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Spinal immobilization

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https://www.readbyqxmd.com/read/27926686/orthopaedic-trauma-care-capacity-assessment-and-strategic-planning-in-ghana-mapping-a-way-forward
#1
Barclay T Stewart, Adam Gyedu, Gavin Tansley, Dominic Yeboah, Forster Amponsah-Manu, Charles Mock, Wilfred Labi-Addo, Robert Quansah
BACKGROUND: Orthopaedic conditions incur more than 52 million disability-adjusted life years annually worldwide. This burden disproportionately affects low and middle-income countries, which are least equipped to provide orthopaedic care. We aimed to assess orthopaedic capacity in Ghana, describe spatial access to orthopaedic care, and identify hospitals that would most improve access to care if their capacity was improved. METHODS: Seventeen perioperative and orthopaedic trauma care-related items were selected from the World Health Organization's Guidelines for Essential Trauma Care...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27875927/what-is-being-trained-how-divergent-forms-of-plasticity-compete-to-shape-locomotor-recovery-after-spinal-cord-injury
#2
J Russell Huie, Kazuhito Morioka, Jenny Haefeli, Adam R Ferguson
Spinal cord injury (SCI) is a devastating syndrome that produces dysfunction in motor and sensory systems, manifesting as chronic paralysis, sensory changes, and pain disorders. The multifaceted and heterogeneous nature of SCI has made effective rehabilitative strategies challenging. Work over the last 40 years has aimed to overcome these obstacles by harnessing the intrinsic plasticity of the spinal cord to improve functional locomotor recovery. Intensive training after SCI facilitates lower extremity function and has shown promise as a tool for retraining the spinal cord by engaging innate locomotor circuitry in the lumbar cord...
November 22, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27856380/t9-versus-t10-as-the-upper-instrumented-vertebra-for-correction-of-adult-deformity-rationale-and-recommendations
#3
Hwee Weng Dennis Hey, Kimberly-Anne Tan, Christabel Shao-En Neo, Eugene Tze-Chun Lau, Denise Ai-Wen Choong, Leok-Lim Lau, Gabriel Ka-Po Liu, Hee-Kit Wong
BACKGROUND CONTEXT: Adult spinal deformity correction sometimes involves long posterior pedicle screw constructs extending from the lumbosacral spine to the thoracic vertebra. As fusion obliterates motion and places supraphysiological stress on adjacent spinal segments, it is crucial to ascertain the ideal upper instrumented vertebra (UIV) to minimize risk of proximal junctional failure (PJF). The T10 vertebra is often chosen to allow bridging of the thoracolumbar junction into the immobile thoracic vertebrae on the basis that it is the lowest immobile thoracic vertebra strut by the rib cage...
November 14, 2016: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/27789329/porous-silicon-nanoparticle-as-a-stabilizing-support-for-chondroitinase
#4
Sara Daneshjou, Bahareh Dabirmanesh, Fereshteh Rahimi, Khosro Khajeh
Chondroitinase ABCI (cABCI) from Proteus vulgaris is a drug enzyme that can be used to treat spinal cord injuries. One of the main problems of chondroitinase ABC1 is its low thermal stability. The objective of the current study was to stabilize the enzyme through entrapment within porous silicon (pSi) nanoparticles. pSi was prepared by an electrochemical etch of p-type silicon using hydrofluoric acid/ethanol. The size of nanoparticles were determined 180nm by dynamic light scattering and the mean pore diameter was in the range of 40-60nm obtained by scanning electron microscopy...
