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Thoracic Spine Anatomy

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721. The Safety and Efficacy of Catheter-based Renal Denervation Using the Vessixâ„¢ Renal Denervation System in Autosomal Dominant Polycystic Kidney Disease (ADPKD) Patients With Severe Debilitating Pain

on dialysis No change in antihypertensive therapy for 1 month prior to study enrollment Women of childbearing potential must be using at least 2 acceptable forms of birth control Exclusion Criteria: Individual has renal artery anatomy that is ineligible for treatment including: Lacks at least one renal artery for each kidney with ≥ 4 mm diameter and with ≥ 20 mm treatable length prior to a significant arterial branch Renal artery stenosis (>50%) or renal artery aneurysm in a renal artery (...) episode(s) of orthostatic hypotension not related to medication changes (reduction of systolic blood pressure of ≥20 mmHg or diastolic blood pressure of ≥10 mmHg within 3 minutes of standing), coupled with symptoms, within the past year or during the screening process. Change in systolic blood pressure associated with symptoms of orthostasis Individual requires chronic oxygen support or mechanical ventilation other than nocturnal respiratory support for sleep apnea. The presence of primary pulmonary

2016 Clinical Trials

722. The Response Patterns to the Electrical Stimulation of Epidural Catheters With Varying Pulse Widths in Term Pregnant Women

in English Informed consent Exclusion criteria: Refusal to provide written informed consent Inability to communicate in English Abnormal vertebral anatomy, including but not limited to previous spine surgery and scoliosis Allergy or hypersensitivity to lidocaine, bupivacaine or fentanyl Coexisting neurological disorders Implanted electronic devices Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study (...) in the standard fashion employed in the investigators' institution by a fellow or staff. Spinal ultrasound will be used prior to performing the epidural catheter insertion. The trans-catheter electric stimulation test (TCEST) will be performed at both a 0.1ms pulse width and a 1ms pulse width. The order in which the two pulse widths are applied will be randomly decided by computer. The test dose of local anesthetic will then be administered, and the TCEST will be repeated 5 minutes later. Again, both pulse

2016 Clinical Trials

723. Airway Changes in Patients Undergoing Elective Surgical Procedures in the Prone and Trendelenburg Positions

classes in patients undergoing lumbar spine surgery in the prone position. Furthermore, although laparoscopic surgery has been shown to increase lung and chest wall mechanical impedance, which leads to increases in abdominal and intrathoracic pressure, as well as an increase in central venous pressure with subsequent increases in intraocular pressure, no studies have been performed to specifically track resultant airway changes. Lastly, to investigators' knowledge no studies have investigated (...) Last Update Posted : January 9, 2019 Sponsor: Tufts Medical Center Information provided by (Responsible Party): Tufts Medical Center Study Details Study Description Go to Brief Summary: The goal of this study is to track the intraoperative changes that occur in the airways of patients undergoing 1) laparoscopic surgeries in the Trendelenburg position, and 2) spinal surgeries in the prone position, as well as the regression of these changes postoperatively. These surgeries are known to cause edema

2016 Clinical Trials

724. Comparison of Modified Mallampati Classification With M-TAC in Difficult Airway

. Modified mallampati classification had four grades & each grade was given a score, similarly thyromental distance (TMD), anatomical abnormality (AA) & cervical mobility (CM) was classified into three grades & each grade was given a score. For M-TAC individual scores were added. Condition or disease Airway Management Detailed Description: The term 'airway' refers to the upper airway which may be defined as the extra-pulmonary air passage, consisting of the nasal and oral cavities, pharynx, larynx (...) in isolation. Combining several risk factors increase the predictive value of the test and multivariable risk models have been developed. As the anatomy of the head and neck region plays a leading role in deciding the fateful profile of the airway, especially associated with influential abnormality. So, simple bedside test, such as the modified Mallampati test, has been found to be of limited value and cannot be relied on for using in predicting difficult laryngoscopy. Exclusively when each individual

