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Olivier Barbier, Maelle Racle
Introduction: The current evolution of surgical practices is increasingly trending toward hyper-specialization. For military surgeons, their practice in France does not differ from their civilian counterparts. In contrast, in external operations, they have to deal with specific war injuries in austere conditions. They are also required to take care of local populations. Therefore, specific training is necessary, and the French Military Health Service Academy (Ecole du Val-de-Grâce) Paris has set up a specific training called Advanced Course for Deployment Surgery (ACDS) in 2007...
March 14, 2018: Military Medicine
Christine A DeForest, Virginia Blackman, John E Alex, Lauren Reeves, Alejandra Mora, Crystal Perez, Joseph Maddry, Domenique Selby, Benjamin Walrath
Introduction: Military prehospital and en route care (ERC) directly impacts patient morbidity and mortality. Provider knowledge and skills are critical variables in the effectiveness of ERC. No Navy doctrine defines provider choice for patient transport or requires standardized provider training. Frequently, Search and Rescue Medical Technicians (SMTs) and Navy Nurses (ERC RNs) are tasked with this mission though physicians have also been used. Navy ERC provider training varies greatly by professional role...
March 14, 2018: Military Medicine
Davy Guillarme, Vincent Desfontaine, Sabine Heinisch, Jean-Luc Veuthey
Mass spectrometry (MS) is considered today as one of the most popular detection methods, due to its high selectivity and sensitivity. In particular, this detector has become the gold standard for the analysis of complex mixtures such as biological samples. The first successful SFC-MS hyphenation was reported in the 80's, and since then, several ionization sources, mass analyzers and interfacing technologies have been combined. Due to the specific physicochemical properties and compressibility of the SFC mobile phase, directing the column effluent into the ionization source is more challenging than in LC...
March 7, 2018: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
Yad Ram Yadav, Shailendra Ratre, Vijay Parihar, Amitesh Dubey, Mashoo N Dubey
Symptomatic ventral cervical cord compressions have been treated by anterior discectomy with fusion, anterior corpectomy and fusion, discectomy with an artificial disc, and minimally invasive techniques. There are complications associated with the fusion procedure, especially when a long segment fusion is undertaken. Partial removal of the vertebral body without fusion could help in avoiding fusion and its associated complications. We are describing the detailed surgical technique, indications, limitations, and early results of endoscopic partially corpectomy...
March 2018: Neurology India
Manas Panigrahi, Manoranjitha Kumari, Sudhindra Vooturi
Background: The diagnosis of lymphocytic hypophysitis (LYH) is a clinical challenge. Medical management with steroids may result in complete resolution of the symptoms and radiological features. We report our approach to the diagnosis and treatment of LYH. Materials and Methods: Retrospective analysis of data of nine consecutive patients of LYH from August 2013 to August 2015 was done. The average age of the study population was 38.4 ± 19.8 years, with five (55...
March 2018: Neurology India
Stephen Honeybul, David Anthony Morrison, Kwok M Ho, Christopher R P Lind, Elizabeth Geelhoed
OBJECTIVE: To compare the long-term outcomes of patients who had been randomly allocated to receive primary titanium cranioplasty or autologous bone graft following decompressive craniectomy. METHODS: Sixty-four patients had been previously enrolled and randomised to receive either their own bone graft or a primary titanium cranioplasty. Functional and cosmetic outcomes had previously been assessed at 1-year following the cranioplasty procedure. Hospital records and the Picture Archiving communication system were reviewed to determine how many patients had cranioplasty failure or associated complications such as seizures beyond 1 year-with a minimum of 24-month follow-up...
March 15, 2018: Acta Neurochirurgica
Fanny Gabrysz-Forget, Mélanie Hébert, André Denault, Louis P Perrault
This case report presents a manual decompression technique used to decompress a postoperative tamponade compressing right chambers. It consists of lateral movements following subxiphoid finger insertion. This is an accessible procedure to rapidly stabilize the haemodynamics of the patient in the intensive care unit to buy time before operating room (OR) revision.
