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Cheng Hui Yang, Tung-Hsin Wu, Chung-Jung Lin, Yi-You Chiou, Ying-Chou Chen, Ming-Huei Sheu, Wan-Yuo Guo, Chen Fen Chiu
PURPOSE: To evaluate the image quality and diagnostic confidence of reduced-dose computed tomography (CT) of the lumbar spine (L-spine) reconstructed with knowledge-based iterative model reconstruction (IMR). MATERIALS AND METHODS: Prospectively, group A consisted of 55 patients imaged with standard acquisition reconstructed with filtered back-projection. Group B consisted of 58 patients imaged with half tube current, reconstructed with hybrid iterative reconstruction (iDose(4)) in Group B1 and knowledge-based IMR in Group B2...
October 2016: European Journal of Radiology
Tamara K Parissenti, Gundula Hebisch, Wieland Sell, Patricia E Staedele, Volker Viereck, Mathias K Fehr
PURPOSE: To identify risk factors for emergency caesarean section in women attempting a vaginal breech delivery at term. METHODS: Data from 1092 breech deliveries performed between 1998 and 2013 at a Swiss cantonal hospital were extracted from an electronic database. Of the 866 women with a singleton, full term pregnancy, 464 planned a vaginal breech delivery. Fifty-seven percent (265/464) were successful in delivering vaginally. Multivariate regression analyses of risk factors were performed, and neonatal and maternal complications were compared...
September 8, 2016: Archives of Gynecology and Obstetrics
Atilla Kazanci, Oktay Gurcan, Ahmet Gurhan Gurcay, Evrim Onder, Burak Kazanci, Mesut Emre Yaman, Murad Bavbek
AIM: Leptomeningeal adhesions and fibrosis in spinal peridural space are the most common causes of post-laminectomy syndrome. Fibrin sealant agents and membrane barriers are commonly used for hemostasis and sealing purposes in spinal surgery. Peridural fibrosis may be a risk of usage of these topical agents. In our study we aimed to compare the effects of Cova™, Tisseel® and Adcon® Gel on spinal epidural fibrosis in an experimental rat model. MATERIAL AND METHODS: 32 Sprague Dawley female rats were divided into 4 groups randomly...
April 20, 2016: Turkish Neurosurgery
Enis Kuruoglu, Mehmet Emin Onger, Abdullah Hilmi Marangoz, Suleyman Emre Kocacan, Cengiz Cokluk, Suleyman Kaplan
AIM: In the present study, a quantitative model of post-laminectomy in rats was designed. Concurrently, the effects of Momordica charantia (MC) and Ankaferd blood stopper (ABS) were evaluated. MATERIAL AND METHODS: Eighteen adult Wistar albino rats underwent lumbar laminectomy at L2-L3 vertebral levels, and were randomly assigned to one of three groups of six rats each. The treatment group received MC and ABS treatment and the Control group was untreated. Rats were sacrificed 4 weeks after treatment...
February 5, 2016: Turkish Neurosurgery
Mar Olga Pérez-Moreno, María José Centelles-Serrano, Julio Nogales-López, Marie France Domenech-Spanedda, Carmen Lozano, Carmen Torres
OBJECTIVE: To characterize a methicillin-resistant Staphylococcus aureus (MRSA) isolate responsible for an aggressive infection (peridural and psoas abscess secondary to haematogenous septic arthritis) in a poultry farmer. METHODS: Molecular characterization was performed, including spa- and multilocus sequence typing of the isolate, assessment of its resistance phenotype and detection of tetracycline resistance and of virulence and immune evasion cluster (IEC) genes were performed...
August 31, 2016: Enfermedades Infecciosas y Microbiología Clínica
Miguel de la Parra, Marco Camacho, Jonatan de la Garza
BACKGROUND: Many articles have been published about breast reconstruction using the deep inferior epigastric perforator (DIEP) flap; however, few articles have been published in plastic/reconstructive surgery journals describing the difference between anesthetic techniques and recovery in microsurgical patients. METHODS: We analyzed 16 patients who underwent DIEP flap for breast reconstruction. Patients were divided into 2 groups: group 1: general anesthesia (n = 9); group 2: epidural block with the patient awake (n = 7)...
May 2016: Plastic and Reconstructive Surgery. Global Open
Begoña Hidalgo-Mendía, Marina Angulo-Taberno, Ricardo Jaroid-Audes, Carmen Untoria-Agustín, David Rivero-Zelada
Intracraneal hypotension headache is a well known syndrome in neurosurgery practice. In most cases cerebrospinal fluid leaks are caused by medical interventions, such as lumbar puncture, peridural anesthesia and surgical interventions on the spine. Clinical symptoms tipically show orthostatic headache that resolves in supine position, and other symptoms like neck tightness, vertigo and diplopia. RMI diagnostic confirms paquimeningeal enhancement and subdural hygromas. Conservative treatment usually includes bed resting, hydratation and administration of caffeine or glucocorticoids, resolving spontaneously in one to four months...
