Progressive lifespan modifications in the corpus callosum following a single juvenile concussion in male mice monitored by diffusion MRI.

Introduction: The sensitivity of white matter (WM) in acute and chronic moderate-severe traumatic brain injury (TBI) has been established. In concussion syndromes, particularly in preclinical rodent models, there is lacking a comprehensive longitudinal study spanning the lifespan of the mouse. We previously reported early modifications to WM using clinically relevant neuroimaging and histological measures in a model of juvenile concussion at one month post injury (mpi) who then exhibited cognitive deficits at 12mpi.

Estimating the total treatment effect in randomized experiments with unknown network structure.

Randomized experiments are widely used to estimate the causal effects of a proposed treatment in many areas of science, from medicine and healthcare to the physical and biological sciences, from the social sciences to engineering, and from public policy to the technology industry. Here we consider situations where classical methods for estimating the total treatment effect on a target population are considerably biased due to confounding network effects, i.e.

Discoidin Domain Receptor-Driven Gene Signatures as Markers of Patient Response to Anti-PD-L1 Immune Checkpoint Therapy.

Background: Anti-programmed cell death 1 (anti-PD-1) and PD ligand 1 (PD-L1) immune checkpoint therapies (ICTs) provided durable responses only in a subset of cancer patients. Thus, biomarkers are needed to predict nonresponders and offer them alternative treatments. We recently implicated discoidin domain receptor tyrosine kinase 2 (DDR2) as a contributor to anti-PD-1 resistance in animal models; therefore, we sought to investigate whether this gene family may provide ICT response prediction.

Extracorporeal Shock Wave Therapy Combined with Complex Decongestive Therapy in Patients with Breast Cancer-Related Lymphedema: A Systemic Review and Meta-Analysis.

Breast cancer-related lymphedema (BCRL) is one of the most significant complications seen after surgery. Several studies demonstrated that extracorporeal shock wave therapy (ESWT), in addition to conventional complex decongestive therapy (CDT), had a positive effect on BCRL in various aspects. The systematic review and meta-analysis aim to explore the effectiveness of ESWT with or without CDT on BRCL patients.

Minimal invasive surgical algorithm for revision lumbar spinal surgery.

Background: Revision spinal surgery following primary spinal fusion procedure occurs in 8-45% of cases. Reasons for revision include recurrence of stenosis, non-union, implant failure, infection, adjacent segment degeneration and flat back fusion. With the rise in elective lumbar fusion rates, it is expected that the rate for revision spinal surgery will also increase with time.

Image-guided pedicle screws using intraoperative cone-beam CT and navigation. A cost-effectiveness study.

Image-guided surgery using intraoperative cone-beam CT and navigation improves screw placement accuracy rates. However, this technology is associated with high acquisition costs. The aim of this study is to evaluate the costs of revision surgery from symptomatic pedicle screw malposition to justify whether the costs of acquiring intraoperative navigation justify the expected benefits.

The incidence of new onset sacroiliac joint pain following lumbar fusion.

Background: The sacroiliac joint (SIJ) can be a new source of pain following lumbar fusion. The aim of this study was to identify the incidence of and predisposing factors for new onset SIJ pain following successful lumbar fusion.

Methods: We review our series of 317 patients who underwent spinal fusion in the past 5 years to identify patients who developed new onset SIJ pain.

Acupuncture effect on digestion in critically ill postoperative oral and hypopharyngeal cancer patients: A protocol for double-blind randomized control trial.

Introduction: Head and neck cancer patients are at a high risk to suffer from malnourishment, a risk that increases in postoperative condition and with the use of enteral nutrition (EN). Until now patients who are suffering from indigestion in the intensive care unit (ICU) received treatment in the form of prokinetic drugs, drugs that can lead to serious side effects and only can partially improve digestion functions. Acupuncture was used successfully in several clinical trials to improve postoperative indigestion in cancer patients without any reported adverse events.

