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Central versus posterior approach

Benjamin C Service, Jason E Hsu, Jeremy S Somerson, Stacy M Russ, Frederick A Matsen
BACKGROUND: While glenoid retroversion and posterior humeral head decentering are common preoperative features of severely arthritic glenohumeral joints, the relationship of postoperative glenoid component retroversion to the clinical results of total shoulder arthroplasty (TSA) is unclear. Studies have indicated concern for inferior outcomes when glenoid components are inserted in 15° or more retroversion. QUESTIONS/PURPOSES: In a population of patients undergoing TSA in whom no specific efforts were made to change the version of the glenoid, we asked whether at 2 years after surgery patients having glenoid components implanted in 15° or greater retroversion had (1) less improvement in the Simple Shoulder Test (SST) score and lower SST scores; (2) higher percentages of central peg lucency, higher Lazarus radiolucency grades, higher mean percentages of posterior decentering, and more frequent central peg perforation; or (3) a greater percentage having revision for glenoid component failure compared with patients with glenoid components implanted in less than 15° retroversion...
July 5, 2017: Clinical Orthopaedics and related Research
Jeremy N Ciporen, Brandon Lucke-Wold, Aclan Dogan, Justin Cetas, William Cameron
Purpose  Simulation training offers a useful opportunity to appreciate vascular anatomy and develop the technical expertise required to clip intracranial aneurysms of the posterior circulation. Materials and Methods  In cadavers, a comparison was made between the endoscopic transclival approach (ETA) alone and a combined multiportal approach using the ETA and a transorbital precaruncular approach (TOPA) to evaluate degrees of freedom, angles of visualization, and ergonomics of aneurysm clip application to the posterior circulation depending on basilar apex position relative to the posterior clinoids...
June 2017: Journal of Neurological Surgery. Part B, Skull Base
Samantha J Reznik, Robin Nusslock, Narun Pornpattananangkul, Lyn Y Abramson, James A Coan, Eddie Harmon-Jones
Research suggests that midline posterior versus frontal electroencephalographic (EEG) theta activity (PFTA) may reflect a novel neurophysiological index of approach motivation. Elevated PFTA has been associated with approach-related tendencies both at rest and during laboratory tasks designed to enhance approach motivation. PFTA is sensitive to changes in dopamine signaling within the fronto-striatal neural circuit, which is centrally involved in approach motivation, reward processing, and goal-directed behavior...
June 5, 2017: Cognitive, Affective & Behavioral Neuroscience
Ulysses de Oliveira Sousa, Matheus Fernandes de Oliveira, Lindolfo Carlos Heringer, Alécio Cristino Evangelista Santos Barcelos, Ricardo Vieira Botelho
Chiari malformation (CM) and basilar invagination (BI) are mesodermal malformations with disproportion between the content and volume of posterior fossa capacity and overcrowding of neural structures at the level of foramen magnum. Several alternatives for posterior approaches are available, including extradural (ED), extra-arachnoidal, and intradural (ID) approaches. The objectives are to evaluate the effect of several surgical techniques for posterior fossa decompression (PFD) in the outcomes of patients with CCJM and to evaluate complications in the techniques reported...
May 2, 2017: Neurosurgical Review
Murat Karacorlu, Isil Sayman Muslubas, Mumin Hocaoglu, Hakan Ozdemir, Serra Arf, Omer Uysal
PURPOSE: To evaluate the long-term outcomes of radial optic neurotomy (RON) in patients with optic disk pit maculopathy and to compare the functional and anatomical outcomes of pars plana vitrectomy (PPV) with temporal side single RON versus PPV without RON. METHODS: This retrospective study included 15 eyes of 15 consecutive patients who had surgery for optic disk pit maculopathy. Patients were followed for 12 to 115 months after surgery. Anatomical and functional results were evaluated with optical coherence tomography, MP-1 microperimetry in the central 20°, and measurement of best-corrected visual acuity...
December 2016: Retina
Lin Liang, Xinlei Chen, Weimin Jiang, Xuefeng Li, Jie Chen, Lijun Wu, Yangyi Zhu
BACKGROUND: Both kyphoplasty (KP) and vertebroplasty (VP) are effective for patients with osteoporotic vertebral compression fracture (OVCF), but which approach might be more effective remains unclear, so we decided to update earlier systematic reviews. OBJECTIVE: Review and analyze studies published as of August 2015 that compared clinical outcomes and complications of KP versus VP. DESIGN: Systematic review and meta-analysis. SEARCH METHOD: Published reports up to August 2015 were found in PubMed, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL)...
