Radiation-induced cavernous malformation after stereotactic radiosurgery for cavernous sinus meningioma: a case report

xlomafota.13 shared this article with you from Inoreader Radiation-induced cavernous malformation after stereotactic radiosurgery for cavernous sinus meningioma: a case report Via Latest Results for BMC Neurology Abstract Background Radiation-induced cavernous malformation (RICM) is a rare sequela of stereotactic radiosurgery (SRS) treatment of intracranial tumors. To date, no study reported on RICM after SRS for meningiomas originating from the skull base. The relationship between locus of initial meningioma and RICM has not been studied. Case presentation A 57-year-old woman presented with persistent headaches and blepharoptosis at initial episode. MRI disclosed a right parasellar lesion, diagnosed as a cavernous sinus meningioma (CSM). After receiving a single-fractionated SRS, headache relieved, but blepharoptosis did not significantly improve. Three years and three months later, she returned with headaches and dizziness. MRI showed an enlarged CSM. Moreover, a new mass-like lesion, suspected hemangioma, appeared in the nearby right temporal lobe. After surgical removal of the new lesion and the CSM, the patient's neurological symptoms significantly improved. Pathology confirmed CSM and temporal RICM. Conclusions We report the first rare case of RICM occurring after SRS for CSM. The RICM may be in the same region as the initial tumor. Surgical intervention was preferred for symptomatic RICM and initial meningioma. We recommend long-term regular followup MRIs for patients with meningioma after SRS treatment. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Solitary juxtacortical lesion associated with anti-N-methyl-D-aspartate receptor encephalitis: a case report

xlomafota.13 shared this article with you from Inoreader Solitary juxtacortical lesion associated with anti-N-methyl-D-aspartate receptor encephalitis: a case report Via Latest Results for BMC Neurology Abstract Background Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a severe autoimmune encephalitis mediated by anti-NMDA receptor antibodies. Brain MRI manifestations vary and are non-specific. If there are any lesions, they tend to be diffusely or multifocally distributed. Solitary lesion is relatively rare. Case presentation We report a 16-year-old girl who initially presented with focal seizures but developed severe psychiatric and extrapyramidal symptoms later on. Brain MRI revealed a solitary juxtacortical demyelinating lesion in the left frontal lobe. No enhancement was noted. Electroencephalogram captured epileptiform discharges in the same region. NMDAR IgGs were tested positive in the serum and cerebrospinal fluid. Corticosteroid and intravenous IgG were administered and the patient completely recovered. Brain MRI revealed a fainter lesion in the left frontal lobe. Conclusion In very rare instances, anti-NMDA receptor encephalitis can present with a solitary brain lesion. A full panel of antibodies for autoimmune encephalitis is the key leading to the diagnosis. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Prehabilitation Programs Improve Exercise Capacity Before and After Surgery in Gastrointestinal Cancer Surgery Patients: A Meta-Analysis

xlomafota.13 shared this article with you from Inoreader Prehabilitation Programs Improve Exercise Capacity Before and After Surgery in Gastrointestinal Cancer Surgery Patients: A Meta-Analysis Via Latest Results for Journal of Gastrointestinal Surgery Abstract Introduction Prehabilitation programs or interventions are employed prior to surgery with the aim to optimize the patient before surgery and to improve their physiologic ability to recover from surgery. Components of these programs often include exercise, nutritional supplementation, and psychological interventions. This meta-analysis examines the impact of prehabilitation programs on both surgical and patient outcomes among gastrointestinal (GI) cancer patients undergoing surgery. Methods A comprehensive literature search was conducted to identify all published randomized control trials (RCT) evaluating the use of prehabilitation programs (with one or more interventions) in GI cancer surgery patients. Outcomes assessed were 6-min walk distance (6MWD), postoperative complications, major complications (as defined as Clavien Dindo grade ≥ 3), surgical site infections (SSI), pneumonia, length of stay (LOS), 30-day readmission, and mortality. Results Eleven RCTs including 929 patients (475 prehabilitation program and 454 controls) were analyzed. Prehabilitation programs were associated with statistically significant improvements in 6MWD between baseline and immediately prior to surgery (MD = 32.542 m; 95% CI, 10.774–54.310; p = 0.003) and 4–8 weeks after surgery (MD = 48.220 m; 95% CI, 1.532–94.908; p = 0.043) compared with patients who did not receive prehabilitation programs. Similar rates of postoperative complications, major complications, SSI, pneumonia, 30-day readmission, and mortality, as well as LOS, were observed (p > 0.05). Conclusions Prehabilitation programs improve exercise capacity both before and after surgery, with no significant difference in LOS, or rates of postoperative complications, 30-day readmission, and mortality. Future studies assessing the different components of prehabilitation programs to identify the most beneficial interventions are required. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Quality Versus Costs Related to Gastrointestinal Surgery: Disentangling the Value Proposition