2016: Revista de la Facultad de Ciencias Médicas
Xiangqian Li, Lin Chen, Hong Lin, Luping Cao, Ji'an Cheng, Jian Dong, Lin Yu, Jiandong Ding
STUDY DESIGN: Experimental animal study. OBJECTIVE: The authors conducted a study to determine the efficacy and safety of the PLGA-PEG-PLGA thermogel to prevent peridural fibrosis in an adult rat laminectomy model. SUMMARY OF BACKGROUND DATA: Peridural fibrosis often occurs after spinal laminectomy. It might cause persistent back and/or leg pain postoperatively and make a reoperation more difficult and dangerous. Various materials have been used to prevent epidural fibrosis, but only limited success has been achieved...
June 28, 2016: Clinical Spine Surgery
H-G Palm, S Uhl, M Zollo, P Lang, B Friemert, H-J Riesner
Background: Postural control, balance stability, is reduced in patients with chronic low back pain, due to pain. Epidural injection therapy (EI) is an established treatment of low back pain. The objective of our study was to investigate whether EI-induced pain relief also leads to improvement in postural control, as detected by computerised dynamic posturography (CDP). Patients and Methods: In a prospective study, 32 patients underwent CDP during and after the EI series of three injections. The main objective was to measure changes in overall stability index (OSI) in a pre- and post-intervention comparison...
June 1, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Jeong Woo Park, Koang Hum Bak, Tae Koo Cho, Hyoung-Joon Chun, Je Il Ryu
OBJECTIVE: A common cause of failure in laminectomy surgery is when epidural, peridural, or perineural adhesion occurs postoperatively. The purpose of this study is to examine the efficacy of a temperature-sensitive, anti-adhesive agent (TSAA agent), Guardix-SG®, as a mechanical barrier for the prevention or reduction of peridural scar adhesion in a rabbit laminectomy model. METHODS: Twenty-six mature rabbits were used for this study. Each rabbit underwent two separate laminectomies at lumbar vertebrae L3 and L6, left empty (the control group) and applied 2 mL of the TSAA agent (the experimental group), respectively...
May 2016: Journal of Korean Neurosurgical Society
Constantin Gomes, Mathieu Kuchenbuch, Grégory Lucas, Soizic Argaud, Philippe Violas, Paul Sauleau
PURPOSE: To assess the validity and utility of monopolar stimulation (between a peridural needle and a large adhesive anode placed in the sternal area) for intraoperative monitoring in scoliosis surgery. METHODS: This procedure was assessed during 41 operations involving either arthrodesis with posterior instrumentation or a Vertical Expandable Prosthetic Titanium Rib (VEPTR). Responses evoked by monopolar stimulation were compared with those evoked by bipolar stimulation between two epidural needle electrodes...
March 8, 2016: European Spine Journal
Filippo Migliorini, Francesco Bianconi, Leonardo Bizzotto, Antonio Benito Porcaro, Walter Artibani
Acute severe ischemia of glans penis after circumcision is a very rare event and, if not treated, can lead to irreversible necrosis with severe consequences such as loss of part of the penis. The possible causes for this condition could be blood-vessel binding or cauterization, dorsal penile nerve block (DPNB), local anesthesia with vasoconstricting agents and wound dressing compression. The aim of the treatment is to provide good blood supply and thus, oxygen delivery to the ischemic penis. The therapeutic options include hyperbaric therapy (HBOT), pentoxifylline (PTX), enoxaparina, iloprost, antiplatelet, corticosteroids and peridural anesthesia...
February 13, 2016: Urologia Internationalis
Hemmo A Bosscher, James E Heavner, Petar Grozdanov, Irfan A Warraich, Mitchell S Wachtel, Janet Dertien
There is evidence that low back pain may originate from a peridural membrane (PDM) at the inferior and medial aspect of neural foramen of the lumbar spine. The objective of this investigation was to determine if this membrane contains neural elements suggestive of sensory innervation with nociceptive function. Spines of four embalmed and three non-embalmed human cadavers were dissected using a sagittal approach to the neural foramen. Seventeen samples of the peridural membrane overlying the neural foramen were collected for immunohistochemistry (IHC) examination by light microscopy and transmission electron microscopy (TEM)...
