Central Sleep Apnea in Adults: Diagnosis and Treatment.

Background: While the literature has demonstrated a higher prevalence of moderate-to-severe obstructive sleep apnea (OSA) in the general population compared with central sleep apnea (CSA), more evidence is needed on the long-term clinical impact of and optimal treatment strategies for CSA.

Observations: CSA is overrepresented among certain clinical populations, such as those with heart failure, stroke, neuromuscular disorders, and opioid use. The clinical concerns with CSA parallel those of OSA.

Operation Blood Rain Phase 2: Evaluating the Effect of Airdrop on Fresh and Stored Whole Blood.

Background: Transfusion of whole blood (WB) is a lifesaving treatment that prolongs life until definitive surgical intervention can be performed; however, collecting WB is a time-consuming and resource-intensive process. Furthermore, it may be difficult to collect sufficient WB at the point of injury to treat critically wounded patients or multiple hemorrhaging casualties. This study is a follow-up to the proof-of-concept study on the effect of airdrop on WB.

Minimally invasive lateral approaches for the treatment of spinal tumors: single-position surgery without the "flip".

Although primary tumors of the spine and neural elements are rare, metastatic disease to the spine is quite common. Traditionally, surgical treatment for spinal tumor patients involves open decompression with or without stabilization. The single-position minimally invasive (MIS) lateral approach, which has been recently described over the recent decade, allows simultaneous access to the anterior and posterior columns with the patient positioned in the lateral decubitus position.

Eye-Related Emergency Department Visits and The Opioid Epidemic: a 10-Year Analysis.

Purpose: To describe the epidemiology of Emergency Department (ED) visits related to opioid abuse with primary ophthalmic diagnoses in the United States (US).

Methods: This retrospective cross-sectional study used National ED Sample (NEDS) (2006-2015), a representative sample of all US EDs, to analyze and compare the epidemiology of primary ophthalmic diagnoses in opioid abusers and a control group of non-opioid users. National incidence and descriptive statistics were calculated for demographics and prevalent diagnoses.

Tissue-Sparing Posterior Cervical Fusion With Interfacet Cages: A Systematic Review of the Literature.

Study Design: Literature review.

Objectives: Posterior cervical interfacet cages are an alternative to lateral mass fixation in patients undergoing cervical spine surgery. Recently, a percutaneous, tissue-sparing system for interfacet cage placement has been developed, however, there is limited clinical evidence supporting its widespread use.

Strategic vaccination of hair sheep against Haemonchus contortus.

In this study, we evaluated in two trials a protocol designed to protect hair sheep using Barbervax®, a vaccine containing Haemonchus contortus gut membrane glycoprotein antigens. Results indicated that naturally infected vaccinated sheep had significant egg count reductions (90.2 ± 4.

Minimally invasive surgery for thoracolumbar spinal trauma.

The indications for operative intervention after thoracolumbar spine trauma have been well described. Advances in minimally invasive techniques, including percutaneous pedicle screw fixation and mini-open anterolateral retractor-based approaches can improve surgical outcomes when appropriately applied by reducing blood loss, operative duration and post-operative pain. Moreover, they allow for theoretical advantages by preservation of muscular and skeletal blood supply and innervation that is typically lost during the muscular dissection of open approaches.

Perioperative complications in patients treated with posterior cervical fusion and bilateral cages.

Context: Posterior cervical cages have recently become available as an alternative to lateral mass fixation in patients undergoing cervical spine surgery.

Aims: The purpose of this study was to quantify the perioperative complications associated with cervical decompression and fusion in patients treated with a posterior cervical fusion (PCF) and bilateral cages.

Settings And Design: A retrospective, multicenter review of prospectively collected data was performed at 11 US centers.

Acute and Hyper-acute Thoracolumbar Corpectomy for Traumatic Burst Fractures Using a Mini-open Lateral Approach.

Study Design: Retrospective chart review.

Objective: The purpose of this study was to examine the feasibility of acute (<24 hours) and hyperacute (<8 hours) treatment of thoracolumbar burst fractures to maintain or improve spinal injury scores.

Summary Of Background Data: Historically, treatment of spinal burst fractures within 24 hours from injury was considered an "acute" treatment timeframe.

Outpatient Minimally Invasive Lumbar Interbody: Fusion Predictive Factors and Clinical Results.

Study Design: Retrospective review of data from a prospective patient outcomes registry.

Objective: The object of this work was to examine patient and surgical predictors of early postoperative discharge and test the predictive model against two clinical series of outpatient minimally invasive lumbar fusion patients.

Summary Of Background Data: Outpatient and ambulatory surgery centers are regularly utilized for procedures with low-risk profiles and minimal need for extended postoperative observation, but little has been reported in lumbar spinal fusion producers.

