Sensory Entrained TMS (seTMS) enhances motor cortex excitability.

Transcranial magnetic stimulation (TMS) applied to the motor cortex has revolutionized the study of motor physiology in humans. Despite this, TMS-evoked electrophysiological responses show significant variability, due in part to inconsistencies between TMS pulse timing and ongoing brain oscillations. Variable responses to TMS limit mechanistic insights and clinical efficacy, necessitating the development of methods to precisely coordinate the timing of TMS pulses to the phase of relevant oscillatory activity.

Creating an Empirical Dermatology Dataset Through Crowdsourcing With Web Search Advertisements.

Importance: Health datasets from clinical sources do not reflect the breadth and diversity of disease, impacting research, medical education, and artificial intelligence tool development. Assessments of novel crowdsourcing methods to create health datasets are needed.

Objective: To evaluate if web search advertisements (ads) are effective at creating a diverse and representative dermatology image dataset.

Systemically injected oxygen within rapidly dissolving microbubbles improves the outcomes of severe hypoxaemia in swine.

Acute respiratory failure can cause profound hypoxaemia that leads to organ injury or death within minutes. When conventional interventions are ineffective, the intravenous administration of oxygen can rescue patients from severe hypoxaemia, but at the risk of microvascular obstruction and of toxicity of the carrier material. Here we describe polymeric microbubbles as carriers of high volumes of oxygen (350-500 ml of oxygen per litre of foam) that are stable in storage yet quickly dissolve following intravenous injection, reverting to their soluble and excretable molecular constituents.

Reduced Incidence of Perioperative Periprosthetic Fractures Using Hybrid Rasp-Impaction Broaching Over Impaction Broaching When Using the Direct Anterior Approach for Total Hip Arthroplasty.

Background: A not infrequent complication encountered with the direct anterior approach is perioperative fracture. The purpose of this study was to compare the incidence of perioperative fractures using a hybrid rasp-impaction broach vs an impaction broach for a similarly designed stem.

Methods: Retrospective study of 798 primary total hip replacements by 1 surgeon performed using noncollared dual tapered femoral stems, including 457 implanted using hybrid rasp-impaction broaching and 341 implanted using impaction broaching.

Oscillopsia following orbitotomy for intracranial tumor resection.

Background: Oscillopsia is a visual phenomenon in which an individual perceives that their environment is moving when it is in fact stationary. In this report, we describe two patients with pulsatile oscillopsia following orbitocranial approaches for skull base meningioma resection.

Case Description: Two patients, both 42-year-old women, underwent orbitocranial approaches for resection of a right sphenoid wing (Patient 1) and left cavernous sinus (Patient 2) meningioma.

Development and Assessment of an Artificial Intelligence-Based Tool for Skin Condition Diagnosis by Primary Care Physicians and Nurse Practitioners in Teledermatology Practices.

Importance: Most dermatologic cases are initially evaluated by nondermatologists such as primary care physicians (PCPs) or nurse practitioners (NPs).

Objective: To evaluate an artificial intelligence (AI)-based tool that assists with diagnoses of dermatologic conditions.

Design, Setting, And Participants: This multiple-reader, multiple-case diagnostic study developed an AI-based tool and evaluated its utility.

Posteriorly Displaced Orbital Implant Causing Intractable Anophthalmic Socket Pain.

Anophthalmic socket pain is a rare complication of enucleation. The authors present a patient presenting with intractable anophthalmic socket pain due to a posteriorly displaced orbital implant. The patient's pain localized to the V1 and V2 orbitofacial dermatomes, and we suspect compression of the frontal and zygomatic branches of the ophthalmic and maxillary nerves, respectively, as the underlying etiology of the patient's pain.

Rapidly Enlarging Hidradenoma of the Eyelid.

Hidradenoma is a rare benign neoplasm, with few cases reported to involve the eyelid. When affecting the eyelid, hidradenomas may mimic other benign or malignant lesions. Rarely, a benign hidradenoma may transform into a malignant hidradenoma and metastasize.

Perioperative Complications Stratified by Body Mass Index for the Direct Anterior Approach to Total Hip Arthroplasty.

