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182. Urological Trauma

trauma from a stab wound to the lower thoracic back, flanks and upper abdomen, or bullet entry or exit wounds. In stab wounds, the extent of the entrance wound may not accurately reflect the depth of penetration. Blunt trauma to the back, flank, lower thorax or upper abdomen may result in renal injury. Haematuria, flank pain, ecchymoses, abrasions, fractured ribs, abdominal distension and/or a mass and tenderness raise the suspicion of renal involvement. 4.1.2.1.1 Recommendations for patient history (...) material [49]. 4.1.2.3.7 Recommendations for radiographic assessment GR Blunt trauma patients with visible haematuria or non-visible haematuria and haemodynamic instability should undergo radiographic evaluation. A* Radiographic evaluation is recommended for all patients with a history of rapid deceleration injury and/or significant associated injuries. B All patients with or without haematuria after penetrating abdominal or lower thoracic injury require urgent renal imaging. A* Ultrasonography alone

2015 European Association of Urology

183. Chronic Pelvic Pain

A in pelvic pain 41 5.4.3 Sacral neuromodulation and percutaneous tibial nerve stimulation in pelvic pain 41 5.4.4 Intermittent chronic anal pain syndrome 41 5.5 Summary 41 5.5.1 Conclusions and recommendations: anorectal pain syndrome 42 6. PERIPHERAL NERVE PAIN SYNDROMES 43 6.1 Neuropathic pain 43 6.2 Anatomy 44 6.2.1 The posterior subgluteal triangle nerves 44 6.2.2 Branches of the pudendal nerve 44 6.2.3 Anatomical relations of the pudendal nerve 44 6.2.4 Afferent nerves and the genitalia 45 6.2.5 (...) to more than one organ site, the term CPPS should be used. Many, including some of the authors of this text, never subdivide by anatomy and prefer to refer to patients with pain perceived within the pelvis and no specific disease process as suffering from CPPS, subdivided by psychological and functional symptoms. 2.4.2.2.2 Psychological considerations for classification Many CPPSs are associated with a range of concurrent negative psychological, behavioural and sexual consequences that must

2015 European Association of Urology

184. Blunt Chest Trauma ? Suspected Aortic Injury

, Garland LW. Aortic injury: comparison of supine and upright portable chest films to evaluate the widened mediastinum. Ann Emerg Med. 1984;13(10):896-899. 15. Khosla A, Ocel J, Rad AE, Kallmes DF. Correlating first- and second-rib fractures noted on spine computed tomography with major vessel injury. Emerg Radiol. 2010;17(6):461-464. 16. Barrios C, Malinoski D, Dolich M, Lekawa M, Hoyt D, Cinat M. Utility of thoracic computed tomography after blunt trauma: when is chest radiograph enough? Am Surg (...) definitive studies. ? MRA chest without and with IV contrast 7 This procedure should be performed on patients with contraindication to CTA. O Aortography thoracic 6 ??? CT chest without IV contrast 5 ??? US echocardiography transesophageal 5 O MRA chest without IV contrast 5 O Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level ACR Appropriateness Criteria ® 2 Blunt Chest Trauma — Suspected Aortic Injury BLUNT CHEST TRAUMA — SUSPECTED

2014 American College of Radiology

185. Cervical Arterial Dissections and Association With Cervical Manipulative Therapy

. The association between CMT and CD suggests that increased education of providers, including CMT providers, in diagnosing CD may be warranted. Correspondingly, patients with neck pain and without neurological symptoms after any trauma should be informed about the potential risks and benefits of receiving CMT, and practitioners should carefully consider CD prior to performing CMT. Cervical Spine Biomechanics and CMT The cervical spine has a unique anatomy and complex biomechanics. Despite centuries of study (...) literature evaluating strain on these vessels because these studies were conducted with human cadavers. Moreover, all studies have shown considerably less force used in cervical manipulation compared with thoracic and lumbar manipulation. , , After studying external forces applied to the cervical spine during manipulation, researchers began attempts to quantify the force absorbed by and strain placed on the VAs during manipulation. Using ultrasonographic crystals surgically placed in the VAs of human

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2014 American Heart Association