Minimally invasive stabilization for thoracolumbar and lumbar fractures: a comparative study with short segment open Schanz screw constructs.

Background: Analysis was performed of two patient cohorts who underwent fixation without fusion for unstable thoracolumbar and lumbar fractures: (I) minimally invasive surgery (MIS) group using combined monoaxial-polyaxial pedicle screws inserted percutaneously; (II) open surgery (OS) group using Schanz screw constructs. Our aim was to compare radiographic and clinical indices of the 'gold standard' of open Schanz screw to MIS monoaxial-polyaxial screw constructs.

Methods: There were 13 patients in the MIS group and 19 in the OS group.

Minimally invasive stabilization of the fractured ankylosed spine: a comparative case series study.

Background: To compare the outcome of minimally invasive fracture stabilization to traditional open methods in the thoracolumbar region in patients with an ankylosing disorder of the spine.

Methods: A prospective, ethics-approved database (Spine Tango) at a tertiary referral center was retrospectively reviewed for results of surgery on fractures of the ankylosed thoracolumbar spine. These were then split by surgical technique into two cohorts: minimally invasive surgical fixation (MIS group) or standard open surgery (open group).

Effects of High-Dose α-Lipoic Acid on Heart Rate Variability of Type 2 Diabetes Mellitus Patients with Cardiac Autonomic Neuropathy in Korea.

Background: Diabetic cardiac autonomic neuropathy (CAN) is one of the important complications of diabetes. It is characterized by reduced heart rate variability (HRV).

Methods: In this randomized, double-blind, placebo-controlled, multicenter trial, 75 patients were randomly assigned to one of two groups.

Most Cited Publications in Cervical Spine Surgery.

Purpose: The purpose of this study is to perform a citation analysis on the most frequently cited articles in the topic of cervical spine surgery and report on the top 100 most cited publication in this topic.

Methods: We used the Thomson Reuters Web of Science to search citations of all articles from 1945 to 2015 relevant to cervical spine surgery and ranked them according to the number of citations. The 100 most cited articles that matched the search criteria were further analyzed by number of citations, first author, journal, year of publication, country and institution of origin.

Traumatic subaxial cervical facet subluxation and dislocation: epidemiology, radiographic analyses, and risk factors for spinal cord injury.

Background Context: Distractive flexion injuries (DFIs) of the subaxial cervical spine are major contributors to spinal cord injury (SCI). Prompt assessment and early intervention of DFIs associated with SCI are crucial to optimize patient outcome; however, neurologic examination of patients with subaxial cervical injury is often difficult, as patients commonly present with reduced levels of consciousness. Therefore, it is important to establish potential associations between injury epidemiology and radiographic features, and neurologic involvement.

Differentiation between Glioblastoma Multiforme and Primary Cerebral Lymphoma: Additional Benefits of Quantitative Diffusion-Weighted MR Imaging.

The differentiation between glioblastoma multiforme (GBM) and primary cerebral lymphoma (PCL) is important because the treatments are substantially different. The purpose of this article is to describe the MR imaging characteristics of GBM and PCL with emphasis on the quantitative ADC analysis in the tumor necrosis, the most strongly-enhanced tumor area, and the peritumoral edema. This retrospective cohort study collected 104 GBM (WHO grade IV) patients and 22 immune-competent PCL (diffuse large B cell lymphoma) patients.

Operative Management of Lumbar Degenerative Disc Disease.

Lumbar degenerative disc disease is extremely common. Current evidence supports surgery in carefully selected patients who have failed non-operative treatment and do not exhibit any substantial psychosocial overlay. Fusion surgery employing the correct grafting and stabilization techniques has long-term results demonstrating successful clinical outcomes.

Impact of 12-s Rule on Performance and Muscle Damage of Baseball Pitchers.

Introduction: A recent US Major League Baseball (MLB) rule change requires baseball pitchers to deliver pitches within 12 s.

Purposes: To examine the effect of three between-pitch rest intervals on throwing performance during a simulated seven-inning game and muscle damage during postgame recovery.

