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- Determinants for Meaningful Clinical Improvement of Pain and Health-Related Quality of Life After Spinal Cord Stimulation for Chronic Intractable Pain. [Journal Article]
- NNeuromodulation 2018 Dec 10
- CONCLUSIONS: The identification of determinants for MCI is a challenge to improve the accuracy of prognostic models in SCS for patients with chronic pain. Our results, if confirmed in other populations with a larger sample size, have implications for patients with chronic pain who are candidates for SCS treatment.
- Minimally invasive internal fixator for unstable pelvic ring injuries with a pedicle screw-rod system: a retrospective study of 23 patients after 13.5 months. [Journal Article]
- AOArch Orthop Trauma Surg 2018 Dec 08
- CONCLUSIONS: The INFIX appears to be a safe and minimally invasive surgical technique which can effectively be combined with posterior pedicle screw-rod fixation. It also can be applied for the definitive treatment of vertically and/or rotationally unstable pelvic ring injuries, especially in severely compromised patients with a high mortality risk.
- Medically Unexplained Physical Symptoms in Hospitalized Patients: A 9-Year Retrospective Observational Study. [Journal Article]
- FPFront Psychiatry 2018; 9:626
- Introduction: "Medically Unexplained Physical Symptoms" (MUPS) defines a subgroup of patients presenting physical symptoms of unclear origin. The study aims to profile clinical and socio-demographic ...
Introduction: "Medically Unexplained Physical Symptoms" (MUPS) defines a subgroup of patients presenting physical symptoms of unclear origin. The study aims to profile clinical and socio-demographic characteristics of patients with MUPS. Materials and Methods: This 9-years observational retrospective study assesses all patients admitted between 2008 and 2016 in the divisions of neurology and gastroenterology. Socio-demographic and clinical variables were evaluated: gender, age, diagnosis or diagnostic hypothesis, presence of psychiatric comorbidities, psychiatric evaluation, pharmacological treatment, number of admissions/visits. Results: Among 2,479 neurological patients 10.1% presented MUPS. Patients were more frequently women (63.5%), with a mean age of about 50 years. Reported symptoms were headache (22.6%), seizures (8.7%), vertigo (5.9%), fibromyalgia (5.5%), paresthesia (5.1%), visual disturbances (5.1%), amnesia (3.9%). The diagnosis was somatoform disorder in 6.3% of cases, conversion disorder in 2.7%, and somatic symptom disorder in 1.5% only. 2,560 outpatients were evaluated in gastroenterology division. 9.6% (n = 248) of patients had MUPS; 62.1% of them were women. The most affected age group ranged between 15 and 45 years. The most frequent diagnoses were functional abdominal pain (50%), dysmotility-like dyspepsia (26.6%), irritable bowel syndrome (10.4%), meteorism of unknown cause (2.4%), hiccup (1.6%), burning mouth syndrome (1.2%). No patients received a diagnosis of somatic symptom disorder. Discussion: Patients with MUPS are more often women, of middle age, with self-referred specific symptomatology. While neurological patients received a diagnostic-therapeutic approach in line with the literature, gastroenterological patients mainly received antipsychotics. A more comprehensive assessment and a development of psychoeducational interventions are needed to improve patients' quality and quantity of life.
- Acute hand pain resulting in spontaneous thenar compartment syndrome: A case report. [Journal Article]
- AJAm J Emerg Med 2018 Nov 24
- Compartment syndrome is a potentially limb-threatening disease process, leading to decreased tissue perfusion and cellular death . The following presentation is believed to be the first reported c...
Compartment syndrome is a potentially limb-threatening disease process, leading to decreased tissue perfusion and cellular death . The following presentation is believed to be the first reported case of thenar compartment syndrome, which occurred without an identifiable cause. A 67-year-old male presented with 12 h of left-hand pain, located at the base of the thumb and worsened with movement. Firmness of the thenar eminence, along with pallor, poikilothermia, and paresthesias of the first and second digits lead to the increased suspicion for compartment syndrome. The diagnosis was confirmed and successfully managed in the operating room. While relatively uncommon, clinicians should consider the diagnosis of compartment syndrome of the hand when patients present with acute hand pain. A missed or delayed diagnosis can lead to severe morbidity, which can profoundly affect patients' functional outcomes and quality of life.
