Articles: cations.
-
Caudal agenesis (CA) is a congenital disease characterized by lower vertebral bone defects. Previous classifications for CA were based on the levels of bony defects or the conus medullaris. We created a new pathoembryogenic classification that takes into account the level of conus, considering both its shape and filum. We evaluated its accuracy in reflecting the neurological status and the need for untethering. ⋯ The correlation between bony classification and spinal cord abnormalities was exaggerated. Our new pathoembryogenic classification was valuable in prognosticating neurological status and identifying the patient group more likely to require untethering among patients with CA.
-
Randomized Controlled Trial
Enhancing placebo analgesia: Unravelling the powerful interplay of ownership and verbal suggestion.
Placebo analgesic research demonstrates pain reduction after using a placebo analgesic. Recent studies have documented that sometimes possessing a placebo analgesic induces placebo analgesia. These prior studies used a 'cream' as the stimulus and proposed that the effect is driven by an expectancy of obtaining benefits from the owned analgesic. This paper examines three pivotal components of placebo analgesia: placebo form, ownership and expectancy induced by verbal suggestion. We investigate analgesic expectancy between cream versus oil form of placebo stimulus and systematically isolate the effects of ownership, verbal suggestion and their interaction, comparing with the effect of use, to decipher the dynamics of placebo analgesia. ⋯ This study delves into the intricate dynamics of placebo analgesia, shedding light on the significant influence of ownership and verbal suggestion. Through a meticulous exploration of the relationship between ownership and expectancy induced by verbal suggestion, we propose novel avenues for enhancing placebo responses. This research has implications for clinical practice and pain management strategies, potentially revolutionizing approaches to pain relief and therapeutic outcomes. Our findings contribute to a paradigm shift in understanding placebo analgesia, emphasizing the pivotal interaction between ownership and verbal suggestion.
-
Multicenter Study Observational Study
Clinical Implications and Risk Factors of Dilatation of Remnant Pancreatic Duct at 1 Year After Pancreatoduodenectomy: A Prospective, Japanese, Multicenter, Observational Cohort Study (DAIMONJI-Study).
To determine the precise frequency of main pancreatic duct (MPD) dilatation within the remnant pancreas at 1 year after pancreatoduodenectomy (PD) and its clinical implications, a prospective multicenter cohort study was performed in patients without MPD dilatation before PD (registry number: UMIN000029662). ⋯ MPD dilatation at 1 year after PD was seen in 21.7% of patients and significantly associated with exocrine function impairment but not with endocrine function, nutrition status, or development of fatty liver.
-
Pelvic fractures are severe traumatic injuries often accompanied by potentially fatal massive bleeding. Rapid control of hemorrhages in prehospital emergency settings is critical for improving outcomes in traumatic bleeding. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a promising technique for controlling active bleeding from pelvic fractures. ⋯ This paper provides a comprehensive overview of the initial management of noncompressive trunk hemorrhage caused by pelvic fractures, introduces the technical principles and developments of REBOA, and explores its extensive application in prehospital emergency care. It delves into the operational details and outlines strategies for effectively managing potential complications. We aim to offer a theoretical framework for the future utilization of REBOA in managing uncontrollable hemorrhage associated with pelvic fractures in prehospital emergencies.
-
To evaluate outcomes after primary surgery (PS) or neoadjuvant treatment followed by surgery (NAT/S) in cT2 staged adenocarcinomas of the esophagus (EAC) and gastroesophageal junction (GEJ), a multinational high-volume center study was undertaken. ⋯ Due to the unreliable identification of cT2N0 disease, all patients should be offered a multimodal therapeutic approach.