Publications by authors named "Spina N"

We here describe a rare case of a 26-year-old male patient, presenting to our hospital after a motorcycle-car accident for the surgical management of long-bone fractures to the tibia and femur and shoulder dislocation and undergoing orthopedic surgery, who postoperatively developed seizure, coma, and respiratory failure due to a cerebral fat embolism. After some hours after the surgery, a loss of consciousness was described by caregivers, and the ICU team was alerted, and the patient was admitted to ICU. Intracranial hemorrhage and stroke were subsequently excluded and, finally, a whole-body computed tomography angiography scan and head magnetic resonance imaging showed lesions consistent with cerebral fat embolism.

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  • - The study investigates the impact of social vulnerability on clinical outcomes for hospitalized influenza patients, analyzing data from over 57,000 cases between the 2014-2015 and 2018-2019 influenza seasons across 13 states.
  • - It aims to understand how social vulnerability correlates with severe outcomes like ICU admission, use of advanced respiratory support, and 30-day mortality, while also examining patterns of vaccine and antiviral use based on social vulnerability levels.
  • - Findings reveal that patients from areas with high social vulnerability experience worse outcomes, such as higher rates of needing invasive ventilation support compared to those from less vulnerable areas.
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Background: While the estimated number of U.S. influenza-associated deaths is reported annually, detailed data on the epidemiology of influenza-associated deaths, including the burden of in-hospital versus post-hospital discharge deaths are limited.

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Problem/condition: Seasonal influenza accounts for 9.3 million-41 million illnesses, 100,000-710,000 hospitalizations, and 4,900-51,000 deaths annually in the United States. Since 2003, the Influenza Hospitalization Surveillance Network (FluSurv-NET) has been conducting population-based surveillance for laboratory-confirmed influenza-associated hospitalizations in the United States, including weekly rate estimations and descriptions of clinical characteristics and outcomes for hospitalized patients.

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Study Design: Review article.

Objective: To provide a comprehensive review and update on the evaluation and management of Hangman's fractures.

Summary Of Background Data: Hangman's fractures are the second most common fracture of the C2 vertebrae, and the prevalence is increasing with our aging population.

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  • This study reviews how physical function (PROMIS PF scores) changes over time after lumbar fusion surgery, particularly focusing on the impact of functional comorbidities like heart failure or COPD on recovery.
  • Researchers analyzed data from 1,893 patients who underwent lumbar fusion from 2014 to 2022, comparing outcomes between those with and without comorbidities at regular intervals over two years.
  • Findings suggest that patients with functional comorbidities had different recovery trends, potentially highlighting the need for tailored rehabilitation strategies in post-surgical care.
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  • Pneumonia is frequent among adults hospitalized with confirmed influenza, but the impact of how quickly antiviral treatment is given on severe outcomes is not well understood.
  • The study analyzed data from over 26,000 adults hospitalized between 2012-2019 to see how the timing of antiviral treatment (given on the day of admission vs. later) affected 30-day mortality rates.
  • Results showed that those who received treatment later (days 2-5) had a significantly higher risk of death compared to those treated on the same day of admission, emphasizing the need for prompt treatment.
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We systematically review literature regarding the contribution of transthyretin amyloidosis to spinal stenosis. Amyloidosis is a protein misfolding condition that causes systemic deposition of amyloid and commonly leads to heart failure and nephropathy. A growing body of literature suggests that amyloid deposits within the ligamentum flavum are frequently associated with spinal stenosis with subsequent myelopathy.

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Introduction: The factors most important in the spine fellowship match may not ultimately correlate with quality of performance during fellowship. This study examined the spine fellow applicant metrics correlated with high application rank compared with the metrics associated with the strongest clinical performance during fellowship.

Methods: Spine fellow applications at three academic institutions were retrieved from the San Francisco Match database (first available to 2021) and deidentified for application review.

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Clinical evidence suggests an association between comorbidities and outcome in patients with glioblastoma (GBM). We hypothesised that the internal carotid artery (ICA) calcium score could represent a promising prognostic biomarker in a competing risk analysis in patients diagnosed with GBM. We validated the use of the ICA calcium score as a surrogate marker of the coronary calcium score in 32 patients with lung cancer.

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(1) Older patients who attend emergency departments are frailer than younger patients and are at a high risk of adverse outcomes; (2) To conduct this systematic review, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. We systematically searched literature from PubMed, Embase, OVID Medline, Scopus, CINAHL via EBSCOHost, and the Cochrane Library up to May 2023, while for grey literature we used Google Scholar. No time restrictions were applied, and only articles published in English were included.

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Severe outcomes were common among adults hospitalized for COVID-19 or influenza, while the percentage of COVID-19 hospitalizations involving critical care decreased from October 2021 to September 2022. During the Omicron BA.5 period, intensive care unit admission frequency was similar for COVID-19 and influenza, although patients with COVID-19 had a higher frequency of in-hospital death.

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Background: Older age and chronic conditions are associated with severe influenza outcomes; however, data are only comprehensively available for adults ≥65 years old. Using data from the Influenza Hospitalization Surveillance Network (FluSurv-NET), we identified characteristics associated with severe outcomes in adults 18-49 years old hospitalized with influenza.

