Teaching ultrasound-guided regional anesthesia remotely: a feasibility study.

Background: Ultrasound-guided regional anesthesia (UGRA) requires acquisition of new skills. Learning requires one-on-one teaching, and can be limited by time and mentor availability. We investigate whether the skills required for UGRA can be developed and subsequently assessed remotely using a novel online teaching platform.

Peginterferon lambda for the treatment of HBeAg-positive chronic hepatitis B: A randomized phase 2b study (LIRA-B).

Background & Aims: Peginterferon lambda-1a (lambda) is a Type-III interferon, which, like alfa interferons, has antiviral activity in vitro against hepatitis B virus (HBV) and hepatitis C virus (HCV); however, lambda has a more limited extra-hepatic receptor distribution. This phase 2b study (LIRA-B) evaluated lambda in patients with chronic HBV infection.

Methods: Adult HBeAg+ interferon-naive patients were randomized (1:1) to weekly lambda (180 μg) or peginterferon alfa-2a (alfa) for 48 weeks.

Flow diverter placement for management of dissecting ruptured aneurysm in a non-fused basilar artery.

Intracranial vertebral artery dissection can be associated with subarachnoid hemorrhage (SAH) and pseudoaneurysm formation. Dissecting aneurysms have a high risk of rebleeding in the acute phase. To our knowledge, the management of an acute vertebrobasilar junction dissecting aneurysm associated with a basilar non-fusion has not been previously reported.

Is laparoscopic repair of incarcerated abdominal hernias safe? Analysis of short-term outcomes.

Background: There is a paucity of literature surrounding the safety and feasibility of laparoscopic repair for acutely incarcerated abdominal hernias. The objective of this study was to compare the 30-day morbidity and mortality between laparoscopic and open repairs of incarcerated abdominal hernias.

Methods: A retrospective cohort study was conducted using data from the National Surgery Quality Improvement Program from 2005 to 2012.

Laparoscopic versus open surgery for T4 colon cancer: evaluation of margin status.

Background: Laparoscopic resection has been considered a relative contraindication for T4 colonic and rectal lesions due to concern over inadequate margins. The objective of this study was to compare planned laparoscopic and open resections of T4 lesions with respect to the positive margin rate.

Methods: Data were obtained from the American College of Surgeons National Surgical Quality Improvement Program participant use file to perform a retrospective cohort analysis.

Bedside Gastric Ultrasonography in Term Pregnant Women Before Elective Cesarean Delivery: A Prospective Cohort Study.

Background: Bedside gastric ultrasound can reliably assess gastric contents in the perioperative period. We aimed to describe the qualitative and quantitative ultrasound assessment of the gastric antrum in fasted pregnant women at term.

Methods: Pregnant women were examined after a minimum period of overnight fasting (solid food, 6 hours; clear liquids, 2 hours) before their scheduled cesarean delivery.

Preoperative Neutrophil-to-Lymphocyte Ratio is a Better Prognostic Serum Biomarker than Platelet-to-Lymphocyte Ratio in Patients Undergoing Resection for Nonmetastatic Colorectal Cancer.

Introduction: Current risk stratification tools for patients with colorectal cancer (CRC) rely on final surgical pathology but may be improved with the addition of novel serum biomarkers. The objective of this study was to evaluate the utility of preoperative NLR and PLR in predicting long-term oncologic outcomes in patients with operable CRC.

Methods: All patients who underwent curative resection for adenocarcinoma at a large tertiary academic hospital were identified.

The Requisites of Needle-to-Nerve Proximity for Ultrasound-Guided Regional Anesthesia: A Scoping Review of the Evidence.

Unlabelled: This scoping review examines the literature to determine whether the position of the needle tip relative to the target nerve is accurately and reliably detected during ultrasound (US)-guided regional anesthesia. The requisites for successful and safe needle tip positioning relative to the target nerve include accurate and reliable needle presentation by the machine, needle interpretation by the operator, nerve presentation by the machine, and nerve interpretation by the operator. Failure to visualize the needle tip is a common occurrence, frequently prompting operators to use needle and probe maneuvers, which are not necessarily based on evidence.

