52426 research outputs found
Sort by
Addressing surgical residency applicants’ priorities: insights from secondary application responses
No full textExtreme Far Lateral Approach for the Resection of the C1 Transverse Process to Relieve Symptomatic Jugular Stenosis
No full text
Neuromyelitis Optica Spectrum Disorder.
No full textNeuromyelitis optica spectrum disorder (NMOSD) is a severe autoimmune disease that predominantly affects the optic nerves and spinal cord, which is a distinct disease process from multiple sclerosis (MS) and myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease. The most common neuro-ophthalmologic manifestation of NMOSD is atypical optic neuritis (ON), characterized by severe vision loss with a higher propensity toward bilateral involvement, longitudinal enhancement of the optic nerve, and chiasmal involvement than MS-related optic neuritis. Due to the severity of disease, high recurrence rate, and significant risk of permanent deficits, early recognition of neuro-ophthalmologic signs and short- and long-term management with immunosuppressive therapies is critical. In this article, we will review the characteristic neuro-ophthalmologic findings in NMOSD, serologic markers, neuroimaging findings, and current approaches to both acute and long-term treatment
Profiles and Predictors of Neurodevelopmental Outcome at 5-6 Years in Children With a History of Acute Provoked Neonatal Seizures.
No full textOBJECTIVE: The objective of this study was to characterize the neurodevelopment and risk factors for impairment at age 5 to 6 years after acute provoked neonatal seizures.
METHODS: Multicenter study of neonates with acute provoked seizures. Wechsler Preschool and Primary Scale of Intelligence IV (WPPSI-IV), Vineland-3 Adaptive Behavior Scales, Behavior Assessment System for Children, Behavior Rating Inventory of Executive Function, Social Responsiveness Scale, cerebral palsy (CP), and epilepsy were assessed at age 5 to 6 years. Latent class analysis defined outcome profiles. Least absolute shrinkage and selection operator (LASSO) was used to determine outcome predictors.
RESULTS: We characterized 3 latent classes among 164 children: (1) Typical Development (63%); (2) Behavioral Dysregulation (13%; low likelihood of physical impairment or severely impaired cognition, high likelihood of attention deficit hyperactivity disorder [ADHD]); and (3) Multi-Domain Impairment (24%; high likelihood of epilepsy and impairment across all domains). Among 144 children with standardized testing, mean WPPSI-IV was 91 ± 25 and Vineland-3 Adaptive Behavior Composite 90 ± 20. Twenty-nine percent had ADHD or elevated attention/hyperactivity scores; 19% had autism or elevated Social Responsiveness scores; 20% had epilepsy, and 19% had CP. Risk factors for Multi-Domain Impairment were abnormal neonatal neurologic examination (odds ratio [OR] = 3.94, 95% confidence interval [CI] = 1.74-8.95), impaired functional development at age 24 months (OR = 3.82, 95% CI = 1.25-11.66), and CP (OR = 3.71, 95% CI = 1.74-7.90). No neonatal or infant characteristics were significantly associated with Behavioral Dysregulation.
INTERPRETATION: Nearly two-thirds of 5 to 6-year-old children with provoked neonatal seizures had typical development. Yet, executive and behavioral dysregulation were prevalent, even with preserved cognitive and physical function. These findings can inform outcome discussions and interventions to promote neurodevelopment. ANN NEUROL 2026
Buccal Sulcus Myomucosal Flap-an Approach for the Closure of Anterior Palatal Fistulae: A Retrospective Cohort Analysis of 132 Patients.
No full textAnterior palatal fistulae (APFs) present a considerable challenge following cleft palate repair, particularly when involving the alveolus and the anterior half of the hard palate. These defects are notoriously difficult to close due to limited local tissue availability, scarring, restricted flap mobility, and altered vascularity, all contributing to high recurrence rates. This study evaluates the effectiveness of the buccal sulcus myomucosal flap (BSMF) as a practical and reliable option for APF closure. A retrospective review of 132 patients treated between January 2021 and December 2023 was conducted. All patients underwent nasal layer closure with turn-in flaps, followed by measurement of the residual defect and harvest of a BSMF of appropriate size. Of the cohort, 59 patients (44.7%) presented with primary fistulae while 73 (55.3%) had recurrent defects. The overall recurrence rate following repair was 10.4%, with similar rates observed in primary and recurrent cases. The technique consistently achieved tension-free closure even in large anterior defects extending into the alveolus, with minimal donor site morbidity. Its technical simplicity and cost-effectiveness further enhance its applicability, particularly in resource-constrained and high-volume settings. The BSMF offers a reproducible, effective solution for managing anterior palatal fistulae and warrants broader consideration in cleft care algorithms
