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https://www.readbyqxmd.com/read/29053501/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-tibia-fracture-pearls-and-pitfalls
#1
Steven A Lovejoy, Charles T Mehlman
Tibial fractures in children present a wide array of challenges to the managing orthopaedic surgeon. Injuries cover a spectrum from subtle tibial spine fractures to comminuted high-energy shaft fractures requiring free flap coverage. Significant risks range from malunion and leg length discrepancy to infected nonunions and Volkmann ischemic contracture. This article offers evidence and experience-based advice that is aimed at helping the community orthopaedic surgeon taking call.
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29053430/gastrointestinal-parasitic-infections-in-dead-or-debilitated-moose-alces-alces-in-sweden
#2
Giulio Grandi, Henrik Uhlhorn, Erik Ågren, Torsten Mörner, Federico Righi, Eva Osterman-Lind, Aleksija Neimanis
Our objectives were to determine prevalence and intensity of gastrointestinal parasites of dead or euthanized emaciated moose in central and southern Sweden (n=50) and to assess parasite intensity as a major contributing factor in the poor condition of these moose. All animals were infected and most had gastrointestinal nematodes. Seven parasite species were found in the abomasa and 10 species were found in the small intestine. Coinfections were commonly found in the abomasum (Ostertagia antipini and Mazamastrongylus dagestanica) and in the small intestine (Nematodirella alcidis and Trichostrongylus capricola)...
October 20, 2017: Journal of Wildlife Diseases
https://www.readbyqxmd.com/read/29052751/-prevention-of-infections-due-to-musculoskeletal-allografts
#3
REVIEW
A Pruß
Transplantation of musculoskeletal tissues is widely used in the treatment of extensive defects of the musculoskeletal system, especially in orthopedics for exchange of prostheses, surgical interventions on the spine and in traumatology for reconstruction after extensive tumor resections. A danger after transplantation is the potential transmission of clinically relevant pathogens. Tissue banks have therefore established a safety level approach for musculoskeletal tissue transplants, which includes donor selection, laboratory testing, tissue procurement, tissue processing, tissue storage and quality assurance...
October 20, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29052036/rapidly-increasing-incidence-in-scoliosis-surgery-over-14%C3%A2-years-in-a-nationwide-sample
#4
Johan von Heideken, Maura D Iversen, Paul Gerdhem
PURPOSE: Severe scoliosis is primarily managed with surgery. This cohort study describes the incidence of surgically treated scoliosis among Swedish youth and young adults, stratified by age, sex, scoliosis type, and surgical approach and identifies changes in incidence rate and hospital length of stay (LOS), infections requiring re-surgery and mortality within 90 days. METHODS: Swedish youth, 0-21 years, (n = 3062) with a diagnostic code for scoliosis and spine surgery between 2000 and 2013 were selected from the National Patient Register...
October 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29050716/postoperative-spine-dressing-changes-are-unnecessary
#5
Ravi S Bains, Mayur Kardile, Lance K Mitsunaga, Sukhraj Bains, Nirmal Singh, Cary Idler
INTRODUCTION: There is minimal literature regarding when dressing changes should be performed. We present the dressing change protocol adopted by our institution. The purpose of this study was to provide an update of our experience with this dressing change protocol over a 15-year period. METHODS: Effective January 2005, we implemented our universal protocol of no dressing changes for five days after surgery. Reviewing a health system administrative database, all spine surgery cases involving instrumentation performed at our institution were captured...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29050042/-therapy-of-spondylodiscitis-by-severity
#6
Nadine Homagk, Tina Jarmuzek, Gunther O Hofmann, Lars Homagk
Spondylodiscitis is a rare but serious infection of the spine. Recognised methods of treatment include immobilisation and systemic antibiotics. However, available data for specific and recommendations for continuing treatment are also rare. The aim of the present study is the optimisation of the therapy of spondylodiscitis using a clinical pathway that depends on a classification of spondylodiscitis. From 1 October 1998 to 31 December 2013, a classification of the severity of spondylodiscitis was established, including specific treatment recommendations...
