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https://www.readbyqxmd.com/read/28718878/deep-brain-and-cortical-stimulation-for-epilepsy
#1
REVIEW
Mathieu Sprengers, Kristl Vonck, Evelien Carrette, Anthony G Marson, Paul Boon
BACKGROUND: Despite optimal medical treatment, including epilepsy surgery, many epilepsy patients have uncontrolled seizures. Since the 1970s interest has grown in invasive intracranial neurostimulation as a treatment for these patients. Intracranial stimulation includes both deep brain stimulation (DBS) (stimulation through depth electrodes) and cortical stimulation (subdural electrodes). This is an updated version of a previous Cochrane review published in 2014. OBJECTIVES: To assess the efficacy, safety and tolerability of DBS and cortical stimulation for refractory epilepsy based on randomized controlled trials (RCTs)...
July 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28712529/dynamic-simulation-of-knee-joint-loading-during-gait-using-force-feedback-control-and-surrogate-contact-modelling
#2
Jonathan P Walter, Marcus G Pandy
The aim of this study was to perform multi-body, muscle-driven, forward-dynamics simulations of human gait using a 6-degree-of-freedom (6-DOF) model of the knee in tandem with a surrogate model of articular contact and force control. A forward-dynamics simulation incorporating position, velocity and contact force-feedback control (FFC) was used to track full-body motion capture data recorded for multiple trials of level walking and stair descent performed by two individuals with instrumented knee implants. Tibiofemoral contact force errors for FFC were compared against those obtained from a standard computed muscle control algorithm (CMC) with a 6-DOF knee contact model (CMC6); CMC with a 1-DOF translating hinge-knee model (CMC1); and static optimization with a 1-DOF translating hinge-knee model (SO)...
July 13, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28706862/flexible-band-versus-rigid-ring-annuloplasty-for-tricuspid-regurgitation-a-systematic-review-and-meta-analysis
#3
REVIEW
Nelson Wang, Steven Phan, David H Tian, Tristan D Yan, Kevin Phan
BACKGROUND: Up to 20% of patients have pre-discharge residual moderate to severe tricuspid regurgitation (TR) after tricuspid repair. Reoperations for recurrent TR carry high mortality rates, which emphasizes the importance of identifying the optimal technique for the surgical management of TR. The present study is a systematic review and meta-analysis that aims to compare short and long term survival and freedom from TR of flexible band ring versus rigid ring for annuloplasty of TR. METHODS: We conducted a systematic review and meta-analysis of comparative studies to evaluate these procedures...
May 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28705170/can-lokomat-therapy-with-children-and-adolescents-be-improved-an-adaptive-clinical-pilot-trial-comparing-guidance-force-path-control-and-freed
#4
Tabea Aurich-Schuler, Fabienne Grob, Hubertus J A van Hedel, Rob Labruyère
BACKGROUND: Robot-assisted gait therapy is increasingly being used in pediatric neurorehabilitation to complement conventional physical therapy. The robotic device applied in this study, the Lokomat (Hocoma AG, Switzerland), uses a position control mode (Guidance Force), where exact positions of the knee and hip joints throughout the gait cycle are stipulated. Such a mode has two disadvantages: Movement variability is restricted, and patients tend to walk passively. Kinematic variability and active participation, however, are crucial for motor learning...
July 14, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28698335/risk-of-a-seizure-recurrence-after-a-breakthrough-seizure-and-the-implications-for-driving-further-analysis-of-the-standard-versus-new-antiepileptic-drugs-sanad-randomised-controlled-trial
#5
L J Bonnett, G A Powell, C Tudur Smith, A G Marson
OBJECTIVES: A breakthrough seizure is one occurring after at least 12 months seizure freedom while on treatment. The Driver and Vehicle Licensing Agency (DVLA) allows an individual to return to driving once they have been seizure free for 12 months following a breakthrough seizure. This is based on the assumption that the risk of a further seizure in the next 12 months has dropped <20%. This analysis considers whether the prescribed 1 year off driving following a breakthrough seizure is sufficient for this and stratifies risk according to clinical characteristics...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28687670/stand-alone-pulmonary-vein-isolation-versus-pulmonary-vein-isolation-with-additional-substrate-modification-as-index-ablation-procedures-in-patients-with-persistent-and-long-standing-persistent-atrial-fibrillation-the-randomized-alster-lost-af-trial-ablation
#6
Thomas Fink, Michael Schlüter, Christian-Hendrik Heeger, Christine Lemes, Tilman Maurer, Bruno Reissmann, Johannes Riedl, Laura Rottner, Francesco Santoro, Boris Schmidt, Peter Wohlmuth, Shibu Mathew, Christian Sohns, Feifan Ouyang, Andreas Metzner, Karl-Heinz Kuck
BACKGROUND: Pulmonary vein isolation (PVI) for persistent atrial fibrillation is associated with limited success rates and often requires multiple procedures to maintain stable sinus rhythm. In the prospective and randomized Alster-Lost-AF trial (Ablation at St. Georg Hospital for Long-Standing Persistent Atrial Fibrillation), we sought to assess, in patients with symptomatic persistent or long-standing persistent atrial fibrillation, the outcomes of initial ablative strategies comprising either stand-alone PVI (PVI-only approach) or a stepwise approach of PVI followed by complex fractionated atrial electrogram ablation and linear ablation (Substrate-modification approach)...
