Observational study of medical marijuana as a treatment for treatment-resistant epilepsies.

Objectives: Medical cannabis formulations with cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC) are widely used to treat epilepsy. We studied the safety and efficacy of two formulations.

Methods: We prospectively observed 29 subjects (12 to 46 years old) with treatment-resistant epilepsies (11 Lennox-Gastaut syndrome; 15 with focal or multifocal epilepsy; three generalized epilepsy) were treated with medical cannabis (1THC:20CBD and/or 1THC:50CBD; maximum of 6 mg THC/day) for ≥24 weeks.

Influence of diabetes on plasma pharmacokinetics and brain bioavailability of grape polyphenols and their phase II metabolites in the Zucker diabetic fatty rat.

Scope: The effect of diabetes on the pharmacokinetics, bioavailability and brain distribution of grape polyphenols and select metabolites was studied in the Zucker diabetic fatty (ZDF) rat model.

Methods And Results: (ZDF) rats and their lean controls (LN) were dosed with a Standardized Grape Polyphenol (SGP) Mixture consisting of grape seed extract, Concord grape juice and resveratrol (RES) by oral gavage for 10 days. An 8-h pharmacokinetic study was performed.

Non-Operative Management of Paget-Schroetter Syndrome: A Single-Center Experience.

Objective: The preponderance of existing literature for the treatment of Paget-Schroetter syndrome (PSS) advocates clot lysis followed by thoracic outlet decompression (TOD). We postulate that long-term anticoagulation has equal outcomes to more invasive and costly surgical intervention, and review our experience with non-operative management of PSS.

Methods: A retrospective review was conducted, examining patients between 1994-2014.

The evidence for nonoperative management of visceral artery dissections: a single-center experience.

Background: Spontaneous isolated visceral artery dissection is an uncommon condition encountered by clinicians. Presentation may vary from asymptomatic to acute intestinal ischemia, although a clear natural history has yet to be elucidated. No consensus exists on how best to manage these patients in the absence of true intestinal ischemia; however, much of the literature suggests that intervention is required.

Outcomes of combined somatosensory evoked potential, motor evoked potential, and electroencephalography monitoring during carotid endarterectomy.

Background: While much has been written about multiple methods of neuromonitoring during carotid endarterectomy (CEA), there has been relatively little discussion of the use of triple monitoring via somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) in conjunction with electroencephalography (EEG). Our objective was to evaluate the rate of detection and prevention of neurologic events by multinerve SEP, MEP, and EEG in patients undergoing CEA while under general anesthesia.

Methods: A prospective study of 181 consecutive patients undergoing CEA between June 2005 and September 2010 was reviewed.

Towards neuronal organoids: a method for long-term culturing of high-density hippocampal neurons.

One of the goals in neuroscience is to obtain tractable laboratory cultures that closely recapitulate in vivo systems while still providing ease of use in the lab. Because neurons can exist in the body over a lifetime, long-term culture systems are necessary so as to closely mimic the physiological conditions under laboratory culture conditions. Ideally, such a neuronal organoid culture would contain multiple cell types, be highly differentiated, and have a high density of interconnected cells.

Reevaluation of the evolutionary events within recA/RAD51 phylogeny.

Background: The recA/RAD51 gene family encodes a diverse set of recombinase proteins that affect homologous recombination, DNA-repair, and genome stability. The recA gene family is expressed across all three domains of life - Eubacteria, Archaea, and Eukaryotes - and even in some viruses. To date, efforts to resolve the deep evolutionary origins of this ancient protein family have been hindered by the high sequence divergence between paralogous groups (i.

Endoleaks with the AneuRx graft: a longer-term, single-center study.

Purpose: To report the frequency of endoleaks after endovascular aneurysm repair (EVAR) with the AneuRx graft.

Material And Methods: The study group included 121 consecutive patients treated with the first-generation AneuRx graft before December 2005, which ensured a potential minimum follow-up of 5 years.

Results: Thirty-seven patients (31%) had 45 different endoleaks at varying times in their follow-up.

The effect of percutaneous intervention on wound healing in patients with mixed arterial venous disease.

Background: Open venous ulcers in patients with combined arterial and venous insufficiency are notoriously hard to treat. Patients with an ankle-brachial index (ABI) of 0.5-0.

Type II endoleaks involving an accessory renal artery and the inferior mesenteric artery.

Two patients are described with type II endoleaks involving an accessory renal artery and the inferior mesenteric artery. One patient was successfully embolized via the translumbar route. The other continues to be observed; the endoleak is expected to close spontaneously because both the inflow and outflow are significantly compromised.

