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1/5.1 degrees; L5/S disc angle, 14.2/12.2 degrees; and SS, 32.0/32.1 degrees. The mean PI (50.5 degrees) was tended to be associated with the final LL (R=0.31, P=0.044) and was correlated with the ΔLL (R=0.43, P<0.01). The data of the LL maintenance/non-maintenance groups were as follows age, 65.0/67.0; primary LL, 43.2/50.2 degrees (P<0.05); final LL, 36.2/27.8 degrees (P<0.05); and PI, 52.8/43.8 degrees (P<0.01).
During the 10-year study period, the LL in middle-aged and elderly volunteers decreased by 11 degrees. The factor of maintenance of LL was PI.
During the 10-year study period, the LL in middle-aged and elderly volunteers decreased by 11 degrees. The factor of maintenance of LL was PI.
Intraoperative hypothermia is associated with perioperative complications such as blood loss and wound infection. Thus, perioperative heat retention methods to prevent perioperative hypothermia such as providing a warmed blanket and active patients' warming are important. Although major surgery and pediatric patient age are noted as risk factors, only a few studies focus on hypothermia as an intraoperative complication in pediatric scoliosis surgery. The aim of this study is to investigate the incidence of intraoperative hypothermia in pediatric scoliosis surgery and the associated preoperative risk factors.
We retrospectively reviewed the records of pediatric patients who underwent posterior spinal fusion at a single institution between 2015 and 2019. We recorded the background data, perioperative data, lowest recorded core temperature, and perioperative complications. Patients were divided into those whose temperature decreased below 36°C (Group H) and those who maintained a temperature of 36°C or great are preoperative risk factors for intraoperative hypothermia.
The incidence of hypothermia in pediatric posterior scoliosis surgery is 38.8%. Diagnosis of non-AIS, lower body mass index, and lower core body temperature at the time of anesthesia induction are preoperative risk factors for intraoperative hypothermia.
The modified Japanese Orthopaedic Association (mJOA) score is considered to be among the most comprehensive scores in the assessment of patients with cervical myelopathy. Hence, providing reliable, translated, and cross-culturally adapted versions in different languages is required to standardize the evaluation of patients. This study aimed to translate a reliable Arabic version of the mJOA score.
A total of 65 patients of variable age and with etiologies for compressive cervical myelopathy were recruited. Both forward and backward translations were performed. Then, intraobserver and interobserver reliabilities were measured using the intraclass correlation coefficient and Cronbach's alpha coefficient.
The mean age of the patients was 58.08 years, and most of them were male (69.2%). The intraobserver and interobserver reliabilities were almost in perfect agreement for the different sections and the total score, which were 96.8% and 97.4%, respectively.
In this study, a reliable, cross-culturally adapted Arabic version of the mJOA score for patients with cervical myelopathy is provided. Although the study was conducted on Egyptian patients, we believe that it could be implemented in majority of the Arabic-speaking population.
In this study, a reliable, cross-culturally adapted Arabic version of the mJOA score for patients with cervical myelopathy is provided. Although the study was conducted on Egyptian patients, we believe that it could be implemented in majority of the Arabic-speaking population.
Reportedly, the medialization of the common carotid artery (MCCA) to be a vascular anomaly with a potential risk of intraoperative carotid artery injury. ACBI1 order Nevertheless, among spine surgeons, the presence of MCCA has not been well recognized.
We retrospectively reviewed consecutive patients who underwent cervical radiographs and magnetic resonance imaging (MRI) examinations in a single spine center. Using MRI, the MCCA grade was classified into grades 1 to 3 in order of severity. Radiographic measurement included C2-C7 angles as cervical lordosis, cervical sagittal vertical axis (C-SVA), T1 slope (T1S), and T1S-cervical lordosis mismatch. We compared each patient's background and radiographic parameters between patients with each of the three MCCA grades. The continuous variables were compared using the Jonckheere-Terpstra trend test and the proportions were compared using the Cochran-Armitage trend test to investigate the trend of variables in three grades.
The present study included data from 133 eligible patients (65 males and 68 females) with a mean age of 63.7 (±14.2) years. The details of MCCA grading were as follows grade 1, n=101; grade 2, n=27; and grade 3, n=5. With an increasing MCCA grade, age (61.9±14.0, 68.2±13.8, and 76.4±9.4 years for grades 1, 2, and 3, respectively, p=0.005) and proportion of female (p<0.001) had an increasing trend, whereas cervical lordosis had a decreasing trend (11.7±13.5°, 7.0±14.5°, and -10.0±19.2° for grades 1, 2, and 3, respectively, p=0.011).
Several patient backgrounds including the female gender, older age, and kyphotic alignment were determined as MCCA risk factors. Careful preoperative neck vasculature assessment would avoid a catastrophic complication during anterior cervical surgery.