March 12, 2018: Interactive Cardiovascular and Thoracic Surgery
Gopalakrishnan M Sasidharan
Epidermoid cysts are notorious for their propensity to sneak into deep recesses between cranial nerves in the posterior fossa. Attempts to achieve complete excision using ordinary instruments when tempted by the seeming ease of dissection is known to cause unacceptable deficits. The Xomed monopolar stimulator electrode probe of the nerve integrity electromyography monitor has several advantages when used as the primary dissection tool for deep-seated epidermoid cysts. Cerebellopontine angle epidermoid is the classical prototype of a strategically placed deep-seated epidermoid tumor...
January 12, 2018: Curēus
Dexin Zou, Junlin Zhou, Xiaobing Jiang
Tuberculosis combined with brucellosis is a very rare condition. Overlapping clinical presentation and laboratory parameters of tuberculosis and brucellosis may lead to misdiagnosis or delayed diagnosis of the condition. The current study presents the case of a 45-year-old male with symptoms of lower back pain, non-tender swelling in the right flank, intermittent hyperpyrexia, sweating, body aches and numbness and weakness of right lower limb. A lumbar computed tomograph (CT) scan and magnetic resonance imaging indicated vertebral destruction and the formation of sequestra and thecal sac compression...
April 2018: Experimental and Therapeutic Medicine
Aleksandra Mazur, Anthony Guernec, Jacky Lautridou, Julie Dupas, Emmanuel Dugrenot, Marc Belhomme, Michael Theron, François Guerrero
Introduction: Commercial divers, high altitude pilots, and astronauts are exposed to some inherent risk of decompression sickness (DCS), though the mechanisms that trigger are still unclear. It has been previously showed that diving may induce increased levels of serum angiotensin converting enzyme. The renin angiotensin aldosterone system (RAAS) is one of the most important regulators of blood pressure and fluid volume. The purpose of the present study was to control the influence of angiotensin II on the appearance of DCS...
2018: Frontiers in Physiology
Sharad Rajpal, Colson Tomberlin, Andrew Bauer, Robert C Forsythe, Sigita Burneikiene
BACKGROUND: The variety of diagnostic characteristics associated with neurocysticercosis have been well studied, however, its potential to be implicated in other differential diagnosis has not been well demonstrated. CASE DESCRIPTION: We report the case of a 55-year-old Hispanic man who underwent a Chiari decompression surgery, which was complicated with hydrocephalus. Despite a ventriculoperitoneal (VP) shunt placement, he continued to have headaches and was soon found to have several skull base subarachnoid lesions, which were later diagnosed as the sequelae of an active neurocysticercosis infection...
March 12, 2018: World Neurosurgery
Jeroen G V Habets, Roel H L Haeren, Suen A N Lie, Noel J C Bauer, Jim T A Dings
BACKGROUND: We present a case of orbital compartment syndrome (OCS) leading to monocular irreversible blindness following a pterional craniotomy for clipping of an anterior communicating artery (ACoA) aneurysm. OCS is an uncommon but vision-threatening entity requiring urgent decompression to reduce the risk of permanent visual loss. Iatrogenic orbital roof defects are a common finding following pterional craniotomies. However, complications related to these defects are rarely reported...
March 12, 2018: World Neurosurgery
Min-Qing Wang, Xu Zhao, Xiao-Fei Wang, Chao Han, De-Guang Xing, Cheng-Wei Wang
BACKGROUND: The purpose of this study was to assess the outcomes in aggressively treated patients with aneurysmal intracerebral hematoma (ICH) and signs of brain herniation, and to investigate possible predictive factors. METHODS: This retrospective study included 43 patients with aneurysmal ICH who presented with brain herniation at emergency department (ED) admission and received aggressive surgical treatment between 2008 and 2016. Emergency surgical clipping, removal of hematoma, and external decompression were combined as an aggressive surgical treatment...
