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Ramasamy Y, Usman J, Sundar V, Towler H, King M. Kinetic and kinematic determinants of shuttlecock speed in the forehand jump smash performed by elite male Malaysian badminton players. Sports Biomech 2024; 23:582-597. [PMID: 33663330 DOI: 10.1080/14763141.2021.1877336] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
Badminton is the fastest racket sport in the world with smash speeds reaching over 111 m/s (400 kph). This study examined the forehand jump smash in badminton using synchronised force plates and full-body motion capture to quantify relationships to shuttlecock speed through correlations. Nineteen elite male Malaysian badminton players were recorded performing forehand jump smashes with the fastest, most accurate jump smash from each player analysed. The fastest smash by each participant was on average 97 m/s with a peak of 105 m/s. A correlational analysis revealed that a faster smash speed was characterised by a more internally rotated shoulder, a less elevated shoulder, and less extended elbow at contact. The positioning of the arm at contact appears to be critical in developing greater shuttlecock smash speeds. Vertical ground reaction force and rate of force development were not correlated with shuttlecock speed, and further investigation is required as to their importance for performance of the jump smash e.g., greater jump height and shuttle angle. It is recommended that players/coaches focus on not over-extending the elbow or excessively elevating the upper arm at contact when trying to maximise smash speed.
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Affiliation(s)
- Yuvaraj Ramasamy
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
- Sports Biomechanics Department, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia
| | - Juliana Usman
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
- Centre for Applied Biomechanics, University of Malaya, Kuala Lumpur, Malaysia
| | - Viswanath Sundar
- Sports Biomechanics Department, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia
| | - Harley Towler
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Mark King
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Diler H, Şahan A, Erman KA. Tool to assess the groundstroke technique of preadolescent tennis players. Front Sports Act Living 2024; 6:1341138. [PMID: 38645723 PMCID: PMC11026554 DOI: 10.3389/fspor.2024.1341138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/20/2024] [Indexed: 04/23/2024] Open
Abstract
Objective In this study, we develop a tool that can be used by tennis coaches to evaluate the groundstroke (forehand and backhand) technique of preadolescent tennis players. Methods The participants of the study were 60 children (30 males and 30 females) aged 10-12 years, with at least two years of training in tennis. The Groundstroke Correction Checklist (GCC) was translated into Turkish by using a blind procedure. The Turkish translation was then evaluated by 15 coaches of the Turkish Tennis Federation who had at least a level-3 coaching license and more than five years of coaching experience. The technical components related to technique in the checklist were labeled as unimportant, important, and very important. Following this, the GCC was converted into a Groundstroke Technique Assessment Test Tool (GTATT) by a selection committee consisting of three experts, and its reliability and validity were assessed by using it in the field. Spearman's correlation was used to analyze the correlation (test-r test) between the technical evaluation scores assigned to the players by the tennis coaches based on the GTATT in the first and second weeks. Intra- and inter-rater reliability was used to analyze the overall scores of technical evaluations in the first and second weeks to assess the reliability of the scale used. We determined each player's number of years of playing experience (TPY), technical evaluation (TE), international tennis-level test score (ITN), I-cord classification order (ICCO), and the number of games won (GW) in a tournament organized among themselves and evaluated the correlations among these parameters by using Spearman's correlation analysis. Conclusion A statistically high and significant correlation was observed between the technical evaluations of the players' forehand and backhand groundstrokes by the tennis coaches by using the GTATT in the first and second weeks (r > .90, p < .01). The analysis of the intra- and inter-rater reliability of the GTATT yielded excellent agreement between the technical observations of the three coaches of the players' forehand and backhand strokes in the first and second weeks.
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Affiliation(s)
- Hakan Diler
- Institute of Medical Science, Akdeniz University, Antalya, Turkey
| | - Asuman Şahan
- Faculty of Sport Sciences, Akdeniz University, Antalya, Turkey
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Abstract
The aim was to compare the transfer of dry-land strength and power (S&P) of the shoulder into thrust in front-crawl between swimmers of different competitive levels. Four elite and six sub-elite swimmers were selected to perform a dry-land or an in-water test in random order. The dry-land S&P measurements comprised mean torque, peak torque and mean power of the shoulder rotators of the dominant and non-dominant upper-limbs that were assessed on an isokinetic dynamometer at 90°/s and 180°/s. In-water mean thrust, peak thrust and peak power were collected using an in-house customised system composed of differential pressure sensors and an underwater camera during a 25 m freestyle swim at three different paces (400 m pace, 200 m pace, all-out). There were non-significant and trivial variations in dry-land S&P between elite and sub-elite swimmers. The variations were non-significant but mostly large in the case of thrust. Correlation coefficients of elite swimmers were significantly larger than sub-elite counterparts. In conclusion, elite swimmers seem to be more efficient than sub-elite swimmers at transferring dry-land S&P into thrust.
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Affiliation(s)
- Julian Q J Tan
- Physical Education and Sport Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
- Temasek Polytechnic, Singapore, Singapore
| | - Marcus J C Lee
- Sport Science and Sport Medicine, Singapore Sport Institute, Singapore, Singapore
| | - Desmond Boey
- Sport Science and Sport Medicine, Singapore Sport Institute, Singapore, Singapore
| | - Danny Lum
- Physical Education and Sport Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
- Sport Science and Sport Medicine, Singapore Sport Institute, Singapore, Singapore
| | - Tiago M Barbosa
- Physical Education and Sport Science Academic Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
- Department of Sport Sciences, Polytechnic Institute of Bragança, Bragança, Portugal
- Research Centre in Sports, Health and Human Development, Vila Real, Portugal
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Perrett CS. The Contribution of Lower-Body Kinematics to Pitching and Hitting Performance in Baseball: Utilizing the OpenBiomechanics Project. J Appl Biomech 2024; 40:98-104. [PMID: 37939700 DOI: 10.1123/jab.2023-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 08/24/2023] [Accepted: 09/29/2023] [Indexed: 11/10/2023]
Abstract
As markerless motion capture systems become more affordable than ever, it is becoming far easier to collect and analyze kinematic data on baseballers. To ensure this data can be used impactfully, coaches and practitioners should possess a good understanding of specific technique characteristics that are associated with enhanced performance in pitchers and hitters. This study used the open-source data provided by Driveline Baseball's OpenBiomechanics Project to evaluate the contribution of lower-body kinematics to pitch velocity and bat speed. In addition to correlational analyses to examine the association between discrete kinematic variables and performance, statistical nonparametric mapping was used to compare slow and fast velocity groups across the entirety of pitching and hitting motions from peak knee height to ball release/contact. It was found that rotation of the trail leg and extension of the lead knee were both associated with performance in pitchers and hitters. Consequently, coaches and practitioners should ensure that individuals possess an adequate level of strength and flexibility to facilitate optimal movement of the trail hip and lead knee during pitching and hitting movements. If deficiencies exist, then training programs should be designed to address these issues and eventually bring about an improvement in performance.
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Affiliation(s)
- Corey S Perrett
- Sport, Performance, and Nutrition Research Group, Department of Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services, & Sport, La Trobe University, Melbourne, VIC, Australia
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Fatani B, Alshalawi H, Fatani A, Almuqrin R, Aburaisi MS, Awartani F. Modifications in the Free Gingival Graft Technique: A Systematic Review. Cureus 2024; 16:e58932. [PMID: 38659709 PMCID: PMC11042501 DOI: 10.7759/cureus.58932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 04/26/2024] Open
Abstract
Free gingival grafts (FGGs) have developed beyond covering exposed roots to improve the width and thickness of gingival tissue. While traditional FGGs have shown a high success rate and are easy to apply, they have some drawbacks, such as potential aesthetic concerns and bulky appearance. Recent advancements in FGGs have been explored, with different modifications proposed to overcome these limitations, including partly epithelialized FGGs (PE-FGG), gingival unit grafts, and epithelialized subepithelial connective tissue grafts. This systematic review aims to evaluate published case reports that discuss the utilization of modified approaches to FGG treatment and their outcome.
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Affiliation(s)
| | | | | | | | | | - Fatin Awartani
- Periodontics and Community Dentistry, King Saud University, Riyadh, SAU
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McDermott M, Rogers M, Prior R, Michna R, Guiroy A, Asghar J, Patel A. Single-Position Prone Lateral Lumbar Interbody Fusion Technique Guide: Surgical Tips and Tricks. Int J Spine Surg 2024; 18:110-116. [PMID: 38365737 DOI: 10.14444/8573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024] Open
Abstract
Lateral lumbar interbody fusion (LLIF) is a popular technique as it allows for the placement of a large interbody implant through a retroperitoneal, transpsoas working corridor. Historically, the interbody is placed with the patient in lateral decubitus and then repositioned to prone for the posterior instrumentation. While this has been an effective and successful technique, removing the interoperative flip would improve the efficiency of these cases. This has led to modified LLIF approaches including single-position prone LLIF (pLLIF). This modification has shown to be an efficient and powerful technique; however, learning to navigate the LLIF approach in the prone position has its own challenges. The purpose of this article is to provide a detailed description of our pLLIF technique while simultaneously introducing surgical tips to overcome the challenges of the approach and optimize the implantation of the interbody device.
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Affiliation(s)
| | - Michael Rogers
- Spine Surgery, Duly Health and Care, Naperville, IL, USA
| | - Robert Prior
- Franciscan Health Olympia Fields, Olympia Fields, IL, USA
| | - Rebecca Michna
- Spine Surgery, Duly Health and Care, Naperville, IL, USA
| | | | | | - Ashish Patel
- Spine Surgery, Duly Health and Care, Naperville, IL, USA
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Deluca M, Hoffman BA, Serdahely K, Ravi S, Sanford C. Addition of a Second Calcaneal Pin for Spanning Ankle External Fixation. Cureus 2024; 16:e55312. [PMID: 38559505 PMCID: PMC10981796 DOI: 10.7759/cureus.55312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Spanning ankle external fixation is a commonly used technique for the treatment of fractures of the lower extremity. Traditionally, a single pin is placed in the safe zone of the calcaneus to provide a point of traction for fracture reduction and stabilization. Complications include infection and pin loosening with subsequent loss of fracture reduction. We aim to highlight the benefits and techniques of adding a second calcaneal pin to reduce the likelihood of infection, pin loosening, and possible loss of fracture reduction. Using the standard medial-to-lateral placement technique, two centrally threaded Schanz pins were placed within the safe zone of the calcaneus approximately 2 cm apart and were connected by clamps and a short carbon fiber rod. The remainder of the external fixation apparatus is assembled using a standard technique after obtaining fracture reduction. There is an increased incidence of infection and pin loosening with decreased bone quality and a longer duration within an external fixator. The addition of a second calcaneal pin can be used to reduce the incidence of pin loosening and associated sequela, especially in patients with decreased bone quality, thus improving outcomes for patients undergoing spanning ankle external fixation.
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Affiliation(s)
- Meridith Deluca
- Orthopedics, The University of Toledo College of Medicine and Life Sciences, Toledo, USA
| | - Brett A Hoffman
- Orthopedics, The University of Toledo College of Medicine and Life Sciences, Toledo, USA
| | - Kevin Serdahely
- Orthopedics, The University of Toledo College of Medicine and Life Sciences, Toledo, USA
| | - Sreeram Ravi
- Orthopedics, Penn State Health Milton S. Hershey Medical Center, State College, USA
| | - Christopher Sanford
- Orthopedics, The University of Toledo College of Medicine and Life Sciences, Toledo, USA
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Campos JK, Meyer BM, Khan MW, Laghari FJ, Zarrin DA, Collard de Beaufort J, Amin G, Golshani K, Bender MT, Colby GP, Lin LM, Coon AL. Feasibility of super-bore 0.088″ mechanical thrombectomy in M1 vessels smaller than 8 French: Experience in 20 consecutive cases. Interv Neuroradiol 2024:15910199241229198. [PMID: 38418397 DOI: 10.1177/15910199241229198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024] Open
Abstract
INTRODUCTION Superbore 0.088″ catheters provide a platform for optimizing aspiration efficiency and flow control during stroke mechanical thrombectomy procedures. New superbore catheters have the distal flexibility necessary to navigate complex neurovascular anatomy while providing the proximal support of traditional 8F catheters. The safety and feasibility of Zoom 88™ superbore angled-tip catheters in the middle cerebral artery (MCA) segments smaller than the catheter diameter have not been previously described. METHODS Twenty consecutive cases of acute MCA mechanical thrombectomy were retrospectively identified from the senior authors' prospectively maintained Institutional Review Board-approved database, in which the Zoom 88 (Imperative Care, Campbell, CA) catheter was successfully navigated to at least the M1 segment. Patient demographics, procedural details, and periprocedural information were analyzed. Rates and averages (standard errors) are generally reported. RESULTS The average National Institutes of Health Stroke Scale at presentation and age were 15 ± 2 and 73 ± 3 years, respectively. The M1 and M2 occlusions were evenly distributed. The average M1 measurements before thrombectomy ranged from 2.36 ± 0.07 mm proximally to 2.00 ± 0.11 mm distally, and after thrombectomy, they ranged from 2.34 ± 0.07 mm proximally to 1.97 ± 0.10 mm distally. First-pass modified thrombolysis in cerebral infarction (mTICI) 2C/3 recanalization was achieved in 40% of cases, and final mTICI 2C/3 recanalization was achieved in 90% of cases. A single case of mild vasospasm was managed with verapamil. No hemorrhagic or periprocedural complications were noted. CONCLUSION Superbore 0.088″ catheters with flexible distal segments can be safely navigated to the MCA to augment mechanical thrombectomy even when the MCA segment is smaller than the catheter.
