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https://www.readbyqxmd.com/read/29149139/reversal-of-growth-of-utilization-of-interventional-techniques-in-managing-chronic-pain-in-medicare-population-post-affordable-care-act
#1
Laxmaiah Manchikanti, Amol Soin, Dharam P Mann, Sanjay Bakshi, Vidyasagar Pampati, Joshua A Hirsch
BACKGROUND: Over the past 2 decades, the increase in the utilization of interventional techniques has been a cause for concern. Despite multiple regulations to reduce utilization of interventional techniques, growth patterns continued through 2009. A declining trend was observed in a previous evaluation; however, a comparative analysis of utilization patterns of interventional techniques has not been performed showing utilization before and after the enactment of the Affordable Care Act (ACA)...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148135/cadence-tracking-and-disturbance-rejection-in-functional-electrical-stimulation-cycling-for-paraplegic-subjects-a-case-study
#2
Lucas O da Fonseca, Antônio P L Bó, Juliana A Guimarães, Miguel E Gutierrez, Emerson Fachin-Martins
Functional electrical stimulation cycling has been proposed as an assistive technology with numerous health and fitness benefits for people with spinal cord injury, such as improvement in cardiovascular function, increase in muscular mass, and reduction of bone mass loss. However, some limitations, for example, lack of optimal control strategies that would delay fatigue, may still prevent this technology from achieving its full potential. In this work, we performed experiments on a person with complete spinal cord injury using a stationary tadpole trike when both cadence tracking and disturbance rejection were evaluated...
November 2017: Artificial Organs
https://www.readbyqxmd.com/read/29145278/safety-of-continuing-aspirin-therapy-during-spinal-surgery-a-systematic-review-and-meta-analysis
#3
Chenggui Zhang, Guodong Wang, Xiaoyang Liu, Yang Li, Jianmin Sun
BACKGROUND: Questions whether to continue or discontinue aspirin administration in the perioperative period of spinal surgery has not been systematically evaluated. OBJECTIVE: The present systematic review is carried out to assess the impact of continuing aspirin administration on the bleeding and cardiovascular events in perispinal surgery period. METHODS: Studies were retrieved through MEDLINE, EMBASE, and Springer Link Databases (search terms, aspirin, continue or discontinue, and spinal fusion), bibliographies of the articles retrieved, and the authors' reference files...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145275/asymptomatic-syringomyelia-accompanied-with-metastatic-cerebellar-and-spinal-intramedullary-lymphoma-a-case-report
#4
Jia-Jia Zhou, Jin-Feng Xu, Xu-Ning Zheng, Guo-Ping Peng
RATIONALE: Asympotamic syringomyelia accompanied with metastatic cerebellar and thoracic spinal intramedullary lymphoma is rare in clinical practice. If the intramedullary lymphoma is large enough, the patient will rapidly develop neurologic signs of spinal injury. The prognosis of this type of complication is always bad. PATIENT CONCERNS: Rapid and correct diagnosis and treatment is important for metastatic extranodal lymphoma with B cell of origin. DIAGNOSES: Syringomyelia accompanied with metastatic cerebellar and thoracic spinal intramedullary lymphoma...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29138652/trauma-a-major-cause-of-death-among-surgical-inpatients-of-a-nigerian-tertiary-hospital
#5
Onyeanunam Ngozi Ekeke, Kelechi Emmanuel Okonta
Introduction: Trauma presents a significant global health burden. Death resulting from trauma remains high in low income countries despite a steady decrease in developed countries. Analysis of the pattern of death will enable intervention to reduce these deaths from trauma in developing countries. This study aims to present the pattern of trauma-related deaths in the surgical wards of University of Port Harcourt Teaching Hospital (UPTH). Methods: This was a retrospective study of all patients who died from trauma during admission into the surgical wards of UPTH from 2007 to 2012...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29138069/traumatic-fractures-of-the-cervical-spine-analysis-of-changes-in-incidence-etiology-concurrent-injuries-and-complications-among-488-262-patients-from-2005-2013
#6
Peter G Passias, Gregory W Poorman, Frank A Segreto, Cyrus M Jalai, Samantha R Horn, Cole A Bortz, Dennis Vasquez-Montes, Bassel G Diebo, Shaleen Vira, Olivia J Bono, Rafael De La Garza-Ramos, John Y Moon, Charles Wang, Brandon P Hirsch, Peter L Zhou, Michael Gerling, Heiko Koller, Virginie Lafage
OBJECTIVE: The etiologies and epidemiology of traumatic cervical spine fracture have not been described with sufficient power or recency. Our goal is to describe demographics, incidence, etiology, spinal cord injuries (SCIs), concurrent injuries, treatments, and complications of traumatic cervical spine fractures. METHODS: Retrospective review of the Nationwide Inpatient Sample. ICD-9 E-Codes identified trauma cases from 2005-2013. Patients with cervical fracture were isolated...
