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Pediatric orthopedics

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https://www.readbyqxmd.com/read/27921127/pre-authorization-processes-have-no-effect-on-patients-undergoing-knee-mri-in-a-pediatric-setting-when-evaluated-by-specialists
#1
Drew Pierce, J Herman Kan, Megan May, George S Bisset
OBJECTIVE: Pre-authorization processes are often used by medical insurance companies to reduce costs by managing the utilization of advanced diagnostic imaging, and their impact on patient care is unclear. The purpose of our study is to determine if a pre-authorization process increases the rate of surgically significant abnormal knee MRI and surgical referrals compared with patients referred from pediatric orthopedic specialists who do not undergo a pre-authorization process. MATERIALS AND METHODS: A retrospective study was performed; 124 patients were identified who were referred for knee MRI by a pediatric orthopedist...
December 5, 2016: Skeletal Radiology
https://www.readbyqxmd.com/read/27920573/femoral-nerve-blockade-using-various-concentrations-of-local-anesthetic-for-knee-arthroscopy-in-the-pediatric-population
#2
Giorgio Veneziano, Jennifer Tripi, Dmitry Tumin, Mumin Hakim, David Martin, Ralph Beltran, Kevin Klingele, Tarun Bhalla, Joseph D Tobias
BACKGROUND: Femoral nerve blockade (FNB) provides effective postoperative analgesia in children undergoing arthroscopic knee surgery as evidenced by their opioid-sparing effects and decreased postoperative pain scores. Increasing the local anesthetic concentration in peripheral nerve blockade for adults undergoing orthopedic surgery has been shown to be beneficial, increasing block success rate, and providing a longer duration of analgesia. The effect of increasing the concentration of local anesthetic in extremity blocks in children remains largely unexplored...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27920572/home-peripheral-nerve-catheters-the-first-24-months-of-experience-at-a-children-s-hospital
#3
Andrew Gable, Candice Burrier, Jenna Stevens, Sharon Wrona, Kevin Klingele, Tarun Bhalla, David P Martin, Giorgio Veneziano, Joseph D Tobias
CONTEXT: Home peripheral nerve catheters (PNCs) have become common practice for adult patients after major orthopedic surgery. However, use in pediatric patients is a recent application. OBJECTIVES: The purpose of this study was to review the demographics and outcomes of pediatric patients receiving a PNC at our institution. METHODS: This retrospective study included patients from October 2012 through October 2014 undergoing orthopedic procedures with a PNC placed for postoperative pain management...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27908650/musculoskeletal-conditions-in-a-pediatric-population-with-ehlers-danlos-syndrome
#4
Courtney M Stern, Michael J Pepin, Joan M Stoler, Dennis E Kramer, Samantha A Spencer, Cynthia J Stein
OBJECTIVE: To describe musculoskeletal conditions in children with Ehlers-Danlos syndrome (EDS). STUDY DESIGN: A retrospective medical record review was performed, which evaluated 205 patients with EDS (ages 6-19 years) seen in sports medicine or orthopedic clinic at a large pediatric hospital over a 5-year period. RESULTS: Female (n = 147) and male (n = 57) patients were identified (mean age 12.7 years). The most common EDS subtype (55...
November 28, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27877097/preoperative-antibiotic-orders-protocol-initiated-pharmacist-order-entry
#5
Ben B Hyde, Richard K Ogden, Ron D Berger, Brad W VanBrimmer, Leslie M Stach
OBJECTIVE: To evaluate the antibiotic selection of preoperative orders before and after a pharmacist order entry protocol for patients with methicillin-resistant Staphylococcus aureus (MRSA) colonization. METHODS: A retrospective chart review of orthopedic surgery procedures on patients with MRSA colonization at a free-standing, academic pediatric hospital, between February 2010 and February 2012. RESULTS: Procedures that were performed pre protocol (n = 27) implementation had a 63% rate of appropriate antibiotic selection compared to 81% in the postprotocol group (n = 32; p = 0...
