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https://www.readbyqxmd.com/read/29672872/neuromuscular-ultrasound-of-the-brachial-plexus-a-standardized-approach
#1
REVIEW
Vanessa Baute, Jeffrey A Strakowski, Jon W Reynolds, Kristopher R Karvelas, Paul Ehlers, Kevin J Brenzy, Zhongyu J Li, Michael S Cartwright
Reliable assessment of brachial plexus disorders can be challenging due to the complexity of the anatomy and variation of potential pathology. Electrodiagnostic testing can be both uncomfortable for the patient and inconclusive. Ultrasound can serve as a complement to clinical assessment, electrodiagnostic testing, and other imaging modalities. This paper describes a systematic approach for performing neuromuscular ultrasound for suspected pathology in the brachial plexus. The literature regarding techniques for brachial plexus ultrasound was reviewed...
April 19, 2018: Muscle & Nerve
https://www.readbyqxmd.com/read/29672403/association-of-hospital-network-participation-with-surgical-outcomes-and-medicare-expenditures
#2
Kyle H Sheetz, Andrew M Ryan, Andrew M Ibrahim, Justin B Dimick
OBJECTIVE: The aim of this study was to evaluate whether hospital network participation is associated with improvement in surgical outcomes and spending compared to control hospitals not participating in a network. SUMMARY BACKGROUND DATE: Hospitals face significant financial and organizational pressures to integrate into networks. It remains unclear whether these business arrangements impact clinical quality or healthcare expenditures. METHODS: We conducted a longitudinal, quasi-experimental study of 1,981,095 national Medicare beneficiaries (2007-2014) undergoing general, vascular, cardiac, or orthopedic surgery at a network (n = 1868) or non-network (n = 2734) hospital...
April 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29670988/reducing-complications-and-overall-healthcare-costs-of-hip-fracture-management-a-retrospective-study-on-the-application-of-a-diagnostic-therapeutic-pathway-in-the-cosenza-general-hospital
#3
M Loizzo, F Gallo, D Caruso
BACKGROUND: Diagnostic Therapeutic Pathways (DTPs) are multidisciplinary plans designed by each healthcare organization for a specific category of patients to reduce the variability of professional behaviors and to ensure greater safety and better overall healthcare outcomes. Hip fractures are a frequent traumatic injury, particularly in the elderly, and DTPs recommend early surgical intervention, often not done due to organizational challenges and bureaucracy. Medical conditions suggesting a delay are not frequent, however long waiting times not only increase the risk of complications and mortality, but also increase the number of diagnostic test and physician consultations...
May 2018: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/29665190/comparison-of-emergency-medicine-malpractice-cases-involving-residents-to-non-resident-cases
#4
Kiersten L Gurley, Shamai A Grossman, Margaret Janes, C Winnie Yu-Moe, Ellen Song, Carrie D Tibbles, Nathan I Shapiro, Carlo L Rosen
BACKGROUND: Data are lacking on how emergency medicine (EM) malpractice cases with resident involvement differs from cases that do not name a resident. OBJECTIVES: To compare malpractice case characteristics in cases where a resident is involved (resident case) to cases that do not involve a resident (non-resident case) and to determine factors that contribute to malpractice cases utilizing EM as a model for malpractice claims across other medical specialties. METHODS: We used data from the Controlled Risk Insurance Company (CRICO) Strategies' division Comparative Benchmarking System (CBS) to analyze open and closed EM cases asserted from 2009-2013...
April 17, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29664512/short-stature-and-hypothyroidism-in-a-child-with-nail-patella-syndrome-a-case-report
#5
C Goecke, C Mellado, C García, H García
BACKGROUND: Nail-Patella syndrome (NPS) (OMIM: 161200) or hereditary onycho-osteodysplasia is an autosomal dominant disorder characterized by skeletal anomalies, nail dysplasia, renal and ocular abnor malities. The diagnosis is based on clinical and radiological findings and confirmed by the identification of a heterozygous pathogenic variant in the LMX1B gene. Management of these patients involves conti nuous follow-up and treatment ofthe orthopedical, ocular and renal problems that mayoccur...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29664339/general-practitioners-referring-adults-to-mr-imaging-for-knee-pain-a-randomized-controlled-trial-to-assess-cost-effectiveness
#6
Kim van Oudenaarde, Nynke M Swart, Johan L Bloem, Sita M A Bierma-Zeinstra, Paul R Algra, Patrick J E Bindels, Bart W Koes, Rob G H H Nelissen, Jan A N Verhaar, Pim A J Luijsterburg, Monique Reijnierse, Wilbert B van den Hout
Purpose To determine the cost-effectiveness of early referral by the general practitioner for magnetic resonance (MR) imaging compared with usual care alone in patients aged 18-45 years with traumatic knee symptoms. Materials and Methods Cost-utility analysis was performed parallel to a prospective multicenter randomized controlled trial in Dutch general practice. A total of 356 patients with traumatic knee symptoms were included from November 2012 to December 2015 (mean age, 33 years ± 8 [standard deviation]; 222 men [62%])...
