A multicenter feasibility randomized controlled trial using a virtual reality application of pain neuroscience education for adults with chronic low back pain.

Background: Chronic low back pain (CLBP) is a highly prevalent condition among adults and is correlated to high levels of pain, high disability, and lower quality of life. Pain neuroscience education (PNE) helps to explain the pain experience and can affect psychosocial factors, such as fear of movement, anxiety, socioeconomic status, work life satisfaction, etc. More recently, virtual reality (VR) programs have emerged allowing for immersive PNE experiences.

Berengeria Gil-Santana & Coletto-Silva, a junior synonym of Ectrichodiella Fracker & Bruner, with new records and taxonomic notes on Ectrichodiinae from Brazil, and with keys to Ectrichodiinae and Reduviinae genera of the New World (Hemiptera: Heteroptera: Reduviidae).

Berengeria Gil-Santana & Coletto-Silva, 2005 is considered a junior synonym of Ectrichodiella Fracker & Bruner, 1924. Ectrichodiella minima (Valdés, 1910) and E. rafaeli (Gil-Santana & Coletto-Silva, 2005), new.

The surgical management of goiter: Part II. Surgical treatment and results.

Objectives/hypothesis: Surgery for goiter embodies a unique challenge. Our objective is to provide a comprehensive analysis of cervical and substernal goiter data in two paired articles. This second article focuses on surgical management.

The surgical management of goiter: Part I. Preoperative evaluation.

Objectives/hypothesis: Our overarching objective is to provide a comprehensive analysis of goiter data in two paired articles. This first article focuses on the preoperative evaluation. The following null hypotheses have been tested: 1) there is no correlation between goiter size and preoperative symptoms, 2) there is no correlation between preoperative neck imaging abnormalities and preoperative symptoms, and 3) there are no predictors for goiter recurrence.

Postpneumonectomy syndrome: surgical management and long-term results.

Objective: Postpneumonectomy syndrome is a rare syndrome of dynamic airway obstruction caused by extreme rotation and shift of the mediastinum after pneumonectomy, resulting in symptomatic central airway compression. We have treated this syndrome by mediastinal repositioning and placement of saline-filled prostheses into the pneumonectomy space. There is a paucity of outcome data for patients treated surgically, with only a single series of 11 patients previously reported.

Segmental laryngotracheal and tracheal resection for invasive thyroid carcinoma.

Background: Laryngotracheal invasion worsens prognosis in patients with thyroid carcinoma. The extent of resection is controversial.

Methods: We performed a retrospective study of patients with thyroid carcinoma and invasion of the larynx or trachea between 1964 and 2005.

Tracheal compression with "hairpin" right aortic arch: management by aortic division and aortopexy by right thoracotomy guided by intraoperative bronchoscopy.

Background: Four patients with severe tracheal obstruction due to right aortic arch, aberrant left subclavian artery, diverticulum of Kommerell, ligamentum or ductus arteriosum, and, additionally, right descending aorta, mild pectus excavatum, and high aortic arch apex, with narrow space between the ascending and descending aortic limbs, underwent division of ligamentum, excision of diverticulum and division (and reimplantation) of aberrant subclavian, either in multiple or single operations, but failed to achieve relief of obstruction.

Methods: In addition to the procedures noted, fabric sling aortopexy of ascending and descending aortic limbs around adjacent ribs, with or without aortic division after prosthetic graft between ascending and descending aortic limbs was required, all performed through a right thoracotomy and adjunctive cervical incision, and with flexible bronchoscopic monitoring of each step.

Results: Three patients obtained full relief of airway obstruction, which has persisted in follow-up from eight to over 12 years.

Uncommon primary tracheal tumors.

Background: Primary tracheal tumors other than adenoid cystic or squamous cell carcinoma are uncommon and have a heterogeneous histologic appearance. The experience regarding their treatment and long-term outcome is limited, and alternatives to segmental tracheal resection, including endoscopic treatment or radiation, continue to be explored.

Methods: A retrospective analysis was performed of uncommon tracheal tumors among 360 primary tracheal tumors seen over 40 years, excluding adenoid cystic and squamous cell carcinoma.

Complications of the tracheal diverticulum after division of congenital tracheoesophageal fistula.

