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  1. Thesis ; Online: Lysosomal Targeting of a Gelatin-Doxorubicin Conjugate and Its Evaluation for Cell Damage in Two Model Breast Cancer Cell Lines

    Alvi, Mohammed M.

    2021  

    Abstract: Doxorubicin (DOX) is one of the most potent anthracycline antibiotics used for treatment of multiple tumor types including breast cancer treatment. However, its efficacy is limited by fatal toxicities associated with DOX therapy causing damage to healthy ...

    Abstract Doxorubicin (DOX) is one of the most potent anthracycline antibiotics used for treatment of multiple tumor types including breast cancer treatment. However, its efficacy is limited by fatal toxicities associated with DOX therapy causing damage to healthy tissues and organs. In this project, a high molecular weight gelatin-doxorubicin (GDOX) conjugate was synthesized and purified. Gelatin was linked to DOX in this conjugation via glygly spacer and an acid labile hydrazone bond. GDOX was characterized for molecular weight distribution of gelatin by size exclusion chromatography. Drug load on the conjugate was measured by UV-visible spectroscopy. DOX release from conjugate was measured at three different pH: 4.8, 6.5 and 7.4. A minimal DOX release of 9% ± 3 % was observed at systemic pH (7.4) and maximum release of 49 ± 1.8 % was observed at tumor microenvironment at pH 4.8. GDOX was then evaluated in an in vitro model consisting of two breast cancer cell lines: MCF7 cells and a triple negative breast cancer (TNBC) MDA-MB-231 cells for intracellular trafficking with emphasis on lysosomal targeting. Cell uptake and localization of an equivalent concentration of 10 µM DOX in GDOX was determined with fluorescence microscopy in these cells and fluorescence quantification was performed with Fiji software. Whole cell fluorescence showed localization of GDOX in both cell lines with higher conjugate accumulation in MDA-MB-231 cells. Lysosomal membrane permeabilization (LMP) was studied using a fluorescent labelled dextran. After 24 h, GDOX triggered 100% LMP in TNBC cells but surprisingly no LMP was observed in MCF7 cells. Finally, to evaluate GDOX induced DNA damage in these cells, TUNEL assay was performed which labels DNA strands breaks using a fluorescent tag. Images were captured on a fluorescent microscope and evaluated for percent apoptotic cell count. A similar extent of apoptosis was seen in both the cell lines and was comparable to free DOX. Overall, these results suggest that conjugate has potential of inducing toxicity to TNBC cells via lysosomal pathway which may induce apoptosis and thus has a potential for treatment of TNBC tumors. However, MCF7 cell studied results indicates a different pathway of toxicity in inducing apoptosis.
    Keywords Pharmaceutical sciences|Cellular biology|Oncology|Genetics|Health sciences|Physiology
    Language ENG
    Publishing date 2021-01-01 00:00:01.0
    Publisher University of the Sciences in Philadelphia
    Publishing country us
    Document type Thesis ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Elderly Patients Show Substantial Improvement in Health-Related Quality of Life After Surgery for Degenerative Cervical Myelopathy Despite Medical Frailty: An Ambispective Analysis of a Multicenter, International Data Set.

    Pedro, Karlo M / Alvi, Mohammed Ali / Hejrati, Nader / Moghaddamjou, Ali / Fehlings, Michael G

    Neurosurgery

    2024  

    Abstract: Background and objectives: We assessed the relationship between Modified Frailty Index-5 (mFI-5) and neurological outcomes, as well as health-related quality of life (HRQoL) measures, in elderly patients with degenerative cervical myelopathy (DCM) after ...

