Complications Associated With Spine Surgery in Patients Aged 80 Years or Older: Japan Association of Spine Surgeons with Ambition (JASA) Multicenter Study

Study Design:Retrospective study of registry data.Objectives:Aging of society and recent advances in surgical techniques and general anesthesia have increased the demand for spinal surgery in elderly patients. Many complications have been described in elderly patients, but a multicenter study of perioperative complications in spinal surgery in patients aged 80 years or older has not been reported. Therefore, the goal of the study was to analyze complications associated with spine surgery in patients aged 80 years or older with cervical, thoracic, or lumbar lesions.Methods:A multicenter study was performed in patients aged 80 years or older who underwent 262 spinal surgeries at 35 facilities. The frequency and severity of complications were examined for perioperative complications, including intraoperative and postoperative complications, and for major postoperative complications that were potentially life threatening, required reoperation in the perioperative period, or left a permanent injury.Results:Perioperative complications occurred in 75 of the 262 surgeries (29%) and 33 were major complications (13%). In multivariate logistic regression, age over 85 years (hazard ratio [HR] = 1.007, P = 0.025) and estimated blood loss ≥500 g (HR = 3.076, P = .004) were significantly associated with perioperative complications, and an operative time ≥180 min (HR = 2.78, P = .007) was significantly associated with major complications.Conclusions:Elderly patients aged 80 years or older with comorbidities are at higher risk for complications. Increased surgical invasion, and particularly a long operative time, can cause serious complications that may be life threatening. Therefore, careful decisions are required with regard to the surgical indication and procedure in elderly patients

Risk Factors for Delirium After Spine Surgery in Extremely Elderly Patients Aged 80 Years or Older and Review of the Literature: Japan Association of Spine Surgeons with Ambition Multicenter Study

Study Design:Retrospective database analysis.Objective:Spine surgeries in elderly patients have increased in recent years due to aging of society and recent advances in surgical techniques, and postoperative complications have become more of a concern. Postoperative delirium is a common complication in elderly patients that impairs recovery and increases morbidity and mortality. The objective of the study was to analyze postoperative delirium associated with spine surgery in patients aged 80 years or older with cervical, thoracic, and lumbar lesions.Methods:A retrospective multicenter study was performed in 262 patients 80 years of age or older who underwent spine surgeries at 35 facilities. Postoperative complications, incidence of postoperative delirium, and hazard ratios of patient-specific and surgical risk factors were examined.Results:Postoperative complications occurred in 59 of the 262 spine surgeries (23%). Postoperative delirium was the most frequent complication, occurring in 15 of 262 patients (5.7%), and was significantly associated with hypertension, cerebrovascular disease, cervical lesion surgery, and greater estimated blood loss (P < .05). In multivariate logistic regression using perioperative factors, cervical lesion surgery (odds ratio = 4.27, P < .05) and estimated blood loss ≥300 mL (odds ratio = 4.52, P < .05) were significantly associated with postoperative delirium.Conclusions:Cervical lesion surgery and greater blood loss were perioperative risk factors for delirium in extremely elderly patients after spine surgery. Hypertension and cerebrovascular disease were significant risk factors for postoperative delirium, and careful management is required for patients with such risk factors

Improvement of Cardiac Function after Granulocyte-colony Stimulating Factor-mobilized Peripheral Blood Mononuclear Cell Implantation in a Patient with Non-ischemic Dilated Cardiomyopathy Associated with Thromboangiitis Obliterans

Cardiac involvement is a rare complication with thromboangiitis obliterans (TAO). We report a 29-year-old man with TAO accompanied with non-ischemic dilated cardiomyopathy. He had no history of heart disease, but echocardiogram demonstrated diffuse hypokinesis and dilated left ventricle. Coronary angiography revealed no organic stenotic lesion. For limb salvage, he was treated with granulocyte-colony stimulating factor (G-CSF)-mobilized peripheral blood mononuclear cell (PBMNC) implantation on his right leg. Not only ischemic leg symptoms, but also plasma level of BNP and ^I-metaiodobenzylguanidine scintigraphic parameters improved after 24 weeks. G-CSF-mobilized PBMNC implantation could be an effective approach to treating non-ischemic cardiomyopathy

Discovery of genome of an immunodeficiency-associated virus-like virus from pig feces in Japan

Immunodeficiency-associated stool virus (IASV) is an unclassified virus, for which the only genome information is available from a patient infected by human immunodeficiency virus. In domestic animals, one report described detection of IASV-like virus in pig feces, whereas no nucleotide sequence information of this virus is currently available. Using deep sequencing method, we detected a DNA fragment homologous to IASV in several pig feces in Japan. The sequence of the PCR product in this sample had 70% homology to that of IASV. The infectious rate of the IASV-like virus was 72.9% among the 9 pig farms, from which the samples were collected. There was no clear correlation between the presence of IASV-like virus and the fecal characteristics

Theoretical study on the origin of anomalous temperature-dependent electric resistivity of ferromagnetic semiconductor

Employing Korringa–Kohn–Rostoker Green’s function methodology, our investigation elucidates the previously obscure origins of the anomalous temperature-dependent electrical resistivity behavior of (Ga,Mn)As ferromagnetic semiconductors. Phonon and magnon excitations induced by temperature effects are addressed via the coherent potential approximation, while the Kubo–Greenwood formula is employed to compute transport properties. Consequently, the anomalous temperature-dependent electrical resistivity arising from the ferromagnetic–paramagnetic transition is successfully replicated. Our examination of electronic structures and magnetic interactions reveals pivotal roles played by antisite defects and interstitial Mn atoms in governing this behavior. As this approach enables both the estimation of temperature-dependent transport properties and the assessment of underlying mechanisms from a microscopic standpoint, it holds significant potential as a versatile tool across diverse fields