bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional outcome and morbidity after microsurgical resection of spinal meningiomas
Authors: Kilinc Fatma , Setzer Matthias , Marquardt Gerhard , Keil Fee , Dubinski Daniel , Bruder Markus , Seifert Volker , Behmanesh Bedjan 
Published: May 2021

OBJECTIVE
The aim of this study was to evaluate functional outcome, surgical morbidity, and factors that affect outcomes of surgically treated patients.

METHODS
The authors retrospectively analyzed patients who underwent microsurgical resection for spinal meningiomas between 2009 and 2020. Patient data and potential variables were collected and evaluated consecutively. Functional outcomes were evaluated using univariate and multivariate analyses.

RESULTS
A total of 119 patients underwent microsurgical resection of spinal meningioma within the study period. After a mean follow-up of 25.4 ± 37.1 months, the rates of overall complication, tumor recurrence, and poor functional outcome were 9.2%, 7.6%, and 5%, respectively. Age, sex, revision surgery, and tumor recurrence were identified as independent predictors of poor functional outcome. Obesity and surgeon’s experience had an impact on the complication rate, whereas extent of resection and tumor calcification affected the rate of tumor recurrence.

CONCLUSIONS
Microsurgical resection of spinal meningiomas remains safe. Nevertheless, some aspects, such as obesity and experience of the surgeons that result in a higher complication rate and ultimately affect clinical outcome, should be considered when performing surgery.
Intraoperative blood loss in oncological spine surgery
Authors: Mohme Malte , Mende Klaus C. , Pantel Tobias , Viezens Lennart , Westphal Manfred , Eicker Sven Oliver , Dreimann Marc , Krätzig Theresa , Stangenberg Martin 
Published: May 2021

OBJECTIVE
Intraoperative blood loss in patients undergoing oncological spine surgery poses a major challenge for vulnerable patients. The goal of this study was to assess how the surgical procedure, tumor type, and tumor anatomy, as well as anesthesiological parameters, affect intraoperative blood loss in oncological spine surgery and to use this information to generate a short preoperative checklist for spine surgeons and anesthesiologists to identify patients at risk for increased intraoperative blood loss.

METHODS
The authors performed a retrospective analysis of 430 oncological patients who underwent spine surgery between 2013 and 2018 at the university medical spine center. Enrolled patients had metastatic tumor of the spine requiring surgical decompression of neural structures and/or stabilization including tumor biopsy using an open, percutaneous, and/or combined dorsoventral approach. Patients requiring vertebro- and kyphoplasty or biopsy only were excluded. Statistical analyses performed included a multiple linear regression analysis.

RESULTS
The mean intraoperative blood loss in the study patient cohort was 1176 ± 1209 ml. In total, 33.8% of patients received intraoperative red blood cell transfusions. The statistical analyses showed that tumor histology indicating myeloma, operative procedure length, epidural spinal cord compression (ESCC) score, tumor localization, BMI, and surgical strategy were significantly associated with increased intraoperative blood loss or risk of needing allogeneic blood transfusions. Anesthesiological parameters such as the American Society of Anesthesiologists (ASA) Physical Status classification score were not associated with blood loss. Multiple linear regression analysis demonstrated good predictive value (r = 0.437) for a five-item preoperative checklist to identify patients at risk for high intraoperative blood loss.

CONCLUSIONS
The analyses performed in this study demonstrated key factors affecting intraoperative blood loss and showed that a simple preoperative checklist including these factors can be used to identify patients undergoing surgery for metastatic spine tumors who are at risk for increased intraoperative blood loss.
Safety and efficacy of cement augmentation with fenestrated pedicle screws for tumor-related spinal instability
Authors: Massaad Elie , Rolle Myron , Hadzipasic Muhamed , Kiapour Ali , Shankar Ganesh M. , Shin John H. 
Published: May 2021

OBJECTIVE
Achieving rigid spinal fixation can be challenging in patients with cancer-related instability, as factors such as osteopenia, radiation, and immunosuppression adversely affect bone quality. Augmenting pedicle screws with cement is a strategy to overcome construct failure. This study aimed to assess the safety and efficacy of cement augmentation with fenestrated pedicle screws in patients undergoing posterior, open thoracolumbar surgery for spinal metastases.

METHODS
A retrospective review was performed for patients who underwent surgery for cancer-related spine instability from 2016 to 2019 at the Massachusetts General Hospital. Patient demographics, surgical details, radiographic characteristics, patterns of cement extravasation, complications, and prospectively collected Patient-Reported Outcomes Measurement Information System Pain Interference and Pain Intensity scores were analyzed using descriptive statistics. Logistic regression was performed to determine factors associated with cement extravasation.