    Abstract Background and objectives: We assessed the relationship between Modified Frailty Index-5 (mFI-5) and neurological outcomes, as well as health-related quality of life (HRQoL) measures, in elderly patients with degenerative cervical myelopathy (DCM) after surgery.
    Methods: Data from 3 major DCM trials (the Arbeitsgemeinschaft für Osteosynthesefragen Spine Cervical Spondylotic Myelopathy-North America, Cervical Spondylotic Myelopathy-International, and CSM-PROTECT studies) were combined, involving 1047 subjects with moderate to severe myelopathy. Patients older than 60 years with 6-month and 1-year postoperative data were analyzed. Neurological outcome was assessed using the modified Japanese Orthopaedic Association score, while HRQoL was measured using the 36-Item Short Form Health Survey (SF-36) (both Physical Component Summary [SF-36 PCS] and Mental Component Summary [SF-36 MCS] scores) and the Neck Disability Index. Frail (mFI ≥2) and nonfrail (mFI = 0-1) cohorts were compared using univariate paired statistics.
    Results: The final analysis included 261 patients (62.5% male), with a mean age of 71 years (95% CI 70.7-72). Frail patients (mFI ≥2) had lower baseline modified Japanese Orthopaedic Association scores (10.45 vs 11.96, P < .001), SF-36 PCS scores (32.01 vs 36.51, P < .001), and SF-36 MCS scores (39.32 vs 45.24, P < .001). At 6-month follow-up, SF-36 MCS improved by a mean (SD) of 7.19 (12.89) points in frail vs 2.91 (11.11) points in the nonfrail group (P = .016). At 1 year after surgery, frail patients showed greater improvement in both SF-36 PCS and SF-36 MCS composite scores compared with nonfrail patients (7.81 vs 4.49, P = .038, and 7.93 vs 3.01, P = .007, respectively). Bivariate regression analysis revealed that higher mFI-5 scores correlated with more substantial improvement in overall mental status at 6 months and 1 year (P = .024 and P = .009, respectively).
    Conclusion: mFI-5 is a clinically helpful signature to reflect the HRQoL status among elderly patients with DCM. Despite preoperative medical frailty, elderly patients with DCM experience significant HRQoL improvement after surgery. These findings enable clinicians to identify elderly patients with modifiable comorbidities and provide informed counseling on anticipated outcomes.
    Level of evidence: II.
    Language English
    Publishing date 2024-01-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 135446-2
    ISSN 1524-4040 ; 0148-396X
    ISSN (online) 1524-4040
    ISSN 0148-396X
    DOI 10.1227/neu.0000000000002818
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Early surgical intervention for acute spinal cord injury: time is spine.

    Quddusi, Ayesha / Pedro, Karlo M / Alvi, Mohammed Ali / Hejrati, Nader / Fehlings, Michael G

    Acta neurochirurgica

    2023  Volume 165, Issue 9, Page(s) 2665–2674

    Abstract: Acute traumatic spinal cord injury (tSCI) is a devastating occurrence that significantly contributes to global morbidity and mortality. Surgical decompression with stabilization is the most effective way to minimize the damaging sequelae that follow ... ...

    Abstract Acute traumatic spinal cord injury (tSCI) is a devastating occurrence that significantly contributes to global morbidity and mortality. Surgical decompression with stabilization is the most effective way to minimize the damaging sequelae that follow acute tSCI. In recent years, strong evidence has emerged that supports the rationale that early surgical intervention, within 24 h following the initial injury, is associated with a better prognosis and functional outcomes. In this review, we have summarized the evidence and elaborated on the nuances of this concept. Additionally, we have reviewed further concepts that stem from "time is spine," including earlier cutoffs less than 24 h and the challenging entity of central cord syndrome, as well as the emerging concept of adequate surgical decompression. Lastly, we identify barriers to early surgical care for acute tSCI, a key aspect of spine care that needs to be globally addressed via research and policy on an urgent basis.
    MeSH term(s) Humans ; Spine/surgery ; Spinal Cord Injuries/surgery ; Spinal Cord Injuries/epidemiology ; Decompression, Surgical/methods ; Prognosis ; Time Factors
    Language English
    Publishing date 2023-07-19
    Publishing country Austria
    Document type Journal Article ; Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 80010-7
    ISSN 0942-0940 ; 0001-6268
    ISSN (online) 0942-0940
    ISSN 0001-6268
    DOI 10.1007/s00701-023-05698-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: EOTE-FSC: An efficient offloaded task execution for fog enabled smart cities.

    Nawaz Tareen, Faheem / Alvi, Ahmad Naseem / Alsamani, Badr / Alkhathami, Mohammed / Alsadie, Deafallah / Alosaimi, Norah

    PloS one

    2024  Volume 19, Issue 4, Page(s) e0298363

    Abstract: Smart cities provide ease in lifestyle to their community members with the help of Information and Communication Technology (ICT). It provides better water, waste and energy management, enhances the security and safety of its citizens and offers better ... ...