March 12, 2018: World Neurosurgery
Carlo Doria, Giulia Raffaella Mosele, Massimo Balsano, Gianluca Maestretti, Gianfilippo Caggiari
OBJECTIVES: The aim of this study was to evaluate the results on anterior decompression and fusion with titanium mesh or expanding cage and plate fixation in patients with cervical myelopathy. METHODS: We conducted a retrospective multicentric review of 114 patients, 75 males and 39 females, with cervical myelopathy who underwent surgical treatment between July 2009 to December 2011. All surgeries were performed via a ventral approach. Based on the type of surgery the patients received, they were divided into 3 groups: group 1 consisted of 49 patients who received multilevel corpectomies and fusion with strut iliac bone graft and plates; group 2 consisted of 26 patients who received multilevel corpectomies and fusion with titanium expanding cage and plating; group 3 consisted of 39 patients who received multilevel corpectomies and fusion using titanium mesh with autologous bone graft and anterior plating...
March 12, 2018: Acta Orthopaedica et Traumatologica Turcica
Stefanos Farfaras, Ninni Sernert, Lars Rostgard Christensen, Erling K Hallström, Jüri-Toomas Kartus
BACKGROUND: The long-term outcome after the treatment of subacromial impingement syndrome (SAIS) with either nonsurgical or surgical methods has not been thoroughly investigated. Hypothesis/Purpose: The purpose was to evaluate the long-term clinical outcome and the presence of rotator cuff injuries and osteoarthritis (OA) after the surgical and nonsurgical treatment of SAIS. The hypothesis was that, at a minimum 10 years after the initial treatment, patients who had undergone acromioplasty would have a better clinical outcome and run a lower risk of developing rotator cuff ruptures and OA as compared with those treated with physical therapy...
March 1, 2018: American Journal of Sports Medicine
Yu V Pilipenko, An N Konovalov, Sh Sh Eliava, O B Belousova, D N Okishev, I A Sazonov, T F Tabasaranskiy
In recent years, the so-called primary or preventive decompressive craniectomy (DC) has been increasingly used in patients with aneurysmal subarachnoid hemorrhage (SAH). The main goal of the technique is prevention of refractory intracranial hypertension (ICH) and its consequences. PURPOSE: The study purpose was to define the CT criteria for reasonability and efficacy of DC as well as clarification of the indications for preventive DC in patients with SAH after microsurgical aneurysm exclusion...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
I Yu Lisitskiy, A M Kiselev, S E Kiselev
Pathological processes in the craniovertebral region (CVR) are usually accompanied by dislocation complications leading to gross neurological disorders. One of the diseases that affect the CVR and lead to atlanto-axial dislocation (AAD) is rheumatoid arthritis. Errors in the diagnosis of rheumatoid disease and in the choice of a treatment approach may cause adverse outcomes. OBJECTIVE: To define the approach for surgical treatment of AAD associated with rheumatoid disease of the CVR, with allowance for the rigidity of deformity...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
I S Lvov, A A Grin', M A Nekrasov, A Yu Kordonskiy, A V Sytnik
Compression of the caudal medulla oblongata and ventral portions of the spinal cord is the most dangerous complication of atlanto-axial dislocation (AAD). AIM: The study objective was to improve surgical management of patients with ventral compression of the spinal cord in the setting of AAD of various genesis. MATERIAL AND METHODS: We analyzed treatment outcomes in 250 patients with C1 and C2 injuries and diseases for the period between 2002 and 2016. Persistent ventral compression of the neural structures in the setting of AAD was detected in 34 (13...
2018: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
N Pinsker, M Papoulas, M Sodergren, P Harrison, N Heaton, K Menon
Introduction A bronchobiliary fistula (BBF) following liver directed therapy (resection/ablation) is a rare complication in which an abnormal communication between the biliary tract and bronchial tree is formed. This case report describes the successful management of a persistent BBF following multiple liver wedge resections and microwave ablation in a patient with a metastatic neuroendocrine tumour of the terminal ileum. Case history A 69-year-old man presented with unexplained weight loss and was subsequently diagnosed with a neuroendocrine tumour of the terminal ileum and liver metastasis...
March 15, 2018: Annals of the Royal College of Surgeons of England
S Al-Benna, T G Arayathinal
No abstract text is available yet for this article.
March 15, 2018: Annals of the Royal College of Surgeons of England
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