October 19, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29049254/one-stage-posterior-approaches-for-treatment-of-thoracic-spinal-infection-transforaminal-and-costotransversectomy-compared-with-anterior-approach-with-posterior-instrumentation
#7
Fu-Cheng Kao, Tsung-Ting Tsai, Chi-Chien Niu, Po-Liang Lai, Lih-Huei Chen, Wen-Jer Chen
Treating thoracic infective spondylodiscitis with anterior surgical approaches carry a relatively high risk of perioperative and postoperative complications. Posterior approaches have been reported to result in lower complication rates than anterior procedures, but more evidence is needed to demonstrate the safety and efficacy of 1-stage posterior approaches for treating infectious thoracic spondylodiscitis.Preoperative and postoperative clinical data, of 18 patients who underwent 2 types of 1-stage posterior procedures, costotransversectomy and transforaminal thoracic interbody debridement and fusion and 7 patients who underwent anterior debridement and reconstruction with posterior instrumentation, were retrospectively assessed...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29037974/impact-of-early-unanticipated-revision-surgery-on-health-related-quality-of-life-after-adult-spinal-deformity
#8
Susana Núñez-Pereira, Alba Vila-Casademunt, Montse Domingo-Sàbat, Juan Bagó, Emre R Acaroglu, Ahmet Alanay, Ibrahim Obeid, Francisco Javier Sánchez Pérez-Grueso, Frank Kleinstück, Ferran Pellisé
Background context Revision surgery represents a major event for patients undergoing ASD surgery. Previous reports suggest minimal or no impact on HRQOL outcomes. Purpose To investigate the impact of early reoperations within the first year on health-related quality of life (HRQOL) and on the likelihood of reaching the MCID after ASD surgery. Design Retrospective analysis of prospectively collected data from consecutive surgically treated adult deformity surgery (ADS) patients included in a multicenter, international database...
October 13, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29033574/surgical-site-infections-following-instrumented-stabilization-of-the-spine
#9
Ulrike Dapunt, Caroline Bürkle, Frank Günther, Wojciech Pepke, Stefan Hemmer, Michael Akbar
BACKGROUND: Implant-associated infections are still a feared complication in the field of orthopedics. Bacteria attach to the implant surface and form so-called biofilm colonies that are often difficult to diagnose and treat. Since the majority of studies focus on prosthetic joint infections (PJIs) of the hip and knee, current treatment options (eg, antibiotic prophylaxis) of implant-associated infections have mostly been adapted according to these results. OBJECTIVE: The aim of this study was to evaluate patients with surgical site infections following instrumented stabilization of the spine with regard to detected bacteria species and the course of the disease...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29026635/lytic-lesions-looking-lethal-but-leaving-room-for-a-simple-cure-a-case-of-veillonella-spinal-osteomyelitis
#10
Sarah Baker, Rebecca Allyn
Introduction. Diagnosing clinically significant infection caused by Veillonella species can be a challenge. Veillonella species are usually found in polymicrobial processes and are often regarded as a contaminant. Additionally, they are slow to grow in culture and this can lead to a delay in diagnosis or a missed diagnosis. Veillonella species rarely cause serious infections, but have been found to cause bacteraemia and osteomyelitis. Case presentation. A 67-year-old man with a history of treated prostate cancer presented with 2 weeks of progressive lower back pain and weakness...
August 2017: JMM Case Reports
https://www.readbyqxmd.com/read/29024614/staphylococcus-aureus-infections-in-german-patients-with-type-2-diabetes-mellitus-after-orthopedic-surgery-incidence-risk-factors-and-clinical-and-health-economic-outcomes
#11
Fraence Gottschalk, Thomas Wilke, Sabrina Mueller, Kirstin Heinrich, Ulf Maywald, Andreas Fuchs, Holly Yu
BACKGROUND: This study assessed Staphylococcus aureus infection risk in patients with type 2 diabetes mellitus (T2DM) undergoing an orthopedic knee, hip, or spine surgery. PATIENTS AND METHODS: All patients with a diagnosis of T2DM in the period from 2010 to 2012 were identified from a German claims database. First inpatient knee, hip, or spine surgery was used as index date. Cumulative incidence of S. aureus infections was calculated for several time intervals...