    Abstract Smart cities provide ease in lifestyle to their community members with the help of Information and Communication Technology (ICT). It provides better water, waste and energy management, enhances the security and safety of its citizens and offers better health facilities. Most of these applications are based on IoT-based sensor networks, that are deployed in different areas of applications according to their demand. Due to limited processing capabilities, sensor nodes cannot process multiple tasks simultaneously and need to offload some of their tasks to remotely placed cloud servers, which may cause delays. To reduce the delay, computing nodes are placed in different vicinitys acting as fog-computing nodes are used, to execute the offloaded tasks. It has been observed that the offloaded tasks are not uniformly received by fog computing nodes and some fog nodes may receive more tasks as some may receive less number of tasks. This may cause an increase in overall task execution time. Furthermore, these tasks comprise different priority levels and must be executed before their deadline. In this work, an Efficient Offloaded Task Execution for Fog enabled Smart cities (EOTE - FSC) is proposed. EOTE - FSC proposes a load balancing mechanism by modifying the greedy algorithm to efficiently distribute the offloaded tasks to its attached fog nodes to reduce the overall task execution time. This results in the successful execution of most of the tasks within their deadline. In addition, EOTE - FSC modifies the task sequencing with a deadline algorithm for the fog node to optimally execute the offloaded tasks in such a way that most of the high-priority tasks are entertained. The load balancing results of EOTE - FSC are compared with state-of-the-art well-known Round Robin, Greedy, Round Robin with longest job first, and Round Robin with shortest job first algorithms. However, fog computing results of EOTE - FSC are compared with the First Come First Serve algorithm. The results show that the EOTE - FSC effectively offloaded the tasks on fog nodes and the maximum load on the fog computing nodes is reduced up to 29%, 27.3%, 23%, and 24.4% as compared to Round Robin, Greedy, Round Robin with LJF and Round Robin with SJF algorithms respectively. However, task execution in the proposed EOTE - FSC executes a maximum number of offloaded high-priority tasks as compared to the FCFS algorithm within the same computing capacity of fog nodes.
    MeSH term(s) Cities ; Algorithms ; Communication ; Health Facilities ; Information Science
    Language English
    Publishing date 2024-04-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0298363
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Secure Computing for Fog-Enabled Industrial IoT.

    Alvi, Ahmad Naseem / Ali, Bakhtiar / Saleh, Mohamed Saad / Alkhathami, Mohammed / Alsadie, Deafallah / Alghamdi, Bushra

    Sensors (Basel, Switzerland)

    2024  Volume 24, Issue 7

    Abstract: Smart cities are powered by several new technologies to enhance connectivity between devices and develop a network of connected objects which can lead to many smart industrial applications. This network known as the Industrial Internet of Things (IIoT) ... ...

    Abstract Smart cities are powered by several new technologies to enhance connectivity between devices and develop a network of connected objects which can lead to many smart industrial applications. This network known as the Industrial Internet of Things (IIoT) consists of sensor nodes that have limited computing capacity and are sometimes not able to execute intricate industrial tasks within their stipulated time frame. For faster execution, these tasks are offloaded to nearby fog nodes. Internet access and the diverse nature of network types make IIoT nodes vulnerable and are under serious malicious attacks. Malicious attacks can cause anomalies in the IIoT network by overloading complex tasks, which can compromise the fog processing capabilities. This results in an increased delay of task computation for trustworthy nodes. To improve the task execution capability of the fog computing node, it is important to avoid complex offloaded tasks due to malicious attacks. However, even after avoiding the malicious tasks, if the offloaded tasks are too complex for the fog node to execute, then the fog nodes may struggle to process all legitimate tasks within their stipulated time frame. To address these challenges, the Trust-based Efficient Execution of Offloaded IIoT Trusted tasks (EEOIT) is proposed for fog nodes. EEOIT proposes a mechanism to detect malicious nodes as well as manage the allocation of computing resources so that IIoT tasks can be completed in the specified time frame. Simulation results demonstrate that EEOIT outperforms other techniques in the literature in an IIoT setting with different task densities. Another significant feature of the proposed EEOIT technique is that it enhances the computation of trustable tasks in the network. The results show that EEOIT entertains more legitimate nodes in executing their offloaded tasks with more executed data, with reduced time and with increased mean trust values as compared to other schemes.
    Language English
    Publishing date 2024-03-25
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2052857-7
    ISSN 1424-8220 ; 1424-8220
    ISSN (online) 1424-8220
    ISSN 1424-8220
    DOI 10.3390/s24072098
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Current landscape of social media use pertaining to glioblastoma by various stakeholders.