186. 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery

. AABB indicates American Association of Blood Banks; AATS, American Association for Thoracic Surgery; ACC, American College of Cardiology; AHA, American Heart Association; ASE, American Society of Echocardiography; CPG, clinical practice guideline; HRS, Heart Rhythm Society; PCNA, Preventive Cardiovascular Nurses Association; SCAI, Society for Cardiovascular Angiography and Interventions; SCA, Society of Cardiovascular Anesthesiologists; STEMI, ST-elevation myocardial infarction; STS, Society (...) of Thoracic Surgeons; and UA/NSTEMI, unstable angina/non–ST-elevation myocardial infarction. 1.5. Definitions of Urgency and Risk In describing the temporal necessity of operations in this CPG, the GWC developed the following definitions by consensus. An emergency procedure is one in which life or limb is threatened if not in the operating room where there is time for no or very limited or minimal clinical evaluation, typically within <6 hours. An urgent procedure is one in which there may be time

2014 American Heart Association

187. Diagnosis and Treatment of Adult Isthmic Spondylolisthesis

Ion /Gu Idel Ine Methodolo Gy Diagnosis and Treatment of Adult Isthmic Spondylolisthesis | NASS Clinical Guidelines NASS Evidence-Based Clinical Guidelines Committee D. Scott Kreiner, MD Committee Co- Chair and Natural History Section Chair Jamie Baisden, MD Diagnosis/Imaging Section Chair Daniel Mazanec, MD Medical/Interventional Treatment Section Chair Rakesh Patel, MD Surgical Treatment Section Chair Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care Diagnosis and Treatment (...) of Adult Isthmic Spondylolisthesis North American Spine Society Clinical Guidelines for Multidisciplinary Spine Care Diagnosis and Treatment of Adult Isthmic Spondylolisthesis Copyright © 2014 North American Spine Society 7075 V eterans Boulevard Burr Ridge, IL 60527 USA 630.230.3600 www.spine.org ISBN 1-929988-37-0 Robert Shay Bess, MD Value Section Chair Douglas Burton, MD Norman B. Chutkan, MD Bernard A. Cohen, PhD Charles H. Crawford III, MD Gary Ghiselli, MD Amgad S. Hanna, MD Steven W . Hwang, MD

2014 North American Spine Society

188. 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery

Stroke Association 2012 (32) Perioperative management of patients with implantable defibrillators, pacemakers and arrhythmia monitors: facilities and patient management HRS/American Society of Anesthesiologists 2011(33) *The 2012 UA/NSTEMI CPG (20) is considered policy at the time of publication of this CPG; however, a fully revised CPG is in development, with publication expected in 2014. AABB indicates American Association of Blood Banks; AATS, American Association for Thoracic Surgery; ACC (...) , American College of Cardiology; AHA, American Heart Association; ASE, American Society of Echocardiography; CPG, clinical practice guideline; HRS, Heart Rhythm Society; PCNA, Preventive Cardiovascular Nurses Association; SCAI, Society for Cardiovascular Angiography and Interventions; SCA, Society of Cardiovascular Anesthesiologists; STEMI, ST- elevation myocardial infarction; STS, Society of Thoracic Surgeons; and UA/NSTEMI, unstable angina/non–ST-elevation myocardial infarction. 1.5. Definitions

2014 Society for Cardiovascular Angiography and Interventions

189. Diagnosis and Treatment of Degenerative Spondylolisthesis

Ion /Gu Idel Ine Methodolo Gy Diagnosis and Treatment of Degenerative Lumbar Spondylolisthesis | NASS Clinical Guidelines NASS Evidence-Based Clinical Guidelines Committee Paul Matz, MD Committee Co-Chair and Surgical Treatment Section Chair R.J. Meagher, MD Diagnosis/Imaging Section Chair Tim Lamer, MD Medical/Interventional Section Chair William Tontz Jr, MD Surgical Treatment and Value Section Chair Evidence-Based Clinical Guidelines for Multidisciplinary Spine Care Diagnosis and Treatment (...) of Degenerative Lumbar Spondylolisthesis 2 nd Edition Thiru M. Annaswamy, MD R. Carter Cassidy, MD Charles H. Cho, MD, MBA Paul Dougherty, DC John E. Easa, MD Dennis E. Enix, DC, MBA Bryan A. Gunnoe, MD Jack Jallo, MD, PhD, FACS Terrence D. Julien, MD Matthew B. Maserati, MD Robert C. Nucci, MD John E. O’Toole, MD, MS Jonathan N. Sembrano, MD Alan T. Villavicencio, MD Jens-Peter Witt, MD North American Spine Society Clinical Guidelines for Multidisciplinary Spine Care Diagnosis and Treatment of Degenerative

