The prevalence of complications associated with lumbar and thoracic spinal deformity surgery in the elderly population: a meta-analysis.

Background: The prevalence of spinal deformities increases with age, affecting between 30% and 68% of the elderly population (ages ≥65). The reported prevalence of complications associated with surgery for spinal deformities in this population ranges between 37% and 71%. Given the wide range of reported complication rates, the decision to perform surgery remains controversial.

Novel adversarial semantic structure deep learning for MRI-guided attenuation correction in brain PET/MRI.

Objective: Quantitative PET/MR imaging is challenged by the accuracy of synthetic CT (sCT) generation from MR images. Deep learning-based algorithms have recently gained momentum for a number of medical image analysis applications. In this work, a novel sCT generation algorithm based on deep learning adversarial semantic structure (DL-AdvSS) is proposed for MRI-guided attenuation correction in brain PET/MRI.

Estimation of the radiation dose in pregnancy: an automated patient-specific model using convolutional neural networks.

Objectives: The conceptus dose during diagnostic imaging procedures for pregnant patients raises health concerns owing to the high radiosensitivity of the developing embryo/fetus. The aim of this work is to develop a methodology for automated construction of patient-specific computational phantoms based on actual patient CT images to enable accurate estimation of conceptus dose.

Methods: We developed a 3D deep convolutional network algorithm for automated segmentation of CT images to build realistic computational phantoms.

Fast and accurate pseudo multispectral technique for whole-brain MRI tissue classification.

Numerous strategies have been proposed to classify brain tissues into gray matter (GM), white matter (WM) and cerebrospinal fluid (CSF). However, many of them fail when classifying specific regions with low contrast between tissues. In this work, we propose an alternative pseudo multispectral classification (PMC) technique using CIE LAB spaces instead of gray scale T1-weighted MPRAGE images, combined with a new preprocessing technique for contrast enhancement and an optimized iterative K-means clustering.

Trends in High-Impact Neurosurgical Randomized Controlled Trials Published in General Medical Journals: A Systematic Review.

Background: The neurosurgery literature lacks a comprehensive report of neurosurgical randomized controlled trials (RCTs) published in general medical journals. RCTs published in these journals have high visibility and impact on decision-making by general medical practitioners and health care policymakers.

Methods: A systematic review of neurosurgical RCTs in the New England Journal of Medicine, The Lancet, Journal of the American Medical Association, The BMJ, and Annals of Internal Medicine was completed.

Effects of exercise training on inflammasome-related mediators and their associations to glucometabolic variables in patients with combined coronary artery disease and type 2 diabetes mellitus: Sub-study of a randomized control trial.

Background: Adipose tissue produces pro-inflammatory mediators involved in the atherosclerotic process. We investigated whether 12-month exercise training in patients with type 2 diabetes mellitus and coronary artery disease would reduce circulating levels and genetic expression of mediators in the interleukin-18, Caspase-1 and NLR pyrin domain containing 3 pathways. Correlations to glucometabolic variables; fasting glucose, HbA1c, duration of diabetes, insulin, C-peptide, insulin resistance (measured by homeostatic model assessment indexes - insulin resistance) and body mass index at baseline were further assessed.

Adult spinal deformity surgery: a systematic review of venous thromboprophylaxis and incidence of venous thromboembolic events.

Venous thromboprophylaxis consisting of chemical and/or mechanical prophylaxis is administered to patients undergoing adult spinal deformity (ASD) surgery to prevent venous thromboembolic events. However, the true incidence of venous thromboembolism (VTE) after these surgeries is unknown resulting in weak recommendations and lack of consensus regarding type and timing of prophylaxis in these patients. A systematic literature review was conducted to examine VTE incidence in addition to optimal type and timing of VTE prophylaxis.

Construction of patient-specific computational models for organ dose estimation in radiological imaging.

Purpose: Diagnostic imaging procedures require optimization depending on the medical task at hand, the apparatus being used, and patient physical and anatomical characteristics. The assessment of the radiation dose and associated risks plays a key role in safety and quality management for radiation protection purposes. In this work, we aim at developing a methodology for personalized organ-level dose assessment in x-ray computed tomography (CT) imaging.

Mini-open Lateral En Bloc Corpectomy: Cadaveric Feasibility and Early Clinical Experience.

Background: Open approaches to the thoracolumbar spine for en bloc vertebral body tumor resection are associated with significant surgical morbidity. Less invasive surgical techniques may reduce complications.

Objective: To present our experience with a staged posterior midline and mini-open anterolateral extracoelomic approach to en bloc corpectomy for vertebral body tumor resection in cadaver specimens and patients.

Impact of Tissue Classification in MRI-Guided Attenuation Correction on Whole-Body Patlak PET/MRI.

Purpose: The aim of this work is to investigate the impact of tissue classification in magnetic resonance imaging (MRI)-guided positron emission tomography (PET) attenuation correction (AC) for whole-body (WB) Patlak net uptake rate constant (K) imaging in PET/MRI studies.

Procedures: WB dynamic PET/CT data were acquired for 14 patients. The CT images were utilized to generate attenuation maps (μ-map) of continuous attenuation coefficient values (A).

