22 results on '"Abdallah, Hussein"'
Search Results
2. Outcomes of the Endoscopic Endonasal Approach for Nonfunctional Pituitary Adenomas in Elderly Patients.
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Abdallah, Hussein M., Tang, Anthony, Plute, Tritan J., Gersey, Zachary C., Abou-Al-Shaar, Hussam, Cabral, David T. Fernandes, Arani, Keerthi, Stefko, Tonya, Bonhomme, Gabrielle, Fazeli, Pouneh, Mahmud, Hussain, Wang, Eric W., Snyderman, Carl H., Zenonos, Georgios A., and Gardner, Paul
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OLDER patients , *PITUITARY tumors - Abstract
This article discusses the outcomes of the endoscopic endonasal approach (EEA) for nonfunctional pituitary adenomas (NFPAs) in elderly patients. The study involved a retrospective review of NFPAs in patients aged 65 and older who underwent EEA between 2007 and 2022 at a single medical center. The results showed that EEA was a safe and effective option for NFPA resection in elderly patients, with high rates of visual recovery postoperatively and acceptable rates of gross total resection (GTR). The study also identified risk factors for progression and subtotal resection, but found no associations between postoperative complications and age or frailty scores. [Extracted from the article]
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- 2024
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3. 30-Day Hospitalization Period for Pituitary Adenoma Patients: Introducing A Novel Outcome Metric.
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Tang, Anthony, Abdallah, Hussein M., Gardner, Paul, Zenonos, Georgios A., Chang, Yue-Fang, Choby, Garret, Wang, Eric W., and Snyderman, Carl
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PITUITARY tumors , *HOSPITAL care , *RHINORRHEA ,CENTRAL nervous system tumors - Abstract
This article, published in the Journal of Neurological Surgery, introduces a novel outcome metric called the 30-day hospitalization ratio (HR) for patients with pituitary adenomas. The metric combines the length of stay and readmission rates within a 30-day period to provide a comprehensive measure of the economic burden of treatment. The study analyzed the clinical records of 468 patients who underwent endoscopic endonasal surgery for pituitary adenoma. Factors associated with a high HR included high preoperative ASA scores, postoperative lumbar drain placement, intradural extension, and employment status. Understanding these risk factors can lead to personalized monitoring and care, ultimately reducing burden and improving outcomes. [Extracted from the article]
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- 2024
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4. Effect of Zeolitic Tuff on Strength, Resilient Modulus, and Permanent Strain of Lime-Stabilized Expansive Subgrade Soil.
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Abdallah, Hussein M., Rabab'ah, Samer R., Taamneh, Madhar M., Taamneh, Mohammad O., and Hanandeh, Shadi
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SWELLING soils , *VOLCANIC ash, tuff, etc. , *SOIL stabilization , *POZZOLANIC reaction , *SCANNING electron microscopy , *CLAY soils - Abstract
The present work aims to evaluate expansive soil stabilization using different additives. Twenty soil mixtures consisting of 10%, 20%, 25%, and 30% zeolitic tuff (ZT) with 2%, 4%, and 6% lime in various combinations were used to stabilize the soil for pavement subbase application. A comprehensive test program, including Atterberg's limits, compaction, unconfined compression strength (UCS), California Bearing Ratio (CBR), resilient modulus, and permanent deformation, was performed on natural and stabilized soil specimens. Scanning electron microscopy (SEM) supplied with energy-dispersive X-ray spectroscopy (SEM/EDX) was used to confirm the study findings. Adding ZT increases the availability of the silica and alumina needed for the pozzolanic reaction; test results revealed that adding ZT increases the maximum dry unit weight, CBR, UCS, resilient modulus, decreases plasticity, and permanent deformation. As such, ZT can improve the physical and mechanical properties of lime-stabilized soil as a pavement's subgrade and subbase layers. [ABSTRACT FROM AUTHOR]
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- 2023
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5. Gamma Knife Radiosurgery for Meningiomas of the Confluence of the Falx and Tentorium.
