Analgesia with Gabapentin and Pregabalin May Involve -Methyl-d-Aspartate Receptors, Neurexins, and Thrombospondins.

The gabapentinoid drugs gabapentin and pregabalin (Neurontin and Lyrica) are mainstay treatments for neuropathic pain and preventing focal seizures. Both drugs have similar effects to each other in animal models and clinically. Studies have shown that a protein first identified as an auxiliary subunit of voltage-gated calcium channels (the -subunit type 1 [ -1], or ) is the high-affinity binding site for gabapentin and pregabalin and is required for the efficacy of these drugs.

Safety and efficacy of outpatient sleeve gastrectomy: 2534 cases performed in a single free-standing ambulatory surgical center.

Background: Sleeve gastrectomy (SG) is currently the most widely performed operation for treatment of morbid obesity. SG leads to significant weight loss and reduction in weight related comorbidities. Procedures performed in ambulatory surgical centers (ASC) can provide several advantages over hospital-based surgery.

Does the future of laparoscopic sleeve gastrectomy lie in the outpatient surgery center? A retrospective study of the safety of 3162 outpatient sleeve gastrectomies.

Background: Laparoscopic sleeve gastrectomy (LSG) is a safe and effective procedure that can be performed as an outpatient procedure.

Objectives: The aim of the study was to determine whether same-day discharge LSG is safe when performed in an outpatient surgery center.

Setting: Outpatient surgery centers.

High acuity sleeve gastrectomy patients in a free-standing ambulatory surgical center.

Background: Procedures performed in ambulatory surgical centers (ASC) can provide several advantages over hospital-based surgery. Understandably, concerns have been raised regarding "high acuity" cases in the ASC setting. Recently the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) presented protocols for ASCs to follow, requiring them to perform only "low acuity" cases to be compliant with accreditation.

A matrix model for valuing anesthesia service with the resource-based relative value system.

Background: The purpose of this study was to propose a new crosswalk using the resource-based relative value system (RBRVS) that preserves the time unit component of the anesthesia service and disaggregates anesthesia billing into component parts (preoperative evaluation, intraoperative management, and postoperative evaluation). The study was designed as an observational chart and billing data review of current and proposed payments, in the setting of a preoperative holing area, intraoperative suite, and post anesthesia care unit. In total, 1,195 charts of American Society of Anesthesiology (ASA) physical status 1 through 5 patients were reviewed.

Primary Pulmonary Synovial Sarcoma during Pregnancy: A Diagnostic and Therapeutic Dilemma.

Synovial sarcoma is a rare soft tissue sarcoma that typically arises in the extremities of young adults. We report a case of a 26-year-old pregnant woman with biopsy-proven primary synovial sarcoma of the lung that was treated with chemotherapy with radiographic response. This is only the third documented case of primary pulmonary synovial sarcoma occurring during pregnancy and the first case where chemotherapy was given.

Does the site of anterior tracheal puncture affect the success rate of retrograde intubation? A prospective, manikin-based study.

Background. Retrograde intubation is useful for obtaining endotracheal access when direct laryngoscopy proves difficult. The technique is a practical option in the "cannot intubate / can ventilate" scenario.

Selection for high oridonin yield in the Chinese medicinal plant Isodon (Lamiaceae) using a combined phylogenetics and population genetics approach.

Oridonin is a diterpenoid with anti-cancer activity that occurs in the Chinese medicinal plant Isodon rubescens and some related species. While the bioactivity of oridonin has been well studied, the extent of natural variation in the production of this compound is poorly known. This study characterizes natural variation in oridonin production in order to guide selection of populations of Isodon with highest oridonin yield.

Mini-open versus open decompression and fusion for lumbar degenerative spondylolisthesis with stenosis.

The outcome of less invasive surgical techniques in comparison to traditional surgical techniques has been the source of debate. In this retrospective study, 51 patients who had undergone posterior lumbar fusion along with bilateral decompression were enrolled. Twenty-one patients underwent fusion using a standard, midline open technique (open group) and 30 patients underwent fusion using a mini-open technique, with a small, central incision for the decompression and bilateral paramedian incisions for the posterolateral fusion and placement of cannulated pedicle screws (mini-open group).

Development of microsatellite markers for the medicinal plant Isodon rubescens (Lamiaceae) and related species.

Premise Of The Study: Microsatellite markers were developed for the medicinal plant Isodon rubescens to investigate genetic variability of the species and, in future studies, to assess its relation to the content of pharmacologically active chemicals produced by the plant.

Methods And Results: Eleven primer pairs were identified and tested in multiple populations of I. rubescens and related species (I.

Heavy metal and pesticide content in commonly prescribed individual raw Chinese Herbal Medicines.

Heavy metal and pesticide contamination has previously been reported in Chinese Herbal Medicines (CHMs), in some cases at potentially toxic levels. This study was conducted to determine general patterns and toxicological significance of heavy metal and pesticide contamination in a broad sample of raw CHMs. Three-hundred-thirty-four samples representing 126 species of CHMs were collected throughout China and examined for arsenic, cadmium, chromium, lead, and mercury.

Traditional Medicine Collection Tracking System (TM-CTS): a database for ethnobotanically driven drug-discovery programs.

Ethnopharmacological Relevance: Ethnobotanically driven drug-discovery programs include data related to many aspects of the preparation of botanical medicines, from initial plant collection to chemical extraction and fractionation. The Traditional Medicine Collection Tracking System (TM-CTS) was created to organize and store data of this type for an international collaborative project involving the systematic evaluation of commonly used Traditional Chinese Medicinal plants.

