Is correction for age necessary in SPECT or PET of the central serotonin transporter in young, healthy adults?

PET and SPECT have suggested that there is an age-related decline of up to 10% per decade in the availability of brain serotonin transporter (SERT) in healthy subjects, starting as early as the age of 20 y. The aim of the present study was to verify these findings in young subjects. METHODS: The equilibrium specific-to-nonspecific partition coefficient V'(3) of the SERT ligand (11)C-(+)McN5652 was obtained for 29 healthy subjects aged 18-33 y. V'(3) was tested for age dependence by linear regression analysis using both a volumes-of-interest approach and voxel-based statistical parametric mapping. The sex of the subject and the season of year were considered nuisance variables. RESULTS: Age had no significant effect on V'(3). The power for the detection of an age-related decline in V'(3) of the magnitude reported previously was 0.917. CONCLUSION: These findings indicate that age is not a relevant confounding factor for SERT availability as measured by (11)C-(+)McN5652 PET in healthy adults up to the age of about 35 y.     

Laparoscopic treatment of hemorrhage after vaginal hysterectomy or laparoscopically assisted vaginal hysterectomy (LAVH)

Background: This study examines the use of laparoscopy for the treatment of secondary hemorrhage following vaginal or laparoscopically assisted vaginal hysterectomies (LAVH). Methods: Over a 5-year period, the incidence and management of postoperative bleeding following vaginal hysterectomies or LAVH were registered prospectively. Results: The overall incidence of hemorrhage after vaginal hysterectomies or LAVH was 1.2% (17 of 1319). Over the 5-year period, it decreased from 2.4% (five of 209) to 0.6% (two of 315). Surgical revision was initiated transvaginally in nine patients and by laparoscopy in eight patients. Five of the eight patients profited from the prompt use of laparoscopy; inconclusive vaginal exploration was followed by laparoscopy in another five patients. Conclusion: Hemorrhage following vaginal hysterectomy or LAVH can be treated by laparoscopy in the majority of patients. Laparoscopy is recommended if the source of bleeding cannot be identified clearly by vaginal examination and/or if an intraabdominal bleeding source is suspected.     

Arbeitsbelastung in der Notaufnahme

Die Anaesthesiologie - Die zentrale Notaufnahme (ZNA) zählt bei hoher Arbeitsdichte neben dem OP, der Intensivstation und den Funktionsbereichen, zu den risikobehafteten Bereichen eines...     

Endplate abnormalities,Modic changes and their relationship to alignment parameters and surgical outcomes in the cervical spine

Modic changes (MC) and endplate abnormalities (EA) have been shown to impact preoperative symptoms and outcomes following spinal surgery. However, little is known about how these phenotypes impact cervical alignment. This study aimed to evaluate the impact that these phenotypes have on preoperative, postoperative, and changes in cervical alignment in patients undergoing anterior cervical discectomy and fusion (ACDF). We performed a retrospective study of prospectively collected data of ACDF patients at a single institution. Preoperative magnetic resonance imagings (MRIs) were used to assess for the MC and EA. Patients were subdivided into four groups: MC-only, EA-only, the combined Modic-Endplate-Complex (MEC), and patients without either phenotype. Pre and postoperative MRIs were used to assess alignment parameters. Associations with imaging phenotypes and alignment parameters were assessed, and statistical significance was set at p < 0.5. A total of 512 patients were included, with 84 MC-only patients, 166 EA-only patients, and 71 patients with MEC. Preoperative MC (p = 0.031) and the MEC (p = 0.039) had significantly lower preoperative T1 slope compared to controls. Lower preoperative T1 slope was a risk factor for MC (p = 0.020) and MEC (p = 0.029) and presence of MC (Type II) and the MEC (Type III) was predictive of lower preoperative T1 slope. There were no differences in postoperative alignment measures or patient reported outcome measures. MC and endplate pathologies such as the MEC appear to be associated with worse cervical alignment at baseline relative to patients without these phenotypes. Poor alignment may be an adaptive response to these degenerative findings or may be a risk factor for their development.     

Das Problem der Reizleitung im Nerven vom Standpunkte der Wellenlehre aus betrachtet

Ohne Zusammenfassung