The Role of Computational Fluid Dynamics in the Management of Unruptured Intracranial Aneurysms: A Clinicians' View

Objective. The importance of hemodynamics in the etiopathogenesis of intracranial aneurysms (IAs) is widely accepted. Computational fluid dynamics (CFD) is being used increasingly for hemodynamic predictions. However, alogn with the continuing development and validation of these tools, it is imperative to collect the opinion of the clinicians. Methods. A workshop on CFD was conducted during the European Society of Minimally Invasive Neurological Therapy (ESMINT) Teaching Course, Lisbon, Portugal. 36 delegates, mostly clinicians, performed supervised CFD analysis for an IA, using the @neuFuse software developed within the European project @neurIST. Feedback on the workshop was collected and analyzed. The performance was assessed on a scale of 1 to 4 and, compared with experts' performance. Results. Current dilemmas in the management of unruptured IAs remained the most important motivating factor to attend the workshop and majority of participants showed interest in participating in a multicentric trial. The participants achieved an average score of 2.52 (range 0–4) which was 63% (range 0–100%) of an expert user. Conclusions. Although participants showed a manifest interest in CFD, there was a clear lack of awareness concerning the role of hemodynamics in the etiopathogenesis of IAs and the use of CFD in this context. More efforts therefore are required to enhance understanding of the clinicians in the subject

Assessing quality of life in an ambulatory Medicare population

Objective: Medicare beneficiaries have unique health-related challenges causing significant impact on quality of life. This study examined the overall health-related quality of life (HRQOL) and differences in HRQOL between subgroups of an ambulatory Medicare beneficiary population. Methods: Nine outreach events were held during the 2011 Medicare Part D prescription drug open-enrollment period, in which 397 beneficiaries were assisted with Part D plan evaluation and comprehensive medication therapy review. Demographic data were collected, and the SF-36v2 was administered to measure beneficiaries\u27 self-reported HRQOL. Correlations were assessed between the mental component summary (MCS) or physical component summary (PCS) scores of the SF-36v2, prescription utilization, number of chronic conditions, and whether beneficiaries were government subsidyrecipients. Results: Mean Å standard deviation of PCS and MCS scores were 43.3 Å 11.4 and 52.2 Å 11.7, respectively. Both PCS and MCS scores were negatively correlated with the number of prescription medications and number of self-reported chronic conditions. Both PCS and MCS scores related to sociodemographics were significantly lower (P \u3c 0.05) in subsidy and least-educated recipients. Conclusions: HRQOL can vary widely as a result of sociodemographic, drug, or disease differences in an ambulatory Medicare beneficiary population

Histopathological study of nasal masses in patients coming to a tertiary care hospital: A study of 70 cases

Introduction: Nasal polyps are defined as prolapsed lining of the nasal sinuses. They may be present as simple inflammatory polyps or neoplastic tumors and neoplastic tumors further divided in benign or malignant types. Objectives: This study was undertaken to note the various histopathological patterns of nasal masses, their classification and relative distribution of various lesions with regard to age and sex in our setting. Materials and Methods: in this study, 70 patients are selected who presented in our hospital with nasal masses and having multiple types of clinical presentations. Time period of study is 2 years. Results: Nonneoplastic nasal masses formed the largest group of lesions; 50 cases (71.43%), followed by 20 cases (28.57%) of neoplastic nasal masses, in neoplastic masses we found 14 benign and 6 malignant cases. Conclusion: Nasal obstruction and rhinorrhea are the most common symptoms of presentation, simple inflammatory nasal polyps are the most common histological pattern seen in our environment, and surgery is the best modality of treatment

The role of computational fluid dynamics in the management of unruptured intracranial aneurysms: a clinicians' view

Objective: The importance of hemodynamics in the etiopathogenesis of intracranial aneurysms (IAs) is widely accepted./nComputational fluid dynamics (CFD) is being used increasingly for hemodynamic predictions. However, alogn with the/ncontinuing development and validation of these tools, it is imperative to collect the opinion of the clinicians. Methods: A workshop/non CFD was conducted during the European Society of Minimally Invasive Neurological Therapy (ESMINT) Teaching Course,/nLisbon, Portugal. 36 delegates, mostly clinicians, performed supervised CFD analysis for an IA, using the @neuFuse software/ndeveloped within the European project @neurIST. Feedback on the workshop was collected and analyzed. The performance/nwas assessed on a scale of 1 to 4 and, compared with experts’ performance. Results: Current dilemmas in the management of/nunruptured IAs remained the most important motivating factor to attend the workshop and majority of participants showed/ninterest in participating in a multicentric trial. The participants achieved an average score of 2.52 (range 0–4) which was 63% (range 0–100%) of an expert user. Conclusions: Although participants showed a manifest interest in CFD, there was a clear lack of/nawareness concerning the role of hemodynamics in the etiopathogenesis of IAs and the use of CFD in this context. More efforts/ntherefore are required to enhance understanding of the clinicians in the subject.The authors would like to thank the European Commission,/nVI Framework Program, Priority 2, Information Society/nComputational Intelligence and Neuroscience 11/nTechnologies, a European Public Funded Organization,/nfor funding @neurIST Project (2) (www.aneurist.org) and/nallowing this study (Research Grant no. IST-FP6-027703). The funding was provided in the form of financial support/nto first two authors along with the arrangement of necessary/nresources to conduct the workshop

Neurosurgery activity levels in the United Kingdom and republic of Ireland during the first wave of the covid-19 pandemic - a retrospective cross-sectional cohort study

The impact of Covid-19 on surgical patients worldwide has been substantial. In the United Kingdom (UK) and the Republic of Ireland (RoI), the first wave of the pandemic occurred in March 2020. The aims of this study were to: (1) evaluate the volume of neurosurgical operative activity levels, Covid-19 infection rate and mortality rate in April 2020 with a retrospective cross-sectional cohort study conducted across 16 UK and RoI neurosurgical centres, and (2) compare patient outcomes in a single institution in April-June 2020 with a comparative cohort in 2019. Across the UK and RoI, 818 patients were included. There were 594 emergency and 224 elective operations. The incidence rate of Covid-19 infection was 2.6% (21/818). The overall mortality rate in patients with a Covid-19 infection was 28.6% (6/21). In the single centre cohort analysis, an overall reduction in neurosurgical operative activity by 65% was observed between 2020 (n = 304) and 2019 (n = 868). The current and future impact on UK neurosurgical operative activity has implications for service delivery and neurosurgical training