المؤلفون: Katharine R. Phillips, Alejandro Enriquez-Marulanda, Charles Mackel, Joseph Ogbonna, Justin M. Moore, Rafael A. Vega, Ron L. Alterman

المصدر: World Neurosurgery: X, Vol 19, Iss , Pp 100176- (2023)

مصطلحات موضوعية: Case management, Craniotomy for tumor resection, Disposition, Length of stay, Readmissions, Therapies, Surgery, RD1-811, Neurology. Diseases of the nervous system, RC346-429

الوصف: Background: Hospital length of stay (LOS) related to craniotomy for tumor resection (CTR) is a marker of neurosurgical quality of care. Limiting LOS benefits both patients and hospitals. This study examined which factors contribute to extended LOS (eLOS) at our academic center. Methods: Retrospective medical record review of 139 consecutive CTRs performed between July 2020 and July 2021. Univariate and multivariable analyses determined which factors were associated with an eLOS (≥8 days). Results: Median LOS was 6 days (IQR 3–9 days). Fifty-one subjects (36.7%) experienced an eLOS. Upon univariate analysis, potentially modifiable factors associated with eLOS included days to occupational therapy (OT), physical therapy (PT), and case management clearance (p

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S259013972300025XTest; https://doaj.org/toc/2590-1397Test

الوصول الحر: https://doaj.org/article/cdcde7e1059148f6ace0f4d2dd0a09ceTest

المؤلفون: Mohamad Abdalkader, Anurag Sahoo, Adam A. Dmytriw, Waleed Brinjikji, Guilherme Dabus, Eytan Raz, Leonardo Renieri, Antonio Laiso, Alberto Maud, Mario Martínez‐Galdámez, Jorge Galván‐Fernández, Miguel Schüller‐Arteaga, Fawaz Al‐Mufti, Krishna Amuluru, Johanna T. Fifi, Shahram Majidi, Priyank Khandelwal, Justin M. Moore, Santiago Ortega‐Gutierrez, Ameer E. Hassan, James E. Siegler, Simon Nagel, Osama O. Zaidat, Thanh N. Nguyen

المصدر: Stroke: Vascular and Interventional Neurology, Vol 1, Iss 1 (2021)

مصطلحات موضوعية: acute stroke, fetal posterior cerebral artery, mechanical thrombectomy, Neurology. Diseases of the nervous system, RC346-429, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Background Fetal posterior cerebral artery (FPCA) occlusion is a rare but potentially disabling cause of stroke. While endovascular treatment is established for acute large vessel occlusion stroke, FPCA occlusions were excluded from acute ischemic stroke trials. We aim to report the feasibility, safety, and outcome of mechanical thrombectomy in acute FPCA occlusions. Methods We performed a multicenter retrospective review of consecutive patients who underwent mechanical thrombectomy of acute FPCA occlusion. Primary FPCA occlusion was defined as an occlusion that was identified on the pre‐procedure computed tomography angiography or baseline angiogram whereas a secondary FPCA occlusion was defined as an occlusion that occurred secondary to embolization to a new territory after recanalization of a different large vessel occlusion. Demographics, clinical presentation, imaging findings, endovascular treatment, and outcome were reviewed. Results There were 25 patients with acute FPCA occlusion who underwent mechanical thrombectomy, distributed across 14 centers. Median National Institutes of Health Stroke Scale on presentation was 16. There were 76% (19/25) of patients who presented with primary FPCA occlusion and 24% (6/25) of patients who had a secondary FPCA occlusion. The configuration of the FPCA was full in 64% patients and partial or “fetal‐type” in 36% of patients. FPCA occlusion was missed on initial computed tomography angiography in 21% of patients with primary FPCA occlusion (4/19). The site of occlusion was posterior communicating artery in 52%, P2 segment in 40% and P3 in 8% of patients. Thrombolysis in cerebral infarction 2b/3 reperfusion was achieved in 96% of FPCA patients. There were no intraprocedural complications. At 90 days, 48% (12/25) were functionally independent as defined by modified Rankin scale≤2. Conclusions Endovascular treatment of acute FPCA occlusion is safe and technically feasible. A high index of suspicion is important to detect occlusion of the FPCA in patients presenting with anterior circulation stroke syndrome and patent anterior circulation. Novelty and significance This is the first multicenter study showing that thrombectomy of FPCA occlusion is feasible and safe.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2694-5746Test

