Dickinsonsolis5515
a comprehensive evaluation of neurofilament light in brain and CSF and enables future investigations of neurofilament light biology and utility as a biomarker.This scientific commentary refers to 'A map of neurofilament light chain species in brain and cerebrospinal fluid and alterations in Alzheimer's disease' by Budelier et al. (https//doi.org/10.1093/braincomms/fcac045).Presurgical identification of the epileptogenic zone is a critical determinant of seizure control following surgical resection in epilepsy. Excitatory glutamate α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor is a major component of neurotransmission. Although elevated α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor levels are observed in surgically resected brain areas of patients with epilepsy, it remains unclear whether increased α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor-mediated currents initiate epileptic discharges. We have recently developed the first PET tracer for α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor, [11C]K-2, to visualize and quantify the density of α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptors in living human brains. Here, we detected elevated [11C]K-2 uptake in the epileptogenic temporal lobe of patients with mesial temporal lobe epilepsy. Brain areas with high [11C]K-2 uptake are closely colocalized with the location of equivalent current dipoles estimated by magnetoencephalography or with seizure onset zones detected by intracranial electroencephalogram. These results suggest that epileptic discharges initiate from brain areas with increased α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptors, providing a biological basis for epileptic discharges and an additional non-invasive option to identify the epileptogenic zone in patients with mesial temporal lobe epilepsy.For patients with glioma located in or adjacent to the linguistic eloquent cortex, awake surgery with an emphasis on the preservation of language function is preferred. However, the brain network basis of postoperative linguistic functional outcomes remains largely unknown. In this work, 34 patients with left cerebral gliomas who underwent awake surgery were assessed for language function and resting-state network properties before and after surgery. We found that there were 28 patients whose language function returned to at least 80% of the baseline scores within 3 months after surgery or to 85% within 6 months after surgery. For these patients, the spontaneous recovery of language function synchronized with changes within the language and cognitive control networks, but not with other networks. Specifically, compared with baseline values, language functions and global network properties were the worst within 1 month after surgery and gradually recovered within 6 months after surgery. The recovery of connections was tumour location dependent and was attributed to both ipsihemispheric and interhemispheric connections. In contrast, for six patients whose language function did not recover well, severe network disruptions were observed before surgery and persisted into the chronic phase. This study suggests the synchronization of functional network normalization and spontaneous language recovery in postoperative patients with glioma.
In 2007, POLYTECH Health & Aesthetics (POLYTECH, Dieburg, Germany) established an ongoing patient survey to improve the post-market surveillance of silicone gel-filled breast implants based on patient-reported outcomes in the context of the pioneering "Implants of Excellence" (IoE) program.
To disclose an update on safety and performance outcomes at 5 years for Mesmo breast implants.
Between January 2014 and October 2019, 919 patients (for a total of 1816 implants) who underwent breast augmentation and reconstruction with Mesmo implants were asked to participate in the IoE program. Data were collected by mean of 1320 questionnaires received. A survival analysis assessed the onset of different complications.
Eight patients (0.9%) experienced capsular contracture Baker grade III or IV with a cumulative rate at 5 years of 1.2% (95% CI = 0.6-2.4). The proportion of revisional surgery was 0.5% with a 5-year rate of 0.6% (95% CI = 0.2-1.5). Additional adverse events such as hematoma, seroma, malposition, open wounds, and other complications were carefully monitored. Questionnaires showed that 93.9% (95% CI = 92.2-95.4) of the patients were satisfied or very satisfied with their aesthetic results with Mesmo implants.
Post-market clinical follow-up revealed that the overall complications rate reported was low. Data demonstrated an excellent safety property on a large cohort of patients. This result allows the rating of Mesmo breast implants as highly competitive and a very safe choice for both surgeons and patients.
Our purpose was to analyze the content and quality of YouTube videos related to distal biceps tendon (DBT) ruptures and repair. We aimed to compare differences between academic and nonacademic video sources.
The most popular YouTube videos related to DBT injuries were compiled and analyzed according to source. Viewing characteristics were determined for each video. Video content and quality were assessed by 2 reviewers and analyzed according to the
benchmark criteria, DISCERN criteria, and a Distal Biceps Content Score. Cohen's kappa was used to measure interrater reliability.
A total of 59 DBT YouTube videos were included. The intraclass correlation coefficients ranged from moderate to excellent for the content scores. The mean DISCERN score was 29, and no videos were rated as either "good" or "excellent" for content quality. With the exception of the mean
criteria score (1.5 vs 0.5), videos from academic sources did not demonstrate significantly higher levels of content quality. Only 4/59 videoss misconceptions regarding the management of DBT tears. Patients are increasingly seeking health information online, and surgeons should direct patients toward more reliable and vetted sources of information.
To evaluate the possibility of posterior interosseous nerve (PIN) injury during cortical button deployment and seating associated with bicortical drilling and passage of the cortical button across the distal cortex when repairing a distal biceps rupture in a cadaveric model.