2016 Clinical Trials

725. A Study of the ReCor Medical Paradise System in Clinical Hypertension

device (e.g. ICD or CRT-D; neuromodulator/spinal stimulator; baroreflex stimulator) Chronic oxygen support or mechanical ventilation other than nocturnal respiratory support for sleep apnea. Primary pulmonary hypertension Documented contraindication or allergy to contrast medium not amenable to treatment Limited life expectancy of < 1 year at the discretion of the Investigator Any known, unresolved history of drug use or alcohol dependency, lacks the ability to comprehend or follow instructions (...) /90 mmHg <180/110 mmHg despite lifestyle measures on no antihypertensive medications TRIO Cohort only: Average seated office BP ≥ 140/90 mmHg at screening visit while on a stable regimen of at least 3 antihypertensive medications of different classes including a diuretic for at least 4 weeks prior to consent Documented daytime ABP ≥ 135/85 mmHg and < 170/105 mmHg after 4-week washout/run-in period (SOLO cohort) or after 4-week stabilization period (TRIO cohort) Suitable renal anatomy compatible

2016 Clinical Trials

726. Imaging of Lymphatic Anomalies

Summary: Lymphatic Anomalies (LA) is characterized by proliferation of lymphatic tissue causing deterioration of pulmonary function. Understanding changes in lymphatic anatomy in these patients is hindered by the difficulty of imaging the lymphatic system. Dynamic Contrast Enhanced MR Lymphangiogram (DCMRL) may be useful in investigating pathological changes in the lymphatic system. Condition or disease Intervention/treatment Phase Gorham Disease Lymphatic Diseases Lymphangiomatosis Other: Dynamic (...) into the MRI suite. Outcome Measures Go to Primary Outcome Measures : Describe lymphatic anatomy of participants with lymphatic anomalies (LA) [ Time Frame: 2 Days ] The primary endpoint will be the description of lymphatic anatomy assessing if participants have a single or branched Thoracic Duct. Secondary Outcome Measures : Development of a classification system for lymphatic flow [ Time Frame: 2 days ] Development of a classification system based on retrograde or anterograde flow of lymphatic fluid

2016 Clinical Trials

727. IINB vs. QLB for Elective Open Inguinal Herniorrhaphy

following open herniorrhaphy. Additionally, because local anesthetic injected during a QLB has the potential to spread cranially into the thoracic paravertebral space following its lumbar deposition it could lead to alleviation of both somatic and visceral pain.3 This might therefore improve the quality and or duration of analgesia as compared to the IINB. To the best of the author's knowledge there has been no investigation comparing the efficacy, with regards to post-operative pain management, between (...) in the study and do not meet exclusion criteria will be randomized to either receiving an IINB or a QLB for post-operative analgesia. After performing a timeout, applying monitors (ECG, capnography, Sp02, non-invasive blood pressure), and confirming all paperwork per the usual pre-procedural check list the study participants will be administered procedural sedation (fentanyl and midazolam) to comfort as well as supplemental oxygen. The anatomy of both block sites will be identified by palpation

2016 Clinical Trials

728. Epidural Anesthesia-analgesia and Long-term Outcome

or Parkinson disease, or unable to complete preoperative assessment due to severe dementia, language barrier or end-stage disease; History of myocardial infarction within 3 months before surgery; Presence of any contraindication to epidural anesthesia and analgesia, including abnormal vertebral anatomy, previous spinal trauma or surgery, severe chronic back pain, coagulation disorder (prothrombin time or activated partial prothrombin time longer than 1.5 times of the upper limit of normal, or platelet (...) of the tumor. Preclinical and retrospective studies suggest that anaesthetic techniques and drugs may affect the long-term prognosis in patients undergoing cancer surgery. The investigators hypothesize that epidural anesthesia-analgesia may improve the long-term outcome of the elderly patients who are scheduled to undergo major thoracic and abdominal surgery for the treatment of malignant tumor. Condition or disease Intervention/treatment Phase Elderly Patients Malignant Tumor Surgical Resection Epidural

