The effect of cannabinoids on wound healing: A review.

Background and Aims: Cannabis and its various derivatives are commonly used for both recreational and medicinal purposes. Cannabinoids have been shown to have anti-inflammatory properties. Inflammation is an important component of wound healing and the effect of cannabinoids on wound healing has become a recent topic of investigation. The objective of this article is to perform a comprehensive review of the literature to summarize the effects of cannabinoids on wound healing of the skin and to guide future avenues of research. Methods: A comprehensive literature review was performed to evaluate the effects of cannabinoids on cutaneous wound healing. Results: Cannabinoids appear to improve skin wound healing through a variety of mechanisms. This is supported through a variety of in vitro and animal studies. Animal studies suggest application of cannabinoids may improve the healing of postsurgical and chronic wounds. There are few human studies which evaluate the effects of cannabinoids on wound healing and many of these are case series and observational studies. They do suggest cannabinoids may have some benefit. However, definitive conclusions cannot be drawn from them. Conclusion: While further human studies are needed, topical application of cannabinoids may be a potential therapeutic option for postsurgical and chronic wounds.

Practice Patterns of Ventriculoperitoneal Shunt Placement in Academic and Community Settings: A National Survey of Practicing Neurosurgeons.

OBJECTIVE: We sought to assess the practice patterns of ventriculoperitoneal shunt (VPS) placement by neurosurgeons at academic, community, and government-based institutions. METHODS: Using the American Association of Neurological Surgeons directory, a total of 3673 practicing neurosurgeons were contacted. The survey received 495 responses (57% academic, 41% community, 3% other/government based). The survey consisted of 9 questions to assess the frequency of general surgery assistance for distal VPS placement and the use of cranial neuronavigation for proximal placement and to assess subjective beliefs of personal practice pattern and the influence on shunt failure rates. RESULTS: Almost half of the respondents reported using general surgery less than half of the time for distal VPS placement. Regardless of personal practice patterns, roughly one third of respondents reported that general surgery assistance is a common or somewhat common practice at their institution. The most common reasons for recruiting general surgery assistance were cases of higher complexity. Although commonly used, almost 40% of respondents believe that general surgery assistance does not decrease shunt failure rates. Cranial neuronavigation is used less than half of the time, and the most common reason was for improved accuracy. Almost half of the respondents believe navigation does decrease shunt failure rates. CONCLUSIONS: General surgery assistance for distal placement and neuronavigation for the proximal placement of VPS catheters are both commonly used by neurosurgeons in academic, community, and other practice locations. This survey provides the first assessment of practice patterns nationally. The results demonstrate that roughly half of the practicing neurosurgeons use general surgery assistance and neuronavigation, particularly for complex or high-risk cases.

Parcellation-based anatomic modeling of the default mode network.

BACKGROUND: The default mode network (DMN) is an important mediator of passive states of mind. Multiple cortical areas, such as the anterior cingulate cortex, posterior cingulate cortex, and lateral parietal lobe, have been linked in this processing, though knowledge of network connectivity had limited tractographic specificity. METHODS: Using resting-state fMRI studies related to the DMN, we generated an activation likelihood estimation (ALE). We built a tractographical model of this network based on the cortical parcellation scheme previously published under the Human Connectome Project. DSI-based fiber tractography was performed to determine the structural connections between cortical parcellations comprising the network. RESULTS: Seventeen cortical regions were found to be part of the DMN: 10r, 31a, 31pd, 31pv, a24, d23ab, IP1, p32, POS1, POS2, RSC, PFm, PGi, PGs, s32, TPOJ3, and v23ab. These regions showed consistent interconnections between adjacent parcellations, and the cingulum was found to connect the anterior and posterior cingulate clusters within the network. CONCLUSIONS: We present a preliminary anatomic model of the default mode network. Further studies may refine this model with the ultimate goal of clinical application.