scholarly journals INTERDISCIPLINARY COOPERATION IN DEALING WITH SPINAL DISEASES

2017 ◽  
Author(s):  
Anna Lesňáková ◽  
◽  
Z. Hudáková ◽  
M. Kolárová ◽  
R. Rusnák ◽  
...  
Keyword(s):  
Interdisciplinary Cooperation ◽  
Spinal Diseases

The Possibilities and Significance of Interdisciplinary Cooperation in Orbital Surgery

Skull Base ◽  
2007 ◽  
Vol 17 (S 1) ◽  
Author(s):  
L. Pekař ◽  
H. Bohutová ◽  
P. Diblík ◽  
A. Nejedý ◽  
J. Mazánek
Keyword(s):  
Interdisciplinary Cooperation ◽  
Orbital Surgery

scholarly journals Functional syndromes and symptom-orientated aftercare after esophagectomy

2021 ◽  
Author(s):  
Kristjan Ukegjini ◽  
Diana Vetter ◽  
Rebecca Fehr ◽  
Valerian Dirr ◽  
Christoph Gubler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Current Knowledge ◽  
Well Being ◽  
Interdisciplinary Cooperation ◽  
Term Therapy ◽  
Gastrointestinal Function ◽  
Postoperative Changes ◽  
Comprehensive Knowledge ◽  
Esophagectomy For Cancer

Abstract Background Surgery is the cornerstone of esophageal cancer treatment but remains burdened with significant postoperative changes of gastrointestinal function and quality of life. Purpose The aim of this narrative review is to assess and summarize the current knowledge on postoperative functional syndromes and quality of life after esophagectomy for cancer, and to provide orientation for the reader in the challenging field of functional aftercare. Conclusions Post-esophagectomy syndromes include various conditions such as dysphagia, reflux, delayed gastric emptying, dumping syndrome, weight loss, and chronic diarrhea. Clinical pictures and individual expressions are highly variable and may be extremely distressing for those affected. Therefore, in addition to a mostly well-coordinated oncological follow-up, we strongly emphasize the need for regular monitoring of physical well-being and gastrointestinal function. The prerequisite for an effective functional aftercare covering the whole spectrum of postoperative syndromes is a comprehensive knowledge of the pathophysiological background. As functional conditions often require a complex diagnostic workup and long-term therapy, close interdisciplinary cooperation with radiologists, gastroenterologists, oncologists, and specialized nutritional counseling is imperative for successful management.

scholarly journals Minimally Invasive Techniques for Iliac Bolt Placement: 2-Dimensional Operative Video

2021 ◽  
Vol 20 (4) ◽  
pp. E292-E292
Author(s):  
Travis Hamilton ◽  
Mohamed Macki ◽  
Thomas M Zervos ◽  
Victor Chang
Keyword(s):  
Minimally Invasive ◽  
Imaging System ◽  
Pedicle Screws ◽  
Vertical Axis ◽  
Spinal Diseases ◽  
Open Approach ◽  
Sagittal Vertical Axis ◽  
Pelvic Fixation ◽  
Iliac Screws ◽  
Invasive Techniques

Abstract As the popularity of minimally invasive surgery (MIS) continues to grow, novel techniques are needed to meet the demands of multisegment fixation for advanced spinal diseases. In one such example, iliac bolts are often required to anchor large fusion constructs, but MIS technical notes are missing from the literature.  A 67-yr-old female presented with a symptomatic coronal deformity: preoperative pelvic incidence = 47°, pelvic tilt = 19°, and lumbar lordosis = 29°, sagittal vertical axis = +5.4 cm with 30° of scoliosis. The operative plan included T10-ilium fusion with transforaminal interbody grafts at L2-3, L3-4, L4-5, and L5-S1. The intraoperative video is of minimally invasive placement of iliac bolts using the O-Arm Surgical Imaging System (Medtronic®). The patient consented to the procedure.  A mini-open exposure that remains above the fascial planes allows for multilevel instrumentation with appropriate decompression at the interbody segments. After the placement of the pedicle screws under image-guidance, the direction is turned to the minimally invasive iliac bolts. Following the trajectory described in the standard open approach,1 the posterior superior iliac spine (PSIS) is identified with the navigation probe, which will guide the Bovie cautery through the fascia. This opening assists in the trajectory of the navigated-awl tap toward the anterior superior iliac spine (ASIS). Next, 8.5 mm x 90 mm iliac screws were placed in the cannulated bone under navigation. After intraoperative image confirmation of screw placement, the contoured rods are threaded under the fascia. The setscrews lock the rod in position. MIS approaches obviate cross-linking the rods, rendering pelvic fixation more facile.  This technique allows for minimal dissection of the posterior pelvic soft tissue while maintaining adequate fixation.

