Pharmacoresistant seizures occur in nearly one-third of people with epilepsy. Medial temporal lobe and lesional epilepsy are the most favorable surgically remediable epileptic syndromes. Successful surgery may render the patient seizure-free, reduce antiseizure drug(s) adverse effects, improve quality of life, and decrease mortality. Surgical management should not be considered a procedure of "last resort." Despite the results of randomized controlled trials, surgery remains an underutilized treatment modality for patients with drug-resistant epilepsy (DRE). Important disparities affect patient referral and selection for surgical treatment. This article discusses the advances in surgical treatment of DRE in adults with focal seizures.
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http://dx.doi.org/10.1016/j.ncl.2020.09.010 | DOI Listing |
Case Rep Dent
January 2025
Department of Cranio-Maxillofacial Surgery, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, India.
For managing peri-implantitis, a variety of treatment modalities involving both surgical and nonsurgical methods including implantoplasty have been proposed. Implants that are placed in a free fibula flap are more prone to peri-implantitis due to the absence of firm, keratinized mucosa. Prosthetic design that offers adequate hygiene access should be designed whenever possible; otherwise, it may lead to the accumulation of plaque or biofilm that may lead to peri-implant diseases.
View Article and Find Full Text PDFFront Neural Circuits
January 2025
Department of Advanced Medical and Surgical Sciences, Advanced MRI Research Center, University of Campania "Luigi Vanvitelli", Naples, Italy.
The substantia nigra pars compacta (SNc), one of the main dopaminergic nuclei of the brain, exerts a regulatory function on the basal ganglia circuitry via the nigro-striatal pathway but its possible dopaminergic innervation of the thalamus has been only investigated in non-human primates. The impossibility of tract-tracing studies in humans has boosted advanced MRI techniques and multi-shell high-angular resolution diffusion MRI (MS-HARDI) has promised to shed more light on the structural connectivity of subcortical structures. Here, we estimated the possible dopaminergic innervation of the human thalamus via an MS-HARDI tractography of the SNc in healthy human young adults.
View Article and Find Full Text PDFInt J Burns Trauma
December 2024
School of Medicine, Islamic Azad University, Najafabad Branch Isfahan, Iran.
The management of complex burn injuries has evolved significantly, with various surgical techniques developed to improve outcomes. This review examines the evolution of these methods, focusing particularly on mesh grafting and the Meek technique. While mesh grafting is effective, it poses challenges such as limited graft coverage and a high demand for autologous skin.
View Article and Find Full Text PDFOrthop J Sports Med
January 2025
Twin Cities Orthopedics, Edina, Minnesota, USA.
Background: Ice hockey players have a high rate of hip pathology, which can lead to hip arthroscopy. Previous studies have not utilized team-based advanced performance statistics in the setting of hip arthroscopy in National Hockey League (NHL) players.
Purpose/hypothesis: The purpose of this study was to use team-based advanced performance statistics to evaluate postoperative performance after hip arthroscopy in NHL players in comparison with their preoperative performance and matched controls of uninjured skaters.
J Clin Orthop Trauma
March 2025
Department of Orthopaedics, Woodend Hospital, Aberdeen, AB15 6XS, UK.
Reverse shoulder arthroplasty (RSA) has witnessed a significant advancement with the introduction of lateralisation techniques, aiming to enhance shoulder function and implant durability. Traditional medialised designs, following Grammont's principles, have encountered challenges such as scapular notching, reduced rotational strength, and instability. In contrast, lateralisation methods, which reposition the joint center of rotation laterally on the glenoid, humerus, or both, seek to improve deltoid leverage, optimize the rotator cuff muscles' length-tension relationship, and enhance joint stability.
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