Today’s Links November 28, 2011

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Today’s Links November 15, 2011

  • Costotransversectomy for Harlequin Syndrome
    Sribnick and Boulis from Emory University School of Medicine reported a case of Harlequin syndrome who has been treated by costotransversectomy and sympathectomy.
    Harlequin syndrome is a rare neurological syndrome including unilateral hyperhidrosis and erythema of the head and neck. The authors reports a 42-year-old female with a history of mastectomy for right-sided breast cancer subsequently had a left partial pneumonectomy for a metastasis. Postoperatively, she had onset of contralateral neck and facial flushing and sweating.
    The surgical intervention consisted of a partial right T3 costotransversectomy with T2 sympathectomy. The authors reports that the patient’s symptoms of Harlequin syndrome resolved postoperatively. The authors stated that “the diagnosis of Harlequin syndrome is relatively new, and the majority of the scientific literature is concerned with descriptive case presentations. We present a surgical technique for the treatment of Harlequin syndrome”.

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Today’s Links November 7, 2011

  • New study about effect of Yoga for chronic low back pain
    Yoga for chronic low back pain: a randomized trial. Tilbrook et al. Ann Intern Med. 2011 Nov 1;155(9):569-78.
    In this tudy, the authors compare the effectiveness of yoga and usual care for chronic or recurrent low back pain. 313 adults with chronic or recurrent low back pain are studied. The study is randomized, controlled trial using computer-generated randomization conducted from April 2007 to March 2010.Yoga (n = 156) or usual care (n = 157). All participants received a back pain education booklet. The intervention group was offered a 12-class, gradually progressing yoga program delivered by 12 teachers over 3 months.
    As a result, 93 (60%) patients offered yoga attended at least 3 of the first 6 sessions and at least 3 other sessions. The yoga group had better back function at 3, 6, and 12 months than the usual care group. The adjusted mean RMDQ score was 2.17 points (95% CI, 1.03 to 3.31 points) lower in the yoga group at 3 months, 1.48 points (CI, 0.33 to 2.62 points) lower at 6 months, and 1.57 points (CI, 0.42 to 2.71 points) lower at 12 months. The yoga and usual care groups had similar back pain and general health scores at 3, 6, and 12 months, and the yoga group had higher pain self-efficacy scores at 3 and 6 months but not at 12 months.

    The authors conclude that offering a 12-week yoga program to adults with chronic or recurrent low back pain led to greater improvements in back function than did usual care.

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Today’s Links October 17, 2011

  • Atlas (C1) Fracture
    Although Atlas (C1) fracture and Jefferson fracture terms are frequently used interchangeably, this approach is not completely right. In its originally described form, which was first reported by Geofrey Jefferson in 1920, the Jefferson fracture is a complex burst fracture of the ring of the C1 vertebra, involving fractures of the anterior and posterior arches of the Atlas on both the right and left sides (4 fractures, see the figure below). Variants of this burst fracture include two or three-part fractures. Other types of Atlas fractures include lateral mass and lamina fractures, which are different than that of a burst (Jefferson) fracture. Thus, Atlas fractures can be classified as:
    1. Burst (Jefferson) fracture: bilateral fractures of anterior and posterior arch
    2. Lateral mass fracture
    3. Lamina fracture.

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Today’s Links October 15, 2011

  • McGill Pain Questionnaire
    The McGill Pain Questionnaire measures not only its intensity, but also its quality. The questionnaire was developed in 1971 by Ronald Melzack and Warren Torgerson from McGill University in Canada. According to the authors, each disease produces a different quality of pain: causalgia is burning; visceral pain is stabbing or cramping, etc.. Thus, the quality of pain provides a key to diagnosis and may even suggest a course of therapy.

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Today’s Links October 6, 2011

  • Karnofsky score
    The Karnofsky Performance Scale Index is used to quantify patients’ general well-being and activities of daily life. The scoring system was named after Dr David A. Karnofsky, who described the scale with Dr Joseph H. Burchenal in 1949. Karnofsky Score allows patients to be classified as to their functional impairment. This can be used to compare effectiveness of different therapies and to assess the prognosis in individual patients. The lower the Karnofsky score, the worse the survival for most serious illnesses.

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Today’s Links October 4, 2011

  • AAOS LUMBAR CLUSTER
    The American Academy of Orthopaedic Surgeons (AAOS) Outcomes Studies Committee, in collaboration with the Council of Musculoskeletal Specialty Societies and the Council of Spine Societies, developed and pretested a series of functional outcomes assessment measurement instruments. AAOS lumbar cluster is one of those scales.
    The instruments were designed to collect patient-based data for use in clinical practice settings to assess the effectiveness of treatment regimens and in musculoskeletal research to study the clinical outcomes of treatment.

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Today’s Links October 4, 2011

  • Allen and Ferguson Classification of Subaxial Spine Injuries
    Allen and colleagues introduced a comprehensive classification system of subaxial spine injuries, also known as “mechanistic” classification. In this system, the injuries are classified on the basis of the mechanical mode of failure of the spine. Then, the choice of instrumentation for surgery is based on the surgeon’s understanding of these injury patterns.
    This classification system includes 3 common mechanisms: compression-flexion, distraction-flexion, and compression-extension. Vertical compression injury results in the burst-type injury with anterior column failure. Less common modes of insult are the distraction-extension and lateral flexion subtypes.

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Today’s Links October 3, 2011

  • AAOS LUMBAR CLUSTER
    The American Academy of Orthopaedic Surgeons (AAOS) Outcomes Studies Committee, in collaboration with the Council of Musculoskeletal Specialty Societies and the Council of Spine Societies, developed and pretested a series of functional outcomes assessment measurement instruments. AAOS lumbar cluster is one of those scales.
    The instruments were designed to collect patient-based data for use in clinical practice settings to assess the effectiveness of treatment regimens and in musculoskeletal research to study the clinical outcomes of treatment.

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