Prediction of postoperative mortality in elderly patient with hip fractures : a single-centre, retrospective cohort study

Peer reviewedPublisher PD

Guiding catheters for transradial approach:New designs and summary of experiences with VDL/VDR catheters. A novel score for PCI technical complexity

N/

The effects of a synthetic epidermis spray on secondary intention wound healing in adult horses.

ObjectivesTo evaluate secondary intention wound healing in the horse's limbs when treated with the synthetic epidermis spray (Novacika®, Cohesive S.A.S, France) or with a standard bandaging technique.MethodsSix Standardbred mares were included in the study. Four 2.5 x 2.5 cm full-thickness skin wounds were created on each thoracic limb. Two wounds were located on the dorsoproximal aspect of the cannon bone and the other two at the dorsoproximal aspect of the fetlock. Six hours after creation, wounds were randomly treated with synthetic epidermis spray or standard bandaging. The wounds were assessed every 4 days by gross visual assessment and using a 3D imaging camera. Analysis was performed with a 3D imaging application.ResultsOut of 46 wounds, 22 showed exuberant granulation tissue and were part of the standard bandaging group. Whether the wounds were treated with synthetic epidermis spray or standard bandaging, the time for healing was the same.ConclusionThe synthetic epidermis spray studied in this model has allowed healing without the production of exuberant granulation tissue but did not reduce the median wound healing time compared to a standard bandaging technique. The synthetic epidermis spray is potentially an interesting alternative for the management of secondary intention wound healing of superficial and non-infected distal limb wounds in adult horses on economical and practical aspects. However, all statistical inference (p-values especially) must be interpreted with caution, given the size of the sample

Effect of a single dose of retigabine in cortical excitability parameters: A cross-over, double-blind placebo-controlled TMS study.

BACKGROUND: Antiepileptic drugs (AEDs) decrease the occurrence of epileptic seizures and modulate cortical excitability through several mechanisms that likely interact. The modulation of brain excitability by AEDs is believed to reflect their antiepileptic action(s) and could be used as a surrogate marker of their efficacy. Transcranial magnetic stimulation (TMS) is one of the best noninvasive methods to study cortical excitability in human subjects. Specific TMS parameters can be used to quantify the various mechanisms of action of AEDs. A new AED called retigabine increases potassium efflux by changing the conformation of KCNQ 2-5 potassium channels, which leads to neuronal hyperpolarisation and a decrease in excitability. HYPOTHESIS: The purpose of this study is to investigate the effect of retigabine on cortical excitability. Based on the known mechanisms of action of retigabine, we hypothesized that the oral intake of retigabine would increase the resting motor threshold (RMT). METHODS: Fifteen healthy individuals participated in a placebo-controlled, double-blind, randomised, clinical trial (RCT). The primary outcome measure was the RMT quantified before and after oral intake of retigabine. Several secondary TMS outcome measures were acquired. RESULTS: The mean RMT, active motor threshold (AMT) and intensity to obtain a 1mV peak-to-peak amplitude potential (SI1mV) were significantly increased after retigabine intake compared to placebo (RMT: P=0.039; AMT: P=0.014; SI1mV: P=0.019). No significant differences were found for short-interval intracortical inhibition/intracortical facilitation (SICI/ICF), long-interval intracortical inhibition (LICI) or short-interval intracortical facilitation (SICF). CONCLUSION: A single dose of retigabine increased the RMT, AMT and S1mV in healthy individuals. No modulating intracortical facilitation or inhibition was observed. This study provides the first in vivo demonstration of the modulating effects of retigabine on the excitability of the human brain, and the results are consistent with the data showing that retigabine hyperpolarizes neurons mainly by increasing potassium conductance

Two Processes In Early Bimanual Motor Skill Learning

Most daily activities are bimanual and their efficient performance requires learning and retention of bimanual coordination. Despite in-depth knowledge of the various stages of motor skill learning in general, how new bimanual coordination control policies are established is still unclear. We designed a new cooperative bimanual task in which subjects had to move a cursor across a complex path (a circuit) as fast and as accurately as possible through coordinated bimanual movements. By looking at the transfer of the skill between different circuits and by looking at training with varying circuits, we identified two processes in early bimanual motor learning. Loss of performance due to the switch in circuit after 15 min of training amounted to 20%, which suggests that a significant portion of improvements in bimanual performance is specific to the used circuit (circuit-specific skill). In contrast, the loss of performance due to the switch in circuit was 5% after 4 min of training. This suggests that learning the new bimanual coordination control policy dominates early in the training and is independent of the used circuit. Finally, switching between two circuits throughout training did not affect the early stage of learning (i.e., the first few minutes), but did affect the later stage. Together, these results suggest that early bimanual motor skill learning includes two different processes. Learning the new bimanual coordination control policy predominates in the first minutes whereas circuit-specific skill improvements unfold later in parallel with further improvements in the bimanual coordination control policy.status: publishe