October 24, 2016: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/27783647/bumetanide-an-inhibitor-of-nkcc1-na-k-2cl-cotransporter-isoform-1-enhances-propofol-induced-loss-of-righting-reflex-but-not-its-immobilizing-actions-in-neonatal-rats
#5
Yukihide Koyama, Tomio Andoh, Yoshinori Kamiya, Tomoyuki Miyazaki, Koichi Maruyama, Takayuki Kariya, Takahisa Goto
Gamma-aminobutyric acid (GABA) has been shown to induce excitation on immature neurons due to increased expression of Na+-K+-2Cl- co-transporter isoform 1 (NKCC1), and the transition of GABAergic signaling from excitatory to inhibitory occurs before birth in the rat spinal cord and spreads rostrally according to the developmental changes in cation-chloride co-transporter expression. We previously showed that midazolam activates the hippocampal CA3 area and induces less sedation in neonatal rats compared with adolescent rats in an NKCC1-dependent manner...
2016: PloS One
https://www.readbyqxmd.com/read/27748690/cervical-spine-immobilization-during-extrication-of-the-awake-patient-a-narrative-review
#6
Alan Cowley, Ashley Hague, Neal Durge
Techniques for extricating vehicle occupants after road-traffic collisions have evolved largely through fear of worsening a cervical spine injury, rather than being evidence-based. Recent research has looked at the safety of allowing the alert patient to self-extricate, rather than being assisted with equipment such as long spinal boards and semirigid cervical collars. This review aims to elucidate whether it is safe to allow an alert, ambulant patient to self-extricate from a vehicle with minimal or no cervical spine immobilization...
September 29, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27718129/the-readiness-of-emergency-and-trauma-care-in-low-and-middle-income-countries-a-cross-sectional-descriptive-study-of-42-public-hospitals-in-albania
#7
Rifat Latifi, Jayleen K L Gunn, John A Stroster, Edmond Zaimi, Fatos Olldashi, Agron Dogjani, Mihal Kerci, Xheladin Draçini, Julian Kuçani, Zhaneta Shatri, Agim Kociraj, Arian Boci, Ross I Donaldson
BACKGROUND: Traumatic injuries have become a substantial but neglected epidemic in low- and middle-income countries (LMICs), but emergency rooms (ERs) in these countries are often staffed with healthcare providers who have minimal emergency training and experience. The aim of this paper was to describe the specialized training, available interventions, and the patient management strategies in the ERs in Albanian public hospitals. METHODS: A cross-sectional descriptive study of 42 ERs in the Republic of Albania between September 5, 2014, and December 29, 2014 was performed...
December 2016: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27683698/kyphotic-deformity-after-laminectomy-surgery-for-a-gunshot-wound-to-the-spine-a-case-report
#8
Ali Babashahi, Morteza Taheri
Spinal kyphotic deformity after spinal laminectomy or laminoplasty is more common in pediatric patients than adults. Laminectomy can lead to decreased cartilage growth, anterior wedging and posterior spinal muscle insufficiency which can result in kyphotic deformity. Herein we outline a case report of a child presenting with kyphotic deformity after receiving a spinal laminectomy to treat a penetrating spinal trauma. The 8-year-old male presented with penetrating spinal trauma following a gunshot wound and subsequently underwent L1 laminectomy and thecal sac decompression to remove the foreign body...
March 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27683694/cervical-spine-immobilization-in-the-elderly-population
#9
Prashanth J Rao, Kevin Phan, Ralph J Mobbs, David Wilson, Jonathon Ball
BACKGROUND: Immobilization of the cervical spine is a cornerstone of spinal injury management. In the context of suspected cervical spine injury, patients are immobilized in a 'neutral position' based on the head and trunk resting on a flat surface. It is hypothesized that the increased thoracic kyphosis and loss of cervical lordosis seen in elderly patients may require alternative cervical immobilization, compared with the 'neutral position'. METHODS: To investigate this, an audit of pan-scan CT performed on consecutive major trauma patients aged over 65 years was carried out over a 6-month period...
