World Neurosurg
-
Observational Study
Antithrombotic medication use and misuse among patients with intracranial hemorrhage: a 16-year Lebanese single-center experience.
The use of antithrombotic medication (ATM) frequently is reported in patients with intracranial hemorrhage (ICH) and is associated with increased mortality. Unfortunately, ATMs sometimes are prescribed and/or used inappropriately. We sought to determine the rate of ATM misprescription/misuse among patients with ICH in a single-center retrospective study. ⋯ In this Lebanese cohort of patients with ICH, the 24.5% rate of ATM misprescription and/or misuse is highly alarming and the origin of this problem is likely multifactorial. Immediate measures should be undertaken, and efforts should be focused on regaining tight control of ATM prescription and fulfillment, ensuring good patient education, and offering more vigilant oversight on physician licensure.
-
Pediatric neurosurgical cases have been identified as an important target for impacting health disparities in Uganda, with over 50% of the population being less than 15 years of age. The objective of the present study was to evaluate the effects of the Duke-Mulago collaboration on pediatric neurosurgical outcomes in Mulago National Referral Hospital. ⋯ Our data show the provision of more complex neurological procedures does not necessitate improved outcomes. Rather, combining these higher-level procedures with essential pre- and postoperative care and continued efforts in health system strengthening for pediatric neurosurgical care throughout Uganda will help to address and decrease the burden throughout the country.
-
To develop modified finite element models to simulate degenerative lumbar scoliosis (DLS) based on the normal lumbar spine model and to investigate the facet joint force of the DLS. ⋯ With the asymmetric loading, facet joints compressive deformation appears on the concave side, and it decreases in the effect of the facet joints to limit the vertebral rotation and listhesis. Asymmetric loading on facet joint contact forces accelerates asymmetry in the lumbar spine.
-
The correct timing and technique of neural tube defect (NTD) repairs significantly decrease the morbidity and mortality of NTD cases. However, infections related to the surgery are still common. We investigated the effects of topical rifampin combined with routine prophylaxis in newborns with open NTDs. ⋯ The use of topical rifampin is an easy and effective method for reducing SSIs and meningitis/VP shunt infections related to NTD surgery.