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Justus G Garweg, Juerg Messerli
Acute posterior and panuveitis mostly affect younger patients and affect both eyes in more than half of cases. Because of the severe consequences in the clinical course, rapid and broad differential diagnosis are critical steps. Permanent loss of vision after a delay in starting therapy and the initiation of ineffective treatment are both serious risks. The initial diagnostic classification is based on clinical presentation (anatomical localisation and type of inflammation) and clinical course and, secondarily, on the response to acute therapy...
February 14, 2019: Klinische Monatsblätter Für Augenheilkunde
Florian Zweipfenning, Sandra P Toelle, Christina Gerth-Kahlert
BACKGROUND: Evaluation and comparison of the ocular phenotype in patients diagnosed with tuberous sclerosis complex (TSC). Analysis of ocular complications during follow-up. PATIENTS AND METHODS: A retrospective chart review was performed of patients with TSC who had received an ocular examination at the eye clinic of the University Hospital Zurich. Data were analysed on visual acuity (VA) assessment, refraction, anterior and posterior eye examination including the distinction of different types of hamartomas and, when available, visual fields...
February 14, 2019: Klinische Monatsblätter Für Augenheilkunde
Chao-Hua Fang, Cheng-Kung Cheng, Tie-Bing Qu, Jun-Hui Zhang, Bo Zhang, Qun Hua, Shi-Gui Yan
Rotational malalignment between the femoral and tibial components in total knee arthroplasty (TKA) can affect clinical outcomes, but there is no consensus on how to best determine tibia tray orientation. The posterolateral corner-locked (PLCL) technique may be a new method. This study aims to assess the applicability of this technique in a Chinese population. Forty normal Chinese volunteers were recruited and underwent computed tomography (CT) of the lower limbs. Knee model reconstructions and simulated standard tibial osteotomy were conducted digitally...
February 14, 2019: Journal of Knee Surgery
Elise R Facer-Childs, Brunno M Campos, Benita Middleton, Debra J Skene, Andrew P Bagshaw
INTRODUCTION: Functional connectivity (FC) of the human brain's intrinsically connected networks underpins cognitive functioning and disruptions of FC are associated with sleep and neurological disorders. However, there is limited research on the impact of circadian phenotype and time of day on FC. STUDY OBJECTIVES: The aim of this study was to investigate resting state FC of the default mode network (DMN) in Early and Late circadian phenotypes over a socially constrained day...
February 15, 2019: Sleep
Xiang-Yang Li, Jin-Bao Ye, Long-Guang Zhang, Yi-Zhen Jia, Ru-Ming Zhou, Pearl Pai
BACKGROUND: Central venous catheter (CVC) is commonly used to provide access for hemodialysis (HD) when arteriovenous access is not available. The misplacement of CVC into azygos vein (AV) is a rare but a potential serious complication. Previous reports communicated the opinion that left-sided catheterization predisposed to AV misplacement, but these reports concentrated on peripherally inserted CVCs, placed for indications rather than HD. Unintended AV misplacement of HD catheters (HDCs) has not been well studied...
February 14, 2019: Blood Purification
J Adnot, H Moizan, O Trost
Dental rehabilitation raises specific challenges in patients with mandibular fibrous dysplasia. We report the 2-year post-operative outcomes on the normal and affected sides in a 64-year-old female with focal left mandibular fibrous dysplasia and bilateral posterior edentulism. On the left, bone shaving of the lesion to restore sufficient vertical height was followed by the insertion of two dental implants. Three dental implants were inserted into the normal bone on the right. Dental prostheses were added 6 months later...
February 11, 2019: Journal of Stomatology, Oral and Maxillofacial Surgery
Anson Jose, Shakil Ahmed Nagori, Saurabh Arya, Indranil Deb Roy
Reconstruction of midface defects are extremely challenging owing to the lack of suitable vascularized local flaps. The temporoparietal fascia and temporalis muscle flaps make excellent choices for midface and orbito-maxillary reconstruction. The muscle provides adequate thickness while the fascia yields pliable soft tissues for lining the midface. The temporalis muscle can be divided antero-posteriorly in three parts and medio-laterally in two parts without losing its vascularity due to its segmental vascular supply...
