Reimersehested7001

Complicated spinal cord injury occurs in 1-5 cases per 100.000. In children, cervical trauma makes up 72% of all spinal trauma. Spinal cord injury complicates vertebral trauma in 25-50% of cases that usually results severe disability. Rehabilitation of these patients is usually ineffective or results a little improvement. Restoration of even minimal movements is essential in these patients. There are reports devoted to surgical rehabilitation of important hand functions after cervical spinal cord injury.

To demonstrate the restoration of key hand functions in patients with C

-C

complicated spinal cord injury using selective neurotization of the median nerve.

Three patients aged 17-19 years with complicated C

-C

spinal cord injury and ASIA class A have been selected for surgery for 2 years. Mean period after rehabilitation was 11.3 months. Prior to surgery, all patients recovered flexion/extension in the elbow joints, forearm rotation, flexion and extension of hands. However, there were no active movements in distal phalanges of the fingers, and initial signs of flexor contracture were observed.

Surgical strategy included selective neurotization of the median nerve with a motor branch of musculocutaneous nerve. In one case, we used additional neurotization of posterior interosseous nerve. Two patients recovered cylindrical grip up to M4 and pinch grip up to M3 within 15 months. In the third patient, postoperative data were not assessed due to short-term follow-up.

Selective neurotization of anterior interosseous nerve may be considered as a stage or independent surgery for restoration of key hand functions. This approach improves the quality of life in patients with complicated spinal cord injury.

Selective neurotization of anterior interosseous nerve may be considered as a stage or independent surgery for restoration of key hand functions. This approach improves the quality of life in patients with complicated spinal cord injury.

Mapping of effective speech connections between the frontal and temporal lobes with cortico-cortical evoked potentials.

There were 3 patients with brain tumors in the left frontoparietal region. The neoplasms were localized in the dominant hemisphere near cortical speech centers and pathways. Cortico-cortical evoked potentials were intraoperatively recorded in response to bipolar stimulation with a direct current delivered through the subdural electrodes (single rectangular biphasic impulses with duration of 300 μs and frequency of 1 Hz). Stimulation intensity was gradually increased from 2 mA within 3-4 mA. Registration was carried out by averaging ECoG (30-50 stimuli in each session) in the 300-ms epoch after stimulus. Direct cortical stimulation was used to validate the results of cortico-cortical speech mapping with cortico-cortical evoked potentials.

In our cases, we obtained cortico-cortical evoked potentials from inferior frontal gyrus after stimulation of superior temporal gyrus. In one case, thontal and temporal lobes. Further study of this method in large samples is required.

To study the possibility of the modern CT and MRI methods in diagnostics of the orbital venous varices (OVV), discover the special characteristics of these lesions concerning their hemodynamic and differential diagnosis with other orbital lesions.

In the period from 2012 to 2019 ten patients with OVV were evaluated. Four of them were men, three

women and three

children (boys aged 7, 10, and 12 years). Age of the patients varied from 7 to 75 years old (mediana

34).

The majority of the OVV was localized in the medial compartments and apex of the orbit. Left sided lesions were found in 6 cases, right

3. One patient had both sided OVV. In one of the cases in 10-year-old child, we revealed malformation of the Galen vein associated with bilateral varicose enlargement of the intraorbital veins (secondary OVV).

Diagnosis of orbital vascular pathology requires an understanding of the classification of vascular lesions, the integration of the patient's medical history with epidemiological data, as we characteristics of its hemodynamics.

To analyze intracellular pH measurement with phosphorus-31 MR spectroscopy in glioblastoma cells and to compare these data with intracellular pH in healthy volunteers.

There were 10 patients aged 41 - 67 years with supratentorial glioblastomas. Intracellular pH in glioblastoma cells was compared with pH in healthy persons.

We found a tendency to increased intracellular pH in glioblastoma cells in comparison with pH in intact brain tissue.

Intracellular pH in brain tissue can be used as a potential marker of early abnormalities which could not be detected by conventional MRI. Moreover, these data may be valuable to estimate the efficacy of chemotherapy. The study was supported by Russian Science Foundation (grant No. 18-15-00337).

Intracellular pH in brain tissue can be used as a potential marker of early abnormalities which could not be detected by conventional MRI. Moreover, these data may be valuable to estimate the efficacy of chemotherapy. The study was supported by Russian Science Foundation (grant No. 18-15-00337).

Surgical treatment of intervertebral disc herniation with a high degree of migration (beyond the vertebral pedicle) is a difficult problem without an unambiguous solution. In this manuscript, we compare the effectiveness of transpedicular endoscopy and standard discectomy in the treatment of patients with this disease.

To compare transpedicular endoscopic sequestrectomy and discectomy in the treatment of lumbar intervertebral disc herniation with a high degree of migration.

