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1.
Neurosurg Rev ; 47(1): 546, 2024 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-39235672

RESUMO

This study evaluates contemporary wound closure techniques in spinal surgery, focusing on the efficacy of barbed sutures, skin staples, and negative-pressure wound therapy (NPWT), compared to traditional methods. Barbed sutures, like STRATAFIX™ Symmetric, and skin staples demonstrate significant advantages, including reduced wound closure time, lower infection rates, and improved surgical outcomes, particularly in multilevel or revisional procedures. In contrast, plastic surgery closures do not show a substantial reduction in postoperative complications despite being used in more complex cases. NPWT is highlighted as an effective adjunct therapy for managing surgical site infections and reducing the need for hardware removal. The findings suggest that while modern techniques offer clear benefits, traditional methods remain valuable in specific contexts. The review advocates for further research through large-scale, long-term studies and emphasizes the need for personalized wound closure strategies based on individual patient risk factors.


Assuntos
Infecção da Ferida Cirúrgica , Técnicas de Fechamento de Ferimentos , Humanos , Infecção da Ferida Cirúrgica/prevenção & controle , Procedimentos Neurocirúrgicos/métodos , Tratamento de Ferimentos com Pressão Negativa/métodos , Coluna Vertebral/cirurgia , Suturas , Cicatrização/fisiologia , Resultado do Tratamento
3.
Neurosurg Rev ; 47(1): 512, 2024 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-39212803

RESUMO

The study highlights that diffuse glioma, a prevalent type of brain tumor, affect approximately 100,000 individuals worldwide each year. IDH-mutant astrocytoma and oligodendrogliomas typically have a more favorable prognosis compared to IDH-wildtype glioblastomas. However, many IDH-mutant astrocytoma has the potential to progress to grade 4 glioblastomas, leading to a less favorable prognosis. In a recent investigation, Shumpei Onishi et al. examined the T2-FLAIR mismatch sign as a possible imaging biomarker for assessing CDKN2A status in non-enhancing IDH-mutant astrocytoma. The findings indicate that the T2-FLAIR mismatch sign is linked to CDKN2A-intact astrocytoma, providing a valuable tool for diagnostic and prognostic purposes. Additionally, the use of Indocyanine Green (ICG) for real-time visualization during neurosurgical procedures demonstrates potential, though it may have limitations in specificity. While these advancements offer promise in glioma management, there remains a critical need for larger, standardized studies to validate these findings and further improve treatment outcomes.


Assuntos
Astrocitoma , Neoplasias Encefálicas , Glioma , Isocitrato Desidrogenase , Mutação , Humanos , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/diagnóstico por imagem , Isocitrato Desidrogenase/genética , Astrocitoma/genética , Astrocitoma/diagnóstico por imagem , Glioma/diagnóstico por imagem , Glioma/genética , Imageamento por Ressonância Magnética/métodos , Biomarcadores Tumorais/genética , Prognóstico
4.
Neurosurg Rev ; 47(1): 489, 2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39187658

RESUMO

This study reviews lateral ventricular tumors (LVTs), which are rare brain lesions accounting for 0.64-3.5% of brain tumors, and the unique challenges they present due to their location and growth patterns. Once deemed inoperable, advancements in microneurosurgery, imaging, and tumor pathobiology have significantly improved treatment outcomes. This letter summarizes recent studies and key findings in the management of LVTs. Research by S.A. Maryashev et al. identified risk factors for early hemorrhagic complications following the surgical resection of lateral ventricular neoplasms, highlighting the significance of patient characteristics, tumor location, and surgical approach. The study found that factors such as gender, hydrocephalus, tumor blood flow, and Evans index correlate with a higher risk of hemorrhage, with the transcallosal approach having a greater risk compared to the transcortical approach. The utilization of navigation technologies, including fMRI, neuronavigation, and intraoperative brain mapping, has been shown to reduce surgical complications and enhance patient outcomes in the treatment of lateral ventricular meningiomas. Moreover, endoscopic and endoport-assisted endoscopic techniques have proven to be valuable in intraventricular tumor surgery, enabling minimally invasive procedures with better visualization and fewer complications. The integration of advanced surgical techniques, neuroimaging, and neurophysiological monitoring emphasizes the necessity of a multidisciplinary approach to optimize patient outcomes. To improve the study's validity and applicability, further research with larger sample sizes and advanced statistical analyses is needed. This letter advocates for the continued exploration of innovative surgical techniques and technologies to enhance the management of lateral ventricular tumors.


