were included in the study. The mean follow-up duration was 52 ± 33.83 months. Considering gestalt outcome evaluation, 41 patients (54.7%) were classified as improved, 24 (32%) as unchanged, and 10 (13.3%) as worsened. All patients with a CCOS score of 14 or higher improved, while all those with a CCOS score of 8 or lower worsened. The AUROC was 0.986, suggesting almost perfect accuracy of the CCOS in delineating clinical improvement. A CCOS score of 13 showed high sensitivity (0.93) and specificity (0.97) for identifying patients with clinical improvement. Additionally, a meaningful correlation was found between higher CCOS scores in each component and better outcomes. Patient stratification by total CCOS score showed that those categorized as improved, unchanged, and worsened scored prevalently between 13 and 16 points, 10 and 12 points, and 4 and 9 points, respectively. CONCLUSIONS In this adult cohort, the CCOS was found to be almost perfectly accurate in reflecting postoperative clinical improvement. Moreover, all four CCOS components (pain symptoms, nonpain symptoms, functionality, and complications) significantly correlated with patient clinical outcomes.
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Affiliation(s)
- Lukasz Antkowiak
- 1Department of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Katowice, Poland
| | - Piotr Stogowski
- 2Department of Neurosurgery, Copernicus Medical Center, Gdansk, Poland
| | - Tomasz Klepinowski
- 3Department of Neurosurgery, Pomeranian Medical University Hospital No. 1, Szczecin, Poland
| | - Tristan Balinski
- 4Department of Neurosurgery, Wroclaw Medical University, Wroclaw, Poland
| | - Hubert Mado
- 1Department of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Katowice, Poland
| | - Piotr Sumislawski
- 5Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marcin Niedbala
- 6Department of Neurosurgery, Medical University of Silesia in Katowice, Regional Hospital, Sosnowiec, Poland
| | - Michalina Rucinska
- 1Department of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Katowice, Poland
| | - Zuzanna Nowaczyk
- 3Department of Neurosurgery, Pomeranian Medical University Hospital No. 1, Szczecin, Poland
| | - Marta Rogalska
- 7Faculty of Medicine, Medical University of Warsaw, Poland
| | - Damian Kocur
- 8Department of Neurosurgery, Medical University of Silesia in Katowice, Katowice, Poland
| | - Anna Kasperczuk
- 9Faculty of Mechanical Engineering, Institute of Biomedical Engineering, Bialystok University of Technology, Bialystok, Poland
| | - Ryszard Sordyl
- 1Department of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Katowice, Poland
| | - Wojciech Kloc
- 2Department of Neurosurgery, Copernicus Medical Center, Gdansk, Poland.,10Department of Psychology and Sociology of Health and Public Health, School of Public Health, Collegium Medicum, University of Warmia-Mazury in Olsztyn, Poland; and
| | - Wojciech Kaspera
- 6Department of Neurosurgery, Medical University of Silesia in Katowice, Regional Hospital, Sosnowiec, Poland
| | - Gertrud Kammler
- 5Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Leszek Sagan
- 3Department of Neurosurgery, Pomeranian Medical University Hospital No. 1, Szczecin, Poland.,11Department of Pediatric Neurosurgery, Zdroje Hospital, Szczecin, Poland
| | - Adam Rudnik
- 8Department of Neurosurgery, Medical University of Silesia in Katowice, Katowice, Poland
| | - Pawel Tabakow
- 4Department of Neurosurgery, Wroclaw Medical University, Wroclaw, Poland
| | - Manfred Westphal
- 5Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marek Mandera
- 1Department of Pediatric Neurosurgery, Medical University of Silesia in Katowice, Katowice, Poland
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Antkowiak L, Rogalska M, Stogowski P, Bruzzaniti P, Familiari P, Rybaczek M, Klepinowski T, Grzyb W, Zimny M, Weclewicz M, Kasperczuk A, Kloc W, Rudnik A, Sagan L, Lyson T, Mariak Z, Santoro A, Mandera M. External validation of the Ruptured Arteriovenous Malformation Grading Scale (RAGS) in a multicenter adult cohort. Acta Neurochir (Wien) 2022; 165:975-981. [PMID: 36473981 PMCID: PMC10068653 DOI: 10.1007/s00701-022-05433-1] [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] [Received: 09/28/2022] [Accepted: 11/14/2022] [Indexed: 12/13/2022]
Abstract
Abstract
Purpose
While Ruptured Arteriovenous Malformation Grading Scale (RAGS) has recently been validated in children, the literature lacks validation on adults exclusively. Therefore, we aimed to determine the validity of RAGS on the external multicenter adult cohort and compare its accuracy with other scales.
