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Stretching Exercises Utilizing trigger point and massage techniques relieve some of the tension in the muscles of the hips 20mg erectafil fast delivery erectile dysfunction va form. We can take advantage of this reduced muscle tension to increase our hip range of motion in all directions with stretching the muscles generic erectafil 20mg on line erectile dysfunction natural cures. Thread the Needle Directions: Lying on your back discount 20 mg erectafil mastercard erectile dysfunction medication free samples, cross the ankle of one leg over the knee of the other cheap erectafil 20mg online impotence treatment vacuum devices. For a larger stretch, interlace your hands behind the leg on the ground and pull towards your chest. Tip: If you are having trouble with the first position, place the sole of the uncrossed leg against the wall, forming a right angle at the knee. Hip Openers Directions: Lying on your back, place the soles of your feet on the ground shoulder width apart. Breathe out as you return your knees to the starting position before dropping them down to the left side. Stretch 3: Lying Quad Stretch Directions: Lay on your side with both legs straight and your bottom hand resting on the ground. Bring the foot that is not touching the ground back towards your bottom and grab onto your heel. Tip: Make sure your hips are stacked- imagine that if a pole ran up between your hipbones it would be sticking straight up, perpendicular to the floor. Stretch 4: Lying Hamstring stretch (with band) Directions: Lay on your back with both legs straight in front of you. Loop an exercise band around the sole of one foot, then hold onto the other end of the band with your hands. Raise this foot as high as you can while keeping your leg straight and the band taught. Tip: To improve your range of motion, try and bring your foot towards the floor while maintaining the tension in the band for five seconds. Stretch 5: Abductor/crossover stretch Directions: Stand up with your feet shoulder width apart, then cross one foot in front of the other. Bring your hands above your head and sidebend to the opposite side to for a long C shape. Try not to compress your back on the other side while stretching the left side body and lateral hip. This program can help you gain mobility in your hips and prevent/reduce back pain. Please contact Body Works Sports Physiotherapy if you have any further questions or would like to schedule an appointment. We investigated the efficacy of acupuncture com- in the minimal acupuncture group, and 6. Patients completed standardized questionnaires at base- Conclusion: Acupuncture was more effective in im- line and at 8, 26, and 52 weeks after randomization. The proving pain than no acupuncture treatment in patients primary outcome variable was the change in low back pain with chronic low back pain, whereas there were no sig- intensity from baseline to the end of week 8, as deter- nificant differences between acupuncture and minimal mined on a visual analog scale (range, 0-100 mm). Minimal acupuncture served as a sham intervention; the additional complementary and alternative medicine 4 no acupuncture waiting list control was in- provider. Among the more commonly used cluded because minimal acupuncture may not complementary and alternative medicine be a physiologically inert placebo. In the acu- treatment strategies, acupuncture is used puncture and minimal acupuncture groups, pa- frequently in patients with low back pain. However, previous systematic reviews7-9 of the Acupuncture Randomized Trial in Low acupuncture for the treatment of low back Back Pain was part of a larger acupuncture pain yielded inconclusive results. The committee recommended that studies be con- in Low Back Pain, we investigated whether ducted on the efficacy of acupuncture in the acupuncture was more efficacious in re- treatment of pain for 3 diseases, including ducing pain than minimal acupuncture or chronic low back pain. The methods used in Author Affiliations are listed at no acupuncture in patients with chronic this trial and the results of the other 3 trials have the end of this article. Patients were randomized in a 2:1:1 (acupuncture? the number, duration, and frequency of the sessions in the minimal acupuncture?waiting list) ratio using a centralized tele- minimal acupuncture group were the same as for the acupunc- phone randomization procedure (a randomized list was gen- ture group. These points for clinical trials (Declaration of Helsinki, version Edinburgh were not in the area of the lower back where the patients were 2000, International Conference on Harmonisation Good Clini- experiencing