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  1. Article ; Online: Evaluation of Patient Education Materials From Large-Language Artificial Intelligence Models on Carpal Tunnel Release.

    Croen, Brett J / Abdullah, Mohammed S / Berns, Ellis / Rapaport, Sarah / Hahn, Alexander K / Barrett, Caitlin C / Sobel, Andrew D

    Hand (New York, N.Y.)

    2024  , Page(s) 15589447241247332

    Abstract: Background: ChatGPT, an artificial intelligence technology, has the potential to be a useful patient aid, though the accuracy and appropriateness of its responses and recommendations on common hand surgical pathologies and procedures must be understood. ...

    Abstract Background: ChatGPT, an artificial intelligence technology, has the potential to be a useful patient aid, though the accuracy and appropriateness of its responses and recommendations on common hand surgical pathologies and procedures must be understood. Comparing the sources referenced and characteristics of responses from ChatGPT and an established search engine (Google) on carpal tunnel surgery will allow for an understanding of the utility of ChatGPT for patient education.
    Methods: A Google search of "carpal tunnel release surgery" was performed and "frequently asked questions (FAQs)" were recorded with their answer and source. ChatGPT was then asked to provide answers to the Google FAQs. The FAQs were compared, and answer content was compared using word count, readability analyses, and content source.
    Results: There was 40% concordance among questions asked by the programs. Google answered each question with one source per answer, whereas ChatGPT's answers were created from two sources per answer. ChatGPT's answers were significantly longer than Google's and multiple readability analysis algorithms found ChatGPT responses to be statistically significantly more difficult to read and at a higher grade level than Google's. ChatGPT always recommended "contacting your surgeon."
    Conclusion: A comparison of ChatGPT's responses to Google's FAQ responses revealed that ChatGPT's answers were more in-depth, from multiple sources, and from a higher proportion of academic Web sites. However, ChatGPT answers were found to be more difficult to understand. Further study is needed to understand if the differences in the responses between programs correlate to a difference in patient comprehension.
    Language English
    Publishing date 2024-04-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2277325-3
    ISSN 1558-9455 ; 1558-9447
    ISSN (online) 1558-9455
    ISSN 1558-9447
    DOI 10.1177/15589447241247332
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Patterns of referral for refugees in western Tanzania: a retrospective review.

    Abrahim, Orit / Rapaport, Sarah / Ngude, Hilary / Abbas, Mohamed / Winch, Peter J / Stevens, Kent A / Enumah, Zachary Obinna

    The Pan African medical journal

    2022  Volume 41, Page(s) 76

    Abstract: Introduction: access to essential secondary and tertiary healthcare, including surgery and medical sub-specialties, is a challenge in low-and-middle income countries (LMICs), especially for displaced populations. Referrals from refugee camps are highly ... ...

    Abstract Introduction: access to essential secondary and tertiary healthcare, including surgery and medical sub-specialties, is a challenge in low-and-middle income countries (LMICs), especially for displaced populations. Referrals from refugee camps are highly regulated and may pose barriers to accessing essential secondary healthcare in a timely manner. Refugee referral systems and the ways they interact with national systems are poorly understood. Such information is necessary for resource allocation and prioritization, optimizing patient outcomes, national-level planning, and investment in capacity-building.
    Methods: a retrospective review of referrals from Nyarugusu Refugee Camp in Tanzania to Kabanga Hospital between January 2016-May 2017 was conducted. Data was collected from logbooks on patient demographics, diagnosis, and reason for referral. Diagnoses and reasons for referral were further coded by organ system and specific referral codes, respectively.
    Results: there were 751 entries in the referral logbook between January 2016 and May 2017. Of these, 79 (10.5%) were excluded as they were caretakers or missing both diagnoses and reason for referral resulting in 672 (89.5%) total entries for analysis.The most common organ system of diagnosis was musculoskeletal (171, 25.5%) followed by head, ear, eye, nose and throat (n=164, 24.4%) and infectious disease (n=92, 13.7%). The most common reason for referral was imaging (n=250, 37.2%) followed by need for a specialist (n=214, 31.9%) and further management (n=116, 17.3%). X-ray comprised the majority of imaging referred (n=249, 99.6%). The most common specialties referred to were ophthalmology (n=104, 48.6%) followed by surgery (n=63, 29.4%), and otolaryngology (ENT) (n=17, 7.9%).
    Conclusion: given a large burden of referral for refugee patients and sharing of in and out-of-camp healthcare facilities with nationals, refugees should be included in national health care plans and have clear referral processes. Epidemiological data that include these intertwined referral patterns are necessary to promote efficient resource allocation, reduce unnecessary referrals, and prevent delays in care that could affect patient outcomes. International agencies, NGOs, and governments should conduct cost analyses to explore innovative capacity-building projects for secondary care in camp-based facilities.
    MeSH term(s) Humans ; Referral and Consultation ; Refugee Camps ; Refugees ; Retrospective Studies ; Tanzania
    Language English
    Publishing date 2022-01-27
    Publishing country Uganda
    Document type Journal Article
    ZDB-ID 2514347-5
    ISSN 1937-8688 ; 1937-8688
    ISSN (online) 1937-8688
    ISSN 1937-8688
    DOI 10.11604/pamj.2022.41.76.32559
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Implementing HIV Prevention in Sub-Saharan Africa: A Systematic Review of Interventions Targeting Systems, Communities, and Individuals.