September 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27876583/treatment-ofpediatric-forearm-midshaft-fractures-is-there-a-difference-between-types-of-orthopedic-surgeon
#6
Di Lu, Zhou Lin, Jing-Dong Zhang, Hua Chen, Liao-Jun Sun
PURPOSE OF THE STUDY: The objective of this study was tocompare the clinical and radiological outcomes of pediatric forearmmidshaft fractures treated operatively with titanium elastic nails (TENs) bypediatric orthopedists and non-pediatric orthopedists. MATERIAL AND METHODS: We conducted a prospective cohort study of 88 childrenofforearmmidshaft fractures, who were randomized to operative stabilization eitherby pediatric orthopedists (Group A, 44 cases) or by non-pediatric orthopedists (Group B, 44 cases) from April 2013 to February 2014...
November 19, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27876383/helmet-use-and-injury-severity-among-pediatric-skiers-and-snowboarders-in-colorado
#7
Melissa Milan, Sandeep Jhajj, Camille Stewart, Laura Pyle, Steven Moulton
INTRODUCTION: Skiing and snowboarding are popular winter recreational activities that are commonly associated with orthopedic type injuries. Unbeknownst to most parents, however, are the significant but poorly described risks for head, cervical spine and solid organ injuries. Although helmet use is not mandated for skiers and snowboarders outside of resort sponsored activities, we hypothesized that helmet use is associated with a lower risk of severe head injury, shorter ICU stay and shorter hospital length of stay...
November 6, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27875955/detection-the-mycoplasma-pneumonia-in-synovial-fluid-of-children-with-negative-culture-arthritis-a-cross-sectional-study-in-tehran-iran
#8
Samileh Noorbakhsh, Mohammad Reza Shokrollahi, Farideh Ebrahimi Taj, Vida Zarabi, Azardokht Tabatabaei
BACKGROUND: arthritis could be caused by different etiologies ranging from rheumatologic diseases to infectious conditions. Therefore, early diagnosis of etiology and treatment is important. The purpose of this study was to determine the the M.pneumonia in synovial fluid of children with arthritis by 2 methods (serology and qualitative PCR). Methods & materials: this trial was carried out as a cross sectional study in pediatric and orthopedic ward of Rasoul-e Akram hospital in Tehran, Iran...
November 21, 2016: Infectious Disorders Drug Targets
https://www.readbyqxmd.com/read/27870687/when-is-it-ok-to-use-a-splint-versus-cast-and-what-remodeling-can-one-expect-for-common-pediatric-forearm-fractures
#9
Robert S Runyon, Shevaun M Doyle
PURPOSE OF REVIEW: The purpose of this review is to provide an overview of common pediatric forearm fractures, clarify the descriptions used to identify and thereby appropriately treat them with a splint or cast, and explain osseous remodeling that is unique to the skeletally immature. RECENT FINDINGS: Recent literature addresses the gap in standard treatment protocols. There is variability in the management of pediatric forearm fractures because of the multiple subspecialty physicians that care for children's fractures and a lack of well established guidelines...
November 18, 2016: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/27867136/pediatric-orthopedic-surgery-in-humanitarian-aid
#10
REVIEW
Jérôme Sales de Gauzy
Pediatric orthopedic surgery in humanitarian aid is conducted mainly in cooperation with emerging countries. Each mission is different, and depends on numerous parameters such as the country, the frequency of such missions, the pathologies encountered, the local structure and team, and the non-governmental organization (NGO) involved. Pathologies vary in etiology (tuberculosis, poliomyelitis) and severity. Each mission requires the presence of an experienced surgeon. Working conditions are often rudimentary...
November 17, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27852496/effect-of-preoperative-indications-conference-on-procedural-planning-for-treatment-of-scoliosis
#11
Charles M Chan, Hasani W Swindell, Hiroko Matsumoto, Howard Y Park, Joshua E Hyman, Michael G Vitale, David P Roye, Benjamin D Roye
STUDY DESIGN: This study determines the rate of change in the scoliosis surgery plan in cases presented in preoperative indications conference. OBJECTIVES: To determine the effect of preoperative indications conference on the plan of surgery and to identify characteristics that increased the likelihood of change. SUMMARY OF BACKGROUND DATA: Preoperative indications conferences are used as a teaching and planning tool. Levels of fusion, construct options, and necessity for osteotomies are often debated in the planning of scoliosis surgery...
