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https://www.readbyqxmd.com/read/28634320/comparison-of-2-analgesia-modalities-in-total-knee-replacement-surgery-is-there-an-effect-on-knee-function-rehabilitation
#1
Janis Zinkus, Lina Mockutė, Arūnas Gelmanas, Ramūnas Tamošiūnas, Arūnas Vertelis, Andrius Macas
BACKGROUND We compared the effects of continuous femoral nerve block (CFNB) and continuous intraarticular block (CIAB) on pain, functional recovery and adverse effects after total knee arthroplasty (TKA). MATERIAL AND METHODS We prospectively randomized 54 patients undergoing TKA into 2 groups: CFNB (Group F) and CIAB (Group I). Surgery was performed under spinal anesthesia. All patients received patient-controlled analgesia (PCA) with morphine, diclofenac, and acetaminophen for the first 72 h postoperatively...
June 20, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28634006/testosterone-differentially-affects-t-cells-and-neurons-in-murine-and-human-models-of-neuroinflammation-and-neurodegeneration
#2
Megan G Massa, Christina David, Stefanie Jörg, Johannes Berg, Barbara Gisevius, Sarah Hirschberg, Ralf A Linker, Ralf Gold, Aiden Haghikia
The high female-to-male sex ratio of multiple sclerosis (MS) prevalence has continuously confounded researchers, especially in light of male patients' accelerated disease course at later stages of MS. Although multiple studies have concentrated on estrogenic mechanisms of disease modulation, fairly little attention has been paid to androgenic effects in a female system, and even fewer studies have attempted to dissociate hormonal effects on the neurodegenerative and neuroinflammatory processes of MS. Herein, we demonstrate the differential effects of hormone treatment on the acute inflammatory and chronic neurodegenerative phases of murine experimental autoimmune encephalomyelitis...
July 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28632550/suture-choice-in-lumbar-dural-closure-contributes-to-variation-in-leak-pressures-experimental-model
#3
George M Ghobrial, Christopher M Maulucci, Matthew J Viereck, Sara Beygi, Ameet Chitale, Srinivas Prasad, Jack Jallo, Joshua Heller, Ashwini D Sharan, James S Harrop
STUDY DESIGN: Open-label laboratory investigational study; non-animal surgical simulation. OBJECTIVE: The authors perform a comparison of dural closure strength in a durotomy simulator across 2 different suture materials. SUMMARY OF BACKGROUND DATA: Incidental durotomy leading to persistent cerebrospinal fluid leak adds considerable morbidity to spinal procedures, often complicating routine elective lumbar spinal procedures. Using an experimental durotomy simulation, the authors compare the strength of closure using Gore-Tex with other suture types and sizes, using various closure techniques...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28632549/biomechanical-investigation-of-a-novel-revision-device-in-an-osteoporotic-model-pullout-strength-of-pedicle-screw-anchor-versus-larger-screw-diameter
#4
Jacinto Manon, Mir M Hussain, Jonathan Harris, Mark Moldavsky, Frank La Marca, Brandon S Bucklen
STUDY DESIGN: In vitro cadaveric biomechanical study. OBJECTIVE: To assess revision pullout strength of novel anchored screws (AS) versus conventional larger diameter traditional pedicle screws (TPS) in an osteoporotic model. SUMMARY OF BACKGROUND DATA: Pedicle screws are the most ubiquitous method of treating spinal pathologies requiring lumbar fusion. Although these screws are effective in providing 3-column stabilization of the spine, revision surgeries are occasionally necessary, particularly for geriatric and osteoporotic populations...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28632535/perioperative-surgical-home-evaluation-of-a-new-protocol-focused-on-a-multidisciplinary-approach-to-manage-children-undergoing-posterior-spinal-fusion-operation
#5
Eugene Kim, Brian Lee, Giovanni Cucchiaro
BACKGROUND: The concept of Perioperative Surgical Home has been gaining significant attention in surgical centers. This model is delivering and improving coordinated care in a cost-effective manner to patients undergoing surgical procedures. It starts with the decision for surgical intervention, continues to the intraoperative and postoperative periods, and follows into long-term recovery. Constant re-evaluation of outcomes and modifications of delivery provides a feedback loop for improvement...