Design: A randomized counterbalanced study.

Cable-Augmented, Quad Ligament Tenodesis Scapholunate Reconstruction.

Maintaining reduction of the scapholunate interval after reconstruction can be difficult. The authors performed scapholunate reconstruction using tensionable suture anchors in 8 patients. The anchors provide a fixed cable that both fixes the graft, and reduces the scapholunate diastasis and maintains reduction.

Reconstruction of Chronic Foveal TFCC Tears with an Autologous Tendon Graft.

Background A triangular fibrocartilage complex (TFCC) injury can produce distal radioulnar joint (DRUJ) instability. If the foveal attachment is avulsed, it translates distally. The footprint is separated from its origin and will become covered in synovitis, preventing healing.

Anatomic foveal reconstruction of the triangular fibrocartilage complex with a tendon graft.

An acute injury to the triangular fibrocartilage complex (TFCC) with avulsion of the foveal attachment can produce distal radioulnar joint (DRUJ) instability. The avulsed TFCC is translated distally so the footprint will be bathed in synovial fluid from the DRUJ and will become covered in synovitis. If the TFCC fails to heal to the footprint, then persistent instability can occur.

Posterolateral and anterolateral approaches to unicondylar posterolateral tibial plateau fractures: a comparative study.

Background: Lateral tibial plateau fractures that are located posterolaterally are difficult to reduce through an anterolateral surgical approach because of the lack of direct visualisation of the fracture. This study compared the results of unicondylar posterolateral tibial plateau fractures in two patient cohorts: one treated through a posterolateral direct approach and the other through an anterolateral indirect approach.

Patients And Methods: All nine patients admitted to our hospital, a tertiary care, urban, public hospital in Australia, from 2007 to 2010 with unicondylar posterolateral tibial plateau fractures were treated through a direct posterolateral transfibular approach and prospectively studied.

Cable-augmented, quad ligament tenodesis scapholunate reconstruction: rationale, surgical technique, and preliminary results.

Eight patients underwent scapholunate reconstruction using tensionable suture anchors. Adapted from a modified Brunelli technique, the anchors provide a fixed cable that reduces the scapholunate diastasis and maintains reduction during the healing phase. The flexor carpi radialis tendon graft is advanced through the scaphoid and stabilizes the volar scaphotrapezial ligament, dorsal scapholunate ligament, dorsal intercarpal ligament, and dorsal radiocarpal ligament.

Repair of the acutely unstable elbow: use of tensionable anchors.

Acute ruptures of the medial or lateral collateral ligaments of the elbow associated with elbow dislocations have traditionally been repaired back to their respective epicondyles using suture anchors or transosseous sutures. Tensioning of those ligaments using conventional techniques had been difficult because of the need to maintain tension while tying and securing sequential knots. Tensionable anchors are a new generation of anchors that have been used for rotator cuff repair, but can be employed for the repair of collateral ligaments and capsular tears.

The effect of hip position on the length of trochanteric muscles: potential implications for early postoperative management of hip arthroplasty.

We investigated the effect several lower limb positions have on muscles that are detached to perform hip arthroplasty through posterior and lateral approaches. We used string models and computer navigation to measure the length changes in these muscles throughout hip movements in the anatomical planes and while simulating several sitting and lying postures. Piriformis and the obturators were shortened by sitting and lying postures when the femur was externally rotated and abducted; the clinical implication being that such postures have the potential to best protect their repair after a posterior approach.

Confirmation of microevolutionary increase in spina bifida occulta among Swiss birth cohorts.

Previous studies on the prevalence of spina bifida occulta have indicated a microevolutionary increase in its frequency and possible population differences in the prevalence of the condition. We studied the frequencies of closed and open sacral canals at each sacral level among two birth cohorts in Switzerland. Transverse CT scans and multiplanar reconstruction images of sacra of 95 males and 96 females born in 1940-1950 and 99 males and 94 females born in 1970-1980 in Switzerland were reviewed.