pain. De qi and manual stimulation of the needles cal Practice, including certification by external audit). All acupuncturists received a videotape, oral in- tocol was approved by the local ethics review boards in all re- struction, and a brochure showing detailed information on mini- gions where the study was conducted. Patients in the waiting list group did not receive acupunc- ture treatment for 8 weeks after randomization. Patients were allowed to treat chronic low back pain with Most participants were recruited through articles in local news- oral nonsteroidal anti-inflammatory drugs, if required. The of corticosteroids or pain-relieving drugs that act through the inclusion criteria were as follows: clinical diagnosis of chronic central nervous system was prohibited. One type is similar to the sual analog scale on the previous 7 days, only use of oral non- acupuncture treatment used in China. The other type does not steroidal anti-inflammatory drugs for pain treatment in the 4 follow these principles, but has also been associated with posi- weeks before treatment, and written consent. The primary outcome variable was the change in low back puncture were developed in a consensus process with pain intensity from baseline to the end of week 8 after random- acupuncture experts from 2 major German societies for medi- ization, as measured by a visual analog scale (range, 0-100 mm). The trial physicians documented medical history and ex- the acupuncture and minimal acupuncture treatments amination results at baseline, study intervention in detail, and consisted of 12 sessions of 30 minutes duration, each admin- any serious adverse events. In addition, adverse effects were istered over 8 weeks (usually 2 sessions in each of the first 4 documented by patients at the end of week 8.

Emeritus Professor of Surgery /Anesthesiology and Molecular Pharmacology/Physiology generic 20mg erectafil mastercard erectile dysfunction nofap, University of South Florida generic erectafil 20 mg online erectile dysfunction world statistics, Tampa buy cheap erectafil 20 mg on-line erectile dysfunction doctors in kansas city, Florida References 1 buy 20 mg erectafil amex impotence signs. Pseudoephedrine for the prevention of barotitis media: a controlled clinical trial in underwater divers. Proceedings of the ninth international symposium on underwater and hyperbaric physiology. De novo cataract development following a standard course of hyperbaric oxygen therapy. Comparison of visual function effects in man during continuous oxygen exposures at 3. Normobaric measurement of O2 tension of blood in subjects exposed to hyperbaric oxygen. Arterial oxygen tension of patients with abnormal lungs treated with hyperbaric oxygen is greater than predicted. Complication and protocol considerations in carbon monoxide-poisoned patients who require hyperbaric oxygen therapy: report from a ten-year experience. Proceedings of the ninth international symposium on underwater and hyper-baric physiology. Incidence of oxygen intoxication to the central nervous system in hyperbaric oxygen therapy. Proceedings of the International Joint Meeting on Hyperbaric and Underwater Medicine. Central nervous system oxygen toxicity during hyperbaric treatment of patients with carbon monoxide poisoning. Delivery of hyperbaric oxygen therapy to critically ill, mechanically ventilated children. Oxygen pretreatment as protection against decompression sickness in rats: pressure and time necessary for hypothesized denucleation and renucleation. Effect of in-water oxygen prebreathing at different depths on decompression-induced bubble formation and platelet activation. Effect of pre-breathing oxygen at different depth on oxidative status and calcium concentration in lymphocytes of scuba divers. Pre-treatment with hyperbaric oxygenation reduces bubble formation and platelet activation. Hyperbaric oxygen may reduce gas bubbles in decompressed prawns by eliminating gas nuclei. On the evolution, generation, and regeneration of gas cavitation nuclei Journal of the Acoustical Society of America 71: 1473-1481 1982. Hyperbaric oxygen pretreatment reduces the incidence of decompression sickness in rats. Balestra C, Germonpre P, Snoeck T, Ezquer M, Leduc O, Leduc A, Willeput F, Marroni A, Cali Corleo R, Vann R. Normobaric oxygen can enhance protein captation by the lymphatic system in healthy humans. Preconditioned hyperbaric oxygenation protects the liver against ischemia-reperfusion injury in rats. Indicators of oxidative injury and alterations of the cell membrane in the skeletal muscle of rats submitted to ischemia and reperfusion. Myocardial protection at a crossroads: the need for translation into