Publications by authors named "Eris Spirollari"

Background And Objective: Due to the potential debilitating sequelae following pediatric mTBI, the CDC published the Guideline on the Diagnosis and Management of mTBI Among Children in 2018. However, the guideline identified several key gaps in our clinical knowledge to support several clinical recommendations. The objective of this review is to evaluate if subsequent research has addressed these gaps in clinical practice recommendations.

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Study Design: Systematic review.

Objective: To systematically review the use of intraoperative methadone in spine surgery and examine its effects on postoperative opioid use, pain, length of stay, and operative time.

Summary Of Background Data: Spine surgery patients commonly have a history of chronic pain and opioid use, and as a result, they are at an increased risk of severe postoperative pain.

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Glioblastoma (GBM) is categorized by the World Health Organization (WHO) as a grade 4 glioma and is a uniformly fatal tumor of the central nervous system. With the discovery of specific gene anomalies, GBM classification has been modified several times to provide better diagnostic and prognostic accuracy. Survival outcomes remain dismal despite the current therapeutic modalities, which include a combination of surgical resection, adjuvant chemotherapy, and radiotherapies, providing brief control of tumor progression.

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Article Synopsis
  • A systematic review and meta-analysis were conducted to explore the relationship between D-dimer levels and the outcomes of thrombectomy in patients with acute ischemic stroke (AIS).
  • The analysis included 14 studies and found that patients with low D-dimer levels experienced significantly better outcomes, including higher rates of favorable functional results and successful recanalization compared to those with high levels.
  • Although there is a noted association between D-dimer levels and thrombectomy outcomes, the evidence is inconsistent and calls for more targeted research to clarify these findings.
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Background And Purpose: Cerebral venous thrombosis (CVT) is associated with a high degree of morbidity and mortality. Our objective is to elucidate characteristics, treatments, and outcomes of patients with cancer and CVT (CA-CVT).

Methods: The 2016-2019 National Inpatient Sample (NIS) database was queried for patients with a primary diagnosis of CVT.

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Objective: To assess the impact of vagus nerve stimulation (VNS) on quality of life contributors such as rescue medications.

Methods: Using the seizure diary application SeizureTracker™ database, we examined trends in rescue administration frequency before and after the first recorded VNS magnet swipe in patients with drug-resistant epilepsy who had 1) At least one VNS magnet swipe recorded in the diary, and 2) Recorded usage of a benzodiazepine rescue medication (RM) within 90 days prior to the first swipe. A paired Wilcoxon rank-sum test was used to assess changes in RM usage frequency between 30-, 60-, 90-, 180- and 360-day intervals beginning 30 days after first magnet swipe.

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As the incidence of subdural hematoma is increasing, it is important to understand symptomatology and clinical variables associated with treatment outcomes and mortality in this population; patients with subdural hematoma were selected from the National Inpatient Sample (NIS) Database between 2016 and 2020 using International Classification of Disease 10th Edition (ICD10) codes. Moderate-to-severe subdural hematoma patients were identified using the Glasgow Coma Scale (GCS). Multivariate regression was first used to identify predictors of in-hospital mortality and then beta coefficients were used to create a weighted mortality score.

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Article Synopsis
  • The study investigates the link between acute kidney injury (AKI) and outcomes in patients with spontaneous subarachnoid hemorrhage (SAH), a serious condition with a high risk of complications.
  • An analysis of over 76,000 SAH patients from 2010 to 2019 shows that about 14% developed AKI, with these patients being older and more likely to be obese compared to those without AKI.
  • Findings indicate that AKI is significantly associated with poorer functional outcomes, longer hospital stays, and higher in-hospital mortality, highlighting the need for early detection to improve recovery chances.
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The mechanistic target of rapamycin (mTOR) is a serine/threonine kinase that functions via its discrete binding partners to form two multiprotein complexes, mTOR complex 1 and 2 (mTORC1 and mTORC2). Rapamycin-sensitive mTORC1, which regulates protein synthesis and cell growth, is tightly controlled by PI3K/Akt and is nutrient-/growth factor-sensitive. In the brain, mTORC1 is also sensitive to neurotransmitter signaling.

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Background: Pediatric non-accidental trauma often necessitates the involvement of protective services. However, the subjectivity and lack of standardization of referral infrastructure may result in some discrepancies between referral patterns and instances of child abuse.

Methods: An institutional retrospective chart review was conducted between 2015 and 2021, in which all cases of patients under the age of 14 who suffered a burn injury and received a child protective service (CPS) consult were reviewed.

