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https://www.readbyqxmd.com/read/28217217/the-effect-of-air-tourniquet-on-interleukin-6-levels-in-total-knee-arthroplasty
#1
Kenji Tsunoda, Motoki Sonohata, Hajime Kugisaki, Shinsuke Someya, Hidefumi Honke, Mitsunori Komine, Masataka Izumi, Shuya Ide, Masaaki Mawatari
BACKGROUND: Air tourniquet-induced skeletal muscle injury increases the concentrations of some cytokines such as interleukin-6 (IL-6) in plasma. However, the effect of an air tourniquet on the IL-6 concentrations after total knee arthroplasty (TKA) is unclear. We therefore investigated the impact of tourniquet-induced ischemia and reperfusion injury in TKA using the IL-6 level as an index. METHODS: Ten patients with primary knee osteoarthrosis who underwent unilateral TKA without an air tourniquet were recruited (Non-tourniquet group)...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28216819/timed-wake-up-anaesthesia-in-hand-a-modification-to-wide-awake-surgery-of-hand
#2
Jagannath Kamath, Trivikram Shenoy, Nikil Jayasheelan, Naufal Rizwan, Vartika Sachan, Rajashekar Danda
INTRODUCTION: Wide awake surgery of the hand (WASH) is a well-accepted technique in hand surgery which allows the surgeon to identify and rectify on the table of some of the inadvertent shortcomings in the surgical procedures to optimise the final outcome. The advantage, however, precludes the use of tourniquet. We describe a modified method which preserves all the advantages of WASH and allows the surgeon to use tourniquet. PATIENTS AND METHODS: Thirty-one cases of hand surgeries were carried out using the modified technique where a wrist block was supplemented with the ultra-short acting intravenous propofol which allowed the surgeon to use the upper arm tourniquet...
September 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28216347/systemic-application-of-carbon-monoxide-releasing-molecule-3-protects-skeletal-muscle-from-ischemia-reperfusion-injury
#3
Aurelia Bihari, Gediminas Cepinskas, Thomas L Forbes, Richard F Potter, Abdel-Rahman Lawendy
OBJECTIVE: Ischemia-reperfusion (IR) is a limb- and life-threatening complication of acute limb ischemia and musculoskeletal trauma. Carbon monoxide-releasing molecules (CORMs) have recently been shown to protect microvascular perfusion and to reduce inflammation and injury in various ischemic animal models. The purpose of this study was to examine the effects of water-soluble CORM-3 on the extent of IR-induced muscle injury. METHODS: Wistar rats were randomized into three groups: sham (no ischemia), IR + CORM-3 (10 mg/kg intraperitoneally), and IR + inactive CORM-3 (iCORM-3; 10 mg/kg intraperitoneally)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28214556/isolated-limb-infusion-as-a-limb-salvage-strategy-for-locally-advanced-extremity-sarcoma
#4
John E Mullinax, Hidde M Kroon, John F Thompson, Neel Nath, Paul J Mosca, Jeffrey M Farma, Rajendra Bhati, Danielle Hardmann, Sean Sileno, Cristina O'Donoghue, Matthew Perez, Syeda Mahrukh Hussnain Naqvi, Y Ann Chen, Ricardo J Gonzalez, Jonathan S Zager
INTRO: Treatment-resistant, locally advanced soft tissue sarcomas (STS) often require amputation for complete tumor extirpation. Isolated limb infusion (ILI) selectively delivers high-dose chemotherapy to the extremity in an attempt to achieve limb salvage The aim of this study is to report perioperative and oncological outcomes after ILI in patients with extremity STS. METHODS: From 1994-2016, 77 patients underwent 84 ILI's at a total of 5 institutions. Melphalan and actinomycin D were circulated for 30 minutes after complete tourniquet occlusion of the limb, then actively washed out to prevent systemic exposure...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28214461/wide-awake-hand-surgery
#5