January 2016: Spine Deformity
https://www.readbyqxmd.com/read/27851666/factors-associated-with-nonaccidental-trauma-evaluation-among-patients-below-36-months-old-presenting-with-femur-fractures-at-a-level-1-pediatric-trauma-center
#12
Allison M Blatz, Catherine W Gillespie, Arielle Katcher, Allison Matthews, Matthew E Oetgen
BACKGROUND: In 2009, the American Academy of Orthopedic Surgeons published clinical practice guidelines (CPGs) on the treatment of pediatric diaphyseal femur fractures, which recommended a nonaccidental trauma (NAT) evaluation for all patients below 36 months of age. A recent study of these guidelines found <50% clinical compliance with this treatment recommendation. We aimed to identify areas for improvement in compliance with this guideline. METHODS: A retrospective review was performed of all patients presenting to a single pediatric tertiary care hospital with a diaphyseal femur fracture from January 2007 to June 2013 who were below 36 months old...
November 15, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27843325/the-role-of-the-multidisciplinary-health-care-team-in-the-management-of-patients-with-marfan-syndrome
#13
REVIEW
Yskert von Kodolitsch, Meike Rybczynski, Marina Vogler, Thomas S Mir, Helke Schüler, Kerstin Kutsche, Georg Rosenberger, Christian Detter, Alexander M Bernhardt, Axel Larena-Avellaneda, Tilo Kölbel, E Sebastian Debus, Malte Schroeder, Stephan J Linke, Bettina Fuisting, Barbara Napp, Anna Lena Kammal, Klaus Püschel, Peter Bannas, Boris A Hoffmann, Nele Gessler, Eva Vahle-Hinz, Bärbel Kahl-Nieke, Götz Thomalla, Christina Weiler-Normann, Gunda Ohm, Stefan Neumann, Dieter Benninghoven, Stefan Blankenberg, Reed E Pyeritz
Marfan syndrome (MFS) is a rare, severe, chronic, life-threatening disease with multiorgan involvement that requires optimal multidisciplinary care to normalize both prognosis and quality of life. In this article, each key team member of all the medical disciplines of a multidisciplinary health care team at the Hamburg Marfan center gives a personal account of his or her contribution in the management of patients with MFS. The authors show how, with the support of health care managers, key team members organize themselves in an organizational structure to create a common meaning, to maximize therapeutic success for patients with MFS...
2016: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/27836765/nasal-breathing-and-the-vertical-dimension-a-cephalometric-study
#14
Amal El Aouame, Asmaa Daoui, Farid El Quars
INTRODUCTION: The aim of this work was to perform a cephalometric analysis of the craniofacial parameters and natural head posture of mouth-breathers compared with control subjects, and to study the relationship between nose-breathing and the vertical dimension. MATERIAL AND METHODS: The headfilms taken at start of treatment of 53 cases (28 girls, 25 boys) aged 9 to 30 who consulted the dento-facial orthopedic department of the Ibn Rochd Casablanca dental consultation and treatment center were studied...
November 8, 2016: International Orthodontics
https://www.readbyqxmd.com/read/27829461/gender-difference-in-preference-of-specialty-as-a-career-choice-among-japanese-medical-students
#15
Ryuichi Kawamoto, Daisuke Ninomiya, Yoshihisa Kasai, Tomo Kusunoki, Nobuyuki Ohtsuka, Teru Kumagi, Masanori Abe
BACKGROUND: In Japan, the absolute deficiency of doctors and maldistribution of doctors by specialty is a significant problem in the Japanese health care system. The purpose of this study was to investigate the factors contributing to specialty preference in career choice among Japanese medical students. METHODS: A total of 368 medical students completed the survey giving an 88.2 % response rate. The subjects comprised 141 women aged 21 ± 3 (range, 18-34) years and 227 men aged 22 ± 4 (range, 18-44) years...