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Mallela, Arka N., Abdallah, Hussein, Wei, Zhishuo, Abou-Al-Shaar, Hussam, Niranjan, Ajay, and Lunsford, L. Dade
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RADIOSURGERY , *KNIVES - Published
- 2023
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6. Outcomes of Redo Endoscopic Endonasal Skull Base Surgery for Recurrent or Residual Nonfunctioning Pituitary Adenomas: An Analysis of 93 Consecutive Patients at the University of Pittsburgh Medical Center.
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Abdallah, Hussein M., Gersey, Zachary C., Gray, Zane N., Fogg, David N., Duehr, James E., Abou-Al-Shaar, Hussam, Arani, Keerthi, Stefko, Tonya, Bonhomme, Gabrielle R., Fazeli, Pouneh, Mahmud, Hussain, Wang, Eric W., Snyderman, Carl H., Gardner, Paul A., and Zenonos, Georgios A.
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SKULL surgery , *SKULL base , *PITUITARY tumors - Published
- 2023
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7. Indications for upper gastrointestinal endoscopy before bariatric surgery: a multicenter study.
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Abdallah, Hussein, El Skalli, Mehdi, Mcheimeche, Hussein, Casagranda, Biagio, de Manzini, Nicolò, and Palmisano, Silvia
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BARIATRIC surgery , *OPERATIVE surgery , *ENDOSCOPY , *BODY mass index , *HELICOBACTER pylori infections , *THERAPEUTICS , *DEEP brain stimulation , *TREATMENT delay (Medicine) - Abstract
Background: The role of preoperative upper gastrointestinal endoscopy before bariatric surgery is still debated, and a consensus among the international scientific community is lacking. The aims of this study, conducted in three different geographic areas, were to analyze data regarding the pathological endoscopic findings and report their impact on the decision-making process and surgical management, in terms of delay in surgical operation, modification of the intended bariatric procedure, or contraindication to surgery. Methods: This is a multicenter cross-sectional study using data obtained from three prospective databases. The preoperative endoscopic reports, patient demographics, Body Mass Index, type of surgery, and Helicobacter pylori status were collected. Endoscopic findings were categorized into four groups: (1) normal endoscopy, (2) abnormal findings not requiring a change in the surgical approach, (3) clinically important lesions that required a change in surgical management or further investigations or therapy prior to surgery, and (4) findings that contraindicated surgery. Results: Between 2006 and 2020, data on 643 patients were analyzed. In all of the enrolled bariatric institutions, preoperative endoscopy was performed routinely. A total of 76.2% patients had normal and/or abnormal findings that did not required a change in surgical management; in 23.8% cases a change or a delay in surgical approach occurred. Helicobacter pylori infection was detected in 15.2% patients. No patient had an endoscopic finding contraindicating surgery. Conclusions: The role of preoperative UGE is to identify a wide range of pathological findings in patients with obesity that could influence the therapeutic approach, including the choice of the proper bariatric procedure. Considering the anatomical modifications, the incidence of asymptomatic pathologies, and the risk of malignancy, we support the decision of performing preoperative endoscopy for all patients eligible for bariatric operation. [ABSTRACT FROM AUTHOR]
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- 2023
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8. Bibliometric Analysis of the Top 100 Cited Articles on Stereotactic Radiosurgery for Trigeminal Neuralgia.