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Affiliation(s)
- Jessica K Campos
- Department of Neurological Surgery, University of California Irvine, Orange, CA, USA
| | | | | | - Fahad J Laghari
- Carondelet Neurological Institute, St. Joseph's Hospital, Tucson, AZ, USA
| | - David A Zarrin
- University of California Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA
| | | | - Gizal Amin
- Carondelet Neurological Institute, St. Joseph's Hospital, Tucson, AZ, USA
| | - Kiarash Golshani
- Department of Neurological Surgery, University of California Irvine, Orange, CA, USA
| | - Matthew T Bender
- Department of Neurosurgery, University of Rochester, Rochester, NY, USA
| | - Geoffrey P Colby
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA
| | - Li-Mei Lin
- Carondelet Neurological Institute, St. Joseph's Hospital, Tucson, AZ, USA
| | - Alexander L Coon
- Carondelet Neurological Institute, St. Joseph's Hospital, Tucson, AZ, USA
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Morrison A, Wells J. Evaluation of shaft angle to ball-to-target line as a predictor of horizontal delivery plane angle in the golf swing. Sports Biomech 2024:1-18. [PMID: 38369900 DOI: 10.1080/14763141.2024.2315253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/25/2024] [Indexed: 02/20/2024]
Abstract
The shaft angle to the ball-to-target line at various points in the golf swing is used by coaches as an indication of the horizontal delivery plane angle (HPA). The aim of the current study was to understand to what degree this simplified method of using the shaft orientation can predict the orientation of the HPA. Fifty-two male golfers hit 40 drives each in an indoor biomechanics laboratory. Between-subject regression models were created for the relationship between the HPA and the shaft angle to the ball-to-target line at three different swing positions. Additionally, single subject regression models were created for each subject for the small variables. The only significant between-subjects regression model was for mid-downswing (Adjusted R2 = 89.5%, RMSE = 2.41°); however, this was deemed not accurate enough to distinguish differences between typical driver and wedge HPA. The only shaft position to have significant single-subject regression models for all participants was mid-downswing. The mean RMSE for those models was determined to be low enough to distinguish typical driver and wedge swing planes within individuals. Overall, the shaft angle was only deemed accurate enough to predict the HPA within individual subjects, and only for mid-downswing.
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Affiliation(s)
- Andrew Morrison
- Cambridge Centre for Sport and Exercise Sciences, School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, UK
| | - Jack Wells
- The Professional Golfers' Association, National Training Academy, The Belfry, Sutton Coldfield, UK
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Starr MC, Gist KM, Zang H, Ollberding NJ, Balani S, Cappoli A, Ciccia E, Joseph C, Kakajiwala A, Kessel A, Muff-Luett M, Santiago Lozano MJ, Pinto M, Reynaud S, Solomon S, Slagle C, Srivastava R, Shih WV, Webb T, Menon S. Continuous Kidney Replacement Therapy and Survival in Children and Young Adults: Findings From the Multinational WE-ROCK Collaborative. Am J Kidney Dis 2024:S0272-6386(24)00610-3. [PMID: 38364956 DOI: 10.1053/j.ajkd.2023.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/28/2023] [Accepted: 12/08/2023] [Indexed: 02/18/2024]
Abstract
RATIONALE & OBJECTIVE There are limited studies describing the epidemiology and outcomes in children and young adults receiving continuous kidney replacement therapy (CKRT). We aimed to describe associations between patient characteristics, CKRT prescription, and survival. STUDY DESIGN Retrospective multicenter cohort study. SETTING & PARTICIPANTS 980 patients aged from birth to 25 years who received CKRT between 2015 and 2021 at 1 of 32 centers in 7 countries participating in WE-ROCK (Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Diseases). EXPOSURE CKRT for acute kidney injury or volume overload. OUTCOMES Death before intensive care unit (ICU) discharge. ANALYTICAL APPROACH Descriptive statistics. RESULTS Median age was 8.8 years (IQR, 1.6-15.0), and median weight was 26.8 (IQR, 11.6-55.0) kg. CKRT was initiated a median of 2 (IQR, 1-6) days after ICU admission and lasted a median of 6 (IQR, 3-14) days. The most common CKRT modality was continuous venovenous hemodiafiltration. Citrate anticoagulation was used in 62%, and the internal jugular vein was the most common catheter placement location (66%). 629 participants (64.1%) survived at least until ICU discharge. CKRT dose, filter type, and anticoagulation were similar in those who did and did not survive to ICU discharge. There were apparent practice variations by institutional ICU size. LIMITATIONS Retrospective design; limited representation from centers outside the United States. CONCLUSIONS In this study of children and young adults receiving CKRT, approximately two thirds survived at least until ICU discharge. Although variations in dialysis mode and dose, catheter size and location, and anticoagulation were observed, survival was not detected to be associated with these parameters. PLAIN-LANGUAGE SUMMARY In this large contemporary epidemiological study of children and young adults receiving continuous kidney replacement therapy in the intensive care unit, we observed that two thirds of patients survived at least until ICU discharge. However, patients with comorbidities appeared to have worse outcomes. Compared with previously published reports on continuous kidney replacement therapy practice, we observed greater use of continuous venovenous hemodiafiltration with regional citrate anticoagulation.
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Affiliation(s)
- Michelle C Starr
- Division of Nephrology, Pediatric and Adolescent Comparative Effectiveness Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
| | - Katja M Gist
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | - Huaiyu Zang
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | - Nicholas J Ollberding
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | - Shanthi Balani
- Division of Nephrology, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Andrea Cappoli
- Division of Nephrology, Department of Pediatrics, Children Hospital Bambino Gesù, Rome, Italy
| | - Eileen Ciccia
- Division of Nephrology, Department of Pediatrics, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, Missouri
| | - Catherine Joseph
- Division of Nephrology, Department of Pediatrics, Texas Children's Hospital, Houston, Texas
| | - Aadil Kakajiwala
- Division of Critical Care Medicine and Nephrology, Department of Pediatrics, Children's National Hospital, Washington, DC
| | - Aaron Kessel
- Division of Critical Care, Department of Pediatrics, Cohen Children's Medical Center, Zucker School of Medicine, New Hyde Park
| | - Melissa Muff-Luett
- Division of Nephrology, Department of Pediatrics, University of Nebraska Medical Center, Children's Hospital & Medical Center, Omaha, NE
| | - María J Santiago Lozano
- Division of Intensive Care, Department of Pediatrics, Gregorio Marañón University Hospital; School of Medicine, Madrid, Spain
| | - Matthew Pinto
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, New York
| | - Stephanie Reynaud
- Division of Pediatric and Neonatal Critical Care, Department of Pediatrics, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Sonia Solomon
- Division of Pediatric Nephrology, Department of Pediatrics, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, New York
| | - Cara Slagle
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | - Rachana Srivastava
- Division of Nephrology, Department of Pediatrics, UCLA Mattel Children's Hospital, Los Angeles, California
| | - Weiwen V Shih
- Division of Nephrology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
| | - Tennille Webb
- Division of Nephrology, Department of Pediatrics, Children's of Alabama and University of Alabama at Birmingham, Birmingham, Alabama
| | - Shina Menon
- Division of Nephrology, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington; Division of Nephrology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
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Yue F, Pei L, Liu H. The inverted elastic mesh cap: A practical tool for retaining surgical dressing in place after occipital operation. J Am Acad Dermatol 2024:S0190-9622(24)00343-8. [PMID: 38360175 DOI: 10.1016/j.jaad.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 01/25/2024] [Accepted: 02/01/2024] [Indexed: 02/17/2024]
Affiliation(s)
- Fagui Yue
- Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital, Jilin University, Changchun, China
| | - Liping Pei
- Department of Echocardiography, First Hospital, Jilin University, Changchun, China
| | - Huibo Liu
- Department of Dermatology and Venerology, First Hospital, Jilin University, Changchun, China.
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Ghosh R, Wong K, Zhang YJ, Britz GW, Wong STC. Automated catheter segmentation and tip detection in cerebral angiography with topology-aware geometric deep learning. J Neurointerv Surg 2024; 16:290-295. [PMID: 37344174 DOI: 10.1136/jnis-2023-020300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 04/20/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Visual perception of catheters and guidewires on x-ray fluoroscopy is essential for neurointervention. Endovascular robots with teleoperation capabilities are being developed, but they cannot 'see' intravascular devices, which precludes artificial intelligence (AI) augmentation that could improve precision and autonomy. Deep learning has not been explored for neurointervention and prior works in cardiovascular scenarios are inadequate as they only segment device tips, while neurointervention requires segmentation of the entire structure due to coaxial devices. Therefore, this study develops an automatic and accurate image-based catheter segmentation method in cerebral angiography using deep learning. METHODS Catheters and guidewires were manually annotated on 3831 fluoroscopy frames collected prospectively from 40 patients undergoing cerebral angiography. We proposed a topology-aware geometric deep learning method (TAG-DL) and compared it with the state-of-the-art deep learning segmentation models, UNet, nnUNet and TransUNet. All models were trained on frontal view sequences and tested on both frontal and lateral view sequences from unseen patients. Results were assessed with centerline Dice score and tip-distance error. RESULTS The TAG-DL and nnUNet models outperformed TransUNet and UNet. The best performing model was nnUNet, achieving a mean centerline-Dice score of 0.98 ±0.01 and a median tip-distance error of 0.43 (IQR 0.88) mm. Incorporating digital subtraction masks, with or without contrast, significantly improved performance on unseen patients, further enabling exceptional performance on lateral view fluoroscopy despite not being trained on this view. CONCLUSIONS These results are the first step towards AI augmentation for robotic neurointervention that could amplify the reach, productivity, and safety of a limited neurointerventional workforce.
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Affiliation(s)
- Rahul Ghosh
- Systems Medicine and Bioengineering, Houston Methodist Research Institute, Houston, Texas, USA
- Biomedical Engineering, Texas A&M University System, College Station, Texas, USA
| | - Kelvin Wong
- Systems Medicine and Bioengineering, Houston Methodist Research Institute, Houston, Texas, USA
- Texas A&M University School of Medicine, Bryan, Texas, USA
| | | | - Gavin W Britz
- Neurological Surgery, Houston Methodist Hospital, Houston, Texas, USA
- Houston Methodist Neurological Institute, Houston, Texas, USA
| | - Stephen T C Wong
- Systems Medicine and Bioengineering, Houston Methodist Research Institute, Houston, Texas, USA
- Texas A&M University School of Medicine, Bryan, Texas, USA
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Isiktas G, Akgun E, Berber E. Laparoscopic versus robotic lateral transabdominal adrenalectomy. J Surg Oncol 2024; 129:224-227. [PMID: 37842936 DOI: 10.1002/jso.27493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/14/2023] [Accepted: 10/02/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND AND OBJECTIVES Despite an increased adaptation of robotic adrenalectomy, its advantages over laparoscopic adrenalectomy (LA) have not been defined. The aim of the study was to compare perioperative outcomes of robotic versus laparoscopic lateral transabdominal adrenalectomy using a large single-center experience. METHODS This was a retrospective single center study. Within 22 years, patients who underwent laparoscopic and robotic transabdominal lateral adrenalectomy were identified from a prospective institutional review board-approved database. Clinical and perioperative outcomes were compared using Mann-Whitney U and χ2 tests. RESULTS There were 190 patients who underwent laparoscopic and 281 patients who underwent robotic transabdominal lateral adrenalectomy. The groups were comparable except for a higher percentage of female patients in the robotic group. For robotic versus LA, operative time and hospital stay were shorter, in addition to less blood loss, conversion to open and margin positivity, for pheochromocytoma and malignant tumors. Morbidity rates were similar between the two groups. CONCLUSIONS Despite the limitations of a retrospective design, this large study demonstrates significant advantages of robotic versus laparoscopic transabdominal lateral adrenalectomy in terms of perioperative outcomes and margin clearance.
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Affiliation(s)
- Gizem Isiktas
- Department of Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ege Akgun
- Department of Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio, USA
| | - Eren Berber
- Department of Endocrine Surgery, Cleveland Clinic, Cleveland, Ohio, USA
- Department of General Surgery, Cleveland Clinic, Cleveland, Ohio, USA
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14
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Cross J, Kung SM, Welch N. Assessing the reliability of biomechanical variables during a horizontal deceleration task in healthy adults. J Sports Sci 2024; 42:263-269. [PMID: 38484285 DOI: 10.1080/02640414.2024.2327874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 03/01/2024] [Indexed: 04/23/2024]
Abstract
Horizontal deceleration technique is an underpinning factor to musculoskeletal injury risk and performance in multidirectional sport. This study primarily assessed within- and between-session reliability of biomechanical and performance-based aspects of a horizontal deceleration technique and secondarily investigated the effects of limb dominance on reliability. Fifteen participants completed four horizontal decelerations on each leg during test and retest sessions. A three-dimensional motion analysis system was used to collect kinetic and kinematic data. Completion time, ground contact time, rate of horizontal deceleration, minimum centre of mass height, peak eccentric force, impulse ratio, touchdown distance, sagittal plane foot and knee angles at initial contact, maximum sagittal plane thorax angle, and maximum knee flexion moment were assessed. Coefficients of variation (COV) and intraclass correlation coefficients (ICC) were used to assess within- and between-session reliability, respectively. Seven variables showed "great" within-session reliability bilaterally (COV ≤9.13%). ICC scores were 'excellent' (≥0.91; n = 4), or 'good' (0.76-0.89; n = 7), bilaterally. Limb dominance affected five variables; three were more reliable for the dominant leg. This horizontal deceleration task was reliable for most variables, with little effect of limb dominance on reliability. This deceleration task may be reliably used to assess and track changes in deceleration technique in healthy adults.
