Neurosurgery
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The origin of syrinx fluid is controversial. ⋯ Transparenchymal bulk flow of CSF from the subarachnoid space to syrinx occurs in Chiari I malformation-related syringomyelia and spinal obstruction-related syringomyelia. Before surgery, more subarachnoid contrast entered syringes associated with CSF pathway obstruction than with tumor, consistent with syrinx fluid originating from the subarachnoid space in Chiari I malformation and spinal obstruction-related syringomyelia and not from the subarachnoid space in tumor-related syringomyelia. Decompressive surgery opened subarachnoid CSF pathways and reduced contrast entry into syringes associated with CSF pathway obstruction.
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Stereoelectroencephalography (SEEG) has been shown to be a valuable tool for the anatomoelectroclinical definition of the epileptogenic zone (EZ) in patients with medically refractory epilepsy considered for surgery (RES patients). In Spain, many of those patients are not offered this diagnostic procedure. ⋯ SEEG is a cost-effective technology in RES patients when compared to no SEEG intervention.
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Physicians are poorly trained in balancing the demands of a career in medicine and maintaining personal health. Physician burnout occurs due to demanding hours and psychological conditions unique to the field. Programs that address overall well-being early in residency are necessary to prevent physician burnout and promote physician mental health. ⋯ Residency-incorporated wellness programs are achievable and can benefit resident mental health. Lack of a control group limits the interpretation of the results. Programs such as these may be implemented to promote well-being and combat physician burnout and its associated mental health abnormalities.