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Parikh, Parth, Abdallah, Hussein M., Patel, Aneek, Shariff, Rimsha K., Nowicki, Kamil W., Mallela, Arka N., Tonetti, Daniel A., Sekula Jr., Raymond F., Lunsford, L Dade, and Abou-Al-Shaar, Hussam
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TRIGEMINAL neuralgia , *STEREOTACTIC radiosurgery , *BIBLIOMETRICS , *RADIOSURGERY , *TRIGEMINAL nerve - Abstract
Background Stereotactic radiosurgical rhizolysis of the trigeminal nerve is an established modality increasingly employed to alleviate the symptoms of refractory trigeminal neuralgia. This study analyzes the academic impact of the top 100 cited articles on the radiosurgical management of trigeminal neuralgia. Methods The Scopus database was searched for articles containing "radiosurgery" and one or more of "trigeminal neuralgia," "trigeminus neuralgia," and "tic douloureux." The top 100 articles written in English were arranged in descending order by citation count. Documents were evaluated for authors, publication year, journal and impact factor, total citations, nationality, study type, radiosurgical modality, and the affiliated institution. Quantitative and qualitative analyses were performed on the data. Results The most cited articles were published between 1971 and 2019. The average citation per year was 4.3. The most targeted anatomic area was the "root entry zone" or proximal portion of the cisternal segment of the trigeminal nerve. The most utilized modality was Gamma Knife radiosurgery. The country with the highest number of publications was the United States. Thirty-six percent of the articles were published in the Journal of Neurosurgery. Lunsford, Kondziolka, Flickinger, and Régis, respectively, were the most frequently listed co-authors. The most prolific institute was the University of Pittsburgh Medical Center. Conclusion Stereotactic radiosurgery is an important modality in the management of medically or surgically refractory trigeminal neuralgia. This analysis assesses its contributions over the past five decades to identify trends in treatment practices for neurosurgeons and to highlight areas where further study is needed. [ABSTRACT FROM AUTHOR]
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- 2023
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9. Towards Context-Aware Facial Emotion Reaction Database for Dyadic Interaction Settings.
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Sham, Abdallah Hussein, Khan, Amna, Lamas, David, Tikka, Pia, and Anbarjafari, Gholamreza
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AFFECTIVE forecasting (Psychology) , *EMOTION recognition , *EMOTIONS , *FACIAL expression , *SOCIAL robots - Abstract
Emotion recognition is a significant issue in many sectors that use human emotion reactions as communication for marketing, technological equipment, or human–robot interaction. The realistic facial behavior of social robots and artificial agents is still a challenge, limiting their emotional credibility in dyadic face-to-face situations with humans. One obstacle is the lack of appropriate training data on how humans typically interact in such settings. This article focused on collecting the facial behavior of 60 participants to create a new type of dyadic emotion reaction database. For this purpose, we propose a methodology that automatically captures the facial expressions of participants via webcam while they are engaged with other people (facial videos) in emotionally primed contexts. The data were then analyzed using three different Facial Expression Analysis (FEA) tools: iMotions, the Mini-Xception model, and the Py-Feat FEA toolkit. Although the emotion reactions were reported as genuine, the comparative analysis between the aforementioned models could not agree with a single emotion reaction prediction. Based on this result, a more-robust and -effective model for emotion reaction prediction is needed. The relevance of this work for human–computer interaction studies lies in its novel approach to developing adaptive behaviors for synthetic human-like beings (virtual or robotic), allowing them to simulate human facial interaction behavior in contextually varying dyadic situations with humans. This article should be useful for researchers using human emotion analysis while deciding on a suitable methodology to collect facial expression reactions in a dyadic setting. [ABSTRACT FROM AUTHOR]
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- 2023
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10. Reduction of giant parietooccipital fibrous dysplasia using dynamic mirror image guidance: a case report and review of the literature.
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Abdallah, Hussein M., Fernandes Cabral, David T., Gersey, Zachary C., Abou-Al-Shaar, Hussam, O’keefe, Sean, Mysels, Shane, John, Ivy, Gardner, Paul A., Solari, Mario G., and Zenonos, Georgios A.