    Rapaport, Sarah F / Peer, Austin D / Viswasam, Nikita / Hahn, Elizabeth / Ryan, Sofia / Turpin, Gnilane / Lyons, Carrie E / Baral, Stefan / Hansoti, Bhakti

    AIDS and behavior

    2022  Volume 27, Issue 1, Page(s) 150–160

    Abstract: HIV remains a threat to global public health, disproportionately affecting countries across Sub-Saharan Africa. Although treatment and access to care have improved, prevention remains critical to ending new HIV infections by 2030. A variety of prevention ...

    Abstract HIV remains a threat to global public health, disproportionately affecting countries across Sub-Saharan Africa. Although treatment and access to care have improved, prevention remains critical to ending new HIV infections by 2030. A variety of prevention strategies exist, yet their effectiveness is difficult to measure and variable due to the nature of the interventions and vulnerability of the intervention during implementation. This systematic review of 51 studies synthesizes data on the implementation and evaluation of evidence-based HIV prevention interventions across Sub-Saharan Africa. Studies were included if they occurred between January 1, 2008, and December 31, 2019, inclusive in Sub-Saharan Africa, were written in English, implemented an HIV prevention intervention in the field, and had reportable results. Using a modified social-ecological model for HIV prevention, we divided studies into three categories: interventions targeting health systems (n = 16), communities (n = 8), and individuals (n = 27). Across all categories, the data emphasized preventing mother-to-child transmission (PMTCT), medical interventions, and psychosocial interventions. The most successful programs bundled several interventions that were integrated into the health system. There is a notable lack of interventions targeting key populations and there are significant rates of loss to follow up (LTFU) across many studies. This review provides insight into the prioritization of evidence-based HIV prevention interventions across Sub-Saharan Africa.
    MeSH term(s) Humans ; Female ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Infectious Disease Transmission, Vertical/prevention & control ; Acquired Immunodeficiency Syndrome ; Africa South of the Sahara/epidemiology ; Global Health
    Language English
    Publishing date 2022-08-01
    Publishing country United States
    Document type Systematic Review ; Journal Article
    ZDB-ID 1339885-4
    ISSN 1573-3254 ; 1090-7165
    ISSN (online) 1573-3254
    ISSN 1090-7165
    DOI 10.1007/s10461-022-03751-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: What Proportion of East African Refugees Report Musculoskeletal Problems? A Cross-sectional Survey.

    Rapaport, Sarah / Ngude, Hilary / Ficke, James R / Yenokyan, Gayane / Rafiq, Mohamed Yunus / Juma, Omar / Sakran, Joseph V / Stevens, Kent A / Enumah, Zachary Obinna

    Clinical orthopaedics and related research

    2023  

    Abstract: Background: Musculoskeletal conditions are the leading cause of disability worldwide and disproportionally affect individuals in low-income and middle-income countries. There is a dearth of evidence on musculoskeletal problems among refugees, 74% of ... ...

