Bentzenhorner7347

Numerous studies have demonstrated detrimental skeletal consequences following bariatric surgery.

A working group of the European Calcified Tissue Society (ECTS) performed an updated review of existing literature on changes of bone turnover markers (BTMs), bone mineral density (BMD), and fracture risk following bariatric surgery and provided advice on management based on expert opinion.

Based on observational studies, bariatric surgery is associated with a 21-44% higher risk of all fractures. Fracture risk is time-dependent and increases approximately 3years after bariatric surgery. The bariatric procedures that have a malabsorptive component (including Roux-en-Y Gastric bypass (RYGB) and biliopancreatic diversion (BPD)) have clearly been associated with the highest risk of fracture. The extent of high-turnover bone loss suggests a severe skeletal insult. This is associated with diminished bone strength and compromised microarchitecture. RYGB was the most performed bariatric procedure worldwide until veommended to ensure adequate 25-OH vitamin D level and calcium supplementation before administering zoledronate.

The bariatric procedures that have a malabsorptive component have been associated with the highest turnover bone loss and risk of fracture. There is a knowledge gap on osteoporosis treatment in patients undergoing bariatric surgery. More research is necessary to direct and support guidelines.

The bariatric procedures that have a malabsorptive component have been associated with the highest turnover bone loss and risk of fracture. There is a knowledge gap on osteoporosis treatment in patients undergoing bariatric surgery. More research is necessary to direct and support guidelines.The aim of this study is to investigate the impact of bisphosphonate treatment on the prognosis of patients with initial hip fracture. Patients aged fifty years and older with initial hip fracture were identified from the Taiwan National Health Insurance Research Database between 2002 and 2011. A multi-state model was established to evaluate the transition between "first to second hip fracture", "first hip fracture to death", and "second hip fracture to death". Transition probability and cumulative hazards were used to compare the prognosis of initial hip fracture in a bisphosphonate treated cohort versus non-treated cohort. In addition, Deyo-Charlson comorbidities, both vertebral and non-vertebral fractures, and cataracts were also included for analysis. After 10-year follow-up, there is decreased cumulative transition probability for both second hip fracture and mortality after both first and second hip fracture in the bisphosphonate treated cohort. Multivariable, transition-specific time-dependent Cox mode and mortality.

Minimally invasive techniques of hematoma evacuation with or without the use of thrombolytic agents to lyse the clots have shown promising outcomes against open surgical evacuation. However, there is a dearth of literature in developing nations.

To evacuate spontaneous hypertensive basal ganglionic haemorrhages using CT guided catheter insertion, hematoma aspiration and lysis with thrombolytic agents and analyse the efficacy and outcomes.

Ten patients with spontaneous basal ganglionic haemorrhage underwent CT guided clot catheter insertion, followed by aspiration of hematoma and clot lysis using 25000 IU urokinase instilled every 12 hours. Details including symptoms, clinical and radiological findings, efficacy of the technique, functional outcomes during follow-up, length of stay and cost were recorded. Relevant details for 12 age and sex-matched conservatively treated patients were compared.

Functional outcome in the catheter group at six months was better than the medically managed group, with improved mean Glasgow outcome scale (+0.4 vs +0.08), reduced modified Rankin score (-0.8 vs -0.25), and reduced National Institute of Health Stroke Scale scores (-6.8 vs -1.5 points). However, it was not statistically significant. Average hematoma volume reduction in catheter group was 83.14%. In the medically managed group, 2 of 12 patients(16.6%) had hematoma expansion, 6 patients(50%) developed hydrocephalus, and 2 patients(16.6%) died. In the catheter group, 4 patients of 10(40%) developed mild pneumocephalus that resolved.

The evacuation of hypertensive basal ganglionic hematomas is feasible with basic neurosurgical instruments and existing resources such as CT scan with improved functional outcome compared to conservative treatment alone.

The evacuation of hypertensive basal ganglionic hematomas is feasible with basic neurosurgical instruments and existing resources such as CT scan with improved functional outcome compared to conservative treatment alone.

Our goal was to systematically review the current literature on racial/ethnic, insurance, and socioeconomic disparities in adult spine surgery in the United States and analyze potential areas for improvement.

We conducted a database search of literature published between January 1990 and July 2020 using PRISMA guidelines for all studies investigating a disparity in any aspect of adult spine surgery care was analyzed based on race/ethnicity, insurance status/payer, or socioeconomic status (SES).

Out of 2,679 articles identified through database searching, 775 were identified for full-text independent review by 3 authors, from which a final list of 60 included studies were analyzedForty-three studies analyzed disparities based on patient race/ethnicity, 32 based on insurance status, and 8 based on SES. Five studies assessed disparities in access to care, 15 examined surgical treatment, 35 investigated in-hospital outcomes, and 25 explored after-discharge outcomes. Minority patients were less likely to undergo surgery, but more likely to receive surgery from a low-volume provider and experience postoperative complications. White and privately insured patients generally had shorter hospital length of stay, were more likely to undergo favorable/routine discharge, and had lower rates of in-hospital mortality. Post-discharge, white patients reported better outcomes than black patients. see more Thirty-three papers (55%) reported no disparities within at least one examined metric.