November 10, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27813341/pharmacological-and-biological-therapeutic-strategies-for-osteogenesis-imperfecta
#16
Ronit Marom, Yi-Chien Lee, Ingo Grafe, Brendan Lee
Osteogenesis imperfecta (OI) is a connective tissue disorder characterized by bone fragility, low bone mass, and bone deformities. The majority of cases are caused by autosomal dominant pathogenic variants in the COL1A1 and COL1A2 genes that encode type I collagen, the major component of the bone matrix. The remaining cases are caused by autosomal recessively or dominantly inherited mutations in genes that are involved in the post-translational modification of type I collagen, act as type I collagen chaperones, or are members of the signaling pathways that regulate bone homeostasis...
November 3, 2016: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/27798714/patellar-sleeve-fracture-with-ossification-of-the-patellar-tendon
#17
Derek S Damrow, Scott E Van Valin
Patellar sleeve fractures make up greater than 50% of all patellar fractures. They are essentially only seen in the pediatric population because of the thick periosteum and the distal patellar pole apophysis in this group. These fractures can lead to complications if not treated appropriately and in a timely fashion. Complications of missed or untreated patellar sleeve fractures include patella alta, anterior knee pain, and quadriceps atrophy. These can all result in severe limitations in activity. The authors describe a case of a 16-year-old boy who sustained a patellar sleeve fracture 3 years prior to presentation...
October 31, 2016: Orthopedics
https://www.readbyqxmd.com/read/27792792/economic-analysis-of-children-s-surgical-care-in-low-and-middle-income-countries-a-systematic-review-and-analysis
#18
Anthony T Saxton, Dan Poenaru, Doruk Ozgediz, Emmanuel A Ameh, Diana Farmer, Emily R Smith, Henry E Rice
BACKGROUND: Understanding the economic value of health interventions is essential for policy makers to make informed resource allocation decisions. The objective of this systematic review was to summarize available information on the economic impact of children's surgical care in low- and middle-income countries (LMICs). METHODS: We searched MEDLINE (Pubmed), Embase, and Web of Science for relevant articles published between Jan. 1996 and Jan. 2015. We summarized reported cost information for individual interventions by country, including all costs, disability weights, health outcome measurements (most commonly disability-adjusted life years [DALYs] averted) and cost-effectiveness ratios (CERs)...
2016: PloS One
https://www.readbyqxmd.com/read/27792040/variation-in-pediatric-orthopedic-case-volume-among-residents-an-assessment-of-accreditation-council-for-graduate-medical-education-case-logs
#19
Richard M Hinds, Donna Phillips, Kenneth A Egol, John T Capo
The aim of this investigation was to examine graduating orthopedic resident case logs to evaluate trends in performing pediatric orthopedic procedures and compare pediatric orthopedic case volume among residents in the 90th, 50th, and 10th percentiles (by case volume) to identify caseload variation. Accreditation Council for Graduate Medical Education orthopedic resident case logs were examined for graduating years 2007-2013. Linear regression analyses were carried out to assess temporal trends in pediatric orthopedic case volume...
October 27, 2016: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/27786528/observed-parent-behaviors-as-time-varying-moderators-of-problem-behaviors-following-traumatic-brain-injury-in-young-children
#20
Amery Treble-Barna, Huaiyu Zang, Nanhua Zhang, H Gerry Taylor, Terry Stancin, Keith Owen Yeates, Shari L Wade
Parent behaviors moderate the adverse consequences of pediatric traumatic brain injury (TBI); however, it is unknown how these moderating effects change over time. This study examined the moderating effect of observed parent behaviors over time since injury on the relation between TBI and behavioral outcomes. Participants included children, ages 3-7 years, hospitalized for moderate (n = 52) or severe (n = 20) TBI or orthopedic injury (OI; n = 95). Parent-child dyads were videotaped during structured task and free play conditions, and parents completed child behavior ratings...
November 2016: Developmental Psychology
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