Materials And Methods: The system was developed using domain-driven design techniques, and is implemented using Java, Hibernate, PostgreSQL, Business Intelligence and Reporting Tools (BIRT), and Apache Tomcat.

Developing a library of authenticated Traditional Chinese Medicinal (TCM) plants for systematic biological evaluation--rationale, methods and preliminary results from a Sino-American collaboration.

While the popularity of and expenditures for herbal therapies (aka "ethnomedicines") have increased globally in recent years, their efficacy, safety, mechanisms of action, potential as novel therapeutic agents, cost-effectiveness, or lack thereof, remain poorly defined and controversial. Moreover, published clinical trials evaluating the efficacy of herbal therapies have rightfully been criticized, post hoc, for their lack of quality assurance and reproducibility of study materials, as well as a lack of demonstration of plausible mechanisms and dosing effects. In short, clinical botanical investigations have suffered from the lack of a cohesive research strategy which draws on the expertise of all relevant specialties.

Trends in epidemiology and management of type II odontoid fractures: 20-year experience at a model system spine injury tertiary referral center.

Study Design: A retrospective cohort study of consecutive type II Odontoid fractures presenting to a Level 1 Regional Model Systems Spinal Cord Injury Center between June 1985 and July 2006.

Objective: To assess trends in management of type II Odontoid fractures presenting to a Level 1 Model Systems Regional Spinal Cord Injury Center over a 20-year period.

Summary Of Background Data: Type II Odontoid fracture management is controversial, and a majority of studies have had relatively small cohorts.

Sedation and anesthesia options for pediatric patients in the radiation oncology suite.

External beam radiation therapy (XRT) has become one of the cornerstones in the management of pediatric oncology cases. While the procedure itself is painless, the anxiety it causes may necessitate the provision of sedation or anesthesia for the patient. This review paper will briefly review the XRT procedure itself so that the anesthesia provider has an understanding of what is occurring during the simulation and treatment phases.

Monitored anesthesia care (MAC) sedation: clinical utility of fospropofol.

Fospropofol, a phosphorylated prodrug version of the popular induction agent propofol, is hydrolyzed in vivo to release active propofol, formaldehyde, and phosphate. Pharmacodynamic studies show fospropofol provides clinically useful sedation and EEG/bispectral index suppression while causing significantly less respiratory depression than propofol. Pain at the injection site, a common complaint with propofol, was not reported with fospropofol; the major patient complaint was transitory perianal itching during the drug's administration.

Total synthesis and absolute configuration of (-)-berkeleyamide A.

A chiral-pool approach to (-)-berkeleyamide A 1 based on a diastereoselective nitrile oxide [3 + 2]-cycloaddition completes the first total synthesis establishing the absolute stereochemistry of the natural product.

Adjacent segment disease after cervical spine fusion.

Anterior cervical diskectomy and fusion is one of the most common cervical spine procedures. Although it is usually successful in relieving the symptoms of radiculopathy and myelopathy, the subsequent development of clinically significant disk disease at levels adjacent to the fusion is a matter of concern. Adjacent segment cervical disease occurs in approximately 3% of patients; the incidence is expected to increase to more than 25% of patients within the first 10 years after the index fusion procedure.

Hospital employee job resourcefulness: an empirical study and implications for health care marketing.

In today's competitive hospital marketing environment, it is imperative that administrators ensure that their hospitals are operating as efficiently and as effectively as possible. "Doing more with less" has become a mandate for hospital administrators and employees. The current research replicates and extends previous work devoted to this topic by examining the job resourcefulness construct in a hospital setting.

Examining the relationship between patient orientation and job satisfaction in health care: evidence from the nursing profession.

It is well-known that the United States faces a serious nursing shortage. A number of factors have contributed to the problem including an aging nursing workforce, fewer nursing job candidates, the aging of the baby boom population, and increased nurse dissatisfaction. The current work addresses one issue that is central to the problem: nursing satisfaction/dissatisfaction.

Endotracheal tube malposition within the pediatric population: a common event despite clinical evidence of correct placement.

Purpose: To ensure that the endotracheal tube (ETT) is ideally placed for proper ventilation, radiographic confirmation of ETT placement is frequently used to supplement clinical examination in the intensive care unit setting. However, fluoroscopy rarely serves the same role during surgery, despite the fact that portable units are often present in the operating room. The purpose of this study was to ascertain the value of fluoroscopy in determining ETT malposition among the pediatric surgical population.

A review of the TLICS system: a novel, user-friendly thoracolumbar trauma classification system.

The classification and treatment of thoracolumbar injuries remain controversial. The Spine Trauma Study Group (STSG) has developed a classification system that has prognostic significance and helps guide treatment decisions. It is based on three aspects: morphology of the injury, integrity of the posterior ligamentous complex, and neurological status of the patient.

Percutaneous techniques for minimally invasive posterior lumbar fusion.

Percutaneous pedicle screw fixation for lumbar posterolateral instrumented fusion is an attractive alternative to standard open techniques. The technical aspects of this procedure can be challenging and even frustrating when first learning the technique. However, once these techniques have been mastered, they offer a safe, less invasive, less traumatic, more aesthetic method for performing fusion.

Delayed femoral shaft fracture secondary to nail gun injury: a case report.

Nail gun injuries are common workplace occurrences among construction workers; however, delayed fractures of the femur after a nail gun injury are not found in the medical literature. We report the case of a patient who presented with such a fracture 3 days after accidentally firing a nail into his thigh. The patient was taken to the operating room for intramedullary nailing, irrigation and debridement, and antibiotic beads.