scholarly journals SWK-07. A MULTINATIONAL SURVEY OF PAEDIATRIC NEURO-ONCOLOGY SERVICES: A EUROPEAN RESEARCH NETWORK (ERN) PAEDCAN PROJECT

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii465-iii466
Author(s):  
Katherine Cooper ◽  
Barry Pizer ◽  
Steven Lane ◽  
Stefan Rutkowski
Keyword(s):  
Economic Status ◽  
Proton Beam Therapy ◽  
Paediatric Oncology ◽  
Interdisciplinary Cooperation ◽  
Research Network ◽  
Online Questionnaire ◽  
Support Design ◽  
Mortality And Morbidity ◽  
Group Members ◽  
Patient Advice

Abstract BACKGROUND Brain tumours are clinically and biologically highly diverse and account for 25% of paediatric neoplasms. They carry the highest mortality and morbidity of tumour groups. Their management presents significant challenges with performing modern diagnostic assessments, applying multimodal treatment and establishing interdisciplinary cooperation. Outcomes across Europe differ significantly with varying 5year survival reports of 42–79%. This SIOP-Europe PaedCan survey assessed the structures and facilities for individual states and highlight areas for cooperation and support. DESIGN: An online questionnaire was sent to SIOP-Europe Brain Tumour Group members. This had 55 questions assessing pathology, staging, surgery, radiotherapy and paediatric oncology infrastructure. For analysis of the data we divided countries into lower and higher economic status according to GDP (World Bank 2019) with a cut off of $30,100. RESULTS There were 388 respondents from 44 countries in 181 different institutions. In the lower GDP group we noted decreased access to biological characterisation of tumours and interdisciplinary tumour boards. In this group of nations, patients were less likely to have treatment by a paediatric specialist neurosurgeon, paediatric neuro-oncologist, neuroradiologist, and paediatric radiation oncologist. There was also less availability to perform early MRI (ventilated) and less access to proton beam therapy. This study supports the aim of the ERN to produce a roadmap document with specific standards and publish guidelines for all relevant diagnostic and therapeutic components of care. The ERN also aims to identify a network of institutions to provide patient advice and training to equalise treatment and outcomes for all children across Europe.

scholarly journals Functional endoscopy in neurogenic dysphagia: a feasibility study focusing on the esophageal phase of swallowing

2021 ◽  
Vol 09 (04) ◽  
pp. E646-E652
Author(s):  
Jan Rückert ◽  
Philipp Lenz ◽  
Hauke Heinzow ◽  
Johannes Wessling ◽  
Tobias Warnecke ◽  
...  
Keyword(s):  
Primary Outcome Measure ◽  
Interdisciplinary Cooperation ◽  
Upper Esophageal Sphincter ◽  
Secondary Outcome ◽  
Diagnostic Tools ◽  
Control Group ◽  
Special Focus ◽  
Neurogenic Dysphagia ◽  
High Resolution Manometry ◽  
Multidisciplinary Study

Abstract Background and study aims Due to demographic transition, neurogenic dysphagia has become an increasingly recognized problem. Patients suffering from dysphagia often get caught between different clinical disciplines. In this study, we implemented a defined examination protocol for evaluating the whole swallowing process by functional endoscopy. Special focus was put on the esophageal phase of swallowing. Patients and methods This prospective observational multidisciplinary study evaluated 31 consecutive patients with suspected neurogenic dysphagia by transnasal access applying an ultrathin video endoscope. Thirty-one patients with gastroesophageal reflux symptoms were used as a control group. We applied a modified approach including standardized endoscopic positions to compare our findings with fiberoptic endoscopic evaluation of swallowing and high-resolution manometry. The primary outcome measure was feasibility of functional endoscopy. Secondary outcome measures were adverse events (AEs), tolerability, and pathologic endoscopic findings. Results Functional endoscopy was successfully performed in all patients. No AEs were recorded. A variety of disorders were documented by functional endoscopy: incomplete or delayed closure of the upper esophageal sphincter in retroflex view, clearance disturbance of tubular esophagus, esophageal hyperperistalsis, and hypomotility. Analysis of results obtained with the diagnostic tools showed some discrepancies. Conclusions By interdisciplinary cooperation with additional assessment of the esophageal phase of deglutition using the innovative method of functional endoscopy, the diagnosis of neurogenic disorders including dysphagia may be significantly improved, leading to a better clinical understanding of complex dysfunctional patterns. To the best of our knowledge, this is the first study to show that a retroflex view of the ultrathin video endoscope within the esophagus can be safely performed. [NCT01995929]