    Alvi, Mohammed Ali / Elkaim, Lior M / Levett, Jordan J / Pando, Alejandro / Roy, Sabrina / Samuel, Nardin / Alotaibi, Naif M / Zadeh, Gelareh

    Neuro-oncology advances

    2023  Volume 5, Issue 1, Page(s) vdad039

    Abstract: Background: Given the potential for social media to allow widespread public engagement, its role in healthcare, including in cancer care as a support network, is garnering interest. To date, the use of social media in neuro-oncology has not been ... ...

    Abstract Background: Given the potential for social media to allow widespread public engagement, its role in healthcare, including in cancer care as a support network, is garnering interest. To date, the use of social media in neuro-oncology has not been systematically explored. In the current manuscript, we sought to review Twitter use on glioblastoma among patients, caregivers, providers, researchers, and other stakeholders.
    Methods: The Twitter application programming interface (API) database was surveyed from inception to May 2022 to identify tweets about glioblastoma. Number of tweet likes, retweets, quotes, and total engagement were noted for each tweet. Geographic location, number of followers, and number of Tweets were noted for users. We also categorized Tweets based on their underlying themes. A natural language processing (NLP) algorithm was used to assign a polarity score, subjectivity score, and analysis label to each Tweet for sentiment analysis.
    Results: A total of 1690 unique tweets from 1000 accounts were included in our analyses. The frequency of tweets increased from 2013 and peaked in 2018. The most common category among users was MD/researchers (21.6%,
    Conclusion: This comprehensive analysis of tweets on glioblastoma found that the academic community are the most common user group on Twitter. Sentiment analysis revealed that most negative tweets are related to personal experience. These analyses provide the basis for further work into supporting and developing the care of patients with glioblastoma.
    Language English
    Publishing date 2023-05-24
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 3009682-0
    ISSN 2632-2498 ; 2632-2498
    ISSN (online) 2632-2498
    ISSN 2632-2498
    DOI 10.1093/noajnl/vdad039
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Pharmacological and non-pharmacological efforts at prevention, mitigation, and treatment for COVID-19.

    Alvi, Mohammed M / Sivasankaran, Sowmya / Singh, Mahima

    Journal of drug targeting

    2020  Volume 28, Issue 7-8, Page(s) 742–754

    Abstract: A global outbreak of the SARS-CoV-2 virus has infected millions of people over a short period of time. The communicability and increased mortality from the SARS-CoV-2 infection mandated the WHO to declare COVID-19 a worldwide pandemic. The virus outbreak ...

    Abstract A global outbreak of the SARS-CoV-2 virus has infected millions of people over a short period of time. The communicability and increased mortality from the SARS-CoV-2 infection mandated the WHO to declare COVID-19 a worldwide pandemic. The virus outbreak has spread when there are no approved vaccines, treatments, or prophylactic therapies available. Researchers from all over the world have prioritised development of vaccines and antivirals. Several vaccine projects have seen successes in preclinical, phase I, and phase II clinical trials using recombinant DNA, mRNA, live attenuated virus, S-protein subunits, virus like particles, and viral vectors. Initial findings from antivirals such as remdesivir, favipiravir, danoprevir or lopinavir with ritonavir are presented. Immunomodulatory molecules such as sarilumab, tocilizumab, janus kinase inhibitors, and hyperimmune convalescent plasma have mixed outcomes from initial clinical findings; however, pending randomised controlled trials will assist national health institutions to make treatment recommendations for COVID-19. Where compassionate use of remdesivir has shown some benefits, therapies such as hydroxychloroquine have proven harmful due to their toxicities. This review discusses pharmacological interventions at play and evidence-based successes and limitations of non-pharmacological therapies such as social distancing, personal protective equipment, and ventilator support associated with the prevention and treatment of COVID-19.
    MeSH term(s) Animals ; Antiviral Agents/administration & dosage ; Coronavirus Infections/drug therapy ; Coronavirus Infections/epidemiology ; Coronavirus Infections/prevention & control ; Coronavirus Infections/therapy ; Humans ; Pandemics/prevention & control ; Personal Protective Equipment ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/therapy ; Respiration, Artificial/methods ; Social Isolation
    Chemical Substances Antiviral Agents
    Keywords covid19
    Language English
    Publishing date 2020-07-16
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1187110-6
    ISSN 1029-2330 ; 1061-186X
    ISSN (online) 1029-2330
    ISSN 1061-186X
    DOI 10.1080/1061186X.2020.1793990
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: The emerging key role of reactive sulfur species in abiotic stress tolerance in plants.