Lumbar total disc replacement by less invasive lateral approach: a report of results from two centers in the US IDE clinical trial of the XL TDR® device.

Purpose: To evaluate the clinical and radiographic outcomes following total disc arthroplasty using the XL TDR(®) Lumbar Disc in the treatment of patients with symptomatic degenerative disc disease at one level between L1-2 and L4-5.

Methods: Data were compiled from two centers participating in a prospective, multi-center Food and Drug Administration-approved investigational device exemption clinical trial enrolling patients with single-level lumbar degenerative disc disease unresponsive to non-operative treatment. Longitudinal outcomes were evaluated through 3-year follow-up and included patient-reported pain, function, and general health, as well as radiographic measures such as maintenance of disc height and range of motion.

Mapping the kinetic and thermodynamic landscape of formaldehyde oligomerization under neutral conditions.

Density functional theory calculations, including Poisson-Boltzmann implicit solvent and free energy corrections, are applied to study the thermodynamic and kinetic free energy landscape of formaldehyde oligomerization up to the C4 species in aqueous solution at pH 7. Oligomerization via C-O bond formation leads to linear polyoxymethylene (POM) species, which are the most kinetically accessible oligomers and are marginally thermodynamically favored over their oxane ring counterparts. On the other hand, C-C bond formation via aldol reactions leads to sugars that are thermodynamically much more stable in free energy than POM species; however, the barrier to dimerization is very high.

Complications of the mini-open anterolateral approach to the thoracolumbar spine.

The mini-open anterolateral approach to the thoracolumbar spine is gaining popularity as a minimally-invasive alternative to traditional open thoracolumbar approaches. Published studies reporting and discussing the complications associated with this minimally invasive approach, however, are limited. We performed a retrospective review of patients undergoing the mini-open lateral approach to the thoracolumbar spine for corpectomy/fusion.

Dispersal of invasive forest insects via recreational firewood: a quantitative analysis.

Recreational travel is a recognized vector for the spread of invasive species in North America. However, there has been little quantitative analysis of the risks posed by such travel and the associated transport of firewood. In this study, we analyzed the risk of forest insect spread with firewood and estimated related dispersal parameters for application in geographically explicit invasion models.

A comparison of perioperative charges and outcome between open and mini-open approaches for anterior lumbar discectomy and fusion.

The objectives of this study were to examine charge data and long-term outcomes of two approaches for anterior lumbar interbody fusion: a mini-open lateral approach (extreme lateral interbody fusion, XLIF) and an open anterior approach (anterior lumbar interbody fusion, ALIF) through retrospective chart review. A total of 202 patients underwent surgery: 87 with ALIF (Open) and 115 with XLIF (Mini-open) procedures, all with transpedicular fixation. Complications occurred in 16.

Minimally invasive lateral approach for symptomatic thoracic disc herniation: initial multicenter clinical experience.

Object: Symptomatic herniated thoracic discs remain a surgical challenge and historically have been associated with significant complications. While neurological outcomes have improved with the abandonment of decompressive laminectomy, the attempt to minimize surgical complications and associated morbidities continues through less invasive approaches. Many of these techniques, such as thoracoscopy, have not been widely adopted due to technical difficulties.

Abdominal wall paresis as a complication of minimally invasive lateral transpsoas interbody fusion.

Object: The minimally invasive lateral transpsoas approach for interbody fusion has been increasingly employed to treat various spinal pathological entities. Gaining access to the retroperitoneal space and traversing the abdominal wall poses a risk of injury to the major nervous structures. Nerve injury of the abdominal wall can potentially lead to paresis of the abdominal musculature and bulging of the abdominal wall.

Minimally invasive lateral extracavitary resection of foraminal neurofibromas.

Nerve sheath tumors are the most common spinal tumors but extradural foraminal nerve sheath tumors are much rarer. Traditionally, these nerve sheath tumors have been resected via an open posterior approach. We describe an alternative minimally invasive (MIS) lateral extracavitary approach for resection of symptomatic extradural foraminal spinal neurofibromas.

Lumbarized sacrum as a relative contraindication for lateral transpsoas interbody fusion at L5-6.

Study Design: Retrospective review.

Objective: To determine if lumbarized sacra at the L5-6 level (functional L4-5) are a contraindication to a lateral transpsoas approach.

Summary Of Background Data: Transitional vertebrae at the lumbosacral junction present mechanical and morphologic changes, though these changes have not been characterized with respect to the feasibility of a lateral transpsoas approach.

Minimally invasive surgery treatment for thoracic spine tumor removal: a mini-open, lateral approach.

Study Design: Prospective registry.

Objective: The objective of this study is to examine procedural and long-term outcomes of a mini-open, lateral approach for tumor removal in the thoracic spine.

Summary Of Background Data: The majority of spinal tumors present as metastatic tumors in the thoracic spine.