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Affiliation(s)
- Joshua Cross
- Sports Medicine Department, UPMC Sports Surgery Clinic, Dublin, Ireland
| | - Stacey M Kung
- Sports Medicine Department, UPMC Sports Surgery Clinic, Dublin, Ireland
| | - Neil Welch
- Sports Medicine Department, UPMC Sports Surgery Clinic, Dublin, Ireland
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
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15
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Bonvini S, Spadoni N, Tasselli S. Endovascular repair of an intrathoracic subclavian artery aneurysm with a single-branched thoracic endograft in a hostile anatomy. Vascular 2024; 32:42-47. [PMID: 36120869 DOI: 10.1177/17085381221128058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
OBJECTIVE Subclavian artery aneurysms (SAA) are rare and usually involve the proximal segment of the artery. In this setting traditional surgical treatment or hybrid procedures are associated with significative morbidity rate so that new endovascular solutions are preferred. METHODS Authors report a case of a patient with an intrathoracic left SAA involving the aortic arch's outer curve. Patient's comorbidities contraindicated open surgical treatment while anatomical issues were not favourable to hybrid or standard endovascular solutions. Thus a single-branched custom-made thoracic stent-graft (Castor, MicroPort Medical, Shanghai, China) was implanted. RESULTS Technical success was achieved with no intra-operative complications and technical steps of the procedure are accurately described.A pre-discharge CT scan showed the correct position of the endograft, complete aneurysm exclusion and branch patency. CONCLUSION Single-branched thoracic stentgrafts could be a good option in unfavourable anatomies with supra-aortic vessels disease involving the aortic arch, with good results in terms of morbidity and early outcomes.
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Affiliation(s)
- Stefano Bonvini
- Department of Vascular Surgery, Santa Chiara Hospital, Trento, Italy
| | - Nicola Spadoni
- Department of Vascular Surgery, Santa Chiara Hospital, Trento, Italy
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Liu M, Peng G, Yang C, He J, Xu X. Pulmonary artery anastomosis during lung transplantation: a novel technique. J Thorac Dis 2024; 16:768-772. [PMID: 38410590 PMCID: PMC10894381 DOI: 10.21037/jtd-23-1147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/08/2023] [Indexed: 02/28/2024]
Abstract
Pulmonary artery anastomosis (PAA) is a critical step in lung transplantation. The conventional approach involves end-to-end anastomosis, which can lead to arterial tortuosity, oozing, stenosis, and thrombosis. Here, we present a modified PAA technique for lung transplantation. The anesthesia protocol and the incision for lung transplantation adhere to standard lung transplantation protocols. The primary innovation is the enhanced pulmonary anastomosis technique. The donor and recipient artery stumps are adjusted to restore their natural anatomical alignment. The donor-recipient stump is everted, ensuring precise alignment of the intima of the donor and recipient arteries. Both ends of the anastomosis are secured using 5-0 Prolene sutures to ensure stability and traction, followed by continuous suturing. In this study, seven patients underwent PAA using this novel technique. Notably, no bleeding was observed upon unveiling and deaerating the anastomosis, eliminating the need for additional sutures. Furthermore, no pulmonary artery torsion or significant prolongation of the anastomotic procedure was observed. Postoperative computed tomography of the chest revealed no anastomotic stenosis or mural thrombosis. This novel cuff anastomosis technique can reduce the risk of thrombosis and prevent torsion and stenosis in the reconstructed artery.
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Affiliation(s)
- Mengyang Liu
- Department of Organ Transplantation, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China
| | - Guilin Peng
- Department of Organ Transplantation, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China
| | - Chao Yang
- Department of Organ Transplantation, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China
| | - Jianxing He
- Department of Organ Transplantation, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China
| | - Xin Xu
- Department of Organ Transplantation, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China
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Hsu C, Krabak B, Cunningham B, Borg-Stein J. Swimming Anatomy and Lower Back Injuries in Competitive Swimmers: A Narrative Review. Sports Health 2024:19417381231225213. [PMID: 38262981 DOI: 10.1177/19417381231225213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
CONTEXT Competitive swimmers are at high risk of overuse musculoskeletal injuries due to their high training volumes. Spine injuries are the second most common musculoskeletal injury in swimmers and are often a result of the combination of improper technique, high loads on the spine in strokes that require hyperextension, and repetitive overuse leading to fatigue of the supporting trunk muscles. The purpose of this review is to summarize the current evidence regarding swimming biomechanics, stroke techniques, and common injuries in the lumbar spine to promote a discussion on the prevention and rehabilitation of lower back injuries in competitive swimmers. EVIDENCE ACQUISITION From a PUBMED/MEDLINE search, 16 articles were identified for inclusion using the search terms "swimming," "low back" or "lumbar," and "injury" or "injuries." STUDY DESIGN Narrative review. LEVEL OF EVIDENCE Levels 4 and 5. RESULTS The trunk muscles are integral to swimming stroke biomechanics. In freestyle and backstroke, the body roll generated by the paraspinal and abdominal muscles is integral to efficient stroke mechanics by allowing synergistic movements of the upper and lower extremities. In butterfly and breaststroke, the undulating wave like motion of the dolphin kick requires dynamic engagement of the core to generate repetitive flexion and extension of the spine and is a common mechanism for hyperextension injuries. The most common lower back injuries in swimming were determined to be lumbar strain, spondylolysis and spondylolisthesis, facet joint pain, and disc disease. Most overuse swimming injuries can be treated conservatively with physical therapy and training adjustments. CONCLUSION Managing swimmers with low back pain requires a basic knowledge of swimming technique and a focus on prevention-based care. Since most swimming injuries are secondary to overuse, it is important for providers to understand the mechanisms underlying the swimming injury, including an understanding of the biomechanics involved in swimming and the role of spine involvement in the 4 strokes that assist in stabilization and force generation in the water. Knowledge of the biomechanics involved in swimming and the significant demands placed on the spinal musculoskeletal system will aid the clinician in the diagnosis and management of injuries and assist in the development of a proper rehabilitation program aimed at correction of any abnormal swimming mechanics, treatment of pain, and future injury prevention. STRENGTH OF RECOMMENDATIONS B. Recommendation based on limited quality or inconsistent patient-oriented evidence.
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Affiliation(s)
- Connie Hsu
- Harvard Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
| | - Brian Krabak
- University of Washington, Department of Physical Medicine and Rehabilitation, Sports Medicine Department, Seattle, Washington
- USA Swimming, Colorado Springs, Colorado
| | - Brian Cunningham
- USA Swimming, Colorado Springs, Colorado
- Advocate Health Care, Glenview, Illinois
| | - Joanne Borg-Stein
- Harvard Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts
- Massachusetts General Brigham Sports Medicine Department, Boston, Massachusetts
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Peled T, Muraca GM, Ratner M, Sela HY, Kirubarajan A, Weiss A, Grisaru-Granovsky S, Rottenstreich M. Impacted fetal head extraction methods at second stage cesarean and subsequent preterm delivery: A multicenter study. Int J Gynaecol Obstet 2024. [PMID: 38235842 DOI: 10.1002/ijgo.15383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/22/2023] [Accepted: 01/02/2024] [Indexed: 01/19/2024]
Abstract
OBJECTIVE Second-stage cesarean delivery (CD) is associated with subsequent preterm birth (PTB). It has been suggested that an increased risk of PTB after second-stage cesarean delivery could be linked to a higher chance of cervical injury due to the extension of the uterine incision. Previous studies have shown that reverse breech extraction is associated with lower rates of uterine incision extensions compared to the "push" method. We aimed to investigate the association between the method of fetal extraction during second-stage CD and the rate of spontaneous PTB (sPTB), as well as other maternal and neonatal outcomes during the subsequent pregnancy. METHODS This was a multicenter retrospective cohort study. The study population included women in their first subsequent singleton delivery following a second-stage CD between 2004 and 2021. The main exposure of interest was the method of fetal extraction in the index CD ("push" method vs. reverse breech extraction). The primary outcome of this study was sPTB <37 weeks in the subsequent pregnancy. Secondary outcomes were overall PTB, trial of labor, and other adverse maternal and neonatal outcomes. Univariate analysis was followed by multiple logistic regression modeling. RESULTS During the study period, 2969 index CD during second stage were performed, of those 583 met the inclusion criteria, of whom 234 (40.1%) had fetal extraction using the reverse breech extraction method, while 349 (59.9%) had the "push" method for extraction. In univariate analysis, women in those two groups had statistically similar rates of sPTB (3.7% vs. 3.0%; odds ratio [OR] 1.25, 95% CI: 0.49-3.19) and overall PTB (<37, <34 and <32 weeks), as well as other maternal, neonatal, and trial of labor outcomes. This was confirmed by multivariate analyses with an adjusted OR of 1.27 (95% CI: 0.43-3.71) for sPTB. CONCLUSION Among women with a previous second-stage CD, no significant difference was observed in PTB rates in the subsequent pregnancies following the "push" method compared to the reverse breech extraction method.
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Affiliation(s)
- Tzuria Peled
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
| | - Giulia M Muraca
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Miri Ratner
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
| | - Hen Y Sela
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
| | - Abirami Kirubarajan
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Ari Weiss
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
| | - Sorina Grisaru-Granovsky
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
| | - Misgav Rottenstreich
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
- Department of Nursing, Jerusalem College of Technology, Jerusalem, Israel
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Hoover M, Berwanger R, Scott JA, DeNardo A, Amuluru K, Payner T, Kulwin C, Raz E, Gibson D, Sahlein DH. Endovascular intervention for the treatment of epistaxis: cone beam CT review of anatomy, collateral, and treatment implications/efficacy. J Neurointerv Surg 2024; 16:192-196. [PMID: 37019626 DOI: 10.1136/jnis-2022-019966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/09/2023] [Indexed: 04/07/2023]
Abstract
Epistaxis is common, impacting more than half the population, and can require procedural intervention in approximately 10% of cases. With an aging population and increasing use of antiplatelets and anticoagulants, severe epistaxis is likely to increase in frequency significantly over the next two decades. Sphenopalatine artery embolization is rapidly becoming the most common type of procedural intervention. The efficacy of endovascular embolization is dependent on a refined understanding of the anatomy and collateral physiology of this circulation as well as the impact of temporizing measures such as nasal packing and inflation of a nasal balloon. Likewise, safety is dependent on a detailed appreciation of collateralization with the internal carotid artery and ophthalmic artery. Cone beam CT imaging has the resolution to enable a clear visualization of the anatomy and collateral circulation associated with the arterial supply to the nasal cavity, in addition to assisting with hemorrhage localization. We present a review of epistaxis treatment, a detailed description of anatomic and physiologic considerations informed by cone beam CT imaging, and a proposed protocol for sphenopalatine embolization for which there is currently no standard.
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Affiliation(s)
- Madeline Hoover
- Neurosurgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Robert Berwanger
- Neurosurgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - John A Scott
- Goodman Campbell Brain and Spine, Carmel, Indiana, USA
- Neurointerventional Radiology, Ascension St. Vincent Hospital, Indianapolis, IN, USA
| | - Andrew DeNardo
- Goodman Campbell Brain and Spine, Carmel, Indiana, USA
- Neurointerventional Radiology, Ascension St. Vincent Hospital, Indianapolis, IN, USA
| | - Krishna Amuluru
- Goodman Campbell Brain and Spine, Carmel, Indiana, USA
- Neurointerventional Radiology, Ascension St. Vincent Hospital, Indianapolis, IN, USA
| | - Troy Payner
- Goodman Campbell Brain and Spine, Carmel, Indiana, USA
| | | | - Eytan Raz
- Radiology, NYU Grossman School of Medicine, New York, New York, USA
| | - Daniel Gibson
- Neurointerventional Surgery, Ascension Columbia St. Mary's Hospital, Milwaukee, Wisconsin, USA
| | - Daniel H Sahlein
- Goodman Campbell Brain and Spine, Carmel, Indiana, USA
- Neurointerventional Radiology, Ascension St. Vincent Hospital, Indianapolis, IN, USA
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Campos JK, Meyer BM, Zarrin DA, Khan MW, Collard de Beaufort JC, Amin G, Avery MB, Golshani K, Beaty NB, Bender MT, Colby GP, Lin LM, Coon AL. Immediate procedural safety of adjunctive proximal coil occlusion in middle meningeal artery embolization for chronic subdural hematomas: Experience in 137 cases. Interv Neuroradiol 2024:15910199231224003. [PMID: 38166510 DOI: 10.1177/15910199231224003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Endovascular embolization of the middle meningeal artery (MMA) has emerged as an adjunctive and stand-alone modality for the management of chronic subdural hematomas (cSDH). We report our experience utilizing proximal MMA coil embolization to augment cSDH devascularization in MMA embolization. METHODS MMA embolization cases with adjunctive proximal MMA coiling were retrospectively identified from a prospectively maintained IRB-approved database of the senior authors. RESULTS Of the 137 cases, all patients (n = 89, 100%) were symptomatic and underwent an MMA embolization procedure for cSDH. 50 of the patients underwent bilateral embolizations, with 53% (n = 72) for left-sided and 47% (n = 65) for right-sided cSDH. The anterior MMA branch was embolized in 19 (14%), posterior in 16 (12%), and both in 102 (74.5%) cases. Penetration of the liquid embolic to the contralateral MMA or into the falx was present in 38 (28%) and 31 (23%) cases, respectively, and 46 (34%) cases had ophthalmic or petrous collateral (n = 41, 30%) branches. MMA branches coiled include the primary trunk (25.5%, n = 35), primary and anterior or posterior MMA trunks (20%, n = 28), or primary with the anterior and posterior trunks (54%, n = 74). A mild ipsilateral facial nerve palsy was reported, which remained stable at discharge and follow-up. Absence of anterograde flow in the MMA occurred in 137 (100%) cases, and no cases required periprocedural rescue surgery for cSDH evacuation. The average follow-up length was 170 ± 17.9 days, cSDH was reduced by 4.24 ± 0.5(mm) and the midline shift by 1.46 ± 0.27(mm). Complete resolution was achieved in 63 (46.0%) cases. CONCLUSION Proximal MMA coil embolization is a safe technique for providing additional embolization/occlusion of the MMA in cSDH embolization procedures. Further studies are needed to evaluate the potential added efficacy of this technique.
