World Neurosurg
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The ongoing trend of societal evolution in contemporary civilization has allowed increased inclusion of heterogenous identity groups into fields, such as neurosurgery, where certain groups have traditionally been underrepresented. In regard to the field of neurosurgery, the increasing recognition of the disparities faced by women is illustrated by a growing body of academic literature. ⋯ Recognition in societal evolutionary trends as evidenced by academic activity has shown increased focus on the explicit and intrinsic biases faced by women in neurosurgery. Recent years have seen significant increases in published reports concerning the subject, as well as rising academic impact per a given report. This phenomenon is speculated to continue, and understanding to broaden as societal perception continues to develop.
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Meta Analysis
Outcomes of Pre-injury Utilization of Statins in Patients with Traumatic Brain Injury: A Systematic review and Meta-analysis.
No completely effective pharmacotherapies have been developed to improve the outcomes of traumatic brain injury (TBI). Given the reporting of cohort studies suggesting that preinjury statin use may reduce TBI-associated mortality, this study aimed to evaluate the effects of statin use in patients with TBI. ⋯ Preinjury statin use may contribute to mortality reduction in patients with TBI, whereas statin withdrawal might increase mortality. In clinical management, statin use should not be discontinued after TBI.
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We investigated the effects of different doses of pregabalin on the pathophysiologic changes in early brain injury after subarachnoid hemorrhage (SAH) in rats. ⋯ Although the antioxidant effect was significant with the lower dose of pregabalin, the anti-inflammatory effects via vasodilatation were more marked with the higher dose. Significant improvements in the histopathological changes were observed with the higher dose of pregabalin. The dose-dependent effects of pregabalin on SAH should be evaluated in animal studies as a function of time and in the acute and chronic phases.
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Mechanical thrombectomy is a proven treatment for large-vessel ischemic stroke with improved functional outcomes compared with intravenous thrombolytics. Access to thrombectomy-capable sites varies greatly by geography, often necessitating interhospital transfer of patients who first present to hospitals unable to provide thrombectomy. The purpose of this meta-analysis was to examine the impact of interhospital transportation on patient outcomes to better inform recommendations for prehospital protocols. ⋯ This meta-analysis represents the largest pooled population examined to date to assess how interfacility transportation to thrombectomy-capable sites affects patient outcomes. Our results indicate that direct admission is a significant predictor of excellent functional outcome. The findings presented here can be used to better inform quality improvement projects to streamline access to facilities providing endovascular mechanical thrombectomy capabilities.