April 17, 2018: Radiology
https://www.readbyqxmd.com/read/29660634/comparison-of-osteointegration-property-between-pekk-and-peek-effects-of-surface-structure-and-chemistry
#7
Bo Yuan, Qinwen Cheng, Rui Zhao, Xiangdong Zhu, Xiao Yang, Xi Yang, Kai Zhang, Yueming Song, Xingdong Zhang
Weak osteointegration affects the long-term stability of polyaryletherketone (PAEK) implants. Surface modification provides a potential solution to improve the osteointegration property of PAEKs. Polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) are two representative PAEK materials, but the former has more ketone groups and better potential for surface chemical modification than the latter. In this work, porous PEKK (PEKK-P) and PEEK (PEEK-P) were fabricated by a porogen leaching method. The samples were treated with 80% sulfuric acid (PEKK-SP and PEEK-SP) and then simulated body fluid (SBF) incubation (PEKK-BSP and PEEK-BSP)...
April 11, 2018: Biomaterials
https://www.readbyqxmd.com/read/29658979/mini-fragment-fixation-is-equivalent-to-bicortical-screw-fixation-for-horizontal-medial-malleolus-fractures
#8
Adam M Wegner, Philip R Wolinsky, Michael A Robbins, Tanya C Garcia, Derek F Amanatullah
Horizontal fractures of the medial malleolus occur through application of valgus or abduction force through the ankle that creates a tension failure of the medial malleolus. The authors hypothesize that mini-fragment T-plates may offer improved fixation, but the optimal fixation construct for these fractures remains unclear. Forty synthetic distal tibiae with identical osteotomies were randomized into 4 fixation constructs: (1) two parallel unicortical cancellous screws; (2) two parallel bicortical cortical screws; (3) a contoured mini-fragment T-plate with 2 unicortical screws in the fragment and 2 bicortical screws in the shaft; and (4) a contoured mini-fragment T-plate with 2 bicortical screws in the fragment and 2 unicortical screws in the shaft...
April 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29658975/thumb-basal-joint-arthroplasty-prospective-comparison-of-perioperative-analgesia-and-opioid-consumption
#9
Andrew J Miller, Michael Livesey, Dennis P Martin, Jack Abboudi, William H Kirkpatrick, Frederic E Liss, Christopher M Jones, Mark L Wang, Jonas L Matzon, Asif M Ilyas
Trapeziectomy alone or in combination with a suspensionplasty technique is a common surgical treatment for symptomatic thumb basal joint arthritis. The authors undertook a prospective comparative study to test the hypothesis that peripheral nerve blocks would provide better pain control than local anesthesia with bupivacaine or liposomal bupivacaine regarding pain scores and opioid pill consumption. Patients who elected to undergo basal joint arthroplasty were allocated to 1 of 3 postoperative pain management groups: (1) peripheral nerve block, (2) local anesthesia with bupivacaine, or (3) local anesthesia with liposomal bupivacaine...
April 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29655486/comprehensive-simulation-on-morphological-and-mechanical-properties-of-trigger-finger-a-cadaveric-model
#10
Yu-Shiuan Cheng, Hsiao-Feng Chieh, Chien-Ju Lin, Li-Chieh Kuo, Kai-Nan An, Fong-Chin Su
Trigger finger has long been a common disorder in hand orthopedics. To clarify the unknown causative factors regarding the disease, numerous experiments were done on human cadavers, including tendon forces, tendon moment arm, mechanical properties of the pulley, gliding resistance, etc. However, most of these studies were conducted on normal fingers. As the etiology of trigger finger is still controversial on whether it is an outcome of tendon nodule or pulley scarring, in this study, a trigger finger model was built combining both the nodule created by silicone gel injection and pulley constriction by external compression...