clinical therapy. Differential cerebral gene expression during cardiopulmonary bypass in the rat: evidence for apoptosis Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium. Kitagawa K, Matsumoto M, Tagaya M, Hata R, Ueda H, Niinobe M, Handa N, Fukunaga R, Kimura K, Mikoshiba K, et al. Effect of remote ischaemic preconditioning on myocardial injury in patients undergoing coronary artery bypass graft surgery: a randomised controlled trial. Arrhythmias in off-pump coronary artery bypass grafting and the antiarrhythmic effect of regional ischemic preconditioning. Preconditioning with hyperbaric oxygen induces tolerance against oxidative injury via increased expression of heme oxygenase-1 in primary cultured spinal cord neurons. Usefulness of hyperbaric oxygen therapy to inhibit restenosis after percutaneous coronary intervention for acute myocardial infarction or unstable angina pectoris. Pretreatment with hyperbaric oxygen and its effect on neuropsychometric dysfunction and systemic inflammatory response after cardiopulmonary bypass: a prospective randomized double-blind trial. Hyperbaric oxygen preconditioning improves myocardial function, reduces length of intensive care stay, and limits complications post coronary artery bypass graft surgery. Heme-oxygenase-1 could mediate the protective effects of hyperbaric oxygen preconditioning against hepatic ischemia-reperfusion injury in rats. Clinical and experimental pharmacology and Physiology 38: 675-682, 2011 Copyright ? 2014 Undersea and Hyperbaric Medical Society, Inc. Review of interim funded service: Hyperbaric oxygen therapy for the treatment of chronic non-diabetic wounds and non-neurological soft tissue radiation injuries. The quality of reports of randomised trials in 2000 and 2006: comparative study of articles indexed in PubMed. Improving the reporting of pragmatic trials: an Copyright ? 2014 Undersea and Hyperbaric Medical Society, Inc. The ethics of randomised controlled trials from the perspectives of patients, the public, and healthcare professionals. Teaching methods relevant to the clinical application of the results of critical appraisals to individual patients. Hyperbaric oxygen treatment of chronic refractory radiation proctitis: a randomised and controlled double-blind crossover trial with long-term follow-up. A blinded trial to investigate whether pressure familiar individuals can determine chamber pressure.

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Individuals cannot say they are using marijuana recreationally to deal with a medical problem and expect that to comply with the law as specific medical conditions (e purchase erectafil 20mg erectile dysfunction pump hcpc. Nevertheless 20 mg erectafil impotence 24-year-old, the use of any substances should be discussed openly and honestly between the person and his or her health care professional order erectafil 20mg without prescription erectile dysfunction risk factors. If the individual is on opioids and/or pain treatment program purchase 20mg erectafil with mastercard erectile dysfunction protocol real reviews, the concurrent use of marijuana should be clearly spelled out in the opioid/pain treatment contract. Although some states allow the legal use of marijuana for medicinal purposes, which may or may not include pain, there is no high-level scientific research supporting the long-term use of marijuana for chronic pain. In fact, there is good evidence that excessive smoking of marijuana can be harmful (especially in young people). American Chronic Pain Association Copyright 2019 149 However, in January 2017, the National Academies of Sciences, Engineering and Medicine published a paper that concluded after studying 10,000 scientific abstracts published since 1999 that found evidence to support that patients who were treated with cannabis or cannabinoids were more likely to experience a significant reduction in pain symptoms 8. That means there is now a disagreement within the federal government whether marijuana can help manage pain (or even be considered medicinal). More frequent marijuana smoking is associated with an increased risk of severe respiratory illnesses, especially chronic bronchitis. Other potential delivery methods include oils, tinctures, vaporizers, and edibles. Use also leads to reduced workplace productivity, as well as impaired judgment, even hours after use. Marijuana intoxication impairs cognitive and psychomotor performance with complex, demanding tasks. Individuals who have used marijuana over long periods of time demonstrate impaired performance on a variety of neuropsychological tests (e. A recent review of the existing medical literature concluded that the use of