Background: Previous studies have addressed the increased risk of perioperative complications in the obese and morbidly obese populations undergoing total hip arthroplasty. Over the last 15 years, the direct anterior approach has increased in popularity. The purpose of this study is to compare the 90-day perioperative complication rate of total hip arthroplasty performed through the direct anterior approach stratified by body mass index (BMI).

Prevalence and Risk Factors of Exposure Keratopathy Across Different Intensive Care Units.

Purpose: To determine the prevalence and risk factors of exposure keratopathy (EK) across different intensive care units (ICU) at Columbia University Medical Center, including the Pediatric ICU (PICU), Medical ICU (MICU), and Neurologic ICU (NICU).

Methods: In this prospective cohort study, 65 patients were examined daily during their admission in the PICU (27 patients), MICU (15 patients), and NICU (23 patients). Data on eyelid position, conjunctival and corneal changes, Bell's and blink reflexes, medications, Glasgow Coma Scale rating, and ventilation type were collected.

Isolated Greater Trochanteric Fracture and the Direct Anterior Approach Using a Fracture Table.

Background: To identify the incidence, contributing factors, and outcomes of perioperative greater trochanter fractures associated with the direct anterior approach.

Methods: This is a retrospective analyses of 1401 primary THAs. Age, side, height, weight, body mass index, preoperative ambulatory status, discharge status, and hospital length of stay were identified.

Primary Cilium-Mediated Retinal Pigment Epithelium Maturation Is Disrupted in Ciliopathy Patient Cells.

Primary cilia are sensory organelles that protrude from the cell membrane. Defects in the primary cilium cause ciliopathy disorders, with retinal degeneration as a prominent phenotype. Here, we demonstrate that the retinal pigment epithelium (RPE), essential for photoreceptor development and function, requires a functional primary cilium for complete maturation and that RPE maturation defects in ciliopathies precede photoreceptor degeneration.

The learning curve for the direct anterior approach for total hip arthroplasty: a single surgeon's first 500 cases.

Background: Concerns arise over the early complications encountered during the learning curve for the direct anterior approach for total hip arthroplasty.The purpose of this study is to examine the learning experience of a single surgeon in adapting this approach.

Methods: The 1st 500 primary total hip arthroplasties are reviewed.

Risk Factors for Perioperative Femoral Fractures: Cementless Femoral Implants and the Direct Anterior Approach Using a Fracture Table.

Background: With the increased popularity of the direct anterior approach, the issue of periprosthetic femur fractures has come into focus. The purpose of this article is to identify patient- and procedure-related characteristics that are associated with periprosthetic femur fractures in cementless total hip arthroplasties performed through a direct anterior approach using a fracture table.

Methods: Five hundred primary total hip arthroplasties performed using cementless femoral implants through a direct anterior approach using a fracture table were evaluated for characteristics associated with perioperative prosthetic femur fracture within the first 3 months of surgery.

Recorrection Osteotomies and Total Knee Arthroplasties After Failed Bilateral High Tibial Osteotomies.

This article reports the case of a 58-year-old man with failed bilateral opening wedge high tibial osteotomies. Because of excessive valgus deformities, each total knee arthroplasty (TKA) was combined with a recorrection osteotomy. TKAs were performed consecutively.

Effect of Pregame Training Tutorials on Player Performance in Kinect-Based Health Games.

Objective: The objective of this study was to examine the influence of pregame tutorials on player performance in Kinect(®) (Microsoft(®), Redmond, WA)-based health games and to determine whether the additional exertion caused by longer playtime introduced by the tutorial would influence in-game performance.

Materials And Methods: Thirty-two college-age test participants were randomly assigned to two groups: pregame training tutorial and pregame verbal instructions. The variable of interest was the degree to which players were able to accurately perform a series of static arm gestures in order to duplicate specific reference poses.

Coordination of multiple services for a patient with severe lymphedema of the right lower extremity.

Surgical resection of the right lower extremity in an adult with severe lymph-edema of the extremity required intensive coordination of multiple services and specialists because of the medical and surgical complexity of the patient's condition, massive limb size, and surgical location in a children's hospital. Early and prolonged planning was necessary to anticipate problems and provide optimal care. The patient had a successful surgical outcome, improvement in medical comorbid conditions postoperatively, and improvement in the quality of life upon discharge.

The short- and long-term effect of duloxetine on painful physical symptoms in patients with generalized anxiety disorder: results from three clinical trials.