RESULTS
Sixty-nine patients underwent open posterior surgery with a total of 502 cement-augmented screws (mean 7.8 screws per construct). The median follow-up period for those who survived past 90 days was 25.3 months (IQR 10.8–34.6 months). Thirteen patients (18.8%) either died within 90 days or were lost to follow-up. Postoperative CT was performed to assess the instrumentation and patterns of cement extravasation. There was no screw loosening, pullout, or failure. The rate of cement extravasation was 28.9% (145/502), most commonly through the segmental veins (77/145, 53.1%). Screws breaching the lateral border of the pedicle but with fenestrations within the vertebral body were associated with a higher risk of leakage through the segmental veins compared with screws without any breach (OR 8.77, 95% CI 2.84–29.79; p < 0.001). Cement extravasation did not cause symptoms except in 1 patient who developed a symptomatic thoracic radiculopathy requiring decompression. There was 1 case of asymptomatic pulmonary cement embolism. Patients experienced significant pain improvement at the 3-month follow-up, with decreases in Pain Interference (mean change 15.8, 95% CI 14.5–17.1; p < 0.001) and Pain Intensity (mean change 28.5, 95% CI 26.7–30.4; p < 0.001).

CONCLUSIONS
Cement augmentation through fenestrated pedicle screws is a safe and effective option for spine stabilization in the cancer population. The risk of clinically significant adverse events from cement extravasation is very low.
A transpedicular approach to complex ventrally situated thoracic intradural extramedullary tumors: technique, indications, and multiinstitutional case series
Authors: Visco Zachary R. , Liu David D. , Leary Owen P. , Oyelese Adetokunbo A. , Gokaslan Ziya L. , Camara-Quintana Joaquin Q. , Galgano Michael A. 
Published: May 2021

OBJECTIVE
Ventrally situated thoracic intradural extramedullary tumors are surgically challenging and difficult to access, and they may be complicated by extensive adhesions and calcifications. Selecting an approach for adequate ventral access is key to complete resection and optimization of outcomes. The authors present a case series of patients who underwent resection of ventral thoracic intradural extramedullary tumors and discuss indications and considerations for this technique. Additionally, they describe the use of a posterolateral transpedicular approach for resection of ventral thoracic intradural extramedullary tumors compared with other techniques, and they summarize the literature supporting its application.

METHODS
From May 2017 to August 2020, 5 patients with ventral thoracic intradural extramedullary tumors underwent resection at one of the two academic institutions.

RESULTS
Patient ages ranged from 47 to 75 (mean 63.4) years. All tumors were diagnosed as meningiomas or schwannomas by histological examination. Three of the 5 patients had evidence of partial or extensive tumor calcification. Four of the 5 patients underwent an initial posterolateral transpedicular approach for resection, with positive radiographic and clinical outcomes from surgery. One patient initially underwent an unsuccessful traditional direct posterior approach and required additional resection 2 years later after interval disease progression. There were no postoperative wound infections, CSF leaks, or other complications related to the transpedicular approach.

CONCLUSIONS
Posterolateral transpedicular tumor resection is a safe technique for the treatment of complex ventrally situated thoracic intradural extramedullary tumors compared with the direct posterior approach. Anecdotally, this approach appears to be particularly beneficial in patients with calcified tumors.
Clinical characteristics and long-term outcomes for patients who undergo cytoreductive surgery for thoracic meningiomas: a retrospective analysis
Authors: Ampie Leonel , Snyder M. Harrison , Dominguez Jose F. , Buchholz Avery , Yen Chun-Po , Shaffrey Mark E. , Syed Hasan R. , Shaffrey Christopher I. , Smith Justin S. 
Published: May 2021

OBJECTIVE
Primary spinal meningiomas represent a rare indolent neoplasm usually situated in the intradural-extramedullary compartment. They have a predilection for afflicting the thoracic spine and most frequently present with sensory and/or motor symptoms. Resection is the first-line treatment for symptomatic tumors, whereas other clinical factors will determine the need for adjuvant therapy. In this study, the authors aimed to elucidate clinical presentation, functional outcomes, and long-term outcomes in this population in order to better equip clinicians with the tools to counsel their patients.

METHODS
This is a retrospective analysis of patients treated at the authors’ institution between 1998 and 2018. All patients with thoracic meningiomas who underwent resection and completed at least one follow-up appointment were included. Multiple preoperative clinical variables, hospitalization details, and long-term outcomes were collected for the cohort.

