Mannitol Shower: The Artefactual Air Embolism!

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Is Propofol Safe in Patients With Phenylketonuria?.

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Complementary Use of Effect Site-Target Controlled Infusion and SmartPilot View for Anesthetic Management in Semi-awake Craniotomy Near BIS 85.

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2016 Society for Neuroscience in Anesthesiology and Critical Care (SNACC) Annual Meeting Report.

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Innovations in Functional Neurosurgery and Anesthetic Implications.

Functional neurosurgery has undergone rapid growth over the last few years fueled by advances in imaging technology and novel treatment modalities. These advances have led to new surgical treatments using minimally invasive and precise techniques for conditions such as Parkinson's disease, essential tremor, epilepsy, and psychiatric disorders. Understanding the goals and technological issues of these procedures is imperative for the anesthesiologist to ensure safe management of patients presenting for functional neurosurgical procedures. In this review, we discuss the advances in neurosurgical techniques for deep brain stimulation, focused ultrasound and minimally invasive laser-based treatment of refractory epilepsy and provide a guideline for anesthesiologists caring for patients undergoing these procedures. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved

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Effects of gait training with body weight support on a treadmill vs. overground for individuals with stroke

Publication date: Available online 27 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Gabriela L. Gama, Melissa L. Celestino, José A. Barela, Larry Forrester, Jill Whitall, Ana M.F. Barela
ObjectiveTo investigate the effects of gait training with body weight support on a treadmill vs. overground in individuals with chronic stroke.DesignRandomized controlled trial.SettingUniversity research laboratoryParticipantsTwenty-eight individuals with chronic stroke (> 6 months).InterventionsParticipants were randomly assigned to receive gait training with BWS on a treadmill (n=14) or overground (n=14) three times a week for six weeks.Main Outcome MeasuresOverground gait speed, 6-minute walk test, motor domain of the functional independence measure, lower extremity domain of Fugl-Meyer movement assessment, step length, step-length symmetry ratio and single limb support duration. Measurements were obtained at baseline (T0), immediately after (T1) and six weeks after (T2) the training session.ResultsAt T1, both groups improved in all outcome measures except paretic step-length and step-symmetry, which were only improved in the overground group (p=0.01 and p=0.01 respectively). At T2, all improvements remained and the treadmill group also improved paretic step length (p<0.001) but not step-symmetry (p>0.05).ConclusionsIndividuals with chronic stroke equally improve gait speed and other gait parameters after 18 sessions of BWS gait training on either treadmill or overground. Only the overground group improved step symmetry, suggesting a role for integrating overground walking into BWS interventions post-stroke.



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Validation of the QuickDASH and DASH in Patients with Distal Radius Fractures through Agreement Analysis

Publication date: Available online 27 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Philemon Tsang, David Walton, Ruby Grewal, Joy MacDermid
ObjectiveTo examine the agreement of scores between the Disability of Arm, Shoulder and Hand (DASH) and QuickDASH Questionnaires in patients with distal radius fractures (DRF) and their score's concurrent validity with PRWE scores.DesignValidity StudySettingHand and upper limb clinicParticipantsOne hundred and seventy-seven patients with Distal Radius Fractures over the age of 18 were included in this study.InterventionsN/AMain Outcome MeasuresMeasurements of the DASH, QuickDASH, and Patient Reported Wrist Evaluation (PRWE) were taken at baseline and 1-year follow-up. QuickDASH scores were extracted from the DASH scores. Agreement analysis of the DASH and QuickDASH were evaluated using Bland-Altman's technique. Item difficultly analysis was performed to examine the distribution of QuickDASH items amongst DASH items. Responsiveness of the DASH, QuickDASH, and PRWE were also evaluated by calculating standardized response means.ResultsQuickDASH scores were higher than DASH scores, particularly at baseline. A mean difference of 3.8 and 1.2 points were observed at baseline and 1-year follow-up, respectively. The limits of agreement (LOA) were wide at baseline with a range of 24.8 points at baseline, but decreased to 12.5 points at 1-year follow-up. Item difficulty analysis revealed that QuickDASH items were not evenly distributed at baseline. Finally, the responsiveness of the DASH, QuickDASH and PRWE were similar from baseline to 1-year follow-up (standardized response mean of 2.13, 2.17, and 2.19, respectively).ConclusionWhen changing from the DASH to the QuickDASH in the context of DRF, a systematic bias of higher scores on the QuickDASH should be considered by the user. However, the QuickDASH still demonstrated good concurrent validity and responsiveness.



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