xlomafota.13 shared this article with you from Inoreader Quality Versus Costs Related to Gastrointestinal Surgery: Disentangling the Value Proposition Via Latest Results for Journal of Gastrointestinal Surgery Abstract Background There has been a dramatic increase in worldwide health care spending over the last several decades. Operative procedures and perioperative care in the USA represent some of the most expensive episodes per patient. In view of both the rising cost of health care in general and the rising cost of surgical care specifically, policymakers and stakeholders have sought to identify ways to increase the value—improving quality of care while controlling (or diminishing) costs. In this context, we reviewed data relative to achieving the "value proposition" in the delivery of gastrointestinal surgical care. Methods The National Library of Medicine online repository (PubMed) was text searched for human studies including "cost," "quality," "outcomes," "health care," "surgery," and "value." Results from this literature framed by the Donabedian conceptual model (identifying structures, processes, and outcomes), and the resulting impact of efforts to improve quality on costs. Results The relationship between quality and costs was nuanced. Better quality care, though associated with better outcomes, was not always reported as concomitant with low costs. Moreover, some centers reported higher costs of surgical care commensurate with higher quality. Conversely, higher costs in health care delivery were not always linked to improved outcomes. While higher quality surgical care can lead to lower costs, higher costs of care were not necessarily associated with better outcomes. Strategies to improve quality, reduce cost, or achieve both simultaneously included regionalization of complex operations to high-volume centers of excellence, overall reduction in complications, introducing evidence-based improvements in perioperative care pathways including as enhanced recovery after surgery (ERAS), and elimination of inefficient or low-value care. Conclusions The relationship between quality and cost following gastrointestinal surgical procedure is complex. Data from the current study should serve to highlight the various means available to improve the value proposition related to surgery, as well as encourage surgeons to become more engaged in the national conversation around the Triple Aim of better health care quality, lower costs, and improved health care outcomes. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Performing Omentectomy During Gastrectomy Does Not Improve Survival: a Multi-Center Analysis of 471 Patients with Gastric Adenocarcinoma

xlomafota.13 shared this article with you from Inoreader Performing Omentectomy During Gastrectomy Does Not Improve Survival: a Multi-Center Analysis of 471 Patients with Gastric Adenocarcinoma Via Latest Results for Journal of Gastrointestinal Surgery View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effectiveness of surgical fixation for rib fractures in relation to its timing: a retrospective Japanese nationwide study

xlomafota.13 shared this article with you from Inoreader Effectiveness of surgical fixation for rib fractures in relation to its timing: a retrospective Japanese nationwide study Via Latest Results for European Journal of Trauma and Emergency Surgery Abstract Purpose The effectiveness of surgical rib fixation is currently controversial, partly because of differences in timing. We used a Japanese nationwide database to investigate the effectiveness of surgical rib fixation in relation to its timing. Methods We used the Japanese Diagnosis Procedure Combination database to identify patients with rib fractures who underwent mechanical ventilation from 1 July 2010 to 31 March 2018. We performed overlap weight analysis to compare in-hospital outcomes between patients who had and had not undergone surgical rib fixation within 3, 6 or 10 days after admission. The primary outcomes were duration of mechanical ventilation and post-rib fixation length of hospital stay. The secondary outcomes were tracheostomy, post-admission pneumonia and all-cause 28-day in-hospital mortality. Results We identified 8922 eligible patients. Surgical rib fixation within 3 days after admission was associated with shorter duration of mechanical ventilation (percent difference, − 42.9%; 95% confidence interval, − 57.4 to − 23.3) and shorter hospital stay (percent difference, − 19.6%; 95% confidence interval, − 31.8 to − 5.2). There were no significant differences between the groups in tracheostomy (risk difference, − 0.04; 95% confidence interval, − 0.15 to 0.07), post-admission pneumonia (risk difference, − 0.04; 95% confidence interval, − 0.13 to 0.05) or all-cause 28-day in-hospital mortality (risk difference, − 0.02; 95% confidence interval, − 0.07 to 0.03). However, there were no significant differences in any in-hospital outcomes between those who had and had not undergone rib fixation within 6 or 10 days after admission. Conclusion Early surgical rib fixation was associated with better in-hospital outcomes, whereas later surgical rib fixation was not. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of model calibration on hydrological and water resources management simulations under climate change in a semi-arid watershed

