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Ugochi C Okoroafor, Lisa K Cannada
Background: The American Academy of Orthopedic Surgeons (AAOS) has provided Clinical Practice Guidelines (CPG) and Appropriate Use Criteria (AUC) regarding management of distal radius fractures. The purpose of this study was to evaluate current practices in management of distal radius fractures among orthopedic trauma surgeons and to examine adherence to the AAOS criteria. Methods: An online survey was posted and distributed via the Orthopaedic Trauma Association (OTA) website...
2018: Iowa Orthopaedic Journal
David L Penn, Kyle C Wu, Kayla R Presswood, Coleman P Riordan, R Michael Scott, Edward R Smith
Children with arteriovenous malformations (AVMs) are at cumulative, life-long risk of debilitating and fatal intracranial hemorrhage, especially with syndromes such as hereditary hemorrhagic telangiectasia. Cerebral angiography is the gold standard for diagnosis and allows simultaneous adjunctive embolization limiting radiation and contrast exposure and intraoperative blood loss, important in pediatric patients with low blood volume. Microsurgical resection of low-grade AVMs offers cure with minimal morbidity...
August 7, 2018: Operative Neurosurgery (Hagerstown, Md.)
Emanuel M Dogan, Linus Beskow, Fredrik Calais, Tal M Hörer, Birger Axelsson, Kristofer F Nilsson
INTRODUCTION: Aortic occlusion during cardiopulmonary resuscitation (CPR) increases systemic arterial pressures. Correct thoracic placement during the resuscitative endovascular balloon occlusion of the aorta (REBOA) may be important for achieving effective CPR. HYPOTHESIS: The positioning of the REBOA in the thoracic aorta during CPR will affect systemic arterial pressures. METHODS: Cardiac arrest was induced in 27 anesthetized pigs. After 7 min of CPR with a mechanical compression device, REBOA in the thoracic descending aorta at heart level (zone Ib, REBOA-Ib, n = 9), at diaphragmatic level (zone Ic, REBOA-Ic, n = 9) or no occlusion (control, n = 9) was initiated...
July 31, 2018: Shock
Vanessa Moll, Carla Maffeo, Matthew Mitchell, Ceressa T Ward, Robert F Groff, Simon C Lee, Michael E Halkos, Craig S Jabaley, Vikas N O'Reilly-Shah
OBJECTIVE: The optimal regional technique for minimally invasive direct coronary artery bypass (MIDCAB) has yet to be determined. The aim of this study was to compare the efficacy of ultrasound-guided serratus anterior plane block (SAPB) with paravertebral block (PVB) and no block for controlling acute thoracotomy pain after robotic-assisted coronary artery bypass grafting (CABG). DESIGN: This is a retrospective study. Multiple variable regression analyses were performed...
April 26, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Velicia Bachtiar, Ainslie Johnstone, Adam Berrington, Clarke Lemke, Heidi Johansen-Berg, Uzay Emir, Charlotte Stagg
Learning a novel motor skill is dependent both on regional changes within the primary motor cortex (M1) contralateral to the active hand, and also on modulation between and within anatomically-distant but functionally-connected brain regions. Inter-regional changes are particularly important in functional recovery after stroke, where critical plastic changes underpinning behavioural improvements are observed in both ipsilesional and contralesional M1s. It is increasingly understood that reduction in γ-aminobutyric acid (GABA) in the contralateral M1 is necessary to allow learning of a motor task...
July 20, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
María Gabriela Merín, Vilma Inés Morata de Ambrosini
Pectinolytic yeasts can be applied to winemaking with the purpose of improving sensory and technological properties of wine because of their enzymes secreted during vinification. In this work, the autochthonous yeast-like pectinolytic strain from D.O. San Rafael viticulture region, Aureobasidium pullulans GM-R-22, was used in co-culture with Saccharomyces cerevisiae IOC 18-2007 in microvinification trials with Malbec must applying pre-fermentative cold maceration (PCM). A. pullulans remained viable during PCM and S...
July 5, 2018: International Journal of Food Microbiology
Fabrice Schneider, Anaïs Peran Dubourg, Jean-Baptiste Ricco
Introduction: The VIABAHN Open Revascularisation TEChnique (VORTEC) was initially described for visceral revascularisation and supra-aortic reconstruction for complex aortic hybrid surgery. Herein is reported the use of this innovative technique for revascularisation of the iliofemoral arteries. Report: The use of the VORTEC to perform proximal anastomosis of a prosthetic iliofemoral bypass in two symptomatic patients with heavily calcified iliac artery lesions and redo surgery, respectively, is reported...
