Rejected

We aimed to study the safety and feasibility of low-dose dobutamine stress echocardiography in a symptomatic high gradient aortic stenosis population scheduled for transfemoral transcatheter aortic valve implantation (TAVI) and to quantify left ventricular (LV) flow reserve.

Physiotherapy is, like all healthcare professions, relational and value-laden. Patient-centred care, evidence-based practice and value-based practices are concepts in which patient values lie at the heart of high-quality healthcare practices. Nevertheless, physiotherapists have limited awareness of what patient values are in the physiotherapy encounter. The purpose of this study is to explore these patient values.

In a previous study, persistent pain was suggested to be a risk factor for tumor patients. However, the mechanism underlying this phenomenon is still unclear. Substance P (SP), a pain-related neuropeptide secreted by the neural system and the immune system, plays an important role in the induction and maintenance of persistent pain.

Syndesmotic instability is a source of significant pain and disability. Both subtle instability and gross diastasis, whether acute or chronic, require stabilization and may benefit from reconstruction with ligamentous augmentation. The use of nonabsorbable suture-tape has emerged as a promising operative strategy, allowing surgeons to anatomically reconstruct the syndesmosis, in particular the anterior inferior tibiofibular ligament. The current work provides a detailed description of the technique and preliminary results of a patient cohort treated using nonabsorbable suture-tape for syndesmotic augmentation. Level V, expert opinion.

To provide clinical data for the conversion of Schedule II opioids to buprenorphine buccal film and to demonstrate sustained analgesia and a reduction in morphine milligram equivalents after conversion.

Intrathecal fentanyl in spinal anesthesia improves intra- and postoperative analgesia. Dexmedetomidine is a fascinating adjuvant with regards to neuraxial anesthesia in children experiencing surgery for abdominal malignancy.

We performed the meta-analysis in order to assess the effect of melatonin on postoperative pain and perioperative opioid consumption.

BACKGROUND Pulmonary carcinoid tumorlets (PCT) are incidental histologic or radiologic discoveries that are localized neuroendocrine tumors whose proliferation is associated with chronic pulmonary inflammatory processes. This study assessed the imaging findings and histological appearances of PCT co-existing with chronic pulmonary inflammatory processes. MATERIAL AND METHODS We performed a retrospective study of 14 patients with incidentally-found PCT with co-existing chronic pulmonary inflammatory processes who underwent preoperative X-rays and CT between 1 January 2003 and 31 December 2012. The clinical symptoms, X-rays, CT imaging findings, and histological appearances were retrospectively evaluated. RESULTS Twelve women and 2 men were found to have PCT, with a mean age of 55.29±13.90 years (range 25-74 years) at diagnosis. Among these 14 patients, hemoptysis, cough, chest pain, expectoration, and chest tightness were found in 9 (64.3%), 5 (35.7%), 4 (28.6%), 3 (21.4%), and 1, respectively. For most patients, we could not find any small nodules on the X-ray or CT images. However, indirect imaging findings of bronchiectasis (85.7%, 12/14), atelectasis (57.1%, 8/14), inflammation (92.8%, 13/14), tuberculosis (7.1%, 1/14), and lung cancer (7.1%, 1/14) were found in all 14 patients. CONCLUSIONS PCT occurs most commonly in middle-aged women who have chronic pulmonary inflammatory processes such as bronchiectasis, atelectasis, and inflammation. Although there are no specific symptoms or direct imaging findings in these patients, our results showed that patients who have bronchiectasis, atelectasis, or recurrent pulmonary infection are at increased risk for PCT.

BACKGROUND Lhermitte-Duclos disease (LDD) is caused by a rare slow-growing mass in the cerebellum. LDD generally is experienced by young adults, but also it has been encountered in the pediatric population. Lhermitte and Duclos first described cerebellar dysplastic gangliocytoma in 1920. The first case they described included occipital headache, paroxysmal vertigo, falls, hearing problems, and memory deficits. Our patient had typical symptoms of the disorder such as headache, nausea, vomiting, blurred vision, and imbalance. The purpose of this case report was to describe the outcome of a computerized dynamic posturography (CDP) vestibular training program combined with home-based exercises designed to improve balance function and reduce the risk of falling by an individual with a posterior fossa tumor. CASE REPORT A 36-year-old male patient was diagnosed with dysplastic gangliocytoma/ganglioglioma according to magnetic resonance imaging, computed tomography, and pathology reports on March 28, 2016. The patient was treated by partial cerebellar tumor resection on April 7, 2016. After the operation, he reported severe imbalance, nausea, and vomiting for 1 month and visited the Audiology Department on October 20, 2016. The patient was evaluated with the CDP-sensory organization test (SOT) and his composite equilibrium score of this examination was 48, 31% below normal. We administered a 6-week posturography-assisted vestibular rehabilitation (VR) protocol (extending an hour per week) combined with a home-based exercise program twice in 2 years. In the second evaluation we applied in 2018, SOT composite equilibrium score increased to 72 after VR, reaching normal limits. After 2 years, his complaints slightly alleviated and his SOT scores were better when we compared the VR results in 2016. CONCLUSIONS We demonstrated that long-term VR may affect a patient with dysplastic cerebellar gangliocytoma (LDD) presenting imbalance or dizziness.