A Pilot Study of the Gut Microbiota in Spine Fusion Surgery Patients.

Background: The microbiome has been identified as a contributor to bone quality. As skeletal health is critical to success of orthopedic surgery, the gut microbiome may be a modifiable factor associated with postoperative outcomes. For spine fusion surgery in particular, bone formation and sufficient bone mineral density are essential for successful outcomes.

Knee Pain Is Not Always the Knee.

» Lumbar spine pathology is a known cause of referred pain to the lower extremities and should be investigated as a possible source of knee pain, especially with patients in their sixth decade.» While primary knee pathology is common, spinal pathology should always be considered in older patients presenting with knee pain, especially in atraumatic cases where knee imaging does not correlate with complaints or examination findings.» Lumbar (L) 3-4 pathology is most commonly affected in referred knee pain, with the 2 most common pathologies being spinal stenosis and disc herniation.

Re-optimizing the Time Frame for Classifying Cerebral Venous Sinus Thrombosis: An Unmet Need.

Cerebral venous thrombosis (CVT) is a rare and complex form of stroke, representing a small percentage of all stroke cases. The disease's clinical presentation is highly variable, involving a wide range of medical specialists due to its diverse manifestations. Over the past decade, significant advancements in understanding CVT have been made, particularly in light of the COVID-19 pandemic and subsequent vaccination efforts.

Pros and Cons of Inpatient SGLT2i Use for Hyperglycemia and Heart Failure.

Sodium-glucose cotransporter 2 inhibitors (SGLT2is), originally approved by the US Food and Drug Administration for glycemic control in type 2 diabetes mellitus (DM2), have shown substantial cardiovascular and renal benefits, leading to their expanded use in managing heart failure (HF) and chronic kidney disease in the outpatient setting. Despite these benefits, their use for inpatient hyperglycemia management is not universally endorsed due to safety concerns and inadequate data. However, emerging evidence suggests potential advantages of initiating SGLT2i treatment for patients during hospitalization in the setting of HF.

Identifying Predictors of Extended Intensive Care Unit Stay Following Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis: An Analysis of 101 ACS NSQIP Pediatric Participating Centers.

Background: While prolonged operative time and increased levels fused have been shown to increase the risk of prolonged intensive care unit (ICU) length-of-stay (LOS), studies are limited in guiding decision-making regarding the need for intensive care postoperatively. This is especially the case among the cohort of adolescent idiopathic scoliosis (AIS) patients undergoing posterior spinal fusion (PSF); associations between comorbidities and ICU LOS are not well-delineated.

Methods: AIS patients who underwent PSF from January 1st, 2016 to December 1st, 2016 at 101 participating centers were identified using the American College of Surgeons (ACS) National Surgical Quality Im-provement Project (NSQIP) Pediatric database.

Pain management in percutaneous nephrolithotomy - an approach rooted in pathophysiology.

Pain related to percutaneous nephrolithotomy (PCNL) is multifactorial and poorly elucidated. However, understanding the pathophysiology of pain can enable a practical approach to pain management, which can be tailored to each patient. A number of potential mechanisms underlie pain perception in PCNL, and these mechanisms can be leveraged at various points on the perioperative care pathway.

Chemotherapy-Related Cognitive Impairment and Changes in Neural Network Dynamics: A Systematic Review.

Background And Objectives: This systematic review aims to synthesize the current literature on the association between chemotherapy (CTX) and chemotherapy-related cognitive impairment (CRCI) with functional and structural brain alterations in patients with noncentral nervous system cancers.

Methods: A comprehensive search of the PubMed/MEDLINE, Web of Science, and Embase databases was conducted, and results were reported following preferred reporting items for systematic review and meta-analyses guidelines. Data on study design, comparison cohort characteristics, patient demographics, cancer type, CTX agents, neuroimaging methods, structural and functional connectivity (FC) changes, and cognitive/psychological assessments in adult patients were extracted and reported.

2024 HRS perspective on advancing workflows for CIED remote monitoring.

Cardiac implantable electronic devices (CIEDs) generate substantial data, often stored in image or PDF formats. Remote monitoring, now an integral component of patient care, places considerable administrative burdens on clinicians and staff, in large part due to the challenge of integrating these data seamlessly into electronic health records. Since 2006, the Heart Rhythm Society, in collaboration with the CIED industry, has led an initiative to establish a unified standard nomenclature.

The Effects of Osteopathic Manipulative Treatment on Arrhythmias: A Double-blind Randomized Controlled Trial in Patients with Cardiac Implantable Electronic Devices.

This double-blind randomized controlled trial investigated the effects of osteopathic manipulative treatment (OMT) on cardiac arrhythmias in patients with cardiac implantable electronic devices (CIEDs). Participants (n = 41) with CIEDs were randomly assigned to either the OMT group or the control group (light touch/sham) and received a one-time intervention. No significant change in arrhythmia burden was found in the 1 month following intervention ( = .

Effects of radiotherapy on the hippocampus and hippocampal neurogenesis: a systematic review of preclinical studies.

Purpose: A comprehensive literature review was undertaken to understand the effects and underlying mechanisms of cranial radiotherapy (RT) on the hippocampus and hippocampal neurogenesis as well as to explore protective factors and treatments that might mitigate these effects in preclinical studies.

Methods: PubMed/MEDLINE, Web of Science, and Embase were queried for studies involving the effects of radiation on the hippocampus and hippocampal neurogenesis. Data extraction followed the Animal Research Reporting of In Vivo Experiments (ARRIVE) guidelines, and a risk of bias assessment was conducted for the included animal studies using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) risk of bias tool.

Comparison of clinical and radiological outcomes of three-column lumbar osteotomies with and without interbody cages for adult spinal deformity.