July 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/28687375/post-operative-stereotactic-radiosurgery-versus-observation-for-completely-resected-brain-metastases-a-single-centre-randomised-controlled-phase-3-trial
#7
Anita Mahajan, Salmaan Ahmed, Mary Frances McAleer, Jeffrey S Weinberg, Jing Li, Paul Brown, Stephen Settle, Sujit S Prabhu, Frederick F Lang, Nicholas Levine, Susan McGovern, Erik Sulman, Ian E McCutcheon, Syed Azeem, Daniel Cahill, Claudio Tatsui, Amy B Heimberger, Sherise Ferguson, Amol Ghia, Franco Demonte, Shaan Raza, Nandita Guha-Thakurta, James Yang, Raymond Sawaya, Kenneth R Hess, Ganesh Rao
BACKGROUND: After brain metastasis resection, whole brain radiotherapy decreases local recurrence, but might cause cognitive decline. We did this study to determine if stereotactic radiosurgery (SRS) to the surgical cavity improved time to local recurrence compared with that for surgical resection alone. METHODS: In this randomised, controlled, phase 3 trial, we recruited patients at a single tertiary cancer centre in the USA. Eligible patients were older than 3 years, had a Karnofsky Performance Score of 70 or higher, were able to have an MRI scan, and had a complete resection of one to three brain metastases (with a maximum diameter of the resection cavity ≤4 cm)...
July 4, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28681500/continuous-support-for-women-during-childbirth
#8
REVIEW
Meghan A Bohren, G Justus Hofmeyr, Carol Sakala, Rieko K Fukuzawa, Anna Cuthbert
BACKGROUND: Historically, women have generally been attended and supported by other women during labour. However, in hospitals worldwide, continuous support during labour has often become the exception rather than the routine. OBJECTIVES: The primary objective was to assess the effects, on women and their babies, of continuous, one-to-one intrapartum support compared with usual care, in any setting. Secondary objectives were to determine whether the effects of continuous support are influenced by:1...
July 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28680576/recommendations-for-the-use-of-oral-treprostinil-in-clinical-practice-a-delphi-consensus-project-pulmonary-circulation
#9
Franck F Rahaghi, Jeremy P Feldman, Roblee P Allen, Victor Tapson, Zeenat Safdar, Vijay P Balasubramanian, Shelley Shapiro, Michael A Mathier, Jean M Elwing, Murali M Chakinala, R James White
Oral treprostinil was recently labeled for treatment of pulmonary arterial hypertension. Similar to the period immediately after parenteral treprostinil was approved, there is a significant knowledge gap for practicing physicians who might prescribe oral treprostinil. Despite its oral route of delivery, use of the drug is challenging because of the requirement for careful titration and management of drug-related adverse effects. We aimed to create a consensus document combining available evidence with expert opinion to provide guidance for use of oral treprostinil...
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28664931/the-evolution-of-brachytherapy-for-prostate-cancer
#10
REVIEW
Nicholas G Zaorsky, Brian J Davis, Paul L Nguyen, Timothy N Showalter, Peter J Hoskin, Yasuo Yoshioka, Gerard C Morton, Eric M Horwitz
Brachytherapy (BT), using low-dose-rate (LDR) permanent seed implantation or high-dose-rate (HDR) temporary source implantation, is an acceptable treatment option for select patients with prostate cancer of any risk group. The benefits of HDR-BT over LDR-BT include the ability to use the same source for other cancers, lower operator dependence, and - typically - fewer acute irritative symptoms. By contrast, the benefits of LDR-BT include more favourable scheduling logistics, lower initial capital equipment costs, no need for a shielded room, completion in a single implant, and more robust data from clinical trials...
