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The use of non-living animals as simulation models for cranial neurosurgical procedures: a literature review

Chinese Neurosurgical Journal 2020年第4期6卷 230-234页

作者： Zahraa F.Al-Sharshahi Samer S.Hoz Mohammed A.Alrawi Mohammed A.Sabah Saja A.Albanaa luis rafael moscote-salazar Department of Neurosurgery Neurosurgery teaching HospitalBaghdadIraq College of Medicine University of BaghdadBaghdadIraq RED LATINO Latin American Trauma&Intensive Neuro-Care OrganizationBogotáColombia

Simulation plays a pivotal role in neurosurgical training by allowing trainees to develop the requisite expertise to enhance patient safety.Several models have been used for simulation purposes.Non-living animal models offer a range of benefits,including affordability,availability,biological texture,and a comparable similarity to human anatomy.In this paper,we review the available literature on the use of non-living animals in neurosurgical simulation training.We aim to answer the following questions:(1)what animals have been used so far,(2)what neurosurgical approaches have been simulated,(3)what were the trainee tasks,and(4)what was the experience of the authors with these models.A search of the PubMed Medline database was performed to identify studies that examined the use of non-living animals in cranial neurosurgical simulation between 1990 and 2020.Our initial search yielded a total of 70 results.After careful screening,we included 22 articles for qualitative analysis.We compared the reports in terms of the(1)animal used,(2)type of surgery,and(3)trainee tasks.All articles were published between 2003 and 2019.These simulations were performed on three types of animals,namely sheep,cow,and swine.All authors designed specific,task-oriented approaches and concluded that the models used were adequate for replicating the surgical approaches.Simulation on non-living animal heads has recently gained popularity in the field of neurosurgical training.Non-living animal models are an increasingly attractive option for cranial neurosurgical simulation training.These models enable the acquisition and refinement of surgical skills,with the added benefits of accessibility and cost-effectiveness.To date,16 different microneurosurgical cranial approaches have been replicated on three non-living animal models,including sheep,cows,and swine.This review summarizes the experience reported with the use of non-living animal models as alternative laboratory tools for cranial neurosurgical training,with particular attention to the se

关键词： Neurosurgery Cranial Simulation Non-living Sheep Swine Cow

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Predicting major adverse cardiovascular events after orthotopic liver transplantation using a supervised machine learning model:A cohort study

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World Journal of Hepatology 2024年第2期16卷 193-210页

作者： Jonathan Soldera Leandro luis Corso Matheus Machado Rech Vinícius Remus Ballotin Lucas Goldmann Bigarella Fernanda Tomé Nathalia Moraes rafael Sartori Balbinot Santiago Rodriguez Ajacio Bandeira de Mello Brandão Bruno Hochhegger Post Graduate Program at Acute Medicine and Gastroenterology University of South WalesCardiff CF371DLUnited Kingdom Postgraduate Program in Pathology Federal University of Health Sciences of Porto Alegre(UFCSPA)Porto Alegre 90050-170Brazil Department of Engineering Universidade de Caxias do SulCaxias do Sul 95070-560Brazil School of Medicine Universidade de Caxias do SulCaxias do Sul 95070-560Brazil Postgraduate Program in Hepatology Federal University of Health Sciences of Porto Alegre(UFCSPA)Porto Alegre 90050-170Brazil

