The University of Texas Health Science Center at San Antonio (UT Health San Antonio) is a public academic health science center in San Antonio, Texas. It is part of the University of Texas System. UT Health San Antonio is the largest health sciences university in South Texas. It is located in the South Texas Medical Center and serves San Antonio and all of the 50,000 square miles (130,000 km2) area of Central and South Texas. It extends to campuses in the Texas border communities of Laredo and the Lower Rio Grande Valley. UT Health San Antonio has produced more than 28,000 graduates; more than 3,000 students a year train in an environment that involves more than 100 affiliated hospitals, clinics and health care facilities in South Texas. The university offers more than 65 degrees, the large majority of them being graduate and professional degrees, in the biomedical and health sciences fields. UT Health San Antonio is home to the Mays Cancer Center, which is in partnership with the MD Anderson Cancer Center and is a designated a National Cancer Institute Cancer Center. The Mays Cancer Center's Institute for Drug Development (IDD) is internationally recognized for conducting one of the largest oncology Phase I clinical drug trials programs in the world. Fifteen of the cancer drugs most recently approved by the U.S. Food & Drug Administration underwent development or testing at the IDD. Other noted programs include: cellular and structural biology, urology, nephrology, transplantation biology, aging and longevity studies, cardiology and research imaging. UT Health San Antonio publishes a periodic magazine, Mission.
Purpose Tinnitus and hearing loss are the most prevalent service-related auditory disabilities among American veterans. Previous studies have examined gray matter or white matter alterations in tinnitus and hearing loss relative to healthy controls, but typically in isolation, and none of them have focused specifically on a military-affiliated population. Methods We employed voxel-based morphometry to assess gray matter differences and diffusion tensor imaging to evaluate white matter integrity in tinnitus and/or hearing loss compared to controls in a sample of 68 military-affiliated adults (56 men, 10 women, two identifying as 'other' gender). Additionally, we conducted an exploratory, hypothesis-generating effect size analysis to describe the magnitude of group differences. Results Combined tinnitus and hearing loss was associated with decreased gray matter volume in the thalamus. White matter integrity was reduced in the forceps minor, right superior longitudinal fasciculus, and left inferior longitudinal fasciculus. Hearing loss alone was associated with white matter orientation changes in the right anterior thalamic radiation, left supe-rior longitudinal fasciculus, and right corticospinal tract. Larger effect sizes were noted in white matter comparisons across tinnitus, hearing loss, and combined conditions, suggesting that white matter differences may be of greater magnitude than gray matter alterations. Conclusion These findings advance the understanding of the neural correlates of tinnitus and hearing loss in the military population, an understudied group with a high prevalence of tinnitus and hearing loss. They also present preliminary effect size estimates that may inform future studies on the neural correlates of tinnitus and hearing loss, indicating a larger overall magnitude in white matter and more subtle contributions from gray matter.
: Chronic tendinopathy affects approximately 30
Prospective, multi-institutional surgical data collection in pediatric neuro-oncology remains limited despite substantial variation in operative and perioperative management across institutions. To address this, we are developing the NeuroPoint Alliance (NPA) Quality Outcomes Database (QOD) Pediatric Tumor Surgery Registry. Here, we used a modified Delphi process to define a core outcome set for the registry. A modified Delphi study was conducted among pediatric neurosurgeons serving as site principal investigators for the proposed registry. Candidate data elements were rated on a 9-point Likert scale. Consensus for inclusion was predefined as ≥70
Portable suction devices are crucial for emergency airway management. Commercially-available units are unsuitable for field use due to size and power needs. A light-weight and multi-orientation operable portable suction device, Battlefield Ready Innovative Suction Kit (BRISK) was developed. The design was informed by feedback from combat medics, paramedics, and EMTs. End-user engagement and feedback defined BRISK’s design. The fabricated prototype used a vacuum pump and hydrophobic syringe filters. Performance tests measured vacuum pressure, air and liquid (water and ISO vomit simulant) flow rates, volume of water suctioned in different orientations (upright, tilted, or inverted), and contamination prevention between BRISK, SSCOR Quickdraw, and Laerdal LCSU4. The BRISK device—weighing 0.97 kg—demonstrated a maximum vacuum pressure of 570 ± 6 mmHg and an air flowrate of 5.20 L/min. Liquid flow rates (L/min) for BRISK, LCSU4, and SSCOR with water were 4.92 ± 0.2, 6.97 ± 0.1, and 5.37 ± 0.1, respectively. With ISO vomit simulant, the rates were 3.23 ± 0.2, 3.06 ± 0.4, and 2.23 ± 0.1. BRISK showed consistent performance across orientations (p = 0.081), while LCSU4 and SSCOR varied significantly (p < 0.0001). The BRISK’s cross-contamination between filters and the pump was 0.01
Background There is potential for adverse events from corticosteroid injections, including increase in blood glucose, decrease in bone mineral density and suppression of the hypothalamic-pituitary axis. Published studies note that doses lower than those commonly injected provide similar benefit.Methods Development of the practice guideline was approved by the Board of Directors of American Society of Regional Anesthesia and Pain Medicine with several other societies agreeing to participate. The scope of guidelines was agreed on to include safety of the injection technique (landmark-guided, ultrasound or radiology-aided injections); effect of the addition of the corticosteroid on the efficacy of the injectate (local anesthetic or saline); and adverse events related to the injection. Based on preliminary discussions, it was decided to structure the topics into three separate guidelines as follows: (1) sympathetic, peripheral nerve blocks and trigger point injections; (2) joints; and (3) neuraxial, facet, sacroiliac joints and related topics (vaccine and anticoagulants). Experts were assigned topics to perform a comprehensive review of the literature and to draft statements and recommendations, which were refined and voted for consensus (>= 75% agreement) using a modified Delphi process. The United States Preventive Services Task Force grading of evidence and strength of recommendation was followed.Results This guideline deals with the use and safety of corticosteroid injections for sympathetic, peripheral nerve blocks and trigger point injections for adult chronic pain conditions. All the statements and recommendations were approved by all participants after four rounds of discussion. The Practice Guidelines Committees and Board of Directors of the participating societies also approved all the statements and recommendations. The safety of some procedures, including stellate blocks, lower extremity peripheral nerve blocks and some sites of trigger point injections, is improved by imaging guidance. The addition of non-particulate corticosteroid to the local anesthetic is beneficial in cluster headaches but not in other types of headaches. Corticosteroid may provide additional benefit in transverse abdominal plane blocks and ilioinguinal/iliohypogastric nerve blocks in postherniorrhaphy pain but there is no evidence for pudendal nerve blocks. There is minimal benefit for the use of corticosteroids in trigger point injections.Conclusions In this practice guideline, we provided recommendations on the use of corticosteroids in sympathetic blocks, peripheral nerve blocks, and trigger point injections to assist clinicians in making informed decisions.
