ESIs were noted to cause a significant increase in the blood glucose levels in diabetics. There was no correlation between preinjection diabetic control, represented by hA(1c) levels, and postinjection response. Diabetics who are candidates for ESI should be counseled that a blood glucose increase may be apparent post intervention, but effects should not last longer than approximately 2 days.
Bacterial contamination of the operative microscope was found to be significant after spine surgery. Contamination was more common around the optic eyepieces, likely due to inadvertent touching of unsterile portions. Similarly, all regions above the eyepieces also have a propensity for contamination because of unknown contact with unsterile parts of the surgeon. Therefore, we believe that changing gloves after making adjustments to the optic eyepieces and avoid handling any portion of the drape above the eyepieces may decrease the risks of intraoperative contamination and possibly postoperative infection as well.
Cyclooxygenase (COX)-2, an inducible enzyme involved in prostaglandin biosynthesis, has attracted considerable attention recently, due to its role in human cancer biology. Several studies have correlated an increase in the expression of COX-2 with a poor clinical outcome, while epidemiological studies demonstrate a reduced risk of cancer mortality in persons with longterm, chronic ingestion of non-steroidal anti-inflammatory drugs (NSAIDs). Originally, these observations were made in patients with colorectal cancer, and subsequent studies suggest a protective role of NSAIDs in other human cancers as well. With the development of COX-2 specific inhibitors, numerous laboratory and clinical studies are underway to help understand the role of COX-2 in cancer and the potential use of COX-2 selective inhibitors for cancer treatment or prevention. This review focuses on the physiological function of COX, and the clinical rationale for evaluating COX-2 selective inhibitors for use in oncology.
Use of cutaneous traction for diaphyseal femur fractures when compared with skeletal traction results in a statistically significant reduction in time of application to the on call practitioner with no complications or detrimental change in operative time and no difference in VAS pain scores or narcotic usage.
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