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Affiliation(s)
- Jessica K Campos
- Department of Neurological Surgery, University of California Irvine, Orange, CA, USA
| | | | - David A Zarrin
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | | | | | - Gizal Amin
- Carondelet Neurological Institute, St Joseph's Hospital, Tucson, AZ, USA
| | - Michael B Avery
- Department of Neurosurgery, Banner University Medical Center / The University of Arizona, Tucson, AZ, USA
| | - Kiarash Golshani
- Department of Neurological Surgery, University of California Irvine, Orange, CA, USA
| | - Narlin B Beaty
- Department of Neurosurgery, Florida State University, Tallahassee Memorial Hospital, Tallahassee, FL, USA
| | - Matthew T Bender
- Department of Neurosurgery, University of Rochester, Rochester, NY, USA
| | - Geoffrey P Colby
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA, USA
| | - Li-Mei Lin
- Carondelet Neurological Institute, St Joseph's Hospital, Tucson, AZ, USA
| | - Alexander L Coon
- Carondelet Neurological Institute, St Joseph's Hospital, Tucson, AZ, USA
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Wettengl C, Karlsson R, Olstad BH, Gonjo T. Load-Velocity Profile and Active Drag in Young Female Swimmers: An Age-Group Comparison. Int J Sports Physiol Perform 2024; 19:44-52. [PMID: 37857381 DOI: 10.1123/ijspp.2022-0213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/09/2023] [Accepted: 09/16/2023] [Indexed: 10/21/2023]
Abstract
PURPOSE The present study aimed to establish differences in load-velocity profiling, active drag (AD), and drag coefficient (Cd) between 3 age groups of female swimmers. METHODS Thirty-three swimmers (11, 13, or 16 y old) were recruited. The individual load-velocity profile was determined for the 4 competitive swimming strokes. The maximal velocity (V0), maximal load (L0), L0 normalized to the body mass, AD, and Cd were compared between the groups. A 2-way analysis of variance and correlation analysis were conducted. RESULTS Compared with their younger counterparts, 16-year-old swimmers generally had larger V0, L0, and AD, which was particularly evident when comparing them with 11-year-old swimmers (P ≤ .052). The exception was breaststroke, where no differences were observed in L0 and AD and Cd was smaller in the 16-year-old group than the 11-year-old group (P = .03). There was a negative correlation between Cd and V0 for all groups in backstroke (P ≤ .038) and for the 11-year-old group and 13-year-old group in breaststroke (P ≤ .022) and front crawl (P ≤ .010). For the 16-year-old group, large correlations with V0 were observed for L0, L0 normalized to the body mass, and AD (P ≤ .010) in breaststroke and for L0 and AD with V0 in front crawl (P ≤ .042). In butterfly, large negative correlations with V0 were observed in the 13-year-old group for all parameters (P ≤ .027). CONCLUSIONS Greater propulsive force is likely the factor that differentiates the oldest age group from the younger groups, except for breaststroke, where a lower Cd (implying a better technique) is evident in the oldest group.
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Affiliation(s)
- Christina Wettengl
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
- Institute for Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Rebecca Karlsson
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Bjørn H Olstad
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
| | - Tomohiro Gonjo
- Department of Physical Performance, Norwegian School of Sport Sciences, Oslo, Norway
- Department of Rehabilitation and Sport Sciences, Bournemouth University, Poole, United Kingdom
- School of Energy, Geoscience, Infrastructure and Society, Institute for Life and Earth Sciences, Heriot-Watt University, Edinburgh, United Kingdom
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22
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Kraja F, Kauweloa K, Ganju RG, Hoover AC. Impact of bowel space contouring variability on radiation dose and volume assessments in treatment planning for gynaecologic cancers. J Med Radiat Sci 2023; 70:417-423. [PMID: 37394743 PMCID: PMC10715335 DOI: 10.1002/jmrs.703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 06/20/2023] [Indexed: 07/04/2023] Open
Abstract
INTRODUCTION Correlations between radiation dose/volume measures and small bowel (SB) toxicity are inconsistent in the medical literature. We assessed the impact of inter-provider variation in bowel bag contouring technique on estimates of radiation dose received by the SB during pelvic radiotherapy. METHODS Ten radiation oncologists contoured rectum, bladder and bowel bags on treatment planning computed tomography (CT) scans of two patients receiving adjuvant radiation for endometrial cancer. A radiation plan was generated for each patient and used to determine the radiation dose/volume for each organ. Kappa statistics were applied to assess the inter-provider contouring agreement, and Levene test evaluated the homogeneity of variance for radiation dose/volume metrics, including the V45Gy (cm3 ). RESULTS The bowel bag showed greater variation in radiation dose/volume estimates compared to the bladder and rectum. The V45Gy ranged from 163 to 384 cm3 for data set A and 109 to 409 cm3 for dataset B. Kappa values were 0.82/0.83, 0.92/0.92 and 0.94/0.86 for the bowel bag, rectum, and bladder on data sets A/B, demonstrating lower inter-provider agreement for bowel bag compared with bladder and rectum. CONCLUSION Inter-provider contouring variability is more significant for the bowel bag than the rectum and bladder, with an associated greater variability in dose and volume estimates during radiation planning.
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Affiliation(s)
- Fatjona Kraja
- Department of OncologyUniversity Hospital Centre Mother TeresaTiranaAlbania
| | - Kevin Kauweloa
- Department of Radiation OncologyQueen's Medical CentreHonoluluHawaiiUSA
| | | | - Andrew C. Hoover
- Department of Radiation OncologyUniversity of Kansas Cancer Centre, Kansas University Medical CentreKansas CityKansasUSA
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Groarke S. Blank pain and pathological mourning in the analytic situation. Int J Psychoanal 2023; 104:1006-1024. [PMID: 38127483 DOI: 10.1080/00207578.2023.2234969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2023] [Indexed: 12/23/2023]
Abstract
This paper presents an account of the psychoanalytic treatment of pathological mourning in the context of early psychic trauma. I introduce the concept of blank pain, understood as a negative of early trauma, to describe a distinct type of unthinkable anxiety. And I treat pathological mourning as a defence against the unbearable pain of the latter. Clinical observations reveal the extent to which, in a situation where the patient reacts to environmental failure by maintaining a façade (an insincere self), the construction of meaning depends on the use the patient makes of the analytic process and the setting. Considering these observations, I explore the relationship between the structural phenomenon of blank pain and defensive pathological mourning through the therapeutically mutative action of processive interventions and co-enacted scenarios.
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Abstract
BACKGROUND Percutaneous balloon compression is a safe and effective treatment for trigeminal neuralgia. Current technique consists of penetrating the foramen ovale using a sharp 14G needle with a stylet. Difficulty of cannulation of the foramen ovale, failures of cannulation and major neurovascular complications of the procedure, although rare, may be due to the relatively large caliber of this needle and its sharp tip. OBJECTIVE To present a novel technique to facilitate and make the cannulation of the foramen ovale with a 14G cannula safer. METHODS A rigid blunt-tip guide of 1.2 or 1.5 mm is used to penetrate the foramen ovale under lateral fluoroscopic control. Once the guide enters the foramen it is advanced further to the clival line, and a 14G cannula is then advanced over the guide to engage the foramen, at which point the guide is withdrawn and replaced with the balloon catheter. RESULTS The technique was employed to deliver a 4F balloon catheter to Meckel's cave successfully in 500 consecutive procedures performed on 416 trigeminal neuralgia patients. None of the patients had neurovascular complications like facial hematoma, arterial injury, carotid-cavernous fistula or cranial nerve palsies. CONCLUSION A novel technique for cannulation of the foramen ovale is described. The use of blunt tip guides of smaller diameters instead of sharp 14 G needles considerably facilitated cannulation of the foramen ovale and enabled cannulation in all cases. Absence of complications of cannulation such as facial hematoma, carotid-cavernous fistula or intracranial hemorrhage in this series of patients suggests that the technique may be safer than the use of conventional sharp tipped 14G needles in terms of avoiding neurovascular complications.
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Affiliation(s)
- Orhan Barlas
- Department of Neurosurgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tugrul Cem Unal
- Department of Neurosurgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Jalolova M, Jankovic D, Sasaki K, Tanaka R, Kato Y. Simulation-Based Bypass Training and Learning Curves-Resident Experience. Asian J Neurosurg 2023; 18:773-776. [PMID: 38161618 PMCID: PMC10756769 DOI: 10.1055/s-0043-1775859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Introduction Bypass surgery is a challenging operative procedure that requires surgical excellence. Achieving the skills required for vascular surgery is difficult to master in the operating room without intensive microsurgical training. Various models have been developed to provide training to young neurosurgeons and increase dexterity and patient safety. Bypass surgery requires complex microsurgical techniques. Methods Microanastomosis training was performed on plastic tubes and chicken wings for 2 months. Each microanastomosis was evaluated by a senior author. Results An improvement in the quality and patency of microanastomosis was observed. Conclusion Microsurgical simulation training can contribute to the improvement of surgical skills and dexterity.
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Affiliation(s)
- Mohira Jalolova
- Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Aichi, Japan
- Republican Scientific Center of Neurosurgery, Tashkent Medical Academy, Uzbekistan
| | - Dragan Jankovic
- Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Aichi, Japan
- Department of Neurosurgery, University Medical Centre of the Johannes Gutenberg University of Mainz, Mainz, Germany
- Faculty of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia
| | - Kento Sasaki
- Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Aichi, Japan
| | - Riki Tanaka
- Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Aichi, Japan
| | - Yoko Kato
- Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Aichi, Japan
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Bait Almal T, AlDkhail M, Alharbi N, Abusulayman L. Laparotomy closure using a surgical spoon. J Surg Case Rep 2023; 2023:rjad698. [PMID: 38164209 PMCID: PMC10758241 DOI: 10.1093/jscr/rjad698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 01/03/2024] Open
Abstract
This study introduces the novel use of a surgical spoon in the closure of midline laparotomy and compares it to known instruments such as the malleable ribbon retractor and the fish glassman viscera retainer. The surgical spoon was implemented in multiple cases at King Faisal Specialist Hospital & Research center, to help close laparotomy incisions, specifically in hyperthermic intraperitoneal chemotherapy surgeries. Unlike currently available retainers, the spoon's concave shape protects underlying viscera and guides the needle, during closure.
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Affiliation(s)
- Tarek Bait Almal
- Surgical Oncology, The Oncology Centre, King Faisal Specialist Hospital & Research Centre, Al Maather Ashmali district, Makkah Al Mukarma road, Riyadh, 11564, Saudi Arabia
| | - Mohammad AlDkhail
- Colorectal Surgery, King Faisal Specialist Hospital & Research Centre, Al Maather Ashmali district, Makkah Al Mukarma road, Riyadh, 11564, Saudi Arabia
| | - Norah Alharbi
- College of Medicine, AlFaisal University, Al Maather district, Aljawhari road (off of Al Takhasusi road), Riyadh, 11533, Saudi Arabia
| | - Lina Abusulayman
- College of Medicine, AlFaisal University, Al Maather district, Aljawhari road (off of Al Takhasusi road), Riyadh, 11533, Saudi Arabia
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Kılıç KK, Gürses C, Karadağ C, Sözel YK, Özdemir Ö. When a balloon catheter or tenaculum is required for cervical traction during hysterosalpingography. J OBSTET GYNAECOL 2023; 43:2171777. [PMID: 36708520 DOI: 10.1080/01443615.2023.2171777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The aim of this study was to define the actual rate of the traction needed and the balloon catheter or tenaculum requirement for hysterosalpingography (HSG) examinations, and to investigate the correlation between pain scores with the type of traction, operator, parity or the type of infertility. 788 patients undergoing HSG participated in the trial. The HSG examinations were completed in 58% of the patients (458) without any traction. Traction was needed in 42% of patients, those with the balloon catheter in 26.9%, and those with the tenaculum only at 15%. Patients with balloon catheter traction had similar pain scores to those using tenaculum traction. The pain scores changed according to the operator. HSG examinations should be performed step-by-step and the need for traction evaluated during the procedure.IMPACT STATEMENTWhat is already known on this subject? HSG is a technique to evaluate fallopian tube patency and other potential intrauterine pathology in infertile women.What do the results of this study add? Traction was not needed in more than half of the HSG examinations. The pain due to the balloon catheter and tenaculum is similar.What the implications are of these findings for clinical practice and/or further research? HSG examinations should be performed step-by-step by checking the need for traction. Traction with the balloon catheter prevents the uterine spasm, infection and bleeding complications during or after the HSG.