There were 28 patients divided into 2 groups group 1 - 13 patients after transpedicular endoscopic sequestrectomy, group 2 - 15 patients after discectomy.

Transpedicular endoscopic sequestrectomy ensured significantly better intraoperative parameters (incision length, blood loss, surgery time) (

<0.01). In both groups, postoperative VAS score of leg pain was significantly reduced within a day after surgery from 7.4±1.3 to 0.7±0.7 and from 7.1±1 to 0.8±0.5, respectively. In the 1

group, VAS score of back pain regressed from 5.2±0.7 to 1.1±0.89 by the end of the 1

postoperative day. This value was 0.6±0.5 a year later. In the 2

group, VAS score of back pain regressed from 4.9±1 to 2.5±0.9 by the end of the 1

postoperative day. This value was 2.8±2.3 a year later. BI-2852 in vitro According to McNab clinical outcome scale, excellent and good results after transpedicular endoscopic sequestrectomy were obtained in all 13 (100%) patients, after discectomy - in 80% of cases.

Transpedicular endoscopic sequestrectomy is optimal for intervertebral disc herniation with a high degree of migration due to fast postoperative recovery and no complications.

Transpedicular endoscopic sequestrectomy is optimal for intervertebral disc herniation with a high degree of migration due to fast postoperative recovery and no complications.

Surgical treatment of intramedullary spinal cord tumors is aimed at total resection of tumor with maximum preservation of neurological and functional status. In some cases, intramedullary tumors have unclear dissection plane or gliosis zone. This area is not a tumor and does not require resection. However, it is difficult to distinguish visually intact spinal cord tissue and tumor at the last surgical stages. Thus, we evaluated the effectiveness of fluorescence combined with laser spectroscopy in surgical treatment of intramedullary spinal cord tumors.

To determine the effectiveness of visual fluorescence combined with laser spectroscopy in surgery for intramedullary spinal cord tumors.

There were 850 patients with intramedullary spinal cord tumors for the period 2001-2019. In 35 cases, intraoperative fluoroscopy with laser spectroscopy were used. All patients underwent a comprehensive pre- and postoperative clinical and instrumental examination (general and neurological status, McCormick grade, spinal noma - 0%, low-grade astrocytoma - 70%, high-grade astrocytoma - 80%, ependymoma - 92%, anaplastic ependymoma 100%. Dissection plane is absent in anaplastic ependymoma, high-grade astrocytoma. We often observed gliosis during resection of ependymoma. This tissue is not a part of tumor. Intraoperative metabolic navigation with neurophysiological monitoring are advisable for total tumor resection in case of unclear dissection plane and peritumoral gliosis.

Visual fluorescence combined with laser spectroscopy is a perspective method for intraoperative imaging of tumor remnants and total resection of intramedullary spinal cord tumors with minimum risk of neurological impairment.

Visual fluorescence combined with laser spectroscopy is a perspective method for intraoperative imaging of tumor remnants and total resection of intramedullary spinal cord tumors with minimum risk of neurological impairment.

Medication‑related harm (MRH) has been recognized as a global public health issue.

This study aimed to assess the prevalence and causes of MRH in geriatric patients. Another objective of the study was to recognize how MRH and drugs prescribed after geriatric interventions affect survival.

It was a cross‑sectional study of 301 geriatric patients admitted to the hospital for any cause, combined with a 2‑year survival analysis. Altogether, 71 drug items were included. Medication‑related harm was defined based on clinical reasoning. Logistic regression models were applied to identify the explanatory variables for each type of MRH. The Cox proportional hazards model was used to determine the association of MRH and postdischarge medications with patient survival.

Medication‑related harms were identified in 35.2% of the study patients. Those included, among others, hypotension (19.3%), hypoglycemia (13.3%), parkinsonism (4.3%), and benzodiazepine addiction (5.7%). Logistic regression, applied to estimate thees, ACEIs, SSRIs, and paracetamol, if indicated, were associated with better survival in geriatric patients.

Vulvar cancer accounts for ~4% of all gynecological malignancies and the majority of tumors (>90%) are squamous cell (keratinizing, ~60% and warty/basaloid, ~30%). Surgical excision forms the foundation of treatment, with resection margin status being the single most influential factor when predicting clinical outcome. link2 There has been a paradigm shift concerning surgical approaches and radicality when managing vulvar cancer within recent times, largely owing to a desire to preserve vulvar structure and function without compromising oncological outcome. As such the safety of the size of resection margin has been called into question. In this narrative review we consider the current literature on the safety of resection margins for vulvar cancer.

PubMed, Medline and the Cochrane Database were searched for original peer-reviewed primary and review articles, from January 2005 to January 2020. link3 The following search terms were used vulvar cancer surgery, vulvar squamous cell carcinoma, excision margins, adjuvasurgical margins alone needs to be closely evaluated, since the attendant morbidity associated with these procedures may not be outweighed by oncological benefit.