World Neurosurg
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The utilization of locum tenens physicians in the United States has risen significantly as a stopgap for clinical practice needs, particularly in rural and other underserved areas. The difficulty in hiring new physicians to remote hospitals has resulted in the dependence of these institutions on locum tenens coverage. Here, we assess the quality and cost of neurosurgical care between locum and non-locum neurosurgeons in the United States, the first study in our knowledge to do so. ⋯ Among Medicare beneficiaries, there exists no difference in short-term complication rates, lengths of hospitalization, or costs between locum and non-locum neurosurgeons.
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Familial cerebral cavernous malformations (CCM) are among the most common vascular malformations of the central nervous system (CNS) and are linked to mutations on the specific genes CCM1/KRIT1, CCM2/MGC4607, and CCM3/PDCD10. We present the first report in the literature of a pharmaco-resistant epileptic patient harboring co-occurring pathogenic mutations within CCM2/MGC4607 and CCM1/KRIT1. ⋯ Although the CCM2/MGC460 variant seems to be the major contributor for the patient's CCM phenotype, the mutated CCM1/KRIT1 seems to act as a booster to CCM overall pathogenicity.
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To propose and validate a novel and comprehensive classification of lumbosacral spondylolysis and spondylolisthesis in the pediatric population according to surgical managements. ⋯ In our study, we proposed and validated a novel comprehensive classification of pediatric lumbosacral spondylolysis and spondylolisthesis. The pedicle screw-U rod system provided more benefits in the treatment of simple lumbosacral spondylolysis, and fusion from L5 to S2 combined with S2 screw would also benefit patients with high-degree spondylolisthesis.
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The neurosurgery match is among the most competitive across all specialties. As a result, numerical Step U.S. Medical Licensing Examination Step 1 scores have historically played a major role in selecting applicants for interviews. With the anticipated change in Step 1 scoring to pass/fail will come significant ramifications for how program directors (PDs) screen and select applicants. The present study characterized the responses of PDs to the change in U.S. Medical Licensing Examination Step 1 scoring and its consequences on medical students applying to neurosurgery. ⋯ Binary Step 1 scoring represents a significant change in medical student evaluations, with consequences for the neurosurgery residency application process. The results from the present study might help guide PD practices and prepare medical students for the anticipated changes to the application process.
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Few studies have examined the impact of teaching status and location on outcomes in subarachnoid hemorrhage (SAH). The objective of the present study was to compare mortality and functional outcomes among urban teaching, urban nonteaching, and rural centers for hospitalizations with SAH. ⋯ Rural and urban nonteaching centers have higher rates of mortality from SAH than urban teaching centers. Further study is necessary to understand drivers of these differences.