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https://www.readbyqxmd.com/read/29787874/ancient-observation-of-spinal-cord-injury-the-case-of-the-assiryan-lion
#1
REVIEW
Gustavo J Luvizutto, Emerson G Siqueira, Pedro Tadao Hamamoto Filho, Viviane F Zétola, Marcos C Lange, Hélio A Theive, Luiz A Resende, Rodrigo Bazan
The description of paraplegia is considered a milestone in the history of neurology. The Egyptians provided excellent descriptions of spinal cord injuries, the Bible has several references to paraplegia, and, more recently, the pioneers of neurology described the classic syndromes related to spinal injuries and paraplegia. Here, we describe an ancient observation by the Assyrian people of paraplegia in an animal. In ancient Assyria, lion hunting was a ritualized activity conducted for political and religious purposes...
May 19, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29781961/-from-ear-to-trunk-mri-reveals-referral-of-pain
#2
Julia Forstenpointner, Stephan Wolff, Patrick W Stroman, Olav Jansen, Stefanie Rehm, Ralf Baron, Janne Gierthmühlen
Referred and projecting pain can be observed in acute and chronic pain states. We present the case of a 69-year-old female patient with postherpetic neuralgia (PHN) in dermatome Th2/3 who reported that touching the ipsilateral earlap (dermatome C2) would enhance pain and dynamic mechanical allodynia (DMA) in the affected Th2/3-dermatome. The aim was to investigate possible underlying mechanisms of this phenomenon using the capsaicin experimental pain sensitization model, quantitative sensory testing (QST) and functional spinal and supraspinal MRI (fMRI)...
May 16, 2018: Pain
https://www.readbyqxmd.com/read/29757758/ultrasound-guided-pulsed-radiofrequency-in-the-management-of-thoracic-post-herpetic-neuralgia-a-randomized-double-blinded-controlled-trial
#3
Mohamed Y Makharita, Hanaa M El Bendary, Zainab M Sonbul, Salma El Sayed Ahmed, Mahmoud Abdel Latif
OBJECTIVES: This study was designed to evaluate the efficacy and safety of ultrasound-guided pulsed radiofrequency (PRF) for the intercostal nerves (ICNs) in the management of thoracic post-herpetic neuralgia (PHN). METHODS: After 2 weeks of treatment by pregabalin 150▒mg/12 hours, patients were randomly allocated into 2 groups. The PRF group, after ultrasound-guided localization of the ICN of the affected thoracic dermatome, sensory stimulation of the ICN was tested...
May 11, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29732437/an-awake-minimally-invasive-fully-endoscopic-surgical-technique-for-treating-lumbar-radiculopathy-secondary-to-heterotopic-foraminal-bone-formation-after-a-minimally-invasive-transforaminal-lumbar-interbody-fusion-with-bmp-technical-note
#4
Albert Edward Telfeian
One complication associated with recombinant human bone morphogenetic protein (rhBMP-2) use in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is heterotopic bone growth at the neural foramen which results in the compression of neural structures. Here we present an awake, minimally invasive surgical approach for treating the radiculopathy that results from this excessive bone growth in the foramen. A 42-year-old male underwent a lumbar 4-sacral 1 MIS-TLIF by another surgeon. He did well in the initial postoperative period, but he began to note right leg pain and numbness in an L5 dermatomal pattern...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29725795/a-low-dose-of-three-local-anesthetic-solutions-for-interscalene-blockade-tested-by-thermal-quantitative-sensory-testing-a-randomized-controlled-trial
#5
Luc A Sermeus, Tom Schepens, Guy H Hans, Stuart G Morrison, Kristien Wouters, Margaretha B Breebaart, Carine J Smitz, Marcel P Vercauteren
This randomized double-blind controlled trial compared the block characteristics of three low-dose local anesthetics at different roots in an ultrasound-guided interscalene block, using thermal quantitative sensory testing for assessing the functioning of cutaneous small nerve fibres. A total of 37 adults scheduled to undergo shoulder arthroscopy were randomized to receive 5 mL of either 0.5% levobupivacaine with and without epinephrine 1/200,000 or 0.75% ropivacaine in a single-shot interscalene block. Thermal quantitative sensory testing was performed in the C4, C5, C6 and C7 dermatomes...
May 3, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29723501/peripheral-and-central-mechanisms-of-itch
#6
REVIEW
Xintong Dong, Xinzhong Dong
Itch is a unique sensory experience that is encoded by genetically distinguishable neurons both in the peripheral nervous system (PNS) and central nervous system (CNS) to elicit a characteristic behavioral response (scratching). Itch interacts with the other sensory modalities at multiple locations, from its initiation in a particular dermatome to its transmission to the brain where it is finally perceived. In this review, we summarize the current understanding of the molecular and neural mechanisms of itch by starting in the periphery, where itch is initiated, and discussing the circuits involved in itch processing in the CNS...