2014 North American Spine Society

190. Cervical Arterial Dissections and Association with Cervical Manipulative Therapy

resulting from CD is warranted. The association between CMT and CD suggests that increased education of providers, including CMT providers, in diagnosing CD may be warranted. Correspondingly, patients with neck pain and without neurolog- ical symptoms after any trauma should be informed about the potential risks and benefits of receiving CMT, and practitioners should carefully consider CD prior to performing CMT. Cervical Spine Biomechanics and CMT The cervical spine has a unique anatomy and complex bio (...) subjects and cadavers demonstrated considerably more force being used on cadavers. 142 It is important to take into account this difference when reviewing the biomechanical literature evaluating strain on these vessels because these studies were conducted with human cadavers. Moreover, all studies have shown considerably less force used in cervical manipulation compared with thoracic and lumbar manipulation. 136,139,143 After studying external forces applied to the cervical spine during manipulation

2014 Congress of Neurological Surgeons

192. Effects of Nonsteroidal Anti-Inflammatory Drugs in Recurrence of Spondyloarthritis Patients After Remission

) to Week24 ] The BASFI is a participant's self-assessment represented as a mean (VAS; 0 to 10) of 10 questions, 8 of which relate to the participant's functional anatomy and 2 of which relate to a participant's ability to cope with everyday life. An increase along the scale indicates a worsening condition. Change in Baseline in Bath Ankylosing Spondylitis Metrology Index (BASMI) [ Time Frame: From Week 0 (baseline) to Week24 ] BASMI is an objective measure of spinal mobility. The BASMI score is composed (...) to mark health status on the day of the interview on a 20 cm vertical scale with end points of 0 and 100. There are notes at the both ends of the scale that the bottom rate (0) corresponds to " the worst health you can imagine", and the highest rate (100) corresponds to "the best health you can imagine". Change in Chest Expansion [ Time Frame: From Week 0 (baseline) to Week24 ] Chest expansion, measured in cm, is defined as the difference in thoracic circumference during full expiration versus full

2018 Clinical Trials

193. Posterolateral cervical transpedicular corpectomy for the surgical management of metastatic tumor. (PubMed)

Posterolateral cervical transpedicular corpectomy for the surgical management of metastatic tumor. Management of metastatic spinal disease in the upper cervical spine can be particularly challenging. Depending on the level of the lesion and the patient's anatomy, multiple anterior approaches have been described for resection of the cancer, followed by posterior fixation and instrumentation. Although a single-stage posterolateral approach is now well established for thoracic pathology, less (...) is known about the applicability of these principles when applied as an approach to the cervical spine. The authors present here a case using a posterolateral transpedicular approach for corpectomy and graft placement for circumferential reconstruction as a treatment of metastatic disease in the cervical spine to illustrate the feasibility of this technique, especially in the setting where the patient's anatomy or pathology may impede an anterior or combined circumferential approach.

2018 European Spine Journal

194. Psoas Minor Muscle: A Cadaveric Morphometric Study (PubMed)

of the lumbar spine in a limited fashion. The aim of the study was to establish the frequency of the muscle in the Bulgarian population. Materials and methods This study was carried out in the Department of Anatomy and Cell Biology, Medical University, Varna, Bulgaria, by Dr. Paraskev Stoyanov in November 2017, on a total of 10 cadavers. The length, width, and circumference of the muscles were measured. The collected data were interpreted in a descriptive manner. Results The PMM was present in six out (...) Psoas Minor Muscle: A Cadaveric Morphometric Study Introduction The psoas muscle group is part of the posterior abdominal wall and is comprised of long muscles - major, minor, and tertius. Out of those, only the psoas major muscle is an obligatory muscle present in all individuals. The psoas minor muscle (PMM) originates as vertical fascicles inserted in the bodies of the last thoracic and first lumbar vertebrae and inserting into the iliopectineal eminence. The muscle provide flexion

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2018 Cureus

195. Erector Spinae Plane (ESP) Versus Paravertebral Nerve (PVB) Blockade for Acute Unilateral Rib Fracture Pain

include bleeding disorders, thrombocytopenia, localized infection, sepsis, possibly abnormalities of the thoracic spine or paravertebral anatomy neoplastic mass occupying the paravertebral space, empyema, allergy to local anesthestic drug, increased intracranial pressure, severe uncorrected hypovolemia, fixed cardiac output states. Exclusion Criteria: Age younger than 18 years or older than 85 years any contraindication to the placement of a paravertebral or erector spinae catheters American Society (...) of the study patient refusal. Comorbid conditions include bleeding disorders, thrombocytopenia, localized infection, sepsis, possibly abnormalities of the thoracic spine or paravertebral anatomy neoplastic mass occupying the paravertebral space, empyema, allergy to local anesthetic drug, increased intracranial pressure, severe uncorrected hypovolemia, fixed cardiac output states. Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your