الوصول الحر: https://doaj.org/article/dfaaa83d8aff4c6987dc101e7120580aTest

المؤلفون: Mohamed M. Salem, Georgios A. Maragkos, Santiago Gomez‐Paz, Luis C. Ascanio, Long H. Ngo, Christopher S. Ogilvy, Ajith J. Thomas, Justin M. Moore

المصدر: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 4 (2021)

مصطلحات موضوعية: incidence, mortality, subarachnoid hemorrhage, unruptured aneurysms, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Background The ISAT (International Subarachnoid Aneurysm Trial) has generated a paradigm shift towards endovascular treatment for intracranial aneurysms but remains unclear if this has led to a true reduction in the risk for aneurysmal subarachnoid hemorrhage (aSAH). We sought to study the association between the treatment burden of unruptured and ruptured aneurysms in the post‐ISAT era. Methods and Results Admissions data from the National Inpatient Sample (2004–2014) were extracted, including patients with a primary diagnosis of aSAH or unruptured intracranial aneurysms treated by clipping or coiling. Within each year, this combined group was randomly matched to non‐aneurysmal control group, based on age, sex, and Elixhauser comorbidity index. Multinomial regression was performed to calculate the relative risk ratio of undergoing treatment for either ruptured or unruptured aneurysms in comparison with the reference control group, adjusted for time. After adjusting for National Inpatient Sample sampling effects, 243 754 patients with aneurysm were identified, 174 580 (71.6%) were women; mean age, 55.4±13.2 years. A total of 121 882 (50.01%) patients were treated for unruptured aneurysms, 79 627 (65.3%) endovascularly and 42 256 (34.7%) surgically. A total of 121 872 (49.99%) patients underwent procedures for aSAH, 68 921 (56.6%) endovascular, and 52 951 (43.5%) surgically. Multinomial regression revealed a significant year‐to‐year decrease in aSAH procedures compared with the control group of non‐aneurysmal hospitalizations (relative risk ratio, 0.963 per year; P

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2047-9980Test

الوصول الحر: https://doaj.org/article/7eb11c951d7841b482f03924a49b60a2Test

المؤلفون: Mira Salih, MirHojjat Khorasanizadeh, Nadia McMillan, Santiago Gomez-Paz, Ajith J. Thomas, Christopher S. Ogilvy, Justin M. Moore

المصدر: World Neurosurgery. 172:e94-e99

مصطلحات موضوعية: Surgery, Neurology (clinical)

الوصف: Chronic subdural hematoma (cSDH) can be treated with conventional surgery or middle meningeal artery embolization (MMAE). The cost profiles of open surgery versus MMAE have never been studied.Comparing costs of surgical and MMAE treatment of cSDH.Patients treated with open surgery (2006-2019) and MMAE (2018-2020) were identified from the institutional database. Propensity score-matching analysis was used to assemble a balanced group of subjects. Detailed hospitalization costs in each group were collected and compared.A total of 341 conventionally treated and 52 MMAE cases were identified. After propensity score matching, 33 patients in each group, in total 66 patients were included for analysis. Direct procedural cost was significantly higher in MMAE group compared with open surgery group ($38255±$11859 vs $11206±$7888; P0.001). Medication cost was also higher in the MMAE group ($6888±$6525 vs $4291±$3547; P=0.048). No significant difference was found in costs for ICU care, pharmacy, therapy, labs and emergency unit. Imaging costs and other miscellaneous costs (e.g. wound care, pre-op and PACU) were higher in the open surgery group (P0.05). Total hospitalization cost was not significantly different between the two groups ($60598±$61315 vs $71569±$37813 for open surgery and MMAE respectively, P=0.385). No significant differences in number of follow ups or total costs for follow up were found (P0.05).Open surgery and MMAE offer an overall equivalent cost-profile for cSDH treatment when matching for potential cost confounders. Direct procedural costs are higher in MMAE; however, total hospitalization costs and follow up costs are not significantly different.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::56d42d66f954ef07f2c53c148bb582fcTest
https://doi.org/10.1016/j.wneu.2022.12.042Test