RESULTS
Forty-six patients who underwent resection for thoracic meningiomas were included. The average age of the cohort was 59 years, and the median follow-up was 53 months. Persistent sensory and motor symptoms were present in 29 patients (63%). Fifteen lesions were ventrally positioned. There were 43 WHO grade I tumors, 2 WHO grade II tumors, and 1 WHO grade III tumor; the grade III tumor was the only case of recurrence. The median length of hospitalization was 4 days. Seventeen patients (37%) were discharged to rehabilitation facilities. Thirty patients (65.2%) experienced resolution or improvement of symptoms, and there were no deaths within 30 days of surgery. Only 1 patient developed painful kyphosis and was managed medically. Ventral tumor position, new postoperative deficits, and length of stay did not correlate with disposition to a facility. Age, ventral position, blood loss, and increasing WHO grade did not correlate with length of stay.

CONCLUSIONS
Outcomes are overall favorable for patients who undergo resection of thoracic meningiomas. Symptomatic patients often experience improvement, and patients generally do not require significant future operations. Tumors located ventrally, while anatomically challenging, do not necessarily herald a significantly worse prognosis or limit the extent of resection.
Short-segment cement-augmented fixation in open separation surgery of metastatic epidural spinal cord compression: initial experience
Authors: Newman William C. , Amin Anubhav G. , Villavieja Jemma , Laufer Ilya , Bilsky Mark H. , Barzilai Ori 
Published: May 2021

OBJECTIVE
High-grade metastatic epidural spinal cord compression from radioresistant tumor histologies is often treated with separation surgery and adjuvant stereotactic body radiation therapy. Historically, long-segment fixation is performed during separation surgery with posterior transpedicular fixation of a minimum of 2 spinal levels superior and inferior to the decompression. Previous experience with minimal access surgery techniques and percutaneous stabilization have highlighted reduced morbidity as an advantage to the use of shorter fixation constructs. Cement augmentation of pedicle screws is an attractive option for enhanced stabilization while performing shorter fixation. Herein, the authors describe their initial experience of open separation surgery using short-segment cement-augmented pedicle screw fixation for spinal reconstruction.

METHODS
The authors performed a retrospective chart review of patients undergoing open (i.e., nonpercutaneous, minimal access surgery) separation surgery for high-grade epidural spinal cord compression using cement-augmented pedicle screws at single levels adjacent to the decompression level(s). Patient demographics, treatment data, operative complications, and short-term radiographic outcomes were evaluated.

RESULTS
Overall, 44 patients met inclusion criteria with radiographic follow-up at a mean of 8.5 months. Involved levels included 19 thoracic, 5 thoracolumbar, and 20 lumbar. Cement augmentation through fenestrated pedicle screws was performed in 30 patients, and a vertebroplasty-type approach was used in the remaining 14 patients to augment screw purchase. One (2%) patient required an operative revision for a hardware complication. Three (7%) nonoperative radiographic hardware complications occurred, including 1 pathologic fracture at the index level causing progressive kyphosis and 2 incidences of haloing around a single screw. There were 2 wound complications that were managed conservatively without operative intervention. No cement-related complications occurred.

CONCLUSIONS
Open posterolateral decompression utilizing short-segment cement-augmented pedicle screws is a viable alternative to long-segment instrumentation for reconstruction following separation surgery for metastatic spine tumors. Studies with longer follow-up are needed to determine the rates of delayed complications and the durability of these outcomes.
OSTEONECROSIS OF THE JAW (ONJ) IN PROSTATE CANCER PATIENTS: EFFECT OF PREVENTIVE MEASURES IN A MONOINSTITUTIONAL EXPERIENCE
Authors: Tartara Daniela , Fusco Vittorio , Fasciolo Antonella , Guglielmini Pamela Francesca , Vincenti Maura , Brigo Paola , Rossi Maura , Ferrero Elisabetta , Alessio Manuela , De Martino Iolanda , Riccio Carmela , Traverso Elena 
Published: May 2021

Background. Osteonecrosis of the Jaw (ONJ) frequency after antiresorptive treatment in prostate cancer patients largely varied in literature.