marijuana at a young age increased the risk of schizophrenia or a schizophrenia-like psychotic illness by approximately three-fold. Emerging evidence suggests a link between more frequent, or severe, marijuana use and anxiety symptoms and disorders. Patients using opioids need to be aware of all prescribed and non-prescribed medications that affect the central nervous system, including marijuana and alcohol, because there may be a synergistic effect that may cause respiratory depression and death. People who are self-medicating with marijuana may not recognize the presence of marijuana withdrawal symptoms. Marijuana causes physical dependence, and withdrawal symptoms can start as early as hours after smoking marijuana and last for up to a month and include sleep disturbances, substantial anxiety (which can worsen pain), discomfort, lack of appetite, and commonly trigger marijuana craving. Despite some states allowing medicinal marijuana, it is a federal crime for a health care professional to prescribe a scheduled drug to a person known to be using the drug illegally. It is also important to remember that possessing marijuana when traveling through a state where medicinal marijuana is not allowed could result in being charged with possession of an illegal substance, even if the person is using the drug under the supervision of a physician and has the proper home state documentation. Additionally, an individual can be denied employment or fired if the employer or prospective employer conducts drug screenings as a part of the hiring process or has a no-drug tolerance policy. American Chronic Pain Association Copyright 2019 150 Illegal Drugs Regarding chronic pain treatment (excluding cancer and end-of-life care), health care professionals will not prescribe opioids and other medications to individuals who are known to use illegal street drugs (heroin, methamphetamines, cocaine, and others) or to be irresponsible with prescription pain medication. Unfortunately, many people suffering from a substance use disorder such as opioid addiction present to pain clinics in search of medication and may need a different form of assistance. If you or a loved one need assistance with an opioid addiction, call 1-877-927- 9043 to speak with someone from the American Addiction Centers available 24/7 to discuss treatment options. The American Chronic Pain Association website can be a great source of information theacpa. This and other pain management programs include ways to track daily pain and activity and can be a useful vehicle to easily summarize progress over time. They can be especially helpful when starting an exercise routine by tracking progress based on frequency and duration of the exercises. These programs can also suggest warm-up and cool-down stretching routines catered for each individuals pain problem. They also can be useful for monitoring medication use and giving helpful reminders throughout the day. Smart phone applications (apps) are in development specifically for persons with chronic pain. These programs are useful in identifying important information about the pain, summarizing progress for the health care professional, and offering daily tips and recommendations for improving pain management. When you understand what makes your pain worse, you can begin to work on ways to reduce or deal with your pain triggers. Being in better control can help you be less afraid and better able to manage your pain. We encourage you to fill out a chart at the end of each day or several times a week. It can help you talk more openly with your health care provider so that together you can find ways to improve your quality of life. This tool can help you create a detailed picture of your pain-where it is, how it feels, how much it hurts, and what triggers it. It is important for the person with pain, family members, and others to avoid quick judgments based on what they hear or read about any particular treatment or medication. The best place to get advice about treatments and medications is from the health care professional assisting the person with pain. Families need to be good reporters?observant, truthful, and honest about what they see in the person who is provided a certain treatment or who is taking medication. Sometimes the person provided the treatment or taking the medication does not realize the changes that are produced. There is no question that there are many treatment approaches (tools) in the tool chest of the treating health care professional or therapist, but they should be used judiciously. Benefit should be based on less pain, more function, and return to everyday activities with the least, manageable side effects possible.

