Physical Health-Related Quality of Life and Postsurgical Outcomes in Brain Tumor Resection Patients.

Background Patient-reported outcome measures (PROMs) have gained traction in assessing patients' health around surgery. Among these, the 29-item Patient-Reported Outcomes Measurement Information System (PROMIS-29) is a widely accepted tool for evaluating overall health, yet its applicability in cranial neurosurgery remains uncertain. Objective This study aimed to evaluate the predictive value of preoperative PROMIS-29 scores for postoperative outcomes in patients undergoing brain tumor resection. Materials and Methods We identified adult patients undergoing brain tumor resection at a single neurosurgical center between January 2018 and December 2021. We analyzed physical health (PH) summary scores to determine optimal thresholds for predicting length of stay (LOS), discharge disposition (DD), and 30-day readmission. Bivariate analyses were conducted to examine the distribution of PH scores based on patient characteristics. Multivariate logistic regression models were employed to assess the association between preoperative PH scores and short-term postoperative outcomes. Results Among 157 patients (mean age 55.4 years, 58.0% female), 14.6% exhibited low PH summary scores. Additionally, 5.7% experienced prolonged LOS, 37.6% had nonroutine DDs, and 19.1% were readmitted within 30 days. Bivariate analyses indicated that patients with low PH summary scores, indicating poorer baseline PH, were more likely to have malignant tumors, nonelective admissions, and adverse outcomes. In multivariate analysis, low PH summary scores independently predicted increased odds of prolonged LOS (odds ratio [OR] = 6.09, p = 0.003), nonroutine DD (OR = 4.25, p = 0.020), and 30-day readmission (OR = 3.93, p = 0.020). Conclusion The PROMIS-29 PH summary score serves as a valuable predictor of short-term postoperative outcomes in brain tumor patients. Integrating this score into clinical practice can enhance the ability to anticipate meaningful postoperative results.

Adhesive surface electrodes versus needle-based neuromonitoring in lumbar spinal surgery.

Background: The relative safety and more widespread utility of an adhesive surface electrode-based neuromonitoring (ABM) system may reduce the time and cost of traditional needle-based neuromonitoring (NBM). Methods: This retrospective cohort review included one- and two-level transforaminal lumbar interbody fusion procedures (2019-2023). The primary variables studied included were time (in minutes) from patient entry into the operating room (OR) to incision, time from patient entry into the OR to closure, and time from incision to closure. Univariate and bivariate analyses were performed to compare the outcomes between the ABM (31 patients) and NBM (51 patients) modalities. Results: We found no significant differences in the time from patient entry into the OR to incision (ABM: 71.8, NBM: 70.3, P = 0.70), time from patient entry into the OR to closure (ABM: 284.2, NBM: 301.7, P = 0.27), or time from incision to closure (ABM: 212.4, NBM: 231.4, P = 0.17) between the two groups. Further, no patients from either group required reoperation for mal-positioned instrumentation, and none sustained a new postoperative neurological deficit. The ABM approach did, however, allow for a reduction in neurophysiologist-workforce and neuromonitoring costs. Conclusion: The introduction of the ABM system did not lower surgical time but did demonstrate similar efficacy and clinical outcomes, with reduced clinical invasiveness, neurophysiologist-associated workforce, and overall neuromonitoring cost compared to NBM.

Intracranial meningeal melanocytoma: a case report and literature review.

Primary intracranial melanocytoma is an uncommon benign pigmented tumor arising from leptomeningeal melanocytes. Neuroimaging characteristics of central nervous system melanocytoma are distinct from similarly presenting intracranial neoplasms and can aid in diagnosis prior to histopathological examination. In rare cases, there may be more than one lesion present. We report a case of a 19-year-old woman presenting with progressively worsening headaches, nausea, emesis, and generalized weakness of 2 months. Imaging revealed tumors in the parietal and ipsilateral medial temporal lobe. The patient underwent gross total resection of the parietal lesion which histopathological assessment revealed to be primary intracranial meningeal melanocytoma. This case highlights the utility of specific imaging criteria such as diffusely increased T1 signal without enhancement in the initial diagnostic evaluation of intracranial melanocytoma. We also describe the clinical characteristics, management strategy, and histopathological features of a rare case of a patient with multiple primary intracranial melanocytoma lesions.

Lower mental health related quality of life precedes dementia diagnosis: findings from the EPIC-Norfolk prospective population-based study.

Lower Health Related Quality of Life (HRQoL) precedes dementia in older adults in the USA. We explore prospective associations between HRQoL and dementia in British adults in mid and late-life, when interventions to optimise cognitive ageing may provide benefit. 7,452 community-dwelling participants (57% women; mean age 69.3 ± 8.3 years) attended the European Prospective Investigation of Cancer-Norfolk study's third health check (3HC) and reported their HRQoL using Short-Form 36 (SF-36). Cox Proportional Hazard regression models explored associations between standard deviation differences in baseline Physical Component (PCS) and Mental Component Summary (MCS) scores, as well as eight SF-36 sub-scales (physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health), and incident dementia over ten years. Logistic regression models explored cross-sectional relationships at the 3HC between HRQoL and objective global cognitive function (n = 4435; poor cognition = lowest performance decile). The cohort was examined as a whole and by age-group (50-69, ≥ 70), considering socio-demographics and co-morbidity. Higher MCS scores were associated with lower chance of incident dementia (Hazard Ratio [HR] = 0.74, 95% CI 0.68-0.81) and lower odds of poor cognition (Odds Ratio [OR] = 0.82, 0.76-0.89), with findings similar by age-group. Higher PCS scores were not associated with dementia in the whole cohort (HR = 0.93, 0.84-1.04) or considering age-groups; and were only associated with poor cognition in younger participants (OR = 0.81, 0.72-0.92). Similarly, associations between higher scores on subscales pertaining to mental, but not physical, HRQoL and lower dementia incidence were observed. Lower mental HRQoL precedes dementia diagnosis in middle-aged and older British adults.

Heat Inactivation of Garlic (Allium sativum) Extract Abrogates Growth Inhibition of HeLa Cells.

The potential anticancer properties of garlic (Allium sativum) may depend on the method of preparation and its storage. Storage of garlic has not been thoroughly investigated to determine whether anticancer properties are retained. Garlic was prepared and processed to mimic normal options for storage and preparation for consumption. Cytotoxicity was determined by crystal violet assay and mechanisms of cytotoxicity were established by microscopy, SDS-PAGE, and Western immunoblotting. Significant (P < 0.0001) cytotoxicity was observed in all preparations, except with boiled (cooked) garlic. Depending on the method of storage, garlic extract induced either type I or type II programmed cell death, detectable by caspase 9 cleavage, or Poly (adenosine diphosphate-ribose) polymerase (PARP) cleavage and LC3-II accumulation, respectively. The conflicting literature on the anticancer properties of garlic may be explained by differences in processing and storage. This study has highlighted that the potency of the antiproliferative properties of cooked garlic, compared to the uncooked form, is diminished in HeLa cells.