June 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28631745/achieving-assessor-accuracy-on-the-international-standards-for-neurological-classification-of-spinal-cord-injury
#6
A J Armstrong, J M Clark, D T Ho, C J Payne, S Nolan, L M Goodes, L A Harvey, R Marshall, M P Galea, S A Dunlop
STUDY DESIGN: A retrospective audit of assessor accuracy using the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) in three multicentre randomised controlled trials (SCIPA: Spinal Cord Injury and Physical Activity) spanning 2010-2014 with standards revised in 2011. OBJECTIVES: To investigate assessor accuracy of neurological classification after spinal cord injury. SETTING: Australia and New Zealand...
June 20, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28629786/-pregnancy-and-delivery-for-women-with-congenital-spinal-cord-defects-and-neurogenic-bladder
#7
Q Manach, M Dommergues, P Denys, K Loiseau, B Idiard-Chamois, E Chartier-Kastler, V Phé
INTRODUCTION: Data are scarce regarding pregnancy and delivery among women with a neurogenic bladder due to congenital spinal cord defects. OBJECTIVE: To report the obstetrical and urological outcomes of women with congenital spinal cord defects and vesico-sphincteric disorders. METHODS: A retrospective multicentric study included all consecutive women with a neurogenic bladder due to congenital spinal defects, who delivered between January 2005 and December 2014...
June 16, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28628531/costs-and-length-of-stay-for-the-acute-care-of-patients-with-motor-complete-spinal-cord-injury-following-cervical-trauma-the-impact-of-early-transfer-to-specialized-acute-sci-center
#8
Andréane Richard-Denis, Debbie Ehrmann Feldman, Cynthia Thompson, Étienne Bourassa-Moreau, Jean-Marc Mac-Thiong
OBJECTIVE: Acute spinal cord injury (SCI) centers aim to optimize outcome following SCI. However, there is no timeframe to transfer patients from regional to SCI centers in order to promote cost-efficiency of acute care. Our objective was to compare costs and length of stay (LOS) following early and late transfer to the SCI center. DESIGN: A retrospective cohort study involving 116 individuals was conducted. Group 1 (n = 87) was managed in an SCI center promptly after the trauma, whereas group 2 (n = 29) was transferred to the SCI center only after surgery...
July 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28627290/continuous-adductor-canal-block-added-to-local-infiltration-analgesia-lia-after-total-knee-arthroplasty-has-no-additional-benefits-on-pain-and-ambulation-on-postoperative-day-1-and-2-compared-with-lia-alone
#9
Svava Gudmundsdottir, Jonas L Franklin
Background and purpose - The additional effects of a continuous adductor canal block (ACB) compared with a single-dose local infiltration anesthesia (LIA) after total knee arthroplasty (TKA) has not been widely researched. Both methods have good effect individually. We hypothesized that a continuous ACB added to a single-dose LIA would lower pain scores while ambulating on postoperative day 1 (POD1) and postoperative day 2 (POD2). Patients and methods - 69 participants were included in this prospective, randomized, double-blind, placebo-controlled trial...
June 19, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28627037/quantitative-gd-dota-uptake-from-cerebrospinal-fluid-into-rat-brain-using-3d-vfa-spgr-at-9-4t
#10
Hedok Lee, Kristian Mortensen, Simon Sanggaard, Palle Koch, Hans Brunner, Bjørn Quistorff, Maiken Nedergaard, Helene Benveniste
PURPOSE: We propose a quantitative technique to assess solute uptake into the brain parenchyma based on dynamic contrast-enhanced MRI (DCE-MRI). With this approach, a small molecular weight paramagnetic contrast agent (Gd-DOTA) is infused in the cerebral spinal fluid (CSF) and whole brain gadolinium concentration maps are derived. METHODS: We implemented a 3D variable flip angle spoiled gradient echo (VFA-SPGR) longitudinal relaxation time (T1) technique, the accuracy of which was cross-validated by way of inversion recovery rapid acquisition with relaxation enhancement (IR-RARE) using phantoms...