2018 Clinical Trials

196. Cervical puncture to deliver nusinersen in patients with spinal muscular atrophy. (PubMed)

is a feasible alternative delivery route to administer intrathecal nusinersen in patients with longstanding SMA and spine anatomy precluding lumbar access when done by providers with expertise in this procedure.© 2018 American Academy of Neurology. (...) lumbar puncture; however, many patients with SMA have scoliosis or solid spinal fusion with hardware that makes lumbar access impossible. Studies in primates have demonstrated better spinal cord tissue concentration with intrathecal injections than with intracerebral ventricular injections. Therefore we have used C1/C2 puncture as an alternative to administer nusinersen.Retrospective chart review.Intrathecal nusinersen via cervical puncture was given to 3 patients who had thoracic and lumbosacral

2018 Neurology

197. Influence of risk-organ–based tube current modulation on CT-induced DNA double-strand breaks in a biological phantom model (PubMed)

was to establish a biological phantom model to evaluate the effect of RTM on X-ray-induced DNA double-strand breaks (DSBs). In breast phantoms and in the location of the spine in an Alderson phantom, isolated human blood lymphocytes were irradiated using a 128-slice CT scanner. A standard thoracic CT protocol (120 kV, 110 ref. mAs, anatomy-based tube current modulation, pitch 0.6, scan length 30 cm) with and without RTM was used. X-ray-induced DSBs were quantified in isolated blood lymphocytes using (...) immunofluorescence microscopy after staining for the phosphorylated histone variant γ-H2AX. Using RTM, the resulting DNA damage reduction was 41% in superficial breast locations (P = 0.0001), 28% in middle breast locations (P = 0.0003) and 29% in lower breast locations (P = 0.0001), but we found a DNA damage increase of 36% in superficial spine locations (P = 0.0001) and of 26% in deep spine locations (P = 0.0001). In summary, we established a biological phantom model that is suitable for detecting DNA damage

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2018 Journal of radiation research

198. Anterior-posterior length discrepancy of the spinal column in adolescent idiopathic scoliosis - a 3d CT study. (PubMed)

Anterior-posterior length discrepancy of the spinal column in adolescent idiopathic scoliosis - a 3d CT study. One of the characteristics of reported observations in adolescent idiopathic scoliosis (AIS) is that the thoracic spine is longer anteriorly than posteriorly, more pronounced around the apex than the transitional zones. This reversal of the normal kyphotic anatomy of the thoracic spine is related to questions of etiopathogenesis of AIS. The changes in the anatomy of the anterior column (...) have been described rather in detail; however, the role of the posterior spinal column and the laminae has so far not been elucidated. If the posterior column exhibits a longitudinal growth disturbance, it could act as a tether, leading to a more or less normal anterior column with a deformed and shorter posterior aspect of the spine. So far, it has remained unclear whether this anterior-posterior length discrepancy is the result of relative anterior lengthening or relative posterior shortening

2018 The Spine Journal

200. Non-Small Cell Lung Cancer Treatment (PDQ®): Health Professional Version

at diagnosis.[ ] Anatomy NSCLC arises from the epithelial cells of the lung of the central bronchi to terminal alveoli. The histological type of NSCLC correlates with site of origin, reflecting the variation in respiratory tract epithelium of the bronchi to alveoli. Squamous cell carcinoma usually starts near a central bronchus. Adenocarcinoma and bronchioloalveolar carcinoma usually originate in peripheral lung tissue. Anatomy of the respiratory system. Pathogenesis Smoking-related lung carcinogenesis (...) shown to alter mortality is low-dose helical CT scanning.[ ] Studies of lung cancer screening with chest radiography and sputum cytology have failed to demonstrate that screening lowers lung cancer mortality rates. (Refer to the subsection in the PDQ summary on for more information.) Clinical Features Lung cancer may present with symptoms or be found incidentally on chest imaging. Symptoms and signs may result from the location of the primary local invasion or compression of adjacent thoracic

2016 PDQ - NCI's Comprehensive Cancer Database

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