May 2, 2018: Neuron
https://www.readbyqxmd.com/read/29717288/effects-of-adding-intrathecal-dexmedetomidine-to-hyperbaric-bupivacaine-for-saddle-spinal-block-in-adults-undergoing-peri-anal-surgeries
#7
Binod Gautam, Sushila Moktan Lama, Mona Sharma
BACKGROUND: Saddle spinal block is the first choice anesthetic technique for adults undergoing peri-anal surgeries. It prevents unnecessary high levels of analgesia and sympathetic block. However, it may not provide prolonged analgesia. This study aims to investigate analgesic effects of dexmedetomidine when added to hyperbaric bupivacaine in saddle spinal block. METHODS: Fifty otherwise healthy adults scheduled for uncomplicated peri-anal surgery were randomly allocated into two equal groups in this double-blinded study...
March 13, 2018: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/29707900/an-observational-case-series-of-spinal-cord-stimulation-waveforms-visualized-on-intraoperative-neuromonitoring
#8
Steven M Falowski
INTRODUCTION: Intraoperative neuromonitoring for spinal cord stimulation uses electromyography (EMG) responses to determine myotomal coverage as a marker for dermatomal coverage. These responses are utilized to determine the orientation of the electrode. Somatosensory evoked potential (SSEP) collision testing can also be used in which sensory signals are decreased and/or eliminated when stimulation is activated. METHODS: Fifteen patients were observed in the study...
April 29, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29704875/frequency-dependent-top-down-modulation-of-temporal-summation-by-anodal-transcranial-direct-current-stimulation-of-the-primary-motor-cortex-in-healthy-adults
#9
S Hughes, M Ali, P Sharma, N Insan, P H Strutton
BACKGROUND: Transcranial direct-current stimulation (tDCS) applied over the primary motor cortex has been shown to be effective in the treatment of a number of chronic pain conditions. However, there is a lack of understanding of the top-down analgesic mechanisms involved. METHOD: In this study, we investigated the effects of tDCS on the facilitation of subjective sensory and pain scores using a transcutaneous electrically-evoked measure of temporal summation. In this randomised, blinded, cross-over study healthy subjects received a single stimulus given at 0...
April 28, 2018: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29701900/single-s1-dorsal-root-ganglia-stimulation-for-intractable-complex-regional-pain-syndrome-foot-pain-after-lumbar-spine-surgery-a-case-series
#10
Ioannis M Skaribas, Christian Peccora, Elena Skaribas
INTRODUCTION: Intractable complex regional pain syndrome (CRPS)-related chronic foot pain, is a common therapeutic challenge for interventional pain management physicians and patients alike. Dorsal root ganglia (DRG) stimulation is a very target specific dorsal column stimulation technique with very promising clinical outcomes. Patients with CRPS foot pain and previous back surgery can benefit from DRG stimulation but also run a significant risk of epidural trauma from the DRG sheath advancement...
April 27, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29684993/the-effects-of-adjuvant-intrathecal-fentanyl-on-postoperative-pain-and-rebound-pain-for-anorectal-surgery-under-saddle-anesthesia
#11
Sung-Min Shim, Jae-Ho Park, Dong-Min Hyun, Eui-Kyun Jeong, Seong-Su Kim, Hwa-Mi Lee
Background: Intrathecal opioid has been known to enhance the quality and prolong the duration of spinal anesthesia, as well as to reduce postoperative pain. The purpose of this study was to evaluate postoperative analgesic characteristics of intrathecal fentanyl for the first 48 hours after anorectal surgery under saddle anesthesia. Methods: Eighty patients were recruited in our study. Forty patients were randomly allocated to group B that received 0.5% bupivacaine 5 mg with 0...
April 24, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29661553/development-of-a-contaminated-ischemic-porcine-wound-model-and-the-evaluation-of-bromelain-based-enzymatic-debridement
#12
Adam J Singer, Jimmy Toussaint, Won Taek Chung, Steve A McClain, Richard A F Clark, Eilon Asculai, Dafna Geblinger, Lior Rosenberg
OBJECTIVES: There are no well accepted animal models of chronic wounds, limiting advances in understanding and treatment of chronic ulcers. We developed a porcine wound model which combines multiple factors involved in chronic wounds to create a contaminated necrotic eschar and evaluated the debriding efficacy of a novel bromelain based enzymatic debriding agent (EscharEx). METHODS: Contaminated ischemic wounds were created on the flanks of domestic pigs by 'sandwiching' the skin between 2 'O' rings (1 placed on the surface of the skin and the other underneath the skin) for 24h prior to dermatomal excision of the necrotic eschar and its contamination with Staphylococcus aureus and Candida albicans...
April 13, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29657082/horner-s-syndrome-following-obstetric-neuraxial-blockade-a-systematic-review-of-the-literature
#13
D J Chambers, K Bhatia
Horner's syndrome is a rarely reported complication of neuraxial blockade. In obstetric practice, the neurological signs of Horner's syndrome may cause anxiety amongst patients and healthcare staff, but more importantly may herald the onset of maternal hypotension. Medline, CINAHL, and EMBASE databases were searched to identify cases of Horner's syndrome following obstetric neuraxial blockade. Anaesthetic technique, clinical features, anaesthetic management of the Horner's syndrome and time to resolution were assessed...
