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Peripheral nerve surgery

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https://www.readbyqxmd.com/read/28546782/neoadjuvant-ifosfamide-and-epirubicin-in-the-treatment-of-malignant-peripheral-nerve-sheath-tumors
#1
Angela C Hirbe, Pippa F Cosper, Sonika Dahiya, Brian A Van Tine
Background and Objectives. Malignant peripheral nerve sheath tumors (MPNSTs) are aggressive soft tissue sarcomas with poor overall survival. Response to chemotherapy has been debated for these tumors. Methods. We performed a retrospective analysis of the patients at our institution with a biopsy-proven diagnosis of MPNST that underwent neoadjuvant chemotherapy prior to surgery. Results. We retrospectively identified five patients who received neoadjuvant chemotherapy with epirubicin and ifosfamide that demonstrated a 30% reduction in tumor growth and a 60% response rate by RECIST criteria...
2017: Sarcoma
https://www.readbyqxmd.com/read/28546014/-anesthetic-requirements-measured-by-bilateral-bispectral-analysis-and-femoral-blockade-in-total-knee-arthroplasty
#2
Maylin Koo, Javier Bocos, Antoni Sabaté, Vinyet López, Carmina Ribes
BACKGROUND AND OBJECTIVES: A continuous peripheral nerve blockade has proved benefits on reducing postoperative morphine consumption; the combination of a femoral blockade and general anesthesia on reducing intraoperative anesthetic requirements has not been studied. The objective of this study was to determine the relevance of timing in the performance of femoral block to intraoperative anesthetic requirements during general anesthesia for total knee arthroplasty. METHODS: A single-center, prospective cohort study on patients scheduled for total knee arthroplasty, were sequentially allocated to receive 20mL of 2% mepivacaine throughout a femoral catheter, prior to anesthesia induction (Preoperative) or when skin closure started (Postoperative)...
May 22, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28544161/bone-marrow-derived-cells-response-in-proximal-regions-of-nerves-after-peripheral-nerve-injury
#3
Lulu Chen, Jia Cheng, Xiaonan Yang, Xiaolei Jin, Zuoliang Qi, Yu-Qing Jin
In recent years, bone marrow-derived cells have been found to be crucial for peripheral nerve regeneration. After traumatic peripheral nerve injury, bone marrow-derived macrophages quickly infiltrate into the distal regions of nerves. To explore the changes caused by bone marrow-derived cells within the proximal regions of the nerves, sciatic nerves of chimeric mice carrying bone marrow cells expressing green fluorescent protein were crushed to observe the infiltration of invading bone marrow-derived cells...
May 24, 2017: Cell Biology International
https://www.readbyqxmd.com/read/28537569/inguinal-pain-syndrome-the-influence-of-intraoperative-local-administration-of-0-5-bupivacaine-on-postoperative-pain-control-following-lichtenstein-hernioplasty-a-prospective-case-control-study
#4
Bartosz Cybułka
With current technological advancement and availability of synthetic materials used in inguinal hernia repair, a recurrence after first intervention is not a common and important adverse event. On the other hand, however, some patients complain about chronic pain of the operated site after surgeries using a polypropylene mesh. Many patients are constrained to a prolonged use of analgesics and increased frequency of control visits, which may eventually result in loss of trust in the operator. Every surgical intervention is associated with the risk of immediate or delayed complications...
April 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28532897/mast-cells-improve-functional-recovery-of-transected-peripheral-nerve-a-novel-preliminary-study
#5
Behrooz Ilkhanizadeh, Leila Zarei, Negin Farhad, Mehran Bahrami-Bukani, Rahim Mohammadi
BACKGROUND: Employment of regenerative properties of cells at the service of nerve repair has been initiated during recent decades. Effects of local transplantation of bone marrow-derived mast cells on peripheral nerve regeneration were studied using a rat sciatic nerve transection model. MATERIALS AND METHODS: A 10-mm sciatic nerve defect was bridged using a conduit chitosan-based hybrid conduit filled with BMMCs in BMMC group. In positive control group (Pos), the conduit was filled with phosphate-buffered saline alone...