2018: EJVES short reports
Jacob S Young, Giovanna Bernal, Sean P Polster, Luis Nunez, Gustavo F Larsen, Nassir Mansour, Michael Podell, Bakhtiar Yamini
BACKGROUND: Despite aggressive multimodal treatment, survival for patients with glioblastoma remains dismal. One obstacle to improving patient outcomes is the difficulty in delivering adequate therapeutic to the central nervous system due to the presence of the blood-brain barrier. Although direct drug infusion by convection-enhanced delivery (CED) can bypass the blood-brain barrier and facilitate delivery to intracranial tumors, determining the distribution of delivered therapeutic remains problematic...
June 27, 2018: World Neurosurgery
Eric D Gaier, Mengyu Wang, Aubrey L Gilbert, Joseph F Rizzo, Dean M Cestari, John B Miller
PURPOSE: Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common cause of non-glaucomatous optic neuropathy in older adults. Optical coherence tomographic angiography (OCT-A) is an emerging, non-invasive method to study the microvasculature of the posterior pole, including the optic nerve head. The goal of this study was to assess the vascular changes in the optic nerve head and peripapillary area associated with NAION using OCT-A. DESIGN: Retrospective comparative case series...
2018: PloS One
Anjali Sharma, Yifei Ma, Phyllis C Tien, Rebecca Scherzer, Kathryn Anastos, Mardge H Cohen, Didier Hans, Michael T Yin
OBJECTIVES: We compared skeletal microarchitecture using trabecular bone score (TBS) and evaluated relationships between change in TBS and lumbar spine (LS) bone mineral density (BMD) in women with and without HIV. METHODS: Dual-energy X-ray absorptiometry was performed on 319 women with HIV and 118 without HIV in the Women's Interagency HIV Study at baseline and 2 and 5 years, to measure regional BMD and lean and fat mass. TBS was extracted from LS dual-energy X-ray absorptiometry images and examined continuously and categorically [normal (≥1...
August 1, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Caroline Eden, Gary Esses, Daniel Katz, Samuel DeMaria
This narrative review will summarize our current understanding of the effects of perioperative interventions on patients undergoing surgical removal of breast malignancies. It will focus on how different anesthetic agents and perioperative interventions might affect both breast cancer behavior and/or tumor recurrence as well as postoperative recovery. The main objective of this study will be to describe the evidence and critically analyze preclinical and clinical studies on the use of intravenous versus inhaled anesthetic agents, opioids, regional anesthetics, and anesthetic adjuncts in patients undergoing breast cancer resection...
June 2018: Surgical Oncology
S Keddie, V Bharambe, A Jayakumar, A Shah, V Sanchez, A Adams, S Gnanapavan
BACKGROUND AND PURPOSE: Central nervous system (CNS) tuberculosis (TB) accounts for over 4% of all TB notifications in the UK and causes death or significant disability in over half of those affected. Tumour necrosis factor alpha is a critical cytokine involved in the neuropathogenesis of CNS TB. Thalidomide has been trialled in CNS TB due to its immunomodulatory and immune reconstitution effects through the inhibition of tumour necrosis factor alpha. Despite animal models demonstrating dramatic improvement in survival, studies in paediatric patients have been associated with higher levels of mortality...
June 23, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Adnan I Qureshi, Muhammad A Saleem, Nishath Naseem, Emrah Aytac, Cetin Kursad Akpinar, Shawn S Wallery
Objective: To test the effectiveness of topical EMLA cream (lidocaine 2.5% and prilocaine 2.5%) for pain control during femoral artery catheterization for neuro-endovascular procedures in adult patients. Methods: The body habitus overlying the femoral arterial pulsation was graded as: (1) pubic symphysis and iliac crest bone protuberances visualized; (2) Pubic Symphysis and Iliac Crest bone protuberances not seen but easily palpable; (3) Pubic Symphysis and Iliac Crest bone protuberances palpable with considerable difficulty; and (4) abdominal layers fold over the femoral region...
June 2018: Journal of Vascular and Interventional Neurology
Samaa Al Sayegh, Tove Filén, Mats Johansson, Susanne Sandström, Gisela Stiewe, Stephen Butler
Background and purpose This case of a 42 year old woman with lower extremity Complex Regional Pain Syndrome (CRPS) after a twisting injury of the ankle, effectively treated with the addition of mirror therapy to a rehabilitation programme, prompted a literature review of both CRPS and mirror therapy. Mirror therapy is a newer adjunct to other forms of pain control and functional restoration for treatment of CRPS as well as other difficult clinical problems. This was a required group project as part of a university based course in chronic pain for healthcare workers...
