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https://www.readbyqxmd.com/read/28742770/role-of-the-perioperative-surgical-home-in-optimizing-the-perioperative-use-of-opioids
#1
Thomas R Vetter, Zeev N Kain
Several federal agencies have recently noted that the United States is in the midst of an unprecedented "opioid epidemic," with an increasing number of opioid-related overdoses and deaths. Providers currently face 3 population-level, public health challenges in providing optimal perioperative pain care: (1) the continued lack of overall improvement in the excessive incidence of inadequately treated postoperative pain, (2) minimizing or preventing postoperative opioid-related side effects, and (3) addressing current opioid prescribing patterns, and the accompanying problematic surge in prescription opioid diversion, misuse, abuse, addiction, and overdose...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28739517/novel-use-of-the-leksell-gamma-frame-for-stereotactic-biopsy-of-posterior-fossa-lesions-technical-note
#2
Shiro Horisawa, Hiroshi Nakano, Takakzu Kawamata, Takaomi Taira
BACKGROUND: Stereotactic transcerebellar biopsies of brainstem tumors have often been reported. The Leksell frame or Cosman-Roberts-Wells frame is often used in transcerebellar approaches. However, to access lesions via the cerebellum, these frames should be secured as inferiorly on the cranium as possible, which can require exaggerated neck flexion and limit the flexible trajectory to the target. To overcome these disadvantages, we have devised a new way to use the Leksell frame for transcerebellar approaches...
July 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28734937/longitudinal-examination-of-resilience-after-traumatic-brain-injury-a-traumatic-brain-injury-model-systems-study
#3
Jennifer H Marwitz, Adam P Sima, Jeffrey S Kreutzer, Laura E Dreer, Thomas F Bergquist, Ross Zafonte, Douglas Johnson-Greene, Elizabeth R Felix
OBJECTIVE: To evaluate the trajectory of resilience during the first year following a moderate-severe TBI, factors associated with resilience at 3, 6 and 12-months post-injury, and changing relationships over time between resilience and other factors. DESIGN: Longitudinal analysis of an observational cohort. SETTING: Five inpatient rehabilitation centers. PARTICIPANTS: Patients with TBI (N = 195) enrolled in the resilience module of the TBI Model Systems study with data collected at 3, 6, and 12-month follow-up...
July 19, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28731291/critical-questions-advancing-the-health-of-female-veterans
#4
Lisa Muirhead, Priscilla Hall, Cedrella Jones-Taylor, Gari D Clifford, Tasha Felton-Williams, Kathy Williams
PURPOSE: Women are the fastest growing Veteran population in the United States and many receive all or part of their health care outside of the Department of Veterans Affairs (VA). The purpose of this article is to review the healthcare issues of women Veterans and discuss implications for care. DATA SOURCES: Review of selected literature, VA resources and guidelines, and expert opinion. CONCLUSIONS: Few providers are aware of the impact military service has on the health of women and fail to ask the all-important question, "Have you served in the military?" Recognizing women's military service can reveal important information that can answer perplexing clinical questions, aid in designing comprehensive plans of care, and enable women to receive the assistance needed to address complex physical and psychosocial issues to improve the quality of their lives...
July 21, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28730652/effects-of-collimator-angle-couch-angle-and-starting-phase-on-motion-tracking-dynamic-conformal-arc-therapy-4d-dcat
#5
Zhengzheng Xu, Rutao Yao, Matthew B Podgorsak, Iris Z Wang
PURPOSE: The aim of this study was to find an optimized configuration of collimator angle, couch angle, and starting tracking phase to improve the delivery performance in terms of MLC position errors, maximal MLC leaf speed, and total beam-on time of DCAT plans with motion tracking (4D DCAT). METHOD AND MATERIALS: Nontracking conformal arc plans were first created based on a single phase (maximal exhalation phase) of a respiratory motion phantom with a spherical target...
July 21, 2017: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28727471/cutting-edge-implant-rehabilitation-design-and-management-a-tapered-abutment-approach
#6
Mark Bishara, Gregori M Kurtzman
Immediate implant placement can pose challenges surgically and, ultimately, restoratively. Yet immediate placement has become the standard when adequate bone is present to achieve primary stability and site infection is minimal. To avoid prosthetic complications and ensure the implant is encased in bone after healing, proper planning must consider that implant placement does not necessarily need to follow the trajectory of the root socket. As discussed in this article, maxillary anterior sites have potential issues related to the "triangle of bone" that are not encountered in molar sites and demand different approaches to ensure treatment success...
July 2017: Compendium of Continuing Education in Dentistry
https://www.readbyqxmd.com/read/28723724/coping-strategies-used-by-breast-prostate-and-colorectal-cancer-survivors-a-literature-review
#7
Mari P Lashbrook, Patricia C Valery, Vikki Knott, Marilynne N Kirshbaum, Christina M Bernardes
BACKGROUND: Individual coping strategies are a fundamental element underpinning psychosocial distress. OBJECTIVE: The aim of this study was to describe coping strategies and their measurement used by survivors of breast, prostate, and/or colorectal cancer after treatment. METHODS: A search of electronic databases (PubMed, CINAHL, and PsycINFO) was conducted from January 1980 to March 2015. Data were extracted using standardized forms and included studies that explored the coping mechanisms of survivorship of breast, prostate, or colorectal cancer...
