Development and Validation of a Neurosurgical Phantom for Simulating External Ventricular Drain Placement.

This study aimed to develop and validate a cost-effective, customizable patient-specific phantom for simulating external ventricular drain placement, combining image segmentation, 3-D printing and molding techniques. Two variations of the phantom were created based on patient MRI data, integrating a realistic skin layer with anatomical landmarks, a 3-D printed skull, an agarose polysaccharide gel brain, and a ventricular cavity. To validate the phantom, 15 neurosurgeons, residents, and physician assistants performed 30 EVD placements.

NnU-Net versus mesh growing algorithm as a tool for the robust and timely segmentation of neurosurgical 3D images in contrast-enhanced T1 MRI scans.

Purpose: This study evaluates the nnU-Net for segmenting brain, skin, tumors, and ventricles in contrast-enhanced T1 (T1CE) images, benchmarking it against an established mesh growing algorithm (MGA).

Methods: We used 67 retrospectively collected annotated single-center T1CE brain scans for training models for brain, skin, tumor, and ventricle segmentation. An additional 32 scans from two centers were used test performance compared to that of the MGA.

Segmentation techniques of brain arteriovenous malformations for 3D visualization: a systematic review.

Background: Visualization, analysis and characterization of the angioarchitecture of a brain arteriovenous malformation (bAVM) present crucial steps for understanding and management of these complex lesions. Three-dimensional (3D) segmentation and 3D visualization of bAVMs play hereby a significant role. We performed a systematic review regarding currently available 3D segmentation and visualization techniques for bAVMs.

Imaging Findings in Pediatric COVID-19: A Review of Current Literature.

The recent COVID-19 pandemic has afflicted over 200 million individuals to date, with many different organ systems involved. The pediatric involvement has been variable, but of note is the risk of cardiac disease in pediatric COVID-19 patients. We review here the cardiac involvement in pediatric patients with COVID-19.

Trisomy 18 Trends over the Last 20 Years.

Objective: To evaluate the trends in hospitalizations for children with trisomy 18 over time and to determine the rate of invasive procedures on these children, using a large inpatient database.

Study Design: A retrospective analysis using the Kids' Inpatient Database from 1997 to 2016 was performed for trisomy 18. We evaluated survival to discharge as well as the presence of pulmonary, skeletal, neurologic, gastrointestinal, renal, and hematologic/bleeding problems.

Fully automatic brain tumor segmentation for 3D evaluation in augmented reality.

Objective: For currently available augmented reality workflows, 3D models need to be created with manual or semiautomatic segmentation, which is a time-consuming process. The authors created an automatic segmentation algorithm that generates 3D models of skin, brain, ventricles, and contrast-enhancing tumor from a single T1-weighted MR sequence and embedded this model into an automatic workflow for 3D evaluation of anatomical structures with augmented reality in a cloud environment. In this study, the authors validate the accuracy and efficiency of this automatic segmentation algorithm for brain tumors and compared it with a manually segmented ground truth set.

Fully Automatic Adaptive Meshing Based Segmentation of the Ventricular System for Augmented Reality Visualization and Navigation.

Objective: Effective image segmentation of cerebral structures is fundamental to 3-dimensional techniques such as augmented reality. To be clinically viable, segmentation algorithms should be fully automatic and easily integrated in existing digital infrastructure. We created a fully automatic adaptive-meshing-based segmentation system for T1-weighted magnetic resonance images (MRI) to automatically segment the complete ventricular system, running in a cloud-based environment that can be accessed on an augmented reality device.

The frequency and efficacy of genetic testing in individuals with scimitar syndrome.

Background: Scimitar syndrome is a rare CHD composed of partial anomalous pulmonary venous connection from the right lung, via a scimitar vein, to the inferior vena cava rather than the left atrium. Genetic conditions associated with scimitar syndrome have not been well investigated at present.

Methods: Our study included patients with scimitar syndrome diagnosed at Texas Children's Hospital from January 1987 to July 2020.

Neonatal brain abscess development following fetal scalp electrode placement: a rare complication.

A fetal scalp electrode (FSE) is a frequently used investigation during labor. However, it is an invasive procedure which can lead to complications. Our patient developed a very large brain abscess after initial superficial infection of the skin site due to an FSE.

Fulminant Enteroviral Myocarditis in a Newborn Accompanying Maternal SARS-CoV-2 Infection.

We present a case of fulminant myocarditis in a preterm neonate born to a SARS-CoV-2-infected mother with COVID-19 disease. Despite complete separation after birth, cardiogenic decompensation initiated on day of life 7. Although the neonate tested negative for SARS-CoV-2, enterovirus viremia accompanied cardiac dysfunction, multiorgan failure, and neonatal death within 36 hours.

Holographic patient tracking after bed movement for augmented reality neuronavigation using a head-mounted display.

Background: Holographic neuronavigation has several potential advantages compared to conventional neuronavigation systems. We present the first report of a holographic neuronavigation system with patient-to-image registration and patient tracking with a reference array using an augmented reality head-mounted display (AR-HMD).