Effect of CO² laser stapedotomy on tinnitus in patients with otosclerosis and predictive role of audiological features

Objective: To evaluate the effect of CO 2 laser stapedotomy and analyze the influence of audiometric factors on the evolution of tinnitus. Study design: Retrospective case series. Setting: Tertiary referral center. Patients: 151 ears (139 patients, 17 years to 74 years) underwent Laser-Intervention: CO 2 laser stapedotomy procedure for otosclerosis. Results: The incidence of preoperative tinnitus in patients with otosclerosis in our cohort is 51.7%, with a complete disappearance in 61% of the cases. We haven't found any statistically significant results between the resolution of tinnitus after surgery and the hearing result pre and postoperatively (BC, AC, ABG, SRT, and WRS). On the other hand, we haven't found any audiometric predictive factors of the effects of surgery on tinnitus. We have seen a tendency to have more tinnitus regarding the number of laser shots, but the results aren't statistically significant. Conclusion: Stapedotomy may also improve tinnitus in most of the patients with a diagnostic of otosclerosis. The tinnitus status does not appear to be related to the preoperative or postoperative audiometric results

Prevalence of Age-Related Changes in Ovine Lumbar Intervertebral Discs during Computed Tomography and Magnetic Resonance Imaging

Ovine models are used to study intervertebral disc (IVD) degeneration. The objective of the current study was to assess the naturally occurring age-related changes of the IVD that can be diagnosed by CT and MRI in the lumbar spine of sheep. We used CT and T2-weighted MR images to score the IVD (L6S1 to L1L2) in 41 sheep (age, 6 mo to 11 y) that were euthanized for reasons not related to musculoskeletal disease. T2 mapping and measurement of T2 time of L6S1 to L2L3 were performed in 22 of the sheep. Degenerative changes manifested as early as 2 y of age and occurred at every IVD level. Discs were more severely damaged in older sheep. The age effect of the L6S1 IVD was larger than the average age effect for the other IVD. The current study provides evidence that lesions similar to those encountered in humans can be identified by CT and MRI in lumbar spine of sheep. Ideally, research animals should be assessed at the initiation of preclinical trials to determine the extent of prevalent degenerative changes. The ovine lumbosacral disc seems particularly prone to degeneration and might be a favorable anatomic site for studying IVD degeneration

Learning a bimanual cooperative skill in chronic stroke under non-invasive brain stimulation: a randomized controlled trial

Background. Transcranial direct current stimulation (tDCS) has been suggested to improve poststroke recovery. However, its effects on bimanual motor learning after stroke have not previously been explored. Objective. We investigated whether dual-tDCS of the primary motor cortex (M1), with cathodal and anodal tDCS applied over undamaged and damaged hemispheres, respectively, improves learning and retention of a new bimanual cooperative motor skill in stroke patients. Method. Twenty-one chronic hemiparetic patients were recruited for a randomized, double-blinded, cross-over, sham-controlled trial. While receiving real or sham dual-tDCS, they trained on a bimanual cooperative task called CIRCUIT. Changes in performance were quantified via bimanual speed/accuracy trade-off (Bi-SAT) and bimanual coordination factor (Bi-Co) before, during, and 0, 30, and 60 minutes after dual-tDCS, as well as one week later to measure retention. A generalization test then followed, where patients were asked to complete a new CIRCUIT layout. Results. The patients were able to learn and retain the bimanual cooperative skill. However, a general linear mixed model did not detect a significant difference in retention between the real and sham dual-tDCS conditions for either Bi-SAT or Bi-Co. Similarly, no difference in generalization was detected for Bi-SAT or Bi-Co. Conclusion. The chronic hemiparetic stroke patients learned and retained the complex bimanual cooperative task and generalized the newly acquired skills to other tasks, indicating that bimanual CIRCUIT training is promising as a neurorehabilitation approach. However, bimanual motor skill learning was not enhanced by dual-tDCS in these patients.status: publishe