Nerve transfers for brachial plexus injuries: grading of volitional control.

Objective: After brachial plexus injuries (BPIs), nerve transfers are used to restore lost muscle function. Brain plasticity underlies the process of regaining volitional control, which encompasses disconnection of the original donor nerve-related programs and reconnection to acceptor nerve programs. To the authors' knowledge, the levels of disconnection and reconnection have never been studied systematically.

Usefulness of Glucose Measurement To Assess Tissue Perfusion of the Nipple-Areola Complex in Conservative Mastectomy: A Prospective Cohort Study Protocol.

Unlabelled: In recent decades, the mastectomy technique has undergone progressive adaptations in order to preserve the integrity of the breast structure and the nipple-areola complex (NAC), allowing reconstruction to be performed immediately after ablation. However, mastectomy flap necrosis or NAC has become a common complication, with an incidence between 2% and 22.3%.

Lumbosacral DREZotomy for oncologic pain treatment: a case-based review.

Purpose: To present 3 cases of oncologic pain treated by DREZotomy in the pediatric population and to review the literature published about this procedure.

Methods: The permanent literature about oncologic pain treatment in children and the applicability of DREZotomy was reviewed. Three cases treated at our institution were reviewed and presented.

Fortification of staple foods with calcium: a novel costing tool to inform decision making.

Low calcium intake and its impact on maternal and child health are a major concern in low- and middle-income countries. Given the low calcium in diet, as well as the low adherence and acceptability of calcium pills in those settings, the discussion about policies to increase calcium intake has moved toward staple food fortification strategies. Nevertheless, there is scarce information on the economic feasibility of implementing these strategies.

New insights into the evaluation of peripheral nerves lesions: a survival guide for beginners.

Purpose: To perform a review of the physical basis of DTI and DCE-MRI applied to Peripheral Nerves (PNs) evaluation with the aim of providing readers the main concepts and tools to acquire these types of sequences for PNs assessment. The potential added value of these advanced techniques for pre-and post-surgical PN assessment is also reviewed in diverse clinical scenarios. Finally, a brief introduction to the promising applications of Artificial Intelligence (AI) for PNs evaluation is presented.

Who is talking about #Facelift on Instagram?

Background: The internet has become a powerful tool for disseminating medical information. Social media platforms have gained popularity among medical professionals to connect with patients and promote their work and practices. We aimed to understand who is posting about facelift procedure on Instagram.

A novel dual nerve transfer for restoration of shoulder function and sensory recovery of the hand, in patients with C567 traumatic root avulsion of the brachial plexus.

Objective: The objective of our study is to determine the anatomical viability in cadavers of a novel doble nerve transfer technique for simultaneous reanimation of shoulder abduction and sensory recovery of the hand, in patients with brachial plexus injuries sustaining a C5-C6-C7 roots avulsion. These new transfers should be complemented in the clinical setting with other classic nerve transfers, i.e.

Nerve autofluorescence under near-ultraviolet light: cutting-edge technology for intra-operative neural tissue visualization in 17 patients.

Background: Nerve visualization and the identification of other neural tissues during surgery is crucial for numerous reasons, including the prevention of iatrogenic nerve and neural structure injury and facilitation of nerve repair. However, current methods of intra-operative nerve detection are generally expensive, unproven, and/or technically challenging. Recently, we have documented, in both in vivo animal models and ex vivo human tissue, that nerves autofluorescence when viewed in near-ultraviolet light (NUV).

Cost-effectiveness of a Multicomponent Intervention for Hypertension Control in Low-Income Settings in Argentina.

Importance: Hypertension is highly prevalent in low- and middle-income countries, and it is an important preventable risk factor for cardiovascular diseases (CVDs). Understanding the economic benefits of a hypertension control program is valuable to decision-makers.

Objective: To evaluate the long-term cost-effectiveness of a multicomponent hypertension management program compared with usual care among patients with hypertension receiving care in public clinics in Argentina from a health care system perspective.

Dual Antiplatelet Therapy after PCI in Patients at High Bleeding Risk.

Background: The appropriate duration of dual antiplatelet therapy in patients at high risk for bleeding after the implantation of a drug-eluting coronary stent remains unclear.