Generalized anxiety disorder (GAD) is associated with painful physical symptoms (PPS). These post hoc analyses of previous trial data assessed PPS and their response to duloxetine treatment in GAD patients. Studies 1 and 2 (n=840) were 9- to 10-week efficacy trials; study 3 (n=887) was a relapse prevention trial comprising a 26-week open-label treatment phase and a 26-week double-blind, placebo-controlled treatment continuation phase.

Implications of pain in generalized anxiety disorder: efficacy of duloxetine.

Objective: To conduct a post hoc evaluation of the prevalence of clinically significant pain and the efficacy of duloxetine in patients with generalized anxiety disorder (GAD) and concurrent pain.

Method: Data from two 9- to 10-week double-blind, placebo-controlled, randomized clinical trials of duloxetine (60 to 120 mg) in DSM-IV-defined GAD were analyzed (study 1 was conducted from July 2004 to September 2005; study 2 was conducted from August 2004 to June 2005). Efficacy was assessed with the Hamilton Rating Scale for Anxiety (HAM-A), visual analog scales (VAS) for pain, the Hospital Anxiety Depression Scale (HADS), the Clinical Global Impressions-Improvement of Illness (CGI-I) scale, the Patient Global Impressions-Improvement (PGI-I) scale, and the Sheehan Disability Scale (SDS) global functional impairment scale.

Efficacy and tolerability of duloxetine in elderly patients with generalized anxiety disorder: a pooled analysis of four randomized, double-blind, placebo-controlled studies.

Objective: To assess the efficacy and tolerability of duloxetine in elderly patients with generalized anxiety disorder (GAD).

Methods: Acute-phase data from a subset of patients (>or=65 years) with GAD were pooled from four randomized, double-blind, placebo-controlled trials of duloxetine (3 flexible, 1 fixed dosing). Patients were treated with duloxetine 60-120 mg once daily or placebo for 9-10 weeks.

Primary meniscal-bearing knee replacements: 8- to 15-year followup.

This study presents the survivorship data of a consecutive series of primary meniscal-bearing total knee replacements at one institution at 8 to 15 years followup. We reviewed 125 meniscal-bearing knee replacements in 93 patients at a minimum followup of 96 months (mean, 130 months; range, 96-191 months). The tibial and femoral components were cemented in 71 knees; uncemented femurs and tibias were used in 48 knees; and cemented tibias and uncemented femurs were used in six knees.

Efficacy of duloxetine in the treatment of generalized anxiety disorder in patients with clinically significant pain symptoms.

Anxiety disorders often are accompanied by painful physical symptoms. This report assessed the effectiveness of duloxetine in improving anxiety symptoms, pain severity, and patient functioning in adults diagnosed with generalized anxiety disorder (GAD), who presented with clinically significant pain symptoms. Data were pooled from two multicenter, randomized, double-blind, placebo-controlled clinical studies evaluating the efficacy of duloxetine 60-120 mg once daily compared with placebo in the treatment of GAD.

Pharmacotherapy of generalized anxiety disorder: results of duloxetine treatment from a pooled analysis of three clinical trials.

Objective: Duloxetine is a serotonergic noradrenergic reuptake inhibitor with demonstrated efficacy in each of three independent studies for treatment of adults with generalized anxiety disorder (GAD). A pooled dataset from all completed trials is provided here to show the most likely clinical outcomes associated with duloxetine treatment for GAD.

Research Design And Methods: Data were summed at the individual patient level from three double-blind, placebo-controlled trials of duloxetine treatment: two were 10-week flexible-dose 60-120 mg/day and one was 9-week fixed dose 60 or 120 mg/day.

Duloxetine as an SNRI treatment for generalized anxiety disorder: results from a placebo and active-controlled trial.

This study examined the efficacy and tolerability of duloxetine 60-120 mg/day for the treatment of patients with generalized anxiety disorder. This was a multicenter, randomized, double-blind, flexible-dose, placebo and active-controlled (venlafaxine extended-release 75-225 mg/day) trial designed to assess duloxetine 60-120 mg/day during 10 weeks of treatment in adults with Diagnostic and statistical manual of mental disorders-IV-defined generalized anxiety disorder. The primary efficacy outcome measure was mean change from baseline to endpoint in the Hamilton Anxiety Rating Scale total score assessed using analysis of covariance.