    Alvi, Ameena Fatima / Iqbal, Noushina / Albaqami, Mohammed / Khan, Nafees A

    Physiologia plantarum

    2023  Volume 175, Issue 3, Page(s) e13945

    Abstract: In plants, sulfur plays a critical role in the formation of important biomolecules such as cysteine, methionine, and tripeptide glutathione. Thiol groups, composed of sulfur, are essential to numerous metabolic processes. The easy and reversible ... ...

    Abstract In plants, sulfur plays a critical role in the formation of important biomolecules such as cysteine, methionine, and tripeptide glutathione. Thiol groups, composed of sulfur, are essential to numerous metabolic processes. The easy and reversible oxidation and reduction of thiol groups have drawn attention to the redox regulation of cellular metabolism. Reactive sulfur species (RSS), including hydrogen sulfide (H
    MeSH term(s) Cysteine/metabolism ; Hydrogen Sulfide/metabolism ; Plants/metabolism ; Reactive Oxygen Species/metabolism ; Antioxidants/metabolism ; Stress, Physiological ; Sulfhydryl Compounds/metabolism ; Sulfur/metabolism
    Chemical Substances Cysteine (K848JZ4886) ; Hydrogen Sulfide (YY9FVM7NSN) ; Reactive Oxygen Species ; Antioxidants ; Sulfhydryl Compounds ; Sulfur (70FD1KFU70)
    Language English
    Publishing date 2023-06-02
    Publishing country Denmark
    Document type Journal Article ; Review
    ZDB-ID 2020837-6
    ISSN 1399-3054 ; 0031-9317
    ISSN (online) 1399-3054
    ISSN 0031-9317
    DOI 10.1111/ppl.13945
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Thirty-Day Stroke and Mortality After Carotid Revascularization Among Octogenarians with Symptomatic Carotid Stenosis: Real-World Evidence from a National Surgical Quality Registry.

    Madhani, Sarosh Irfan / Alvi, Mohammed Ali / Pando, Alejandro / Alotaibi, Naif M / Lanzino, Giuseppe / Al-Omran, Mohammed / Savastano, Luis

    World neurosurgery

    2022  Volume 167, Page(s) e40–e52

    Abstract: Background: The outcomes of carotid revascularization among octogenarians are not well studied. We present analyses of 30-day stroke and mortality of patients aged ≥80 years using real-world data from a national surgical quality registry.: Methods: ... ...