Each cadaver was placed in the supine position with the arm extended. A single 4 cm transverse incision was made in the region of the radial tuberosity, 3-4 cm distal to the antecubital fossa flexion crease, and dissected down to the radial tuberosity. A #2 looped nonabsorbable suture was used to baseball stitch the musculotendinous junction to the distal 2.5 cm end of the tendon. A 3.2 mm cannulated drill bit (Arthrex) was used to create a bicortical drill hole in the center of the radial tuberosity aiming 30° ulnar to maximize the distance from the PIN. Fluoroscopy was used to confirm drill placement in the radial tuberosity for all specimens. The posterior aspect of the elbow in all cadavers was subsequently dissected out to directly visualize how far the cannulated drill was from the PIN.
Twelve cadavers, average age 57.4 years (range, 27-83 years), were dissected. During deployment, the cortical button contacted the PIN directly in 6 extremities. The cortical button came within 6 mm of the PIN in eleven extremities. In 8 specimens, the cortical button was within 2 mm of the PIN. ThePIN was caught directly under the cortical button in one specimen.
Placement of a biceps cortical button bicortically when repairing a distal biceps tendon may increase the risk of injury to the PIN during cortical button deployment and seating.
Therapeutic IV.
Therapeutic IV.We report a case of a 49-year-old patient with an isolated dorsal radial dislocation of the right trapezium that occurred in a context of polytrauma. At first, the lesion went unnoticed. The diagnosis was made 1 month later because of persistent pain in the thumb. An open reduction of the dislocation was carried out, and osteosynthesis using scaphoid-trapezium and trapeziotrapezoid pinning was conducted under fluoroscopic control. The patient was immobilized for 3 months after surgery. After 4 years, the mobility of the thumb was complete and painless.
Despite advancements in surgical techniques, suture pull-though and rupture continue to limit the early range of motion and functional rehabilitation after flexor tendon repairs. The aim of this study was to evaluate a suturable mesh compared with a commonly used braided suture in an invivo rabbit intrasynovial tendon model.
Twenty-four New Zealand female rabbits (3-4 kg) were injected with 2 units/kg botulinum toxin evenly distributed into 4 sites in the left calf. After 1 week, the animals underwent surgical tenotomy of the flexor digitorum tendon and were randomized to repair with either 2-0 Duramesh suturable mesh or to 2-0 Fiberwire using a 2-strand modified Kessler and 6-0 polypropylene running epitendinous suture. Rabbits were killed at 2, 4, and 9 weeks after surgery.
Grouping across time points, 58.3% (7 of 12) of Duramesh repairs were found to be intact for the explant compared with 16.7% (2 of 12) of Fiberwire repairs (
= .09). At 2 weeks, the mean Duramesh repairs were significantly stronger than the Fiberwire repairs with a mean failure load of 50.7 ± 12.7 N compared to 14.8 ± 18.3 N (
= .02). The load supported by the Duramesh repairs at 2 weeks (mean 50.7 ± 12.7 N) was similar to the load supported by both Fiberwire (52.2 ± 13.6 N) and Duramesh (57.6 ± 22.3 N) at 4 weeks. Triparanol The strength of repair between Fiberwire and Duramesh at 4 weeks and 9 weeks was not significantly different.
The 2-strand tendon repair with suturable mesh achieved significantly greater strength at 2 weeks than the conventional suture material. Future studies should evaluate the strength of repair prior to 2 weeks to determine the strength curve for this novel suture material.
This study evaluates the utility of a novel suturable mesh for flexor tendon repair in an invivo rabbit model compared with conventional suture material.
This study evaluates the utility of a novel suturable mesh for flexor tendon repair in an in vivo rabbit model compared with conventional suture material.A 57-year-old man with diabetes mellitus presented with a 4-day history of left palm pain out of proportion, with swelling, erythema, and dense median and ulnar nerve distribution sensory changes. Magnetic resonance imaging with and without contrast revealed diffuse hand edema and myonecrosis. The patient was treated surgically because the examination was concerning for acute carpal tunnel syndrome and ulnar nerve compression. Spontaneous diabetic myonecrosis is a complication of diabetes mellitus that can be confused with several other conditions. It presents as acute-onset painful swelling in any muscle, and in the hand, may cause compressive neuropathies that necessitate surgical intervention.
Chronic, nonspecific wrist pain in adolescents can be challenging to assess and treat. We hypothesized that an algorithmic approach beginning with grip strengthening can alleviate pain, improve function, and identify patients in need of further intervention.
We retrospectively reviewed the results of a grip-strengthening protocol for adolescents with chronic, nonspecific wrist pain. Before and after treatment, grip strength was measured using handheld dynamometry, and patient-reported pain and function were measured using the adolescent self-reported Pediatric Outcomes Data Collection Instrument's (PODCI's) Pain/Comfort and Upper Extremity Function domains (PODCI/pain and PODCI/UE, respectively).
Thirty-two patients (28 female, 4 male) were included, with a mean age of 14 years (range, 10-18 years) and the dominant hand affected in 19, nondominant hand in 9, and bilateral impacts in 4. The mean symptom duration prior to presentation was 9 months (range, 1-63 months); 17 patients had undergone prior immobilization and 5 prior occupational/physical therapy.