Assuntos
Neoplasias do Ventrículo Cerebral , Procedimentos Neurocirúrgicos , Humanos , Neoplasias do Ventrículo Cerebral/cirurgia , Procedimentos Neurocirúrgicos/métodos , Resultado do Tratamento , Neuronavegação/métodos
6.
Neurosurg Rev ; 47(1): 436, 2024 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-39145916

RESUMO

This study reviews recent progress in the surgical treatment of Rathke's cleft cysts (RCCs) and Sellar region meningiomas, based on findings from three key studies. RCCs are benign, fluid-filled remnants from pituitary gland development that are usually asymptomatic and found by chance. However, surgical intervention is needed when they become symptomatic or increase in size. Research by Stefan Linsler et al. and others examines various surgical methods, including transcranial keyhole and transsphenoidal techniques for RCCs, and endoscopic endonasal and supraorbital keyhole approaches for Sellar meningiomas. The results show that both transcranial keyhole and transsphenoidal surgeries for RCCs have high success rates with no recurrences over 5.7 years, although the keyhole approach has fewer complications. For Sellar meningiomas, the choice between endoscopic endonasal and supraorbital keyhole techniques should be based on tumor characteristics, highlighting the importance of surgeon proficiency in both methods. These studies emphasize the need for personalized treatment strategies tailored to patient and tumor characteristics and highlight the importance of ongoing surgical skill development and further research to refine minimally invasive techniques. This study highlights the crucial role of personalized surgical approaches in improving outcomes for patients with RCCs and Sellar region meningiomas.


Assuntos
Cistos do Sistema Nervoso Central , Neoplasias Meníngeas , Meningioma , Procedimentos Neurocirúrgicos , Sela Túrcica , Humanos , Meningioma/cirurgia , Cistos do Sistema Nervoso Central/cirurgia , Procedimentos Neurocirúrgicos/métodos , Neoplasias Meníngeas/cirurgia , Sela Túrcica/cirurgia , Neoplasias Hipofisárias/cirurgia , Resultado do Tratamento , Neuroendoscopia/métodos
7.
Neurosurg Rev ; 47(1): 457, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39168924

RESUMO

Spinal surgery, crucial for correcting structural abnormalities, involves decompressing nerve structures, realigning or stabilizing vertebral segments, and replacing damaged components to restore spinal integrity. Effective wound closure is vital in these procedures, as it prevents infections, minimizes wound dehiscence, and ensures optimal cosmetic results. Recent advancements, particularly in barbed suture technology like STRATAFIX™ Symmetric, offer promising improvements in surgical outcomes. A study by Steven R. Glener et al. evaluated STRATAFIX™ Symmetric for fascial closure in spinal surgery, comparing it to traditional braided absorbable sutures. Although the difference in closure time was not statistically significant, STRATAFIX™ demonstrated a higher closure rate and required significantly fewer sutures, reducing post-surgical material counts and the risk of accidental needle sticks. No adverse events were observed in either group over a 6-month follow-up period. Despite their benefits in reducing operating room time and costs, barbed sutures remain underutilized in neurosurgery. Studies indicate that barbed sutures can significantly decrease wound closure time, particularly in complex or multilevel spinal surgeries, without compromising clinical outcomes. These findings suggest that adopting barbed suture technology in spinal surgery could enhance surgical efficiency and patient care. Further research with larger sample sizes and multicenter studies is necessary to validate these benefits and refine surgical practices, ultimately improving patient outcomes.