المؤلفون: Ksenia A Aaron, John Vaughan, Raghav Gupta, Noor-E-Seher Ali, Alicia H Beth, Justin M Moore, Yifei Ma, Iram Ahmad, Robert K Jackler, Yona Vaisbuch

المصدر: PLoS ONE, Vol 16, Iss 2, p e0244868 (2021)

مصطلحات موضوعية: Medicine, Science

الوصف: Lack of ergonomic training and poor ergonomic habits during the operation leads to musculoskeletal pain and affects the surgeon's life outside of work. The objective of the study was to evaluate the severity of ergonomic hazards in the surgical profession across a wide range of surgical subspecialties. We conducted intraoperative observations using Rapid Entire Body Assessment (REBA) score system to identify ergonomic hazards. Additionally, each of the ten surgical subspecialty departments were sent an optional 14 question survey which evaluated ergonomic practice, environmental infrastructure, and prior ergonomic training or education. A total of 91 surgeons received intraoperative observation and were evaluated on the REBA scale with a minimum score of 0 (low ergonomic risk

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1932-6203Test

الوصول الحر: https://doaj.org/article/9433e279ac4547fc823f6fcc7443bd0eTest

المؤلفون: Ksenia A. Aaron (7582727), John Vaughan (10119999), Raghav Gupta (10120002), Noor-E-Seher Ali (10120005), Alicia H. Beth (10120008), Justin M. Moore (10120011), Yifei Ma (206062), Iram Ahmad (9416924), Robert K. Jackler (10120014), Yona Vaisbuch (10120017)

مصطلحات موضوعية: Medicine, Neuroscience, Biotechnology, Cancer, Science Policy, Mental Health, Biological Sciences not elsewhere classified, ergonomic hazards, REBA, 14 question survey, ergonomic training, ergonomic interventional program, increase ergonomic risk hazards, specialties Objective Lack, musculoskeletal pain, Rapid Entire Body Assessment

الوصف: (DOCX)

العلاقة: https://figshare.com/articles/journal_contribution/S1_Table_-/13815846Test

الإتاحة: https://doi.org/10.1371/journal.pone.0244868.s001Test

المؤلفون: Mira Salih, MirHojjat Khorasanizadeh, Mohamed M. Salem, Ammad A. Baig, Hoon Kim, Brandon Lucke-Wold, Brian L. Hoh, Brian T. Jankowitz, Jan-Karl Burkhardt, Adnan H. Siddiqui, Philipp Taussky, Ajith J. Thomas, Justin M. Moore, Christopher S. Ogilvy

المصدر: Neurosurgery.

مصطلحات موضوعية: Surgery, Neurology (clinical)

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::a8caf09a6af5f0e935f72a0d16c3ae50Test
https://doi.org/10.1227/neu.0000000000002523Test

المؤلفون: Mohamed M. Salem, Okkes Kuybu, Alex Nguyen Hoang, Ammad A. Baig, Mirhojjat Khorasanizadeh, Cordell Baker, Joshua C. Hunsaker, Aldo A. Mendez, Gustavo Cortez, Jason M. Davies, Sandra Narayanan, C. Michael Cawley, Howard A. Riina, Justin M. Moore, Alejandro M. Spiotta, Alexander A. Khalessi, Brian M. Howard, Ricardo Hanel, Omar Tanweer, Elad I. Levy, Ramesh Grandhi, Michael J. Lang, Adnan H. Siddiqui, Peter Kan, Christopher S. Ogilvy, Bradley A. Gross, Ajith J. Thomas, Brian T. Jankowitz, Jan-Karl Burkhardt

