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This study aimed to adapt a Spanish translation of the Oswestry Disability Index (ODI) into a cross-cultural version for the Mexican population. The objectives were to verify the validity and reliability of the adapted ODI and to compare pain perception between patients with and without obesity. We included 102 patients with low back pain from two neurosurgery departments in Mexico. The ODI questionnaire was translated and culturally adapted. Validity and construct were evaluated using exploratory factor analysis, and the external convergent validity was assessed by correlating ODI scores with pain intensity, age, and obesity. Test-retest reliability was calculated using the intraclass correlation coefficient, and confirmatory analysis was employed to validate the factorial structure. Patients with obesity were older and had higher pain scores than patients without obesity. The exploratory analysis of the ODI in Mexican Spanish showed good reliability (Cronbach's alpha of 0.923) and validity (factorial loading range, 0.681 − 0.818). The confirmatory analysis showed almost null or very low discrepancy between the proposed model and the real data. A Spanish translation of ODI was cross-culturally adapted for the Mexican population. The Mexican version of the ODI showed good reliability and validity in Mexican culture. The Oswestry Disability Index (ODI) is a widely used tool to measure physical disability in daily activities due to low back pain. A Spanish-language version has not been culturally adapted and validated for Mexican habits and lifestyle. This study describes the process of the Spanish ODI translation and cultural adaptation, showing it is a reliable and valid tool for assessing disability in patients with low back pain, with a good factorial structure. [ABSTRACT FROM AUTHOR]

Tumors of the pineal region account for 3 to 8% of the tumors involving the central nervous system. The most common are germ cell tumors (39%). Less common examples include teratomas, primitive neuroectodermic tumors, astrocytomas, and choriocarcinomas. Clinical presentation in pediatric patients is in direct relation to the anatomical structures surrounding the pineal region and to the associated hydrocephalus that is present in almost 90% of cases. The diagnosis of a tumor in the pineal region is based on radiological findings and the presence of tumor markers such as α-fetoprotein and human chorionic gonadotrophic hormone subfraction β. Neuroendoscopy is considered to be one of the minimally invasive techniques useful for the management of such patients. This minimally invasive approach to pineal region tumors allows the treatment of hydrocephalus in a safe and effective way, avoiding the complications derived from other procedures such as external ventricular drainage or shunt surgery. [ABSTRACT FROM AUTHOR]

Background Aneurysmal subarachnoid hemorrhage (ASAH) is a serious and unstable condition. Patient safety indicators (PSI) are a group of potentially preventable events in patient health care. The aim of this study is to determine the prevalence of 8 relevant PSI in a group of patients with ASAH and their relation with 2 health care outcomes. Methods We performed a retrospective review of all patients admitted with ASAH. A total of 35 patients were selected with the following variables: age, sex, Hunt and Hess scale at admission, brain aneurysm treatment, length of hospital stay, and Glasgow Outcome Scale (GOS) score with the presence or absence of all 8 PSI: decubitus ulcer, pneumothorax, bacteremia, perioperative hematoma, postoperative respiratory failure, deep vein thrombosis (DVT), pulmonary thromboembolism, and accidental puncture or laceration. Results Average age (±standard deviation) was 53 ± 13.9 years, with a female predominance of 63%. The most common PSI was decubitus ulcer followed by central line-related bacteremia. Prolonged hospital stay was increased for inpatients with DVT. Males had a risk effect (odds ratio, 6.25) in relation to the appearance of pulmonary thromboembolism as well as a poor neurologic condition according to the GOS (GOS score <4) related to the appearance of DVT (odds ratio, 8.0). Conclusions In our study population, we found 3 PSI related to a poor outcome measured with the GOS or to a longer hospital stay: decubitus ulcer, central line-related bacteremia, and DVT. PSI have been academically considered as useful tools in clinical, epidemiologic, and research outcome scenarios. An adequate prevention protocol for these indicators could produce better outcomes in medical care for patients with ASAH. [ABSTRACT FROM AUTHOR]

Objective: To report the efficacy, safety, and outcomes through time of the biggest series to our knowledge of pituitary surgery using transcranial, transsphenoidal, and endoscopic techniques. Methods: An observational, retrospective, and descriptive review was performed of 3004 patients surgically treated by the senior author from 1973 to June 2011 in Mexico City. A sublabial approach was used in 3000 patients, and a transnasal approach was used in the remaining 4 patients. Tumors were classified according to size as microadenomas or macroadenomas. Results: During the time period of this study, 3004 patients were surgically treated; there were 510 prolactinomas, 822 growth hormone adenomas, 62 adrenocorticotropic hormone–producing adenomas, 8 tumors that produced Nelson syndrome, and 1562 adenomas that were not biologically active. The cure rate of prolactinoma was 82% for microadenomas and 9% for macroadenomas. Gender distribution showed a male predominance of 57.1%. Cure rate for growth hormone adenomas was 87%. Adrenocorticotropic hormone adenomas showed no cure rate; surgery simply aided pharmacologic control. Global mortality rate was 1.6%. The main complications were cerebrospinal fluid fistula, diabetes insipidus, and meningitis. Conclusions: The sum of this 38-year experience of managing pituitary pathology and its surgical treatment shows the importance of working together with other specialists such as endocrinologists, ophthalmologists, and radiologists. The correct treatment approach for each case must be individually selected. Transsphenoidal surgery is an effective and safe treatment for most patients with pituitary adenoma and could be considered the first-choice therapy in all cases except for prolactinomas that respond to pharmacologic therapy (dopamine agonist). [ABSTRACT FROM AUTHOR]

Introduction Clinoid segment aneurysms are cerebral vascular lesions recently described in the neurosurgical literature. They arise from the clinoid segment of the internal carotid artery, which is the segment limited rostrally by the dural carotid ring and caudally, by the carotid-oculomotor membrane. Even although clinoid segment aneurysms represent a common incidental finding in magnetic resonance studies, its prevalence has not been yet reported. Objective To determine the prevalence of incidental clinoid segment saccular aneurysms diagnosed by magnetic resonance imaging as well as their anatomic architecture and their association with smoking, arterial hypertension, age, and sex of patients. Methods A total of 500 patients were prospectively studied with magnetic resonance imaging time-of-flight sequence and angioresonance with contrast material, to search for incidental saccular intracranial aneurysms. The site of primary interest was the clinoid segment, but the presence of aneurysms in any other location was determined for comparison. The relation among the presence of clinoid segment aneurysms, demographic factors, and secondary diagnosis of arterial hypertension, smoking, and other vascular/neoplastic cerebral lesions was analyzed. Results We found a global prevalence of incidental aneurysms of 7% (95% confidence interval, 5–9), with a prevalence of clinoid segment aneurysms of 3% (95% confidence interval, 2–4). Univariate logistic regression analysis showed a statistically significant relationship among incidental aneurysms, systemic arterial hypertension ( P = 0.000), and smoking ( P = 0.004). Conclusions In the studied population, incidental clinoid segment aneurysms constitute the variety with highest prevalence. [ABSTRACT FROM AUTHOR]