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showing 10 items of 6213 documents
Avaliação por OCT in vivo do comprimentos axiais centrais do segmento anterior
2017
ABSTRACT Purpose: To assess changes in anatomic structures in the anterior eye segment in terms of axial lengths with accommodation via optical coherence tomography. Methods: In this observational study, 25 eyes of 25 healthy adults were examined using the Visante® omni optical coherence tomography system. Central corneal thickness, anterior chamber depth, central lens thickness, and anterior segment length were assessed. The evaluated parameters were obtained with accommodation using different stimulus vergences, namely 0.0, -1.0, -2.0, and -3.0 D. Variation of these parameters was compared among different levels of accommodation. Results: Central corneal thickness was not altered at any s…
Evaluation of the Upper Limb Lymphatic System: A Prospective Lymphoscintigraphic Study in Melanoma Patients and Healthy Controls
2016
Background Current research on the upper limb lymphatic system mainly studies breast cancer patients with unilateral lymphedema. Without preoperative lymphoscintigraphy, the contralateral limb is used as a control, assuming that it is functionally intact. Few lymphoscintigraphic studies investigate patients before any axillary surgery. The purpose of this study was to evaluate, through lymphoscintigraphy, the preoperative condition of the upper limb lymphatic system in melanoma patients and healthy controls. Methods Two groups were studied: the study group (16 patients with trunk/upper limb melanoma candidates for axillary sentinel lymph node biopsy) and the control group (10 healthy volunt…
Operative management of epidural tumors of the spine
1994
Seventy-two patients with neoplastic involvement of the vertebral column were operated on between 1986 and 1991. In the course of 79 operations anterior decompression and stabilization alone were performed in 3 cases, while ventrodorsal spondylodesis was carried out in 10 individuals. The remainder of the patients underwent exclusively dorsal decompression and stabilization, mainly with the Cotrel-Dubousset instrumentation (CDI). No external spinal support was required following posterior fixation by CDI alone or in combination with ventral spondylodesis. Forty patients suffered from neurological deficits preoperatively, 20 of them being unable to walk, in most cases owing to severe vertebr…
An adaptive display for the treatment of diverse trauma PTSD victims.
2009
El trastorno de estrés postraumático (TEPT) puede desarrollarse después de la exposición a un evento aterrador. Las personas que sufren de trastorno de estrés postraumático presentan hiperactividad y evitación, y experimentan síntomas que provocan angustia y deterioro en áreas de vida significativas. Los programas de comportamiento cognitivo, incluida la terapia de exposición, son actualmente el tratamiento de elección para el TEPT. Aunque estos programas son eficaces, hay margen de mejora; La utilización de la terapia de exposición por los médicos es baja y las tasas de desgaste son altas. La aplicación de nuevas tecnologías, especialmente la realidad virtual (VR), podría ayudar a superar …
The Propeller Flap for Traumatic Distal Lower-Limb Reconstruction: Risk Factors, Pitfalls, and Recommendations.
2019
BACKGROUND Defects in the distal third of the leg are difficult to cover and often require free tissue transfer, even for defects of limited sizes. Propeller flaps have been designed specifically as an alternative to free tissue transfer but at times have been associated with unacceptably high complication rates. We therefore aimed to prospectively assess our own institutional experience with this technique and to define its role in lower-limb reconstruction. METHODS All patients who had been managed with reconstruction of the distal part of the leg with a propeller flap between 2014 and 2017 were included in the study. Demographic, clinical, and follow-up data on the patients and surgical …
Endoscopic endonasal pituitary surgery: Surgical and outcome analysis of 50 cases
2007
Abstract Objective Microsurgical transsphenoidal surgery for pituitary tumors has been standard therapy for decades and was established by Harvey Cushing in the early twentieth century. Today, endoscopy is increasingly accepted in the therapy of pituitary lesions. In this retrospective study, we analysed the surgical technique and outcome of 50 patients with pituitary lesions treated with an endoscopic endonasal trans-sphenoidal approach. Methods Between January 2004 and July 2005, 50 patients (30 female and 20 male) with pituitary tumors were operated upon using an endoscopic endonasal trans-sphenoidal procedure without nasal speculum or postoperative nasal packing. The follow-up period ra…
Cingulo-Insular Structural Alterations Associated with Psychogenic Symptoms, Childhood Abuse and PTSD in Functional Neurological Disorders
2017
Objective Adverse early-life events are predisposing factors for functional neurological disorder (FND) and post-traumatic stress disorder (PTSD). Cingulo-insular regions are implicated in the biology of both conditions and are sites of stress-mediated neuroplasticity. We hypothesised that functional neurological symptoms and the magnitude of childhood abuse would be associated with overlapping anterior cingulate cortex (ACC) and insular volumetric reductions, and that FND and PTSD symptoms would map onto distinct cingulo-insular areas. Methods This within-group voxel-based morphometry study probes volumetric associations with self-report measures of functional neurological symptoms, advers…
Robotic Versus Laparoscopic Gastric Resection for Primary Gastrointestinal Stromal Tumors5 cm: A Size-Matched and Location-Matched Comparison.
2017
This study compared robotic (RR) and laparoscopic resection (LR) for primary gastrointestinal stromal tumors (GISTs) of the stomach >5 cm. Twelve consecutive patients who underwent RR from 2012 to 2015 were matched for tumor size and location with 24 patients who underwent LR from 2000 to 2012. The median tumor size was 7.1 cm (range, 5.5 to 11.5). GISTs were resected by wedge resection (91.7%) or distal gastrectomy. The median RR operative time was longer than that of LR (162.5 vs. 130 min, respectively; P=0.004). Only 1 LR patient required conversion. The time to flatus and hospital stay were similar between groups. Overall, 3 patients developed minor postoperative complications that w…
Contemporary Management of Struvite Stones Using Combined Endourologic and Medical Treatment: Predictors of Unfavorable Clinical Outcome
2016
Struvite stones have been associated with significant morbidity and mortality, yet there has not been a report on the medical management of struvite stones in almost 20 years. We report on the contemporary outcomes of the surgical and medical management of struvite stones in a contemporary series.A retrospective review of patients who were treated with percutaneous nephrolithotomy (PCNL) for struvite stones at Duke University Medical Center between January 2005 and September 2012 identified a total of 75 patients. Of these, 43 patients had adequate follow-up and were included in this analysis. Stone activity, defined as either stone recurrence or stone-related events, and predictors of acti…
Endovascular therapy for vasospasm after aneurysmatic subarachnoid hemorrhage
2016
Balloon angioplasty and/or selective intra-arterial vasodilator therapies are treatment options in patients with vasospasm after subarachnoid hemorrhage (SAH). We analyzed the effect of balloon angioplasty and/or selective intra-arterial vasodilator therapy in our patients.Twenty-six patients (vasodilation group, VDT) were treated with intra-arterial nimodipine. The balloon angioplasty with nimodiopine-group (BAP-N group) comprised 21 patients. The primary endpoint of this study was successful angiographic vessel dilation in vasospastic vessels after balloon angioplasty, together with nimodipine (BAP-N group), compared to intra-arterial vasodilator therapy (VDT group) with nimodipine alone.…