May 2016: Annals of Saudi Medicine
Damian A Stanley
Learning about other peoples' attributes, e.g. whether an individual is generous or selfish, is central to human social cognition. It is well documented that a network of cortical regions is reliably activated when we engage social processes. However, little is known about the specific computations performed by these regions or whether such processing is specialized for the social domain. We investigated these questions using a task in which participants (N= 26) learned about four peoples' generosity by watching them choose to share money with third party partners, or not...
April 2016: Social Cognitive and Affective Neuroscience
M Mathur, A V L D'Souza, D Prasad, R Garsa, N Bansal, R Jhorawat, S Sharma, P Beniwal, D Agrawal, V Malhotra
Internal jugular (IJ) catheter insertion for hemodialysis (HD) is an indispensable procedure in the management of patients with renal failure. The central approach is favored over posterior approach to insert IJ catheters. There are no studies comparing the outcomes between the two approaches. The aim of this study was to compare central approach with posterior approach for IJ HD catheter insertion and to analyze various outcomes like procedure-related complication rates, catheter insertion failure rates, interruptions during dialysis due to blood flow obstruction and catheter infection rates between the two methods among patients receiving HD...
September 2015: Indian Journal of Nephrology
Simon C McSweeney, Matthew Cichero
BACKGROUND: Tarsal tunnel syndrome is classified as a focal compressive neuropathy of the posterior tibial nerve or one of its associated branches individually or collectively. The tunnel courses deep to fascia, the flexor retinaculum and within the abductor hallucis muscle of the foot/ankle. The condition is rare and regularly under-diagnosed leading to a range of symptoms affecting the plantar margins of the foot. There are many intervention strategies for treating tarsal tunnel syndrome with limited robust evidence to guide the clinical management of this condition...
December 2015: Foot
Arnau Benet, Shawn L Hervey-Jumper, Jose Juan González Sánchez, Michael T Lawton, Mitchel S Berger
OBJECTIVE: Transcortical and transsylvian corridors have been previously described as the main surgical approaches to the insula, but there is insufficient evidence to support one approach versus the other. The authors performed a cadaveric comparative study regarding insular exposure, surgical window and freedom, between the transcortical and transsylvian approaches (with and without cutting superficial sylvian bridging veins). Surgical anatomy and skull surface reference points to the different insular regions are also described...
February 2016: Journal of Neurosurgery
Bernardo O Ratilal, João Costa, Lia Pappamikail, Cristina Sampaio
BACKGROUND: Basilar skull fractures predispose patients to meningitis because of the possible direct contact of bacteria in the paranasal sinuses, nasopharynx or middle ear with the central nervous system (CNS). Cerebrospinal fluid (CSF) leakage has been associated with a greater risk of contracting meningitis. Antibiotics are often given prophylactically, although their role in preventing bacterial meningitis has not been established. OBJECTIVES: To evaluate the effectiveness of prophylactic antibiotics for preventing meningitis in patients with basilar skull fractures...
April 28, 2015: Cochrane Database of Systematic Reviews
Felicity R P Borrie, David R Bearn, Nicola P T Innes, Zipporah Iheozor-Ejiofor
BACKGROUND: Comforting behaviours, such as the use of pacifiers (dummies, soothers), blankets and finger or thumb sucking, are common in babies and young children. These comforting habits, which can be referred to collectively as 'non-nutritive sucking habits' (NNSHs), tend to stop as children get older, under their own impetus or with support from parents and carers. However, if the habit continues whilst the permanent dentition is becoming established, it can contribute to, or cause, development of a malocclusion (abnormal bite)...
March 31, 2015: Cochrane Database of Systematic Reviews
Malcolm P Hilton, Darren K Pinder
BACKGROUND: This is an update of a Cochrane Review first published in The Cochrane Library in Issue 1, 2002 and previously updated in 2004 and 2007.Benign paroxysmal positional vertigo (BPPV) is a syndrome characterised by short-lived episodes of vertigo in association with rapid changes in head position. It is a common cause of vertigo presenting to primary care and specialist otolaryngology clinics. Current treatment approaches include rehabilitative exercises and physical manoeuvres, including the Epley manoeuvre...
2014: Cochrane Database of Systematic Reviews
David Del Curto, Marcel Jun Tamaoki, Délio E Martins, Eduardo Barros Puertas, João Carlos Belloti
BACKGROUND: The choice of surgical approach for the management of subaxial cervical spine facet dislocations is a controversial subject amongst spine surgeons. Reasons for this include differences in the technical familiarity and experience of surgeons with the different surgical approaches, and variable interpretation of image studies regarding the existence of a traumatic intervertebral disc herniation and of the neurological status of the patient. Moreover, since the approaches are dissimilar, important variations are likely in neurological, radiographical and clinical outcomes...