March 30, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29652237/failure-of-facet-replacement-system-with-metal-on-metal-bearing-surface-and-subsequent-discovery-of-cobalt-allergy-report-of-2-cases
#11
Matthew L Goodwin, William Ryan Spiker, Darrel S Brodke, Brandon D Lawrence
The aim of this study was to report on 2 patients in whom metal-on-metal (MOM) facet replacements failed, with subsequent positive findings on allergy testing. Motion-preserving devices have been used with limited success when instrumentation is indicated in the mobile spine. MOM-bearing surfaces in orthopedics were developed to increase implant longevity, yet have been associated with numerous adverse outcomes, including local tissue reactions, pseudotumors, metallosis, and the need for revision surgery. Five patients with spinal stenosis and low-grade spondylolisthesis were randomized to undergo facet replacement surgery with the ACADIA facet replacement system at the authors' institution...
April 13, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29650034/complex-fracture-orthopedic-rehabilitation-comfort-real-time-visual-biofeedback-on-weight-bearing-versus-standard-training-methods-in-the-treatment-of-proximal-femur-fractures-in-the-elderly-study-protocol-for-a-multicenter-randomized-controlled-trial
#12
Marco Raaben, Syaiful Redzwan, Robin Augustine, Taco Johan Blokhuis
BACKGROUND: Proximal femur fractures are a common injury after low energy trauma in the elderly. Most rehabilitation programs are based on restoring mobility and early resumption of weight-bearing. However, therapy compliance is low in patients following lower extremity fractures. Moreover, little is known about the relevance of gait parameters and how to steer the rehabilitation after proximal femur fractures in the elderly. Therefore, the aim of this prospective, randomized controlled trial is to gain insight in gait parameters and evaluate if real-time visual biofeedback can improve therapy compliance after proximal femur fractures in the elderly...
April 12, 2018: Trials
https://www.readbyqxmd.com/read/29643970/in-vitro-degradation-behaviors-of-manganese-calcium-phosphate-coatings-on-an-mg-ca-zn-alloy
#13
Yichang Su, Yingchao Su, Wei Zai, Guangyu Li, Cuie Wen
In order to decrease the degradation rate of magnesium (Mg) alloys for the potential orthopedic applications, manganese-calcium phosphate coatings were prepared on an Mg-Ca-Zn alloy in calcium phosphating solutions with different addition of Mn2+ . Influence of Mn content on degradation behaviors of phosphate coatings in the simulated body fluid was investigated to obtain the optimum coating. With the increasing Mn addition, the corrosion resistance of the manganese-calcium phosphate coatings was gradually improved...
2018: Scanning
https://www.readbyqxmd.com/read/29642512/finite-element-simulations-of-hard-on-soft-hip-joint-prosthesis-accounting-for-dynamic-loads-calculated-from-a-musculoskeletal-model-during-walking
#14
Alessandro Ruggiero, Massimiliano Merola, Saverio Affatato
The hip joint replacement is one of the most successful orthopedic surgical procedures although it involves challenges to overcome. The patient group undergoing total hip arthroplasty now includes younger and more active patients who require a broad range of motion and a longer service lifetime for the replacement joint. It is well known that wear tests have a long duration and they are very expensive, thus studying the effects of geometry, loading, or alignment perturbations may be performed by Finite Element Analysis...
April 9, 2018: Materials
https://www.readbyqxmd.com/read/29627737/in-vitro-biocompatibility-bioactivity-and-mechanical-strength-of-pmma-pcl-polymer-containing-fluorapatite-and-graphene-oxide-bone-cements
#15
F Pahlevanzadeh, H R Bakhsheshi-Rad, E Hamzah
In this study, a bone cement consisting of poly methyl methacrylate (PMMA)-poly caprolactone (PCL)-fluorapatite (FA)-graphene oxide (GO) was synthesized as bone filler for application in orthopedic surgeries. The FA and GO particulates were homogenously distributed in the PMMA-PCL polymer matrix and no defects and agglomeration were found in the PMMA-PCL/FA/GO bone cement. The in-vitro bioactivity result exhibited that addition of FA and GO to the polymer cement (PMMA-PCL) improved the apatite formation ability on the surface of polymer...
