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https://www.readbyqxmd.com/read/28365529/giant-cell-tumour-of-bone-in-the-denosumab-era
#1
REVIEW
Lizz van der Heijden, P D Sander Dijkstra, Jean-Yves Blay, Hans Gelderblom
Giant cell tumour of bone (GCTB) is an intermediate locally aggressive primary bone tumour, occurring mostly at the meta-epiphysis of long bones. Overexpression of receptor activator of nuclear factor kappa-B ligand (RANKL) by mononuclear neoplastic stromal cells promotes recruitment of numerous reactive multinucleated osteoclast-like giant cells, causing lacunar bone resorption. Preferential treatment is curettage with local adjuvants such as phenol, alcohol or liquid nitrogen. The remaining cavity may be filled with bone graft or polymethylmethacrylate (PMMA) bone cement; benefits of the latter are a lower risk of recurrence, possibility of direct weight bearing and early radiographic detection of recurrences...
March 30, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/28337460/caudal-epidural-block-an-updated-review-of-anatomy-and-techniques
#2
REVIEW
Sheng-Chin Kao, Chia-Shiang Lin
Caudal epidural block is a commonly used technique for surgical anesthesia in children and chronic pain management in adults. It is performed by inserting a needle through the sacral hiatus to gain entrance into the sacral epidural space. Using conventional blind technique, the failure rate of caudal epidural block in adults is high even in experienced hands. This high failure rate could be attributed to anatomic variations that make locating sacral hiatus difficult. With the advent of fluoroscopy and ultrasound in guiding needle placement, the success rate of caudal epidural block has been markedly improved...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28332251/measuring-the-depth-of-the-caudal-epidural-space-to-prevent-dural-sac-puncture-during-caudal-block-in-children
#3
Hyun Jeong Lee, Ji Young Min, Hyun Il Kim, Hyo-Jin Byon
BACKGROUND: Caudal blocks are performed through the sacral hiatus in order to provide pain control in children undergoing lower abdominal surgery. During the block, it is important to avoid advancing the needle beyond the sacrococcygeal ligament too much to prevent unintended dural puncture. This study used demographic data to establish simple guidelines for predicting a safe needle depth in the caudal epidural space in children. METHODS: A total of 141 children under 12 years old who had undergone lumbar-sacral magnetic resonance imaging were included...
March 23, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28328326/interleukin-12-and-interleukin-23-blockade-in-leukocyte-adhesion-deficiency-type-1
#4
Niki M Moutsopoulos, Christa S Zerbe, Teresa Wild, Nicolas Dutzan, Laurie Brenchley, Giovanni DiPasquale, Gulbu Uzel, Karen C Axelrod, Andrea Lisco, Lucia D Notarangelo, George Hajishengallis, Luigi D Notarangelo, Steven M Holland
A patient with leukocyte adhesion deficiency type 1 (LAD1) had severe periodontitis and an intractable, deep, nonhealing sacral wound. We had previously found a dominant interleukin-23-interleukin-17 signature at inflamed sites in humans with LAD1 and in mouse models of the disorder. Blockade of this pathway in mouse models has resulted in resolution of the immunopathologic condition. We treated our patient with ustekinumab, an antibody that binds the p40 subunit of interleukin-23 and interleukin-12 and thereby blocks the activity of these cytokines, inhibiting interleukin-23-dependent production of interleukin-17...
March 23, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28247084/anatomy-of-the-sacral-hiatus-and-its-clinical-relevance-in-caudal-epidural-block
#5
Hassan Bagheri, Figen Govsa
PURPOSE: Caudal epidural anesthesia (CEB) is widely used for the prevention of chronic lower back pain, the control of intraoperative analgesia such as genitourinary surgery and labor pain cases in sacral epidural space approach for the implementation of analgesia. CEB is an anesthetic solution used into the sacral canal via sacral hiatus (SH). For optimal access into the sacral epidural space, detailed anatomical landmarks of SH are required. This study aims at exploring the anatomical structures and differences of the SH by using the sacral bone as a guide point to failure criteria for reviewing the caudal epidural anesthesia and improving the criteria for success in practice...