2016 Clinical Trials

729. Pain Reduction With Intranasal Medications for Extremity Injuries

to 17 years (up to the 18th birthday) Presenting to emergency department with one or more extremity injuries Visual analog scale score 35 mm or greater Parent or legal guardian present and willing to provide written consent Exclusion Criteria: Received narcotic pain medication prior to arrival Evidence of significant head, chest, abdomen, or spine injury Glasgow coma score less than 15 or unable to self report pain score Nasal trauma or aberrant nasal/airway anatomy Active epistaxis Allergy

2016 Clinical Trials

730. Human Electrical-Impedance-Tomography Reconstruction Models

, spine, etc.) and non-aerated lung tissues - which is a major limitation for the clinical use of information derived from EIT-imaging. Moreover, current EIT-reconstruction algorithms are based on the consideration of a complete circular thoracic shape and do not take into account the body contours and lung borders. The investigators are convinced that EIT-derived dynamic bedside lung imaging can be advanced by morphing computed tomography (CT) scans of the respective thoracic levels with concomitant (...) EIT images - thus enhancing EIT-image information with CT-data. Integrating the anatomy of thoracic shape and lung borders provided by high-spatial resolution multi detector CT-scans (MDCT) with high-temporal resolution EIT has the potential to improve image quality considerably. This data can be used to compute mean EIT-reconstruction models that further offer the possibility to develop novel and clinically meaningful EIT parameters. Therefore, the investigators hypothesize that by integration

2016 Clinical Trials

731. Demographical aspects in cervical vertebral bodies' size and shape (c3-c7): a skeletal study. (Abstract)

Demographical aspects in cervical vertebral bodies' size and shape (c3-c7): a skeletal study. This cross-sectional study was conducted on the skeletal remains of individuals of known sex, age, and ethnic origin. The vertebral bodies of levels C3-C7 were measured and analyzed. Whereas many studies were performed on the size and shape of the vertebral bodies in the thoracic and lumbar spines, few have focused on the cervical vertebral bodies. Thus, there is insufficient data in the literature (...) on the anatomy of the cervical spine, especially based on large study populations.To establish a large database on cervical vertebral bodies' size and shape and analyze their association with demographic parameters.The population studied was composed of 277 individuals, adult males and females of African American (AA) and European American (EA) origin. The skeletal remains are housed at the Hamman-Todd Osteological collection (Cleveland Museum of Natural History, Cleveland, OH).A 3-D digitizer was used

2016 The Spine Journal

732. Validation of an inanimate low cost model for training minimal invasive surgery (MIS) of esophageal atresia with tracheoesophageal fistula (AE/TEF) repair. (Abstract)

and spine and tubular latex balloons to simulate the esophagus and lungs to make the basic model. This device was inserted into the thoracic cavity of a rubber dummy simulating a 3kg newborn with a work area volume of 50ml. The model was designed taking into account the experience of doing this procedure in neonates. The cost of the materials used was 50 US$. Regular video endoscopic equipment and 3mm instruments were used. Thirty-nine international faculty or pediatric surgeons attending hands (...) on courses with different levels of training in minimal invasive surgery (MIS) repair of EA/TEF performed the procedure in the model. We compared the performance of the practitioners with their experience in thoracoscopic repair of EA. A Likert-type scale was used to evaluate results. Previous experience in MIS, anatomical appearance of the model, surgical anatomy compared to a real patient, and utility as a training method were analyzed. We also used a checklist to assess performance. We evaluated

2016 Journal of Pediatric Surgery

733. A neglected point in surgical treatment of adolescent idiopathic scoliosis: Variations in the number of vertebrae. Full Text available with Trip Pro

A neglected point in surgical treatment of adolescent idiopathic scoliosis: Variations in the number of vertebrae. Inaccurate identification of vertebral levels is the main cause of wrong-site spine surgery which is performed by nearly half of the spine surgeons. Unusual anatomy and failure to verify the surgical level on radiographs have been commonly reported. We aimed at investigating the variations in vertebral number in adolescent idiopathic scoliosis (AIS) patients and thus to raise (...) awareness of the possibility for wrong-level spinal surgery and to make a comparison with normal adolescents. A cohort of 657 AIS patients and 248 normal adolescents, presented to our center from June 2008 to February 2013, who met the inclusion criteria, were recruited. Radiographs were reviewed to identify the number of thoracic or lumbar vertebrae and the presence of a lumbosacral transitional vertebra. In the AIS group, 70 (10.6%) patients had variations in the number of thoracic and/or lumbar

