The trend of using smaller operative corridors is seen in various surgical specialties. Neurosurgery has also recently embraced minimal access spine technique, and it has rapidly evolved over the past 2 decades. There has been a progression from needle access, small incisions with adaptation of the microscope, and automated percutaneous procedures to endoscopically and laparoscopically assisted procedures. More recently, new muscle-sparing technology has come into use with tubular access. This has now been adapted to the percutaneous placement of spinal instrumentation, including intervertebral spacers, rods, pedicle screws, facet screws, nucleus replacement devices, and artificial discs. New technologies involving hybrid procedures for the treatment of complex spine trauma are now on the horizon. Surgical corridors have been developed utilizing the interspinous space for X-STOP placement to treat lumbar stenosis in a minimally invasive fashion. The direct lateral retroperitoneal corridor has allowed for minimally invasive access to the anterior spine.
Adequate debridement, control of infection, off-loading of pressure, and appropriate topical management are the most important interventions in treating nonhealing wounds.
In a remote village in Central America, an otherwise unmanaged child's infection can take a turn for worse if not for the long distance diagnosis capacity brought about by the recently installed telemedicine system between Zacapa, Guatemala, and Houston, Texas, where subspecialists in the field of Pediatric Dermatology viewed the wound and prescribed the critically needed treatment.
After 60 years of availability of antibiotics, surprisingly little is known about their role in obstructive airway diseases. Areview of antibiotic therapy will necessarily involve a discussion of the role of bacterial infection in asthma and chronic obstructive pulmonary disease
Reactive Airways Dysfunction Syndrome (RADS) and Irritant-Induced Asthma (IIA) are both new-onset, irritant-induced, non-allergic asthma. These two pulmonary disorders are clinically very similar; both are caused by the inhalation of irritating substances such as smoke, dust, fumes, gases, and vapors