    Abstract Background: The outcomes of carotid revascularization among octogenarians are not well studied. We present analyses of 30-day stroke and mortality of patients aged ≥80 years using real-world data from a national surgical quality registry.
    Methods: The National Surgical Quality Improvement Program targeted data set for carotid endarterectomy (CEA) and carotid angioplasty and stenting (CAS) was queried for patients aged ≥80 years undergoing CEA and CAS between 2012 and 2019.
    Results: A total of 122 and 3013 patients aged ≥80 years with symptomatic carotid stenosis undergoing CAS and CEA, respectively, were identified. Patients with CAS were more likely to be older than 90 years (P = 0.006) and have diabetes (P = 0.036), were more likely to have high-risk anatomy (P < 0.001), but had lower American Society of Anesthesiologists score (P < 0.001). An ipsilateral stroke had been experienced by 43.6% of patients with CAS and 44.7% of patients with CEA. The rate of 30-day composite outcome was 6.4% in the CAS group and 4.5% in the CEA group (P = 0.326). The f 30-day mortality was significantly higher for CAS (5.6% vs. 1.7%, P = 0.001); however, the difference between the cohorts was not significant (CAS, 2.4% vs. CEA, 3.4%, P = 0.555). On multivariable analysis, CEA was associated with significantly lower odds of mortality (odds ratio [OR], 0.32; P = 0.0145). Symptom presentation other than ipsilateral stroke was associated with significantly decreased odds of 30-day outcome (amaurosis fugax/transient monocular blindness, OR, 0.39, P = 0.004; transient ischemic attack, OR, 0.57, P = 0.003), whereas higher age had significantly increased odds (OR, 1.95; P = 0.0172).
    Conclusions: Real-world analyses from a surgical quality registry show that CEA may be associated with lower odds of mortality compared with CAS among octogenarians.
    MeSH term(s) Aged, 80 and over ; Humans ; Carotid Stenosis/complications ; Octogenarians ; Risk Factors ; Risk Assessment ; Myocardial Infarction/etiology ; Treatment Outcome ; Stroke/etiology ; Endarterectomy, Carotid/adverse effects ; Registries ; Stents ; Retrospective Studies
    Language English
    Publishing date 2022-07-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2022.07.056
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Prevention, Diagnosis, and Management of Intraoperative Spinal Cord Injury in the Setting of Spine Surgery: A Proposed Care Pathway.

    Srikandarajah, Nisaharan / Hejrati, Nader / Alvi, Mohammed Ali / Quddusi, Ayesha / Tetreault, Lindsay A / Evaniew, Nathan / Skelly, Andrea C / Douglas, Sam / Rahimi-Movaghar, Vafa / Arnold, Paul M / Kirshblum, Steven / Kwon, Brian K / Fehlings, Michael G

    Global spine journal

    2024  Volume 14, Issue 3_suppl, Page(s) 166S–173S

    Abstract: Study design: This study is a mixed methods approach.: Objectives: Intraoperative spinal cord injury (ISCI) is a challenging complication in spine surgery. Intra-operative neuromonitoring (IONM) has been developed to detect changes in neural function. ...

    Abstract Study design: This study is a mixed methods approach.
    Objectives: Intraoperative spinal cord injury (ISCI) is a challenging complication in spine surgery. Intra-operative neuromonitoring (IONM) has been developed to detect changes in neural function. We report on the first multidisciplinary, international effort through AO Spine and the Praxis Spinal Cord Institute to develop a comprehensive guideline and care pathway for the prevention, diagnosis, and management of ISCI.
    Methods: Three literature reviews were registered on PROSPERO (CRD 42022298841) and performed according to PRISMA guidelines: (1) Definitions, frequency, and risk factors for ISCI, (2) Meta-analysis of the accuracy of IONM for diagnosis of ISCI, (3) Reported management approaches for ISCI and related events. The results were presented in a consensus session to decide the definition of IONM and recommendation of its use in high-risk cases. Based on a literature review of management strategies for ISCI, an intra-operative checklist and overall care pathway was developed by the study team.
    Results: An operational definition and high-risk patient categories for ISCI were established. The reported incidence of deficits was documented to be higher in intramedullary tumour spine surgery. Multimodality IONM has a high sensitivity and specificity. A guideline recommendation of IONM to be employed for high-risk spine cases was made. The different sections of the intraoperative checklist include surgery, anaesthetic and neurophysiology. The care pathway includes steps (1) initial clinical assessment, (2) pre-operative planning, (3) surgical/anaesthetic planning, (4) intra-operative management, and (5) post-operative management.
    Conclusions: This is the first evidence based comprehensive guideline and care pathway for ISCI using the GRADE methodology. This will facilitate a reduction in the incidence of ISCI and improved outcomes from this complication. We welcome the wide implementation and validation of these guidelines and care pathways in prospective, multicentre studies.
    Language English
    Publishing date 2024-03-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2648287-3
    ISSN 2192-5690 ; 2192-5682
    ISSN (online) 2192-5690
    ISSN 2192-5682
    DOI 10.1177/21925682231217980
    Database MEDical Literature Analysis and Retrieval System OnLINE

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