Matthew Cantlon, Steven Yang
Wide awake hand surgery employs local-only anesthesia with low-dose epinephrine to create a bloodless field without the use of an arm tourniquet. Despite traditional teaching, evidence-based medicine suggests epinephrine is safe for use in hand and digital anesthesia. Eliminating an arm tourniquet reduces the requirement for sedation and general anesthetic. This confers particular advantage in surgeries such as tendon repairs, tendon transfers, and soft tissue releases in which intraoperative active motion can used to optimize outcomes...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28210050/a-study-of-the-relationships-of-changes-in-pain-and-gait-after-tourniquet-induced-ischemia-reperfusion-in-rats
#6
Kazuki Aihara, Takeya Ono, Namiko Umei, Wakako Tsumiyama, Atsushi Tasaka, Hideki Ishikura, Yuta Sato, Tomohiro Matsumoto, Sadaaki Oki
[Purpose] The purpose of this study was to determine the relationships of changes in pain and gait after ischemia reperfusion was induced by tourniquet in rats. [Subjects and Methods] The subjects were six ten-week-old male Wistar rats. Ischemia was induced in the left lower limbs of the experimental rats at a pressure of 300 mmHg for 90 minutes. Pain behavior evaluations were measured using the von Frey test in all the rats' hind limbs. A consistently increasing plantar stimulus was applied until the rats exhibited an escape behavior...
January 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28207503/clamping-drainage-is-unnecessary-after-minimally-invasive-total-knee-arthroplasty-in-patients-with-tranexamic-acid-a-randomized-controlled-trial
#7
Yuangang Wu, Timin Yang, Yi Zeng, Canfeng Li, Bin Shen, Fuxing Pei
BACKGROUND: Drainage and tranexamic acid (TXA) have been widely used in total knee arthroplasty (TKA). However, it remains unclear whether it is necessary to clamp the drain after minimally invasive TKA (MIS-TKA) when TXA is used. We therefore conducted a randomized controlled trial to compare the effects of clamping versus not clamping drainage following MIS-TKA in patients in whom TXA was used. METHODS: From January 2015 to December 2015, 121 patients undergoing unilateral primary MIS-TKA were enrolled and randomly divided into 2 groups...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28198293/locating-difficult-veins-for-venepuncture-and-cannulation
#8
Sally Jane Shaw
Vein location and assessment are essential to improve the success rates for vascular access. However, problems remain with first attempt success rates for peripheral cannulation and locating difficult veins. Practitioners may not be aware of developments in technology and aids to assist in the location and assessment of veins to achieve vascular access. This article provides an overview of two vein location aids that can be used to locate difficult veins: the IV-eye vein imager and the Vacuderm tourniquet. It discusses the patient factors that can increase the difficulty of vein assessment and location, and emphasises the importance of vessel health and preservation, and vein palpation...
February 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28187025/de-novo-upper-extremity-lymphedema-after-elective-hand-surgery-in-breast-cancer-survivors
#9
Heather L Baltzer, Jamison Harvey, Paige M Fox, Steven L Moran
BACKGROUND: The safety of elective hand surgery in breast cancer (BC) survivors is controversial because of concerns of developing upper extremity lymphedema. This study aimed to evaluate the risk of developing lymphedema after elective hand surgery among patients that underwent ipsilateral axillary lymph node dissection (ALND), sentinel lymph node biopsy (SLNB), and/or radiation therapy (RT). METHOD: A retrospective cohort of BC patients treated with ALND, SLNB, and/or RT was identified (1997-2012)...