xlomafota.13 shared this article with you from Inoreader Effects of model calibration on hydrological and water resources management simulations under climate change in a semi-arid watershed Via Latest Results for Climatic Change Abstract Semi-arid regions are known for erratic precipitation patterns with significant effects on the hydrological cycle and water resources availability. High temporal and spatial variation in precipitation causes large variability in runoff over short durations. Due to low soil water storage capacity, base flow is often missing and rivers fall dry for long periods. Because of its climatic characteristics, the semi-arid north-eastern region of Brazil is prone to droughts. To counter these, reservoirs were built to ensure water supply during dry months. This paper describes problems and solutions when calibrating and validating the eco-hydrological model SWIM for semi-arid regions on the example of the Pajeú watershed in north-eastern Brazil. The model was calibrated to river discharge data before the year 1983, with no or little effects of water management, applying a simple and an enhanced approach. Uncertainties result mainly from the meteorological data and observe d river discharges. After model calibration water management was included in the simulations. Observed and simulated reservoir volumes and river discharges are compared. The calibrated and validated models were used to simulate the impacts of climate change on hydrological processes and water resources management using data of two representative concentration pathways (RCP) and five earth system models (ESM). The differences in changes in natural and managed mean discharges are negligible (< 5%) under RCP8.5 but notable (> 5%) under RCP2.6 for the ESM ensemble mean. In semi-arid catchments, the enhanced approach should be preferred, because in addition to discharge, a second variable, here evapotranspiration, is considered for model validation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Liver graft harbouring hydatid disease: how far can we extend our donor pool?

xlomafota.13 shared this article with you from Inoreader Liver graft harbouring hydatid disease: how far can we extend our donor pool? Via Latest Results for Parasitology Research Abstract As the current demand for liver transplantation exceeds our donor pool, the donor search is shifted towards the extended donor criteria. The livers harbouring hydatid disease are a controversial source of grafts. We report the use of a liver graft harbouring hydatid disease in urgent liver transplantation in a patient with autoimmune hepatitis. Corroborated with previous experiences, we show that the liver grafts harbouring hydatid cysts provide a rare but valuable source of organs. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Warmer incubation temperature influences sea turtle survival and nullifies the benefit of a female-biased sex ratio

xlomafota.13 shared this article with you from Inoreader Warmer incubation temperature influences sea turtle survival and nullifies the benefit of a female-biased sex ratio Via Latest Results for Climatic Change Abstract Climate change plays a key role in the development and survival of oviparous ectotherms such as sea turtles. Higher environmental temperatures are expected to lead to increased production of female hatchlings and potential feminization of many populations, as well as reduced hatching success and hatchling fitness. We investigated how different sand temperatures affect sea turtle embryo mortality, hatchling phenotype, and hatchling predation during their crawl to the sea. The study was conducted in Cabo Verde, the only rookery of the endangered loggerhead turtle (Caretta caretta) in the Eastern Atlantic. During three consecutive seasons (2015–2017), 240 loggerhead clutches were exposed to three different incubation temperature regimes created by different sand colours. The warm treatment (mean = 32.3 °C ± 0.5) killed 33% more embryos than the cold treatment (mean = 29.7 °C ± 0.6). Hatchlings from the warm treatment were mos tly females, smaller in size, and had lower performance. Hatchling predation by ghost crabs during seaward transit was higher for hatchlings incubated in the warm treatment. Combining embryo mortality and hatchling predation, the rate of female hatchling arrival at the sea was more than twice as high in the cold treatment (34.4 females per 100 eggs) than in the warm treatment (16.0 females per 100 eggs). This increase in mortality caused by warmer incubation temperatures may cancel any potential benefit of a female-biased sex ratio. Conservation planners should consider behavioural adaptations and the potential dispersal of the nesting areas to colder areas to increase resilience of loggerhead turtles to climate change. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Gas aggregated Ag NPs as a matrix for small molecules: a study on natural amino acids