Patients and Methods. Charts of all prostate cancer patients affected by bone metastases observed at the Oncology Unit of Alessandria Hospital in years 2005-2020 have been reviewed. ONJ frequency after antiresorptive treatment (bisphosphonates and/or denosumab) was investigated in prostate cancer patients with bone metastases undergoing preventive (before start of treatment) and/or screening (during treatment) evaluations, including oral inspection and panoramic dental radiography. Patients received antiresorptive agents according to international guidelines. Results. We examined charts of 120 patients receiving bisphosphonates (mostly zoledronic acid, or pamidronate or ibandronate) or denosumab or sequences of drugs, and evaluated for oral health, 112 being treated since 2006 after pre-treatment oral evaluation. Out of 120 total patients, 8 cases of Osteonecrosis of the Jaw (ONJ) were registered among prostate cancer patients treated at Alessandria Hospital: 2 ONJ cases were detected among 8 patients starting antiresorptive treatment before 2006 and without preventive visit, whereas 6 cases were found among 112 cases receiving dental visit before treatment start (6/112, 5.3%). Furthermore, other 8 ONJ cases in prostate cancer patients were referred by neighbour hospitals to the ONJ multidisciplinary group. Conclusions. Our preliminary data confirm that prostate cancer patients receiving bisphosphonates or denosumab are at not irrelevant risk of ONJ, even if in last decade less intensive schedules of antiresorptive drugs and measures of pre-treatment evaluation were adopted. Further evaluations have been planned to investigate if higher ONJ risk was associated to drug (denosumab versus zoledronic acid), prolonged treatment (> 2 years), pre-existing oral disease (periodontal disease, need for tooth extraction, ill-fitting dentures), and other potential predictive factors.
PENGGUNAAN BERBAGAI JENIS ZPT TERHADAP PERTUMBUHAN VEGETATIF SETEK BATANG JAMBU AIR CITRA (Syzygium aqueum Murr)
Authors: Gusti Meka , Darlis Olivia 
Published: May 2021

Jambu air Citra (Syzygium aqueum Murr) merupakan salah satu jenis tanaman buah tahunan yang berasal dari Asia Tenggara, ditemukan di daerah Indo Cina dan Indonesia, tersebar ke Malaysia, dan pulau-pulau di Pasifik. Tujuan dari laporan tugas akhir ini adalah mengetahui pengaruh penggunaan berbagai jenis ZPT terhadap pertumbuhan setek batang tanaman jambu air Citra dan mendapatkan jenis ZPT yang terbaik terhadap pertumbuhan setek batang tanaman jambu air Citra. Perbanyakan tanaman jambu air Citra salah satunya dapat dilakukan dengan cara setek. Perbanyakan tanaman secara setek membutuhkan zat pengatur tumbuh (ZPT). Zat pengatur tumbuh yang digunakan meliputi Rapid root, ekstrak daun kelor, ekstrak tauge, dan kontrol. Jumlah sampel yang digunakan untuk masing-masing perlakuan adalah 5 sampel dengan 2 kali ulangan.
Hasil yang diperoleh dari percobaan ini adalah pemberian zat pengatur dari ekstrak tauge memberikan hasil yang terbaik terhadap pertumbuhan setek batang tanaman jambu air Citra, dengan persentase tumbuh 80 %, jumlah tunas 2,5 buah, rata–rata jumlah akar 7 buah dan rata–rata panjang akar 6,4 cm. Kesimpulan dari percobaan ini adalah Penggunaan beberapa ZPT berpengaruh terhadap pertumbuhan setek batang tanaman jambu air Citra dan penggunaan ZPT ekstrak tauge memberikan hasil terbaik terhadap pertumbuhan setek batang tanaman jambu air Citra dibandingkan penggunaan ZPT yang lain. Disarankan untuk perbanyakan tanaman jambu air Citra secara setek batang menggunakan ZPT ekstrak tauge.
RESPON PERTUMBUHAN TANAMAN TOMAT (Lycopersicum esculentum mill)TERHADAP KOMBINASI PEMBERIAN PUPUK ORGANIK POS, EP DAN ST DI PT. INDMIRA YOGYAKARTA
Authors: Effendi Fatma , Rasdanelwati Rasdanelwati 
Published: May 2021