BACKGROUND Liver transplant(LT)patients have become older and sicker.The rate of post-LT major adverse cardiovascular events(MACE)has increased,and this in turn raises 30-d post-LT mortality.Noninvasive cardiac stress testing loses accuracy when applied to pre-LT cirrhotic patients.AIM To assess the feasibility and accuracy of a machine learning model used to predict post-LT MACE in a regional cohort.METHODS This retrospective cohort study involved 575 LT patients from a Southern Brazilian academic center.We developed a predictive model for post-LT MACE(defined as a composite outcome of stroke,new-onset heart failure,severe arrhythmia,and myocardial infarction)using the extreme gradient boosting(XGBoost)machine learning model.We addressed missing data(below 20%)for relevant variables using the k-nearest neighbor imputation method,calculating the mean from the ten nearest neighbors for each case.The modeling dataset included 83 features,encompassing patient and laboratory data,cirrhosis complications,and pre-LT cardiac assessments.Model performance was assessed using the area under the receiver operating characteristic curve(AUROC).We also employed Shapley additive explanations(SHAP)to interpret feature impacts.The dataset was split into training(75%)and testing(25%)sets.Calibration was evaluated using the Brier score.We followed Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis guidelines for reporting.Scikit-learn and SHAP in Python 3 were used for all analyses.The supplementary material includes code for model development and a user-friendly online MACE prediction calculator.RESULTS Of the 537 included patients,23(4.46%)developed in-hospital MACE,with a mean age at transplantation of 52.9 years.The majority,66.1%,were male.The XGBoost model achieved an impressive AUROC of 0.89 during the training stage.This model exhibited accuracy,precision,recall,and F1-score values of 0.84,0.85,0.80,and 0.79,respectively.Calibration,as assessed by the Brier score,indicated excell

关键词： Liver transplantation Major adverse cardiac events Machine learning Myocardial perfusion imaging Stress test

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Intracranial hematoma development following thrombolysis inpatients suffering with acute myocardial infarction: Management strategy

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Journal of Acute Disease 2018年第5期7卷 217-219页

作者： luis rafael moscote salazar Amit Agrawal Guru Dutta Satyarthee George Chater Cure Alfonso Pacheco-Hernandez Universidad de Cartagena Cartagena de IndiasColombia Department of Neurosurgery Narayna Medical College HospitalChinthareddypalemNellore-524003Andhra PradeshIndia All India Institute of Medical Sciences New DelhiIndia Clinica General de Norte BarranquillaColombia

Intracerebral hemorrhage secondary to thrombolysis in patients with acute myocardial infarction is a catastrophic condition.Several factors predispose to intracranial bleeding including low body weight,female sex,advanced age,use of oral anticoagulants prior to the administration of fibrinolytic therapy,diastolic blood pressure (greater than 110 mm Hg),among others.Optimal medical management involves multidisciplinary roles of hematology,neurosurgery and critical medicine.In this illustrative case,a classification and management algorithm were proposed for patients with complications hemorrhage associated with thrombolysis after myocardial infarction.

关键词： Acute myocardial infarction Thrombolysis Intracranial hematoma Management Outcome

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Neuroprotective effects of progesterone in acute brain trauma and its physiological mechanism

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Journal of Acute Disease 2018年第1期7卷 20-25页

作者： luis rafael moscote-salazar Alexis Narvaez-Rojas Amit Agrawal Guru Dutta Satyarthee Samer Hoz Johana Maraby-Salgado Andrei FJoaquim Cartagena Neurotrauma Research Group Universidad de Cartagena CartagenaColombia Universidad Nacional Autonoma de Nicaragua Managua Cartagena Neurotrauma Research GroupUniversidad de CartagenaCartagenaColombia Department of Neurosurgery Narayna Medical College Hospital ChinthareddypalemNellore-524003Andhra PradeshIndia All India Institute of Medical Science New DelhiIndia Teaching Neurosurgery Hospital Bagdad-Iraq Universidad de Cartagena CartagenaColombia Department of Neurology Neurosurgery DivisionState University of CampinasCampinas-Sao PauloBrazil

Traumatic brain injury (TBI) is the leading cause of death and neurological disability in young adults worldwide. This work aims to review the role of progesterone in traumatic brain injury and the usefulness as a possible treatment. We searched pubmed database (2000-2017) for articles containing 'progesterone and brain traumatic injury'. Basic science studies have advanced knowledge of the mechanisms of secondary brain injury, creating prospects for the medical and pharmacological management of TBI. Although several comparative studies evaluated both the efficacy and safety of several groups of drugs, in which, corticosteroids, tranexamic acid, βreceptor antagonists, erythropoiesis-stimulating agents, reductase inhibitorsinclude hydroxymethyl glutaryl-CoA inhibitors (statins), among others. Several studies even evaluated the role of progesterone in the treatment of TBI, which is providing growing evidence about its potential neuroprotective mechanisms during the acute phase of trauma. Despite recent advances in the field of management of TBI care in the emergency units, intensive care and the multiple trials for more than 20 years to find useful pharmacological treatments, most of these efforts failed in pre-clinical stages (II and III).