xlomafota.13 shared this article with you from Inoreader Gas aggregated Ag NPs as a matrix for small molecules: a study on natural amino acids Via Latest Results for Journal of Nanoparticle Research Abstract The use of nanomaterials as a matrix for soft ionization mass spectrometry has been investigated and reported various times. Under certain conditions, measurements of samples containing small molecules enhanced by nanomaterials have better sensitivity compared with other methods. Nanoscaled Ag prepared by various methods was reported as a substrate for surface-assisted LDI MS. Higher desorption and (in some cases) charge transfer through adduct formation with silver ion was reported. But primary ionization mechanism was through attachment of proton or alkali ion. Our approach is to overcoat the sample by Ag nanoparticles (the so-called nanoparticle-assisted LDI MS or nanoPALDI MS). As nanoparticles having adsorption maxima close to the laser wavelength, we expect an improvement in desorption enhancement, release of silver ions and (as a result of latter) increased adduct formation of [analyte+Ag]+ ions. The nanoparticles are produce d by gas aggregation under low-pressure, making the process homogeneous over relatively large areas, free from impurities, and absence of capping agent often presented in colloidal nanoparticles. This work reports the detection of natural amino acids with Ag nanoparticles as a matrix. We successfully detected all amino acids (as [analyte+Ag]+ ion), including in the mixtures of few amino acids. Moreover, a formation of other adducts, particularly [analyte+Ag3]+ and [analyte2+Ag]+ is reported. The differences in ion intensity ratios depending on amino acid types are discussed. The obtained results showed that laser ablation is more efficient for amino acids with hydrophobic, unique, and neutral side chains. Graphical abstract View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Hyperthermia, but not dehydration, alters the electrical activity of the brain

xlomafota.13 shared this article with you from Inoreader Hyperthermia, but not dehydration, alters the electrical activity of the brain Via Latest Results for European Journal of Applied Physiology Abstract Purpose Whole-body thermal and hydration clamps were used to evaluate their independent and combined impact on the electrical activity of the brain. It was hypothesised that those stresses would independently modify the electroencephalographic (EEG) responses, with those changes being greater when both stresses were superimposed. Methods Alpha and beta spectral data (eyes closed) were collected from the frontal, central-parietal and occipital cortices of both hemispheres in resting, healthy and habitually active males (N = 8; mean age 25 years). Three dehydration states were investigated (euhydrated and 3% and 5% mass decrements) in each of two thermal states (normothermia [mean body temperature 36.3 °C] and moderate hyperthermia [38.4 °C]). The combination of those passively induced states yielded six levels of physiological strain, with the EEG data from each level separately examined using repeated-measures ANOVA with planned contrasts. Results When averaged across the frontal cortices, alpha power was elevated relative to the occipital cortices during moderate hyperthermia (P = 0.049). Conversely, beta power was generally reduced during hyperthermia (P = 0.013). Neither the alpha nor beta power spectra responded to dehydration, nor did dehydration elevate the heat-induced responses (P > 0.05). Conclusion Moderate hyperthermia, but neither mild nor moderate dehydration, appeared to independently alter brain electrical activity. Moreover, the combination of moderate hyperthermia with 5% dehydration did not further increase those changes. That outcome was interpreted to mean that, when those states were superimposed, the resulting neurophysiological changes could almost exclusively be attributed to the thermal impact per se, rather than to their combined influences. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.