Browsing by Author "Blackwell, Matthew P."

Now showing 1 - 4 of 4
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    Asymptomatic Thoracic Migration of a Ventriculoperitoneal Shunt: A Case Report
    (Springer Nature, 2024-09-18) Griffith-Linsley, Jackson; Blackwell, Matthew P.; Gulizia, Dustin J.; Medicine, School of Medicine
    Hydrocephalus is often treated with CSF diversion via ventriculoperitoneal (VP) shunting. We present the unique case of a 33-year-old female with a history of infiltrating astrocytoma and consequent obstructive hydrocephalus necessitating shunt placement. She later presented with non-specific symptoms prompting shunt evaluation. Ultimately, while a cause for her symptoms was not identified, imaging revealed distal catheter migration into the pleural space. The patient remained asymptomatic during two years of follow-up without surgical intervention. This case highlights the potential for asymptomatic distal catheter migration after VP shunt placement and underscores the importance of appropriate monitoring and management once such migration is detected.
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    Minimally invasive exoscope-assisted coccygectomy: A novel approach for chronic refractory coccydynia
    (Elsevier, 2024-09-25) Obeng-Gyasi, Barnabas; Wilmes, Danielle; Blackwell, Matthew P.; Kwon, Jae H.; Mao, Gordon; Neurological Surgery, School of Medicine
    Background: This technical note presents a novel minimally invasive exoscope assisted coccygectomy to treat chronic refractory coccydynia. Traditional treatments often fail to provide adequate relief for this debilitating condition, prompting the need to explore surgical approaches. Case description: A 40-year-old female patient with persistent pain unresponsive to conservative treatments underwent this advanced procedure. Utilizing the Synaptive exoscope-microscope system, the surgery allowed for precise dissection and removal of affected coccygeal segments, with a focus on minimizing skin and soft tissue disruption to optimize wound healing and surgical site pain. Conclusion: Postoperative recovery showcased significant pain reduction and improved quality of life, emphasizing the method's potential for better outcomes and fewer complications. Despite the promising results, the limitations of a single-case study necessitate further research to establish long-term effectiveness across a broader patient population.
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    Program Signaling and Geographic Preferences in the United States Residency Match for Neurosurgery
    (Springer Nature, 2024-09-20) Ozair, Ahmad; Hanson, Jacob T.; Detchou, Donald K.; Blackwell, Matthew P.; Jenkins, Abigail; Tissot, Marianne I.; Barrie, Umaru; McDermott, Michael W.; Neurological Surgery, School of Medicine
    Postgraduate residency training has long been the cornerstone of academic medicine in the United States. The Electronic Residency Application Service (ERAS), managed by the Association of American Medical Colleges (AAMC), is the central residency application platform in the United States for most clinical specialties, with the National Residency Matching Program (NRMP) being the algorithm for matching residency programs with applicants. However, the determination of the best fit between ERAS applicants and programs has been increasingly challenged by the rising number of applicants per residency spot. This application overburdening across competitive specialties led to several adverse downstream effects, which affected all stakeholders. While several changes and proposals were made to rectify the issue of application overburdening, the 2020-2021 ERAS Match Cycle finally saw several competitive specialties, including otolaryngology and urology, utilize a new system of supplemental residency application based on preference signals/tokens. These tokens permit applicants to electronically signal a select number of programs in a specialty of choice, with the program reviewing the application now cognizant that they have been signaled, i.e., the applicant has chosen to use up a limited set of signals for their program. Initial results from otolaryngology and urology, as described in this article, indicated the value of this new system to both applicants and educators. Given the favorable outcomes and broader uptake of the system among other specialties, the field of neurosurgery adopted the utilization of the ERAS-based program signaling and geographic preference for the first time for the 2022-2023 Residency Application Cycle and later opted to continue them for the 2023-2024 and 2024-2025 cycles. For the 2024-2025 Match Cycle, neurosurgery applicants have 25 signals, i.e., a "high-signal" approach, where non-signaled programs have a low interview conversion rate. This literature review discusses the rationale behind the change, the outcomes of other competitive specialties from prior cycles, the evolving nature of the change, and the potential impact on applicants and programs. As we describe in this review, signaling may potentially represent a surrogate form of an application cap. Other considerations relate to cost savings for both applicants and programs from a high-signal approach in neurosurgery. These modifications represent a foundational attempt to alleviate the application overburdening and non-holistic review in the residency application process, including for neurosurgery. While these changes have been a welcomed addition for all stakeholders in residency match cycles so far, further prospectively directed surveys along with qualitative research studies are warranted to better delineate the downstream impact of these changes and guide further optimization of the application system.
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    Sex-specific trisomic Dyrk1a-related skeletal phenotypes during development in a Down syndrome model
    (The Company of Biologists, 2024) LaCombe, Jonathan M.; Sloan, Kourtney; Thomas, Jared R.; Blackwell, Matthew P.; Crawford, Isabella; Bishop, Flannery; Wallace, Joseph M.; Roper, Randall J.; Biology, School of Science
    Skeletal insufficiency affects all individuals with Down syndrome (DS) or trisomy 21 and may alter bone strength throughout development due to a reduced period of bone formation and early attainment of peak bone mass compared to those in typically developing individuals. Appendicular skeletal deficits also appear in males before females with DS. In femurs of male Ts65Dn DS model mice, cortical deficits were pronounced throughout development, but trabecular deficits and Dyrk1a overexpression were transitory until postnatal day (P) 30, when there were persistent trabecular and cortical deficits and Dyrk1a was trending toward overexpression. Correction of DS-related skeletal deficits by a purported DYRK1A inhibitor or through genetic means beginning at P21 was not effective at P30, but germline normalization of Dyrk1a improved male bone structure by P36. Trabecular and cortical deficits in female Ts65Dn mice were evident at P30 but subsided by P36, typifying periodic developmental skeletal normalizations that progressed to more prominent bone deficiencies. Sex-dependent differences in skeletal deficits with a delayed impact of trisomic Dyrk1a are important to find temporally specific treatment periods for bone and other phenotypes associated with trisomy 21.