Methods
A retrospective analysis was performed in five neurosurgical departments to extract patients who presented with the first episode of acute brain arteriovenous malformation (bAVM) rupture between 2012 and 2019. Standard logistic regression and area under the receiver operating curve (AUROC) calculations were performed to determine the value of the following scales: intracerebral hemorrhage (ICH), AVM-associated ICH (AVICH), Spetzler-Martin (SM), Supplemented SM (Supp-SM), Hunt and Hess (HH), Glasgow Coma Scale (GCS), World Federation of Neurological Surgeons (WFNS), and RAGS to predict change in categorical and dichotomized modified Rankin Scale (mRS) across three follow-up periods: within the 6 months, 6 months to 1 year, and above 1 year.
Results
Sixty-one individuals with a mean age of 43.6 years were included. The RAGS outperformed other grading scales during all follow-up time frames. It showed AUROC of 0.78, 0.74, and 0.71 at the first 6 months, between 6 and 12 months, and after 12 months of follow-up, respectively, when categorized mRS was applied, while corresponding values were 0.79, 0.76, and 0.73 for dichotomized mRS, respectively.
Conclusion
The RAGS constitutes a reliable scale predicting clinical outcomes following bAVM rupture among adults. Furthermore, the RAGS proved its generalizability across medical centers with varying treatment preferences.
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Dąbrowski F, Stogowski P, Białek J, Fliciński F, Piotrowski M, Pankowski R, Ceynowa M, Marek R, Wałejko S, Mazurek T. Video-Based Microsurgical Education versus Stationary Basic Microsurgical Course: A Noninferiority Randomized Controlled Study. J Reconstr Microsurg 2022; 38:585-592. [PMID: 35738297 DOI: 10.1055/s-0042-1750122] [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: 10/17/2022]
Abstract
BACKGROUND Repetitive training is essential for microsurgical performance. This study aimed to compare the improvement in basic microsurgical skills using two learning methods: stationary microsurgical course with tutor supervision and self-learning based on digital instructional materials. We hypothesized that video-based training provides noninferior improvement in basic microsurgical skills. METHODS In this prospective study, 80 participants with no prior microsurgical experience were randomly divided into two groups: the control group, trained under the supervision of a microsurgical tutor, and the intervention group, where knowledge was based on commonly available online instructional videos without tutor supervision. Three blinded expert microsurgeons evaluated the improvement in basic microsurgical skills in both groups. The evaluation included an end-to-end anastomosis test using the Ten-Point Microsurgical Anastomosis Rating Scale (MARS10) and a six-stitch test on a latex glove. Statistically significant differences between groups were identified using standard noninferiority analysis, chi-square, and t-tests. RESULTS Seventy-seven participants completed the course. Baseline test scores did not differ significantly between groups. After the 4-day microsurgical course, both groups showed statistically significant improvement in microsurgical skills measured using the MARS10. The performed tests showed that data for self-learning using digital resources provides noninferior data for course with surpervision on the initial stage of microsurgical training (7.84; standard deviation [SD], 1.92; 95% confidence interval [CI], 7.25-8.44) to (7.72; SD, 2.09; 95% CI, 7.07-8.36). CONCLUSION Video-based microsurgical training on its initial step provides noninferior improvement in microsurgical skills to training with a dedicated instructor.