Background Context: Correcting sagittal malalignment in adult spinal deformity (ASD) is a challenging task, often requiring complex surgical interventions like pedicle subtraction osteotomies (PSOs). Different types of three-column osteotomies (3COs), including Schwab 3, Schwab 4, Schwab 4 with interbody cages, and the "sandwich" technique, aim to optimize alignment and fusion outcomes. The role of interbody cages in enhancing fusion and segmental correction remains unclear.

Microvascular decompression: a contemporary update.

Background: Microvascular decompression (MVD) is the gold-standard surgical treatment for cranial nerve compression disorders, including trigeminal neuralgia (TN), hemifacial spasm (HFS), and glossopharyngeal neuralgia (GPN). This review synthesizes historical milestones, recent advances, and evolving techniques in MVD, with a primary focus on these conditions.

Methods: A comprehensive literature review was conducted using databases such as PubMed, SpringerLink, Google Scholar, BioMed Central, Scopus, and ScienceDirect.

Primary intrarenal hemangioma - A series of 39 cases.

Intrarenal hemangiomas lack concise clinicopathologic information, due to the predominance of single case reports and inclusion of other vascular neoplasms and hemangiomas of perirenal, hilar, and renal vein origin. Herein, in this multi-institutional study we evaluate clinicopathologic features of 39 intrarenal hemangiomas. The median age was 62 years (range = 27-94 years; 2:1 male to female ratio), with left-sided predominance (left = 21, right = 13; one case was bilateral).

The Estrogen-Immune Interface in Endometriosis.

Endometriosis is a gynecologic condition characterized by the growth of endometrium-like stroma and glandular elements outside of the uterine cavity. The involvement of hormonal dysregulation, specifically estrogen, is well established in the initiation, progression, and maintenance of the condition. Evidence also highlights the association between endometriosis and altered immune states.

Connectome imaging to facilitate preservation of the frontal aslant tract.

Supplementary motor area (SMA) syndrome is characterized by contralateral akinesia and mutism, and frequently occurs following resection of tumors involving the superior frontal gyrus. The frontal aslant tract (FAT), involved in functional connectivity of the supplementary area and other related large-scale brain networks, is implicated in the pathogenesis of, and recovery from, SMA syndrome. However, intraoperative neuromonitoring of the FAT is inconsistent and poorly reproducible, leading to a high rate of postoperative SMA syndrome.

Perseverance of Optimal Realignment is Associated With Improved Cost-utility in Adult Cervical Deformity Surgery.

Background: Early-term complications may not predict long-term success after adult cervical deformity (ACD) correction.

Objective: Evaluate whether optimal realignment results in similar rates of perioperative complications but achieves longer-term cost-utility.

Study Design: Retrospective cohort study.

Left Ventricular Assist Device Therapy in Cold and Dry Patients.

Background: Patients with end-stage heart failure and low pulmonary capillary wedge pressure are referred to as cold and dry and represent an understudied minority in whom the benefit of left ventricular assist device (LVAD) therapy is unclear.

Methods: Adults receiving LVADs between 2006 and 2017 in the Interagency Registry for Mechanically Assisted Circulatory Support database were classified as cold and wet (pulmonary capillary wedge pressure >15 mm Hg) and cold and dry (pulmonary capillary wedge pressure ≤15 mm Hg) based on pre-LVAD hemodynamics obtained via right heart catheterization. The primary outcome was 1-year survival.

Comparative Analysis of Outcomes in Adult Spinal Deformity Patients with Proximal Junctional Kyphosis or Failure Initially Fused to Upper Versus Lower Thoracic Spine.

Patients with proximal junctional kyphosis (PJK) or failure (PJF) may demonstrate disparate outcomes and recovery when fused to the upper (UT) versus lower (LT) thoracic spine. Few studies have distinguished the reoperation and recovery abilities of patients with PJK or PJF when fused to the upper (UT) versus lower (LT) thoracic spine. Adult spine deformity patients ≥ 18 yrs with preoperative and 5-year (5Y) data fused to the sacrum/pelvis were included.

Optimum diagnostic pathway and pathologic confirmation rate of early stage lung cancer: Results from the VIOLET randomised controlled trial.

Background: Pathologic confirmation of lung cancer influences treatment selection for suspected early-stage lung cancer. High pre-treatment tissue confirmation rates are recommended. We sought to define management and outcomes of patients undergoing surgery for primary lung cancer in a UK multi-centre clinical trial.

Patellar Instability After Total Knee Arthroplasty.

Patellar instability following total knee arthroplasty (TKA) is a rare, yet serious complication, potentially requiring revision surgery or resulting in chronic dysfunction. When encountered, it is paramount to understand the etiologies, diagnostic approaches, treatment options, and outcomes of the selected treatment. The most common cause of patella instability is improper positioning of components, leading to lateral maltracking of the patella.

P2Y12 inhibitors plus aspirin versus aspirin alone in patients with ischemic cerebrovascular events: An updated meta-analysis of randomized controlled trials.

Background: The efficacy and safety of P2Y12 inhibitors (P2Y12i) with aspirin in patients with non-cardioembolic ischemic cerebrovascular events remains a topic of ongoing debate. Therefore, we conducted an updated meta-analysis to compare these drugs with aspirin alone.

Methods: We systematically searched PubMed, Embase, and Cochrane Central for randomized controlled trials (RCTs) comparing the two treatment regimens in patients with ischemic cerebrovascular events.

The gap between surgeon goal and achieved sagittal alignment in adult cervical spine deformity surgery.

Objective: Malalignment following cervical spine deformity (CSD) surgery can negatively impact outcomes and increase complications. Despite the growing ability to plan alignment, it remains unclear whether preoperative goals are achieved with surgery. The objective of this study was to assess how good surgeons are at achieving their preoperative goal alignment following CSD surgery.