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Heterotopic ossifcation was Methods: Prospective discount erectafil 20 mg with amex doctor yourself erectile dysfunction, multi-center data from two graded according to the method of McAfee buy 20mg erectafil overnight delivery erectile dysfunction without pills, et al discount 20 mg erectafil with mastercard erectile dysfunction drugs egypt. The purpose of this study males discount erectafil 20 mg overnight delivery erectile dysfunction treatment australia, 17 females) with an average age of 50 (range was to investigate the alteration of the range of motion 26-68). Health status scores improved disc replacement using the Bryan disc, Mobi-C and from 0. But investigation after collecting all patients showed statistically signifcant difference of motion by severity of heterotopic ossifcation. With methods of the salvage surgery, pain response using regards to long term follow-up data, there are few studies visual analog scale, and inframmation parameters were to compare one and two levels total disc replacement. Surgical methods conducted by previous at surgical level and adjacent level were measured. The cephalad antibiotic therapies were administered for all patients, adjacent levels were evaluated for degeneration. Multi-center in 3, and Pseudomonas cepacia, Bacillus cereus in clinical results may need to verify these results. Averaged duration of the antibiotic therapy was 157 days after the salvage surgery. In postoperative imaging studies, epidural abscess and abscess in the iliopsoas muscle disappeared. The purpose of this study is a consecutive number of patients from 1/2006 - to determine if the placement of a drain and the duration 06/2011. In 284 patients dorsal open stabilizations of time the drain is in place increase the likelihood of with decompression and in 199 patients percutaneus surgical site infections occurring in spinal patients. Two groups one with reviewed; eligible patients were identifed within a deep and one with superfcial infection with bacterial database that was compiled as part of a previous study. All deep infections have Demographic, operative and perioperative measures been treated with wide debridement, jetlavage, were statistically evaluated to compare patients that drainage, parenteral antibiotics over 7 to 10 days with did and did not receive drains. Patients with drains were classifed by the duration of the drain (fewer or antibiogramm. The superfcial infections have been greater than 3 days) as well as by the length of their treated after revision 3 days with parenteral then with postoperative antibiotic treatment (24 hours or the oral antibiotics by antibiogramm. Risk factors for infection were also Results: 01/2006 - 06/2011 156 open mono- and 128 bi- evaluated. With 24 hours of antibiotics, patients whose drains were 2,06% deep, 1,03% superfcial, 2008 1,12% deep and in place for fewer than 3 days (n=156) had a signifcantly 1,12% superfcial infections. This was not true of patients who received and long-term antibiotics was necessary. Bacterial deep infections in two cases showed (n=127) while those with a drain for more than 3 days Staph. Superfcial infections showed in 3 cases signifcant differences in infection rates between patients Staph. Wiltse approach and the postoperative scar of the Risk factors amongst patients that received drains with muscle is much lower. For patients receiving antibiotics for complication in case of screw displacement, neurological the duration of the drain, risk factors for infection were complications, pseudoarthrosis, and failure of the smoking (p=0. The shorter time of operation, identifed risk factor in patients without drains was the the less invasive trauma for the muscle and the less surgical approach (p=0. Our and also the rate of screw loosening is reduced results suggest that, regardless of antibiotic treatment, signifcant. Our results suggest that more aggressive prophylactic measures may be appropriate for spinal patients who have postoperative drains for more than 3 days. Plate and screw system fxation may be necessary for patients 392 having disease with more than two levels. Chen4 1Taichung Veterans General Hospital, Department of Neurosurgery, Taichung, Taiwan, Republic of China, 2National Defense Medical Center, School of Public Health, Taipei, 111 Taiwan, Republic of China, 3Taichung Veterans General Anterior Cervical Discectomy and Fusion versus Hospital, Department of Radiology, Taichung, Taiwan, Republic of China, 4China Medical University Hospital, Department of Cervical Disc Arthroplasty: Cost Analysis of Peri- Orthopaedic Surgery, Taichung, Taiwan, Republic of China operative and Operating Room Related Costs D. Anterior interbody