June 30, 2017: Nature Reviews. Urology
https://www.readbyqxmd.com/read/28664433/factors-influencing-the-outcome-of-magnetic-sphincter-augmentation-for-chronic-gastroesophageal-reflux-disease
#11
Heather F Warren, Lisa M Brown, Matias Mihura, Alexander S Farivar, Ralph W Aye, Brian E Louie
OBJECTIVES: Magnetic sphincter augmentation (MSA) is a surgical treatment option for patients with gastroesophageal reflux disease (GERD). MSA consistently improves quality of life, maintains freedom from PPIs, and objectively controls GERD. However, up to 24% of patients did not achieve these outcomes. We sought to identify factors predicting outcomes after MSA placement with the aim of refining selection criteria. METHODS: We retrospectively analyzed clinical, endoscopic, manometric, pH data, and intraoperative factors from two databases: Pivotal Trial (N = 99) and our prospectively maintained esophageal database (N = 71)...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28648324/drug-coated-balloon-angioplasty-for-the-management-of-recurring-infrapopliteal-disease-in-diabetic-patients-with-critical-limb-ischemia
#12
Luis M Palena, Larry J Diaz-Sandoval, Efren Gòmez Jabalera, Olga Peypoch Perez, Enrico Sultato, Cesare Brigato, Enrico Brocco, Marco Manzi
OBJECTIVE: To describe the 1-year outcomes of recurring infrapopliteal disease after endovascular revascularization with the Lutonix drug-coated balloons (LDCB) in diabetic patients with critical limb ischemia (CLI), and to benchmark our findings with previously published objective performance goals (OPG) addressing safety and efficacy of new catheter-based therapies for CLI. METHODS: The present study was a retrospective, single-center, and single-arm trial of symptomatic diabetic patients with CLI, who underwent LDCB-angioplasty for recurring infrapopliteal disease...
June 20, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28647390/neural-synergies-for-controlling-reach-and-grasp-movement-in-macaques
#13
Yaoyao Hao, Shaomin Zhang, Qiaosheng Zhang, Guanglin Li, Weidong Chen, Xiaoxiang Zheng
It has been suggested that the brain adopts a simplified strategy to coordinate a large number of degrees of freedom in motor control. Synergies have been proposed as a strategy to produce movements by recruitment of a small number of fixed modular patterns. However, there is no direct support for a synergistic organization of the brain itself. In this study, we recorded neural activities from the dorsal premotor cortex (PMd) of monkeys trained to reach and grasp differently shaped objects (grasping task) or the same object in different positions (reaching task)...
June 22, 2017: Neuroscience
https://www.readbyqxmd.com/read/28644979/intraoperative-fast-ripples-independently-predict-postsurgical-epilepsy-outcome-comparison-with-other-electrocorticographic-phenomena
#14
Shaun A Hussain, Gary W Mathern, Phoebe Hung, Julius Weng, Raman Sankar, Joyce Y Wu
In the surgical management of epilepsy, the resection of cortex exhibiting interictal fast ripples (250-500Hz) on electrocorticography has been linked to postoperative seizure-freedom. Although fast ripples appear to accurately identify the epileptogenic zone-the minimum tissue that must be removed at surgery to achieve seizure-freedom-it has not been established that fast ripples are a superior biomarker in comparison with multimodal presurgical neuroimaging and other electrocorticography abnormalities. Hence, in the prediction of postoperative seizure-freedom, we compared the value of fast ripples with other intraoperative electocorticography abnormalities including focal slowing, paroxysmal fast activity, intermittent spike discharges, continuous epileptiform discharges, focal attenuation, and intraoperative seizures, as well as complete resection of the lesion defined by MRI and other neuroimaging...
June 16, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28642012/evaluation-of-a-device-combining-an-inferior-vena-cava-filter-and-a-central-venous-catheter-for-preventing-pulmonary-embolism-among-critically-ill-trauma-patients
#15
Victor F Tapson, Joshua P Hazelton, John Myers, Claudia Robertson, Ramyar Gilani, Julie A Dunn, Marko Bukur, Martin A Croce, Ann Peick, Sonlee West, Lawrence Lottenberg, Jay Doucet, Preston R Miller, Bruce Crookes, Rajesh R Gandhi, Chasen A Croft, Anthony Manasia, Brian A Hoey, Howard Lieberman, Oscar D Guillamondegui, Victor Novack, Gregory Piazza, Samuel Z Goldhaber
PURPOSE: To evaluate efficacy and safety of a novel device that combines an inferior vena cava (IVC) filter and central venous catheter (CVC) for prevention of pulmonary embolism (PE) in critically ill patients. MATERIALS AND METHODS: In a multicenter, prospective, single-arm clinical trial, the device was inserted at the bedside without fluoroscopy and subsequently retrieved before transfer from the intensive care unit (ICU). The primary efficacy endpoint was freedom from clinically significant PE or fatal PE 72 hours after device removal or discharge, whichever occurred first...