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Abstract Background Observations Lessons Craniofacial fibrous dysplasia (CFD) typically occurs in the facial bones and anterior cranial vault and can produce both disfigurement and functional limitations for patients disfigurement. Treatment consists of reducing the abnormal bone. Bone contouring can become challenging when the exposure does not extend to the corresponding normal contralateral structures for comparison or when normal landmarks are not available, which may compromise the overall aesthetic outcome. We describe a technique using dynamic mirroring to accurately contour the involved part of the cranium in a case of giant CFD.A 49-year-old male presented with a giant deforming fibrous dysplasia of the right mastoid and parieto-temporo-occiput that was causing functional limitations due to the size of the bony mass. This was managed with multidisciplinary bony reduction. Several neurovascular structures were in proximity to the areas of planned drilling of the expansile lesion, and dynamic mirroring of the uninvolved left skull was utilized to maximize safety and symmetry of reduction. High-speed drilling of the right occipital bone was performed until the navigation system alerted the surgeon that symmetric depth had been achieved. There were no complications from the procedure and this technique maximized the limits of symmetric reduction without significantly increasing surgical complexity or duration.Dynamic mirroring of bony structures in the posterior cranium is not commonly employed in neurosurgical practice. This technique may help improve the aesthetic outcomes of bony reduction in craniofacial dysplasia and a variety of similarly managed bony lesions, contour cranioplasties, and in unilateral craniosynostosis surgery. [ABSTRACT FROM AUTHOR]
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- 2022
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11. An Integrated Management Paradigm for Skull Base Chordoma Based on Clinical and Molecular Characteristics.
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Abdallah, Hussein M., Gersey, Zachary C., Muthiah, Nallammai, McDowell, Michael M., Pearce, Thomas, Costacou, Tina, Snyderman, Carl H., Wang, Eric W., Gardner, Paul A., and Zenonos, Georgios A.
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SKULL base , *CHORDOMA , *PROGRESSION-free survival , *PROPORTIONAL hazards models , *FLUORESCENCE in situ hybridization , *GENOTYPES , *PROGNOSIS - Abstract
Objective Previous work categorized skull base chordoma (SBC) into three genetic risk groups based on 1p36 and homozygous 9p21(p16) deletions, accounting for a wide variability in prognosis (A = low-risk, B = intermediate-risk, C = high-risk). However, it remains unclear how these groups could guide management. Study Design By integrating surgical outcome and adjuvant radiation (AdjXRT) information with genetic data on 152 tumors, we sought to develop an evidence-based management algorithm for SBC. Results Gross total resections (GTRs) were associated with improved progression free survival (PFS) in all genetic groups. For Group C tumors, GTR and AdjXRT independently contributed to PFS (multivariate Cox proportional hazard ratio [HR] = 0.14, p = 0.002, and HR = 0.40, p = 0.047, respectively). For Group B tumors, AdjXRT improved outcomes only when GTR was not feasible (log-rank p = 0.008), but not following GTR (log-rank p = 0.54). However, 24 of 25 Group A tumors underwent GTR, and AdjXRT for these did not confer any benefit (log-Rank p = 0.285). The high GTR rates in Group A could be explained by smaller tumor sizes (mean = 0.98cc/4.08cc/4.92cc for Group A/B/C, respectively, p = 0.031) and lack of invasiveness. Group A tumors were also more frequently diagnosed in young people (p = 0.002) as asymptomatic lesions (p = 0.001), suggesting that they could be precursors to tumors in higher risk groups. Conclusion Genotypic grouping by 1p36 and homozygous 9p21(p16) deletions can predict prognosis in SBC and guide management. GTR remains the cornerstone of SBC treatment and can be sufficient without AdjXRT in low and intermediate risk tumors. Low-risk tumors are associated with a less invasive phenotype, which makes them more amenable to GTR. [ABSTRACT FROM AUTHOR]
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- 2021
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12. Laparoscopic extended right colectomy and splenectomy for splenic flexure cancer with isolated synchronous splenic metastases – A video vignette.
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Abdallah, Hussein, Nagliati, Carlo, Troian, Marina, Pennisi, Damiano, and Balani, Alessandro
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COLECTOMY , *SPLENECTOMY , *LAPAROSCOPIC surgery , *MESENTERIC veins , *MINIMALLY invasive procedures - Abstract
The surgeon is positioned on the right side, the camera holder on the surgeon's left side and the assistant between patient's legs. Step 6: Splenectomy The surgeon is between the patient's legs with camera holder to the patient's right and the assistant on the other side. Step 4: Mobilization of the hepatic flexure and caecostomy The assistant exposes the hepatocolic ligament and phrenocolic ligament by pulling the hepatic flexure downwards. [Extracted from the article]
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- 2022
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13. Polycystic ovary syndrome preceding the diagnosis of acromegaly: a retrospective study in 97 reproductive-aged women.
