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Background: A treatment algorithm and screening examination have been developed to guide patient management and prospectively determine potential for highly active individuals to succeed with nonoperative care after anterior cruciate ligament rupture.

Objective: To prospectively characterize and classify the entire population of highly active individuals over a 10-year period and provide final outcomes for individuals who elected nonoperative care.

Methods: Inclusion criteria included presentation within 7 months of the index injury and an International Knee Documentation Committee level I or II activity level before injury. Concomitant injury, unresolved impairments, and a screening examination were used as criteria to guide management and classify individuals as noncopers (poor potential) or potential copers (good potential) for nonoperative care.

Results: A total of 832 highly active patients with subacute anterior cruciate ligament tears were seen over the 10-year period; 315 had concomitant injuries, 87 had unresolved impairments, and 85 did not participate in the classification algorithm. The remaining 345 patients (216 men, 129 women) participated in the screening examination a mean of 6 weeks after the index injury. There were 199 subjects classified as noncopers and 146 as potential copers. Sixty-three of 88 potential copers successfully returned to preinjury activities without surgery, with 25 of these patients not undergoing anterior cruciate ligament reconstruction at the time of follow-up.

Conclusion: The classification algorithm is an effective tool for prospectively identifying individuals early after anterior cruciate ligament injury who want to pursue nonoperative care or must delay surgical intervention and have good potential to do so.



NAVIGATION


         

 

A team of neurosurgeons at Heidelberg University Hospital and psychiatrists at the Central Institute of Mental Health, Mannheim have for the first time successfully treated a patient suffering from severe depression by stimulating the habenula, a tiny nerve structure in the brain…

 

A key brain protein called monoamine oxidase A (MAO-A) - is highly elevated during clinical depression yet is unaffected by treatment with commonly used antidepressants, according to an important study published in the Archives of General Psychiatry. The study has important implications for our understanding of why antidepressants don’t always work…

 

Thanks to a new method there is a reason for hope for patients with very severe depression. Physicians at the University Clinics of Bonn and Cologne have treated ten patients with deep brain stimulation. This involved implanting electrodes in the patients’ nucleus accumbens. This centre has a key role as the brains reward system, whose function may be impaired in depressive people. Subsequent to this treatment, the patients’ depression improved significantly in half of the patients.

 

An innovative diagnostic technique invented by a Monash University researcher could dramatically fast-track the detection of mental and neurological illnesses. Monash biomedical engineer Brian Lithgow has developed electrovestibulography which is something akin to an ‘ECG for the mind’.

 

It’s more than just feeling bad. Clinical depression affects the way we process information in the brain, negatively affecting memory, attention span, and the brain’s ability to learn new things. Now Tel Aviv University research has provided scientific proof that depression changes our visual perception as well. A research team headed by Dr.

 

When anticipating pain, the brains of subjects with major depressive disorder appear to react more strongly, and appear to display altered functioning of the neural network that moderates pain sensitivity, according to an article released on November 3, 2008 in Archives of General Psychiatry, one of the JAMA/Archives journals. “Chronic pain and depression are common and often overlapping syndromes,” write the authors.

 

CNS Response, Inc. (OTCBB: CNSO) reported the results of a study by the Center for Health Economics, Epidemiology, and Science Policy at United BioSource Corporation, a global pharmacoeconomic research firm and one of the most experienced firms providing evidence-based review of innovative healthcare technologies.

 

The US Food and Drug Administration (FDA) gave the green light earlier this month for a new non-invasive treatment for depression that relies on a magnetic device to stimulate the brain by sending magnetic pulses through the skull.

 

Neuronetics, Inc., a privately-held medical device company and a leader in the field of neuromodulation, announced today that the U.S. Food and Drug Administration (FDA) has cleared its NeuroStar TMS (Transcranial Magnetic Stimulation) Therapy system for the treatment of depression.

 

Images of the brain’s fastest signals reveal an electromagnetic marker that predicts a patient’s response to a fast-acting antidepressant, researchers have discovered. “Such biomarkers that identify who will benefit from a new class of antidepressants could someday minimize trial-and-error prescribing and speed delivery of care for what can be a life-threatening illness,” said Carlos Zarate, M.D.




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