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Article Synopsis
  • Improved surgical outcomes for brain tumor patients are linked to high-volume centers (HVCs), which handle more cases and provide specialized care.
  • A study analyzed 118,390 patients across 3,009 hospitals, finding that only 3% qualified as HVCs, primarily located in the Mid-Atlantic and South Atlantic regions.
  • Patients at HVCs experienced fewer complications and better overall outcomes, highlighting the importance of access to specialized care in enhancing treatment effectiveness.
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Acute neurological manifestations in patients with Behcet's syndrome are rare yet may lead to devastating outcomes. Distinguishing primary neurological deficits from spontaneous hemorrhagic insults is of particular importance for the prognosis of patients with Behcet's syndrome. Here, we investigate the clinical characteristics, management, and outcomes of nontraumatic hemorrhagic injury in patients with Bechet's syndrome.

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Background: Intracerebral hemorrhage (ICH) carries significant morbidity and mortality. Previous single-center retrospective analysis suggests that end-stage renal disease (ESRD) is a risk factor for severe ICH and worse outcomes. This investigation aims to examine the impact of ESRD on ICH severity, complications, and outcomes using a multicenter national database.

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Dexamethasone, a long-acting potent glucocorticoid, is one of the most widely used medications in neurosurgery. In this paper, the authors recount the history of dexamethasone's rise in neurosurgery and discuss its use in brain tumors in the context of emerging neuro-oncological immunotherapies. In 1958, Glen E.

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Background: The systemic inflammatory response syndrome (SIRS) is a clinical reaction that can occur due to a variety of stimuli. Reamed intramedullary femoral nailing is a common orthopedic surgery that has been shown to induce SIRS. To date, no nationwide analyses have been performed to evaluate the incidence, risk factors, and economic burdens of SIRS following intramedullary femoral nailing for femoral shaft fractures.

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Background: Traumatic spondyloptosis (TS) with complete spinal cord transection and unrepairable durotomy is particularly rare and can lead to a difficult-to-manage cerebrospinal fluid (CSF) leak.

Methods: We performed a systematic review of the literature on TS and discuss the management strategies and outcomes of TS with cord transection and significant dural tear. We also report a novel case of a 26-year-old female who presented with thoracic TS with complete spinal cord transection and unrepairable durotomy with high-flow CSF leak.

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Study Design: Retrospective case series and systemic literature meta-analysis.

Background: Thoracolumbar junction region stenosis produces spinal cord compression just above the conus and may manifest with symptoms that are not typical of either thoracic myelopathy or neurogenic claudication from lumbar stenosis.

Objective: As few studies describe its specific pattern of presenting symptoms and neurological deficits, this investigation was designed to improve understanding of this pathology.

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(1) Background: Celiac disease (CD) can cause long-term inflammation and endothelial dysfunction and has been cited as a risk factor for acute ischemic stroke (AIS) in pediatric patients. However, the rate and outcomes of AIS in pediatric patients with CD has not been explored in a large population. Our objective is to explore the rate, severity, and outcomes of CD amongst pediatric AIS patients on a nationwide level.

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Article Synopsis
  • * The research examined four studies involving a total of 201 patients, revealing that using native dura with autologous fat grafts led to the lowest CSF leak rates, while utilizing artificial dura and fibrin glue resulted in higher leak rates.
  • * The study indicates that the method of dural closure significantly affects the likelihood of CSF leaks post-surgery, although the findings are limited by the overall low quality of the included studies.
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Objective: The objective of this paper was to compare the predictive ability of the recalibrated Risk Analysis Index (RAI-rev) with the 5-item modified frailty index-5 (mFI-5) for postoperative outcomes of anterior cervical discectomy and fusion (ACDF).

Methods: This study was performed using data of adult (age > 18 years) ACDF patients obtained from the National Surgical Quality Improvement Program database during the years 2015-2019. Multivariate modeling and receiver operating characteristic (ROC) curve analysis, including area under the curve/C-statistic calculation with the DeLong test, were performed to evaluate the comparative discriminative ability of the RAI-rev and mFI-5 for 5 postoperative outcomes.

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Background: Burn injuries play a significant role in pediatric injury-related mortality and morbidity. In this study, we aim to explore the relationship between patient demographics, socioeconomic factos and burn severity in pediatric patients.

Methods: Patients under age 14 hospitalized at Westchester Medical Center for burn injury between 2015 and 2021 were reviewed.

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Purpose: Respiratory failure following mechanical thrombectomy (MT) for acute ischemic stroke (AIS) is a known complication, and requirement of tracheostomy is associated with worse outcomes. Our objective is to evaluate characteristics associated with tracheostomy timing in AIS patients treated with MT.

Methods: The National Inpatient Sample was queried for adult patients treated with MT for AIS from 2016 to 2019.

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Background: Disparities in neurosurgical care have emerged as an area of interest when considering the impact of social determinants on access to health care. Decompression via anterior cervical discectomy and fusion (ACDF) for cervical stenosis (CS) may prevent progression towards debilitating complications that may severely compromise one's quality of life. This retrospective database analysis aims to elucidate demographic and socioeconomic trends in ACDF provision and outcomes of CS-related pathologies.

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