    Abstract Background: Musculoskeletal conditions are the leading cause of disability worldwide and disproportionally affect individuals in low-income and middle-income countries. There is a dearth of evidence on musculoskeletal problems among refugees, 74% of whom reside in low-income and middle-income countries.
    Questions/purposes: (1) What proportion of refugees in Nyarugusu Camp, Kigoma, western Tanzania, are affected by musculoskeletal problems and what are the characteristics of those individuals? (2) What are the characteristics of these musculoskeletal problems, including their causes, location, and duration? (3) What forms of healthcare do those with musculoskeletal problems seek, including those for both musculoskeletal and nonmusculoskeletal problems?
    Methods: We conducted a cross-sectional study among refugees in Nyarugusu Camp, using the Surgeons OverSeas Assessment of Surgical Need tool. The Surgeons OverSeas Assessment of Surgical Need tool is a validated population-based survey tool developed for use in limited-resource settings that is intended to determine the prevalence of surgical disease in a community. It uses a cluster random sampling methodology with house-to-house data collection in the form of a verbal head-to-toe examination that is performed by a trained community healthcare worker. A total of 99% responded, and 3574 records were analyzed. The mean age of respondents was 23 ± 18 years, with under 18 as the most-represented age group (44% [1563]). A total of 57% (2026) of respondents were women, 79% (2802 of 3536) were generally healthy, and 92% (3297 of 3570) had visited a camp medical facility. Only records endorsing musculoskeletal problems (extremity or back) were included in this analysis. Using all refugees surveyed as our denominator and refugees who endorsed a musculoskeletal problem (extremity or back) as the numerator, we calculated the proportion of refugees who endorsed a musculoskeletal problem. We then analyzed the characteristics of those endorsing musculoskeletal problems, including their healthcare-seeking behavior, and the characteristics of the musculoskeletal problems themselves.
    Results: Among 3574 refugees interviewed, 22% (769) reported musculoskeletal problems, with 17% (609) reporting extremity problems and 7% (266) reporting back problems. Among all people surveyed, 8% (290) reported current extremity problems while 5% (188) reported current back problems. Among those reporting musculoskeletal problems, respondents younger than 18 years were the most-represented age group (28% [169 of 609]) whereas respondents between 30 and 44 years of age were the most-represented age group for back problems (29% [76 of 266]). Wounds from an injury or trauma (24% [133 of 557]) and acquired disability (24% [133 of 557]) were the most-common causes of extremity problems, whereas acquired disability (53% [97 of 184]) followed by a wound not from injury or trauma (25% [45 of 184]) were the most common causes of back problems. Fifty percent (303) of those with extremity problems characterized it as disabling, whereas 76% (203) of those with back problems did.
    Conclusion: Over one of five refugees endorsed musculoskeletal problems, which are most often caused by acquired disease and injury. These musculoskeletal problems are often characterized as disabling, yet only slightly more than half have sought treatment for problems. This warrants further research on care-seeking behavior in this setting, and emphasizes that investing in the spectrum of musculoskeletal health systems, including medical management and rehabilitation services, is critical to decreasing disability caused by musculoskeletal problems.
    Level of evidence: Level IV, prognostic study.
    Language English
    Publishing date 2023-07-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80301-7
    ISSN 1528-1132 ; 0009-921X
    ISSN (online) 1528-1132
    ISSN 0009-921X
    DOI 10.1097/CORR.0000000000002729
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Patterns, procedures, and indications for pediatric surgery in a Tanzanian Refugee Camp: a 20-year experience.

    Rapaport, Sarah / Enumah, Zachary Obinna / Ngude, Hilary / Rhee, Daniel S / Abbas, Mohamed / Lekey, Amber / Winch, Peter J / Sakran, Joseph V / Stevens, Kent A

    World journal of pediatric surgery

    2023  Volume 6, Issue 3, Page(s) e000528

    Abstract: Background: There are 103 million displaced people worldwide, 41% of whom are children. Data on the provision of surgery in humanitarian settings are limited. Even scarcer is literature on pediatric surgery performed in humanitarian settings, ... ...