关键词： Head trauma Progesterone Neural trauma Hormones

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From liver to hormones:The endocrine consequences of cirrhosis

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World Journal of Gastroenterology 2024年第9期30卷 1073-1095页

作者： Juan Eduardo Quiroz-Aldave Elman Rolando Gamarra-Osorio María del Carmen Durand-Vásquez Luciana del Pilar rafael-Robles Jhean Gabriel Gonzáles-Yovera María Alejandra Quispe-Flores luis Alberto Concepción-Urteaga Alejandro Román-González José Paz-Ibarra Marcio José Concepción-Zavaleta Non-communicable Diseases Endocrinology Research LineHospital de Apoyo ChepénChepén 13871Peru Department of Endocrinology Hospital Víctor Lazarte EchegarayTrujillo 13006Peru Department of Endocrinology Clínica Javier PradoLima 15046Peru Department of Gastroenterology Hospital Nacional Guillermo Almenara IrigoyénLima 15018Peru Department of Endocrinology Hospital de Emergencias GrauLima 15001Peru Internal Medicine Hospital Regional Docente de TrujilloTrujillo 13011Peru Department of Endocrinology Hospital Universitario de San Vicente FundaciónMedellin 050010Colombia Internal Medicine Universidad de AntioquiaMedellín 050010Colombia School of Medicine Universidad Nacional Mayor de San MarcosLima 15081Peru Department of Endocrinology Hospital Nacional Edgardo Rebagliati MartinsLima 15072Peru Carrera de Medicina Humana Universidad Científica del SurLima 15067Peru

Hepatocrinology explores the intricate relationship between liver function and the endocrine system.Chronic liver diseases such as liver cirrhosis can cause endocrine disorders due to toxin accumulation and protein synthesis disruption.Despite its importance,assessing endocrine issues in cirrhotic patients is frequently neglected.This article provides a comprehensive review of the epidemiology,pathophysiology,diagnosis,and treatment of endocrine disturbances in liver cirrhosis.The review was conducted using the PubMed/Medline,EMBASE,and Scielo databases,encompassing 172 articles.Liver cirrhosis is associated with endocrine disturbances,including diabetes,hypoglycemia,sarcopenia,thyroid dysfunction,hypogonadotropic hypogonadism,bone disease,adrenal insufficiency,growth hormone dysfunction,and secondary hyperaldosteronism.The optimal tools for diagnosing diabetes and detecting hypoglycemia are the oral glucose tolerance test and continuous glucose monitoring system,respectively.Sarcopenia can be assessed through imaging and functional tests,while other endocrine disorders are evaluated using hormonal assays and imaging studies.Treatment options include metformin,glucagon-like peptide-1 analogs,sodium-glucose co-transporter-2 inhibitors,and insulin,which are effective and safe for diabetes control.Established standards are followed for managing hypoglycemia,and hormone replacement therapy is often necessary for other endocrine dysfunctions.Liver transplantation can address some of these problems.