2016 Medicine

734. Termination of Pregnancy for Fetal Abnormality in England, Scotland and Wales

abnormalities (such as holoprosencephaly, schizencephaly) and thoracic or high lumbar neural tube defects are relatively straightforward to diagnose. However, the outcome for other CNS abnormalities (such as mild to moderate ventriculomegaly) is much less certain and further investigations will be required to refine the diagnosis. This may mean that decisions based on optimal information cannot be made before 24 weeks of gestation. In 2008, one- third of terminations undertaken beyond 24 weeks were (...) the need for a repeat scan several weeks after the initial diagnosis. This can result in delayed diagnosis. Severe cardiac abnormalities Severe cardiac abnormalities have a reasonably predictable outcome. Once an abnormality has been identified, paediatric cardiologists can offer fairly accurate information on whether the anomaly can be corrected (to normal anatomy) or whether a palliative procedure is required, with the much greater risk of long term morbidity. In 2008, there were 17 late termi

2010 Royal College of Obstetricians and Gynaecologists

735. Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition) Full Text available with Trip Pro

. Beaulieu Jean-François JF azh Université de Sherbrooke , Department of Anatomy and Cell Biology , Faculty of Medicine and Health Sciences , Sherbrooke, QC , Canada. Beck George R GR Jr av Atlanta Department of Veterans Affairs Medical Center , Decatur , GA. kh Emory University, Division of Endocrinology, Metabolism, and Lipids , Department of Medicine , Atlanta , GA , USA. Becker Christoph C lx Friedrich-Alexander-University Erlangen-Nürnberg , Department of Medicine 1 , Erlangen , Germany. Beckham J (...) , Department of Neurosurgery , Irvine , CA , USA. Chen Jian-Kang JK nf Georgia Regents University, Medical College of Georgia , Department of Cellular Biology and Anatomy , Augusta , GA , USA. ng Georgia Regents University, Medical College of Georgia , Department of Medicine , Augusta , GA , USA. Chen Min M io Dalian Medical University , Department of Food Nutrition and Safety , Dalian , China. Chen Mingzhou M cbx Wuhan University, College of Life Science, State Key Laboratory of Virology , Wuhan, Hubei

2016 Autophagy

736. Microscopic Posterior Transdural Resection of Cervical Retro-Odontoid Pseudotumors Full Text available with Trip Pro

. The patient's clinical symptoms subsequently improved and the pathologic findings showed degenerative fibrocartilaginous tissue. In addition, no neurological deterioration, central spinal fluid leakage, or arachnoiditis was observed. Currently, the usefulness of the transdural approach has been reported for cervical and thoracic disk herniation. According to our results, the transdural approach is recommended for resection of retro-odontoid pseudotumors because it enables direct decompression of the spinal (...) Microscopic Posterior Transdural Resection of Cervical Retro-Odontoid Pseudotumors Retro-odontoid pseudotumors are noninflammatory masses formed posterior to the odontoid process. Because of their anatomy, the optimal surgical approach for resecting pseudotumors is controversial. Conventionally, 3 approaches are used: the anterior transoral approach, the lateral approach, and the posterior extradural approach; however, each approach has its limitations. The posterior extradural approach