May 11, 2017: Injury
https://www.readbyqxmd.com/read/28525514/perineural-dexmedetomidine-is-more-effective-than-clonidine-when-added-to-local-anesthetic-for-supraclavicular-brachial-plexus-block-a-systematic-review-and-meta-analysis
#6
Kariem El-Boghdadly, Richard Brull, Herman Sehmbi, Faraj W Abdallah
BACKGROUND: Clonidine, an α-2 agonist, has long been used as a local anesthetic adjunct with proven efficacy to prolong peripheral nerve block duration. Dexmedetomidine, a newer α-2 agonist, has a more favorable pharmacodynamic and safety profile; however, data comparing its efficacy as an adjunct to that of clonidine are inconsistent. We sought to compare the clinical efficacy of these 2 α-2 agonists by examining their effects on peripheral nerve block characteristics for upper extremity surgery...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28521032/a-neglected-cause-of-iatrogenic-brachial-plexus-injuries-in-psychiatric-patients
#7
José Fernando Guedes-Corrêa, Maristella Reis da Costa Pereira, Francisco José Lourenço Torrão-Junior, José Vicente Martins, Daniel Alves Neiva Barbosa
BACKGROUND: Psychiatric patients are often kept immobilized during hospitalization to avoid self-inflicted injuries and danger to third parties. Inadequate positioning can lead to brachial plexus injuries (BPI). OBJECTIVE: To present a series of 5 psychiatric patients with BPI after being left sedated and restrained for prolonged periods of time during hospitalization. METHODS: We retrospectively reviewed the charts of 5 psychiatric patients with iatrogenic BPI referred by other institutions to our service...
May 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28515751/malignant-triton-tumor-of-the-lung-infiltrating-the-left-atrium-and-left-ventricle-with-metastasis-to-the-small-intestine
#8
Dariusz Tomaszewski, Sebastian Beta, Jan A Rogowski
Malignant triton tumors are a rare subtype of malignant peripheral nerve sheath tumors showing rhabdomyosarcomatous differentiation. We report the case of a 33-year-old patient who underwent an excision of such a tumor by thoracic and cardiac surgery. He was reoperated on 1 month later because of a tumor of the small intestine and received adjuvant radiation.
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28514241/phrenic-nerve-palsy-and-regional-anesthesia-for-shoulder-surgery-anatomical-physiologic-and-clinical-considerations
#9
Kariem El-Boghdadly, Ki Jinn Chin, Vincent W S Chan
Regional anesthesia has an established role in providing perioperative analgesia for shoulder surgery. However, phrenic nerve palsy is a significant complication that potentially limits the use of regional anesthesia, particularly in high-risk patients. The authors describe the anatomical, physiologic, and clinical principles relevant to phrenic nerve palsy in this context. They also present a comprehensive review of the strategies for reducing phrenic nerve palsy and its clinical impact while ensuring adequate analgesia for shoulder surgery...
May 17, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28509777/ultrasound-guided-percutaneous-cryoneurolysis-for-acute-pain-management-a-case-report
#10
Rodney A Gabriel, John J Finneran, Deepa Asokan, Andrea M Trescot, NavParkash S Sandhu, Brian M Ilfeld
We report 3 different cases in which ultrasound-guided percutaneous cryoneurolysis was performed to treat acute pain: 1 patient with refractory incisional pain after percutaneous nephrolithotomy; 1 patient with burns to the foot; and 1 patient with pain from iliac crest grafting. Acute pain associated with surgery or injury is a challenge to treat with local anesthetic-based regional anesthesia techniques when the anticipated pain duration exceeds a few days. Cryoneurolysis is an alternative analgesic method that utilizes extremely cold temperatures to reversibly ablate peripheral nerves and is potentially a novel method for acute pain management...
May 12, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28508686/malignant-peripheral-nerve-sheath-tumor-of-the-femur-a-rare-diagnosis-supported-by-complete-immunohistochemical-loss-of-h3k27me3
#11
Masato Sugawara, Eisuke Kobayashi, Naofumi Asano, Akihiko Yoshida, Akira Kawai
The histological diagnosis of malignant peripheral nerve sheath tumor (MPNST) is challenging because of the wide morphological spectrum and suboptimal performance of conventional immunohistochemical markers. MPNST arising primarily in the bone is exceptional, and its definitive diagnosis, particularly out of the neurofibromatosis type 1 (NF1) context, is even more problematic. Recurrent inactivation of EED or SUZ12 in a majority of MPNSTs results in a complete loss of trimethylated histone H3 at lysine 27 (H3K27me3) immunoreactivity, making it a highly specific biomarker of MPNSTs...
