Articles: cations.
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Jugular paragangliomas (JPG) pose a surgical challenge because of their vascularity and complex location. Stereotactic radiosurgery (SRS) offers a minimally invasive management for patients with JPG. Our aim was to evaluate outcomes of Gamma Knife radiosurgery (GKRS) for the treatment of JPG over the long term. ⋯ As a minimally invasive management, GKRS proved to be a safe and effective treatment of JPG. GKRS should be considered both as an optimal primary management and as an early adjuvant strategy for residual or recurrent tumors after initial resection.
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The global average life expectancy has been increasing steadily as the quality of healthcare continues to improve. However, there is a paucity of data looking at surgical fixation of thoracolumbar spine fractures in patients ≥80 years (super-elderly). Aim of this study is to look at whether there is higher rate of complications from surgical fixation of thoracolumbar fractures in this group of patients. ⋯ The super-elderly had a higher incidence of osteoporosis and worse comorbidities, but there was no significant difference regarding implant complications, revision surgery required, or all-cause mortality. Hence, surgical fixation of thoracolumbar spine fractures in people older than 80 years should be considered despite their advanced age.
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Critical care medicine · Jan 2025
Transfusion Practices in Traumatic Brain Injury: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Balancing oxygen requirements, neurologic outcomes, and systemic complications from transfusions in traumatic brain injury (TBI) patients is challenging. This review compares liberal and restrictive transfusion strategies in TBI patients. ⋯ Our findings suggest that a liberal transfusion strategy results in better neurologic outcomes than a restrictive approach. Future research should examine the complication profile and the effects of using a 9 g/dL threshold. We advocate for revising current guidelines to establish 9 g/dL as the standard threshold for transfusions in TBI patients.
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Music has long been recognized as a noninvasive and cost-effective means of reducing pain. However, the selection of music for pain relief often relies on intuition rather than on a scientific understanding of the impact of basic musical attributes on pain perception. This study examines how a fundamental element of music-tempo-affects its pain-relieving properties. ⋯ Next, they were asked to rate painful thermal stimulations under 4 conditions: music modified to match participants' SPR, music modified to be 15% faster or 15% slower than participants' SPR, and silence. Results revealed that musical tempos matching participants' SPR produced stronger reductions in pain compared to faster or slower tempo conditions, supporting the hypothesis that musical tempo aligned with individual rates is optimal for reducing pain. These findings underscore the individual-specific effects of musical tempo on pain perception, offering implications for personalized pain management strategies.
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This narrative review discusses the mechanisms connecting gut dysbiosis to adverse clinical outcomes in critically ill patients and explores potential therapeutic strategies. ⋯ The microbiota plays an important role in shaping outcomes for critically ill patients. According to evidence, alterations in the gut and lung microbiota are associated with disease severity, mortality, and overall patient recovery. Evolving research opens possibilities for personalized medicine by tailoring treatments based on individual microbiota profiles, though clinical applications are still developing.