June 20, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28637515/current-globalization-of-drug-interventional-clinical-trials-characteristics-and-associated-factors-2011-2013
#16
Sohyun Jeong, Minji Sohn, Jae Hyun Kim, Minoh Ko, Hee-Won Seo, Yun-Kyoung Song, Boyoon Choi, Nayoung Han, Han-Sung Na, Jong Gu Lee, In-Wha Kim, Jung Mi Oh, Euni Lee
BACKGROUND: Clinical trial globalization is a major trend for industry-sponsored clinical trials. There has been a shift in clinical trial sites towards emerging regions of Eastern Europe, Latin America, Asia, the Middle East, and Africa. Our study objectives were to evaluate the current characteristics of clinical trials and to find out the associated multiple factors which could explain clinical trial globalization and its implications for clinical trial globalization in 2011-2013. METHODS: The data elements of "phase," "recruitment status," "type of sponsor," "age groups," and "design of trial" from 30 countries were extracted from the ClinicalTrials...
June 21, 2017: Trials
https://www.readbyqxmd.com/read/28637175/multiple-subpial-transections-for-medically-refractory-epilepsy-a-disaggregated-review-of-patient-level-data
#17
John D Rolston, Hansen Deng, Doris D Wang, Dario J Englot, Edward F Chang
BACKGROUND: Multiple subpial transections (MST) are a treatment for seizure foci in nonresectable eloquent areas. OBJECTIVE: To systematically review patient-level data regarding MST. METHODS: Studies describing patient-level data for MST procedures were extracted from the Medline and PubMed databases, yielding a synthetic cohort of 212 patients from 34 studies. Data regarding seizure outcome, patient demographics, seizure type, surgery type, and complications were extracted and analyzed...
June 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28626781/both-cladribine-and-alemtuzumab-may-effect-ms-via-b-cell-depletion
#18
David Baker, Samuel S Herrod, Cesar Alvarez-Gonzalez, Lukasz Zalewski, Christo Albor, Klaus Schmierer
OBJECTIVE: To understand the efficacy of cladribine (CLAD) treatment in MS through analysis of lymphocyte subsets collected, but not reported, in the pivotal phase III trials of cladribine and alemtuzumab induction therapies. METHODS: The regulatory submissions of the CLAD Tablets Treating Multiple Sclerosis Orally (CLARITY) (NCT00213135) cladribine and Comparison of Alemtuzumab and Rebif Efficacy in Multiple Sclerosis, study one (CARE-MS I) (NCT00530348) alemtuzumab trials were obtained from the European Medicine Agency through Freedom of Information requests...
July 2017: Neurology® Neuroimmunology & Neuroinflammation
https://www.readbyqxmd.com/read/28626337/is-robot-assisted-therapy-effective-in-upper-extremity-recovery-in-early-stage-stroke-a-systematic-literature-review
#19
REVIEW
GaYeong Kim, SeungYeop Lim, HyunJong Kim, ByungJoon Lee, SeungChul Seo, KiHun Cho, WanHee Lee
[Purpose] The aim of this study was to systematically investigate the effects of robot-assisted therapy on the upper extremity in acute and subacute stroke patients. [Subjects and Methods] The papers retrieved were evaluated based on the following inclusion criteria: 1) design: randomized controlled trials; 2) population: stroke patients 3) intervention: robot-assisted therapy; and 4) year of publication: May 2012 to April 2016. Databased searched were: EMBASE, PubMed and COCHRAN databases. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies...
June 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28606140/imepitoin-is-well-tolerated-in-healthy-and-epileptic-cats
#20
Odilo Engel, Thilo von Klopmann, Arianna Maiolini, Jessica Freundt-Revilla, Andrea Tipold
BACKGROUND: Epilepsy in the cat is a serious medical condition. To date there are no licensed treatments for feline epilepsy and no well-controlled clinical studies on the efficacy or safety of antiepileptic drugs in cats. The aim of this study was to collect tolerability data and first exploratory efficacy data of imepitoin in both healthy and epileptic cats. RESULTS: In two tolerability studies, 30 healthy cats received imepition twice daily in doses of 0, 30, 40 or 80 mg/kg bodyweight for 30 days...
June 12, 2017: BMC Veterinary Research
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