November 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29137580/prevalence-and-predictors-of-persistent-post-surgical-opioid-use-a-prospective-observational-cohort-study
#7
N Stark, S Kerr, J Stevens
Post-surgical opioid prescribing intended for the short-term management of acute pain may lead to long-term opioid use. This study was undertaken to determine the prevalence of persistent post-surgical opioid use and patient-related factors associated with post-surgical opioid use. One thousand and thirteen opioid-naïve patients awaiting elective surgery in a tertiary private hospital in Sydney were enrolled. Preoperatively, patients completed a questionnaire comprising potential predictors of persistent post-surgical opioid use...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29135883/an-analysis-of-the-incidence-and-outcomes-of-major-vs-minor-neurological-decline-after-complex-adult-spinal-deformity-surgery-a-sub-analysis-of-scoli-risk-1-study
#8
So Kato, Michael G Fehlings, Stephen J Lewis, Lawrence G Lenke, Christopher I Shaffrey, Kenneth M C Cheung, Leah Carreon, Mark B Dekutoski, Frank J Schwab, Oheneba Boachie-Adjei, Khaled M Kebaish, Christopher P Ames, Yong Qiu, Yukihiro Matsuyama, Benny T Dahl, Hossein Mehdian, Ferran Pellisé, Sigurd H Berven
STUDY DESIGN: A sub-analysis from a prospective, multicenter, international cohort study in 15 sites (Scoli-RISK-1). OBJECTIVE: To report detailed information regarding the severity of neurological decline related to complex adult spine deformity (ASD) surgery and to examine outcomes based on severity. SUMMARY OF BACKGROUND DATA: The basis of post-operative neurological decline after ASD surgeries can occur due to nerve root(s) or spinal cord dysfunction...
November 10, 2017: Spine
https://www.readbyqxmd.com/read/29123886/sudden-cerebral-depression-detected-by-bispectral-index-monitoring-in-cryptococcal-meningitis-with-elevated-near-fatal-cerebrospinal-fluid-pressure
#9
Hironori Matsumoto, Suguru Annen, Kensuke Umakoshi, Jun Takeba, Satoshi Kikuchi, Yuki Nakabayashi, Naoki Moriyama, Muneaki Ohshita, Mayuki Aibiki
Case: An increase in cerebrospinal fluid pressure (CSFP) is usually prominent in cryptococcal meningitis, which has a high mortality rate, so aggressive management to control CSFP is crucial. In this case, a 40-year-old-man survived cryptococcal meningitis treated with continuous spinal drainage under bispectral index (BIS) monitoring. He unexpectedly showed hypertension, went into a coma, and even loss his light reflexes due to CSFP elevation. His BIS values had abruptly dropped before developing these symptoms, but dramatically recovered after lumbar puncture drainage, suggesting that BIS monitoring could reflect cerebral function changes due to CSFP alternations...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29120355/-to-work-just-like-anyone-else-a-narrative-from-a-man-aging-with-spinal-cord-injury
#10
Ulrica Lundström, Margareta Lilja, Gunilla Isaksson
People aging with spinal cord injury (SCI) develop medical problems commonly associated with the aging process at a younger age than the general population. However, research about how the life story changes and how meaning will be experienced in occupations is lacking. The aim was to describe and offer an explanation of how a man experienced meaning in everyday occupations while aging with an SCI. Four narrative interviews were performed over a four-year period, with a man in his fifties, who lived with SCI for 39 years...
November 9, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29118209/in-vivo-imaging-of-cns-injury-and-disease
#11
Katerina Akassoglou, Mario Merlini, Victoria A Rafalski, Raquel Real, Liang Liang, Yunju Jin, Sarah E Dougherty, Vincenzo De Paola, David J Linden, Thomas Misgeld, Binhai Zheng
In vivo optical imaging has emerged as a powerful tool with which to study cellular responses to injury and disease in the mammalian CNS. Important new insights have emerged regarding axonal degeneration and regeneration, glial responses and neuroinflammation, changes in the neurovascular unit, and, more recently, neural transplantations. Accompanying a 2017 SfN Mini-Symposium, here, we discuss selected recent advances in understanding the neuronal, glial, and other cellular responses to CNS injury and disease with in vivo imaging of the rodent brain or spinal cord...