Assuntos
Procedimentos Neurocirúrgicos , Coluna Vertebral , Técnicas de Sutura , Suturas , Humanos , Procedimentos Neurocirúrgicos/métodos , Coluna Vertebral/cirurgia
8.
Resour Policy ; 83: 103687, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37193091

RESUMO

In recent times, industrialized economies have focused more on achieving a sustainable environment while maintaining economic prosperity. However, it is clear from the current research that natural resource exploitation and decentralization substantially affect environmental quality. To experimentally validate such data, the current study examines decentralized economies during the previous three decades (1990-2020). This study discovered the existence of long-term cointegration between carbon emissions, economic growth, revenue decentralization, spending decentralization, natural resources, and human capital using panel data econometric techniques. The findings are based on non-parametric techniques, indicating that economic growth and revenue decentralization are the primary barriers to meeting the COP26 objective. Human capital drives down carbon emissions and contributes to meeting the COP26 objective. On the contrary, decentralization of spending and natural resources has a mixed influence on carbon emissions across quantiles. This report recommends investing in human capital, education, and research & development to speed up COP26's target accomplishment.

9.
J Environ Manage ; 297: 113316, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34293673

RESUMO

Agriculture and the food system emit a considerable amount of Greenhouse Gas (GHG) emissions in the atmosphere. Hence, current researchers, policymakers, and other stakeholders are calling for improving the environmental performance of agriculture. This study utilizes the countries of The Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC) to investigate the effect of agriculture value-added, pesticide use, renewable energy adoption, human capital, and economic growth on greenhouse gas emissions. The moderation effect of renewable energy use and human capital is also introduced to see whether they can offset agriculture's emissions in these BIMSTEC economies. Having reported a state-of-the-art literature review, the econometric procedure applies the second-generation unit root tests, panel cointegration and panel quantile regression for three preferred model specifications. The result from the Panel quantile regression method reveals a U-shaped relationship between agriculture value-added and greenhouse gas emissions, suggesting the significance of a small farming system. Human capital has a negative effect, whereas pesticide use has a positive effect on greenhouse gas emissions. Furthermore, the moderation effect of human capital and pesticide use suggests that human capital is not significant enough to offset the effect of pesticide use on the greenhouse gas emissions, whereas the interaction of renewable and pesticide use suggests that renewable energy adoption in the agriculture sector can mitigate the effect of pesticide use on GHG emissions. Finally, the conclusions of the study support the achievement of few sustainable development goals.


Assuntos
Gases de Efeito Estufa , Agricultura , Baías , Dióxido de Carbono/análise , Desenvolvimento Econômico , Efeito Estufa , Gases de Efeito Estufa/análise , Humanos , Energia Renovável
10.
Environ Sci Pollut Res Int ; 28(18): 22758-22767, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33423194

RESUMO

With growing concerns about climate change, global warming and greenhouse gas (GHG) emissions, environmental taxes, renewable energy consumption, and environmental technologies have caught attention from researchers, policymakers, and concerned organizations in developed and developing world. The environmental-related taxes and carbon and energy taxes are considered as effective tool and highly recommended by economists and environmental scientists in developed nations (e.g., European economies). To this end, the current study examines the role of environmental policies and regulations and cleaner energy consumption for GHG emissions across leading emitter countries in Europe. The study used annual data of variables from 1994 to 2018 for nine leading European economies. The empirical estimates of quantile regression, FMOLS, and DOLS revealed that environmental taxes and promotion of cleaner energy sources can be effective to reduce overall pollution efflux. The study reports new implications regarding sustainable development goals.


Assuntos
Gases de Efeito Estufa , Dióxido de Carbono/análise , Europa (Continente) , Efeito Estufa , Gases de Efeito Estufa/análise , Energia Renovável , Impostos
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