Publications by authors named "Jacob Topfer"
Article Synopsis
- Spinal anesthesia, first performed by Dr. August Bier on August 16, 1898, involved injecting cocaine into the spinal cord to provide pain relief during surgery, marking a significant advancement in anesthesia techniques.
- Despite its initial success, concerns about the potential toxic effects of local anesthetics led to the development of newer drugs with a wider therapeutic window and the addition of adjuvants like epinephrine and alpha-2 agonists to enhance safety and effectiveness.
- This review aims to explore the current understanding of spinal anesthesia, its indications and contraindications, and the role of adjuvants, drawing insights from recent literature on alpha-2 agonists from 2015 to the present.
Importance: Buprenorphine is a Schedule III analgesic that is recommended as the firstline long-acting opioid for the treatment of chronic pain due to its ceiling effect on respiratory depression, adverse effect profile, and analgesic efficacy. However, prescription drug coverage policies commonly require that patients try and fail multiple Schedule II conventional opioids before approval of on-label use of buprenorphine for chronic pain.
Design: A retrospective review was performed looking at coverage of buprenorphine in the forms of Butrans and Belbuca.
Article Synopsis
- Expandable endoprostheses are effective for treating limb-length inequality in young patients with lower extremity bone sarcomas, allowing limb-sparing procedures.
- In a study of 7 patients, the average Musculoskeletal Tumor Society (MSTS) score was 93.3%, with noninvasive and minimally invasive options yielding scores of 97% and 85%, respectively.
- While complications like nerve issues and infections were noted, none of the patients required amputation, indicating these reconstruction methods can significantly improve quality of life for these patients.
Soft tissue sarcomas arising in the foot and ankle are often misdiagnosed, resulting in excision without adequate preoperative staging or surgical margins. The goal of the present study was to review a case series of soft tissue sarcomas of the foot and ankle with attention directed at unplanned excisions of sarcomas. An unplanned excision means that a patient either underwent an inadequate preoperative workup or the preoperative workup indicated a benign entity, resulting in surgical resection.
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