May 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28507996/effects-of-pulsed-electromagnetic-field-with-predatory-stress-on-functional-and-histological-index-of-injured-sciatic-nerve-in-rat
#12
Maryam Tasbih-Forosh, Leila Zarei, Ehsan Saboory, Mehran Bahrami-Bukani
OBJECTIVE: To assess the effect of combination of pulsed electromagnetic fields (PEMF) with predatory stress on transected sciatic nerve regeneration in rats. METHODS: In sham- operated group (SOG) the nerve was manipulated and left intact. The 10-mm rat sciatic nerve gap was created in rats. In transected group (Transected) nerve stumps were sutured to adjacent muscle and in vein graft group (VG) the gap was bridged using an inside-out vein graft. In VG/PEMF group the transected nerve was bridged using vein graft, phosphate buffered saline was administered into the graft and the whole body was exposed to PEMF...
April 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28507468/paradoxical-effect-of-minocycline-on-established-neuropathic-pain-in-rat
#13
Malek Zarei, Masoumeh Sabetkasaei, Taraneh Moini-Zanjani
Neuropathic pain occurs after peripheral nerve damage, inflammation or infection. In this situation, microglial cells become activated and play a key role in producing pain. Minocycline (microglia inhibitor), was reported to reduce pain when used preventively. However, it seems that, when used after nerve injury, results in its pain reducing effects are different. In this regard, to assess the pain reducing differences of minocycline, neuropathic pain was induced by the ligation of the sciatic nerve in the rat which is recognized as chronic constriction injury (CCI) and minocycline was administered before and after sciatic nerve injury...
2017: EXCLI journal
https://www.readbyqxmd.com/read/28505957/spindle-cell-type-malignant-peripheral-nerve-sheath-tumor-arising-in-benign-schwannoma-with-multiple-intraosseous-spinal-metastasis-a-case-report
#14
Jae Yoon Chung, Sung Sun Kim, Sung Kyu Kim
BACKGROUND: Malignant peripheral nerve sheath tumor (MPNST) arising in benign schwannoma with multiple intraosseous spinal metastasis is extremely rare, having a highly aggressive progression and poor prognosis. In such cases, the malignant cells of MPNST usually have an epithelioid morphology. Here, the authors present a very rare case of spindle cell type MPNST arising in benign schwannoma. CASE: A 47-year-old woman had a history of wide marginal excision of right buttock spindle cell sarcoma previously...
May 5, 2017: Journal of Back and Musculoskeletal Rehabilitation
https://www.readbyqxmd.com/read/28502561/acute-hydrocephalus-due-to-a-primary-malignant-peripheral-nerve-sheath-tumor-of-the-cervicothoracic-junction-a-case-report-and-review-of-the-literature
#15
Y Samanci, H S Togay, R Yakar, F Kabukcuoglu, S E Celik
BACKGROUND: The estimated incidence of malignant nerve sheath tumors is 0.001% per year, and only 2-3% of those tumors involve the spinal nerves. We present a rare case of acute hydrocephalus caused by primary malignant peripheral nerve sheath tumor of the cervicothoracic junction. CASE DESCRIPTION: A 29-year-old previously healthy male patient, except for a history of two previous surgeries for ulnar nerve entrapment and progressive left upper extremity weakness, presented with acute onset somnolence...
May 11, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28500566/an-update-on-addressing-important-peripheral-nerve-problems-challenges-and-potential-solutions
#16
Wilson Z Ray, Mark A Mahan, Danzhu Guo, Danqing Guo, Michel Kliot
From time to time it is thoughtful and productive to review a medical field and reflect upon what are the major issues that need to be addressed and what is being done to do so. This review article is not meant to be all-inclusive but rather focuses on four evolving areas in the field of peripheral nerve disorders and treatments: (1) nerve surgery under ultrasound guidance using a new ultra-minimally invasive thread technique; (2) evolving magnetic resonance imaging (MRI) and ultrasound imaging techniques that are helping to both diagnose and treat a variety of peripheral nerve problems including entrapment neuropathies, traumatic nerve injuries, and masses arising from nerves; (3) promoting recovery after nerve injury using electrical stimulation; and (4) developing animal models to reproduce a severe nerve injury (neurotmetic grade in continuity) that requires a surgical intervention and repair...