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Affiliation(s)
- Filip Dąbrowski
- Pomeranian Medical University in Szczecin, Department of General and Hand Surgery, Szczecin, Poland
| | - Piotr Stogowski
- Pomeranian Medical University in Szczecin, Department of General and Hand Surgery, Szczecin, Poland
| | - Jan Białek
- Pomeranian Medical University in Szczecin, Department of General and Hand Surgery, Szczecin, Poland
| | - Filip Fliciński
- Pomeranian Medical University in Szczecin, Department of General and Hand Surgery, Szczecin, Poland
| | - Maciej Piotrowski
- Pomeranian Medical University in Szczecin, Department of General and Hand Surgery, Szczecin, Poland
| | - Rafał Pankowski
- Pomeranian Medical University in Szczecin, Department of General and Hand Surgery, Szczecin, Poland
| | - Marcin Ceynowa
- Pomeranian Medical University in Szczecin, Department of General and Hand Surgery, Szczecin, Poland
| | - Rocławski Marek
- Pomeranian Medical University in Szczecin, Department of General and Hand Surgery, Szczecin, Poland
| | - Szymon Wałejko
- Pomeranian Medical University in Szczecin, Department of General and Hand Surgery, Szczecin, Poland
| | - Tomasz Mazurek
- Pomeranian Medical University in Szczecin, Department of General and Hand Surgery, Szczecin, Poland
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Anuszkiewicz K, Stogowski P, Zawadzka M, Waszak P, Sokolewicz E, Dułak NA, Dzwilewski K, Jażdżewska K, Karbowiak K, Karlińska D, Marczak A, Niebrzydowska A, Niebrzydowski B, Pasierbska E, Sadowska A, Szczęsna M, Stanisław Szczęsny P, Szerszenowicz A, Sztramski K, Radziwon J, Tkaczuk M, Ziołkowska K, Mazurkiewicz-Bełdzińska M. COVID-19 pandemic influence on epilepsy course in pediatric patients. Epilepsy Behav 2022; 129:108581. [PMID: 35203013 PMCID: PMC8784425 DOI: 10.1016/j.yebeh.2022.108581] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/16/2022] [Accepted: 01/17/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION In 2020, Coronavirus Disease 2019 (COVID-19) was declared as a global pandemic. Self-reported stress, anxiety, and insomnia, which are believed to be common triggers for epilepsy, are more likely to occur. We aimed to establish the influence of COVID-19 pandemic itself on changes in the daily life routine related to pandemic on epilepsy course in pediatric patients. The unique form of clinical care which is telemedicine was also taken into consideration. We wanted to evaluate patients' satisfaction with telemedicine and if changing stationary visits into telemedicine influenced epilepsy course in our patients. METHODS Patients, who attended developmental neurology outpatient clinic in the period March-December 2020 were collected. As patients were minors, legal guardians were asked to fill out the questionnaire. Patients were divided according to the outcome into three groups: those with a worsened, stable, or improved course of epilepsy during the pandemic. Appropriate statistical tests for two-group and multi-group comparisons have been implemented. Post hoc p values were also calculated. RESULTS Four hundred and two questionnaires were collected. Most of the patients had a stable course of epilepsy during the pandemic; in 13% of participants an improvement has been observed, worsening of the disease was seen in 16% of patients. Age, sex, type of epilepsy, number of seizure incidents before pandemic, and duration of the disease had no statistically significant connection with changes in the course of the disease. Behavioral changes and altered sleep patterns were found to be more common in the worsened group. Fifty-eight percent of patients were satisfied with telemedicine. Poorer satisfaction was connected with less frequent visits, cancellation of scheduled appointments, and lack of help in case of need in an emergency situation. CONCLUSION Epilepsy course in pediatric patients seems to be stable during COVID-19 pandemic. Sleep disturbances and changes in a child's behavior may be related to increase in seizure frequency. Telemedicine is an effective tool for supervising children with epilepsy. Patients should be informed about possible ways of getting help in urgent cases.