2015 Journal of spinal disorders & techniques

737. Surgical Incision and Approach in Thoracolumbar Extreme Lateral Interbody Fusion Surgery - an Anatomic Study of the Diaphragmatic Attachments. Full Text available with Trip Pro

is yet to be elaborated.Dissections were performed on 21 cases of formalin fixed specimens (12 males, 9 females, a total of 42 sets of data). Special attention was paid to the attachment points of diaphragm on both sides at the midaxillary line (MAL point) and the vertebral level parallel to the MAL point (VL-MAL). The attachment points of diaphragm on the front and back edge of the spinal column (FES point and BES point) were also described.The MAL point of diaphragm muscle lied between the inferior (...) Surgical Incision and Approach in Thoracolumbar Extreme Lateral Interbody Fusion Surgery - an Anatomic Study of the Diaphragmatic Attachments. Cadaveric study.To provide anatomical basis for deciding the surgical approach and skin incision in thoracolumbar extreme lateral interbody fusion (XLIF) by delineating the attachment points of diaphragm.Although the general anatomy of the thoracic diaphragm is well described, the specific attachment points of diaphragm concerned with the XLIF approach

2015 Spine

738. A Study to Evaluate the Efficacy and Safety of Ustekinumab in the Treatment of Anti-TNFα Naive Participants With Active Radiographic Axial Spondyloarthritis

in the following 7 domains: 1) 1st costochondral joint left and right, 2) 7th costochondral joint left and right, 3) posterior superior iliac spine left and right, 4) anterior superior iliac spine left and right, 5) iliac crest left and right, 6) 5th lumbar spinous process and 7) proximal insertion of Achilles tendon left and right. Entheses were scored as either 0 (nontender) or 1 (tender) yielding total MASES ranging from 0 (no tenderness) to 13 (worst possible score; severe tenderness). Early escape rule (...) [NRI] (missing responses at post baseline visit imputed as non-responder). Percentage of Participants Who Achieved ASAS 5/6 Response at Week 16 and 24 [ Time Frame: Week 16 and 24 ] ASAS 5/6 is defined as a >=20% improvement in any 5 of the 6 domains of pain (VAS 0 to 10), patient global (VAS 0 to 10), function (BASFI score), morning stiffness (from BASDAI), hsCRP, and spine mobility (lumbar side flexion). ASAS 5/6 response is based on imputed data using treatment failure(consider non-responders

2015 Clinical Trials

739. Multicenter clinical trial of the conformable stent graft for the treatment of acute, complicated type B dissection. Full Text available with Trip Pro

Multicenter clinical trial of the conformable stent graft for the treatment of acute, complicated type B dissection. The treatment of acute, complicated type B aortic dissection has evolved in the past several decades. Thoracic endovascular aortic repair when anatomy is suitable, has been regarded as the preferable treatment to seal the primary entry tear, redirect and re-establish adequate true lumen flow, and thereby promote aortic remodeling. This study was designed to determine the safety (...) and efficacy of a conformable thoracic endoprosthesis device for patients with acute, complicated type B aortic dissection, defined as malperfusion or rupture or both.Between January 2010 and January 2012, 50 patients with complicated type B aortic dissection from 26 sites in the United States were included in this prospective, multicenter, nonrandomized single-arm study. The primary safety end point was all-cause mortality through 30 days after treatment, and the primary efficacy end point was exclusion

2015 Journal of Vascular Surgery

740. Comparing Rectus Sheath Catheter to Epidural Post Cystectomy

controlled analgesia Patients must be undergoing a cystectomy with an infra-umbilical midline incision Exclusion Criteria: Patients with BMI greater than 40 Patients with an allergy to local anaesthetics Patients who are contraindicated to having an epidural (e.g. coagulopathic, distorted anatomy, patient refusal, infection at the site of proposed insertion) Patients with previous spinal surgery at the proposed site of epidural Patients with neurodegenerative disorders or spinal cord injury Patients (...) Official Title: A Randomised Controlled Trial of Thoracic Epidural Analgesia Versus Surgically Placed Rectus Sheath Catheters for Open Radical Cystectomy: Is There a Difference in Patient Outcomes? Study Start Date : September 2015 Estimated Primary Completion Date : December 2016 Estimated Study Completion Date : June 2017 Resource links provided by the National Library of Medicine related topics: related topics: Arms and Interventions Go to Arm Intervention/treatment Active Comparator: Rectus Sheath

2015 Clinical Trials

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