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Khiyami, Anamil M., Jokar, Tahereh Orouji, Abdallah, Hussein M., Gardner, Paul A., Zenonos, Georgios A., Styer, Aaron K., and Fazeli, Pouneh K.
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ACROMEGALY , *CHILDBEARING age , *POLYCYSTIC ovary syndrome , *DELAYED diagnosis , *ACADEMIC medical centers , *SYMPTOMS - Abstract
Background: Acromegaly is a disease of growth hormone excess that results in enlargement of extremities, abnormal glucose and lipid metabolism, and gonadal disruption. Manifestations of the disease are insidious and typically lead to a diagnostic delay of 7–10 years. Classically the polycystic ovary syndrome (PCOS) phenotype is described in women with irregular menses, clinical or biochemical evidence of androgen excess, and/or multiple ovarian follicles on pelvic ultrasonography. Women with acromegaly may present with some or all of these symptoms. Our objective was to evaluate the prevalence of PCOS in patients with acromegaly and to determine if diagnosis of PCOS results in a delay in diagnosing acromegaly. Methods: Using patient databases at two academic health centers, we identified 97 premenopausal women aged 18–49 years old presenting with acromegaly. Data were collected regarding pelvic sonography and reproductive history, including the diagnosis of PCOS. Patients carrying the diagnosis of PCOS before their diagnosis of acromegaly were identified and the remaining patients were screened using the Rotterdam criteria to identify additional patients meeting the criteria for PCOS prior to their diagnosis of acromegaly. Results: Mean age of the population (n = 97) at the time of diagnosis of acromegaly was 33.4 ± 7.5 years (SD). Thirty-three percent of patients (n = 32) either carried a diagnosis of PCOS or met diagnostic criteria for PCOS before their diagnosis of acromegaly. In the subset of patients in whom data on symptom onset were available, those who met criteria for PCOS were diagnosed with acromegaly a median of 5 years [4, 9] after the onset of symptoms compared to 2 years [0.92, 3] (p = 0.006) in the patients who did not meet criteria for PCOS. Conclusions: Our data demonstrate a high prevalence of signs and symptoms of PCOS in reproductive-aged women with acromegaly and a longer time to diagnosis in women who meet the clinical criteria for PCOS. As screening for acromegaly is relatively simple and done with measurement of a random, non-fasting IGF-1 level that can be drawn at any time during the menstrual cycle, screening patients with PCOS for acromegaly may lessen the delay in diagnosis for reproductive-aged women with this disease. [ABSTRACT FROM AUTHOR]
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- 2023
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14. Radiogenomics and Radiomics of Skull Base Chordoma: Machine Learning-Based Classification of Genetic Signatures and Clinical Outcomes by Multiparametric MRI.
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Gersey, Zachary C., Zenkin, Serafettin, Plute, Tritan, Murat, A.K., Mamindla, Priyadarshini, Peddagangireddy, Vishal, Abdallah, Hussein, Muthiah, Nallammai, Wang, Eric W., Snyderman, Carl H., Gardner, Paul A., Colen, Rivka, and Zenonos, Georgios A.
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RADIOMICS , *TREATMENT effectiveness , *CHORDOMA , *SKULL base , *MAGNETIC resonance imaging , *TEXTURE analysis (Image processing) - Abstract
This article explores the use of radiomic feature analysis to predict overall survival and progression-free survival after surgery in patients with skull base chordomas. The study extracted radiomic features from preoperative MRI scans and used unsupervised analysis to identify distinct groups based on these features. The results showed that the radiomic features were able to model overall survival and progression-free survival, and were also associated with genetic markers commonly used in clinical decision-making. The authors suggest that radiomics-based imaging biomarkers could be a noninvasive and cost-effective way to personalize care for patients with skull base chordomas. [Extracted from the article]
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- 2024
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15. Impact of Frailty on Outcomes after Surgery in Patients with Cushing's Disease: Findings from the Multicenter Rapid Registry.