November 8, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29115658/combined-and-individual-use-of-pancaspase-inhibitor-q-vd-oph-and-nmda-receptor-antagonist-riluzole-in-experimental-spinal-cord-injury
#12
Halil Can, Aydın Aydoseli, Cengiz Gömleksiz, Burcu Göker, Muhittin Emre Altunrende, Müge Dolgun, Altay Sencer
BACKGROUND: We investigated the effects of an N-methyl-D-aspartate receptor antagonist, riluzole, and a pancaspase inhibitor and basic apoptosis mediator, Q-VD-OPh, in combination or alone in posttraumatic spinal cord injury. METHODS: In our study, 45 healthy male Sprague Dawley rats were used. Spinal trauma was induced by the clip compression technique via thoracal 7, 8, 9 laminectomies. After inducing the trauma, the drug was continuously administered intraperitoneally for 5 days...
2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29114184/relationships-between-caregiving-stress-depression-and-self-esteem-in-family-caregivers-of-adults-with-a-disability
#13
DeokJu Kim
This study aimed to examine the relationships between caregiving stress, depression, and self-esteem of family caregivers of an adult person with a disability and to identify their effects on their caregiving burden. The study was performed with 108 care providers of adult people with a disability who visited hospital rehabilitation centers. Caregiving stress showed a significant positive correlation with depression and with economic and psychological stress, and it showed a significant negative correlation with self-esteem...
2017: Occupational Therapy International
https://www.readbyqxmd.com/read/29113795/a-novel-rat-model-of-brachial-plexus-injury-with-nerve-root-stumps
#14
Jintao Fang, Jiantao Yang, Yi Yang, Liang Li, Bengang Qin, Wenting He, Liwei Yan, Gang Chen, Zhehui Tu, Xiaolin Liu, Liqiang Gu
BACKGROUND: The C5-C6 nerve roots are usually spared from avulsion after brachial plexus injury (BPI) and thus can be used as donors for nerve grafting. To date, there are no appropriate animal models to evaluate spared nerve root stumps. Hence, the aim of this study was to establish and evaluate a rat model with spared nerve root stumps in BPI. NEW METHOD: In rupture group, the proximal parts of C5-T1 nerve roots were held with the surrounding muscles and the distal parts were pulled by a sudden force after the brachial plexus was fully exposed, and the results were compared with those of sham group...
November 4, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/29112956/hiv-1-persistence-following-extremely-early-initiation-of-antiretroviral-therapy-art-during-acute-hiv-1-infection-an-observational-study
#15
Timothy J Henrich, Hiroyu Hatano, Oliver Bacon, Louise E Hogan, Rachel Rutishauser, Alison Hill, Mary F Kearney, Elizabeth M Anderson, Susan P Buchbinder, Stephanie E Cohen, Mohamed Abdel-Mohsen, Christopher W Pohlmeyer, Remi Fromentin, Rebecca Hoh, Albert Y Liu, Joseph M McCune, Jonathan Spindler, Kelly Metcalf-Pate, Kristen S Hobbs, Cassandra Thanh, Erica A Gibson, Daniel R Kuritzkes, Robert F Siliciano, Richard W Price, Douglas D Richman, Nicolas Chomont, Janet D Siliciano, John W Mellors, Steven A Yukl, Joel N Blankson, Teri Liegler, Steven G Deeks
BACKGROUND: It is unknown if extremely early initiation of antiretroviral therapy (ART) may lead to long-term ART-free HIV remission or cure. As a result, we studied 2 individuals recruited from a pre-exposure prophylaxis (PrEP) program who started prophylactic ART an estimated 10 days (Participant A; 54-year-old male) and 12 days (Participant B; 31-year-old male) after infection with peak plasma HIV RNA of 220 copies/mL and 3,343 copies/mL, respectively. Extensive testing of blood and tissue for HIV persistence was performed, and PrEP Participant A underwent analytical treatment interruption (ATI) following 32 weeks of continuous ART...
