Wilson's disease: neuropsychiatric presentation and delayed diagnosis.

A woman in her 30s with unclear history of cirrhosis presented to the emergency department with 8 months of worsening bilateral hand tremors, falls, depressed mood, altered mental status, difficulty swallowing and faecal/urinary incontinence. The patient was diagnosed with liver cirrhosis 6 years prior based on outside hospital ultrasound and liver biopsy. The hospital inpatient neurology team was promptly consulted for evaluation of worsening mental status.

Trends in Racial and Ethnic Representation Among Neurosurgery Applicants and Residents: A Comparative Analysis of Procedural Specialties.

Background: Diversity, equity, and inclusion within the healthcare workforce are conducive to providing culturally competent care. However, few existing studies have assessed the level of racial and ethnic diversity among resident physicians and residency applicants. Our objective was to provide a comparative analysis of the trends in racial and ethnic representation within different subspecialties in medicine.

Political Campaign Contributions of Surgeons in the United States Throughout the 2020 Election Cycle.

Importance: Political engagement by the physician workforce is necessary to ensure continued representation of their interests in health care legislation. Limited data are available pertaining to the political involvement of US surgeons.

Objective: To analyze the magnitude and distribution of political donations made by all US surgeons throughout the 2020 election cycle.

Psoas Muscle Index as a Predictor of Perioperative Outcomes in Geriatric Patients Undergoing Spine Surgery.

Study Design: Single-center retrospective study.

Objective: The objective of this study was to evaluate the association of psoas muscle mass defined sarcopenia with perioperative outcomes in geriatric patients undergoing elective spine surgery.

Methods: We included geriatric patients undergoing thoracolumbar spinal surgery.

Decisional Regret Among Older Adults Undergoing Corrective Surgery for Adult Spinal Deformity: A Single Institutional Study.

Study Design: Retrospective.

Objective: To investigate the prevalence of decisional regret among older adults undergoing surgery for adult spinal deformity (ASD).

Summary Of Background Data: Among older adults (≥65 years old), ASD is a leading cause of disability, with a population prevalence of 60% to 70%.

Patient and Spine Surgeon Perceptions on Shared Decision-Making in the Treatment of Older Adults Undergoing Corrective Surgery for Adult Spinal Deformity.

Study Design: Retrospective.

Objective: To understand patients' and spine surgeons' perspectives about decision-making around surgery for adult spinal deformity.

Summary Of Background Data: Surgery for correction of adult spinal deformity is often beneficial; however, in over 20% of older adults (≥ 65 yrs of age), outcomes from surgery are less desirable.

Perioperative Factors Associated With Chronic Opioid Use After Spine Surgery.

Study Design: Retrospective case control.

Objectives: The purpose of the current study is to determine risk factors associated with chronic opioid use after spine surgery.

Methods: In our single institution retrospective study, 1,299 patients undergoing elective spine surgery at a tertiary academic medical center between January 2010 and August 2017 were enrolled into a prospectively collected registry.

Perioperative Optimization of Senior Health in Spine Surgery: Impact on Postoperative Delirium.

Background: Delirium is a common postoperative complication in geriatric patients, especially in those with underlying risk factors. Multicomponent nonpharmacologic interventions are effective in preventing delirium, however, implementation of these measures is variable in perioperative care. The aim of our study was to assess the impact of our Perioperative Optimization of Senior Health Program (UTSW POSH) on postoperative delirium in patients undergoing elective spine surgery.

Association of osteopenia and osteoporosis with higher rates of pseudarthrosis and revision surgery in adult patients undergoing single-level lumbar fusion.

Objective: Patients with osteopenia or osteoporosis who require surgery for symptomatic degenerative spondylolisthesis may have higher rates of postoperative pseudarthrosis and need for revision surgery than patients with normal bone mineral densities (BMDs). To this end, the authors compared rates of postoperative pseudarthrosis and need for revision surgery following single-level lumbar fusion in patients with normal BMD with those in patients with osteopenia or osteoporosis. The secondary outcome was to investigate the effects of pretreatment with medications that prevent bone loss (e.

Generation of model tissues with dendritic vascular networks via sacrificial laser-sintered carbohydrate templates.

Sacrificial templates for patterning perfusable vascular networks in engineered tissues have been constrained in architectural complexity, owing to the limitations of extrusion-based 3D printing techniques. Here, we show that cell-laden hydrogels can be patterned with algorithmically generated dendritic vessel networks and other complex hierarchical networks by using sacrificial templates made from laser-sintered carbohydrate powders. We quantified and modulated gradients of cell proliferation and cell metabolism emerging in response to fluid convection through these networks and to diffusion of oxygen and metabolites out of them.