157 research outputs found

    The analgesic effect of electroacupuncture on acute thermal pain perception-a central neural correlate study with fMRI

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    Abstract Background Electrical acupuncture (EA) has been utilized in acute pain management. However, the neuronal mechanisms that lead to the analgesic effect are still not well defined. The current study assessed the intensity [optimal EA (OI-EA) vs. minimal EA (MI-EA)] effect of non-noxious EA on supraspinal regions related to noxious heat pain (HP) stimulation utilizing an EA treatment protocol for acute pain and functional magnetic resonance imaging (fMRI) with correlation in behavioral changes. Subjects underwent five fMRI scanning paradigms: one with heat pain (HP), two with OI-EA and MI-EA, and two with OI-EA and HP, and MI-EA and HP. Results While HP resulted in activations (excitatory effect) in supraspinal areas known for pain processing and perception, EA paradigms primarily resulted in deactivations (suppressive effect) in most of these corresponding areas. In addition, OI-EA resulted in a more robust supraspinal sedative effect in comparison to MI-EA. As a result, OI-EA is more effective than MI-EA in suppressing the excitatory effect of HP in supraspinal areas related to both pain processing and perception. Conclusion Intensities of EA plays an important role in modulating central pain perception

    Discursos de viajeros europeos en la Argentina del siglo XIX: comunicación transatlántica, na(rra)ción y alteridad

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    Esta investigación tuvo sus antecedentes en dos proyectos anteriores, consolidando la línea: Comunicación e Historia. El análisis de los discursos de viajeros europeos que recorrieron estas latitudes durante el siglo XIX ha permitido profundizar ahora en la reflexión, en primer lugar, acerca del rol histórico, cultural y político de los viajeros en los procesos de construcción, lucha y reconfiguración de los proyectos político-culturales regional y nacional, al hilo de las comunicaciones transatlánticas establecidas a través de los “discursos de (en) viaje”, materializados en el objeto cultural “libro” (al decir de Raymond Williams, el primero de los medios modernos de comunicación). En segundo término, acerca de las narrativas de los viajeros europeos, a través de las publicaciones resultantes de esos viajes y sus traducciones, en tanto conjunto de procesos y de prácticas que suponen el traslado de un texto o conjunto de textos de la tradición cultural y el contexto en el que fueron producidos a otra. Finalmente, a partir de la puesta en relación entre discurso y alteridad, se analizan los modos en que tales viajeros establecieron su vinculación con la otredad y, por tanto, los efectos de sentido que se materializaron en la construcción discursiva de las figuras del “otro"

    Transfemoral versus transcarotid access for transcatheter aortic valve replacement

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    Objectives: To compare the outcomes after transcatheter aortic valve replacement (TAVR) through a transfemoral (TF) and transcarotid (TC) access at our institution. Methods: From January 2014 to January 2020, 62 TC-TAVR and 449 TF-TAVR were performed using 2 prosthesis devices (Edwards SAPIEN 3, n = 369; Medtronic Evolut R, n = 142). Propensity score matching was used to adjust for imbalance in the baseline characteristics of the study groups. Results: Propensity score matching provided 62 matched pairs with comparable operative risk (mean European System for Cardiac Operative Risk Evaluation II, TC-TAVR 7.6% vs TF-TAVR 6.6%, P = .17). Thirty-day mortality (4.8% vs 3.2%, P = 1.00) and 2-year mortality (11.3% vs 12.9%, P = .64) after TC-TAVR were comparable with TF-TAVR. Strokes were numerically more frequent after TC-TAVR compared with TF-TAVR (3.2% vs 0%, P = .23), but the difference did not reach statistical significance. TF-TAVR was associated with a significantly greater risk of permanent pacemaker implantation (29.0% vs 12.9%, P = .04) compared with TC-TAVR. Other complications were not frequent and were similarly distributed between the matched groups. Conclusions: TC access for TAVR was associated with satisfactory results compared to the femoral access. TC-TAVR could be considered a valid and safe alternative to TF-TAVR when femoral access is contraindicated. © 2022</p

    Contemporary management of primary parapharyngeal space tumors

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    The parapharyngeal space is a complex anatomical area. Primary parapharyngeal tumors are rare tumors and 80% of them are benign. A variety of tumor types can develop in this location; most common are salivary gland neoplasm and neurogenic tumors. The management of these tumors has improved greatly owing to the developments in imaging techniques, surgery, and radiotherapy. Most tumors can be removed with a low rate of complications and recurrence. The transcervical approach is the most frequently used. In some cases, minimally invasive approaches may be used alone or in combination with a limited transcervical route, allowing large tumors to be removed by reducing morbidity of expanded approaches. An adequate knowledge of the anatomy and a careful surgical plan is essential to tailor management according to the patient and the tumor. The purpose of the present review was to update current aspects of knowledge related to this more challenging area of tumor occurrence.Peer reviewe
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