Several patient backgrounds including the female gender, older age, and kyphotic alignment were determined as MCCA risk factors. Careful preoperative neck vasculature assessment would avoid a catastrophic complication during anterior cervical surgery.
Since 1929, only 171 epidural hemangioma cases have been reported. We report five epidural hemangiomas and review cases reported over the past decade in terms of radiological features and clinical findings.
Among patients operated on for spinal tumors at our hospital between 2009 and 2020, five had epidural hemangiomas. We retrospectively examined patient records and images and reviewed relevant English literature in PubMed from 2009 to 2019. Eighty-seven epidural hemangioma cases were reported in the last 10 years.
Among 87 cases, the average age was 49.58 years; 43 and 44 cases were male and female, respectively. The most common lesion level was thoracic (59.8%), while common symptoms were back pain (42.5%); numbness, hypoesthesia, or anesthesia (37.9%); paraparesis (34.5%); and radicular pain (20.7%). On magnetic resonance imaging (MRI), 77.1% showed hypo-isointensity on T1-weighted image (WI), hyperintensity on T2WI, and homogenous enhanced patterns with contrast. Total resection was performed in moeducing bleeding. Although there were almost no recurrences after resection, careful follow-up for longer periods is required.An intraoperative functional spinal cord monitoring system is a technology used by spine and spinal cord surgeons to perform a safe surgery and to gain further surgical proficiency. However, no existing clinical neurophysiological method used in the operating room can monitor all complex spinal cord functions. Therefore, by observing the activities of certain neural action potentials transferred via limited neural tissues, surgeons need to deductively estimate the function of the whole spinal cord. Thus, as the number of spinal cord functions that need to be observed increases, spinal cord monitoring can be more reliable. However, in some situations, critical decision-making is affected by the limited capability of these methods. Nevertheless, good teamwork enables sharing of seamless information within the team composed of a surgeon, anesthesiologist, monitoring technician and nurses greatly contributes to making quick and accurate decisions. The surgeon, who is the person in charge of the team, should communicate with multidisciplinary team members using common technical terms. For this reason, spine and spinal cord surgeons must have appropriate knowledge of the methods currently used, especially of their utility and limitations. To date, at least six electrophysiological methods are available for clinical utilization three are used to monitor sensory-related tracts, and three are used to monitor motor-related spinal cord functions. If surgeons perform electrode setting, utilizing their expertise, then the range of available methods is broadened, and more meticulous intraoperative functional spinal cord monitoring can be carried out. Furthermore, if the team members share information effectively by utilizing a clinically feasible judicious checklist or tools, then spinal cord monitoring will be more reliable.
The aim of this study was to examine, using PubMed, the number of articles in the field of physical medicine and rehabilitation medicine originating in Japan, especially those containing high-quality scientific evidence (randomized controlled trials [RCTs], systematic reviews, meta-analyses) and those published in high impact factor journals.
We searched the PubMed database to identify articles, RCTs, systematic reviews, and meta-analyses from Japan covering physical medicine and rehabilitation published between 2001 and 2019; we then calculated the proportion of articles from Japan. Additionally, using Journal Citation Reports, we selected the top ten highest impact factor journals on "Rehabilitation" each year between 2001 and 2019. For each year, we searched PubMed for the total number of articles in these top ten journals and for articles originating in Japan. The Cochran-Armitage test was used to evaluate the change in the proportion of publications from Japan over time.
The proportion of articles on physical medicine and rehabilitation originating in Japan increased from 2001 to 2019 (P<0.0001). An increase in the percentages of systematic reviews (P=0.046) and meta-analyses (P=0.0013) originating in Japan and a decrease in the percentage of original articles published in the top ten highest impact factor journals were demonstrated (P=0.002). However, there was no change in the percentage of RCTs from Japan over time (P=0.055).
Our findings suggest that the proportion of articles from Japan containing high-quality scientific evidence is increasing. However, there is a need to expand the support system for research while considering the quality of research.
Our findings suggest that the proportion of articles from Japan containing high-quality scientific evidence is increasing. However, there is a need to expand the support system for research while considering the quality of research.
Adrenomedullin (AM), a vasodilatory peptide, is known for its pleiotropic actions. AM levels are increased under inflammatory conditions such as sepsis and can be useful as a prognostic biomarker. However, there are only a few reports on the physiological actions of AM in the perioperative period. The aim of this single-center, prospective, and observational study was to investigate the changes in the plasma levels of mature AM (mAM) and total AM (tAM) observed during the perioperative period. In addition, we aimed to determine the association between each AM level and immune-inflammatory parameters to explore the usefulness of AM as a biomarker of the magnitude of surgical stress responses.
The levels of both mAM and tAM, in addition to the levels of presepsin, interleukin-6, procalcitonin, white blood cell, and C-reactive protein, were measured in blood samples obtained during the perioperative period. Other laboratory data, including sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation (APACHE) II scores, were obtained from individual clinical records.
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