February 10, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28176605/topical-versus-intravenous-tranexamic-acid-in-total-knee-arthroplasty
#10
Sanjay Meena, Francesco Benazzo, Saumitra Dwivedi, Matteo Ghiara
PURPOSE: The aim of this meta-analysis is to examine the efficacy and safety of intra-articular tranexamic acid (TXA) when compared to intravenous (IV) route. METHODS: The literature search was conducted using PubMed, Cochrane Library, MEDLINE, EMBASE and China National Knowledge Infrastructure (CNKI). All randomized controlled trials evaluating the effectiveness of topical route and IV route of TXA administration were included. RESULTS: Eight randomized clinical trials comprising of 857 patients were included in this analysis...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28164065/localized-tetanus-in-an-adult-patient-case-report
#11
Mohamed Amirali Gulamhussein, Yueyang Li, Abhijit Guha
INTRODUCTION: Tetanus is a severe and potentially fatal infection caused by the bacterium Clostridium tetani. Of all the cases described in literature, generalized tetanus is by far the most common presentation, but it may also present as neonatal tetanus, cephalic tetanus, and localized tetanus, the latter two being much rarer. In this case report, we present the rare form of this disease, i.e., localized tetanus in an adult male with a history of minimal trauma as well as a late, unusual mode of presentation...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28163242/is-there-a-relevance-of-suction-drainage-in-non-septic-wrist-surgery
#12
Guillaume Prunières, Juan Jose Hidalgo Diaz, Paul Vernet, Santiago Salazar Botero, Sybille Facca, Philippe A Liverneaux
INTRODUCTION: No rational argument leads to conclude to the benefit or the innocuousness of drainage in non-septic wrist surgery. HYPOTHESIS: The goal of this study was to validate the hypothesis that for those indications drainage is unnecessary. MATERIAL AND METHOD: We reviewed 1001 consecutive cases, concerning 885 patients, 58 years old in average. RESULTS: Out of 1001 procedures, 9 patients were operated on both sides, 145 were operated twice of which 130 for the implantation and then the removal of surgical material...
February 2, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28162621/-126-submaximal-effort-tourniquet-a-test-of-pain-and-motor-function
#13
M Simmonds, N Bernussi, R Espey, G Loza, J Suarez
No abstract text is available yet for this article.
April 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28159709/role-of-the-plasma-cascade-systems-in-ischemia-reperfusion-injury-of-bone
#14
Shengye Zhang, Carlos Wotzkow, Anjan K Bongoni, Jane Shaw-Boden, Mark Siegrist, Adriano Taddeo, Fabian Blank, Willy Hofstetter, Robert Rieben
Ischemia/reperfusion (I/R) injury has been extensively studied in organs such as heart, brain, liver, kidney, and lung. As a vascularized organ, bone is known to be susceptible to I/R injury too, but the respective mechanisms are not well understood to date. We therefore hypothesized that, similar to other organs, plasma cascade-induced inflammation also plays a role in bone I/R injury. Reperfusion injury in rat tibia was induced by unilateral clamping of the femoral artery and additional use of a tourniquet, while keeping the femoral vein patent to prevent venous congestion...
January 31, 2017: Bone
https://www.readbyqxmd.com/read/28159434/-and-if-it-happened-to-children-adapting-medical-care-during-terrorist-attacks-with-multiple-pediatric-victims
#15
L Alix-Séguin, N Lodé, G Orliaguet, E Chamorro, F Kerroué, C Lorge, A Moreira
In light of the recent terrorist attacks in Europe, we need to reconsider the organization of rescue and medical management and plan for an attack involving multiple pediatric victims. To ensure quick surgical management, but also to minimize risk for on-site teams (direct threats from secondary terrorist attacks targeting deployed emergency services), it is crucial to evacuate patients in a swift but orderly fashion. Children are vulnerable targets in terrorist attacks. Their anatomical and physiological characteristics make it likely that pediatric victims will suffer more brain injuries and require more, often advanced, airway management...