March 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27676080/evaluation-of-a-battery-of-marine-species-based-bioassays-against-raw-and-treated-municipal-wastewaters
#10
Kassiani Harbi, Pavlos Makridis, Christos Koukoumis, Marina Papadionysiou, Theodoros Vgenis, Michael Kornaros, Ioanna Ntaikou, Sinos Giokas, Stefanos Dailianis
The present study evaluates a battery of marine species-based bioassays against chemically characterized municipal wastewater samples (raw and WWTP treated). We estimated Dunaliella tertiolecta growth rate inhibition (24-96h IC50 values), Artemia franciscana immobilization (24h LC50 values), mussel hemocytes viability and lipid peroxidation enhancement (in terms of neutral red retention assay/NRRT and malondialdehyde/MDA content, respectively) in influent- and WWTP effluent-treated species. We found algal growth arrest and stimulation respectively, almost similar 24hLC50 values in Artemia sp...
September 15, 2016: Journal of Hazardous Materials
https://www.readbyqxmd.com/read/27636578/bisphosphonates-inhibit-pain-bone-loss-and-inflammation-in-a-rat-tibia-fracture-model-of-complex-regional-pain-syndrome
#11
Liping Wang, Tian-Zhi Guo, Tzuping Wei, Wen-Wu Li, Xiaoyou Shi, J David Clark, Wade S Kingery
BACKGROUND: Bisphosphonates are used to prevent the bone loss and fractures associated with osteoporosis, bone metastases, multiple myeloma, and osteogenesis deformans. Distal limb fractures cause regional bone loss with cutaneous inflammation and pain in the injured limb that can develop into complex regional pain syndrome (CRPS). Clinical trials have reported that antiresorptive bisphosphonates can prevent fracture-induced bone loss, inhibit serum inflammatory cytokine levels, and alleviate CRPS pain...
October 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27628762/-modified-pembersal-osteotomy-technique-with-lyophilized-human-allograft
#12
C Druschel, K Heck, C Kraft, R Placzek
OBJECTIVE: PemberSal osteotomy to improve femoral head coverage by rotating the acetabular roof ventrally and laterally. INDICATIONS: Insufficient coverage of the femoral head, and can be combined with other surgical procedures such as femoral intertrochanteric varus-derotation osteotomy and open reduction for developmental dysplasia and dislocation of the hip or to improve sphericity and containment in Legg-Calvé-Perthes disease. This specific acetabuloplasty can only be performed in patients with an open epiphyseal growth-plate...
December 2016: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/27484826/-infections-of-the-spine-therapeutic-strategies
#13
S Weckbach, B Lutz, J V Wölfle-Roos, H Reichel
Spinal infections are relatively rare entities but the incidence is significantly increasing due to the rapidly growing numbers of interventions on the spine. Primary infections of intervertebral discs (spondylodiscitis) and vertebral bodies (spondylitis) are distinguished from secondary postinterventional infections. Treatment relies primarily on either conservative or surgical management. In the absence of indications for surgery, a conservative approach is indicated when the patient is neurologically intact and the bony destruction is minimal...
October 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27460202/rgds-and-sikvavs-modified-superporous-poly-2-hydroxyethyl-methacrylate-scaffolds-for-tissue-engineering-applications
#14
Hana Macková, Zdeněk Plichta, Vladimír Proks, Ilya Kotelnikov, Jan Kučka, Helena Hlídková, Daniel Horák, Šárka Kubinová, Klára Jiráková
Three-dimensional hydrogel supports for mesenchymal and neural stem cells (NSCs) are promising materials for tissue engineering applications such as spinal cord repair. This study involves the preparation and characterization of superporous scaffolds based on a copolymer of 2-hydroxyethyl and 2-aminoethyl methacrylate (HEMA and AEMA) crosslinked with ethylene dimethacrylate. Ammonium oxalate is chosen as a suitable porogen because it consists of needle-like crystals, allowing their parallel arrangement in the polymerization mold...
