erformed in neurosurgery practice. The load of emergency neurosurgery procedures did not change throughout the three periods, which reflects the need to designate ample resources to cover emergencies. Notably, with strict screening for COVID -19 infections, neurosurgical procedures could be safely performed during the early pandemic phase. We recommend to restart performing neurosurgical procedures once the pandemic gets stabilized to avoid possible post pandemic health-care system intolerable overload.
The performance of cervical disc arthroplasty (CDA) in the spine with malalignment was unclear. The purpose of the study was to report the clinical and radiological outcomes of single-level CDA in the patients with preoperative reversible kyphosis (RK) and compare these results with a matched cohort of preoperative lordosis.
From 2014 to 2018, 36 patients with preoperative RK were matched with 229 patients with preoperative lordosis. The Japanese Orthopedic Association score, Neck Disability Index, Visual Analog Scale were used to evaluate clinical outcomes. Radiological evaluations included range of motion (ROM), C2-7 Cobb angle, shell angle (SA) at surgical level, functional spinal unit (FSU) angle and heterotopic ossification (HO).
The mean follow-up was 40.1 months. Both groups achieved significant improvements in clinical outcomes without significant intergroup differences. Before surgery, lordosis group had significantly greater C2-7 angle (9.5° vs -8.4°), SA (1.6° vs -3.7°), and FSU (2.9° vs -3.7ry and comparable clinical outcomes after CDA. Despite the remarkable improvements compared with preoperative values, the cervical alignment of RK group was still significantly inferior to that of lordosis group. More HO formation occurred in RK group. Based on these results, we did not recommend CDA to the patients with preoperative RK.
There is no dedicated study on outcome after meningioma surgery in neurofibromatosis type 2 (NF2) patients.
We processed the French Système National des Données de Santé (SNDS) database using an algorithm combining the type of surgical procedure and the International Classification of Diseases to retrieve cases of meningioma operated in NF2 patients between 2007 and 2017. Descriptive and survival analyses were performed.
This nationwide study found 184 patients who were operated on for 315 meningiomas over a 10-year period. 57.6 % were female, median age at first surgery was 40 years IQR[24.8-50.2] and 10.9 % were under 18 years. learn more Cranial convexity (23.4 %) and posterior skull base (16.8 %) were the most common locations. 89.7 % of the tumours were benign and 3.3 % malignant. 16.3 % of the patient received radiotherapy and 13.6 % stereotactic radiosurgery. Median follow-up was 6.3 years, IQR[5.3-7]. At data collection, 28 patients were dead (15.2 %) and median age at death was 41.7 years, IQR [32.7-50.4]ties and affected by a malignant meningioma.The aim of this study was to examine the cognitive processes involved in time contraction caused by a non-temporal distractor during the presentation of a temporal stimulus. To this aim 95 children aged 5 to 8 years old as well as 25 adults were first trained to discriminate, on two visual temporal bisection tasks, a short standard duration (400 or 600 ms) from a long one (1500 or 2400 ms). They had then to decide whether intermediate stimulus duration was more similar to the short or to the long standard duration. Furthermore, a 40 ms distractor taking the form of a 4 cm diameter rosette, either did or did not appear during the temporal stimulus. Participants' task was to report whether they had been exposed to the short or long standard duration. Subsequently, each subject's capacities in terms of memory skills (short term and working memory), as well as attention (selective attention and inhibition), were assessed using different neuropsychological tests. The results showed a shortening effect of the perceived time from non-distractor to distractor trials, which also turned out to attenuate with the age increase. Interestingly, inhibition was found to mediate this effect while the other cognitive variables were found to be of no significance. We therefore discussed the importance of categorizing two attentional interferences one related to attention control and the other to attentional resources.
To evaluate the cost-utility of treatment for macular edema in central retinal vein occlusion (CRVO) using intravitreal injections of the anti-vascular endothelial growth factor (VEGF) agents bevacizumab, ranibizumab, and aflibercept.
Decision analysis model of cost-utility.
Data from study participants in the Lucentis, Eylea, Avastin in Vein Occlusion (LEAVO) study.
A decision analysis of a disease simulation model was used to calculate comparative cost-utility of intravitreal bevacizumab (IVB), intravitreal ranibizumab (IVR), and intravitreal aflibercept (IVA) for the treatment of macular edema associated with CRVO based on data from the LEAVO study. Center for Medicare and Medicaid Services data were used to calculate associated modeled costs in a hospital- or facility-based and nonfacility setting from a third-party payer perspective, and societal costs also were calculated. Cost utility was calculated based on the preserved visual utility during the 2 years of the study and also by estimating utime cost per QALY while having a favorable cost utility compared with IVR.
In the treatment of macular edema in CRVO, IVB yields the best cost utility among the 3 anti-VEGF agents modeled. Intravitreal aflibercept maintains acceptable lifetime cost per QALY while having a favorable cost utility compared with IVR.Angiotensin II type 1 receptor antibodies (AT1R-Ab) are among the most investigated types of non-HLA antibodies in kidney transplantation. Our aim is to provide an update regarding the clinical relevance of AT1R-Ab by outlining their prevalence, testing methodology, mechanism of graft injury and the association with graft rejection phenotypes, the relationship with HLA-donor specific antibodies (DSA) and some therapeutic aspects. To accomplish these, we performed a literature review between 2005 and 2019, identifying 27 relevant studies for inclusion. The reported prevalence of these antibodies is widely variable in part related to testing variability and lack of a standardized threshold for positivity. Data available suggest that both pre-formed and de novo antibodies are associated with negative graft outcomes. The pathogenesis of AT1R-Ab mediated graft injury seems to be complement-independent. Different phenotypes of antibody-mediated, T-cell-mediated and vascular rejection have been described in patients with AT1R-Ab.learn more
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