Therapeutic Reference Range for Aripiprazole in Schizophrenia Revised: a Systematic Review and Metaanalysis.

Rationale: While one of the basic axioms of pharmacology postulates that there is a relationship between the concentration and effects of a drug, the value of measuring blood levels is questioned by many clinicians. This is due to the often-missing validation of therapeutic reference ranges.

Objectives: Here, we present a prototypical meta-analysis of the relationships between blood levels of aripiprazole, its target engagement in the human brain, and clinical effects and side effects in patients with schizophrenia and related disorders.

TDM in psychiatry and neurology: A comprehensive summary of the consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology, update 2017; a tool for clinicians.

Objectives: Therapeutic drug monitoring (TDM) combines the quantification of drug concentrations in blood, pharmacological interpretation and treatment guidance. TDM introduces a precision medicine tool in times of increasing awareness of the need for personalized treatment. In neurology and psychiatry, TDM can guide pharmacotherapy for patient subgroups such as children, adolescents, pregnant women, elderly patients, patients with intellectual disabilities, patients with substance use disorders, individuals with pharmacokinetic peculiarities and forensic patients.

Syndesmosis preserving osteotomy of the fibula for access to the lateral talar dome.

Background: Open surgical access to the postero-lateral talar dome for the treatment of osteochondral lesions is challenging, often requiring a segmental osteotomy of the fibula (fibular window) and division of the anterior inferior tibiofibular ligament (AITFL) or a fibular osteotomy with division of the AITFL and the anterior talofibular ligament (ATFL) (fibular door). Alternatively, to preserve the tibiofibular syndesmosis both the fibula and the lateral tibial plafond can be osteotomised to expose the entire lateral talar dome. All of these techniques involve extensive surgical exposures and a significant amount of internal fixation of the osteotomy to achieve surgical access.

Performance test of different 3.5 mm drill bits and consequences for orthopaedic surgery.

Introduction: Drilling of bones in orthopaedic and trauma surgery is a common procedure. There are yet no recommendations about which drill bits/coating should be preferred and when to change a used drill bit.

Materials And Methods: In preliminary studies typical "drilling patterns" of surgeons concerning used spindle speed and feeding force were recorded.

Clamshell thoracotomy and open heart massage--A potential life-saving procedure can be taught to emergency physicians: An educational cadaveric pilot study.

Aims: Selected patients in traumatic cardiac arrest may benefit from pre-hospital thoracotomy. Pre-hospital care physicians rarely have surgical training and the procedure is rarely performed in most European systems. Limited data exists to inform teaching and training for this procedure.

The risk of injury to the peroneal artery in the posterolateral approach to the distal tibia: a cadaver study.

Objectives: The posterolateral approach to the distal tibia allows excellent visualization, direct reduction, and stabilization of posterior malleolar fractures. Concomitant fractures of the lateral malleolus may be internally fixed through the same approach. The approach may also be used for pilon fractures and for bone grafting in nonunions.

The influence of ultrasound guidance in the rate of success of acromioclavicular joint injection: an experimental study on human cadavers.

Background: Injections of the acromioclavicular joint (ACJ) are performed routinely in patients with ACJ arthritis, both diagnostically and therapeutically. The aim of this prospective controlled study was to estimate the frequency of successful intra-articular ACJ injections with the aid of sonographic guidance versus non-guided ACJ injections.

Materials And Methods: A total of 80 cadaveric ACJs were injected with a solution containing methylene blue and subsequently dissected to distinguish intra- from peri-articular injections.

Drilling, not a benign procedure: laboratory simulation of true drilling depth.

Introduction: Drilling is an integral part of almost all boney operations. Various anatomical structures coursing close to the bone are at risk if the drill bit projects beyond the far cortex. Aim of this study was to evaluate and quantify the depth to which surgeons over drill beyond the far cortex.

Anatomical structures at risk with the proud retrograde femoral nail.

Background: Post-operative knee pain is common following retrograde nailing, with its etiology often multifactorial although a well-established cause is nail protrusion from the intercondylar notch. The aim of this study was to assess the structures at risk if the nail is left proud of the femoral articular surface.

Methods: A retrograde femoral nail (Synthes Distal Femoral Nail) was inserted into the distal femur of 15 cadaveric lower limbs using the standard technique.

Accuracy of anterolateral versus posterolateral subtalar injection.

Introduction: Injections into the subtalar joint may be performed for diagnostic or therapeutic reasons. The anterolateral approach is most commonly utilised for this purpose. We evaluated the success of an intra-articular puncture by using the anterolateral in comparison to the posterolateral approach.

Anatomical basis of the risk of radial nerve injury related to the technique of external fixation applied to the distal humerus.