November 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29112802/consensus-treatment-plans-for-chronic-nonbacterial-osteomyelitis-refractory-to-nonsteroidal-anti-inflammatory-drugs-and-or-with-active-spinal-lesions
#16
Yongdong Zhao, Eveline Y Wu, Melissa S Oliver, Ashley M Cooper, Matthew L Basiaga, Sheetal S Vora, Tzielan C Lee, Emily Fox, Gil Amarilyo, Sara M Stern, Jeffrey A Dvergsten, Kathleen A Haines, Kelly A Rouster-Stevens, Karen B Onel, Julie Cherian, Jonathan S Hausmann, Paivi Miettunen, Tania Cellucci, Farzana Nuruzzaman, Angela Taneja, Karyl S Barron, Matthew C Hollander, Sivia K Lapidus, Suzanne C Li, Seza Ozen, Hermann Girschick, Ronald M Laxer, Fatma Dedeoglu, Christian M Hedrich, Polly J Ferguson
OBJECTIVE: To develop standardized treatment regimens for chronic nonbacterial osteomyelitis (CNO), also known as chronic recurrent multifocal osteomyelitis (CRMO) to enable comparative effectiveness treatment studies. METHODS: Virtual and face-to-face discussions and meetings were held within the CNO subgroup of the Childhood Arthritis and Rheumatology Research Alliance (CARRA). A literature search was conducted, and CARRA membership was surveyed to evaluate available treatment data and identify current treatment practices...
November 7, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/29112542/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-neurosurgery
#17
David Faraoni, Raquel Ferrandis, William Geerts, Matthew D Wiles
: Although there are numerous publications addressing venous thromboembolism and its prevention in neurosurgery, there are relatively few high-quality studies to guide decisions regarding thromboprophylaxis. In patients undergoing craniotomy, we recommend that if intermittent pneumatic compression (IPC) is used, it should be applied before the surgical procedure or on admission (Grade 1C). In craniotomy patients at particularly high risk for venous thromboembolism, we suggest considering the initiation of mechanical thromboprophylaxis with IPC preoperatively with addition of low molecular weight heparin (LMWH) postoperatively when the risk of bleeding is presumed to be decreased (Grade 2C)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29112125/the-development-of-an-imu-integrated-clothes-for-postural-monitoring-using-conductive-yarn-and-interconnecting-technology
#18
Sung-Won Kang, Hyeob Choi, Hyung-Il Park, Byoung-Gun Choi, Hyobin Im, Dongjun Shin, Young-Giu Jung, Jun-Young Lee, Hong-Won Park, Sukyung Park, Jung-Sim Roh
Spinal disease is a common yet important condition that occurs because of inappropriate posture. Prevention could be achieved by continuous posture monitoring, but most measurement systems cannot be used in daily life due to factors such as burdensome wires and large sensing modules. To improve upon these weaknesses, we developed comfortable "smart wear" for posture measurement using conductive yarn for circuit patterning and a flexible printed circuit board (FPCB) for interconnections. The conductive yarn was made by twisting polyester yarn and metal filaments, and the resistance per unit length was about 0...
November 7, 2017: Sensors
https://www.readbyqxmd.com/read/29111396/limitations-and-pitfalls-of-the-pedicle-screw-testing-monitoring-technique-an-in-vivo-and-in-vitro-study
#19
Julie Zyss, Isabelle Bernat, Stéphane Wolff, Guillaume Riouallon, Hugues Pascal-Moussellard
OBJECTIVES: Pedicle screw testing is a widely used technique in the field of neuromonitoring for spinal surgery. It was designed by Calancie et al. (1992) in order to detect pedicle breach, one of the major complications of pedicle screw fixation, which can lead to neurological impairment. However, numerous false negative and equivocal results led to its clinical relevance being questioned. We aimed to clarify these discrepancies and characterize electrical parameters underlying this technique...
October 27, 2017: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/29107040/longitudinal-recovery-and-reduced-costs-after-120-sessions-of-locomotor-training-for-motor-incomplete-spinal-cord-injury
#20
Sarah A Morrison, Douglas Lorenz, Carol P Eskay, Gail F Forrest, D Michele Basso
OBJECTIVE: To determine the impact of long term, body weight supported locomotor training (BWSLT) after chronic, incomplete spinal cord injury (SCI). Also, health care costs were estimated related to lost recovery potential and preventable secondary complications that may have occurred due to visit limits imposed by insurers. DESIGN: Prospective observational cohort with longitudinal follow up. SETTING: Eight outpatient rehabilitation centers that participate in the Christopher & Dana Reeve Foundation NeuroRecovery Network® (NRN)...
October 26, 2017: Archives of Physical Medicine and Rehabilitation
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