May 12, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28497931/is-outpatient-continuous-regional-analgesia-more-effective-and-equally-safe-than-single-shot-peripheral-nerve-blocks-after-ambulatory-orthopedic-surgery-a-systematic-review-of-randomized-double-blinded-placebo-controlled-trials
#17
Andrea Saporito, Luciano Anselmi, Evelina Sturini, Alain Borgeat, José A Aguirre
BACKGROUND: Continuous regional analgesia is an established technique for effective postoperative pain treatment, particularly after orthopedic surgical procedures. Even if it has been increasingly applied to the outpatient setting as well, many anesthesiologists are still reluctant to discharge patients with a perineural catheter in place. Aim of this review was to clarify the evidences about safety and effectiveness of outpatient continuous peripheral nerve blocks. METHODS: A systematic review of all prospective, randomized, double-blinded, placebo-controlled trials of the last 20 years on outpatient continuous peripheral nerve blocks after ambulatory orthopedic surgery was performed, using both PubMed and OVID databases were...
May 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28497343/bdnf-contributes-to-spinal-long-term-potentiation-and-mechanical-hypersensitivity-via-fyn-mediated-phosphorylation-of-nmda-receptor-glun2b-subunit-at-tyrosine-1472-in-rats-following-spinal-nerve-ligation
#18
Song Li, Jie Cai, Zhi-Bo Feng, Zi-Run Jin, Bo-Heng Liu, Hong-Yan Zhao, Hong-Bo Jing, Tian-Jiao Wei, Guan-Nan Yang, Ling-Yu Liu, Yan-Jun Cui, Guo-Gang Xing
Previously we have demonstrated that brain-derived neurotrophic factor (BDNF) contributes to spinal long-term potentiation (LTP) and pain hypersensitivity through activation of GluN2B-containing N-methyl-D-aspartate (GluN2B-NMDA) receptors in rats following spinal nerve ligation (SNL). However, the molecular mechanisms by which BDNF impacts upon GluN2B-NMDA receptors and spinal LTP still remain unclear. In this study, we first documented that Fyn kinase-mediated phosphorylation of GluN2B subunit at tyrosine 1472 (pGluN2B(Y1472)) was involved in BDNF-induced spinal LTP and pain hypersensitivity in intact rats...
May 11, 2017: Neurochemical Research
https://www.readbyqxmd.com/read/28494560/-visual-impact-of-sub-tenon-s-anesthesia-during-surgery-for-retinal-detachment
#19
W Q Chen, G H Zhang, H J Lin, H C Huang, D S Lin, J L Zheng, D Z Zheng
Objective: To investigate the visual impact and influence factors of sub-Tenon's anesthesia in retinal detachment patients during pars plana vitrectomy (PPV) or combined phacoemulsification and PPV surgery. Methods: In this prospective case series study, 104 consecutive patients who underwent PPV or combined phacoemulsification and PPV under sub-Tenon's anesthesia between October 2012 and December 2013 were enrolled. Intraoperatively, the patients were asked whether they could see the light of the operating microscope or not at 5 minutes after sub-Tenon's anesthesia, and at the end of phacoemulsification, core vitreous removal, peripheral vitreous removal and the whole surgery, with their contralateral eyes being covered tightly and no photobleaching...
May 11, 2017: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
https://www.readbyqxmd.com/read/28494088/peripheral-nerve-blocks-for-hip-fractures
#20
REVIEW
Joanne Guay, Martyn J Parker, Richard Griffiths, Sandra Kopp
BACKGROUND: Various nerve blocks with local anaesthetic agents have been used to reduce pain after hip fracture and subsequent surgery. This review was published originally in 1999 and was updated in 2001, 2002, 2009 and 2017. OBJECTIVES: This review focuses on the use of peripheral nerves blocks as preoperative analgesia, as postoperative analgesia or as a supplement to general anaesthesia for hip fracture surgery. We undertook the update to look for new studies and to update the methods to reflect Cochrane standards...
May 11, 2017: Cochrane Database of Systematic Reviews
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