BACKGROUND Clinical guidelines are a constructive response to the reality that practicing physicians require assistance in assimilating and applying the exponentially expanding, often contradictory, body of medical knowledge. They attempt to define practices that meet the needs of most patients under most circumstances. Ideally, specific clinical recommendations contained within practice guidel...

Spontaneous intracranial hypotension (SIH) is an increasingly recognised syndrome. Postural headache with typical findings on magnetic resonance imaging (MRI) are the key to diagnosis. Orthostatic headache, low cerebrospinal fluid opening pressure, and diffuse meningeal enhancement on post-contrast T1-weighted MRI brain studies are the major features of this increasingly recognised syndrome. He...

1. Inaba H, Kochi A, Yorozu S. Suppression by methylprednisolone of augmented plasma endotoxin-like activity and interleukin-6 during cardiopulmonary bypass. British Journal of Anaesthesia 1994; 72: 348-350. 2. Andersen L, Baek L, Thomsen B, Rasmussen J. Effect of methylprednisolone on endotoxemia and complement activation during cardiac surgery. Journal of Cardiothoracic Anesthesia 1989; 3: 54...

BACKGROUND: Idiopathic scoliosis is accompanied by postural alterations, instability of gait, and functional disabilities. The objective was to verify radiographic parameters (coronal sagittal) adolescents with idiopathic (AIS) pre- post-surgery direct vertebral rotation (DVR), associated type 1 osteotomies in all segments (except the most proximal) 2 periapical vertebrae curves. METHODS: A pro...

Neuromodulation practitioners increasingly recognize the potential for peripheral nerve field stimulation (PNfS) to treat pain originating from the trunk. Conditions resulting in truncal pain that may respond to PNfS include cervical and lumbar postlaminectomy syndrome, inguinal neurapraxia, post-herpetic neuralgia, and post-thoracotomy pain. The focus of this chapter is to review the mechanism...

Risk factors Increased intra-abdominal pressure eg, constipation, diarrhoea, benign prostatic hypertrophy, pregnancy, severe or chronic cough (eg, chronic obstructive pulmonary disease, cystic fibrosis, whooping cough). [4] Previous surgery. [5] Pelvic floor dysfunction. [6] Parasitic infections eg, amoebiasis, schistosomiasis. [7] Neurological disease eg, previous lower back or pelvic trauma, ...

Risk factors Increased intra-abdominal pressure eg, constipation, diarrhoea, benign prostatic hypertrophy, pregnancy, severe or chronic cough (eg, chronic obstructive pulmonary disease, cystic fibrosis, whooping cough). [4] Previous surgery. [5] Pelvic floor dysfunction. [6] Parasitic infections eg, amoebiasis, schistosomiasis. [7] Neurological disease eg, previous lower back or pelvic trauma, ...

Gout or pseudogout, caused by deposition of crystals, rarely affects the spine. We report 4 cases with gout or pseudogout in the lumbar spine. Two had cauda equina syndrome and another 2 had spinal stenosis. To avoid unnecessary surgery, this should be considered in the differential diagnosis when treating patients with histories of gout or pseudogout for spinal problems.

A 45-year-old woman, with a history of asymmetric facial flushing, was presented to the Endocrinology Unit after pituitary macroadenoma removal. After other pathological entities had been ruled out, she was diagnosed with harlequin syndrome following a lesion of the postganglionic sympathetic fibers during transsphenoidal pituitary macroadenoma surgery. We herein report the first case of harleq...

Empty Nose Syndrome (ENS) is a rare and controversial sequelae from previous radical turbinate surgery. We report on a 50-year-old Chinese gentleman with long-standing nasal problems who has had radical turbinate surgery many years prior to presenting at the ENT clinic with mucoid nasal discharge and chronically blocked nose. His nasal cavities were ironically very patent and there were only mi...