关键词： Diabetes mellitus Hypoglycemia Thyroid diseases Hypogonadism Metabolic bone diseases Liver cirrhosis

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Cardiovascular complications associated with spinal cord injury

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Journal of Acute Disease 2018年第4期7卷 139-144页

作者： Roberto Fabio Calvo-Infante Alexis Narvaez-Rojas Huber Padilla-Zambrano Samer S.Hoz Amit Agrawal luis rafael moscote-salazar University of Cartagena Cartagena de IndiasColombia Universidad Nacional Autonoma de Nicaragua Nicaragua Neurosurgeon Department of NeurosurgeryNeurosurgery teaching Hospital-BaghdadIraq Department of Neurosurgery Narayna Medical College HospitalChinthareddypalemNellore-524003Andhra PradeshIndia Neurosurgery-Critical Care Cartagena Neurotrauma Research GroupUniversidad de CartagenaCartagena de IndiasColombia

Spinal cord injury can lead to important functional, psychological and social sequelae. Despite the progress in medicine and greater understanding of the pathophysiological events associated with a traumatic spinal cord injury, spinal cord injury is still associated with a high morbidity and mortality. The involvement of the autonomic nervous system has implications in acute and chronic stages of the injured spinal cord patients. The most frequent cardiovascular complications in the acute phase of the traumatic spinal lesions are bradyarrhythmia, hypotension, increased vasovagal reflexes, ventricular and supraventricular ectopic beats, venous stasis, and vasodilation. In the chronic phase, we find orthostatic hypotension, alteration of the arterial pressure and the regulation of the body temperature as well as alteration of the blood volume. The knowledge of the cardiovascular alterations is of vital importance for the management and rehabilitation of the patients with spinal cord injury. In this article, we present a critical review of medical literature.

关键词： Complications Spinal cord trauma Spinal cord

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Acute intra-operative brain swelling managed effectively with emergency basal cisternostomy: A case report

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Journal of Acute Disease 2018年第1期7卷 43-44页

作者： Muthanna Noman Abdulqader Ahmed Hamid Al-Tameemi Hayder Salih Samer SHoz Abdullah HAl Ramadan luis rafael moscote salazar Department of Neurosurgery Neurosurgery Teaching HospitalBaghdadIraq Department of Neurosurgery King Faisal Specialist Hospital and Research CentreRiyadhSaudi Arabia Department of Neurosurgery Red-Latino-Colombia

The cisternostomy is a novel technique for the management of intracranial hypertension. Intracranial hypertension is the most frequent cause of mortality in patients with acute brain injury. The availability of a less aggressive technique compared to decompressive craniectomy is an advantage for neurosurgeons. We presented a case that demonstrates the successful use of this technique.

关键词： Neurosurgery Cysternostomy Stroke

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Cranio-cervical bone hyperpneumatization: An overview and illustrative case

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Journal of Acute Disease 2018年第4期7卷 145-148页

作者： Mohammed Maan AbdulAzeez Padilla-Zambrano Huber Salima B.Alsaadi Cabreras-Nanclares B.Vladimir luis rafael moscote salazar Samer S.Hoz College of Medicine Baghdad UniversityBaghdadIraq College of Medicine University of CartagenaCartagena de IndiasColombia Neuroradiology Department Neurosurgery Teaching HospitalBaghdadIraq Department of Neurosurgery Red-Latino-Colombia Neurosurgery Department Neurosurgery Teaching HospitalBaghdadIraq

The pneumatization of regions such as the apex of the temporal crag, the mastoid cells and the perilaberytic region is considered physiological in adults. The process of craniocervical pneumatization in unhealthy adults derives from a dysfunction at the level of the eustachian tube, which provides a valve effect causing an increase in pressure at the level of the middle ear, forcing the entry of air into the dome of the skull through the opening of the occipitomastoidal suture. The process of standard pneumatization of the temporal bones, begins in the final weeks preceding birth, characterized by a decrease in the embryonic mesenchyme at the antrum level and progresses through childhood until adolescence, when the stone portion at the level of the rock is pneumatized;Normal variants have been reported, such as pneumatization that extends from the temporal scale to behind the sigmoid sinus. With regard to the process of hyperneumatization, several etiologies have been proposed that a congenital process versus an acquired process to develop this condition should be compared. The present illustrative case is a seventy-three years old male presented to the outpatient clinic with chronic recurrent occipital headache, already investigated by general practitioner for elevated blood pressure which was excluded. We had checked him to exclude the cervical spinal origin of the occipital headache which was then excluded too. This case scenario demonstrates the debate about how to deal with such cases and thus the review will bring the attention of those who take care of such radiological findings to keep in mind the possible causes and complications according to the reported cases till now. We concluded that the hyperpneumatization of the craniocervical junction is an uncommon radiological finding that is usually asymptomatic although it can entail serious complications in some instances, especially when it enlarges progressively, which may be due to an acquired process. Thus, craniocervical hyperpneumatization deserves hig