    Abstract Background: There are 103 million displaced people worldwide, 41% of whom are children. Data on the provision of surgery in humanitarian settings are limited. Even scarcer is literature on pediatric surgery performed in humanitarian settings, particularly protracted humanitarian settings.
    Methods: We reviewed patterns, procedures, and indications for pediatric surgery among children in Nyarugusu Refugee Camp using a 20-year retrospective dataset.
    Results: A total of 1221 pediatric surgical procedures were performed over the study period. Teenagers between the ages of 12 and 17 years were the most common age group undergoing surgery (n=991; 81%). A quarter of the procedures were performed on local Tanzanian children seeking care in the camp (n=301; 25%). The most common procedures performed were cesarean sections (n=858; 70%), herniorrhaphies (n=197; 16%), and exploratory laparotomies (n=55; 5%). Refugees were more likely to undergo exploratory laparotomy (n=47; 5%) than Tanzanian children (n=7; 2%; p=0.032). The most common indications for exploratory laparotomy were acute abdomen (n=24; 44%), intestinal obstruction (n=10; 18%), and peritonitis (n=9; 16%).
    Conclusions: There is a significant volume of basic pediatric general surgery performed in the Nyarugusu Camp. Services are used by both refugees and local Tanzanians. We hope this research will inspire further advocacy and research on pediatric surgical services in humanitarian settings worldwide and illuminate the need for including pediatric refugee surgery within the growing global surgery movement.
    Language English
    Publishing date 2023-06-21
    Publishing country England
    Document type Journal Article
    ISSN 2516-5410
    ISSN (online) 2516-5410
    DOI 10.1136/wjps-2022-000528
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: A Scoping Review of the Essential Components of Emergency Medical Response Systems for Mass Casualty Incidents.

    Usoro, Agnes / Mehmood, Amber / Rapaport, Sarah / Ezeigwe, Angelica K / Adeyeye, Adebisi / Akinlade, Oluwafunmilayo / Dias, Jennifer / Barnett, Daniel J / Hsu, Edbert B / Tower, Craig / Razzak, Junaid

    Disaster medicine and public health preparedness

    2023  Volume 17, Page(s) e274

    Abstract: Objective: Emergency medical (EM) response systems require extensive coordination, particularly during mass casualty incidents (MCIs). The recognition of preparedness gaps and contextual priorities to MCI response capacity in low- and middle-income ... ...

    Abstract Objective: Emergency medical (EM) response systems require extensive coordination, particularly during mass casualty incidents (MCIs). The recognition of preparedness gaps and contextual priorities to MCI response capacity in low- and middle-income countries (LMICs) can be better understood through the components of EM reponse systems. This study aims to delineate essential components and provide a framework for effective emergency medical response to MCIs.
    Methods: A scoping review was conducted using 4 databases. Title and abstract screening was followed by full-text review. Thematic analysis was conducted to identify themes pertaining to the essential components and integration of EM response systems.
    Results: Of 20,456 screened citations, 181 articles were included in the analysis. Seven major and 40 sub-themes emerged from the content analysis as the essential components and supportive elements of MCI medical response. The essential components of MCI response were integrated into a framework demonstrating interrelated connections between essential and supportive elements.
    Conclusions: Definitions of essential components of EM response to MCIs vary considerably. Most literature pertaining to MCI response originates from high income countries with far fewer reports from LMICs. Integration of essential components is needed in different geopolitical and economic contexts to ensure an effective MCI emergency medical response.
    MeSH term(s) Humans ; Mass Casualty Incidents ; Emergency Medical Services ; Disaster Planning
    Language English
    Publishing date 2023-01-04
    Publishing country United States
    Document type Journal Article ; Review ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2375268-3
    ISSN 1938-744X ; 1935-7893
    ISSN (online) 1938-744X
    ISSN 1935-7893
    DOI 10.1017/dmp.2022.235
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Epidemiology of surgery in a protracted humanitarian setting: a 20-year retrospective study of Nyarugusu Refugee Camp, Kigoma, Western Tanzania.

    Rapaport, Sarah / Ngude, Hilary / Lekey, Amber / Abbas, Mohamed / Winch, Peter J / Stevens, Kent / Enumah, Zachary Obinna

    BMC surgery

    2021  Volume 21, Issue 1, Page(s) 381

    Abstract: Background: There are 80 million forcibly displaced persons worldwide, 26.3 million of whom are refugees. Many refugees live in camps and have complex health needs, including a high burden of non-communicable disease. It is estimated that 3 million ... ...