July 14, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28721677/the-pervasive-nature-of-uncertainty-a-qualitative-study-of-patients-with-advanced-cancer-and-their-informal-caregivers
#8
Valerie Shilling, Rachel Starkings, Valerie Jenkins, Lesley Fallowfield
PURPOSE: The aim of this study was to explore the impact of extended cancer survival on broader aspects of life and wellbeing such as occupational, financial and family life for patients with advanced cancer and their nominated informal caregivers. METHODS: In-depth qualitative interviews were transcribed verbatim. A thematic framework was developed from an initial process of open coding and tested iteratively as new data were collected. RESULTS: Twenty-four patient-caregiver dyads with advanced ovarian (9), melanoma (9) or lung cancer (6)...
July 18, 2017: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/28718167/are-computer-numerical-control-cnc-manufactured-patient-specific-metal-templates-available-for-posterior-thoracic-pedicle-screw-insertion-feasibility-and-accuracy-evaluation
#9
Xiangxue Kong, Lei Tang, Qiang Ye, Wenhua Huang, Jianyi Li
PURPOSE: Accurate and safe posterior thoracic pedicle insertion (PTPI) remains a challenge. Patient-specific drill templates (PDTs) created by rapid prototyping (RP) can assist in posterior thoracic pedicle insertion, but pose biocompatibility risks. The aims of this study were to develop alternative PDTs with computer numerical control (CNC) and assess their feasibility and accuracy in assisting PTPI. METHODS: Preoperative CT images of 31 cadaveric thoracic vertebras were obtained and then the optimal pedicle screw trajectories were planned...
July 17, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28717141/children-s-first-handwriting-productions-show-a-rhythmic-structure
#10
Elena Pagliarini, Lisa Scocchia, Mirta Vernice, Marina Zoppello, Umberto Balottin, Sana Bouamama, Maria Teresa Guasti, Natale Stucchi
Although much research has been concerned with the development of kinematic aspects of handwriting, little is known about the development along with age of two principles that govern its rhythmic organization: Homothety and Isochrony. Homothety states that the ratio between the durations of the single motor events composing a motor act remains invariant and independent from the total duration of the movement. Isochrony refers to the proportional relationship between the speed of movement execution and the length of its trajectory...
July 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28715981/trajectory-of-weight-patterns-in-urban-youth-throughout-their-stay-in-a-juvenile-justice-system
#11
Lori Keough, Meghan Cobb, Tatum Sinclair, Dawn Beckman
Incarceration is associated with health risks including overweight and obesity. This study explored obesity rates and weight gain in incarcerated youth by tracking weight trajectory during continuous stays in juvenile justice facilities. Among 65 youth, mean weight gain was 17.8 pounds and significant, F(2, 12) = 25.44, p = .03. Youth gained an average of 15.6 pounds (standard deviation [ SD] = 3.6) during the initial incarceration period (mean = 71 days). From the assessment to treatment period (mean = 46 days), mean weight gain was 4...
July 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/28712607/patients-perspectives-on-outcomes-of-care-after-discharge-from-the-emergency-department-a%C3%A2-qualitative-study
#12
Samuel Vaillancourt, M Bianca Seaton, Michael J Schull, Amy H Y Cheng, Dorcas E Beaton, Andreas Laupacis, Katie N Dainty
STUDY OBJECTIVE: Much effort has been expended to understand what care experiences patients value in the emergency department (ED), yet little is known about which outcomes patients value after ED care. Our goal is to define outcomes of ED care that are valued by patients discharged from the ED, with the goal of informing the development of a patient-reported outcome measure for ED care. METHODS: We conducted qualitative semistructured interviews with patients recruited during their care at 1 of 2 EDs and interviewed in either English or French 1 to 9 days after their visit...
July 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28710548/retrospective-evaluation-and-seeg-trajectory-analysis-for-interactive-multi-trajectory-planner-assistant
#13
Davide Scorza, Elena De Momi, Lisa Plaino, Gaetano Amoroso, Gabriele Arnulfo, Massimo Narizzano, Luis Kabongo, Francesco Cardinale
PURPOSE: Focal epilepsy is a neurological disease that can be surgically treated by removing area of the brain generating the seizures. The stereotactic electroencephalography (SEEG) procedure allows patient brain activity to be recorded in order to localize the onset of seizures through the placement of intracranial electrodes. The planning phase can be cumbersome and very time consuming, and no quantitative information is provided to neurosurgeons regarding the safety and efficacy of their trajectories...