关键词： Craniocervical bone Hyperpneumatization of cranial bones

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Has Coca-Cola treatment become the first-line therapy for gastric bezoars,both in general and specifically for western countries?

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World Journal of Gastrointestinal Endoscopy 2024年第5期16卷 237-243页

作者： Maria Delgado Galan luis Ramon Rabago Department of Gastroenterology Hospital Severo OchoaLeganes 28914Spain Department of Gastroenterology Hospital San RafaelMadrid 28016Spain

Phytobezoars is a rare disease and less common in Western countries.The stomach is the primary site for these formations,and endoscopic treatment involving fragmentation and extraction has traditionally been the most effective approach.However,medical treatments using enzymatic and chemical agents,such as cellulase and Coca-Cola,aimed at dissolving the bezoars,have also been utilized,showing varying degrees of resolution success.Notably,the oral dissolution treatment with Coca-Cola has emerged as a promising,simpler,and more costeffective method.The study by Liu et al represents an important step in clinical research on this topic,despite some limitations that need addressing for a more comprehensive understanding of its findings.Key considerations for future research include sample size calculation,endoscopic procedure details,outpatient vs.inpatient treatment,and detailed cost calculations.The study's exclusions,such as patients with upper gastric surgery,phytobezoars older than 14 d,and cases of gastroparesis,limit its applicability to broader populations,especially in Western countries.Given the promising outcomes of the Coca-Cola treatment,it's advocated as a first-line therapy for phytobezoars.Nonetheless,further research is essential to overcome these limitations.However special situations such as perforation or small bowel obstruction will require surgical treatment.

关键词： Phytobezoars Endoscopic treatment Oral dissolution treatment with Coca-Cola Randomized study Editorial

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Precision in detecting colon lesions:A key to effective screening policy but will it improve overall outcomes?

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World Journal of Gastrointestinal Endoscopy 2024年第3期16卷 102-107页

作者： luis Ramon Rabago Maria Delgado Galan Department of Gastroenterology Hospital San RafaelMadrid 28016Spain Gastroenterology Department Hospital Severo OchoaLeganes 28914Spain

Colonoscopy is the gold standard for the screening and diagnosis of colorectal cancer,resulting in a decrease in the incidence and mortality of colon cancer.However,it has a 21%rate of missed polyps.Several strategies have been devised to increase polyp detection rates and improve their characterization and delimi-tation.These include chromoendoscopy(CE),the use of other devices such as Endo cuffs,and major advances in endoscopic equipment[high definition,magnification,narrow band imaging,i-scan,flexible spectral imaging color enhancement,texture and color enhancement imaging(TXI),etc.].In the retrospective study by Hiramatsu et al,they compared white-light imaging with CE,TXI,and CE+TXI to determine which of these strategies allows for better definition and delimitation of polyps.They concluded that employing CE associated with TXI stands out as the most effective method to utilize.It remains to be demonstrated whether these results are extrapolatable to other types of virtual CE.Additionally,further investigation is needed in order to ascertain whether this strategy could lead to a reduction in the recurrence of excised lesions and potentially lower the occurrence of interval cancer.

关键词： Colonoscopy screening Interval colorectal cancer Post colonoscopy colorectal cancer chromoendoscopy Virtual chromoendoscopy high-definition whitelight endoscopy Texture and color enhancement imaging Indigo carmine Adenoma Sessile serrated lesion

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