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Affiliation(s)
- Koray Kaya Kılıç
- Department of Radiology, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey
| | - Cemil Gürses
- Department of Radiology, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey
| | - Ceyda Karadağ
- Gynecologic Oncologic Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Yıldız Kılar Sözel
- Department of Radiology, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey
| | - Özgür Özdemir
- Department of Obstetrics and Gynecology, University of Health Sciences, Antalya Education and Research Hospital, Antalya, Turkey
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Tonetti DA, Koneru M, Bhattacharyya M, English JD, Settecase F, Kim WT, Khalife J, Patel P, Thomas A, Jovin T, Hanel R, Benalia VHC, Cortez GM, Aghaebrahim A, Sauvageau E, Abdalkader M, Nguyen TN, Klein P, Dmytriw AA, Shaikh H. Tenzing 7 delivery catheter with or without a leading microwire for single pass aspiration thrombectomy: A multicenter experience. Interv Neuroradiol 2023:15910199231216765. [PMID: 38018024 DOI: 10.1177/15910199231216765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023] Open
Abstract
INTRODUCTION Aspiration mechanical thrombectomy traditionally includes use of an inner microcatheter and leading microwire to navigate an aspiration catheter (AC) to the site of occlusion. Early clinical experience suggests that a leading microwire is often not needed with the Tenzing 7 (T7, Route 92 Medical, San Mateo, CA), a soft tapered tip ledge-reducing delivery catheter. This multicenter experience aims to describe AC delivery success in single-pass thrombectomy using T7 with and without a leading microwire. METHODS A retrospective review was conducted of consecutive patients who underwent single-pass thrombectomy with T7 at six institutions between 2020 and 2022. We examined the percentage of successful AC delivery, puncture-to-revascularization time, and procedural complication rate. RESULTS A leading microwire with T7 was used in 19/89 (21%) of patients, and it was not used with T7 in 70/89 (79%) of patients. Successful AC delivery was similar with and without microwires (97% vs. 90%, p = 0.15). Median puncture-to-revascularization times were similar (17 min microwire vs. 16 min no-microwire, p = 0.12). No complications were associated with microwire use; one (1.4%) patient had a T7-related vasospasm resolved with verapamil during thrombectomy without a leading microwire. Differences in complication rates were not statistically significant (p = 0.46). CONCLUSION In our real-world clinical experience, leading microwire use was infrequently necessary with the T7 delivery catheter. Successful AC delivery and complication rates were similar with and without microwire use in single-pass T7 thrombectomies. Initial pass with T7 may be performed without use of leading microwire, reserving microwire use for refractory cases or known difficult-to-navigate vasculature.
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Affiliation(s)
- Daniel A Tonetti
- Cooper University Health Care, Camden, NJ, USA
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Manisha Koneru
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | | | - Joey D English
- Sutter California Pacific Medical Center, San Francisco, CA, USA
- Sutter Mills-Peninsula Medical Center, Burlingame, CA, USA
| | - Fabio Settecase
- Sutter California Pacific Medical Center, San Francisco, CA, USA
- Sutter Mills-Peninsula Medical Center, Burlingame, CA, USA
| | - Warren T Kim
- Sutter California Pacific Medical Center, San Francisco, CA, USA
- Sutter Mills-Peninsula Medical Center, Burlingame, CA, USA
| | - Jane Khalife
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Pratit Patel
- Cooper University Health Care, Camden, NJ, USA
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Ajith Thomas
- Cooper University Health Care, Camden, NJ, USA
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Tudor Jovin
- Cooper University Health Care, Camden, NJ, USA
- Cooper Medical School of Rowan University, Camden, NJ, USA
| | | | | | | | | | | | | | | | | | | | - Hamza Shaikh
- Cooper University Health Care, Camden, NJ, USA
- Cooper Medical School of Rowan University, Camden, NJ, USA
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Baig AA, Manion C, Khawar WI, Donnelly BM, Raygor K, Turner R, Holmes DR, Iyer VS, Hopkins LN, Davies JM, Levy EI, Siddiqui AH. Cerebral emboli detection and autonomous neuromonitoring using robotic transcranial Doppler with artificial intelligence for transcatheter aortic valve replacement with and without embolic protection devices: a pilot study. J Neurointerv Surg 2023:jnis-2023-020812. [PMID: 37940386 DOI: 10.1136/jnis-2023-020812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/26/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Periprocedural ischemic stroke remains a serious complication in patients undergoing transcatheter aortic valve replacement (TAVR). We used a novel robotic transcranial Doppler (TCD) system equipped with artificial intelligence (AI) for real-time continuous intraoperative neuromonitoring during TAVR to establish the safety and potential validity of this tool in detecting cerebral emboli, report the quantity and distribution of high intensity transient signals (HITS) with and without cerebral protection, and correlate HITS occurrence with various procedural steps. METHODS Consecutive patients undergoing TAVR procedures during which the robotic system was used between October 2021 and May 2022 were prospectively enrolled in this pilot study. The robotic TCD system included autonomous adjustment of the TCD probes and AI-assisted post-processing of HITS and other cerebral flow parameters. Basic demographics and procedural details were recorded. Continuous variables were analyzed by a two-sample Mann-Whitney t-test and categorical variables by a χ2 or Fisher test. RESULTS Thirty-one patients were prospectively enrolled (mean age 79.9±7.6 years; 16 men (51.6%)). Mean aortic valve stenotic area was 0.7 cm2 and mean aortic-ventricular gradient was 43 mmHg (IQR 31.5-50 mmHg). Cerebral protection was used in 16 cases (51.6%). Significantly fewer emboli were observed in the protection group than in the non-protection group (mean 470.38 vs 693.33; p=0.01). Emboli counts during valve positioning and implantation were significantly different in the protection and non-protection groups (mean 249.92 and 387.5, respectively; p=0.01). One (4%) transient ischemic attack occurred post-procedurally in the non-protection group. CONCLUSION We describe a novel real-time intraoperative neuromonitoring tool used in patients undergoing TAVR. Significantly fewer HITS were detected with protection. Valve positioning-implantation was the most significant stage for intraprocedural HITS.
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Affiliation(s)
- Ammad A Baig
- Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
- Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA
| | | | - Wasiq I Khawar
- Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Brianna M Donnelly
- Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Kunal Raygor
- Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
- Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA
| | - Ryan Turner
- Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
- Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA
| | - David R Holmes
- Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
| | - Vijay S Iyer
- Cardiology, Gates Vascular Institute, Buffalo, New York, USA
| | - L Nelson Hopkins
- Neurosurgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
- Jacobs Institute, Buffalo, New York, USA
| | - Jason M Davies
- Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA
- Jacobs Institute, Buffalo, New York, USA
- Neurosurgery and Bioinformatics and Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Elad I Levy
- Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA
- Jacobs Institute, Buffalo, New York, USA
- Neurosurgery and Radiology and Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
| | - Adnan H Siddiqui
- Neurosurgery, Gates Vascular Institute, Buffalo, New York, USA
- Jacobs Institute, Buffalo, New York, USA
- Neurosurgery and Radiology and Canon Stroke and Vascular Research Center, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA
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Alsaegh MA, Azzawi ADA, Marouf BKA. The performance of inferior alveolar nerve block technique among undergraduate students. Eur J Dent Educ 2023; 27:985-991. [PMID: 36540005 DOI: 10.1111/eje.12890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/15/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
AIMS This study aimed at evaluating the ability to feel bone touch, positive aspirations, and frequency of the success rate during the direct inferior alveolar nerve block (IANB) among dental students. METHODS This prospective cross-sectional study involved 203 cases of IANB injections for patients requiring extraction of mandibular posterior teeth who visited student dental clinics at Ajman University, Fujairah Campus. Students' performance of direct IANB including ability to perceive bone touch, frequency of positive aspirations, and success rate were reported. RESULTS Students reported feeling bone contact in 148 (72.9%), 43 (21.2%), and 12 (5.9%) of the first, second, and third attempts during the IANB, respectively. Positive aspiration was found in 46 (22.7%) of the injections. The success was in 195 (96.1%) of the total injections. Spearman's correlation coefficient indicated that there was no significant correlation between the success rate and the result of aspiration (rho = .054, p = .440). Additionally, there was no correlation between attempts to touch the bone and the outcome of the aspiration (rho = -.091, p = .198) or success rate (rho = -.083, p = .240). CONCLUSION There is a relatively high success rate of direct IANB technique among dental students. This confirms the inclusion of this technique in the curriculum. Furthermore, the high rate of positive aspiration reflects the awareness and competency of dental students with the aspiration technique. In turn, this will reduce the failure of anaesthesia and the subsequent systemic complications.
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Affiliation(s)
- Mohammed Amjed Alsaegh
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - Amna Dafer Al Azzawi
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Ajman University, Fujairah, UAE
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Lui H, Kakar S. Partial Denervation of the Thumb Carpometacarpal Joint: A New Technique. Hand (N Y) 2023:15589447231200646. [PMID: 37888777 DOI: 10.1177/15589447231200646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
BACKGROUND To report the clinical outcomes of partial denervation for the treatment of basilar thumb joint arthritis. METHODS Patients who underwent partial denervation of the basilar thumb joint for osteoarthritis from a single center between 2019 and 2021 were recruited into the study. This involved a technique that involved cauterization of the joint capsule and its innervation through the branches of the superficial radial, palmar cutaneous branch of the median, lateral antebrachial, and ulnar nerves. Patients were followed up postoperatively to record clinical (grip strength, thumb apposition and opposition pinch grip strength, Kapandji score) and patient-reported outcomes (visual analogue scale [VAS], Quick Disabilities of the Arm, Shoulder and Hand [QuickDASH], Patient-reported Wrist Evaluation [PRWE]). RESULTS Twelve patients (15 carpometacarpal joints; 9 female and 3 male patients) underwent a partial denervation of the thumb (Eaton stage 3-4). The mean age at the time of surgery was 63 ± 5 years (range 56-72). The mean clinical follow-up duration was 23 ± 11 months (range 9-42 months), and functional score follow-up duration was 27 ± 7 months (range 14-42 months). At the latest clinical follow, VAS score, Kapandji score, grip strength, and thumb apposition/opposition pinch strength all improved significantly (P < .05). The mean QuickDASH score was 30 ± 16, and PRWE score was 32 ± 17. Patients who had unilateral partial thumb denervation demonstrated greater improvement in grip strength than patients who had bilateral partial thumb denervation procedures (P = .01). CONCLUSION In this clinical case series, our method of basilar thumb joint partial denervation has been effective in improving clinical outcomes and reducing pain due to osteoarthritis. LEVEL OF EVIDENCE IV, case series.
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Affiliation(s)
- Hayman Lui
- School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Sanjeev Kakar
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
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Shapiro M, Sharashidze V, Nossek E, Sen C, Rutledge C, Chung C, Khawaja A, Kvint S, Riina H, Nelson PK, Raz E. Superior hypophyseal arteries: angiographic re-discovery, comprehensive assessment, and embryologic implications. J Neurointerv Surg 2023:jnis-2023-020922. [PMID: 37875341 DOI: 10.1136/jnis-2023-020922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023]
Abstract
The superior hypophyseal arteries (SHAs) are well known in anatomical and surgical literature, with a well-established role in supply of the anterior hypophysis and superjacent optic apparatus. However, due to small size and overlap with other vessels, in vivo imaging by any modality has been essentially non-existent. Advances in high resolution cone beam CT angiography (CBCTA) now enables this deficiency to be addressed. This paper presents, to the best of our knowledge, the first comprehensive in vivo imaging evaluation of the SHAs. METHODS Twenty-five CBCTA studies of common or internal carotid arteries were obtained for a variety of clinical reasons. Dedicated secondary reconstructions of the siphon were performed, recording the presence, number, and supply territory of SHAs. A spectrum approach, emphasizing balance with adjacent territories (inferior hypophyseal, ophthalmic, posterior and communicating region arteries) was investigated. RESULTS The SHAs were present in all cases. Supply of the anterior pituitary was nearly universal (96%) and almost half (44%) originated from the 'cave' region, in excellent agreement with surgical literature. Optic apparatus supply was more difficult to adjudicate, but appeared present in most cases. The relationship with superior hypophyseal aneurysms was consistent. Patency following flow diverter placement was typical, despite a presumably rich collateral network. Embryologic implications with respect to the ophthalmic artery and infraoptic course of the anterior cerebral artery are intriguing. CONCLUSIONS SHAs are consistently seen with CBCTA, allowing for correlation with existing anatomical and surgical literature, laying the groundwork for future in vivo investigation.
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Affiliation(s)
- Maksim Shapiro
- Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Neurology, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYC Health Hospitals Bellevue, New York, NY, USA
| | - Vera Sharashidze
- Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Neurology, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYC Health Hospitals Bellevue, New York, NY, USA
| | - Erez Nossek
- Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYC Health Hospitals Bellevue, New York, NY, USA
- Neurosurgery, NYC Health Hospitals Bellevue, New York, NY, USA
| | - Chandra Sen
- Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
| | - Caleb Rutledge
- Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
- Neurosurgery, NYC Health Hospitals Bellevue, New York, NY, USA
| | - Charlotte Chung
- Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYC Health Hospitals Bellevue, New York, NY, USA
| | - Ayaz Khawaja
- Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYC Health Hospitals Bellevue, New York, NY, USA
| | - Svetlana Kvint
- Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYC Health Hospitals Bellevue, New York, NY, USA
| | - Howard Riina
- Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | - Peter Kim Nelson
- Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYC Health Hospitals Bellevue, New York, NY, USA
| | - Eytan Raz
- Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYC Health Hospitals Bellevue, New York, NY, USA
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Barrenechea IJ, Márquez L, Miralles S, Rojas HP, Pastore J, Vincenti P, Nicola T. A multilevel posterior tension band-sparing laminectomy for intraspinal lesions: patient series. J Neurosurg Case Lessons 2023; 6:CASE23292. [PMID: 37782961 PMCID: PMC10555601 DOI: 10.3171/case23292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/25/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Minimally invasive spine surgery (MISS) represents a major development in spinal tumor surgery. However, considering that many intradural lesions compromise multiple spinal segments, MISS has certain limitations. Thus, some intraspinal lesions still require traditional approaches. Because laminectomy has been shown to predispose patients to kyphosis, laminoplasty and hemilaminectomy are the most widely used approaches to preserve the posterior tension band (PTB). However, these techniques are not devoid of complications. To overcome these issues, the authors modified a previously described technique to preserve the PTB while removing various types of intradural lesions. This procedure was originally designed to treat lumbar stenosis and was modified to avoid muscle ischemia during long procedures. OBSERVATIONS Between 2014 and 2021, the authors found 17 cases of spinal lesions with a minimum of 2 years of follow-up after surgical treatment using their approach. No significant postoperative changes in the paraspinal Goutallier grade or spinal angles were observed. The cross-sectional area of the measured paraspinal muscles decreased 6% postoperatively. By performing certain technical modifications in this PTB-sparing (PBS) laminectomy, the authors avoided ipsilateral muscle ischemia. LESSONS In this initial series, PBS laminectomy proved to be a safe, versatile, inexpensive, and reliable technique to remove intraspinal lesions.