June 19, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28620735/meningocele-manqu%C3%A3-a-comprehensive-review-of-this-enigmatic-finding-in-occult-spinal-dysraphism
#11
REVIEW
Cameron Schmidt, Ellie Bryant, Joe Iwanaga, Rod J Oskouian, W Jerry Oakes, R Shane Tubbs
The term meningocele manqué (MM) was coined in 1972 to describe a broad range of surgical findings characterized by intradural bands tethering neural structures to the dorsal dura. Over the following decades, reports continued to lump intradural tethering bands associated with a variety of comorbidities under the umbrella term MM. In more recent years, disorders previously called MM have been identified as embryologically distinct and were reclassified. While this sectioning continues, there remains a set of intradural tethering disorders for which no better term than MM exists...
June 15, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28619424/cerebrospinal-fluid-and-serum-levels-of-interleukin-8-in-patients-with-multiple-sclerosis-and-its-correlation-with-q-albumin
#12
Z Matejčíková, J Mareš, V Sládková, T Svrčinová, J Vysloužilová, J Zapletalová, P Kaňovský
INTRODUCTION: Multiple sclerosis (MS) is an inflammatory-demyelinating disease of the central nervous system (CNS). Autoimmune inflammation is common in the early stages of MS and is followed by neurodegenerative processes. The result of these changes is axon and myelin breakdown. The paraclinical examination methods are an important part of the diagnostic process. Magnetic resonance imaging of the brain and the cervical spinal cord and an examination of cerebrospinal fluid (CSF) are common paraclinical examinations...
May 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/28618974/cystic-dilation-of-a-ventriculus-terminalis-case-report-and-review-of-the-literature
#13
Masoud Zeinali, Hosein Safari, Saleh Rasras, Reza Bahrami, Mahdi Arjipour, Nima Ostadrahimi
The ventriculus terminalis (VT) is a small ependyma-lined cavity within the conus medullaris that is in direct continuity with the central canal of the spinal cord. Cystic dilatation of the ventriculus terminalis on its own is an extremely rare pathological event in adults whose pathogenesis is uncertain. VT has been described in children as a normal developmental phenomenon. These lesions are often diagnosed incidentally during imaging and are in most cases asymptomatic, especially in children. Symptomatic dilatation of VT in adults is a rare condition with 61cases being reported to date...
June 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28615336/prevention-and-reversal-of-latent-sensitization-of-dorsal-horn-neurons-by-glial-blockers-in-a-model-of-low-back-pain-in-male-rats
#14
Juanjuan Zhang, Siegfried Mense, Rolf-Detlef Treede, Ulrich Hoheisel
In an animal model of non-specific low back pain, recordings from dorsal horn neurons were made to investigate the influence of glial cells in the central sensitization process. To induce a latent sensitization of the neurons, nerve growth factor (NGF) was injected into the multifidus muscle; the manifest sensitization to a second NGF injection 5 days later was used as a read-out. The sensitization manifested in increased resting activity and in an increased proportion of neurons responding to stimulation of deep somatic tissues...