In 3 patients, recurrent respiratory symptoms after neonatal repair of congenital tracheoesophageal fistula (Gross type C in 2, D in 1) were associated with a large tracheal remnant of the fistula termed diverticulum. Symptoms resolved after resection of the diverticulum in 1 child with airway obstruction and 1 adult with recurrent tracheoesophageal fistula.

Tracheal compression caused by straight back syndrome, chest wall deformity, and anterior spinal displacement: techniques for relief.

Background: Straight back syndrome and other causes of extreme narrowing of the space between sternal notch and vertebrae can cause critical tracheal obstruction. Additional points of compression may result from the brachiocephalic artery and from anterior vertebral displacement.

Methods: Individualized surgical maneuvers are necessary to correct all points of obstruction.

Predictors of recurrence in thymic tumors: importance of invasion, World Health Organization histology, and size.

Objective: This study sought to define predictors of recurrence after resection of thymic tumors.

Methods: A single-institution retrospective study was performed of 179 patients who underwent resection of a thymic tumor from 1972 through 2003.

Results: Resection was complete in 90% (161/179) of patients.

Tracheoplasty for expiratory collapse of central airways.

Background: Severe central airway obstruction due to expiratory collapse occurs with malacia of intrathoracic trachea and main bronchi, often with chronic obstructive pulmonary disease. Bronchoscopically observed, it is confirmed by inspiratory-expiratory computerized tomographic chest scans. Prior attempts at surgical stabilization have not given dependable results.

Adjuvant radiation of stage III thymoma: is it necessary?

Background: The criteria for administration of adjuvant radiation therapy after thymoma resection remains controversial, and it is unclear whether patients with Masaoka stage III thymoma benefit from adjuvant radiation. The goal of this report was to determine whether or not this group benefits from radiation therapy in disease-specific survival and disease-free survival.

Methods: Case records of the Massachusetts General Hospital were retrospectively reviewed from 1972 to 2004.

Laryngotracheoplastic resection for primary tumors of the proximal airway.

Background: Primary tumors of the airway with proximity to vocal cords and recurrent laryngeal nerves can be resected with sparing of the larynx. Long-term data on survival and local recurrence after laryngotracheal resection are scarce.

Methods: We conducted a retrospective study of laryngotracheal resection and reconstruction for primary tumors of the airway since 1972.

Airway obstruction owing to tracheopathia osteoplastica: treatment by linear tracheoplasty.

Background: Tracheopathia osteoplastica is a rare disease that may involve the entire trachea and progress to critical airway obstruction. It is not dilatable and does not respond to laser therapy or bronchoscopic curettage. Stents usually cannot be inserted.

Esophageal leiomyoma: a 40-year experience.

Background: Esophageal leiomyomas, although infrequent, are the most common benign intramural tumors of the esophagus. They represent 10% of all gastrointestinal leiomyomas and frequently cause symptoms, necessitating resection.

Methods: The Massachusetts General Hospital Pathologic Database was reviewed over a 40-year period for patients who underwent surgical resection of esophageal leiomyomas.

Long-term survival after resection of primary adenoid cystic and squamous cell carcinoma of the trachea and carina.

Background: Tracheal resection for primary carcinoma may extend survival. We evaluated survival after surgical resection or palliative therapy to identify prognostic factors.

Methods: We conducted a retrospective study of patients diagnosed with primary adenoid cystic carcinoma (ACC) or squamous cell carcinoma (SCC) of the trachea between 1962 and 2002.

Anastomotic complications after tracheal resection: prognostic factors and management.

Objective: We sought to identify risk factors for anastomotic complications after tracheal resection and to describe the management of these patients.

Methods: This was a single-institution, retrospective review of 901 patients who underwent tracheal resection.

Results: The indications for tracheal resection were postintubation tracheal stenosis in 589 patients, tumor in 208, idiopathic laryngotracheal stenosis in 83, and tracheoesophageal fistula in 21.

Idiopathic laryngotracheal stenosis: effective definitive treatment with laryngotracheal resection.

Objective: Little was known about idiopathic laryngotracheal stenosis when it was first described. We have operated on 73 patients with idiopathic laryngotracheal stenosis, have confirmed its mode of presentation and response to surgical therapy, and have established long-term follow-up.

Methods: Charts of 73 patients treated surgically for idiopathic laryngotracheal stenosis between 1971 and 2002 were retrospectively reviewed.