Reference values for standardized tests of walking speed and distance: a systematic review.

Objective: To provide an overview of the reference values and methodology used to obtain them for time- and distance-limited walk tests.

Methods: We performed a systematic review and searched PubMed, MEDLINE (Ovid), EMBASE, CINAHL, Scopus, PEDro, and The Cochrane Library from 1946 to May 2013. Full-text peer-reviewed articles written in English, French or Spanish were considered eligible.

Health-related quality of life following decompression compared to decompression and fusion for degenerative lumbar spondylolisthesis: a Canadian multicentre study.

Background: Decompression alone (D) is a well-accepted treatment for patients with lumbar spinal stenosis (LSS) causing neurogenic claudication; however, D is controversial in patients with LSS who have degenerative spondylolisthesis (DLS). Our goal was to compare the outcome of anatomy-preserving D with decompression and fusion (DF) for patients with grade I DLS. We compared patients with DLS who had elective primary 1-2 level spinal D at 1 centre with a cohort who had 1-2 level spinal DF at 5 other centres.

Can Isolated Enlarged Virchow-Robin Spaces Influence the Clinical Manifestations of Parkinson's Disease?

Dilated Virchow-Robin (VR) spaces are usually not considered to be symptomatic. We present three cases presenting with atypical clinical features, which otherwise had clinical/imaging findings consistent with idiopathic Parkinson's disease. In all cases, an isolated large VR space in the basal ganglia contralateral to the side of symptom onset was observed.

Practical evaluation of post-prostatectomy incontinence.

For patients undergoing radical prostatectomy, urinary incontinence is not an uncommon postoperative complication. For some, it can resolve over time, while in others the condition persists and requires medical and/or surgical intervention. This summary provides a review of the recommended evaluations to perform in this setting.

Treatment considerations for OAB: Case studies.

As part of the program at the 3(rd) Annual Canadian Urology Forum (2013), participants engaged in interactive discussions of difficult cases throughout the event. The following is a summary of discussions pertaining to two cases illustrating treatment considerations in overactive bladder.

Pearls & Oy-sters: a rare case of neurotrichinosis with MRI.

The neurologic manifestations of trichinosis are diverse, and range from encephalopathy to cerebral, cerebellar, and spinal cord abnormalities.

Pharmacotherapy of overactive bladder in adults: a review of efficacy, tolerability, and quality of life.

Introduction: Overactive bladder (OAB) is a prevalent condition that has a significant impact on quality of life. The usual treatment approach is both behavioral and pharmacological. The first-line pharmacological treatment commonly utilizes anticholinergic agents, which may be limited by their tolerability, efficacy, and long-term compliance.

The risk of knee arthroplasty following cruciate ligament reconstruction: a population-based matched cohort study.

Background: Evidence regarding the risk of end-stage osteoarthritis following cruciate ligament reconstruction is based upon small sample sizes and radiographic, rather than clinical, criteria. The goals of this study were to determine the risk of knee arthroplasty, a surrogate for end-stage osteoarthritis, following cruciate ligament reconstruction, and to identify patient, provider, and surgical factors that influence knee arthroplasty risk.

Methods: Using administrative databases, we identified all patients who were sixteen to sixty years of age and had undergone cruciate ligament reconstruction in Ontario from July 1993 to March 2008.

Focused ultrasound delivery of Raman nanoparticles across the blood-brain barrier: potential for targeting experimental brain tumors.

Unlabelled: Spectral mapping of nanoparticles with surface enhanced Raman scattering (SERS) capability in the near-infrared range is an emerging molecular imaging technique. We used magnetic resonance image-guided transcranial focused ultrasound (TcMRgFUS) to reversibly disrupt the blood-brain barrier (BBB) adjacent to brain tumor margins in rats. Glioma cells were found to internalize SERS capable nanoparticles of 50nm or 120nm physical diameter.