March 17, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29606943/successful-treatment-of-inflammatory-linear-verrucous-epidermal-nevus-with-concomitant-psoriasis-using-etanercept
#14
Reda Hesham Saifaldeen, Mohammad I Fatani, Badee Baltow, Abdulmajeed S Khan
Linear psoriasis is a rare form of the disease characterized by the linear distribution of lesions involving dermatome or along Blaschko's lines. Clinically, it may resemble inflammatory linear verrucous epidermal nevus; a combination of history, skin examination, and histopathology are required to ensure correct diagnosis and appropriate therapy. This paper describes a case of a 23-year-old male presenting with unilateral erythematous scaly plaques arranged in a linear path on the left leg. Etanercept was initiated after poor response to adalimumab...
January 2018: Case Reports in Dermatology
https://www.readbyqxmd.com/read/29600482/pectoral-nerves-i-block-is-associated-with-a-significant-motor-blockade-with-no-dermatomal-sensory-changes-a-prospective-volunteer-randomized-controlled-double-blind-study
#15
Jean Desroches, Marc Belliveau, Carole Bilodeau, Michel Landry, Maxim Roy, Pierre Beaulieu
PURPOSE: The pectoral nerves (PECS) I block, first described in 2011 for surgery involving the pectoralis muscle, has principally been used for breast cancer surgery. No formal evaluation of its differential motor- and sensory-blocking abilities has been reported. We hypothesize that the PECS I block will produce a motor block of the pectoralis muscles with diminished upper limb adduction strength as measured with a handheld dynamometer. METHODS: We conducted a PECS I block in a randomized placebo-controlled trial in six healthy subjects who received 0...
March 29, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29596683/marjolin-s-ulcer-arising-in-a-burn-scar
#16
Andrea Sisti, Edoardo Pica Alfieri, Roberto Cuomo, Luca Grimaldi, Cesare Brandi, Giuseppe Nisi
Marjolin's ulcer is an aggressive disease arising in chronic wounds and cutaneous scars. Corbo et al define Marjolin's ulcer an often overlooked or misdiagnosed tumor. We report a case of Marjolin's ulcer arose in a burn scar of a 51-year-old man who sustained a burn in childhood. A punch biopsy showed squamous cell carcinoma. The lesion was surgically removed with wide excision. The loss of substance was covered with a partial-thickness skin graft, harvested from the left thigh with dermatome. Histological examination confirmed a well-differentiated squamous cell carcinoma...
January 18, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29589417/blocking-around-the-transversalis-fascia-behind-the-scene
#17
Francesco Vasques, Carla Stecco, Raffaele Mitri, Raffaele DE Caro, Pierfrancesco Fusco, Astrid U Behr
BACKGROUND: The transversalis fascia plane and the quadratus lomborum blocks target the branches of T12-L1 nerves and provide analgesia in patients undergoing surgery involving the corresponding dermatomes. The transversalis fascia is believed to contribute to determine the spread of local anesthetic in such blocks. Nonetheless, the anatomy of this fascia and its possible role in these blocks still have to be precisely defined. METHODS: We conducted a series of 10 dissections and full-thickness specimens were obtained from one side for the microscopic analysis...
March 27, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29588242/primary-spinal-malignant-mesothelioma-a-case-report-and-literature-review
#18
Fan Chen, Beifang Liu, Ying Yu, Jianyang Du, Dawei Chen
BACKGROUND: Malignant mesotheliomas are aggressive and rapidly-fatal neoplasms arising from the mesothelial cells. The most common sites of origin are the pleural and peritoneal cavities, and additionally, malignant mesotheliomas can also infrequently involve the pericardium and the tunica vaginalis. However, malignant mesothelioma occurring in the spinal canal is extremely rare. Herein, we reported a case with primary spinal malignant mesothelioma. METHODS: A literature search was using PubMed with specific key terms, inclusion criteria, and exclusion criteria...
March 24, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29562363/older-patients-have-better-pain-outcomes-following-microvascular-decompression-for-trigeminal-neuralgia
#19
Sarah K Bick, David Huie, Gabriel Sneh, Emad N Eskandar
BACKGROUND: Trigeminal neuralgia (TN) increases in prevalence with age. Although microvascular decompression (MVD) is the most effective long-term operative treatment for TN, its use in older patient populations has been debated due to its invasive nature. Recent studies have demonstrated safety of MVD in older patients; however, efficacy data are more limited. OBJECTIVE: To determine the relationship between age and pain outcomes following MVD for TN. METHODS: Subjects underwent MVD for TN at our institution between 1/1/2004 and 12/31/2013, had typical TN, and demonstrated neurovascular compression on preoperative imaging...
March 17, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29548863/scalp-as-a-donor-site-in-children-is-it-really-the-best-option
#20
G van Niekerk, S Adams, H Rode
BACKGROUND: Since 2003 we have used the scalp as a donor site for split skin grafts (SSGs) in major burns when there was a shortage of conventional donor areas. However, we seen a high incidence of complications, contrary to international experience. OBJECTIVE: The aim of this study was to analyze the results and complications related to the scalp as a donor site and to determine whether there is an association between our specific patient population and the complications encountered...
March 13, 2018: Burns: Journal of the International Society for Burn Injuries
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