Articles: cations.
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J Biol Reg Homeos Ag · Oct 2017
Targeted muscle reinnervation for improved control of myoelectric upper limb prostheses.
Targeted muscle reinnervation (TMR) is a novel surgical technique developed to improve the control of myoelectric upper limb prostheses. Nerves transected by the amputation, which retain their original motor pathways even after being severed, are redirected to residual denervated muscles that serve as target for consequent reinnervation. Once the process is complete, reinnervated muscles will contract upon voluntary activation of transferred nerves while attempting to move missing regions of the amputated limb, generating EMG signals that can be recorded and used to control a prosthetic device. ⋯ TMR has been widely performed in individuals who underwent shoulder disarticulation amputation and transhumeral amputation since proximal amputations do not leave enough functional muscles exploitable to control independent degree of freedoms of multi-articulated prostheses. TMR application is currently under investigation in patients suffering further distal amputations, as well as for treating and preventing painful post-amputation neuromas. The purpose of this paper is to describe the physiologic basis and the surgical technique of TMR, reporting current knowledge on the clinical results.
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To construct and validate a scoring system for evidence-based selection of bariatric and metabolic surgery procedures according to severity of type 2 diabetes (T2DM). ⋯ This is the largest reported cohort (n = 900) with long-term postoperative glycemic follow-up, which, for the first time, categorizes T2DM into 3 validated severity stages for evidence-based procedure selection.
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Delayed gastric emptying (DGE) is a common serious problem after pancreaticoduodenectomy (PD). Flange gastrojejunostomy (FL-GE) is a previously described technique that creates an internal flange in a hand-sewn gastroenterostomy. Results of FL-GE on incidence and severity of DGE after PD are presented. ⋯ In this cohort study, the flange technique was associated with a marked reduction in the incidence of DGE after PD.
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Intraoperative neuromonitoring (IONM) has been reported to be sensitive and specific in the detection of neurologic injury during spinal surgery. The purpose of this study was to clarify the incidence of C5 palsy using multimodality IONM and to compare the accuracy of multimodality IONM to predict postoperative C5 palsy with isolated transcranial motor evoked potentials (MEPs). ⋯ Incidence of any neurologic deficit, including C5 palsy, during laminoplasty while using multimodality IONM was relatively low. MEP alerts in the deltoids or biceps had 100% sensitivity and 98.4% specificity for predicting a postoperative deficit. Somatosensory evoked potentials did not appear to be helpful in predicting postoperative deficits.
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To investigate the baseline patient characteristics, nonoperative modalities, surgical procedures, and complications rates of surgical cervical spondylotic myelopathy (CSM) patients. To evaluate risk factors for developing complications and compare the changes in health-related quality of life (HRQOL) from baseline to 2 years postoperatively. ⋯ The overall complication rate was 7.4% for the cohort. Baseline clinical information, comorbidities, use of nonoperative treatment modalities, and procedure type were not significantly associated with an increased risk of complications. Previous cervical spine surgery increased the risk of complications by 9-fold. The patients showed significantly improved SF-36 PCS, SF-36 MCS, and NDI scores at 2 years after surgery.