June 14, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28614233/discordant-lumbar-epidural-hematoma-after-caudal-steroid-injection-a-case-report-care-compliant
#15
Jung Ju Choi, Young Jin Chang, Wol Seon Jung, Kyung Cheon Lee, Ju Ho Kim, Youn Yi Jo
RATIONALE: Caudal epidural injection is one of the conventional treatments of chronic back pain. Even though spinal epidural hematoma after caudal epidural injection is rare but it can cause serious neurologic complication. PATIENT CONCERNS: An 83-year-old woman taking cilostazol received caudal epidural steroid injection because of her chronic back pain. Six hours later, she experienced an acute hip pain which worsened with time. DIAGNOSIS: Magnetic resonance image showed acute cord compression due to a spinal epidural hematoma at L2-S1 level with concomitant central canal compromise at L2/3, L3/4 level...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28611986/scipad-effective-implementation-of-telemedicine-using-ipads-with-individuals-with-spinal-cord-injuries-a-case-series
#16
Kazuko Shem, Samantha J Sechrist, Eleanor Loomis, Linda Isaac
BACKGROUND: Individuals with spinal cord injury (SCI) must often travel long distances to see a rehabilitation specialist. While telemedicine (TM) for pressure ulcer management has been used in this population, real-time video telecommunication using iPad has never been described. OBJECTIVE: The objective of this study was to provide specialized care for persons with SCI through TM consultation expediently in order to address medical needs, manage secondary complications, and to improve quality of life (QoL) of individuals with SCI...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28609308/evaluation-of-a-clinical-protocol-to-assess-and-diagnose-neuropathic-pain-during-acute-hospital-admission-results-from-traumatic-spinal-cord-injury
#17
Lise M A Bélanger, Hamed S Umedaly, Vanessa K Noonan, So Eyun Park, Jennifer Prince, Nancy P Thorogood, Tian Shen, Andrea F Townson, John T Street, Marcel F Dvorak, Michael Negraeff
OBJECTIVES: A clinical protocol was developed for clinicians to routinely assess and initiate treatment for patients with neuropathic pain (NP) in an acute care setting. The objectives of this study were to: (1) determine the incidence and onset of NP in patients with traumatic SCI during acute care and (2) describe how the implementation of a clinical protocol impacts the assessment and diagnosis of NP. METHODS: The study was a cohort analysis with a pre-post-test utilizing a historical control...
June 12, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28608305/quality-assurance-of-the-preopanc-trial-2012-003181-40-for-preoperative-radiochemotherapy-in-pancreatic-cancer-the-dummy-run
#18
Eva Versteijne, Eelco Lens, Astrid van der Horst, Arjan Bel, Jorrit Visser, Cornelis J A Punt, Mustafa Suker, Casper H J van Eijck, Geertjan van Tienhoven
BACKGROUND: The Dutch Pancreatic Cancer Group initiated the national, multicentre, controlled PREOPANC trial, randomising between preoperative radiochemotherapy and direct explorative laparotomy for patients with (borderline) resectable pancreatic cancer. The aim of this dummy run is to evaluate compliance with the radiotherapy protocol of this trial, and the quality of delineation and radiation plans. METHODS: Eleven radiation oncology departments open for accrual of patients in the PREOPANC trial were provided with all necessary information of a selected 'dummy' patient...
June 12, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28607062/biomechanical-coupling-facilitates-spinal-neural-tube-closure-in-mouse-embryos
#19
Gabriel L Galea, Young-June Cho, Gauden Galea, Matteo A Molè, Ana Rolo, Dawn Savery, Dale Moulding, Lucy H Culshaw, Evanthia Nikolopoulou, Nicholas D E Greene, Andrew J Copp
Neural tube (NT) formation in the spinal region of the mammalian embryo involves a wave of "zippering" that passes down the elongating spinal axis, uniting the neural fold tips in the dorsal midline. Failure of this closure process leads to open spina bifida, a common cause of severe neurologic disability in humans. Here, we combined a tissue-level strain-mapping workflow with laser ablation of live-imaged mouse embryos to investigate the biomechanics of mammalian spinal closure. Ablation of the zippering point at the embryonic dorsal midline causes far-reaching, rapid separation of the elevating neural folds...
June 12, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28605971/impaired-baroreflex-function-during-orthostatic-challenge-in-patients-after-spinal-cord-injury
#20
Katarina Ondrusova, Jana Svacinova, Michal Javorka, Jan Novak, Marie Novakova, Zuzana Novakova
The level of spinal cord injury (SCI) affects baroreflex regulation of blood pressure (BP). While a parasympathetic cardiac chronotropic effect is preserved, baroreflex response could be impaired by sympathetic dysfunction under the SCI level. This study was aimed to evaluate the baroreflex function in SCI patients by the analysis of causal interaction between systolic blood pressure (SBP) and inter-beat intervals (IBI). BP was continuously recorded in 13 cervical SCI patients (CSCI), 9 thoracic SCI (ThSCI) and 13 able-bodied controls (Con) during two phases: sitting (PS) and orthostatic challenge (PO)...
June 12, 2017: Journal of Neurotrauma
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