المصدر: Radiology. 307

مصطلحات موضوعية: Radiology, Nuclear Medicine and imaging

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::95c7a116ac2a24f935e584057addc275Test
https://doi.org/10.1148/radiol.222045Test

المؤلفون: Mira, Salih, Mohmed M, Salem, Justin M, Moore, Christopher S, Ogilvy

المصدر: Neurosurgery. 92:150-158

مصطلحات موضوعية: Surgery, Neurology (clinical)

الوصف: The prevalence of intracranial aneurysms among female cigarette smokers was shown to be high in previous studies, yet the cost-effectiveness of screening them has never been explored.To explore the most cost-effective screening strategy for female smokers.A decision analytical study was performed with a Markov model to compare different screening strategies with no screening and to explore the most optimal screening strategy for female smokers. Input data for the model were extracted from literature. A single screening at different ages and multiple screening every 15 years, 10 years, 5 years, and 2 years were performed for female smokers in different age ranges. Deterministic and probabilistic sensitivity analyses were performed to evaluate the robustness of the model. Finally, value of information analysis was performed to investigate the value of collecting additional data.Screening female smokers for unruptured intracranial aneurysm is cost-effective. All screening strategies yield extra quality-adjusted life years. Screening at younger age brings more health benefit at lower cost. Frequent screening strategies decrease rupture rate of aneurysms more with higher costs per quality-adjusted life year. Screening after age 70 years and frequent screening (every 2 years) after age 60 years is not optimal. Among all the parameters in the model, collecting additional data on utility of the unscreened population would be most valuable.Screening female smokers for intracranial aneurysms once at younger age is most optimal. However, in clinical practice, the duration and intensity of exposure to cigarettes should be taken into consideration.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::27a26576c04f228317ec5c37a4180a06Test
https://doi.org/10.1227/neu.0000000000002166Test

المؤلفون: MirHojjat Khorasanizadeh, Max Shutran, Alfonso Garcia, Alejandro Enriquez-Marulanda, Justin M. Moore, Christopher S. Ogilvy, Ajith J. Thomas

المصدر: World Neurosurgery. 165:e581-e587

مصطلحات موضوعية: Hematoma, Subdural, Chronic, Humans, Surgery, Neurology (clinical), Embolization, Therapeutic, Meningeal Arteries, Blood Vessel Prosthesis, Retrospective Studies

الوصف: Middle meningeal artery embolization (MMAE) is a novel approach for treatment of chronic subdural hematoma (cSDH). Studies comparing different procedural techniques for MMAE are lacking. It is unclear whether isolated use of coils results in suboptimal outcomes compared to when particle embolization is also performed. The objectives of this study are to describe the outcomes of coil-only MMAE and compare them with those of combined use of coils and particles.A single-institution retrospective study of cSDH cases treated by MMAE was performed. Clinical outcomes, need for rescue surgery, and changes in hematoma's size were compared between the coil-only and coil + particle groups.Ninety-four hematomas in 78 patients were included. Twelve cases were treated by a coil-only MMAE procedure, often due to presence of dangerous ophthalmic collaterals. No treatment-related complications were observed in the coil-only group. There was no significant difference between the coil-only and coil + particle groups in baseline hematoma axial thickness, volume, midline shift, and duration of follow-up. The rate of need for rescue surgery was similar between the 2 groups (8.3% vs. 8.5%; P = 0.98). Coiling alone resulted in a similar percentage of reduction in cSDH volume (68.3% vs. 71.8%; P = 0.8) and rate of achieving ≥50% reduction in volume (81.8% vs. 76.3%; P = 0.68) compared to coils + particles.Isolated use of coils for endovascular treatment of cSDHs can be as effective as adjunct use of particle embolization. This method eliminates the risks of cranial nerve and visual complications associated with MMAE, can prevent procedural abortion due to presence of dangerous anastomoses, and reduces the technical complexity of the procedure.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bc8a9cb8488da38a8d79b69ca6f8331fTest
https://doi.org/10.1016/j.wneu.2022.06.099Test