Vacuum-assisted closure instill as a method of sterilizing massive venous stasis wounds prior to split thickness skin graft placement.

Patients with massive venous stasis ulcers that have very high bacterial burdens represent some of the most difficult wounds to manage. The vacuum-assisted closure (VAC) device is known to optimise wound bed preparation; however, these patients have too high a bacterial burden for simple VAC application to facilitate this function. We present the application of the VAC with instillation of dilute Dakins solution as a way of bacterial eradication in these patients.

Bacterial burden and wound outcomes as influenced by negative pressure wound therapy .

Unlabelled:  Abstract: Negative pressure wound therapy (NPWT) has consistently shown significant clinical benefits in wound healing, but the mechanisms are not fully elucidated. While a reduction in bacterial burden is one possible contributor, studies have shown mixed results in this regard. The present study used a porcine infected wound model to test the effect of NPWT on bacterial burden.

Single-incision laparoscopic cholecystectomy using a flexible endoscope.

Objective: To describe our experience with a single-incision laparoscopic cholecystectomy (SILC) performed using a flexible endoscope as the means of visualization and surgical dissection. The use of flexible endoscopy in intra-abdominal surgery has never been described.

Design: Prospective observational case series.

Laparoscopic single-site surgery for placement of adjustable gastric band--a series of 22 cases.

Background: We present a series of 22 patients who underwent laparoendoscopic single-site (LESS) surgery for placement of an adjustable gastric band at a U.S. university hospital.

Analysis of patient cost for recombinant human platelet-derived growth factor therapy as the first-line treatment of the insured patient with a diabetic foot ulcer.

Introduction: The 2-year cost of a new diabetic foot ulcer (DFU) is estimated to be $27,987. These costs are thought to be secondary to hospitalization, amputation, and the duration of care. Treatments that accelerate rapid and complete healing of DFUs reduce the need for hospitalization, thus reducing the costs of care.

Mid-term results and patient perceptions of robotically-assisted coronary artery bypass grafting.

We sought to study our mid-term outcomes and our patient's perceptions of robotically-assisted coronary artery bypass (RACAB). The daVinci robotic system was utilized to harvest and prepare the internal thoracic artery (ITA) as well as to open the pericardium and identify the target vessels. Anastomoses were performed by hand on the beating heart through limited incisions using an endoscopic stabilizing device.

Neuropsychological dysfunction in the absence of structural evidence for cerebral ischemia after uncomplicated carotid endarterectomy.

Objective: Neurocognitive dysfunction has been shown to occur in roughly 25% of patients undergoing carotid endarterectomy (CEA). Despite this, little is known about the mechanism of this injury. Recently, several groups have shown that new diffusion weighted imaging (DWI)-positive lesions are seen in 20% of patients undergoing CEA.

A novel drill set for the enhancement and assessment of robotic surgical performance.

Background: There currently exist several training modules to improve performance during video-assisted surgery. The unique characteristics of robotic surgery make these platforms an inadequate environment for the development and assessment of robotic surgical performance.

Methods: Expert surgeons (n=4) (>50 clinical robotic procedures and >2 years of clinical robotic experience) were compared to novice surgeons (n=17) (<5 clinical cases and limited laboratory experience) using the da Vinci Surgical System.

The LapSim: a learning environment for both experts and novices.

Background: Simulated environments present challenges to both clinical experts and novices in laparoscopic surgery. Experts and novices may have different expectations when confronted with a novel simulated environment. The LapSim is a computer-based virtual reality laparoscopic trainer.

Antegrade endovascular repair of a coarctation-associated aneurysm through an upper hemi-sternotomy.

Late aneurysm formation is a well-described complication after surgical correction of aortic coarctation. Endovascular repair of such aneurysms avoids the morbidity of conventional reoperative thoracic surgery. We describe a unique case of antegrade endovascular repair of a distal coarctation-associated aneurysm with vascular access acquired through the aortic arch by an upper hemi-sternotomy.

A controlled prospective study of neuropsychological dysfunction following carotid endarterectomy.

Background: Although subtle cognitive injury as revealed by neuropsychological testing occurs in a substantial number of patients following carotid endarterectomy (CEA), there is controversy about whether this finding is a result of the surgery or the anesthesia.

Objectives: To examine the changes in neuropsychological test performance in patients following CEA vs a control group of patients older than 60 years following spine surgery, so as to determine whether neuropsychological dysfunction after CEA is a result of surgery or anesthesia.

Methods: Patients undergoing CEA (n = 80) and lumbar spine surgery (n = 25) were assessed with a battery of neuropsychological tests preoperatively and on postoperative days 1 and 30.