Methods: We included FluSurv-NET data from nonpregnant adults 18-49 years old hospitalized with laboratory-confirmed influenza during the 2011-2012 through 2018-2019 seasons.

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Background: Influenza is a substantial cause of annual morbidity and mortality; however, correctly identifying those patients at increased risk for severe disease is often challenging. Several severity indices have been developed; however, these scores have not been validated for use in patients with influenza. We evaluated the discrimination of three clinical disease severity scores in predicting severe influenza-associated outcomes.

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  • The 2022-23 influenza season saw increased activity and hospitalizations among children and adolescents, with a notable severity compared to previous years.
  • Children under 5 and those aged 5-17 were hospitalized at higher rates, with peak activity occurring in late November and early December.
  • A significant portion of hospitalized patients (18.3%) were unvaccinated, and the use of antiviral treatments was lower than in pre-pandemic years, highlighting the importance of vaccination.
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Adults aged ≥65 years remain at elevated risk for severe COVID-19 disease and have higher COVID-19-associated hospitalization rates compared with those in younger age groups. Data from the COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) were analyzed to estimate COVID-19-associated hospitalization rates during January-August 2023 and identify demographic and clinical characteristics of hospitalized patients aged ≥65 years during January-June 2023. Among adults aged ≥65 years, hospitalization rates more than doubled, from 6.

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Background: Influenza burden varies across seasons, partly due to differences in circulating influenza virus types or subtypes. Using data from the US population-based surveillance system, Influenza Hospitalization Surveillance Network (FluSurv-NET), we aimed to assess the severity of influenza-associated outcomes in individuals hospitalised with laboratory-confirmed influenza virus infections during the 2010-11 to 2018-19 influenza seasons.

Methods: To evaluate the association between influenza virus type or subtype causing the infection (influenza A H3N2, A H1N1pdm09, and B viruses) and in-hospital severity outcomes (intensive care unit [ICU] admission, use of mechanical ventilation or extracorporeal membrane oxygenation [ECMO], and death), we used FluSurv-NET to capture data for laboratory-confirmed influenza-associated hospitalisations from the 2010-11 to 2018-19 influenza seasons for individuals of all ages living in select counties in 13 US states.

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  • Nontuberculous mycobacteria (NTM) infections are challenging to diagnose and treat, affecting both the lungs (PNTM) and other parts of the body (ENTM) in various settings, including healthcare.
  • A pilot study by the CDC involved NTM surveillance across four U.S. sites, collecting patient data from October 2019 to March 2020, and found 299 reported cases, with the majority being pulmonary.
  • The study's findings highlight the need for active surveillance to better understand NTM prevalence and characteristics of affected populations, which can inform future healthcare interventions.
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Study Design: Retrospective cohort study.

Objective: The decision to pursue operative intervention for patients with isthmic spondylolisthesis is complex. Although steroid injections are a well-accepted therapeutic modality that may delay or obviate surgery, little is known regarding their ability to predict surgical outcomes.

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Background: The role of computed tomography (CT) in the diagnosis and characterization of coronavirus disease 2019 (COVID-19) pneumonia has been widely recognized. We evaluated the performance of a software for quantitative analysis of chest CT, the LungQuant system, by comparing its results with independent visual evaluations by a group of 14 clinical experts. The aim of this work is to evaluate the ability of the automated tool to extract quantitative information from lung CT, relevant for the design of a diagnosis support model.

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  • This study focused on the link between preoperative albumin levels and outcomes in lumbar spine surgery, specifically looking at mortality and morbidity.
  • Hypoalbuminemia, or low albumin levels, was found to be a significant risk factor, with patients showing a much higher risk of death after surgery compared to those with normal levels.
  • Although hypoalbuminemic patients had worse disability scores before surgery, their rates of hospital readmission post-surgery were similar to those with normal albumin levels.
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From surveillance data of patients hospitalized with laboratory-confirmed influenza in the United States during the 2015-2016 through 2018-2019 seasons, initiation of antiviral treatment increased from 86% to 94%, with increases seen across all age groups. However, 62% started therapy ≥3 days after illness onset, driven by late presentation to care.

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The 2022-23 influenza season shows an early rise in pediatric influenza-associated hospitalizations (1). SARS-CoV-2 viruses also continue to circulate (2). The current influenza season is the first with substantial co-circulation of influenza viruses and SARS-CoV-2 (3).

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Background: Influenza is a persistent public health problem associated with severe morbidity and mortality. Drug use is related to myriad health complications, but the relationship between drug use and severe influenza outcomes is not well understood. The study objective was to evaluate the relationship between drug use and severe influenza-associated outcomes.

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Beginning the week of March 20–26, 2022, the Omicron BA.2 variant of SARS-CoV-2, the virus that causes COVID-19, became the predominant circulating variant in the United States, accounting for >50% of sequenced isolates.* Data from the COVID-19–Associated Hospitalization Surveillance Network (COVID-NET) were analyzed to describe recent COVID-19–associated hospitalization rates among adults aged ≥18 years during the period coinciding with BA.

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