October 30, 2014: Cochrane Database of Systematic Reviews
Jimmy C Yang, George Papadimitriou, Ryan Eckbo, Edward H Yeterian, Lichen Liang, Darin D Dougherty, Sylvain Bouix, Yogesh Rathi, Martha Shenton, Marek Kubicki, Emad N Eskandar, Nikos Makris
Subcaudate tractotomy (SCT) is a neurosurgical lesioning procedure that can reduce symptoms in medically intractable obsessive compulsive disorder (OCD). Due to the putative importance of the orbitofrontal cortex (OFC) in symptomatology, fibers that connect the OFC, SCT lesion, and either the thalamus or brainstem were investigated with two-tensor tractography using an unscented Kalman filter approach. From this dataset, fibers were warped to Montreal Neurological Institute space, and probability maps with center-of-mass analysis were subsequently generated...
June 2015: Brain Imaging and Behavior
Joel S Beckett, Eric D Brooks, Cheryl Lacadie, Brent Vander Wyk, Roger J Jou, Derek M Steinbacher, R Todd Constable, Kevin A Pelphrey, John A Persing
OBJECT: Sagittal nonsyndromic craniosynostosis (sNSC) is the most common form of NSC. The condition is associated with a high prevalence (> 50%) of deficits in executive function. The authors employed diffusion tensor imaging (DTI) and functional MRI to evaluate whether hypothesized structural and functional connectivity differences underlie the observed neurocognitive morbidity of sNSC. METHODS: Using a 3-T Siemens Trio MRI system, the authors collected DTI and resting-state functional connectivity MRI data in 8 adolescent patients (mean age 12...
June 2014: Journal of Neurosurgery. Pediatrics
Khalid Alsheikh, Dominique Behrends, Adam Cota, Paul A Martineau
PURPOSE: This study was designed to determine whether the use of a flexible guide pin and reamer through an anterior single-incision approach would allow for a more anatomic insertion point on the radial tuberosity when compared with the traditional rigid instrumentation used for cortical button fixation. METHODS: Seven matched pairs of fresh-frozen cadaveric upper extremity specimens were used in this study. One specimen from each matched pair was randomly assigned to undergo a simulated repair using the standard instrumentation required for a cortical button fixation device, and the other specimens were assigned to undergo the same repair using a 42° anterior cruciate ligament femoral guide with a flexible guide pin and reamer...
May 2014: Arthroscopy: the Journal of Arthroscopic & related Surgery
Mohammad O Sharif, Alison Merry, Melanie Catleugh, Martin Tickle, Paul Brunton, Stephen M Dunne, Vishal R Aggarwal, Lee Yee Chong
BACKGROUND: Amalgam is a common filling material for posterior teeth, as with any restoration amalgams have a finite life-span. Traditionally replacement was the ideal approach to treat defective amalgam restorations, however, repair offers an alternative more conservative approach where restorations are only partially defective. Repairing a restoration has the potential of taking less time and may sometimes be performed without the use of local anaesthesia hence it may be less distressing for a patient when compared with replacement...
2014: Cochrane Database of Systematic Reviews
Mohammad O Sharif, Melanie Catleugh, Alison Merry, Martin Tickle, Stephen M Dunne, Paul Brunton, Vishal R Aggarwal, Lee Yee Chong
BACKGROUND: Composite filling materials have been increasingly used for the restoration of posterior teeth in recent years as a tooth-coloured alternative to amalgam. As with any filling material composites have a finite life-span. Traditionally, replacement was the ideal approach to treat defective composite restorations, however, repairing composites offers an alternative more conservative approach to the tooth structure where restorations are partly still serviceable. Repairing the restoration has the potential of taking less time and may sometimes be performed without the use of local anaesthesia hence it may be less distressing for a patient when compared with replacement...
2014: Cochrane Database of Systematic Reviews
Wiebe C Verra, Lennard G H van den Boom, Wilco Jacobs, Darren J Clement, Ate A B Wymenga, Rob G H H Nelissen
BACKGROUND: The functional and clinical basis on which to choose whether or not to retain the posterior cruciate ligament during total knee arthroplasty surgery remained unclear after a Cochrane systematic review and meta-analysis in 2005, which contained eight clinical trials. Several new trials have been conducted since then. Hence, an update of the review was performed. OBJECTIVES: Our aim was to assess the benefits and harms of retention compared to sacrifice of the posterior cruciate ligament in total knee arthroplasty in patients with osteoarthritis of the knee...
2013: Cochrane Database of Systematic Reviews
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