- Treatment of spinal malignant fibrous histiocytoma, a case report and literature review. [Journal Article]
- NNeurocirugia (Astur) 2018 Dec 07
- CONCLUSIONS: Spondylectomy is an effective option for the treatment of spinal malignant fibrous histiocytoma that involves combined approaches. However the challenge is greater since it requires a knowledge of the great abdominal vessels and multidisciplinary intervention.
- Pediatric Spine Emergencies. [Journal Article]
- SUSemin Ultrasound CT MR 2018; 39(6):605-617
- Acute onset of neurological signs and symptoms referable to the spine including difficulty walking, bowel and bladder dysfunction, and paresthesias in the extremities may be manifestations of pediatr...
Acute onset of neurological signs and symptoms referable to the spine including difficulty walking, bowel and bladder dysfunction, and paresthesias in the extremities may be manifestations of pediatric spine emergency. Trauma is the most common etiology for a pediatric spinal emergency. Because a history of trauma is often available, the role of imaging involves detection of spinal injuries. Other pathologies such as infection, inflammation, vascular, and neoplasms may lead to pediatric spinal emergencies that also require imaging for assistance in determining the etiology and appropriate management.
- An in-vitro evaluation of a novel design of miniplate for fixation of fracture segments in the transition zone of parasymphysis-body region of mandible using finite element analysis. [Journal Article]
- JCJ Craniomaxillofac Surg 2018 Nov 12
- The mandibular parasymphysis and body regions are highly dynamic areas. They are constantly subjected to both occlusal and muscular forces. Fractures at this transition zone of the parasymphysis and ...
The mandibular parasymphysis and body regions are highly dynamic areas. They are constantly subjected to both occlusal and muscular forces. Fractures at this transition zone of the parasymphysis and body region thus represent a special pattern that creates a dilemma for the surgeons - whether to use one miniplate fixation or two miniplates as per Champy's guidelines. Mental nerve paresthesia is a very common complication due to dissection and stretching of the mental nerve in this region. Hence, an in-vitro research study of a novel twin fork design of miniplate is performed, which evaluates the biomechanical behavior using computerized finite element analysis. A comparison is carried out with the conventional design. The results show that the twin fork miniplate produces the lowest stresses - 23.821 MPa - and the least total structural deformation after applying the maximum occlusal bite force. This study concludes that the newly designed miniplate is superior in terms of stability because it shows the least structural deformation, and produces the lowest equivalent stresses on application of maximal occlusal forces. An additional advantage is the preservation of the mental nerve during the plating procedure because the broad end of the Y shape allows atraumatic positioning of the miniplate and hence the fixation of fractured segments.
- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- The radial nerve is a peripheral nerve that provides motor and sensory function to the arm. The motor function innervates the posterior compartment of the arm including the medial and lateral heads o...
The radial nerve is a peripheral nerve that provides motor and sensory function to the arm. The motor function innervates the posterior compartment of the arm including the medial and lateral heads of the triceps brachii muscles in addition to all 12 muscles in the posterior forearm compartment, as well as, the extrinsic extensor muscles found in the wrist and fingers. The sensory function provides cutaneous innervation to a portion of the anterolateral arm, distal posterior arm, posterior forearm, posterior aspects of the thumb, index finger, middle finger, and the lateral half of the ring finger. The radial nerve originates from the ventral roots of the spinal nerves C5-T1 of brachial plexus which eventually forms the posterior cord. Disruption of the radial nerve can have motor consequences such as an inability to extend the arm, wrist, and fingers and paresthesias about its sensory distribution.
- Postoperative Visual Loss: A Report of One Patient With Unilateral Blindness After Orthognathic Surgery. [Journal Article]
- JCJ Craniofac Surg 2018 Nov 30
- CONCLUSIONS: By a systematic literature review, we discuss about surgical and anesthesic causes of postoperative visual loss, and particularly pathophysiology mechanism of posterior ischemic optic neuropathy. Some predisposition and risk factors have been identified and need to be taken into account.
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- Uniportal vs. triportal video-assisted thoracic surgery in the treatment of primary pneumothorax-a propensity matched bicentric study. [Journal Article]
- JTJ Thorac Dis 2018; 10(Suppl 31):S3712-S3719
- CONCLUSIONS: U-VATS is feasible and safe and may be a less invasive alternative to triportal VATS for the treatment of PSP because of its effectiveness in reducing postoperative pain, paresthesia, hospital stay and in improving cosmetic results.