Purpose: Stabilization of humeral shaft and elbow fractures can be achieved with an external-fixator. Reports about nerve injuries associated with this procedure are rare in literature. Purpose of this anatomical study was to examine the relation of the radial nerve to distal humeral half pins.

Various circular arc radii of the distal volar radius and the implications on volar plate osteosynthesis.

The purpose of this anatomical study was to explore the different circular arc radii of the distal volar radius and provide more detailed anatomic information that will further the understanding of volar plate osteosynthesis. The profiles of the volar distal radii of 100 cadaver specimens were measured with a common profile gauge. Profiles were copied onto paper and then matched to a best-fit circular arc template to determine the radius of curvature on the radial and ulnar sides of the distal volar radius.

Morphometric analysis of lister's tubercle and its consequences on volar plate fixation of distal radius fractures.

Purpose: The objective of this study was to measure the size and shape of Lister's tubercle and the depth of the extensor pollicis longus (EPL) groove to assess the risk of injury to the EPL tendon when performing volar plating of distal radius fractures.

Methods: The length and height of Lister's tubercle and the depth of the EPL groove were measured in 100 cadavers.

Results: The size of Lister's tubercle varied from 2 to 6 mm (average, 3.

Frequency of instrument breakage during orthopaedic procedures and its effects on patients.

Background: While breakage of an orthopaedic instrument is a relatively rare occurrence, orthopaedic surgeons need to be familiar with this complication and how to deal with it. Relatively little information about this subject has been published.

Methods: Every case of instrument breakage during orthopaedic procedures performed in two hospitals during a two-year period was documented prospectively.

The anatomy of the proximal ulna.

The posterior border of the ulna is the most important bony landmark for all dorsal surgical approaches and the guideline for open reduction, internal fixation of displaced comminuted fractures of the proximal ulna. We examined 74 cadaveric specimens to evaluate the anatomy of the proximal ulna, especially the course of the posterior border, the point of varus angulation, the width of the shaft, and the relationship of the posterior border to the interosseous and anterior ones. In 63 specimens, the mean point of varus angulation was 85.

Primary transection of the superficial peroneal nerve resulting from a distal fibula fracture.

Although a superficial peroneal nerve injury following an ankle fracture occurs frequently, primary transection of the nerve represents a rare injury. This report documents a case of primary lesion of the superficial peroneal nerve sustained following a Weber B bimalleolar ankle fracture. The nerve injury was diagnosed at the initial examination when the patient was found to have hypoesthesia in the area of her third to fifth toes.

Anatomy of the greater femoral trochanter: clinical importance for intramedullary femoral nailing. Anatomic study of 100 cadaver specimens.

Background: Fossa piriformis is considered the correct point of entry for a straight femoral nail. A trochanteric overhang may make the access to fossa piriformis difficult. We investigated the anatomy of the trochanteric region, paying special attention to the entry point for antegrade intramedullary femoral nailing.

A morphometrical study of the medullary cavity of the ulna referred to intramedullary nailing.

Intramedullary fixation is preferred for osteosynthesis in the case of long bone fractures; but the problem of the nails' adjustment to the anatomical needs remains. About 80 cadaveric ulnae were examined to elucidate the curvature of the medullary cavity, the point of varus angulation, the thickness of the radial and ulnar cortical bone and the diameter of the medullary cavity at that point. Furthermore, the point of varus angulation of the posterior border was compared to that of the medullary cavity, to evaluate if it allows any conclusion to the curvature of the medullary cavity.

Delayed hypopharyngeal and esophageal perforation after anterior spinal fusion: primary repair reinforced by pedicled pectoralis major flap.

Study Design: This report documents a case of delayed hypopharyngeal and esophageal perforation after anterior spinal fusion and reviews relevant literature.

Objectives: Presentation of an alternative solution of primary repair and reinforcement of a delayed esophageal and hypopharyngeal perforation after anterior spinal fusion.

Summary Of Background Data: Anterior plating is generally used for stabilization after cervical spine trauma.

1-trichloromethyl-1,2,3,4-tetrahydro-beta-carboline (TaClo) induces apoptosis in human neuroblastoma cell lines.

The former popular hypnotic chloral hydrate has been known to spontaneously condense with tryptamine in the body to give rise to a highly unpolar 1-trichloromethyl-1,2,3,4-tetrahydro-beta-carboline (TaClo) derivative. Earlier studies have revealed the relative permeability of the molecule through the body, and its ability to induce Parkinson-like symptoms in rats. In this study, we report that TaClo is a highly cytotoxic agent that leads to apoptosis in human neuroblastoma cells involving caspase-3 activation.