scholarly journals The cGMP Pathway and Inherited Photoreceptor Degeneration: Targets, Compounds, and Biomarkers

Genes ◽  
2019 ◽  
Vol 10 (6) ◽  
pp. 453 ◽  
Author(s):  
Arianna Tolone ◽  
Soumaya Belhadj ◽  
Andreas Rentsch ◽  
Frank Schwede ◽  
François Paquet-Durand
Keyword(s):  
Cell Death ◽  
Gene Mutations ◽  
Interdisciplinary Cooperation ◽  
Response To Treatment ◽  
Common Denominator ◽  
Photoreceptor Degeneration ◽  
Diverse Range ◽  
Cell Death Pathway ◽  
Cgmp Signaling ◽  
Dependent Cell

Photoreceptor physiology and pathophysiology is intricately linked to guanosine-3’,5’-cyclic monophosphate (cGMP)-signaling. Here, we discuss the importance of cGMP-signaling for the pathogenesis of hereditary retinal degeneration. Excessive accumulation of cGMP in photoreceptors is a common denominator in cell death caused by a variety of different gene mutations. The cGMP-dependent cell death pathway may be targeted for the treatment of inherited photoreceptor degeneration, using specifically designed and formulated inhibitory cGMP analogues. Moreover, cGMP-signaling and its down-stream targets may be exploited for the development of novel biomarkers that could facilitate monitoring of disease progression and reveal the response to treatment in future clinical trials. We then briefly present the importance of appropriate formulations for delivery to the retina, both for drug and biomarker applications. Finally, the review touches on important aspects of future clinical translation, highlighting the need for interdisciplinary cooperation of researchers from a diverse range of fields.

Study and Analysis of Mechanical Behavior between Rigid and Dynamic Fixation Systems Analyzed by the Finite Element Method

2017 ◽  
Vol 33 ◽  
pp. 12-31 ◽  
Author(s):  
Samir Zahaf ◽  
Said Kebdani
Keyword(s):  
Finite Element Method ◽  
Finite Element ◽  
Intervertebral Disc ◽  
Spinal Diseases ◽  
Main Role ◽  
Rigid Fixation ◽  
Dynamic Fixation ◽  
Motion Segment ◽  
Fixation Devices ◽  
Element Method

Orthopedic fixation devices are widely used in treatment of spinal diseases. It is expected that application of dynamic stabilization confers valuable movement possibility besides its main role of load bearing. Comparative investigation between pedicle screw model rigid fixation and (B Dyne, Elaspine, Bioflex, Coflexe rivet) models dynamic fixation systems may elucidate the efficacy of each design. The goal of the present study is to evaluate the efficacy of five fixation systems mounted on L4-L5 motion segment. In this numerical study, a 3D precious model of L4, L5 and their intervertebral disc has been employed based on CT images. five fixation devices have been also implanted internally to the motion segment. Finite element method was used to evaluate stress distribution in the disc and determine the overall displacement of the segment as a measure of movement possibility. The results show that The Coflex rivet implantation can provide stability in all motions and reduce disc annulus stress at the surgical segment (L4-L5), on the other hand, Maximum stress in the disc has been observed in dynamic systems but within the safe range. The greater movement of the motion segment has been also appeared in dynamic fixations. Existence of the fixation systems reduced the stress on the intervertebral disc which might be exerted in intact cases. Use of the fixation devices can considerably reduce the load on the discs and prepare conditions for healing of the injured ones. Furthermore, dynamic modes of fixation confer possibility of movement to the motion segments in order to facilitate the spinal activities.

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