March 15, 2018: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/29626545/hypoxia-selective-allosteric-destabilization-of-activin-receptor-like-kinases-a-potential-therapeutic-avenue-for-prophylaxis-of-heterotopic-ossification
#16
Guorong Lu, Mary R Tandang-Silvas, Alyssa C Dawson, Trenton J Dawson, Jay C Groppe
Heterotopic ossification (HO), the pathological extraskeletal formation of bone, can arise from blast injuries, severe burns, orthopedic procedures and gain-of-function mutations in a component of the bone morphogenetic protein (BMP) signaling pathway, the ACVR1/ALK2 receptor serine-threonine (protein) kinase, causative of Fibrodysplasia Ossificans Progressiva (FOP). All three ALKs (-2, -3, -6) that play roles in bone morphogenesis contribute to trauma-induced HO, hence are well-validated pharmacological targets...
April 4, 2018: Bone
https://www.readbyqxmd.com/read/29626272/a-semi-passive-planar-manipulandum-for-upper-extremity-rehabilitation
#17
Chih-Kang Chang, Edward P Washabaugh, Andrew Gwozdziowski, C David Remy, Chandramouli Krishnan
Robotic rehabilitation is a promising approach to treat individuals with neurological or orthopedic disorders. However, despite significant advancements in the field of rehabilitation robotics, this technology has found limited traction in clinical practice. A key reason for this issue is that most robots are expensive, bulky, and not scalable for in-home rehabilitation. Here, we introduce a semi-passive rehabilitation robot (SepaRRo) that uses controllable passive actuators (i.e., brakes) to provide controllable resistances at the end-effector over a large workspace in a manner that is cost-effective and safe for in-home use...
April 6, 2018: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29625732/healthcare-use-patterns-and-economic-burden-of-chronic-musculoskeletal-pain-in-children-before-diagnosis
#18
Frances Tian, Patsy Guittar, Melissa Moore-Clingenpeel, Gloria Higgins, Stacy P Ardoin, Charles H Spencer, Karla Jones, Bethanne Thomas, Shoghik Akoghlanian, Sharon Bout-Tabaku
OBJECTIVES: To evaluate the healthcare use and costs of amplified musculoskeletal pain syndrome (AMPS) in children before diagnosis. STUDY DESIGN: We performed a retrospective study in children with AMPS at a pediatric rheumatology clinic between 2010 and 2014. Data were abstracted on 80 patients after primary rheumatic diseases were excluded. Healthcare visits, medications and diagnostic testing that occurred in the years before diagnosis were collected. The Medical Expenditure Panel Survey was used to estimate visit costs...
April 3, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29624437/burden-of-care-of-various-infant-orthopedic-protocols-for-improvement-of-nasolabial-esthetics-in-patients-with-cuclp
#19
Emily Singer, John Daskalogiannakis, Kathy A Russell, Ana M Mercado, Ronald R Hathaway, Alicia Stoutland, Ross E Long, Jennifer Fessler, Gunvor Semb, William C Shaw
OBJECTIVES: 1. To evaluate the orthodontic burden of care of nasoalveolar molding (NAM) and modified McNeil for the treatment of patients with complete unilateral cleft lip and palate (CUCLP). 2. To compare the esthetic outcomes of each with those of centers not utilizing infant orthopedics (IO). DESIGN: Retrospective cohort study. SETTING: Institutional. PARTICIPANTS: Four cohorts with repaired CUCLP (n = 149) from 3 centers...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29615019/wearable-sensor-shown-to-specifically-quantify-pruritic-behaviors-in-dogs
#20
Joel D Griffies, Jason Zutty, Marcel Sarzen, Stuart Soorholtz
BACKGROUND: Wearable technology is an exciting new field in humans and animals. In dogs activity monitors have helped to provide objective measurement tools where pet owner observation had been the only source of information. Previous research has focused on measuring overall activity versus rest. This has been relatively useful in determining changes in activity in orthopedic disease or post-surgical cases [Malek et al., BMC Vet Res 8:185, 2012, Yashari et al., BMC Vet Res 11:146, 2015]...
April 3, 2018: BMC Veterinary Research
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