February 28, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28178092/a-randomized-comparison-between-ultrasound-and-fluoroscopy-guided-sacral-lateral-branch-blocks
#6
Roderick J Finlayson, John-Paul B Etheridge, Maria Francisca Elgueta, Atikun Thonnagith, Frederick De Villiers, Bill Nelems, De Q Tran
BACKGROUND AND OBJECTIVES: This randomized trial compared ultrasound (US)- and fluoroscopy-guided sacral lateral branch (SLB) blocks. We hypothesized that US would require a shorter performance time. METHODS: Forty patients who required unilateral sacral lateral branch blocks for chronic low back pain were randomized to US or fluoroscopy guidance. Before the performance of the assigned block, an investigator who was not involved in patient care carried out baseline analgesic testing...
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28034599/neuraxial-analgesia-in-a-pregnant-woman-with-fowler-s-syndrome-and-sacral-neuromodulation
#7
M Ansó, L Veiga-Gil, J De Carlos, A Hualde, J Pérez-Cajaraville
We report the anesthetic management of a 16-year-old woman with Fowler's syndrome who became pregnant three years after sacral neuromodulation was initiated for treatment of the condition. Multidisciplinary consensus was to switch off the neurostimulator during pregnancy, and attempt vaginal delivery with a neuraxial block. When the patient was admitted for labor, an epidural catheter was placed successfully. The patient had a normal vaginal delivery. Sacral neuromodulation was restarted uneventfully in the early puerperium and the Fowler's syndrome remains well controlled...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27906939/a-new-radiofrequency-ablation-procedure-to-treat-sacroiliac-joint-pain
#8
Jianguo Cheng, See Loong Chen, Nicole Zimmerman, Jarrod E Dalton, Garret LaSalle, Richard Rosenquist
BACKGROUND: Low back pain may arise from disorders of the sacroiliac joint in up to 30% of patients. Radiofrequency ablation (RFA) of the nerves innervating the sacroiliac joint has been shown to be a safe and efficacious strategy. OBJECTIVES: We aimed to develop a new RFA technique to relieve low back pain secondary to sacroiliac joint disorders. STUDY DESIGN: Methodology development with validation through prospective observational non-randomized trial (PONRT)...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27903340/-the-clinical-application-of-lumbar-plexus-the-first-posterior-sacral-foramina-block-for-hip-arthroplasty-in-elderly-patients
#9
J Li, X J Ke, Y Liu, K Chen, M B Chen, W Mei
Objective: To evaluate the clinical efficacy of lumbar plexus-the first posterior sacral foramina block as an anesthesia technique for hip arthroplasty in elderly patients. Methods: Forty-four patients, aged 60-91 years, weighing 37-100 kg, American Society of Anesthesiologists (ASA) Ⅰ-Ⅲ, underwent elective hip arthroplasty in Tongji Hospital from February 2015 to January 2016.All patients received lumbar plexus and the first posterior sacral foramina block.The first posterior sacral foramina puncture point of 23 cases were located by traditional positioning method, the others were orientated via ultrasonic method...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27865134/polychromatic-light-480-3400nm-similar-to-the-terrestrial-solar-spectrum-without-its-uv-component-in-post-surgical-immunorehabilitation-of-breast-cancer-patients
#10
Natalia A Zhevago, Alexander A Zimin, Tatyana V Glazanova, Natalia I Davydova, Natalia V Bychkova, Zhanna V Chubukina, Anna I Buinyakova, Marina F Ballyuzek, Kira A Samoilova
To this day, two methods of phototherapy (PT) have been successfully used in post-surgical immunorehabilitation of patients with breast cancer (BC): intravenous laser irradiation of the patients' blood and reinfusion of lympholeukosuspension of BC patients after single irradiation with HeNe laser. The objective of this pilot experimental study was to verify the effectiveness of the percutaneous use of polychromatic visible light combined with polychromatic infrared (pVIS+pIR) radiation similar to the major components of natural solar spectrum in post-surgical management of BC patients...