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Affiliation(s)
- Karolina Anuszkiewicz
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland.
| | - Piotr Stogowski
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Marta Zawadzka
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Przemysław Waszak
- Department of Hygiene and Epidemiology, Department of Developmental Psychiatry, Psychotic and Geriatric Disorders, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Ewa Sokolewicz
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Natalia Aleksandra Dułak
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Kamil Dzwilewski
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Karolina Jażdżewska
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Kamila Karbowiak
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Daria Karlińska
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Anna Marczak
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Anna Niebrzydowska
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Bartosz Niebrzydowski
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Ewa Pasierbska
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Agnieszka Sadowska
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Małgorzata Szczęsna
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Piotr Stanisław Szczęsny
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Anna Szerszenowicz
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Kamil Sztramski
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Jakub Radziwon
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Magdalena Tkaczuk
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Kinga Ziołkowska
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
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Zawadzka M, Anuszkiewicz K, Szmuda M, Błaszczyk W, Knurowska A, Stogowski P, Sokolewicz EM, Waszak P, Mazurkiewicz-Bełdzińska M. Epilepsy awareness among school-aged students in Poland. Epilepsy Behav 2022; 128:108603. [PMID: 35151191 DOI: 10.1016/j.yebeh.2022.108603] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Epilepsy can be a well-controlled condition with only a slight impact on patients' life. Lack of knowledge within society contributes to children with epilepsy experiencing discrimination and hostility. The aim of this study was to evaluate the awareness of epilepsy and general views on people struggling with this disease among school-aged children. METHODS The study was conducted on a random sample of Polish school students, in total 472 participants. Participants' knowledge was assessed by a self-completed survey. RESULTS Students are unaware of the wide range of symptoms occurring during seizures. More than half claimed that people experiencing epilepsy should not perform sports activities. Alarmingly, 30% of participants believe that those patients should not leave the house and they should be excluded from many jobs. Almost all participants would help a person experiencing seizures and remember proper head protection; shockingly, 20% of children would try to put something in the person's mouth. Older students seem to be better educated on epilepsy, but the percentage of incorrect personal beliefs and myths is similar for each age group. SIGNIFICANCE School-aged students have insufficient knowledge of epilepsy. More emphasis should be put on first aid during seizures and on the spectrum of epilepsy symptoms. Educating society is important for life quality of people experiencing epilepsy.
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Affiliation(s)
- Marta Zawadzka
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland.
| | - Karolina Anuszkiewicz
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Marta Szmuda
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Weronika Błaszczyk
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Agata Knurowska
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Piotr Stogowski
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Ewa Maria Sokolewicz
- Department of Developmental Neurology, Medical University of Gdańsk, Dębinki 7 Street, 80-952 Gdańsk, Poland
| | - Przemysław Waszak
- Department of Hygiene and Epidemiology, Department of Developmental Psychiatry, Psychotic and Geriatric Disorders, Dębinki 7 Street, 80-952 Gdańsk, Poland
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Stogowski P, Antkowiak L, Trzciński R, Rogalska M, Dułak N, Anuszkiewicz K, Kloc W. Content quality and audience engagement analysis of online videos for anterior lumbar interbody fusion. World Neurosurg 2022; 160:e636-e642. [DOI: 10.1016/j.wneu.2022.01.102] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/24/2022] [Indexed: 11/30/2022]
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Stogowski P, Fliciński F, Białek J, Dąbrowski F, Piotrowski M, Mazurek T. Microsurgical Anastomosis Rating Scale (MARS10): A Final Product Scoring System for Initial Microsurgical Training. Plast Surg (Oakv) 2021; 29:243-249. [PMID: 34760840 DOI: 10.1177/2292550320969649] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background High cost and ethical controversy of using living models in microsurgical training made non-living models more popular. However, non-living models don't provide appropriate feedback of microsurgical performance. Currently existing Global Rating Scales used for advanced microsurgical skills validation are difficult to apply on non-living model. This study presents a simple instrument for basic assessment of microsurgical anastomosis on non-living model. Methods Seventy medical students were divided into 2 groups depending on their prior microsurgical experience. Each participant performed 3 end-to-end anastomoses on chicken femoral artery model. Anastomoses were reviewed by 3 blinded experts and then photographed. Evaluation included a patency tests, longitudinal cut of anastomosis, and the newly proposed tool 10 Point Microsurgical Anastomosis Rating Scale (MARS10). Presented scale consists of 5 factors important for anastomosis closure (anastomosis closure, suture spacing, bites size, knot tying, and cut ends length), graded on 3 point scale (0-2 points). Results were analyzed with analysis of variance, Spearman correlation, and t Student test. Results Anastomoses evaluated by experts as patent significantly correlated with a high summary score in MARS10 scale (r = 0.73 P < .0001). There was a significant difference in MARS10 score between groups (P < .0001). There were no significant inter-rater differences in scoring among all 3 evaluators (p > .05). Conclusions 10 Point Microsurgical Anastomosis Rating Scale is a quick, valid, and reliable tool to assess microsurgical end-to-end arterial anastomoses on non-living model.