    Abstract Background: There are 80 million forcibly displaced persons worldwide, 26.3 million of whom are refugees. Many refugees live in camps and have complex health needs, including a high burden of non-communicable disease. It is estimated that 3 million procedures are needed for refugees worldwide, yet very few studies exist on surgery in refugee camps, particularly protracted refugee settings. This study utilizes a 20-year dataset, the longest dataset of surgery in a refugee setting to be published to date, to assess surgical output in a setting of protracted displacement.
    Methods: A retrospective review of surgeries performed in Nyarugusu Camp was conducted using paper logbooks containing entries between November 2000 and September 2020 inclusive. Abstracted data were digitized into standard electronic form and included date, patient nationality, sex, age, indication, procedure performed, and anesthesia used. A second reviewer checked 10% of entries for accuracy. Entries illegible to both reviewers were excluded. Demographics, indication for surgery, procedures performed, and type of anesthesia were standardized for descriptive analysis, which was performed in STATA.
    Results: There were 10,799 operations performed over the 20-year period. Tanzanians underwent a quarter of the operations while refugees underwent the remaining 75%. Ninety percent of patients were female and 88% were 18 years of age or older. Caesarean sections were the most common performed procedure followed by herniorrhaphies, tubal ligations, exploratory laparotomies, hysterectomies, appendectomies, and repairs. The most common indications for laparotomy procedures were ectopic pregnancy, uterine rupture, and acute abdomen. Spinal anesthesia was the most common anesthesia type used. Although there was a consistent increase in procedural volume over the study period, this is largely explained by an increase in overall camp population and an increase in caesarean sections rather than increases in other, specific surgical procedures.
    Conclusion: There is significant surgical volume in Nyarugusu Camp, performed by staff physicians and visiting surgeons. Both refugees and the host population utilize these surgical services. This work provides context to the surgical training these settings require, but further study is needed to assess the burden of surgical disease and the extent to which it is met in this setting and others.
    MeSH term(s) Adolescent ; Adult ; Female ; Humans ; Pregnancy ; Refugee Camps ; Refugees ; Retrospective Studies ; Tanzania
    Language English
    Publishing date 2021-10-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050442-1
    ISSN 1471-2482 ; 1471-2482
    ISSN (online) 1471-2482
    ISSN 1471-2482
    DOI 10.1186/s12893-021-01365-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Adapting the 5-factor modified frailty index for prediction of postprocedural outcome in patients with unruptured aneurysms.

    Feghali, James / Gami, Abhishek / Rapaport, Sarah / Patel, Jaimin / Khalafallah, Adham M / Huq, Sakibul / Mukherjee, Debraj / Tamargo, Rafael J / Huang, Judy

    Journal of neurosurgery

    2021  Volume 136, Issue 2, Page(s) 456–463

    Abstract: Objective: The 5-factor modified frailty index (mFI-5) is a practical tool that can be used to estimate frailty by measuring five accessible factors: functional status, history of diabetes, chronic obstructive pulmonary disease, congestive heart failure, ...

    Abstract Objective: The 5-factor modified frailty index (mFI-5) is a practical tool that can be used to estimate frailty by measuring five accessible factors: functional status, history of diabetes, chronic obstructive pulmonary disease, congestive heart failure, and hypertension. The authors aimed to validate the utility of mFI-5 for predicting endovascular and microsurgical treatment outcomes in patients with unruptured aneurysms.
    Methods: A prospectively maintained database of consecutive patients with unruptured aneurysm who were treated with clip placement or endovascular therapy was used. Because patient age is an important predictor of treatment outcomes in patients with unruptured aneurysm, mFI-5 was supplemented with age to create the age-supplemented mFI-5 (AmFI-5). Associations of scores on these indices with major complications (symptomatic ischemic or hemorrhagic stroke, pulmonary embolism, pneumonia, or surgical site infection requiring reoperation) were evaluated. Validation was carried out with the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database (2006-2017).
    Results: The institutional database included 275 patients (88 underwent clip placement, and 187 underwent endovascular treatment). Multivariable analysis of the surgical cohort showed that major complication was significantly associated with mFI-5 (OR 2.0, p = 0.046) and AmFI-5 (OR 1.9, p = 0.028) scores. Significant predictive accuracy for major complications was provided by mFI-5 (c-statistic = 0.709, p = 0.011) and AmFI-5 (c-statistic = 0.720, p = 0.008). The American Society of Anesthesiologists Physical Status Classification System (ASA) provided poor discrimination (area under the curve = 0.541, p = 0.618) that was significantly less than that of mFI-5 (p = 0.023) and AmFI-5 (p = 0.014). Optimal relative fit was achieved with AmFI-5, which had the lowest Akaike information criterion value. Similar results were obtained after equivalent analysis of the endovascular cohort, with additional significant associations between index scores and length of stay (β = 0.6 and p = 0.009 for mFI-5; β = 0.5 and p = 0.003 for AmFI-5). In 1047 patients who underwent clip placement and were included in the NSQIP database, mFI-5 (p = 0.001) and AmFI-5 (p < 0.001) scores were significantly associated with severe postoperative adverse events and provided greater discrimination (c-statistic = 0.600 and p < 0.001 for mFI-5; c-statistic = 0.610 and p < 0.001 for AmFI-5) than ASA score (c-statistic = 0.580 and p = 0.003).
    Conclusions: mFI-5 and AmFI-5 represent potential predictors of procedure-related complications in unruptured aneurysm patients. After further validation, integration of these tools into clinical workflows may optimize patients for intervention.
    MeSH term(s) Aneurysm ; Frailty/complications ; Humans ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Quality Improvement ; Reoperation/adverse effects ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Surgical Wound Infection
    Language English
    Publishing date 2021-08-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 3089-2
    ISSN 1933-0693 ; 0022-3085
    ISSN (online) 1933-0693
    ISSN 0022-3085
    DOI 10.3171/2021.2.JNS204420
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Hemorrhage Following Complete Arteriovenous Malformation Resection With No Detectable Recurrence: Insights From a 27-Year Registry.