Randomized controlled trials comparing surgery to non-operative management in neurosurgery: a systematic review.

Background: A randomized controlled trial (RCT) remains the pinnacle of clinical research design. However, RCTs in neurosurgery, especially those comparing surgery to non-operative treatment, are rare and their relevance and applicability have been questioned. This study set out to assess trial design and quality and identify their influence on outcomes in recent neurosurgical trials that compare surgery to non-operative treatment.

Emergency Department-Based Palliative Interventions: A Novel Approach to Palliative Care in the Emergency Department.

Patients with cancer and palliative care needs frequently use the emergency department (ED). ED-based palliative services may extend the reach of palliative care for these patients. To assess the feasibility and reach of an ED-based palliative intervention (EPI) program.

Does whole-body Patlak F-FDG PET imaging improve lesion detectability in clinical oncology?

Purpose: Single-pass whole-body (WB) F-FDG PET/CT imaging is routinely employed for the clinical assessment of malignant, infectious, and inflammatory diseases. Our aim in this study is the systematic clinical assessment of lesion detectability in multi-pass WB parametric imaging enabling direct imaging of the highly quantitative F-FDG influx rate constant K, as a complement to standard-of-care standardized uptake value (SUV) imaging for a range of oncologic studies.

Methods: We compared SUV and K images of 18 clinical studies of different oncologic indications (lesion characterization and staging) including standard-of-care SUV and dynamic WB PET protocols in a single session.

Computed Tomography Angiography Versus Digital Subtraction Angiography for Postclipping Aneurysm Obliteration Detection.

Background and Purpose- Digital subtraction angiography has been used as the gold standard to confirm successful aneurysmal obliteration after aneurysm clipping procedures using titanium or cobalt alloy clips. Computed tomographic angiography is a newer, less invasive imaging technique also used to confirm successful aneurysmal obliteration; however, its use compared with digital subtraction angiography remains controversial. Methods- A comprehensive literature search was conducted on Pubmed, EMBASE, and Cochrane databases through November 6, 2017, for studies that evaluated postclipping aneurysm obliteration with both computed tomographic angiography and digital subtraction angiography.

Fertility after transsphenoidal surgery in patients with prolactinomas: A meta-analysis.

Pituitary prolactinomas in women often lead to amenorrhea, galactorrhea, or infertility. The purpose of this study was to evaluate the effectiveness of transsphenoidal surgery (TSS) in restoring fertility in women with proloactinomas. A systematic search of the literature was conducted in accordance with PRISMA guidelines through 6/13/2017.

Endocrine function and gland volume after endoscopic transsphenoidal surgery for nonfunctional pituitary macroadenomas.

Objective: Loss of pituitary function due to nonfunctional pituitary adenoma (NFPA) may be due to compression of the pituitary gland. It has been proposed that the size of the gland and relative perioperative gland expansion may relate to recovery of pituitary function, but the extent of this is unclear. This study aims to assess temporal changes in hormonal function after transsphenoidal resection of NFPA and the relationship between gland reexpansion and endocrine recovery.

Spindle cell oncocytoma of the pituitary gland.

Objective: The authors report the diagnosis, management, and outcomes of 6 cases of spindle cell oncocytoma (SCO) in an effort to guide clinical diagnosis and management of these uncommon lesions.

Methods: This study is a retrospective review of cases involving adult patients who underwent resection of pituitary lesions at the authors' institutions between January 2000 and October 2017. The authors identified patients with histopathological confirmation of SCO and collected clinical data, including preoperative, perioperative, and postoperative management, complications, and outcomes.

The Effectiveness of Antiepileptic Medications as Prophylaxis of Early Seizure in Patients with Traumatic Brain Injury Compared with Placebo or No Treatment: A Systematic Review and Meta-Analysis.

Background: The use of antiepileptic drugs (AEDs) to prevent early posttraumatic seizure (PTS) for patients with severe traumatic brain injury (TBI) is currently recommended, although published studies present contradictory results concerning the protective effect of AEDs.

Objective: The purpose of this study was to quantify the association between the use of prophylactic AEDs, particularly of the 4 main drugs of interest (phenytoin, levetiracetam, valproate, or carbamazepine) versus placebo or no treatment, and risk of early seizures after TBI.

Methods: A comprehensive search was performed on PubMed, Embase, Cochrane Library, and ClinicalTrials.

Development of a proforma to improve quality of handover of surgical patients at the weekend.

Rationale, Aims, And Objectives: The introduction of shift pattern of working in the medical profession has led to an increase in reliance on effective handover of patient information. We evaluated the use of a weekend handover proforma in General Surgical patients at a University Teaching Hospital.

Methods: A standardized weekend handover proforma was implemented.

Novel Quantitative PET Techniques for Clinical Decision Support in Oncology.

Quantitative image analysis has deep roots in the usage of positron emission tomography (PET) in clinical and research settings to address a wide variety of diseases. It has been extensively employed to assess molecular and physiological biomarkers in vivo in healthy and disease states, in oncology, cardiology, neurology, and psychiatry. Quantitative PET allows relating the time-varying activity concentration in tissues/organs of interest and the basic functional parameters governing the biological processes being studied.