Tomat (Lycopersicum esculentum mill) merupakan tanaman Amerika Latin, seperti Peru, Ekuador dan Meksiko. Permintaan pasar tomat sangat banyak, karena tomat merupakan komoditas hortikultura yang diperlukan dalam kebutuhan sehari – hari. Potensi hasil tanaman tidak tercapai, hal ini disebabkan tanah tidak mengandung unsur hara yang dibutuhkan dalam jumlah cukup. Cara untuk memenuhi kebutuhan unsur hara tanaman tomat dengan penambahan beberapa pupuk berupa pupuk organik serbuk (POS), essen post (EP), dan soil treatment (ST). Tujuan pelaksanaan percobaan adalah mengetahui respon pertumbuhan tanaman tomat dengan pemberian kombinasi beberapa jenis pupuk organik dan menentukan respon pertumbuhan tanaman tomat terbaik dengan pemberian kombinasi beberapa jenis pupuk organik. Percobaan dilaksanakan di lahan percobaan Wonogiri, PT. Indmira Yogyakarta mulai akhir Februari sampai awal Mei 2019. Percobaan kombinasi beberapa jenis pupuk ini dilakukan dengan perlakuan A (Kontrol), perlakuan B (POS), perlakuan C (EP), perlakuan D (ST), perlakuan E (POS + ST), dan perlakuan F (EP + ST). Parameter yang diamati yaitu tinggi tanaman (cm), jumlah daun per tanaman (helai), jumlah tandan bunga, dan jumlah buah. Pemberian kombinasi jenis pupuk organik memberikan pengaruh berbeda terhadap pertumbuhan tanaman tomat. Berdasarkan parameter yang diamati dapat disimpulkan, penggunaan kombinasi pupuk organik dan pembenah tanah pada perlakuan F (EP + ST) memperlihatkan hasil lebih baik, diikuti perlakuan C (EP), perlakuan D (ST), perlakuan E (POS + ST), perlakuan B (POS) dan perlakuan A (Kontrol). Penggunaan kombinasi pupuk EP dan pembenah tanah pada perlakuan F (EP + ST)memberikan hasil optimal. Berdasarkan kesimpulan disarankan menggunakan kombinasi pupuk organik dan pembenah tanah untuk mendapatkan hasil optimal.
PENGARUH KEDALAMAN TANAM SPROUT TERHADAP PERTUMBUHAN VEGETATIF TANAMAN KENTANG (Solanum tuberosum L.) DI BPTP SUMATERA BARAT
Authors: Kanara Nahda , Asrani Disi 
Published: May 2021

Tanaman kentang (Solanum tuberosum L.) merupakan tanaman semusim yang berbentuk semak. Permintaan kentang dari tahun ke tahun terus meningkat, itu dikarenakan kentang memiliki protein dan vitamin yang cukup tinggi. Agar kentang tidak terjadi penurunan maka salah satu cara yang dapat dilakukan adalah dengan cara pembibitan kentang bisa menggunakan sprout kentang dengan berbagai kedalaman tanam.
Perbanyakan tanaman kentang dapat dilakukan dengan cepat melalui perbanyakan secara vegetatif, adapun kelebihan dari perbanyakan tanaman dengan cara vegetatif antara lain masa muda tanaman relatif pendek, tanaman lebih cepat bereproduksi, dapat diterapkan pada tanaman yang tidak menghasilkan biji, sifat-sifat yang lebih baik pada induknya dapat diturunkan, dan dapat tumbuh pada tanah yang memiliki lapisan tanah dangkal karena memiliki sistem perakaran yang dangkal. Pada kedalaman tanam harus disesuaikan dengan kondisi tanah. Untuk dataran tinggi dengan kelembaban udara yang relatif tinggi, penanaman dangkal yang semakin mendekat permukaan tanah, lebih dianjurkan.Tujuan dari percobaan ini adalah mengetahui pengaruh kedalaman tanam terhadap pertumbuhan vegetatif sprout kentang, dan mendapatkan kedalaman tanam terbaik dari perbanyakan sprout kentang.
Percobaan dilakukan mulai bulan Februari – Maret 2019. Tempat pelaksanaan percobaan di Balai Pengkajian Teknologi Pertanian Sumatera Barat. Perlakuan yang diberikan adalah kedalaman tanam 2 cm (KT2), kedalaman tanam 3 cm (KT3), kedalaman tanam 4 cm (KT4), dan kedalaman tanam 5 cm (KT5). Parameter yang diamati pada percobaan ini adalah, tinggi tanaman, lebar daun, panjang daun dan jumlah tangkai daun. Tahapan pelaksanaannya yaitu pertama penyiapan media tanam, kedua pengadaan bibit, ketiga penanaman, keempat pemberian perlakuan dan kelima pemeliharaan yang meliputi : penyiraman, penyiangan, pengendalian hama dan penyakit, serta yang keenam pengamatan. Hasil yang didapat dari percobaan ini adalah perlakuan yang terbaik terdapat KT4, untuk tinggi tanaman dan lebar daun, sedangkan untuk parameter pada panjang daun yang paling baik pada perlakuan KT2, dan untuk parameter jumlah tangkai daun yang paling baik pada perlakuan KT5.Oleh karena itu, kedalaman tanam 4 cm adalah perlakuan yang paling baik untuk penanaman sprout kentang.