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Affiliation(s)
| | | | - Sabrina Miralles
- 2Radiology, Hospital Privado de Rosario, Rosario, Santa Fe, Argentina
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Robinow ZM, Peterson C, Riestenberg R, Waldau B, Yu N, Shahlaie K. Cosmetic Outcomes of Supraorbital Keyhole Craniotomy Via Eyebrow Incision: A Systematic Review and Meta-Analysis. J Neurol Surg B Skull Base 2023; 84:470-498. [PMID: 37671300 PMCID: PMC10477017 DOI: 10.1055/s-0042-1755575] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/08/2022] [Indexed: 10/14/2022] Open
Abstract
Background Supraorbital eyebrow craniotomy is a minimally invasive alternative to a frontotemporal craniotomy and is often used for tumor and vascular pathologies. The purpose of this study was to investigate how patient cosmetic outcomes are affected by technique variations of this approach. Methods PubMed, Embase, and Scopus databases were systematically searched, and results were reported according to PRISMA guidelines. For the meta-analysis portion, the DerSimonian-Laird random effects model was used, and the primary end points were patient satisfaction and percentage of permanent cosmetic complications. Results A total of 2,629 manuscripts were identified. Of those, 124 studies (8,241 surgical cases) met the inclusion criteria. Overall, 93.04 ± 11.93% of patients reported favorable cosmetic outcome following supraorbital craniotomy, and mean number of cases with permanent cosmetic complications was 6.62 ± 12.53%. We found that vascular cases are associated with more favorable cosmetic outcomes than tumor cases ( p = 0.0001). Addition of orbital osteotomy or use of a drain is associated with adverse cosmetic outcomes ( p = 0.001 and p = 0.0001, respectively). The location of incision, size of craniotomy, utilization of an endoscope, method of cranial reconstruction, skin closure, use of antibiotics, and addition of pressure dressing did not significantly impact cosmetic outcomes ( p > 0.05 for all). Conclusions Supraorbital craniotomy is a minimally invasive technique associated with generally high favorable cosmetic outcomes. While certain techniques used in supraorbital keyhole approach do not pose significant cosmetic risks, utilization of an orbital osteotomy and the addition of a drain correlate with unfavorable cosmetic outcomes.
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Affiliation(s)
- Zoe M. Robinow
- California Northstate University College of Medicine, Elk Grove, California, United States
| | - Catherine Peterson
- Department of Neurological Surgery, University of California Davis, Sacramento, California, United States
| | - Robert Riestenberg
- Department of Neurological Surgery, University of California Davis, Sacramento, California, United States
| | - Ben Waldau
- Department of Neurological Surgery, University of California Davis, Sacramento, California, United States
| | - Nina Yu
- Department of Neurological Surgery, University of California Davis, Sacramento, California, United States
| | - Kiarash Shahlaie
- Department of Neurological Surgery, University of California Davis, Sacramento, California, United States
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Şahin İG, Can FI, Gültaç E, Kilinc RM, Aydoğan NH, Kilinc CY. Treatment of Acetabulum Anterior Wall Fractures Using the Modified Stoppa Approach. Cureus 2023; 15:e47770. [PMID: 37899900 PMCID: PMC10603276 DOI: 10.7759/cureus.47770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction The objective of this study was to describe the modified Stoppa approach for anterior wall fracture fixation and to present our radiological and functional results of this approach. Materials and methods Between April 2013 and December 2019, 256 acetabular fractures operated with the modified Stoppa approach in our clinic were retrospectively reviewed, and 11 patients who were operated for anterior acetabular wall fractures with at least two years of follow-up were included in the study. Results The median amount of bleeding during surgery was found to be 450 ml (200-800), and the median operation time was 120 minutes (90-180). The modified Merle d'Aubigné and Postel Hip Score (MDS), modified Harris Hip Score (HHS), Matta's Reduction Criteria (MRC), and Kellgren-Lawrence Classification (KLC) outcomes are similar to the anterior surgical approach. Conclusion We suggest that the modified Stoppa approach can be safely used in the surgical treatment of isolated anterior acetabular fractures due to its short operative duration, low amount of bleeding, low complication rate, and favorable radiological and clinical results. The modified Stoppa procedure is a considerable alternative to the ilioinguinal approach in anterior acetabular fractures.
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Affiliation(s)
- İsmail G Şahin
- Orthopedics and Traumatology, Muğla Sıtkı Koçman Training and Research Hospital, Muğla, TUR
| | - Fatih I Can
- Orthopedics and Traumatology, Muğla Sıtkı Koçman University, Muğla, TUR
| | - Emre Gültaç
- Orthopedics and Traumatology, Muğla Sıtkı Koçman University, Muğla, TUR
| | | | - Nevres H Aydoğan
- Orthopedics and Traumatology, Muğla Sıtkı Koçman University, Muğla, TUR
| | - Cem Y Kilinc
- Orthopedics and Traumatology, Muğla Sıtkı Koçman University, Muğla, TUR
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Cannizzaro D, Zaed I, Olei S, Fernandes B, Peschillo S, Milani D, Cardia A. Growth and rupture of an intracranial aneurysm: the role of wall aneurysmal enhancement and CD68. Front Surg 2023; 10:1228955. [PMID: 37744724 PMCID: PMC10511771 DOI: 10.3389/fsurg.2023.1228955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/15/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Intracranial aneurysms occur in 3%-5% of the general population. While the precise biological mechanisms underlying the formation, growth, and sudden rupture of intracranial aneurysms remain partially unknown, recent research has shed light on the potential role of inflammation in aneurysm development and rupture. In addition, there are ongoing investigations exploring the feasibility of employing new drug therapies for controlling the risk factors associated with aneurysms. CD68, a glycosylated glycoprotein and the human homolog of macrosialin, is prominently expressed in monocyte/macrophages within inflamed tissues and has shown potential application in oncology. An observational study was conducted with the aim of comparing the histological characteristics of aneurysm walls with preoperative MRI scans, specifically focusing on CD68 activity. Method An observational pilot study was conducted to investigate the histological characteristics of the aneurysm wall that could be potentially associated with aneurysm growth and rupture. A total of 22 patients diagnosed with ruptured and unruptured intracranial aneurysms who had undergone conventional clipping between January 2017 and December 2022 were included in the study. Results A histopathological analysis of the aneurysm wall was performed in all patients, particularly focusing on the presence of CD68. A preoperative MRI with gadolinium was conducted in 10 patients with unruptured aneurysms and six patients with ruptured aneurysms. An emergency clipping was performed in the remaining six patients. The results showed that CD68 positivity and wall enhancement were significantly associated with intracranial aneurysm wall degeneration, growth, and rupture. Conclusion The histological and radiological inflammatory findings observed in the wall of cerebral aneurysms, as well as the CD68 positivity, are significantly associated with the risk of intracranial aneurysm growth and rupture. This study highlights the crucial importance of considering clinical and medical data when making treatment decisions for intracranial aneurysms. Furthermore, it emphasizes the relevance of evaluating wall enhancement in MRI scans as part of the diagnostic and prognostic process.
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Affiliation(s)
- Delia Cannizzaro
- Department of Neurosurgery, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Ismail Zaed
- Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Simone Olei
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Bethania Fernandes
- Department of Pathology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Simone Peschillo
- Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Davide Milani
- Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Andrea Cardia
- Department of Neurosurgery, Neurocenter of South Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
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Hayashi T, Hiranaka T, Fujishiro T, Okamoto K, Koide M. Restricted Kinematically Aligned Total Knee Arthroplasty Following Failed Oxford Unicompartmental Knee Arthroplasty. Cureus 2023; 15:e45104. [PMID: 37842438 PMCID: PMC10569232 DOI: 10.7759/cureus.45104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
In this report, we describe how to revise a failed Oxford unicompartmental knee arthroplasty to kinematically aligned total knee arthroplasty (TKA). Its benefits are the maintenance of the native joint line along with the avoidance of supplemental parts, such as metal augments and stems. This can be applied to patients whose medial tibial cortex is well preserved. The distal cutting plane and rotation alignment are decided before the removal of the femoral component. The tibial cutting plane is up to 12 mm below the lateral joint surface and the varus is up to 5° below the extramedullary rod. Eventually, the native joint line and alignment along with the soft tissue envelope can be well maintained, similar to the restricted kinematically aligned TKA.
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Affiliation(s)
- Takuma Hayashi
- Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, JPN
| | - Takafumi Hiranaka
- Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, JPN
| | - Takaaki Fujishiro
- Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, JPN
| | - Koji Okamoto
- Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, JPN
| | - Motoki Koide
- Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, JPN
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Leivaditis V, Grapatsas K, Ehle B, Dahm M, Chatzimichalis A, Margaritis E, Baltayiannis N, Charokopos N, Sakellaropoulos G, Verras GI, Schizas D, Mulita A, Panagiotopoulos I, Mulita F, Koletsis E. Modified pericostal suture technique to reduce postoperative pain and provide optimum anatomic restoration after conversion of minimally invasive thoracic surgery to thoracotomy. Kardiochir Torakochirurgia Pol 2023; 20:193-199. [PMID: 37937165 PMCID: PMC10626407 DOI: 10.5114/kitp.2023.131940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/18/2023] [Indexed: 11/09/2023]
Abstract
Minimally invasive thoracic techniques often need to be converted to open thoracotomy. Thoracotomy is associated with severe postoperative pain in 50% of the patients, and this situation can be maintained for a prolonged period. Many efforts have been made to avoid this complication. We propose an easy and fast thoracotomy closure technique to avoid nerve entrapment at the time of chest closure suitable for cases of conversion to thoracotomy after a minimally invasive attempt. The proposed method effectively avoids interference with the intercostal nerve, which remains intact and restores the anatomy of the intercostal space. Efforts to decrease postoperative pain are vital. Thoracic surgeons are the principal health professionals able to deal with operative factors and postoperative pain management. We believe that the use of this easy and fast technique can facilitate excellent anatomic repositioning of the ribs alongside nerve sparing.
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Affiliation(s)
- Vasileios Leivaditis
- Department of Cardiothoracic Surgery, School of Medicine, University of Patras, Patras, Greece
- Department of Cardiothoracic and Vascular Surgery, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - Konstantinos Grapatsas
- Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Benjamin Ehle
- Department of Thoracic Surgery, Asklepios Lung Clinic Munich-Gauting, Gauting, Germany
| | - Manfred Dahm
- Department of Cardiothoracic and Vascular Surgery, Westpfalz-Klinikum, Kaiserslautern, Germany
| | | | - Emmanuil Margaritis
- Department of Cardiothoracic Surgery, School of Medicine, University of Patras, Patras, Greece
| | | | - Nikolaos Charokopos
- Department of Cardiothoracic Surgery, School of Medicine, University of Patras, Patras, Greece
| | | | | | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Admir Mulita
- Department of Medical Physics, School Of Medicine, University of Patras, Patras, Greece
| | - Ioannis Panagiotopoulos
- Department of Cardiothoracic Surgery, School of Medicine, University of Patras, Patras, Greece
| | - Francesk Mulita
- Department of General Surgery, University of Patras, Patras, Greece
| | - Efstratios Koletsis
- Department of Cardiothoracic Surgery, School of Medicine, University of Patras, Patras, Greece
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Catapano JS, Winkler EA, Srinivasan VM, Dishion EL, Rutledge C, Baranoski JF, Cole TS, Rudy RF, Rumalla K, Zomaya MP, Jadhav AP, Ducruet AF, Albuquerque FC. Retained radial catheters associated with variant radial anatomy in neurointerventional procedures. J Neurointerv Surg 2023; 15:858-863. [PMID: 36190952 DOI: 10.1136/jnis-2022-019004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/15/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Transradial artery access (TRA) for neurointerventional procedures is gaining widespread acceptance. However, complications that were previously rare may arise as TRA procedures increase. Here we report a series of retained catheter cases with a literature review. METHODS All patients who underwent a neurointerventional procedure during a 23-month period at a single institution were retrospectively reviewed for a retained catheter in TRA cases. In cases of retained catheters, imaging was reviewed for anatomical variances in the radial artery, and clinical and demographic case details were analyzed. RESULTS A total of 1386 nondiagnostic neurointerventional procedures were performed during the study period, 631 (46%) initially via TRA. The 631 TRA cases were performed for aneurysm embolization (n=221, 35%), mechanical thrombectomy (n=116, 18%), carotid stent/angioplasty (n=40, 6%), arteriovenous malformation embolization (n=38, 6%), and other reasons (n=216, 34%). Thirty-nine (6%) TRA procedures crossed over to femoral access, most commonly because the artery of interest could not be catheterized (26/39, 67%). A retained catheter was identified in five cases (1%), and one (0.2%) patient had an entrapped catheter that was recovered. All six patients with a retained or entrapped catheter had aberrant radial anatomy. CONCLUSION Retained catheters for neurointerventional procedures performed via TRA are rare. However, this complication may be associated with variant radial anatomy. With the increased use of TRA for neurointerventional procedures, awareness of anatomical abnormalities that may lead to a retained catheter is necessary. We propose a simple protocol to avoid catheter entrapment, including in emergent situations such as TRA for stroke thrombectomy.
