Publications by authors named "Morell A"

Article Synopsis
  • The study aims to predict the likelihood of death or severe neurodevelopmental impairment (NDI) in neonates with hypoxic-ischemic encephalopathy (HIE) who undergo hypothermia treatment.
  • The research involved 424 neonates from U.S. neonatal intensive care units, tracking their outcomes up to the age of 2 years, with a focus on clinical indicators taken 24 hours after birth.
  • Findings revealed that specific clinical characteristics, including severely abnormal EEG, low pH, and a poor Apgar score, can effectively signal high risk for severe outcomes, offering a high level of specificity and predictive value for clinicians.
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Understanding the response of marine organisms to temperature is crucial for predicting climate change impacts. Fundamental physiological thermal performance curves (TPCs), determined under controlled conditions, are commonly used to project future species spatial distributions or physiological performances. Yet, real-world performances may deviate due to extrinsic factors covarying with temperature (food, oxygen, etc.

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Background: The incidence of brain metastases from gastric origin is less than 1% in those with primary gastric cancer. Given this exceedingly rare presentation, there is limited literature describing the outcomes of their neurosurgical treatment. We wish to identify the role of surgical intervention for brain lesions in metastatic gastric cancer via institutional case series and systematic review.

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  • The study assesses the long-term hearing outcomes in patients with small to medium vestibular schwannomas (VS) who underwent either a conservative "wait-and-scan" (WAS) approach or stereotactic radiosurgery (SRS).
  • The analysis included nine studies with a total of 1,275 patients, finding that WAS results in better preservation of serviceable hearing and improved quality of life measures compared to SRS.
  • While WAS showed promising outcomes, the overall certainty of evidence ranged from "very low" to "moderate," indicating the need for more research in this area.
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  • Recurrence of high-grade gliomas is common even after the best treatment, and current imaging methods can't effectively predict when it will happen.
  • A new whole-brain magnetic resonance spectroscopy (WB-MRS) method was tested, focusing on tumor microenvironments to improve understanding of glioma progression and assist in treatment decisions.
  • By analyzing tumor metabolites and using machine learning techniques on data from 16 patients, researchers were able to predict glioma progression, particularly identifying key features that indicate future growth.
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Background And Objectives: Laser interstitial thermal therapy (LITT) has demonstrated promise in surgical neuro-oncology because of its effectiveness in delivering precise thermal energy to lesions. The extent of ablation (EOA) is a prognostic factor in improving patient outcomes but is often affected by perilesional heatsink structures, which can lead to asymmetric ablations. The purpose of this study was to quantitatively evaluate the impact of various perilesional heatsink structures on the EOA in LITT for brain metastases.

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Article Synopsis
  • - The study aimed to assess the quality of life in patients with common immune-mediated inflammatory diseases in Spain (like IBD, psoriasis, RA, etc.) and identify factors affecting their quality of life.
  • - Conducted in four hospitals in Madrid, this observational study analyzed 578 adult patients using various questionnaires to measure aspects like mobility, pain, and anxiety.
  • - The results indicated that patients with psoriasis and inflammatory bowel disease had better quality of life scores compared to those with psoriatic arthritis and rheumatoid arthritis, and factors such as gender, disease severity, age, and treatment persistence significantly impacted quality of life.
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Background: Brain metastases from esophageal cancer (BMEC) are rare and aggressive, with limited literature on optimal treatment modalities and a standard of care yet to be established. The objective of this study was to systematically review existing literature and perform a retrospective analysis of our institution's patients to evaluate the influence of different treatment modalities on patient outcomes.

Methods: A systematic review of the literature following Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines and a retrospective review of our institutional experience with BMEC were both conducted.

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Objective: As the coronavirus disease 2019 (COVID-19) pandemic spread to the United States in 2020, there was an impetus toward postponing or ceasing nonurgent transsphenoidal pituitary surgeries to prevent the spread of the virus. Some centers encouraged transcranial approaches for patients with declining neurologic function. However, no large-scale data exist evaluating the effects that this situation had on national pituitary practice patterns.

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  • The study focused on the surgical anatomy of the frontal lobe and introduced a keyhole technique for frontal lobectomy used in patients with frontal gliomas from 2016 to 2022.
  • A total of 47 patients underwent surgeries via a minimally invasive, four-step process, reporting only 10.6% perioperative complications and an average hospital stay of 3.3 days.
  • Results showed promising survival rates, with high-grade gliomas having a median progression-free survival of 14.8 months and overall survival of 23.9 months, highlighting the importance of surgical technique and anatomical knowledge in achieving successful outcomes.
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Article Synopsis
  • Infants with hypoxic ischemic encephalopathy (HIE) may have underlying genetic or congenital anomalies, which could influence their health outcomes, but the extent of this impact is not well understood.
  • In a study of 500 infants with HIE, 5% were found to have genetic or congenital anomalies; these infants showed higher rates of death or neurodevelopmental impairment (NDI) compared to those without anomalies.
  • Despite similar severity of HIE, infants with genetic or congenital issues had worse neurological outcomes, including higher instances of cerebral palsy and lower developmental scores at age two.
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Background: Craniopharyngiomas are benign tumors of the anterior skull base arising from epithelial remnants of Rathke pouch. They mainly occur in the suprasellar space, can be incredibly debilitating, and remain difficult to resect as they frequently involve critical neurovascular structures. Although it is embryologically possible for craniopharyngiomas to arise extracranially along the entire migrational path of Rathke pouch, these remain exceedingly rare, especially among adults, and can be mistaken for nasopharyngeal cancer.