fusion is the treatment of choice to restore the physiological Purpose: Patients with cervical disc herniation and disc height and provide segmental stability and solid radiculopathy from single-level disease have traditionally arthrodesis after adequate decompression. However, subsidence may occur in the rates and reduced adjacent segment degeneration is interbody fusion process with a stand-alone cage. We aim to structure Purpose: To determine the possible risk factors causing to future research in relative cost effectiveness of interbody cage subsidence and how to prevent it. Study design: A retrospective analysis of image fndings Methods: the medical and fnancial records of 28 and clinical results. All patients were treated for single-level cervical trauma or cervical spondylosis who received cervical disc disease. The traditional surgical approach for this disorder has been to remove the posterior arch of L5 and decompress the L5 nerve roots if the patient presents with radicular complaints. Tan 1National University Health System, Orthopaedic Surgery, Methods: Twenty-six consecutive patients with Singapore, Singapore symptomatic L5-S1 level isthmic spondylolisthesis (grade 1 or grade 2) successfully underwent this combined Purpose: To determine whether additional implantation procedure. Patients opting for Cofex? the mean blood loss was 64 cc, and the mean hospital implantation formed the Cofex? group (22 patients) stay was one day (range 1 to 2 days). A reduction in one while those opting for decompression alone formed or more grade of the spondylolisthesis was achieved in the Control group (24 patients). No complications resulted from the disability and pain scores were measured using the procedures. The procedure was Results: Cofex? patients experienced statistically associated with minimal morbidity while avoiding the greater improvements (p < 0.

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There was a1 significantly better response to active treatment at References one month but this difference was no longer apparent at three and six months order 20mg erectafil with mastercard erectile dysfunction occurs at what age. A double-blind study treated at Aarau erectafil 20 mg line erectile dysfunction hypnosis, Switzerland generic erectafil 20 mg fast delivery erectile dysfunction doctors in connecticut, 22 with refractory of superficial radiotherapy in chronic palmar eczema and six with psoriasis of palms and/or soles eczema cheap erectafil 20 mg impotence workup. Long-term results of radiotherapy in patients with chronic palmo-plantar eczema or psoriasis. Does Prevention of gynaecomastia and breast pain prophylactic breast irradiation prevent caused by androgen deprivation therapy in antiandrogen-induced gynaecomastia Evaluation of 253 patients in the randomized Int J Radiat Oncol Biol Phys 2012; 83(4): e519? Scandinavian trial spcg-7/sfuo-3. Tamoxifen as prophylaxis for prevention of gynaecomastia and breast pain associated with 10. Efficacy of tamoxifen and radiotherapy for An open, randomised, multicenter, phase 3 trial prevention and treatment of gynaecomastia and comparing the efficacy of two tamoxifen breast pain caused by bicalutamide in prostate schedules in preventing gynaecomastia induced cancer: a randomised controlled trial. Evaluation of tamoxifen and anastrozole in the Radiotherapeutic prophylaxis of estrogen- prevention of gynaecomastia and breast pain induced gynaecomastia: a study of late sequela. Prophylactic of radiation on prevention of gynaecomastia breast irradiation with a single dose of electron due to oestrogen therapy. Optimal prophylactic and definitive therapy for bicalutamide-induced gynaecomastia: results of a meta-analysis. In most cases, the absolute risk is very small organisations in Scotland, Wales and Northern and needs to be balanced against the risk of Ireland regarding potential national approaches. It is provided for use by appropriately qualified professionals, and the making of any decision regarding the applicability and suitability of the material in any particular circumstance is subject to the users professional judgement. Part I: the 100 top-cited papers in neurosurgical journals A review Fr a n c i s c o a. The number of citations a published article receives is a measure of its impact in the scientifc com- munity. This study identifes and characterizes the current 100 top-cited articles in journals specifcally dedicated to neurosurgery. Neurosurgical journals were identifed using the Institute for Scientifc Information Journal Citation Reports. A search was performed using Institute for Scientifc Information Web of Science for articles appearing in each of these journals. The 100 most cited manuscripts in neurosurgical