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Affiliation(s)
- Joshua S Catapano
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Ethan A Winkler
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Visish M Srinivasan
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Evan L Dishion
- Department of Neurology, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Caleb Rutledge
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Jacob F Baranoski
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Tyler S Cole
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Robert F Rudy
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Kavelin Rumalla
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Martin P Zomaya
- The University of Arizona College of Medicine Phoenix, Phoenix, Arizona, USA
| | - Ashutosh P Jadhav
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Andrew F Ducruet
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
| | - Felipe C Albuquerque
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
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Xepoleas MD, Naidu P, Nagengast E, Collier Z, Islip D, Khatra J, Auslander A, Yao CA, Chong D, Magee WP. Systematic Review of Postoperative Velopharyngeal Insufficiency: Incidence and Association With Palatoplasty Timing and Technique. J Craniofac Surg 2023; 34:1644-1649. [PMID: 37646567 PMCID: PMC10445635 DOI: 10.1097/scs.0000000000009555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 05/19/2023] [Indexed: 09/01/2023] Open
Abstract
Cleft palate is among the most common congenital disorders worldwide and is correctable through surgical intervention. Sub-optimal surgical results may cause velopharyngeal insufficiency (VPI). When symptomatic, VPI can cause hypernasal or unintelligible speech. The postoperative risk of VPI varies significantly in the literature but may be attributed to differences in study size, cleft type, surgical technique, and operative age. To identify the potential impact of these factors, a systematic review was conducted to examine the risk of VPI after primary palatoplasty, accounting for operative age and surgical technique. A search of PubMed, Embase, and Web of Science was completed for original studies that examined speech outcomes after primary palatoplasty. The search identified 4740 original articles and included 35 studies that reported mean age at palatoplasty and VPI-related outcomes. The studies included 10,795 patients with a weighted mean operative age of 15.7 months (range: 3.1-182.9 mo), and 20% (n=2186) had signs of postoperative VPI. Because of the heterogeneity in reporting of surgical technique across studies, small sample sizes, and a lack of statistical power, an analysis of the VPI risk per procedure type and timing was not possible. A lack of data and variable consensus limits our understanding of optimal timing and techniques to reduce VPI occurrence. This paper presents a call-to-action to generate: (1) high-quality research from thoughtfully designed studies; (2) greater global representation; and (3) global consensus informed by high-quality data, to make recommendations on optimal technique and timing for primary palatoplasty to reduce VPI.
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Affiliation(s)
| | - Priyanka Naidu
- Operation Smile Inc, Virginia Beach, VA
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC
| | - Eric Nagengast
- Operation Smile Inc, Virginia Beach, VA
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC
| | - Zach Collier
- Operation Smile Inc, Virginia Beach, VA
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC
| | - Delaney Islip
- University of California, Los Angeles, School of Dentistry
| | | | - Allyn Auslander
- Operation Smile Inc, Virginia Beach, VA
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles
| | - Caroline A. Yao
- Operation Smile Inc, Virginia Beach, VA
- Department of Plastic Surgery, Shriners Hospital for Children, Los Angeles, CA
| | - David Chong
- Royal Children’s Hospital, Melbourne, VIC, Australia
| | - William P. Magee
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC
- Division of Plastic and Maxillofacial Surgery, Children’s Hospital Los Angeles
- Department of Plastic Surgery, Shriners Hospital for Children, Los Angeles, CA
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Duarte Valim M, Righetto Corrêa E, Paulo Machado A, Victorino Alves Corrêa L, Borges de Morais R, Florentino da Silva Teixeira R, Lacey G. The impact of an effective 3-step hand hygiene technique in reducing potentially pathogenic microorganisms found on nursing professionals' hands. J Infect Dev Ctries 2023; 17:1088-1098. [PMID: 37699087 DOI: 10.3855/jidc.16709] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 02/28/2023] [Indexed: 09/14/2023] Open
Abstract
INTRODUCTION Healthcare-associated infections are concerning adverse events and hand hygiene is considered an essential preventive measure. The objective of the present study was to assess the effect of a correct 3-step hand hygiene technique on reducing of potentially pathogenic microorganisms on hands related to the WHO five moments for hand hygiene. METHODOLOGY A cross-sectional study was performed by means of direct observation involving 60 Intensive Care Units (ICU) and clinical nursing professionals in a Brazilian hospital. Observations were performed in order to ascertain the adherence rate and the correct technique during health assistance. Additionally, microbiological analysis of material collected from the nursing professional's hands was carried out. Exploratory and inferential analyses were performed on R software and binomial analysis was carried out by using the Z-test. The study was approved by the research ethics committee and covered all the legal principles for the protection of human subjects. RESULTS Hand hygiene adherence rate was 63.3%. However, only 13.3% of the professionals performed the correct 3-step hand hygiene technique regarding steps and time. Sixty-five microorganisms were isolated, among which 56.9% were coagulase-negative Staphylococcus, 26.2% were Gram-negative bacilli, 7.7% were Enterococcus faecalis, and 6.2% were Candida parapsilosis. There was no presence of potentially pathogenic microorganisms on the nursing professional's hands who performed the correct three-step technique. CONCLUSIONS Overall correct hand hygiene technique was poor. The results indicated the presence of potentially pathogenic microorganisms at moments in which hand hygiene was mandatory but was not executed or was executed incorrectly. The 3-step hand hygiene technique proved to be effective when correctly performed since there were no microorganism growth. Larger studies are needed to test if these results can be replicated at a larger scale, since streamlining hand hygiene technique yielded encouraging results.
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Affiliation(s)
- Marília Duarte Valim
- Nursing Department, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
| | | | | | | | | | | | - Gerard Lacey
- Electronic Engineering, Bioscience and Electronic Engineering Building Maynooth University, Maynooth, Co. Kildare, Ireland
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Kleinig TJ, Abou-Hamden A, Laidlaw J, Churilov L, Kellner CP, Wu T, Mocco J, Lau H, Adamides A, Kavar B, Dimou J, Cranefield J, McDonald A, Plummer S, Davis S, Campbell BCV. Early minimally invasive intracerebral hemorrhage evacuation: a phase 2a feasibility, safety, and promise of surgical efficacy study. J Neurointerv Surg 2023:jnis-2023-020446. [PMID: 37611941 DOI: 10.1136/jnis-2023-020446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/13/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Surgical treatment of intracerebral hemorrhage (ICH) is unproven, although meta-analyses suggest that both early conventional surgery with craniotomy and minimally invasive surgery (MIS) may be beneficial. We aimed to demonstrate the safety, feasibility, and promise of efficacy of early MIS for ICH using the Aurora Surgiscope and Evacuator. METHODS We performed a prospective, single arm, phase IIa Simon's two stage design study at two stroke centers (10 patients with supratentorial ICH volumes ≥20 mL and National Institutes of Health Stroke Scale (NIHSS) score of ≥6, and surgery commencing <12 hours after onset). Positive outcome was defined as ≥50% 24 hour ICH volume reduction, with the safety outcome lack of significant ICH reaccumulation. RESULTS From December 2019 to July 2020, we enrolled 10 patients at two Australian Comprehensive Stroke Centers, median age 70 years (IQR 65-74), NIHSS score 19 (IQR 19-29), ICH volume 59 mL (IQR 25-77), at a median of 227 min (IQR 175-377) post-onset. MIS was commenced at a median time of 531 min (IQR 437-628) post-onset, had a median duration of 98 min (IQR 77-110), with a median immediate postoperative hematoma evacuation of 70% (IQR 67-80%). A positive outcome was achieved in 5/5 first stage patients and in 4/5 second stage patients. One patient developed significant 24 hour ICH reaccumulation; otherwise, 24 hour stability was observed (median reduction 71% (IQR 61-80), 5/9 patients <15 mL residual). Three patients died, unrelated to surgery. There were no surgical safety concerns. At 6 months, the median modified Rankin Scale score was 4 (IQR 3-6) with 30% achieving a score of 0-3. CONCLUSION In this study, early ICH MIS using the Aurora Surgiscope and Evacuator appeared to be feasible and safe, warranting further exploration. TRIAL REGISTRATION NUMBER ACTRN12619001748101.
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Affiliation(s)
- Timothy J Kleinig
- Department of Neurology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Medicine, The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia
| | - Amal Abou-Hamden
- Neurosurgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Surgery, The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia
| | - John Laidlaw
- Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, Victoria, Australia
- Surgery, The University of Melbourne, Melbourne, Victoria, Australia
| | - Leonid Churilov
- Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Teddy Wu
- Neurology, Christchurch Hospital, Christchurch, Canterbury, New Zealand
| | - J Mocco
- Neurosurgery, Mount Sinai Health System, New York, New York, USA
| | - Hui Lau
- Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Alexios Adamides
- Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Bhadrakant Kavar
- Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - James Dimou
- Department of Neurosurgery, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Jennifer Cranefield
- Department of Neurology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Amy McDonald
- Neurology, Royal Melbourne Hospital, Parkville, Victoria, Adelaide, Australia
| | - Stephanie Plummer
- Neurosurgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Stephen Davis
- Medicine, The University of Melbourne, Melbourne, Victoria, Australia
- Neurology, Royal Melbourne Hospital, Parkville, Victoria, Adelaide, Australia
| | - Bruce C V Campbell
- Medicine, The University of Melbourne, Melbourne, Victoria, Australia
- Neurology, Royal Melbourne Hospital, Parkville, Victoria, Adelaide, Australia
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Vukadinović MS. The dance of hair - toward a more powerful performance. Front Psychol 2023; 14:1214861. [PMID: 37674748 PMCID: PMC10477601 DOI: 10.3389/fpsyg.2023.1214861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 08/08/2023] [Indexed: 09/08/2023] Open
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Pradas F, Toro-Román V, Castellar C, Carrasco L. Analysis of the spatial distribution of the serve and the type of serve-return in elite table tennis. Sex differences. Front Psychol 2023; 14:1243135. [PMID: 37637893 PMCID: PMC10452007 DOI: 10.3389/fpsyg.2023.1243135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/24/2023] [Indexed: 08/29/2023] Open
Abstract
Serve and return of the serve are among the most critical technical-tactical factors influencing performance in table tennis (TT). The present study aimed to analyse sex differences in the spatial distribution of serve and serve-return in elite TT players. A total of 48 elite TT players (men: n = 24; women: n = 24) participated in the investigation. A total of 24 matches were recorded and examined, analysing 1,177 plays and 5,319 strokes in the men's competition and 950 games and 5,097 strokes in the women's competition. Technical actions were analysed using an observation tool validated by two expert TT coach with a high level of agreement (K > 0.80). Men distributed their serves over zones 1 and 2 of the table, while women more frequently selected zone 5 (p < 0.05). In men, 30.1% of the serves were near the net, 63.6% in the middle zone of the table and 6.2% in the end zone of the table, while in women, these values were 10.9%, 67.2%, and 21.8%, respectively. As for the technique of the serve-return depending on the zone of the service, in men the action of the cut from zone 1 and 2 predominated, while in women this technique was more frequent from zone 5 (p < 0.05). On the other hand, the serve-return with the flip technique in zone 1, 3 and 4 was more frequent in men (p < 0.05). As for the return of the serve with the topspin technique, there were differences in zone 3, being more frequent in men (p < 0.05). Finally, the serve return with cut and defensive serve-return techniques in zones 3, 4, 5, and 6 were more frequent in women (p < 0.05). There are differences between sexes in service and return of serve actions during a match in elite players.
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Affiliation(s)
- Francisco Pradas
- ENFYRED Research Group, Faculty of Health and Sports Sciences, University of Zaragoza, Huesca, Spain
| | - Víctor Toro-Román
- Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
| | - Carlos Castellar
- ENFYRED Research Group, Faculty of Health and Sports Sciences, University of Zaragoza, Huesca, Spain
| | - Luis Carrasco
- Faculty of Education, University of Sevilla, Sevilla, Spain
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Ryu B, Mochizuki T, Kushi K, Ishikawa T, Shima S, Sato S, Inoue T, Kawamata T, Niimi Y. Optimal guiding catheter position during advancement of the guiding catheter into the carotid artery from the aortic arch via transfemoral approach. Neuroradiol J 2023; 36:470-478. [PMID: 36661360 PMCID: PMC10588598 DOI: 10.1177/19714009221150858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Guiding catheter (GC) advancement into the target carotid artery is a crucial step in neuroendovascular therapy. In difficult anatomies, alternative methods have been reported to overcome difficult carotid access for swift GC advancement. However, studies focusing on the positional relationship between the GC and inner catheter (IC) at the aortic arch are lacking. METHODS We evaluated the impact of the positional relationship between the GC and IC on whether the GC position affects catheter support or system straightening. We retrospectively reviewed 89 patients who underwent neuroendovascular therapy. We assessed the time to carotid access across difficult arch anatomies. The GC position was divided into Position 1, descending aorta level; Position 2, aortic arch level; and Position 3, origin of the left common carotid artery or innominate artery. We also evaluated the GC support and straightening effects in an in vitro vascular model study. RESULTS The coaxial catheter flexion angle at the aortic arch was significantly larger when the GC was set to Position 3 (p < 0.0001). A significantly shorter time to carotid access was observed with Positions 2 and 3 than with Position 1 in the difficult arch anatomy group. In the in vitro vascular model evaluation, the catheter support effect significantly increased as the GC position became closer to the IC tip (p < 0.0001) and straightening effect significantly increased as the GC moved to Position 2 from Position 1 (p < 0.0001). CONCLUSION During GC advancement, the GC positional relationship changed the support of the coaxial system with system straightening. The optimal GC position, Position 3, facilitated swift GC advancement.