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Findlay, Matt, Massey, Conner, Rennert, Robert, Lucke-Wold, Brandon, Evans, James, Collopy, Sarah, Kim, Won, Delery, William, Pacione, Donato, Kim, Albert, Silverstein, Julie, Kanga, Mridu, Chicoine, Michael, Gardner, Paul, Valappil, Benita, Abdallah, Hussein, Sarris, Christina, Henricks, Benjamin, Torok, Ildiko, and Low, Trevor
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CUSHING'S syndrome , *FRAILTY , *TREATMENT effectiveness - Abstract
This article, published in the Journal of Neurological Surgery, examines the impact of frailty on surgical outcomes in patients with Cushing's disease (CD). The study analyzed data from the Registry of Adenomas of the Pituitary and Related Disorders (RAPID) and found that mild frailty independently predicted outcomes after transsphenoidal surgery for CD. Mildly frail patients had longer hospital stays and were more likely to be discharged to skilled nursing facilities. The study suggests that assessing frailty could be useful for preoperative risk stratification and prognostication in CD patients. [Extracted from the article]
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- 2024
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16. Founding of a National Surgical Research Consortium for Pituitary Disorders: Description of Cushing's Disease Cohort, Surgeon Characteristics, and Report of Outcomes.
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Little, Andrew S., Karsy, Michael, Evans, James, Kim, Won, Gardner, Paul, Pacione, Donato, Kim, Albert, Torok, Ildiko, Crocker, Tomi, Low, Trevor, Silverstein, Julie, Rennert, Robert, Wu, Kyle, Couldwell, William, Abdallah, Hussein, Garrett, Trey, Vigo, Vera, Fernandez-Miranda, Juan, Zada, Gabriel, and Barkhoudarian, Garni
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CUSHING'S syndrome , *CONSORTIA , *SURGEONS - Abstract
This article discusses the establishment of a national pituitary surgical research platform called RAPID, which aims to improve patient care and surgical outcomes for pituitary disorders. The initial focus of the collaboration is on Cushing's disease. The study provides an overview of the patient cohort, surgical outcomes, and lays the foundation for future research. The data collected from nine academic pituitary centers shows that 528 patients with Cushing's disease were treated by 26 neurosurgeons from 2003 to 2023. The report highlights insights into surgical outcomes and disease recurrence rates across different surgeons and environments. The collaboration is expected to advance the standard of care for patients with pituitary disorders. [Extracted from the article]
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- 2024
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17. Crooke Cell Adenoma Confers Poorer Endocrinologic Outcomes Compared with Corticotroph Adenoma: Results of a Multicenter, International Analysis.
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Findlay, Matt, Drexler, Richard, Azab, Mohammed, Karbe, Arian, Rotermund, Roman, Ricklefs, Franz, Flitsch, Jörg, Smith, Timothy, Kilgallon, John, Honegger, Jürgen, Nasi-Kordhishti, Isabella, Gardner, Paul, Gersey, Zachary, Abdallah, Hussein, Jane, John, Marino, Alexandria, Knappe, Ulrich, Uksul, Nesrin, Rzaev, Jamil, and Bervitskiy, Anatoliy
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ADENOMATOUS polyps , *ADENOMA , *CUSHING'S syndrome - Abstract
This article, published in the Journal of Neurological Surgery, examines the outcomes of patients with Crooke cell adenomas (CCA) compared to those with corticotroph adenomas (sCTA), both of which are types of pituitary corticotroph adenomas found in patients with Cushing's disease. The study, which included 2,826 patients from 12 international centers, found that CCA patients had poorer endocrinologic outcomes compared to sCTA patients, despite having better local control rates and fewer residual tumors. The authors suggest that further research is needed to better understand CCA and develop more targeted treatment approaches. [Extracted from the article]
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- 2024
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18. Unplanned Hospital Readmissions Following Trans-sphenoidal Surgery for Cushing's Disease from a Multicenter Pituitary Surgery Outcomes Registry of 26 Surgeons.