    Rapaport, Sarah / Feghali, James / Yang, Wuyang / Gami, Abhishek / Patel, Jaimin / Tamargo, Rafael J / Caplan, Justin M / Huang, Judy

    Neurosurgery

    2021  Volume 89, Issue 2, Page(s) 212–219

    Abstract: Background: Although recurrence and de novo formation of arteriovenous malformations (AVMs) have been reported following complete resection, the occurrence of hemorrhage in the same location of an AVM with no detectable lesion (lesion-negative ... ...

    Abstract Background: Although recurrence and de novo formation of arteriovenous malformations (AVMs) have been reported following complete resection, the occurrence of hemorrhage in the same location of an AVM with no detectable lesion (lesion-negative hemorrhage) has not been described after microsurgery.
    Objective: To characterize the incidence and properties of lesion-negative hemorrhage following complete microsurgical resection.
    Methods: A prospectively maintained registry of AVM patients seen at our institution between 1990 and 2017 was used. Microsurgically treated patients were selected, and the incidence of a lesion-negative hemorrhage was calculated and described with a Kaplan-Meier curve. Baseline characteristics as well as functional outcome at last follow-up were compared between patients with and without a lesion-negative hemorrhage.
    Results: From a total of 789 AVM patients, 619 (79%) were treated, and 210 out of 619 patients (34%) underwent microsurgery with or without preoperative embolization or radiosurgery. The microsurgically treated cohort was followed up for a mean of 6.1 ± 3.0 yr after surgery with 5 (2.4%) patients experiencing postresection lesion-negative hemorrhage (3.9 per 1000 person-years) at an average of 8.6 ± 9.0 yr following surgery. Follow-up angiograms after hemorrhage (up to 2 mo posthemorrhage) confirmed the absence of a recurrent or de novo AVM in all cases. All patients with a lesion-negative hemorrhage initially presented with rupture before resection (Fisher P = .066; log-rank P = .057). The occurrence of a lesion-negative hemorrhage was significantly associated with worse modified Rankin scale scores at last follow-up (P = .031).
    Conclusion: A lesion-negative hemorrhage can occur following complete microsurgical resection in up to 2.4% of patients. Exploration of possible underlying causes is warranted.
    MeSH term(s) Embolization, Therapeutic ; Hemorrhage ; Humans ; Intracranial Arteriovenous Malformations/epidemiology ; Intracranial Arteriovenous Malformations/surgery ; Radiosurgery/adverse effects ; Registries ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2021-04-07
    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 10.1093/neuros/nyab104
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: In Reply: Hemorrhage Following Complete Arteriovenous Malformation Resection With No Detectable Recurrence: Insights From a 27-Year Registry.

    Feghali, James / Rapaport, Sarah / Yang, Wuyang / Gami, Abhishek / Patel, Jaimin / Tamargo, Rafael J / Caplan, Justin M / Huang, Judy

    Neurosurgery

    2021  Volume 89, Issue 5, Page(s) E288

    MeSH term(s) Hemorrhage ; Humans ; Intracranial Arteriovenous Malformations/complications ; Intracranial Arteriovenous Malformations/diagnostic imaging ; Intracranial Arteriovenous Malformations/surgery ; Registries
    Language English
    Publishing date 2021-08-02
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 135446-2
    ISSN 1524-4040 ; 0148-396X
    ISSN (online) 1524-4040
    ISSN 0148-396X
    DOI 10.1093/neuros/nyab314
    Database MEDical Literature Analysis and Retrieval System OnLINE

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