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Affiliation(s)
- Bikei Ryu
- Department of Neuroendovascular Therapy, St Luke’s International Hospital, Chuo-ku, Japan
- Department of Neurosurgery, St Luke’s International Hospital, Chuo-ku, Japan
- Department of Neurosurgery, Tokyo Women’s Medical University, Shinjuku-ku, Japan
| | - Tatsuki Mochizuki
- Department of Neurosurgery, St Luke’s International Hospital, Chuo-ku, Japan
| | - Kazuki Kushi
- Department of Neurosurgery, St Luke’s International Hospital, Chuo-ku, Japan
| | - Tomomi Ishikawa
- Department of Neurosurgery, St Luke’s International Hospital, Chuo-ku, Japan
- Department of Neurosurgery, Tokyo Women’s Medical University, Shinjuku-ku, Japan
| | - Shogo Shima
- Department of Neurosurgery, St Luke’s International Hospital, Chuo-ku, Japan
| | - Shinske Sato
- Department of Neuroendovascular Therapy, St Luke’s International Hospital, Chuo-ku, Japan
- Department of Neurosurgery, St Luke’s International Hospital, Chuo-ku, Japan
- Department of Neurosurgery, Tokyo Women’s Medical University, Shinjuku-ku, Japan
| | - Tatsuya Inoue
- Department of Neurosurgery, St Luke’s International Hospital, Chuo-ku, Japan
| | - Takakazu Kawamata
- Department of Neurosurgery, Tokyo Women’s Medical University, Shinjuku-ku, Japan
| | - Yasunari Niimi
- Department of Neuroendovascular Therapy, St Luke’s International Hospital, Chuo-ku, Japan
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Morais JE, Barbosa TM, Lopes T, Moriyama SI, Marinho DA. Comparison of swimming velocity between age-group swimmers through discrete variables and continuous variables by Statistical Parametric Mapping. Sports Biomech 2023:1-12. [PMID: 37526077 DOI: 10.1080/14763141.2023.2241845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
The aim of this study was to compare the swimming velocity in front-crawl between age-group swimmers using discrete variables against Statistical Parametric Mapping (SPM). The sample consisted of 30 young male swimmers divided into three groups (each with 10 swimmers) based on their age (group #1: 13.60 ± 0.84 years; group #2: 15.40 ± 0.32 years; group 3: 16.39 ± 0.69 years). Swimmers performed three maximal trials in front-crawl. The best performance was used for analysis. Comparison of swimming velocity between groups was analysed using discrete variables and as a continuous variable (SPM). As a discrete variable, the mean swimming velocity showed a significant difference between groups (p < 0.05). Moreover, when analysed by SPM, swimming velocity showed a significant difference (p = 0.021) between the ~ 44% and ~ 51% of the stroke cycle (transition of the propulsion phases between sides). Post-hoc comparison revealed a significant difference between group #1 and group #3 only in SPM analysis. Researchers, coaches, and practitioners should know that both measurement approaches can be used simultaneously. However, SPM offers more sensitive and accurate results about the swimmers' stroke cycle.
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Affiliation(s)
- Jorge E Morais
- Department of Sport Sciences, Instituto Politécnico de Bragança, Bragança, Portugal
- Research Centre in Sports, Health and Human Development (CIDESD), Covilhã, Portugal
| | - Tiago M Barbosa
- Department of Sport Sciences, Instituto Politécnico de Bragança, Bragança, Portugal
- Research Centre in Sports, Health and Human Development (CIDESD), Covilhã, Portugal
| | - Tiago Lopes
- Department of Sport Sciences, University of Beira Interior, Covilhã, Portugal
| | - Shin-Ichiro Moriyama
- Department of Health & Sports Sciences, Faculty of Education, Tokyo Gakugei University, Tokyo, Japan
| | - Daniel A Marinho
- Research Centre in Sports, Health and Human Development (CIDESD), Covilhã, Portugal
- Department of Sport Sciences, University of Beira Interior, Covilhã, Portugal
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Tanaka S, Hiranaka T, Fukai Y, Okajima T, Kanno T. A Muscle-Preserving Short Transverse Incision for Unicompartmental Knee Arthroplasty: A Technical Note. Cureus 2023; 15:e43662. [PMID: 37719491 PMCID: PMC10505075 DOI: 10.7759/cureus.43662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 09/19/2023] Open
Abstract
We describe the use of a short transverse incision technique with muscle retention for unicompartmental knee arthroplasty (UKA). The incision is made transversely just above the joint line, followed by a detachment of subcutaneous soft tissue from the underlying capsule and fascia to create a mobile window. The fascia is incised along the medial border of the vastus medialis and the capsule of the suprapatellar pouch is incised laterally, preserving vastus medialis muscle. All procedures are performed within the mobile window while controlling the knee flexion angle. Following implantation, the capsule and fascia are anatomically repaired. This approach was used in 30 consecutive patients who underwent Oxford UKA, including one bi-unicompartmental knee arthroplasty without complications. Importantly, no patients had any disturbances of the infrapatellar branch of the saphenous nerve disturbances such as numbness, hyperesthesia, hypoesthesia, or neuroma pain. The transverse approach is thought to be a safe and feasible method for UKA.
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Affiliation(s)
- Sho Tanaka
- Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, JPN
| | - Takafumi Hiranaka
- Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, JPN
| | - Yasuhiro Fukai
- Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, JPN
| | - Takahiro Okajima
- Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, JPN
| | - Tatsuhiko Kanno
- Orthopaedic Surgery and Joint Surgery Centre, Takatsuki General Hospital, Takatsuki, JPN
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Kim WJ, Samarage HM, Jafari M, Zarrin D, Goel K, Qi X, Wang AC, Johnson J, Colby GP. Novel endovascular transmural technique for pharmacological block of superior cervical ganglion prevents sympathetic-mediated cerebral vasospasm. J Neurointerv Surg 2023:jnis-2023-020636. [PMID: 37500479 PMCID: PMC10818000 DOI: 10.1136/jnis-2023-020636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Sympathetic-mediated vasoconstriction from the superior cervical ganglion (SCG) is a significant contributor to cerebral vasospasm. Inhibition of the SCG has been shown to improve cerebral blood flow and reverse cerebral vasospasm in swine models. We evaluated the efficacy of a novel minimally invasive endovascular approach to target and pharmacologically inhibit the SCG, using a Micro-Infusion Device for transmural drug delivery. METHODS Eight SCGs in four Yorkshire swine were surgically identified. After confirming appropriate sympathetic-mediated intracranial vasoconstriction response with SCG stimulation, an endovascular Micro-Infusion Device was used for transmural targeting of the SCG and delivery of 1.5-2 mL of 1% lidocaine-contrast mixture to the perivascular space. Digital subtraction angiography was obtained at: (1) baseline; (2) with SCG stimulation; and (3) after lidocaine delivery to the SCG using the Micro-Infusion Device with concurrent SCG stimulation. Vessel diameters were measured and compared. RESULTS Endovascular transmural delivery of lidocaine to the SCG and carotid perivascular tissue using the Micro-Infusion Device successfully inhibited sympathetic-mediated vasoconstriction response. Measured vessel diameters after lidocaine delivery were comparable to baseline despite SCG stimulation. CONCLUSION A novel endovascular technique of transmural delivery of lidocaine to the SCG and carotid artery perivascular tissues successfully inhibits the sympathetic input to the cerebral vasculature and modulates sympathetic-mediated cerebral vasospasm. These results suggest promising steps towards translation to potential clinical use for patients suffering from cerebral vasospasm.
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Affiliation(s)
- Wi Jin Kim
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Hasitha Milan Samarage
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Matiar Jafari
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - David Zarrin
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Keshav Goel
- University of California Los Angeles, Los Angeles, California, USA
| | - Xin Qi
- School of Medicine, UCLA, Los Angeles, California, USA
| | - Anthony C Wang
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Jeremiah Johnson
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Geoffrey P Colby
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
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Beaman C, Gautam A, Peterson C, Kaneko N, Ponce L, Saber H, Khatibi K, Morales J, Kimball D, Lipovac JR, Narsinh KH, Baker A, Caton MT, Smith ER, Nour M, Szeder V, Jahan R, Colby GP, Cord BJ, Cooke DL, Tateshima S, Duckwiler G, Waldau B. Robotic Diagnostic Cerebral Angiography: A Multicenter Experience of 113 Patients. J Neurointerv Surg 2023:jnis-2023-020448. [PMID: 37468266 DOI: 10.1136/jnis-2023-020448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/14/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Neurointerventional robotic systems have potential to reduce occupational radiation, improve procedural precision, and allow for future remote teleoperation. A limited number of single institution case reports and series have been published outlining the safety and feasibility of robot-assisted diagnostic cerebral angiography. METHODS This is a multicenter, retrospective case series of patients undergoing diagnostic cerebral angiography at three separate institutions - University of California, Davis (UCD); University of California, Los Angeles (UCLA); and University of California, San Francisco (UCSF). The equipment used was the CorPath GRX Robotic System (Corindus, Waltham, MA). RESULTS A total of 113 cases were analyzed who underwent robot-assisted diagnostic cerebral angiography from September 28, 2020 to October 27, 2022. There were no significant complications related to use of the robotic system including stroke, arterial dissection, bleeding, or pseudoaneurysm formation at the access site. Using the robotic system, 88 of 113 (77.9%) cases were completed successfully without unplanned manual conversion. The principal causes for unplanned manual conversion included challenging anatomy, technical difficulty with the bedside robotic cassette, and hubbing out of the robotic system due to limited working length. For robotic operation, average fluoroscopy time was 13.2 min (interquartile range (IQR), 9.3 to 16.8 min) and average cumulative air kerma was 975.8 mGY (IQR, 350.8 to 1073.5 mGy). CONCLUSIONS Robotic cerebral angiography with the CorPath GRX Robotic System is safe and easily learned by novice users without much prior manual experience. However, there are technical limitations such as a short working length and an inability to support 0.035" wires which may limit its widespread adoption in clinical practice.
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Affiliation(s)
- Charles Beaman
- University of California Stroke Consortium Robotics Workgroup, California, California, USA
- Radiology, University of California Los Angeles, Los Angeles, California, USA
| | - Ayushi Gautam
- University of California Stroke Consortium Robotics Workgroup, California, California, USA
- Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Catherine Peterson
- University of California Stroke Consortium Robotics Workgroup, California, California, USA
- Neurosurgery, University of California Davis, Sacramento, CA, USA
| | - Naoki Kaneko
- University of California Stroke Consortium Robotics Workgroup, California, California, USA
- Radiology, University of California Los Angeles, Los Angeles, California, USA
| | - Luciano Ponce
- Radiology, University of California Los Angeles, Los Angeles, California, USA
| | - Hamidreza Saber
- Radiology, University of California Los Angeles, Los Angeles, California, USA
| | - Kasra Khatibi
- Radiology, University of California Los Angeles, Los Angeles, California, USA
| | - Jose Morales
- Radiology, University of California Los Angeles, Los Angeles, California, USA
| | - David Kimball
- Radiology, University of California Los Angeles, Los Angeles, California, USA
| | | | - Kazim H Narsinh
- University of California Stroke Consortium Robotics Workgroup, California, California, USA
- Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Amanda Baker
- Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - M Travis Caton
- Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Eric R Smith
- Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - May Nour
- Radiology, University of California Los Angeles, Los Angeles, California, USA
| | - Viktor Szeder
- Radiology, University of California Los Angeles, Los Angeles, California, USA
| | - Reza Jahan
- Radiology, University of California Los Angeles, Los Angeles, California, USA
| | - Geoffrey P Colby
- University of California Stroke Consortium Robotics Workgroup, California, California, USA
- Radiology, University of California Los Angeles, Los Angeles, California, USA
- Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Branden J Cord
- University of California Stroke Consortium Robotics Workgroup, California, California, USA
- Neurosurgery, University of California Davis, Sacramento, CA, USA
| | - Daniel L Cooke
- University of California Stroke Consortium Robotics Workgroup, California, California, USA
- Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA
| | - Satoshi Tateshima
- Radiology, University of California Los Angeles, Los Angeles, California, USA
| | - Gary Duckwiler
- University of California Stroke Consortium Robotics Workgroup, California, California, USA
- Radiology, University of California Los Angeles, Los Angeles, California, USA
| | - Ben Waldau
- University of California Stroke Consortium Robotics Workgroup, California, California, USA
- Neurosurgery, University of California Davis, Sacramento, CA, USA
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Sakamoto A, Noguchi T, Matsuda S. Anatomic variations in retaining ligaments during minimally invasive resection of subcutaneous lipomas. GMS Interdiscip Plast Reconstr Surg DGPW 2023; 12:Doc02. [PMID: 37577726 PMCID: PMC10413276 DOI: 10.3205/iprs000172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Objective Lipomas are common, benign tumors usually located in the subcutaneous tissue. The "one-inch method" is a minimally invasive technique for resecting large subcutaneous lipomas through a one-inch incision after blunt dissection of the lipoma from its peripheral retaining ligaments. The limitations of this method are currently unclear. Materials and methods We assessed twenty-five patients with large lipomas, defined as a tumor diameter greater than 5 cm. The location of the lipoma was at the shoulder in fifteen patients, the extremity in six patients, and the torso in four patients. Results The mean operative time for all lesions was 28.3 minutes, with a mean time of 25.9 minutes for lipomas at the shoulder, 21.8 minutes for the extremities, and 47.0 minutes for the torso. We classified patients into three groups according to operative time: the short group (10-29 min), middle group (30-49 min), and long group (50-70 min). For lipomas of the shoulder, there were eleven patients (73%) in the short group, three patients (20%) in the middle group, and one patient (7%) in the long group. For lipomas of the extremity, the groups contained five patients (83%), one patient (17%), and no patients (0%), respectively. For lipomas of the torso, the groups contained one patient (25%), no patients (0%), and three patients (75%), respectively. Conclusions Lipomas of the torso require a longer operative time than those of the shoulder or extremity; this difference could be due to the number of retaining ligaments present, which is reportedly higher in the back than in the anterior or side body. Lipomas of the back are less amenable to the one-inch method, and posterior shoulder lipomas may take more time than those at other parts of the shoulder or at the extremities.
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Affiliation(s)
- Akio Sakamoto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Japan
| | - Takashi Noguchi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Japan
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