February 11, 2019: Journal of Stomatology, Oral and Maxillofacial Surgery
Daniel J Snyder, Sean N Neifert, Jonathan S Gal, Brian C Deutsch, John M Caridi
BACKGROUND: The purpose of this study was to identify predictors for post-acute care facility discharge for patients undergoing posterior cervical decompression and fusion (PCDF), and to determine if discharge placement impacts post-discharge outcomes. METHODS: Patients undergoing PCDF from 2012-2015 were queried from the NSQIP database (n=8,743) and separated by discharge placement. Outcomes included non-home discharge, unplanned 30-day readmission, and adverse events (AE), both pre- and post-discharge...
February 11, 2019: World Neurosurgery
Joe Iwanaga, Emily Simonds, Maia Schumacher, Emre Yilmaz, Juan Altafulla, R Shane Tubbs
Superior cluneal nerve entrapment neuropathy is one cause of low back pain often referred to as "pseudosciatica." Studies have found that the superior cluneal nerve can arise variably from the T11 to L5. The osteofibrous tunnels formed by a groove on the iliac crest might compress the superior cluneal nerve. Therefore, the purpose of this study was to investigate the origin of the superior cluneal nerve and its course through such bony grooves. Twenty sides from ten fresh frozen Caucasian cadavers were used in this study...
February 11, 2019: World Neurosurgery
Silvia Papalini, Iris Lange, Jindra Bakker, Stijn Michielse, Machteld Marcelis, Marieke Wichers, Bram Vervliet, Jim van Os, Therese Van Amelsvoort, Liesbet Goossens, Koen Schruers
BACKGROUND: Exposure is the gold standard treatment for phobic anxiety and is thought to represent the clinical application of extinction learning. Reward sensitivity might however also represent a predictive factor for exposure therapy outcome, as this therapy promotes positive experiences and involves positive comments by the therapist. We hypothesized that high reward sensitivity, as expressed by elevated reward expectancy and reward value, can be associated with better outcome to exposure therapy specifically...
February 11, 2019: Progress in Neuro-psychopharmacology & Biological Psychiatry
Howard J Lee, Andrew Stacey, Todd R Klesert, Craig Wells, Alison Skalet, Charles Bloch, Angela Fung, Stephen R Bowen, Tony P Wong, Dean Shibata, Lia M Halasz, Ramesh Rengan
PURPOSE: The present study examines the relationship between dose to corneal substructures and incidence of corneal toxicity within six months of proton beam therapy (PBT) for uveal melanoma. We aim to develop clinically meaningful dose constraints that can be used to mitigate corneal toxicity. METHODS AND MATERIALS: Ninety-two patients were treated with PBT between 2015 and 2017 and evaluated for grade 2+ (GR2+), intervention-requiring corneal toxicity in our prospectively maintained database...
February 11, 2019: International Journal of Radiation Oncology, Biology, Physics
Matthew F Jacques, Rachel C Stockley, Emma I Bostock, Jonathon Smith, Christian G DeGoede, Christopher I Morse
INTRODUCTION: The purpose of this study was to present and compare pain between adult males with Duchenne (DMD), Becker's (BMD), Limb-Girdle (LGMD) Facioscapulohumeral (FSHD) forms of Muscular Dystrophy (MD), and healthy controls (CTRL), using three different methods of assessment. METHODS: Pain was assessed using 1) a whole body visual analogue scale (VAS) of pain, 2) a generalised body map and 3) a localised body map. RESULTS: All types of MD reported more VAS pain than CTRL, with 97% of all MD participants reporting pain; however, no differences were reported between types of MD...
2019: PloS One
Chelsea M Kaplan, Andrew Schrepf, Deniz Vatansever, Tony E Larkin, Ishtiaq Mawla, Eric Ichesco, Laura Kochlefl, Steven E Harte, Daniel J Clauw, George A Mashour, Richard E Harris
A critical component of brain network architecture is a robust hub structure, wherein hub regions facilitate efficient information integration by occupying highly connected and functionally central roles in the network. Across a wide range of neurological disorders, hub brain regions seem to be disrupted, and the character of this disruption can yield insights into the pathophysiology of these disorders. We applied a brain network-based approach to examine hub topology in fibromyalgia, a chronic pain condition with prominent central nervous system involvement...