journals appeared in 3 of 13 journals dedicated to neurosurgery. These included 79 in the Journal of Neurosurgery, 11 in the Journal of Neurology, Neurosurgery and Psychiatry, and 10 in Neurosurgery. Representation varied widely across neurosurgi- cal disciplines, with cerebrovascular diseases leading (43 articles), followed by trauma (27 articles), stereotactic and functional neurosurgery (13 articles), and neurooncology (12 articles). The study types included 5 randomized trials, 5 cooperative studies, 1 observational cohort study, 69 case series, 8 review articles, and 12 animal studies. Thirty ar- ticles dealt with surgical management and 12 with nonsurgical management. There were 15 studies of natural history of disease or outcomes after trauma, 11 classifcation or grading scales, and 10 studies of human pathophysiology. The most cited articles in neurosurgical journals are trials evaluating surgical or medical therapies, descriptions of novel techniques, or systems for classifying or grading disease. The time of publication, feld of study, nature of the work, and the journal in which the work appears are possible determinants of the likelihood of citation and impact. These are the studies that cal community is the number of times that article has A have helped defne the way that our discipline is been cited (the citation count). The purpose of this study practiced by serving as the foundation for new methods, is to identify, using the citation count, works that have procedures, or concepts. A surrogate for measuring the made key contributions in the feld and are driving or have driven the practice of neurosurgery. The study and anal- British Journal of Neurosurgery ysis of citation indexes, or bibliometrics, have resulted in Clinical Neurology and Neurosurgery the development of various metrics to assess the impact Journal of Neurology, Neurosurgery and Psychiatry of scientifc journals or individual investigators based on the number of citations to their respective works. In the Journal of Neurosurgery present study, we take advantage of these tools, not read- Minimally Invasive Neurosurgery ily available in the past, to identify the important works Neurosurgery in neurosurgery. In this frst part, Neurosurgical Review we identify the 100 top-cited articles published in neu- rosurgical journals since 1950 and provide an analysis of Neurosurgery Quarterly the felds and types of study represented in these articles. The source of the data of citations to these articles made by other neurosurgical presented in this study is the web-based bibliometric data- journals. We identifed 11 the most cited articles in all 13 neurosurgical journals neurosurgical journals by searching the Journal Citation were sorted by the citation counts. The citation counts ranged from 287 to 1515, and tifed a journal specializing in neurosurgical anesthesiol- the years of publication ranged from 1956 to 2001, with 77 ogy, which was excluded from our analysis. The journals having been published between 1976 and 1995, 19 before Surgical Neurology and Acta Neurochirurgica, not cap- 1976, and 4 after 1995. A search In the following sections, the numbers in parentheses was then performed on Web of Science of each journal represent the ranking of the articles in terms of number under Publication Name, and results were sorted by the of citations. The journal Spine was also considered for inclusion, Field of Study and 32 articles were found in Spine that had been cited over 265 times (a cutoff value corresponding to the num- the articles were categorized as studies concerning ber of citations for the 100th most cited article in the Jour- cerebrovascular disease, trauma, tumors, or functional nal of Neurosurgery). Spinal cord injury was included under primarily by a neurosurgeon; thus, despite the overlap trauma, and stereotaxy, epilepsy, and pain were included and relevance of the topics covered in Spine with neuro- under functional neurosurgery. Ninety-fve of the articles surgery, the journal was not considered a neurosurgical fell under 1 of these 4 categories; in addition, 5 articles journal for the purposes of this study. Highly cited neuro- were about syringomyelia, hydrocephalus, infection, and surgical papers appearing in general medical journals are spine surgery (Table 4). These was compiled in August 2009, and the numbers presented included 19 articles on the management of intracranial thus refect the citation counts at that time. Wada J, Rasmussen T: Intracarotid injection of sodium amytal for the lateralization of cerebral speech dominance. Guglielmi G, Vinuela F, Dion J, Duckwiler G: Electrothrombosis of saccular aneurysms via endovascular approach.

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