This comprehensive systematic review underscores ongoing potential for healthcare disparities among adult patients in the field of spinal surgery. We demonstrate a need for continued efforts to promote equity and cultural competency within the field of neurological surgery.

This comprehensive systematic review underscores ongoing potential for healthcare disparities among adult patients in the field of spinal surgery. link2 We demonstrate a need for continued efforts to promote equity and cultural competency within the field of neurological surgery.

As many as 30% of patients with non-small-cell lung cancer (NSCLC) will develop brain metastases (BMs) over the course of their illness. Here, we quantitatively compare the efficacy of the various emerging regimens for NSCLC BMs without a definitive targetable EGFR mutation/ALK rearrangement.

We searched MEDLINE, EMBASE, Web of Science, ClinicalTrials.gov, CENTRAL and references of key studies for randomized controlled trials (RCTs) published from inception until June 2020. Comparative RCTs that included >10 patients were included. We used a frequentist fixed or random-effects model for network meta-analysis. The outcomes of interest included intracranial progression-free survival (iPFS), overall survival (OS) and overall progression-free survival (PFS).

18 studies representing 17 trials (n=2726 patients) were identified. Immune checkpoint inhibitor regimens showed significant improvement in OS compared to chemotherapy alone, including Pembrolizumab and chemotherapy (6 studies, HR 0.36, 95%CI 0.21-0.S benefit of immune checkpoint inhibitor-based immunotherapy in this patient population.

To develop and validate a radiomics-clinical nomogram for the prediction of short-term prognosis in patients with deep intracerebral hemorrhage (DICH) on admission.

A total of 326 patients with DICH (development cohort = 187; testing cohort = 81; validation cohort = 58) were retrospectively included. Radiomics features were extracted from computed tomography (CT) images and optimal features were selected using least absolute shrinkage and selection operator regression. A radiomics score (R-score) was developed using the optimal features. Univariate and multivariate analyses were used to determine independent risk factors for poor outcomes at 30 days. A radiomics-clinical (R-C) nomogram was developed and validated in the three cohorts. Receiver operating characteristic curve (ROC), calibration curve and decision curve analyses were conducted to evaluate the performances of the R-C nomogram.

Only 4 of 396 radiomics features were selected to develop R-scores. Age, onset-to-CT time, Glasgow Coma Scale score, midline shift and R-score were detected as independent predictors of poor prognosis of DICH. The R-C nomogram was developed by the independent predictors and showed acceptable discrimination with areas under ROCs of 0.80, 0.79 and 0.70 in the development, testing and validation cohorts, respectively. link3 The R-C nomogram showed good agreement between the predicted probability and the actual probability (all P > 0.05) and clinical applicability in each cohort.

The R-C nomogram is a stable and effective tool for predicting the short-term prognosis of DICH, which may help clinicians perform individual risk assessments and make decisions for patients with DICH.

The R-C nomogram is a stable and effective tool for predicting the short-term prognosis of DICH, which may help clinicians perform individual risk assessments and make decisions for patients with DICH.

Internal neurolysis has been proposed as an alternative to microvascular decompression in patients with idiopathic trigeminal neuralgia (TN) in whom neurovascular compression is not confirmed by magnetic resonance imaging (MRI). External neurolysis, which straightens and realigns the trigeminal nerve root axis by dissecting the arachnoid membranes around the nerve, was reported 20 years ago in the context of so-called negative exploration when MRI did not confirm the absence of the offending vessel, but is not currently used.

External neurolysis was performed in 4 patients with idiopathic TN with typical evoked neuralgic pain despite the absence of suspected offending vessels on MRI. The surgical findings that caused TN were summarized and the outcomes were evaluated using the Barrow Neurological Institute Pain Intensity Scale (BNI-PS).

Tethering and distortion of the nerve root by surrounding arachnoid membranes were commonly found. All 4 patients showed complete pain relief immediately after surgery. During the follow-up period of 26.5 ± 16.92 months (±standard deviation), 3 of 4 patients had no pain (score I, BNI-PS). One patient received a score of IIIa on the BNI-PS assessment. There was no instance of recurrence or side effects associated with the surgery.

Idiopathic TN can be induced by individual variation of the surrounding inner arachnoid membranes supporting the trigeminal nerve root, and the condition cannot be identified by MRI. Intradural external neurolysis may be considered an effective treatment for MRI-negative idiopathic TN.

Idiopathic TN can be induced by individual variation of the surrounding inner arachnoid membranes supporting the trigeminal nerve root, and the condition cannot be identified by MRI. Intradural external neurolysis may be considered an effective treatment for MRI-negative idiopathic TN.