Rejected

Brain-derived neurotrophic factor (BDNF) is vital in the pathogenesis of mechanical allodynia with a paucity of reports available regarding diabetic neuropathy pain (DNP). Herein we identified the involvement of BDNF in driving mechanical allodynia in DNP rats via the activation of transient receptor potential canonical 6 (TRPC6) channel.

Pulmonary endarterectomy (PEA) is a curative procedure for patients with chronic thromboembolic pulmonary hypertension. Body composition and exercise capacity have been associated with adverse outcomes in patients undergoing cardiothoracic surgeries, but their significance with PEA is unclear. We evaluated the association of body composition and 6-minute walk distance (6MWD) with disease severity, hospital length of stay, discharge disposition and post-operative functional recovery.

A long-span ventral cervical epidural abscess is a rare and devastating condition. Typically, extensive procedures are chosen to deal with this condition and usually end up with limited cervical motion. Here, we describe a novel minimally invasive anterior full-endoscopic transcorporeal approach for drainage of large ventral cervical epidural abscess.

Spinal deformity is a complex issue that can lead to global spine imbalance with subsequent neurologic deficits, clinical deformity, and chronic back pain. The vertebral column resection (VCR) osteotomy technique is used in select cases of rigid severe spinal deformities to achieve significant curve correction. We present a previously undiagnosed ankylosing spondylitis patient with a previously fused spine in marked coronal and sagittal malalignment that required a staged two level non-contiguous VCR for treatment of his fixed thoracic and cervicothoracic kyphoscoliosis. In this patient with ankylosing spondylitis, a postoperative rigid thoracic kyphoscoliosis, and marked truncal imbalance and skull to pelvis imbalance a 2 level non-contiguous VCR performed in a staged fashion at the apex of the thoracic curve and subsequently at the apex of the cervicothoracic curve were utilized to restore sagittal and coronal imbalance and improved skull position and optimal visual gaze. The need for performing two non-contiguous VCR is quite rare and necessary only in a small subset of deformity patients with rigid curves causing malignment in different areas of the spine. The non-contiguous VCR surgery is challenging but also capable of correcting even the most rigid and severe spine deformity with appropriate planning and optimal surgical technique.

Insomnia is a common problem in older persons and is associated with poor prognosis from a functional or clinical perspective. The purpose of this study was to investigate the prevalence of insomnia and identify comprehensive geriatric assessment (CGA) based clinical factors associated with insomnia in elderly hospitalized patients.

To evaluate three different analgesic techniques, continuous epidural analgesia (EA), continuous intra-articular (IA) infusion analgesia and continuous femoral nerve block (FNB) in postoperative pain management, length of hospital stay (LOS), and time of patient mobilization after total knee arthroplasty (TKA).

Ten male sheep (Sheep group; SGk) and seven male goats (Goat group; GGks+) were used in this study. The objective was to compare the use of racemic ketamine or ketamine S(+) associated with lidocaine on spinal anesthesia and evaluate if the drugs leads to a surgical anesthesia state, as well as to verify the cardiorespiratory, sedative and motor effects of this technique in these species. After correct placement of the needle in the subarachnoid space, 3.0 mg kg of racemic ketamine (SGk) or ketamine S(+) (GGks+), both diluted in 1.5 mg kg of 2% lidocaine, were administered. Evaluations were performed during orchiectomy, at times 0 (T0), 5 (T5), 10 (T10), 20 (T20), 30 (T30) and 60 (T60) minutes after subarachnoid anesthesia administration. No significant changes in heart and respiratory rates were observed in both experimental groups. All animals showed surgical analgesia and stood conscious or slightly sedated with ataxia immediately after the drugs administration (T5), allowing the execution of bilateral orchiectomy. The ataxia in SGk was classified as severe with recumbency in 80% of the animals, moderate ataxia in 10% of the animals, and mild ataxia in 10% of the animals. All goats (GGks+; 100%) presented severe ataxia and recumbency. At 60 min, animals of both groups were in standing position and with normal gait. Subarachnoid RS-ketamine and ketamine S(+) (3 mg kg), associated with lidocaine in sheep and goats, produces surgical anesthesia and recumbency without causing cardiorespiratory abnormalities, regurgitation and bloating.

The relation between segmental mobility and degree of lumbar degenerative change is still unknown. This cross-sectional study aimed to elucidate the association between intervertebral disc degeneration (IVDD) and segmental mobility in chronic low back pain using magnetic resonance imaging (MRI) T2 mapping.

As the opioid epidemic in the United States has continued to gain momentum in recent years, the current study aims to explore the efficacy of ketamine in a traditionally challenging setting regarding pain control, and contribute toward developing an opioid-free intraoperative pain protocol in spinal deformity surgery.