. (2015). Phenomenologically distinct psychotomimetic effects of ketamine are associated with cerebral blood flow changes in functionally relevant cerebral foci: A continuous arterial spin labelling study. Psychopharmacology, 232(24), 4515-4524. https://doi.org/10.1007/s00213-015-4078-8 Citing this paperPlease note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections. General rightsCopyright and moral rights for the publications made accessible in the Research Portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognize and abide by the legal requirements associated with these rights.•Users may download and print one copy of any publication from the Research Portal for the purpose of private study or research.•You may not further distribute the material or use it for any profit-making activity or commercial gain •You may freely distribute the URL identifying the publication in the Research Portal Take down policyIf you believe that this document breaches copyright please contact librarypure@kcl.ac.uk providing details, and we will remove access to the work immediately and investigate your claim. The N-methyl-D-aspartate (NMDA) receptor antagonist ketamine provides a pragmatic approach to address the link between glutamate-mediated changes in brain function and psychosis-like experiences. Most studies using PET or BOLD fMRI have assessed these symptoms broadly, which may limit inference about specific mechanisms. Objectives: The objective of this study is to identify the cerebral blood flow (CBF) correlates of ketamine-induced psychopathology, focusing on individual psychotomimetic symptom dimensions, which may have separable neurobiological substrates. Methods: We measured validated psychotomimetic symptom factors following intravenous ketamine administration in 23 healthy male volunteers (10 given a lower dose and 13 a higher dose) and correlated ketamine-induced changes in symptoms with regional changes in CBF, measured non-invasively using arterial spin labelling (ASL). Results:The main effect of ketamine paralleled previous studies, with increases in CBF in anterior and subgenual cingulate cortex and decreases in superior and medial temporal cortex. Subjective effects were greater in the high-dose group. For this group, ketamine-induced anhedonia inversely related to orbitofrontal cortex CBF changes and cognitive disorganisation was positively correlated with CBF changes in posterior thalamus and the left inferior and middle temporal gyrus. Perceptual distortion was correlated with different regional CBF changes ...
Purpose of Review This review article presents the current knowledge on the use of telemedicine and summarizes the literature highlighting the advantages and limitations of this technology in the field of orthopedic surgery during the COVID-19 pandemic and beyond. Recent Findings Orthopedic surgery is the surgical specialty that has seen the highest proportion of its procedures cancelled due to the pandemic. In this context and onward, telemedicine seems to be a reasonable option for the orthopedic surgeon. Multiple studies have described its safety and a similar patient satisfaction compared to in-person consultations. It has a potential to increase productivity and decrease wait times by providing easier access to the clinician and by decreasing travel-associated limitations and costs. Authors have described the possibility to conduct a reliable virtual assessment of the patient range of motion. Some of the limitations to the use of this technology are technological literacy and access to virtual consultation platforms, the inability to conduct a complete physical examination, potential reduction in identification of intimate and child abuse victims, and limited knowledge about the legal implications of this technology. Summary Telemedicine in orthopedic surgery has a potential to increase productivity, reduce costs, and increase the access to healthcare. Identified limitations include risk of misdiagnosis, required technologic literacy, unknown legal implications, and failure to identify victims of abuse. In order to use this technology judiciously, the clinician must take into consideration the patient's condition and his technological literacy and be aware of the advantages and disadvantages.
Osteomyelitis of the pubis symphysis is a rare condition. There have been various reports in the literature of inflammation and osteomyelitis as well as septic arthritis of pubic symphysis. However, due to the fact that these conditions are rare and that the usual presenting symptoms are very nonspecific, osteomyelitis of the pubic symphysis is often misdiagnosed, thus delaying definitive treatment. We present a case that to our knowledge is the first case in literature of osteomyelitis of the pubic symphysis in a 17-year-old boy with juvenile idiopathic arthritis (JIA), which was initially misdiagnosed and progressed to bilateral adductor abscesses. A high suspicion of such condition should be considered in a JIA patient who presents with symphysis or thigh pain.
III, Retrospective review of a prospective cohort of elbow fracture patients: Diagnostic Study.
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