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Affiliation(s)
- Piotr Stogowski
- Department of Orthopaedics and Traumatology Medical University of Gdansk, Poland
| | - Filip Fliciński
- Department of Orthopaedics and Traumatology Medical University of Gdansk, Poland
| | - Jan Białek
- Department of Orthopaedics and Traumatology Medical University of Gdansk, Poland
| | - Filip Dąbrowski
- Department of Orthopaedics and Traumatology Medical University of Gdansk, Poland
| | - Maciej Piotrowski
- Department of Orthopaedics and Traumatology Medical University of Gdansk, Poland
| | - Tomasz Mazurek
- Department of Orthopaedics and Traumatology Medical University of Gdansk, Poland
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Stogowski P, Anuszkiewicz K. Letter to the editor: "Microsurgical suturing assessment scores: a systematic review". Neurosurg Rev 2021; 45:1809-1810. [PMID: 34739610 DOI: 10.1007/s10143-021-01688-x] [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] [Received: 08/09/2021] [Revised: 08/09/2021] [Accepted: 11/02/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Piotr Stogowski
- Faculty of Medicine, Medical University of Gdansk, Marii Skłodowskiej- Curie 3a, 80-210, Gdansk, Poland.
| | - Karolina Anuszkiewicz
- Faculty of Medicine, Medical University of Gdansk, Marii Skłodowskiej- Curie 3a, 80-210, Gdansk, Poland
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Antkowiak L, Rogalska M, Stogowski P, Anuszkiewicz K, Mandera M. Clinical Application of Diffusion Tensor Imaging in Chiari Malformation Type I- Advances and Perspectives. A Systematic Review. World Neurosurg 2021; 152:124-136. [PMID: 34147690 DOI: 10.1016/j.wneu.2021.06.052] [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] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) application in Chiari malformation type I (CMI) is still poorly defined. This study aimed to systematically review the literature and propose perspectives toward the clinical application of DTI in CMI. METHODS PubMed and Embase were searched for English-language articles published until October 20, 2020. Clinical studies and case series, evaluating fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), or radial diffusivity values in patients with CMI, were included. RESULTS Eight articles were included. Lower FA values were found at the syrinx level, which decreased with syrinx extent and intensity of symptoms, reflecting myelopathy severity. Decreased AD and MD in the middle cerebellar peduncles in symptomatic patients with CMI might explain the presence of cerebellar signs. Increased FA in various supratentorial structures positively correlated with pain severity. Worse performance in neuropsychological tests correlated with decreased FA, increased MD, and radial diffusivity, reflecting axonal degeneration. Postoperative FA decrease in the brainstem compression area reflects successful decompression. A positive correlation was found between the extent of tonsillar ectopia and increased FA, MD, and AD values, which could act as an early indicator of acute brainstem compression. CONCLUSIONS DTI might provide a valuable insight into the neurobiological foundation of symptomatic CMI presentation. The severity of white matter injury evident on DTI could serve as a reliable predictor of postoperative outcomes, therefore facilitating selection of appropriate surgical candidates. Postinterventional DTI reassessment might enable differentiation between unsuccessful surgical technique and irreversible myelopathy. The extent of tonsillar ectopia reflects the severity of microstructural brainstem injury.
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Affiliation(s)
- Lukasz Antkowiak
- Department of Pediatric Neurosurgery, Medical University of Silesia, Katowice, Poland.
| | - Marta Rogalska
- Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Stogowski
- Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | | | - Marek Mandera
- Department of Pediatric Neurosurgery, Medical University of Silesia, Katowice, Poland
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