July 14, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28708339/-advance-directives-and-advance-care-planning
#14
Petra Vayne-Bossert, Christiane Vailloud, Dominique Ducloux, Caroline Matis, Laurence Déramé
Advance directives (AD) and Advance Care Planning (ACP) are two measures a person may undertake to assure that their treatment preferences will be respected until the end of his / her life. Anticipation is based on an open and honest communication between the patient, the durable medical power of attorney and the health care professionals. ADs and ACPs are based on a person's values and beliefs that are important to his quality of life. ACP is a continuing process, initiated by health care professionals and integrated into the health care plan of a person...
February 1, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28706478/the-effects-of-reducing-preparation-time-on-the-execution-of-intentionally-curved-trajectories-optimization-and-geometrical-analysis
#15
Dovrat Kohen, Matan Karklinsky, Yaron Meirovitch, Tamar Flash, Lior Shmuelof
When subjects are intentionally preparing a curved trajectory, they are engaged in a time-consuming trajectory planning process that is separate from target selection. To investigate the construction of such a plan, we examined the effect of artificially shortening preparation time on the performance of intentionally curved trajectories using the Timed Response task that enforces initiation of movements prematurely. Fifteen subjects performed obstacle avoidance movements toward one of four targets that were presented 25 or 350 ms before the "go" signal, imposing short and long preparation time conditions with mean values of 170 ms and 493 ms, respectively...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28705699/posterolateral-trajectories-favor-a-longer-motor-domain-in-stn-dbs-for-parkinson-s-disease
#16
Idit Tamir, Odeya Marmor-Levin, Renana Eitan, Hagai Bergman, Zvi Israel
OBJECTIVE: The clinical outcome of Parkinson's disease (PD) patients that undergo Subthalamic Nucleus Deep Brain Stimulation (STN DBS) is, in part, determined by the length of the electrode trajectory through the motor STN domain, the Dorso-Lateral Oscillatory Region (DLOR). Trajectory length has been found to correlate with the stimulation-related improvement in patients' motor function (estimated by part III of the United Parkinson's Disease Rating Score (UPDRS)). Therefore, it seems that ideally trajectories should have maximal DLOR length...
July 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28701975/to-pass-or-not-to-pass-modeling-the-movement-and-affordance-dynamics-of-a-pick-and-place-task
#17
Maurice Lamb, Rachel W Kallen, Steven J Harrison, Mario Di Bernardo, Ali Minai, Michael J Richardson
Humans commonly engage in tasks that require or are made more efficient by coordinating with other humans. In this paper we introduce a task dynamics approach for modeling multi-agent interaction and decision making in a pick and place task where an agent must move an object from one location to another and decide whether to act alone or with a partner. Our aims were to identify and model (1) the affordance related dynamics that define an actor's choice to move an object alone or to pass it to their co-actor and (2) the trajectory dynamics of an actor's hand movements when moving to grasp, relocate, or pass the object...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28698090/the-superior-frontal-transsulcal-approach-to-the-anterior-ventricular-system-exploring-the-sulcal-and-subcortical-anatomy-using-anatomic-dissections-and-dti-tractography
#18
Christos Koutsarnakis, Faidon Liakos, Aristotelis V Kalyvas, Georgios P Skandalakis, Spyros Komaitis, Fotini Christidi, Efstratios Karavasilis, Evangellia Liouta, George Stranjalis
OBJECTIVE: To explore the superior frontal sulcus morphology, trajectory of the applied surgical corridor and white matter bundles that are traversed during the superior frontal transsulcal transventricular approach METHODS: Twenty (20) normal, adult, formalin-fixed cerebral hemispheres and two (2) cadaveric heads were included in the study. The superior frontal sulcus (SFS) topography, morphology and dimensions were recorded in all specimens. Fourteen (14) hemispheres were investigated through the fiber dissection technique while the remaining six (6) were explored using coronal cuts...
July 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28694591/atlas-instrumentation-guided-by-the-medial-edge-of-the-posterior-arch-an-anatomic-and-radiologic-study
#19
Amro F Al-Habib, Abdulkarim Al-Rabie, Sami Aleissa, Abdulrahman Albakr, Abdulaziz Abobotain
STUDY DESIGN: This was an interventional human cadaver study and radiological study. OBJECTIVES: Atlas instrumentation is frequently involved in fusion procedures involving the craniocervical junction area. Identification of the entry point at the center of atlas lateral mass (ALM) is challenging because of its rounded posterior surface and the surrounding venous plexus. This report examines using the medial edge of atlas posterior arch (MEC1) as a fixed and reliable anatomic reference to guide the entry point of ALM screws...
April 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28691957/empirically-identified-subgroups-of-children-served-in-part-c-early-intervention-programs
#20
Batya Elbaum, Seniz Celimli-Aksoy
OBJECTIVE: Early intervention (EI) programs under Part C of the Individuals with Disabilities Education Act serve a developmentally heterogeneous population of infants and toddlers with or at risk of developmental delays or disabilities. The aim of this study was to identify empirically distinct subgroups of children in EI so as to inform early prognosis and service planning. METHODS: We applied mixture modeling to developmental assessment data from 1513 children who enrolled in a large, urban EI program between 2009 and 2013...
July 6, 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
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