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Pacult, Mark A, Karsy, Michael, Evans, James J., Kim, Won, Pacione, Donald R., Kim, Albert H., Gardner, Paul A., Hendricks, Benjamin K., Sarris, Christina E., Torok, Ildiko E., Low, Trevor M., Crocker, Tomiko A., Valappil, Benita, Kanga, Mridu, Abdallah, Hussein, Collopy, Sarah, Fernandez-Miranda, Juan C, Vigo, Vera, Delery, William, and Yuen, Kevin C.
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CUSHING'S syndrome , *PATIENT readmissions , *PROPORTIONAL hazards models , *SURGEONS - Abstract
This article discusses the issue of unplanned hospital readmissions following trans-sphenoidal surgery for Cushing's disease. The study analyzed data from a multi-institutional database of patients who underwent this surgery between 2003 and 2023. The results showed that 10.3% of patients experienced unplanned readmissions, with the most common reasons being hyponatremia, CSF leak evaluation, headache/nausea, and epistaxis. The study also found that an increased number of chronic medical conditions and the need for a return to surgery were associated with a higher chance of unplanned readmission. The authors suggest strategies to mitigate these readmissions, such as fluid restriction and optimizing chronic medical conditions. [Extracted from the article]
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- 2024
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19. Surgical Predictors of Cushing's Disease Remission: Pilot Investigations Using the Multicenter Rapid Registry.
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Findlay, Matthew, Massey, Conner, Alt, Jeremiah, Rennert, Robert, Couldwell, William, Evans, James, Collopy, Sarah, Kim, Won, Delery, William, Pacione, Donato, Kim, Albert H., Kanga, Mridu, Chicoine, Michael, Gardner, Paul, Valappi, Benita, Zada, Gabriel, Garrett, Trey, Abdallah, Hussein, Sarris, Christina, and Henricks, Benjamin
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CUSHING'S syndrome , *DISEASE remission , *PROGRESSION-free survival - Abstract
This article, published in the Journal of Neurological Surgery, explores the factors that contribute to the recurrence of Cushing's disease (CD) after transsphenoidal surgery. The study analyzed data from the Registry of Adenomas of the Pituitary and Related Disorders (RAPID) database, which included 383 CD patients. The results showed that patients who experienced recurrence had a longer postoperative hospital stay, larger tumor volumes, and a higher rate of failed prior treatment. Younger age and the absence of cavernous sinus invasion were identified as potential protective factors against recurrence. The findings suggest that early detection and treatment of tumors may improve outcomes for CD patients. [Extracted from the article]
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- 2024
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20. Crooke Cell Adenoma Confers Poorer Endocrinological Outcomes Compared with Corticotroph Adenoma: Results of a Multicenter, International Analysis.
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Findlay, Matthew C., Drexler, Richard, Azab, Mohammed, Karbe, Arian, Rotermund, Roman, Ricklefs, Franz L., Flitsch, Jörg, Smith, Timothy R., Kilgallon, John L., Honegger, Jürgen, Nasi-Kordhishti, Isabella, Gardner, Paul A., Gersey, Zachary C., Abdallah, Hussein M., Jane, John A., Marino, Alexandria C., Knappe, Ulrich J., Uksul, Nesrin, Rzaev, Jamil A., and Bervitskiy, Anatoliy V.