November 2016: Macromolecular Bioscience
https://www.readbyqxmd.com/read/27455480/the-feasibility-of-atlas-based-automatic-segmentation-of-mri-for-h-n-radiotherapy-planning
#15
Kieran Wardman, Robin J D Prestwich, Mark J Gooding, Richard J Speight
Atlas-based autosegmentation is an established tool for segmenting structures for CT-planned head and neck radiotherapy. MRI is being increasingly integrated into the planning process. The aim of this study is to assess the feasibility of MRI-based, atlas-based autosegmentation for organs at risk (OAR) and lymph node levels, and to compare the segmentation accuracy with CT-based autosegmentation. Fourteen patients with locally advanced head and neck cancer in a prospective imaging study underwent a T1-weighted MRI and a PET-CT (with dedicated contrast-enhanced CT) in an immobilization mask...
2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/27436301/mice-with-sclerostin-gene-deletion-are-resistant-to-the-severe-sublesional-bone-loss-induced-by-spinal-cord-injury
#16
W Qin, W Zhao, X Li, Y Peng, L M Harlow, J Li, Y Qin, J Pan, Y Wu, L Ran, H Z Ke, C P Cardozo, W A Bauman
: Bone loss after spinal cord injury (SCI) is rapid, severe, and refractory to interventions studied to date. Mice with sclerostin gene deletion are resistant to the severe sublesional bone loss induced by SCI, further indicating pharmacological inhibition of sclerostin may represent a promising novel approach to this challenging medical problem. INTRODUCTION: The bone loss secondary to spinal cord injury (SCI) is associated with several unique pathological features, including the permanent immobilization, neurological dysfunction, and systemic hormonal alternations...
July 20, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27430440/imaging-of-trauma-of-the-spine
#17
Vahe M Zohrabian, Adam E Flanders
The goal of imaging in spine trauma is to gauge the extent of bony, vascular, and neurologic compromise. Neurologic and mechanical stability are key pieces of information that must be efficiently communicated to the referring clinician. From immobilization and steroid therapy, to vascular repair and emergent surgical intervention, clinical outcomes of spine-injured patients depend on timely and well-chosen imaging studies. Multidetector computed tomography (CT) has essentially replaced radiography in clearance of the spine and is the gold standard in evaluation of the bony spinal column...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27422216/effects-of-spinal-immobilization-at-20%C3%A2-on-respiratory-functions
#18
Şaban Akkuş, Şeref Kerem Çorbacıoğlu, Yunsur Çevik, Emine Akıncı, Hüseyin Uzunosmanoğlu
PURPOSE: The purpose of the study is to investigate whether spinal immobilization with a long backboard (LBB) and semirigid cervical collar (CC) at 20° instead of 0° conserve pulmonary functions, including forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio. METHODOLOGY: The study included 56 adult healthy volunteers. Volunteers were randomly divided into 2 groups, and those in the first group (group 1) had LBBs and CCs applied at 0° (n=30), whereas volunteers in the second group (group 2) had LBBs and CCs applied at 20° (n=26)...
July 1, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27410996/community-implementation-of-a-prehospital-spinal-immobilization-guideline
#19
Whitney Jones Rhodes, David Steinbruner, Lani Finck, Kathleen Flarity
OBJECTIVE: The purpose of this study was to qualitatively describe the underpinnings of the successful implementation of a collaborative prehospital spinal immobilization guideline throughout the emergency medical services (EMS) community in two counties in Colorado. We also describe lessons learned that may be beneficial to other communities considering similar initiatives. METHODS: Qualitative data were collected from key informants who were directly involved in the implementation of a new prehospital spinal immobilization guideline among four community hospitals in two different hospital systems and the associated EMS providers within the two counties...
November 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27408498/spinal-infections-in-children-a-review
#20
REVIEW
Rahul Tyagi
Spinal infections are uncommon but significant causes of morbidity and hospitalization in the paediatric population. These infections encompass a broad range of conditions, from discitis to osteomyelitis and spinal epidural and intramedullary abscesses. Paediatric spinal infections can be caused by a range of bacterial, viral, fungal and parasitic agents. Ultrastructural differences of the vertebrae and associated structures result in distinct mechanisms of pathogenesis of spinal infections in children compared to adults...
December 2016: Journal of Orthopaedics
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