October 1, 2013: Scandinavian Journal of Pain
Kristen K Ellard, Aishwarya G Gosai, Emily E Bernstein, Navneet Kaur, Lousia G Sylvia, Joan A Camprodon, Darin D Dougherty, Andrew A Nierenberg, Thilo Deckersbach
BACKGROUND: Anxiety in bipolar disorder (BD) exacerbates emotion dysregulation and reduces treatment response. We recently conducted a pilot trial of transdiagnostic CBT to target anxiety and emotion dysregulation in BD adjunctive to pharmacotherapy. Reductions in depression and anxiety symptoms were significantly predicted by baseline levels of neuroticism and perceived affective control, as well as changes over time in emotion regulation skills. The present study investigates mechanism of treatment response by examining the relationship between baseline emotion regulation-related neural circuitry and trial outcomes...
October 1, 2018: Journal of Affective Disorders
Paul A Lapchak, Paul D Boitano, Geoffrey de Couto, Eduardo Marbán
Acute ischemic stroke is devastating to patients and their families because of few viable therapeutic options to promote recovery after reperfusion windows close. Recent breakthroughs in biotechnology have resulted in a reproducible patented process for the purification of extracellular vesicles (EVs) from human cardiosphere-derived cells (CDCs). Because CDC-EVs have many features potentially beneficial to treat acute ischemic stroke, CDC-EVs were evaluated in an established small-clot rabbit embolic stroke model, where clinically relevant end points were used to assess recovery in a more translational large animal model...
September 2018: Experimental Neurology
Christina Wei, Elizabeth Crowne
Endocrine abnormalities are common among childhood cancer survivors. Abnormalities of the hypothalamic-pituitary-adrenal axis (HPAA) are the least common, but the consequences are severe if missed. Patients with tumours located and /or had surgery performed near the hypothalamic-pituitary region and those treated with an accumulative cranial radiotherapy dose of over 30 Gy are most at risk of adrenocorticotrophic hormone (ACTH) deficiency. Primary adrenal insufficiency may occur in patients with tumours located in or involving one or both adrenals...
June 12, 2018: Endocrine-related Cancer
Jennifer K Reagan, Laura E Selmic, Caroline Fallon, Elizabeth A Driskell, Laura D Garrett
For canine mast cell tumour (MCT), histopathology reports are one of the main factors considered in the decision-making process regarding need and type of adjunctive therapy. However, considerable variation exists in types of information reported, especially relating to surgical margins. The purpose of this study was to describe and evaluate how information is presented within canine MCT histopathology reports across the United States. The reports were collected from medical and surgical oncologists from 4 geographic regions of the USA: Midwest, Northeast, South and West...
June 7, 2018: Veterinary Medicine and Science
Megan Li, Flora Mulkey, Chen Jiang, Bert H O'Neil, Bryan P Schneider, Fei Shen, Paula N Friedman, Yukihide Momozawa, Michiaki Kubo, Donna Niedzwiecki, Howard S Hochster, Heinz-Josef Lenz, James N Atkins, Hope S Rugo, Susan Halabi, William Kevin Kelly, Howard L McLeod, Federico Innocenti, Mark J Ratain, Alan P Venook, Kouros Owzar, Deanna L Kroetz
Purpose: Bevacizumab is a VEGF-specific angiogenesis inhibitor indicated as an adjunct to chemotherapy for the treatment of multiple cancers. Hypertension is commonly observed during bevacizumab treatment, and high-grade toxicity can limit therapy or lead to cardiovascular complications. The factors that contribute to interindividual variability in blood pressure rise during bevacizumab treatment are not well understood. Experimental Design: To identify genomic regions associated with bevacizumab-induced hypertension risk, sequencing of candidate genes and flanking regulatory regions was performed on 61 patients treated with bevacizumab (19 cases developed early-onset grade 3 hypertension and 42 controls had no reported hypertension in the first six cycles of treatment)...
June 5, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Eric S Schwenk, Eugene R Viscusi, Asokumar Buvanendran, Robert W Hurley, Ajay D Wasan, Samer Narouze, Anuj Bhatia, Fred N Davis, William M Hooten, Steven P Cohen
BACKGROUND: Ketamine infusions have been used for decades to treat acute pain, but a recent surge in usage has made the infusions a mainstay of treatment in emergency departments, in the perioperative period in individuals with refractory pain, and in opioid-tolerant patients. The widespread variability in patient selection, treatment parameters, and monitoring indicates a need for the creation of consensus guidelines. METHODS: The development of acute pain ketamine guidelines grew as a corollary from the genesis of chronic pain ketamine guidelines...
July 2018: Regional Anesthesia and Pain Medicine
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