January 31, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28159420/efficacy-in-deep-vein-thrombosis-prevention-with-extended-mechanical-compression-device-therapy-and-prophylactic-aspirin-following-total-knee-arthroplasty-a-randomized-control-trial
#16
Mark A Snyder, Alexandra N Sympson, Christina M Scheuerman, Justin L Gregg, Lala R Hussain
BACKGROUND: Aspirin at 325 mg twice daily is now included as a nationally approved venous thromboembolism (VTE) prophylaxis protocol for low-risk total knee arthroplasty (TKA) patients. The purpose of this study is to examine whether there is a difference in deep vein thrombosis (DVT) occurrence after a limited tourniquet TKA using aspirin-based prophylaxis with or without extended use of mechanical compression device (MCD) therapy. METHODS: One hundred limited tourniquet TKA patients, whose DVT risk was managed with aspirin 325 mg twice daily for 3 weeks, were randomized to either using an MCD during hospitalization only or extended use at home up to 6 weeks postoperatively...
December 23, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28149307/a-novel-atraumatic-tourniquet-technique-for-excessive-bleeding-during-cesarean-sections
#17
Baris Buke, Emre Canverenler, Hatice Akkaya, Fuat Akercan
Objective. Controlling excessive bleeding in cesarean sections which may cause a life-threatening event even under well-prepared conditions. We used a novel atraumatic tourniquet technique to temporary arrest blood flow through the uterine and ovarian vessels and compare with other techniques. Toothless vascular clamps were used as clamp. Methods. Tourniquet technique performed postpartum hemorrhage (PPH) cases (19 out of 37) were compared with 18 other cases with PPH. Results. The difference between preoperative and postoperative hemoglobin values was significantly lower in the study group as well as the number of blood products needed during and after surgery...
2017: Obstetrics and Gynecology International
https://www.readbyqxmd.com/read/28149139/can-we-perform-distal-nerve-block-instead-of-brachial-plexus-nerve-block-under-ultrasound-guidance-for-hand-surgery
#18
Ilker Ince, Mehmet Aksoy, Mine Celik
OBJECTIVE: Distal nerve blocks are used in the event of unsuccessful blocks as rescue techniques. The primary purpose of this study was to determine the sufficiency for anesthesia of distal nerve block without the need for deep sedation or general anesthesia. The secondary purpose was to compare block performance times, block onset times, and patient and surgeon satisfaction. MATERIALS AND METHODS: Patients who underwent hand surgery associated with the innervation area of the radial and median nerves were included in the study...
October 2016: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28144581/tourniquets-do-not-increase-the-total-blood-loss-or-re-amputation-risk-in-transtibial-amputations
#19
Christian Wied, Peter T Tengberg, Gitte Holm, Thomas Kallemose, Nicolai B Foss, Anders Troelsen, Morten T Kristensen
AIM: To investigate the total blood loss (TBL) and the safety with respect to the re-amputation rate after transtibial amputation (TTA) conducted with and without a tourniquet. METHODS: The study was a single-centre retrospective cohort study of patients with a primary TTA admitted between January 2013 and April 2015. All patients with a primary TTA were assessed for inclusion if the amputation was performed because of arteriosclerosis or diabetic complications...
January 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28139973/effects-of-five-treatment-regimens-on-blood-loss-and-blood-transfusion-in-total-knee-arthroplasty-a-preliminary-study-in-china%C3%A2
#20
Kong-Zu Hu, He-Yan Sun, Cong Sui
OBJECTIVE: Our study is aimed to explore effects of five treatment regimens on blood loss and blood transfusion rate in total knee arthroplasty (TKA) patients. METHODS: 191 TKA patients were divided into the rivaroxaban, nadroparin, and tranexamic acid groups (n = 37 each) as well as into the affected-limb-position and tourniquet group (n = 40 each). A 3-month follow-up after operation was needed for all patients. The total blood loss, hidden blood loss, and dominant blood loss were recorded, and hemoglobin and red blood cell changes, pain and knee swelling degrees, hospital for special surgery (HSS), and American knee society (KSS) knee scores were observed...
January 30, 2017: International Journal of Clinical Pharmacology and Therapeutics
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