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Article Synopsis
  • - Cancer-related pain significantly impacts patients' quality of life, and while first-line treatments like opioids and NSAIDs are commonly used, they can have limitations and side effects.
  • - A systematic review of literature involving 735 patients found that hypophysectomy and other neuromodulation techniques can provide substantial pain relief for those who haven't responded to standard treatments.
  • - Among the various treatment methods examined, hypophysectomy showed promising results; however, complications, particularly diabetes insipidus, were noted, indicating the need for careful consideration in treatment planning.
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Background: Giant falcine meningiomas are surgically complex as they are deep in location, concealed by normal brain parenchyma, in close proximity to various neurovascular structures, and frequently involve the falx bilaterally. Although classically accessed using a bifrontal craniotomy and interhemispheric approach, little data exist on alternative operative corridors for these challenging tumors. We evaluated perioperative and long-term outcomes in patients undergoing transcortical resection of giant bilateral falcine meningiomas.

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Purpose: Laser interstitial thermal therapy (LITT) is a minimally invasive cytoreductive treatment option for brain tumors with a risk of vascular injury from catheter placement or thermal energy. This may be of concern with deep-seated tumors that have surrounding end-artery perforators and critical microvasculature. The purpose of this study was to assess the risk of distal ischemia following LITT for deep-seated perivascular brain tumors.

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Traumatic brain injury (TBI) poses significant challenges for assessing fitness-to-drive (FTD) and determining the appropriate timing for return-to-driving (RTD) in civilian adults. This systematic review and meta-analysis protocol is designed to offer a comprehensive assessment of RTD timelines post-TBI, examining the effects of injury severity as well as demographic and clinical factors that influence driving capabilities. In response to gaps identified in previous literature-namely, the absence of recent systematic search strategies and thorough quality assessments-this study employs rigorous methodologies for literature search, data extraction, and evaluation of study quality.

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Background: Autologous cranioplasty has been used for decades and is the gold standard treatment in patients who underwent decompressive craniectomy (DC). One of the most common methods to store the cranial bone flap is cryopreservation at very low temperatures (-70 to -80°). The only way to achieve these low temperatures is by using special freezers which are not always available in all medical facilities, especially in low-resource centers.

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Objective: Neurosurgery, among other surgical fields, is amid a shift in patient management with enhanced recovery and same-day discharge (SDD) protocols slowly becoming more popular and feasible. While such protocols reduce the risk of nosocomial complications and improve patient satisfaction, appropriate patient selection remains an area of debate. The authors aimed to better quantify selection criteria through a prospective follow-up study of patients undergoing brain tumor resection with SDD.

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The aim is to evaluate the diagnostic yield of echocardiography and [mTc]Tc-DPD scintigraphy in the detection of amyloid cardiomyopathy (CM) and define potential prognostic echocardiographic parameters. 133 patients were retrospectively studied, from 2016 to 2021, with a mean age of 80.2 ± 7.

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Background And Objectives: Bilateral/butterfly glioblastoma (bGBM) has a poor prognosis. Resection of these tumors is limited due to severe comorbidities that arise from surgical procedures. Laser interstitial thermal therapy (LITT) offers a minimally invasive cytoreductive therapy for deep-seated tumors such as bGBM.

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Laser interstitial thermal therapy (LITT) is a minimally invasive neurosurgical technique used to ablate intra-axial brain tumors. The impact of LITT on the tumor microenvironment is scarcely reported. Nonablative LITT-induced hyperthermia (33-43˚C) increases intra-tumoral mutational burden and neoantigen production, promoting immunogenic cell death.

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Introduction: Corticosteroids are the most cost-effective anti-inflammatory drugs available for the treatment of asthma. Despite their effectiveness, several asthmatic patients have corticosteroid resistance or insensitivity and exhibit a poor response. Corticosteroid insensitivity implies a poor prognosis due to challenges in finding alternative therapeutic options for asthma.

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Background: Current trends in surgical neuro-oncology show that early discharges are safe and feasible with shorter lengths of stay (LOS) and fewer thromboembolic complications, fewer hospital-acquired infections, reduced costs, and greater patient satisfaction. Traditionally, infratentorial tumor resections have been associated with longer LOS and limited data exist evaluating predictors of early discharge in these patients. The objective was to assess patients undergoing posterior fossa craniotomies for tumor resection and identify variables associated with postoperative day 1 (POD1) discharge.

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Objective: Ovarian cancer is a rare origin of brain metastasis (BM), with an incidence of only 1%-3%. Consequently, the literature is sparse, and no treatment consensus guideline is available for ovarian BM. The authors conducted a systematic review of ovarian BM and performed a combined pooled cohort survival analysis with their case series.

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Brain tumor incidence is on the rise, and glioblastoma comprises the majority of primary tumors. Despite maximal safe resection and adjuvant chemoradiation, median survival for high-grade glioma remains poor. For this reason, it is important to develop and incorporate new treatment strategies.

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