Kimchristian2553

attendance by 13.9 % (p less then 0.01 with OR = 2.41). Conclusion Factors that should be considered during implementation HIS included the digital gap, PHC's staff workload, as well as the level of commitment and leadership in the health office.Background Cerebrospinal fluid (CSF) leakage after penetrating skull base injury is relatively rare compared with close head injuries involving skull base fractures. Case description We report the case of a 65-year-old man who had presented with epistaxis and serous rhinorrhea. When he had fallen to the ground near his bee boxes, a garden pole had poked into his right nostril. He had instantly removed the pole from his nostril himself. However, immediately after removal of the pole, he had developed nasal bleeding and serous rhinorrhea. He then drove to our emergency room. Computed tomography showed pneumocephalus with a minor cerebral contusion in the left frontal lobe and a penetrating injury in the left anterior skull base. His CSF leakage had not resolve spontaneously within 1 week after the injury with strict bed rest. E7766 STING agonist We repaired the CSF leakage using a fat (adipose tissue)-on-fascia autograft plug and caulked the defect in the anterior skull base with the fat-on-fascia graft (FFG) plug through the left nostril with endoscopic guidance. The CSF rhinorrhea was successfully controlled. Intranasal local application of fluorescein aided in the detection of the direction of flow of the CSF leakage. Conclusions Endonasal endoscopic caulking of a skull base defect using an FFG plug can be useful to treat CSF leakage due to the localized skull base defect, especially in the coronavirus disease 2019 pandemic. It is simple, inexpensive, and timesaving. It requires no special skills nor sophisticated instruments that can cause aerosolization, reducing the risk of infection during the surgery.Objective The aim of this study was to assess the association of insurance status and inpatient hospital outcomes among a nationally representative population of pediatric trauma neurosurgery patients. Methods The 2006, 2009, and 2012 Healthcare Cost and Utilization Project Kids' Inpatient Database was queried for all pediatric neurosurgery patients (birth through 17 years) with primary ICD-9-CM procedure codes for trauma or hematoma. Results Self-pay patients were 2.5 times more likely to die during hospitalization. Results also showed that pediatric neurosurgery patients with private insurance had a reduced length of stay and were more likely to have a favorable disposition at discharge. Conclusions Insurance status is significantly associated with mortality, LOS and favorable discharge disposition among pediatric neurosurgery trauma patients. Further studies are needed to examine the underlying mechanism of the observed associations.The authors present the first reported case of a fibroblastic reticular cell tumour (FRCT) presenting with spinal cord compression. FRCT are the rarest subset of dendritic cell tumours, a specific group of haematological malignancies. FRCTs reportedly behave similar to low grade sarcomas as opposed to malignant tumours. We present the case of a 45 year old female presenting with a two and a half week history of a flu-like illness and one week history of lower limb imbalance. MRI revealed an extradural lesion at T3/4 compressing the spinal cord. Initially the patient was presumed to have metastatic spinal cord compression (MSCC) and the patient underwent a decompressive thoracic laminectomy with debulking of the lesion with follow-up adjuvant radiotherapy. However, histology identified a unique primary FRCT originating from spine, not secondary MSCC. There were no histologically aggressive features likely contributing to the favourable outcome following surgery and adjuvant radiotherapy. Her post-operative recovery was unremarkable and she recovered fully. Although rare, we report the first case of FRCT originating in the spine causing spinal cord compression. The clinical presentation of the case, histological features of FRCT and the treatment options are reviewed.Hyperplasia of the choroid plexus represents a rare cause of communicating hydrocephalus in children. Recent work has come to associate such pathology with genetic abnormalities (e.g. most particularly, perturbations in chromosome 9). Given such extensive cerebrospinal fluid (CSF) overproduction, patients with choroid plexus hyperplasia often fail CSF diversion and therefore require adjuvant interventions. Herein, the authors present the case of a male infant with a ventriculoperitoneal shunt (VPS) and radiographic choroid hyperplasia that presented to our institution with a massive abdominal hydrocele caused by an inability to absorb the significant amount of CSF drainage into the abdomen. The child was eventually treated with an endoscopic third ventriculostomy (ETV) and choroid plexus coagulation (CPC); however, he still required CSF diversion via a ventriculoatrial shunt (VAS). Of note, a genetic work-up revealed tetraploidy of chromosome 9.A 70-year-old male patient consults because of a long history of low back pain. Imaging studies were compatible with vertebral angioma at T12; we decided to perform a minimally invasive surgical procedure such as kyphoplasty. During surgery, there was a sharp decrease in pulmonary saturation, and the patient underwent a CT-scan evaluation confirming a left hemothorax due to segmental branch vascular injury at T12. Given the patient's poor medical condition and the complexity of an emergent open procedure in the thoracic spine, we decided to undertake a minimally invasive endovascular coil placement to solve the vascular injury. Due to a favorable outcome, we discharged the patient after 72 hours of surveillance. In conclusion, even in the case of a complication to occur, we should always consider a minimally invasive solution to solve the problem, since patients undergoing these procedures correspond to elderly patients with poor medical conditions or comorbidities.With the health-care environment becoming increasingly patient centric and cost-conscious, interest levels in spinal endoscopy are at an all-time high. Patient demand for the least invasive procedures combined with surgeon desire to maximally shorten the post-operative recovery period have further driven this surgical evolution. Mounting scientific evidence demonstrates the non-inferiority and perhaps even superiority of endoscopic techniques to more conventional spinal surgery for the treatment of spinal stenosis and disc herniations. While higher level evidence is much needed to support the clinical utility of the latest endoscopic techniques and surgical indications, it appears that the entrance of spinal endoscopy into the mainstream arena of spinal surgery is inevitable.