April 2016: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
P Kranke, T Annecke, D H Bremerich, R Hanß, L Kaufner, C Klapp, H Ohnesorge, U Schwemmer, T Standl, S Weber, T Volk
Obstetric analgesia and anesthesia have some specific aspects, which in particular are directly related to pathophysiological alterations during pregnancy and also to the circumstance that two or even more individuals are always affected by complications or therapeutic measures. This review article deals with some evergreens and hot topics of obstetric anesthesia and essential new knowledge on these aspects is described. The article summarizes the talks given at the 16th symposium on obstetric anesthesia organized by the Scientific Committee for Regional Anaesthesia and Obstetric Anaesthesia within the German Society of Anaesthesiology...
January 2016: Der Anaesthesist
M A Juárez-Parra, J Carmona-Cantú, J R González-Cano, S Arana-Garza, R J Trevino-Frutos
BACKGROUND: There is a coordinated inhibition of motility of the colon after its surgical manipulation that contributes to the accumulation of fluids and gas, in turn characterized by nausea,vomiting, pain, abdominal distension, and constipation. Motility is recovered in the majority of patients within the first 72 hours. A delay in its resolution is known as prolonged postoperative ileus. AIMS: To study the preoperative, intraoperative, and postoperative risk factors for developing prolonged ileus in patients that underwent elective colon resection...
October 2015: Revista de Gastroenterología de México
Christelle Nguyen, Clémence Palazzo, Sophie Grabar, Antoine Feydy, Katherine Sanchez, Nathalie Zee, Laurent Quinquis, Myriam Ben Boutieb, Michel Revel, Marie-Martine Lefèvre-Colau, Serge Poiraudeau, François Rannou
INTRODUCTION: The aim of this study was to assess the efficacy and safety of tumor necrosis factor (TNF)-α inhibition with infliximab (IFX) in treating recurrent and disabling chronic sciatica pain associated with post-operative peridural lumbar fibrosis. METHOD: A double-blind, placebo-controlled study randomized 35 patients presenting with sciatica pain associated with post-operative peridural lumbar fibrosis to two groups: IFX (n = 18), a single intravenous injection of 3 mg/kg IFX; and placebo (n = 17), a single saline serum injection...
2015: Arthritis Research & Therapy
Noriaki Yokogawa, Hideki Murakami, Satoru Demura, Satoshi Kato, Katsuhito Yoshioka, Miyuki Yamamoto, Shoichi Iseki, Hiroyuki Tsuchiya
PURPOSE: Spinal surgery in a previously irradiated field carries increased risk of perioperative complications, such as delayed wound healing or wound infection. In addition, adhesion around the dura mater is often observed clinically. Therefore, similar to radiation-induced fibrosis--a major late-stage radiation injury in other tissue--epidural fibrosis is anticipated to occur after spinal radiation. In this study, we performed histopathologic assessment of postirradiation changes in the spinal dura mater and peridural tissue in mice...
2015: PloS One
C Tawk, M El Hajj Moussa, R Zgheib, G Nohra
INTRODUCTION: Spontaneous epidural hematoma of the spine (SEHS) is an extremely rare entity. Patients known to have thrombophilia or on anticoagulant drugs are the most affected. It is generally caused by a rupture of the postero-internal vertebral venous plexus secondary to minor barotrauma such as cough, peridural catheter insertion... Early diagnosis and treatment showed to have the best outcome. CASES REPORT: We report 3 cases of spontaneous epidural hematoma in patients treated by acenocoumarol, which occurred without any provocative factor...
2015: International Journal of Surgery Case Reports
A Gottschalk
BACKGROUND: In most cases cerebrospinal fluid (CSF) leaks are iatrogenic and caused by medical interventions, such as lumbar puncture, peridural anesthesia and surgical interventions on the spine, However, spontaneous cerebral hypotension is currently detected more frequently due to improvements in diagnostic possibilities but often the cause cannot be clarified with certainty. METHODS: There are various diagnostic tools for confirming the diagnosis and searching for the site of CSF leakage, such as postmyelography computed tomography (postmyelo-CT), indium(111) radioisotope cisternography and (myelo) magnetic resonance imaging (MRI), which show different sensitivities...
June 2015: Der Radiologe
Rogelio Cruz-Martínez, Antonio Méndez, Hugo Pineda-Alemán, Carlos Rebolledo-Fernández
Congenital oral and neck masses are associated with a high perinatal mortality and morbidity secondary to airway obstruction due to a mass effect of the tumor with subsequent neonatal asphyxia and/or neonatal death. In 1997, the Ex Utero Intrapartum Treatment (EXIT) technique was designed to establish a secure neonatal airway. This procedure allows neonatal tracheal intubation while the uteroplacental circulation maintains fetal oxygenation in a partial fetal delivery during cesarean section. However, it must be emphasized that this technique requires a multidisciplinary team, maternal general anesthesia, high surgery times and potential maternal risks such as placental abruption and increased maternal blood loss due to uterine atony...
January 2015: Ginecología y Obstetricia de México
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