January 16, 2019: Pain
Emily C Harrold, Niamh M Peters, Laura J Williams, Jane Sy Sui, John A McCaffrey
No abstract text is available yet for this article.
February 2019: Journal of Oncology Practice
Zhenning Yu, Viswanathan Ramakrishnan, Caitlyn Meinzer
Multi-arm multi-stage designs, in which multiple active treatments are compared to a control and accumulated information from interim data are used to add or remove arms from the trial, may reduce development costs and shorten the drug development timeline. As such, this adaptive update is a natural complement to Bayesian methodology in which the prior clinical belief is sequentially updated using the observed probability of success. Simulation is often required for planning clinical trials to accommodate the complexity of the design and to optimize key design characteristics...
February 14, 2019: Journal of Biopharmaceutical Statistics
Mamiko Noguchi, Michal Glinka, Graham R Mayberry, Kimihiro Noguchi, Jack P Callaghan
Potential alternatives for conventional sitting and standing postures are hybrid sit-stand postures (i.e., perching). The purposes of this study were i) to identify where lumbopelvic and pelvic angles deviate from sitting and standing and ii) to use these breakpoints to define three distinct postural phases: sitting, perching, and standing, in order to examine differences in muscle activations and ground reaction forces between phases. Twenty-four participants completed 19 one-minute static trials, from sitting (90°) to standing (180°), sequentially in 5°trunk-thigh angle increments...
February 14, 2019: Ergonomics
Sang-Min Lee, Seong-Il Bin, Jong-Min Kim, Bum-Sik Lee, Chang-Rack Lee, Dong-Wook Son, Jun-Gu Park
BACKGROUND: Meniscal allograft transplantation (MAT) is a widely performed surgical technique used to reconstruct meniscal deficiencies after meniscectomy. However, the long-term effects of extrusion on clinical and radiologic outcomes are unclear. HYPOTHESIS: In long-term follow-up, extrusion after MAT would show poorer outcomes than nonextrusion and would lead to faster progression of arthritic changes. STUDY DESIGN: Cohort study; Level of evidence, 3...
February 14, 2019: American Journal of Sports Medicine
Markus R Konieczny, Rüdiger Krauspe
STUDY DESIGN: This study was a retrospective radiographic analysis of consecutive patients. OBJECTIVES: To analyze exposure to radiation of the surgeon and-separately-of patients in minimally invasive surgery (MIS) of multilevel posterior stabilization by percutaneous pedicle screw insertion guided by navigation (PIN) versus percutaneous pedicle screw insertion guided by fluoroscopy (PIF). SUMMARY OF BACKGROUND DATA: Spine surgeons are exposed to a 12-fold higher dose of radiation than other nonspinal musculoskeletal surgeons and PIF in MIS leads to a 2-fold higher dose of radiation than in open surgery...
February 12, 2019: Clinical Spine Surgery
Koji Tamai, Phillip Grisdela, Joshua Romanu, Permsak Paholpak, Hiroaki Nakamura, Jeffrey C Wang, Zorica Buser
STUDY DESIGN: This is a retrospective analysis of kinematic magnetic resonance images (kMRI). OBJECTIVE: To assess the association of cervical paraspinal muscle with cervical sagittal balance and degenerative spinal disorders. SUMMARY OF BACKGROUND DATA: Although the effects of spinal disorders and cervical imbalance on patient's symptoms have been well described, the relationship of the cervical muscle quality and volume to cervical imbalance or spinal disorders is not well established...
February 12, 2019: Clinical Spine Surgery
Jung K Mok, Evan D Sheha, Andre M Samuel, Steven J McAnany, Avani S Vaishnav, Todd J Albert, Catherine Himo Gang, Sheeraz Qureshi
STUDY DESIGN: This was a retrospective cohort study. OBJECTIVES: The main objectives of this study were to identify epidemiological trends, differences, and complications in patients undergoing surgical treatment for single-level cervical radiculopathy (SLCR). SUMMARY OF BACKGROUND DATA: SLCR that fails nonoperative management is effectively treated with either anterior cervical discectomy and fusion (ACDF), cervical disc replacement (CDR), or posterior cervical foraminotomy (PCF)...
February 12, 2019: Clinical Spine Surgery
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