UW Neurological Surgery Recent PubMed Publications

Due to demographic changes, a growing number of elderly patients with comorbidities will require spine surgery in the next decades. However, age and multimorbidity have been associated with considerably worse postoperative outcomes, and is often associated with surgical invasiveness. Full-endoscopic spine-surgery (FESS), as a cornerstone of contemporary minimally invasive surgery, has the potential to mitigate some of these disparities. Thus, we conducted an analysis of all FESS cases at a...

CONCLUSIONS: Students with concussion report a large number and type of symptoms that necessitate symptom-tailored academic accommodations. High school implementation of an evidence-based RTL program may aid in identifying and addressing many RTL needs after concussion, including potential identification of students with concussion who will require longer-term support.

CONCLUSIONS: Study data suggest a brief behavioral intervention for substance use and ART adherence may support employment among people with HIV living in a resource-constrained community. However, future research with larger sample sizes and longer-term follow ups is needed to replicate these findings.

BACKGROUND: Patients with non-traumatic intracerebral haemorrhage have a substantial risk of major adverse cardiovascular and cerebrovascular events, including ischaemic stroke, after surgery. The optimal timing of antiplatelet therapy after surgery for spontaneous intracerebral haemorrhage in patients at high risk of postoperative ischaemic events has not been characterised. We aimed to investigate the safety and efficacy of early versus late initiation of antiplatelet therapy after surgery for...

CONCLUSIONS: In this secondary analysis of the PROUD cluster randomized trial, after an added year of the intervention, OUD treatment continued to increase in intervention clinics compared with usual care. The treatment increase over 3 years exceeded that of the first 2 years, suggesting that implementation of the Massachusetts OBAT model leads to ongoing increases in OUD treatment among primary care patients in the third year of implementation.

CONCLUSION: Implementation facilitation, relative to a standard educational strategy, has a moderate-to-high likelihood of being considered cost-effective from a health care-sector perspective, depending on decisionmakers' willingness to pay for units of effectiveness.

CONCLUSIONS: Among patients with symptomatic subacute or chronic subdural hematoma with an indication for surgical evacuation, middle meningeal artery embolization plus surgery was associated with a lower risk of hematoma recurrence or progression leading to reoperation than surgery alone. Further study is needed to evaluate the safety of middle meningeal artery embolization in the management of subdural hematoma. (Funded by Medtronic; EMBOLISE ClinicalTrials.gov number, NCT04402632.).

Parkinson's disease (PD) is a chronic neurodegenerative disorder affecting the motor system, with non-classic symptoms such as sleep disturbances and respiratory dysfunctions. These issues reflect a complex pathophysiological interaction that severely impacts quality of life. Using a 6-hydroxydopamine (6-OHDA) mouse model of PD, we investigated these connections by analyzing sleep patterns and respiratory parameters during non-rapid eye movement (NREM) and rapid eye movement (REM) sleep. Our...

CONCLUSIONS: Quantitative smartphone pupillometry metrics may predict cerebral ischemia and ischemic penumbra in acute ischemic stroke patients with large vessel occlusion prior to intervention.

CONCLUSION: Collectively, these data support the development of MTX-101 for the treatment of autoimmune diseases.

Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, is a rare autoimmune disorder characterized by necrotizing vasculitis affecting small to medium-sized vessels. This condition most commonly affects the lungs, kidneys, and upper respiratory tract. Early recognition and treatment are critical to prevent severe complications and improve prognosis. This report presents the case of a 48-year-old male with GPA, with primary pulmonary and articular involvement, who...

An evaluation was conducted to predict the economic and clinical burden of vaccinating all immunocompromised (IC) individuals aged ≥30 years with mRNA-1273 variant-adapted COVID-19 vaccines versus BNT162b2 variant-adapted vaccines in Fall 2023 and Spring 2024 in France. The number of symptomatic SARS-CoV-2 infections, hospitalizations or deaths due to COVID-19, and long COVID cases, costs and quality-adjusted life years (QALYs) were estimated using a static decision-analytic model. Predicted...

CONCLUSIONS: This study is the first to demonstrate the risks associated with the duration of catheter use during MT and to propose strategies to mitigate these risks in AIS.

The Von-Meyenburg complex, also known as biliary hamartomas, are benign malformations of the intrahepatic bile ducts. Typically identified incidentally, these lesions are generally asymptomatic and have no pathological significance. However, their imaging characteristics can mimic malignancy, and they possess a rare potential for progression to hepatocellular carcinoma. Familial clusters suggest a potential genetic basis, with the polycystic kidney and hepatic disease 1 (PKHD1) gene most...

Tail-specific proteases (Tsp) are members of a widely distributed family of serine proteases that commonly target and process periplasmic proteins in Gram-negative bacteria. The obligately intracellular, Gram-negative Chlamydia encode a highly conserved Tsp homolog whose target and function are unclear. We identified a Chlamydia muridarum mutant with a nonsense mutation in tsp. Differentiation of the tsp mutant elementary bodies into vegetative reticulate bodies was delayed at 37°C and...

In congenital stationary night blindness, type 2 (CSNB2)-a disorder involving the Ca(v)1.4 (L-type) Ca^(2+) channel-visual impairment is mild considering that Ca(v)1.4 mediates synaptic release from rod and cone photoreceptors. Here, we addressed this conundrum using a Ca(v)1.4 knockout (KO) mouse and a knock-in (G369i KI) mouse expressing a non-conducting Ca(v)1.4. Surprisingly, Ca(v)3 (T-type) Ca^(2+) currents were detected in cones of G369i KI mice and Ca(v)1.4 KO mice but not in cones of...

CONCLUSIONS: RL-IPostC tends to promote functional independence and reduces infarct growth and cerebral edema in patients with acute ischemic stroke post-reperfusion.

BACKGROUND: In the United States, most (~ 70%) annual newly diagnosed HIV infections are among substance-using sexual minority men (SMM) and gender minority transgender women (trans women). Trans women and SMM are more likely to report or be diagnosed with a substance use disorder (SUD) than their cisgender or heterosexual counterparts and the presence of an SUD substantially increases the risk of HIV infection in both groups. Although Pre-Exposure Prophylaxis (PrEP) is highly effective,...

Perfluorooctanoic acid (PFOA) has been widely documented to affect various aspects of health, including development, metabolism and neuronal function in a variety of organisms. Despite numerous reports detailing these effects, a comprehensive mechanistic model remains elusive, especially with regard to the long-term effects of PFOA, as it bioaccumulates in food chains with a long half-life. In this study, we evaluated the impact of PFOA on several critical physiological states of Drosophila...

Cerebrospinal fluid (CSF) plays a critical role in the healthy function of the brain, yet the mechanics of CSF flow remain poorly understood. Computational fluid dynamics is a powerful tool capable of resolving the spatiotemporal evolution of CSF pressures and velocities, but technical and methodological limitations have limited the clinical use of CFD to date. With improvements in medical imaging, computational power, and machine learning, however, CFD may be on the cusp of breaking through...