January 2017: Journal of Photochemistry and Photobiology. B, Biology
https://www.readbyqxmd.com/read/27852382/-effect-comparison-of-ultrasound-guided-lower-extremity-nerve-block-and-spinal-anesthesia-in-ankle-surgery
#11
L L Yang, J S Ji, Z W Zhao, W Wang, S Luo, Y C Mo, J L Wang
Objective: To compare the anesthesia effect between ultrasound-guided lower extremity nerve block and spinal anesthesia in ankle surgery. Methods: Upon the approval of institutional Ethics Committee and informed consent, 80 patients American Society of Anesthesiology (ASA)Ⅰ-Ⅱaged 18-70 yr, undergoing ankle surgery from December 2014 to May 2015 in the Fifth Affiliated Hospital of Wen Zhou Medical College, were randomly divided by random numbers into two groups (n=40): nerve block group (group N) and spinal anesthesia (group S)...
November 8, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27811527/a-cadaveric-study-evaluating-the-feasibility-of-an-ultrasound-guided-diagnostic-block-and-radiofrequency-ablation-technique-for-sacroiliac-joint-pain
#12
Shannon L Roberts, Robert S Burnham, Anne M Agur, Eldon Y Loh
BACKGROUND AND OBJECTIVES: Ultrasound (US)-guided diagnostic block/radiofrequency ablation (RFA) along the lateral sacral crest (LSC) has been proposed for managing sacroiliac joint (SIJ) pain. We sought to investigate (1) ease of visualization of bony landmarks using US; (2) consistency of US-guided needle placement along the LSC; and (3) percentage of the posterior sacral network (PSN) innervating the SIJ complex that would be captured if an RFA strip lesion were created between the needles...
January 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27747222/sacro-iliac-joint-sensory-block-and-radiofrequency-ablation-assessment-of-bony-landmarks-relevant-for-image-guided-procedures
#13
Trevor J G Robinson, Shannon L Roberts, Robert S Burnham, Eldon Loh, Anne M Agur
Image-guided sensory block and radiofrequency ablation of the nerves innervating the sacro-iliac joint require readily identifiable bony landmarks for accurate needle/electrode placement. Understanding the relative locations of the transverse sacral tubercles along the lateral sacral crest is important for ultrasound guidance, as they demarcate the position of the posterior sacral network (S1-S3 ± L5/S4) innervating the posterior sacro-iliac joint. No studies were found that investigated the spatial relationships of these bony landmarks...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27729478/contribution-of-gabaa-glycine-and-opioid-receptors-to-sacral-neuromodulation-of-bladder-overactivity-in-cats
#14
Xuewen Jiang, Thomas W Fuller, Jathin Bandari, Utsav Bansal, Zhaocun Zhang, Bing Shen, Jicheng Wang, James R Roppolo, William C de Groat, Changfeng Tai
In α-chloralose-anesthetized cats, we examined the role of GABAA, glycine, and opioid receptors in sacral neuromodulation-induced inhibition of bladder overactivity elicited by intravesical infusion of 0.5% acetic acid (AA). AA irritation significantly (P < 0.01) reduced bladder capacity to 59.5 ± 4.8% of saline control. S1 or S2 dorsal root stimulation at threshold intensity for inducing reflex twitching of the anal sphincter or toe significantly (P < 0.01) increased bladder capacity to 105.3 ± 9...
