Twelve patients were treated over 29 months, receiving contralateral, ventroposterolateral sensory thalamic DBS. Five patients were amputees and 7 had BPAs, all from traumas. A postoperative trial of externalized DBS failed in 1 patient with BPA. Eleven patients proceeded to implantation and gained improvement in pain scores at 12 months. No surgical complications
or stimulation side effects were noted. In the amputation group, GDC-0941 datasheet after 12 months the mean VAS score improved by 90.0% +/- 10.0% (p = 0.001), SF-36 by 57.5% +/- 97.9% (p = 0.127), UWNPS by 80.4% +/- 12.7% (p < 0.001), and BPI by 79.9% +/- 14.7% (p < 0.001). In the BPA group, after 12 months the mean VAS score improved by 52.7% +/- 30.2% (p < 0.001), SF-36 by 15.6% +/- 30.5% (p = 1.000), UWNPS by 26.2% +/- 40.8% (p = 0.399), and BPI by 38.4% +/- 41.7% (p = 0.018). Mean DBS parameters were 2.5 V, 213 microseconds,
and 25 Hz.\n\nConclusions. Deep brain stimulation demonstrated efficacy at 1 year for chronic neuropathic pain after traumatic amputation and BPA. Clinical trials that retain patients in long-term follow-up are desirable to confirm findings from prospectively assessed case series.”
“Pinch-off syndrome (POS) is a serious complication encountered during the long-term management of totally implantable access ports (TIAPs). The aim of this study was to examine the effect of ultrasound-guided infraclavicular axillary vein puncture to avoid POS in patients with long-term use of a TIAP.\n\nThis was a retrospective review of 207 consecutive TIAPs: one hundred devices implanted using an anatomical landmark technique were used as historical controls (Landmark group), while find more 107 devices were implanted CBL0137 cell line using an ultrasound (US)-guided puncture method (US group). The pinch-off grade (POG) was determined using chest X-ray findings following the definition of Hinke, and
the progression of POG during the follow-up period of the Landmark and US groups was compared.\n\nSixteen cases in the Landmark group were POG-1 and 3 were POG-2, while all cases in the US group were POG-0 at the time of venipuncture (p < 0.001). Eleven patients in the Landmark group showed some degree of progression of the POG during the follow-up period. In contrast, there were no cases showing progression of the POG in the US group (p = 0.002).\n\nUS-guided infraclavicular axillary vein puncture was found to effectively make it possible to avoid POS for the long-term management of TIAPs, as well as at the time of implantation.”
“Soccer, one of the most popular sports worldwide among young men, can result in a wide range of orthopedic injuries. Although vascular injuries such as dissection occur rarely, they can cause significant mortality if left undiagnosed. We report herein a 31-year-old male who suffered a large middle cerebral artery infarction due to traumatic internal carotid artery dissection after a ball struck his head and neck. He recovered with mild neurologic deficit after decompressive surgery.