Methods: Three patients undergoing an intracranial neurosurgical procedure were included in this pilot study.

Current Accuracy of Augmented Reality Neuronavigation Systems: Systematic Review and Meta-Analysis.

Background: Augmented reality neuronavigation (ARN) systems can overlay three-dimensional anatomy and disease without the need for a two-dimensional external monitor. Accuracy is crucial for their clinical applicability. We performed a systematic review regarding the reported accuracy of ARN systems and compared them with the accuracy of conventional infrared neuronavigation (CIN).

Management of hydrocephalus in patients with leptomeningeal metastases: an ethical approach to decision-making.

Purpose: Leptomeningeal metastases (LM) are a rare, but often debilitating complication of advanced cancer that can severely impact a patient's quality-of-life. LM can result in hydrocephalus (HC) and lead to a range of neurologic sequelae, including weakness, headaches, and altered mental status. Given that patients with LM generally have quite poor prognoses, the decision of how to manage this HC remains unclear and is not only a medical, but also an ethical one.

Transcatheter Occlusion of the Patent Ductus Arteriosus in 747 Infants <6 kg: Insights From the NCDR IMPACT Registry.

Objectives: The authors sought to identify risk factors associated with major adverse events (MAEs) in infants <6 kg undergoing transcatheter patent ductus arteriosus (PDA) occlusion.

Background: Transcatheter PDA occlusion is among the safest of interventional cardiac procedures in adults and older children, but use among infants <6 kg has not been characterized adequately.

Methods: Using the IMPACT (IMproving Pediatric and Adult Congenital Treatments) registry, we identified infants <6 kg undergoing transcatheter PDA occlusion (January 1, 2011, to March 1, 2015).

Severe hypertriglyceridemia at new onset type 1 diabetes mellitus.

Background: Severe hypertriglyceridemia (HTG) as well as diabetic ketoacidosis (DKA) are complications of type 1 diabetes (T1DM). HTG is an exceedingly rare complication in the pediatric population and herein we report a case of HTG at new-onset T1DM in DKA and discuss management and potential complications.

Case Presentation: An 11-year-old previously well patient with a history of fatigue and weight loss presented with: glucose >600 mg/dL, venous blood gas: pH 7.

Persistent Oxygen Requirement beyond Prematurity: A Case of Acquired Pulmonary Vein Stenosis.

Acquired pulmonary vein stenosis is a rare cardiac defect and diagnosis can often be challenging, as many cases present with refractory or prolonged oxygen requirement over the expected course. Comorbid conditions can cloud this diagnosis further. Prognosis is poor for most patients.

Percutaneous Patent Ductus Arteriosus (PDA) Closure During Infancy: A Meta-analysis.

Context: Patent ductus arteriosus (PDA) is a precursor to morbidity and mortality. Percutaneous (catheter-based) closure is the procedure of choice for adults and older children with a PDA, but use during infancy (<1 year) is not well characterized.

Objective: Investigate the technical success and safety of percutaneous PDA closure during infancy.

Intravitreal anti-vascular endothelial growth factor therapy for choroidal neovascularization secondary to ocular histoplasmosis syndrome.

Background: Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy is beneficial in treating choroidal neovascularization from age-related macular degeneration, but few long-term studies have shown its efficacy in choroidal neovascularization from ocular histoplasmosis syndrome. Intravitreal anti-VEGF therapy may be effective in cases of choroidal neovascularization because of ocular histoplasmosis syndrome.

Methods: Retrospective chart review of 54 eyes treated with intravitreal anti-VEGF therapy for choroidal neovascularization in ocular histoplasmosis syndrome with >1 year of follow-up after initiation of anti-VEGF treatment was performed.

A framework of teaching competencies across the medical education continuum.

Background: The quality of teachers in higher education is subject of increasing attention, as exemplified by the development and implementation of guidelines for teacher qualifications at Universities in The Netherlands.

Aim: Because medical education takes a special position in higher education the Council of Deans of Medical Schools in The Netherlands installed a national task force to explore a method to weigh criteria for teacher qualifications of medical teachers.

Methods: A framework was developed covering competencies of teachers throughout the medical education continuum and including medicine, dentistry and veterinary medicine.

Inter- and intra-individual variation in tests of cell-mediated immunity in young and old women.

Exploring means to maintain or improve immunity in older persons has been receiving attention. To establish relationships between immune function and variables of interest, it is important to determine these variables accurately and precisely. Precision relates to the degree of variation in the laboratory test.

Recurrence and survival after abdominoperineal and low anterior resection for rectal cancer, without adjunctive therapy.

Sphincter-saving operations for rectal cancer are performed with increasing frequency. In the present study outcome after low anterior resection (LAR) was compared with outcome after abdominoperineal resection (APR). Morbidity, mortality, local and distant failure and survival were retrospectively studied in 68 patients, surgically treated for rectal cancer without adjunctive therapy between 1980 and 1985.