December 2016: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/27684866/transsacrococcygeal-approach-to-ganglion-impar-block-for-treatment-of-chronic-coccygodynia-after-spinal-arachnoid-cyst-removal-a-case-report
#15
Young Deog Cha, Chun Woo Yang, Jung Uk Han, Jang Ho Song, WonJu Na, Sora Oh, Byung-Gun Kim
BACKGROUND: Coccygodynia is a pain in the region of the coccyx that radiates to the sacral, perineal area. The cause of the pain is often unknown. Coccygodynia is diagnosed through the patient's past history, a physical examination, and dynamic radiographic study, but the injection of local anesthetics or a diagnostic nerve blockade are needed to distinguish between somatic, neuropathic, and combined pain. Ganglion impar is a single retroperitoneal structure made of both paravertebral sympathetic ganglions...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27676716/dystonia-of-the-lower-limb-after-sacral-neuromodulation-implanted-to-a-16-year-old-boy-with-non-obstructive-chronic-urinary-retention
#16
Teng Maëlys, Gilberte Robain, Samy Bendaya
OBJECTIVE: Sacral neuromodulation is usually used to treat non-obstructive urinary retention when other forms of treatment have failed. An improvement greater than 50% in urinary symptoms after 40months of follow-up has been shown: - moreover, it also has few complications: infections, technical failures, discomfort; - we report a case of dystonia of the lower limb, appeared after sacral neuromodulation implantation. OBSERVATIONS: MMP is a 16-year-old boy with early puberty as noteworthy medical history...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27637163/induced-wedge-technique-to-improve-liquid-embolic-agent-penetration-into-spinal-dural-arteriovenous-fistula
#17
Dae Chul Suh, Ji Eun Park, Hairi Liu, Sung Chul Jung
OBJECTIVE: To promote embolization of spinal dural arteriovenous fistula (SDAVF) with a small long tortuous feeder that may impede successful application of an embolic agent. METHODS: An induced-wedge technique was developed in which blood flow was blocked by coiling at the proximal part of the microcatheter for secure injection of N-butyl cyanoacrylate. We used this techniques in 11 SDAVF patients (M:F = 8:3): 7 thoracic, 2 lumbar, 1 sacral, and 1 cervical. Clinical outcome was evaluated by the Aminoff-Logue Disability Scale...
September 13, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27546959/lower-limb-orthopedic-surgery-in-geriatric-patients-under-paravertebral-blocks-a-prospective-feasibility-study
#18
Rajesh Kumar Singh, J P Chaturvedi, H S Agrawal, Nitesh Agrawal
BACKGROUND: Aging causes progressive deterioration of all the organ systems. Physiological changes of aging and co-morbidities make regional anesthesia a preferred technique for this age group. Regional anesthesia with risk of hypotension and its consequences is fraught with dangers. Peripheral nerve blocks (PNBs) are much safer and give much superior post-op analgesia. The present study was undertaken to perform major lower limb orthopedic surgeries PNBs in geriatric settings. METHODS: A feasibility study was undertaken in patients above age of 60 years admitted for lower limb surgeries to undertake these surgeries under para-vertebral blocks for a period of one year from Mar 2011 to Feb 2012...
July 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/27376481/a-novel-supine-isocentric-approach-for-craniospinal-irradiation-and-its-clinical-outcome
#19
Yi-Kan Cheng, Lei Zeng, Shu-Biao Ye, Jian Zheng, Lin Zhang, Peng Sun, Xiao-Bo Jiang, Wen-Zhao Sun, Tao Xu, Lei Chen
OBJECTIVE: To report a novel approach for craniospinal irradiation (CSI) using a supine isocentric technique. METHODS: Patients were treated in the supine position using CT simulation. Half-beam-blocked lateral cranial fields and superior spinal fields have the same isocentre, and their beam divergences match. Tangential irradiation provides a non-divergent junction for the other two full-beam spinal fields. Shielding for cranial fields was generated, and dose distribution was calculated using a three-dimensional planning system...
September 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27349628/liposomal-bupivacaine-incisional-injection-in-single-level-lumbar-spine-surgery
#20
Ross C Puffer, Kevin Tou, Rose E Winkel, Mohamad Bydon, Bradford Currier, Brett A Freedman
BACKGROUND CONTEXT: Postsurgical pain control is important in spine surgery as it can lead to earlier mobilization, decreased length of stay, decreased side effects from narcotic medications, and improved patient satisfaction. Liposomal bupivacaine (LB) is an injectable formulation of bupivacaine, providing prolonged local anesthesia, up to 72 hours postinjection. Although, LB has been used with increasing frequency following other musculoskeletal procedures, specifically total joint replacements, its pre-emptive analgesic effect following lumbar microdiskectomy has hitherto not been reported...
June 24, 2016: Spine Journal: Official Journal of the North American Spine Society
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