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ADENOMA , *CUSHING'S syndrome , *MAGNETIC resonance imaging , *SKULL base , *PITUITARY tumors , *HORMONE deficiencies - Abstract
Crooke cell adenomas (CCAs) are a rare, aggressive subset of secretory pituitary corticotroph adenomas (sCTAs) found in 5%–10% of patients with Cushing disease. Multiple studies support worse outcomes in CCAs but are limited by small sample size and single-institution databases. We compared outcomes in CCA and sCTA using a multicenter, international retrospective database of high-volume skull base centers. Patients surgically treated for pituitary adenoma from January 2017 through December 2020 were included. Among 2826 patients from 12 international centers, 20 patients with CCA and 480 patients with sCTA were identified. No difference in baseline demographics, tumor characteristics, or postoperative complications was seen. Microsurgical approaches (60% CCA vs. 62.3% sCTA) were most common. Gross total resection was higher in CCA patients (100% vs. 83%, P = 0.05). Among patients with gross total resection according to intraoperative findings, fewer CCA patients had postoperative hormone normalization of pituitary function (50% vs. 77.8%, P < 0.01) and remission of hypersecretion by 3–6 months (75% vs. 84.3%, P < 0.01). This was the case despite CCA having better local control rates (100% vs. 96%, P < 0.01) and fewer patients with remnant on magnetic resonance imaging (0% vs. 7.2%, P < 0.01). A systematic literature review of 35 studies reporting on various treatment strategies reiterated the high rate of residual tumor, persistent hypercortisolism, and tumor-related mortality in CCA patients. This modern, multicenter series of patients with CCA reflects their poor prognosis and reduced postsurgical hormonal normalization. Further work is necessary to better understand the pathophysiology of CCA to devise more targeted treatment approaches. [ABSTRACT FROM AUTHOR]
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- 2023
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21. Defining benchmark outcomes for transsphenoidal surgery of pituitary adenomas: a multicenter analysis.
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Drexler, Richard, Rotermund, Roman, Smith, Timothy R., Kilgallon, John L., Honegger, Jürgen, Nasi-Kordhishti, Isabella, Gardner, Paul A., Gersey, Zachary C., Abdallah, Hussein M., Jane Jr, John A., Marino, Alexandria C., Knappe, Ulrich J., Uksul, Nesrin, Rzaev, Jamil A., Galushko, Evgeniy V., Gormolysova, Ekaterina V., Bervitskiy, Anatoliy V., Schroeder, Henry W. S., Eördögh, Márton, and Losa, Marco
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PITUITARY cancer , *OPERATIVE surgery , *TREATMENT effectiveness - Abstract
Importance: Benchmarks aid in improve outcomes for surgical procedures. However, best achievable results that have been validated internationally for transsphenoidal surgery (TS) are not available. Objective: We aimed to establish standardized outcome benchmarks for TS of pituitary adenomas. Design: A total of 2685 transsphenoidal tumor resections from 9 expert centers in 3 continents were analyzed. Setting: Patients were risk stratified, and the median values of each center's outcomes were established. The benchmark was defined as the 75th percentile of all median values for a particular outcome. The postoperative benchmark outcomes included surgical factors, endocrinologyspecific values, and neurology-specific values. Results: Of 2685 patients, 1149 (42.8%) defined the low-risk benchmark cohort. Within these benchmark cases, 831 (72.3%) patients underwent microscopic TS, and 308 (26.8%) patients underwent endoscopic endonasal resection. Of all tumors, 799 (29.8%) cases invaded the cavernous sinus. The postoperative complication rate was 19.6% with mortality between 0.0% and 0.8%. Benchmark cutoffs were ≤2.9% for reoperation rate, ≤1.9% for cerebrospinal fluid leak requiring intervention, and ≤15.5% for transient diabetes insipidus. At 6 months, benchmark cutoffs were calculated as follows: readmission rate: ≤6.9%, new hypopituitarism ≤6.0%, and tumor remnant ≤19.2%. Conclusions: This analysis defines benchmark values for TS targeting morbidity and mortality and represents the best outcomes in the best patients in expert centers. These cutoffs can be used to assess different centers, patient populations, and novel surgical techniques. It should be noted that the benchmark values may influence each other and must be evaluated in their own context. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
22. The Utility of Inflammatory Biomarkers in Predicting Overall Survival and Recurrence among Primary Skull Base Chordoma Patients.
- Author
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Muthiah, Nallammai, Gersey, Zachary, Hoppe, Meagan, Abdallah, Hussein, Wang, Eric, Synderman, Carl, Zenonos, Georgios, and Gardner, Paul
- Subjects
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SKULL base , *OVERALL survival , *CHORDOMA , *BIOMARKERS , *FORECASTING - Published
- 2023
- Full Text
- View/download PDF
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