Methods: One month after they had undergone implantation of a biodegradable-polymer sirolimus-eluting coronary stent, we randomly assigned patients at high bleeding risk to discontinue dual antiplatelet therapy immediately (abbreviated therapy) or to continue it for at least 2 additional months (standard therapy). The three ranked primary outcomes were net adverse clinical events (a composite of death from any cause, myocardial infarction, stroke, or major bleeding), major adverse cardiac or cerebral events (a composite of death from any cause, myocardial infarction, or stroke), and major or clinically relevant nonmajor bleeding; cumulative incidences were assessed at 335 days.

Differences in management and treatment of traumatic adult pan brachial plexus injuries: a global perspective regarding continental variations.

An expert opinion study was designed to query five countries and six brachial plexus surgeons regarding the demographics, mechanisms of injury, evaluation, timing of surgery, reconstructive strategies and controversies in adult traumatic pan brachial plexus injuries. Variations in assessing outcomes, management of neuropathic pain and future considerations were elucidated. Clear differences in regional demographics, mechanisms of injury, patient evaluation and treatment strategies were identified.

Mechanical Thromboprophylaxis Alone in Body Contouring Surgery for Post Massive Weight Loss Patients: Is this Good Enough?

Background: Although the use of pharmacological thromboprophylaxis effectively reduces Deep vein thrombosis (DVT) incidence after body contouring surgery, this might increase the risk of bleeding and hematoma formation. In this scenario, the use of mechanical prophylaxis alone could be an attractive alternative. We aimed to evaluate the incidence of DVT in patients with massive weight loss undergoing body contouring surgeries in whom mechanical prophylaxis alone was indicated.

Neuropathic inguinal pain due to nerve injury after a laparoscopic appendectomy: first pediatric case described in the literature.

Objective: To describe the first pediatric case in the literature of neuropathic inguinal pain secondary to iatrogenic nerve injury that occurred during a laparoscopic appendectomy, detailing clinical and morphological findings before and after surgery. The literature on adult patients is reviewed and pathophysiological, therapeutic, and prognostic factors are discussed.

Clinical Presentation: A 14-year-old female patient presented with a history of a laparoscopic appendectomy 3 years previously.

Approach to the Superior Ophthalmic Vein for Endovascular Treatment of Cavernous Dural Fistula.

The cavernous sinus area is the second most common location for intracranial dural fistulas. Although these spontaneous dural cavernous fistulas are self-limited, a sizeable number of patients will develop progressive vision loss, diplopia, or intractable glaucoma, which warrant interventional therapy. We present the case of a 54-year-old male with hypertension and type 2 diabetes, who presented with a red right eye associated with progressive exophthalmos, ophthalmoparesis, and deterioration of visual acuity.

A Value Framework for the Assessment of Diagnostic Technologies: A Proposal Based on a Targeted Systematic Review and a Multistakeholder Deliberative Process in Latin America.

Objectives: there are very few value frameworks (VFs) to assess health technologies that are focused on diagnostic tests; they usually do not reflect a multistakeholder process; and they are all developed in high-income countries. Our project performed a targeted systematic review, with the objective of proposing an evidence-based, up-to-date VF informed by a multinational multistakeholder group working in the health technology assessment (HTA) space.

Methods: (1) A targeted systematic review, with the aim to identify existing VFs and their dimensions; and (2) generation a VF proposal through a mixed-methods, qualitative-quantitative approach.

A Novel Low-Cost Exoscopy Station for Training Neurosurgeons and Neurosurgery Trainees.

Background: The loss of stereopsis and the need for markedly enhanced hand-eye coordination are obstacles to overcome when performing exoscopic procedures, but both should improve with training. Our objectives were to describe an exoscopy training station and to compare time and performance of a given microsurgical technique among neurosurgery residents and junior neurosurgeons.

Methods: We designed a low-cost exoscopy training station featuring a notebook computer, a webcam, and a light-emitting diode source.

Brain changes after peripheral nerve repair: limitations of neuroplasticity.

Neuroplasticity is the capacity of the central nervous system to adapt to external or internal stimuli. It is being increasingly recognized as an important factor which contributes to the successful outcome of nerve transfers. Other much more well-known factors are the number of axons that cross the coaptation site, the interval between trauma and repair, and age.