October 12, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29023477/possible-cases-of-leprosy-from-the-late-copper-age-3780-3650-cal-bc-in-hungary
#12
Kitti Köhler, Antónia Marcsik, Péter Zádori, Gergely Biro, Tamás Szeniczey, Szilvia Fábián, Gábor Serlegi, Tibor Marton, Helen D Donoghue, Tamás Hajdu
At the Abony-Turjányos dűlő site, located in Central Hungary, a rescue excavation was carried out. More than 400 features were excavated and dated to the Protoboleráz horizon, at the beginning of the Late Copper Age in the Carpathian Basin, between 3780-3650 cal BC. Besides the domestic and economic units, there were two special areas, with nine-nine pits that differed from the other archaeological features of the site. In the northern pit group seven pits contained human remains belonging to 48 individuals...
2017: PloS One
https://www.readbyqxmd.com/read/29022646/low-skeletal-mass-is-an-important-predictor-of-osteoporosis-in-hiv-infected-men-in-india
#13
Deep Dutta, Meha Sharma, Rahul Bansal, Neera Sharma, Umesh Chandra Garga, Atul Anand, Kumar Gaurav
INTRODUCTION: This study evaluated prevalence and predictors of osteoporosis and sarcopenia in men with HIV. MATERIAL AND METHODS: 220 men with HIV were screened, of which 115 men, 30-50 years-age, having at least 1-year follow-up, underwent hormonal and DEXA analysis. 40 controls were also evaluated. RESULTS: Males with HIV had significantly lower BMD and Z-scores at all sites. Osteoporosis was diagnosed in 64.35%; commonest site being radius total (49...
October 12, 2017: Endokrynologia Polska
https://www.readbyqxmd.com/read/29020329/vitamin-d3-supplementation-increases-spine-bone-mineral-density-in-adolescents-and-young-adults-with-hiv-infection-being-treated-with-tenofovir-disoproxil-fumarate-a-randomized-placebo-controlled-trial
#14
Peter L Havens, Charles B Stephensen, Marta D Van Loan, Gertrud U Schuster, Leslie R Woodhouse, Patricia M Flynn, Catherine M Gordon, Cynthia G Pan, Brandy Rutledge, D Robert Harris, Georgine Price, Alyne Baker, William A Meyer, Craig M Wilson, Rohan Hazra, Bill G Kapogiannis, Kathleen Mulligan
Background: Tenofovir disoproxil fumarate (TDF) decreases bone mineral density (BMD). We hypothesized vitamin D3 (VITD3) would increase BMD in youth receiving TDF. Methods: Randomized double-blind placebo-controlled trial of directly observed VITD3 vs. placebo every 4 weeks for 48 weeks in youth ages 16-24 years with HIV, viral load <200 copies/mL, taking TDF-containing combination antiretroviral therapy (TDF-cART) for ≥180 days. Participants (N=214) received a daily multivitamin containing VITD3 400 IU and calcium 162 mg, plus monthly randomized VITD3 50,000 IU (N=109) or placebo (N=105)...
August 21, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29016441/epidemiology-and-outcomes-of-infectious-spondylodiscitis-in-hemodialysis-patients
#15
Yueh-An Lu, Wei-Chiao Sun, George Kuo, Chao-Yu Chen, Huang-Kai Kao, YuJr Lin, Chia-Hui Lee, Cheng-Chieh Hung, Ya-Chung Tian, Yu-Shien Ko, Hsiang-Hao Hsu
STUDY DESIGN: A retrospective study of patients who were hospitalized for infectious spondylodiscitis over a 13 year period. OBJECTIVE: To elucidate the epidemiology and prognostic factors of infectious spondylodiscitis in hemodialysis (HD) patients and to identify the impact of HD on infectious spondylodiscitis. SUMMARY OF BACKGROUND DATA: Only a few case studies of infectious spondylodiscitis in HD patients can be found in the literature...
October 9, 2017: Spine
https://www.readbyqxmd.com/read/29016436/trends-and-disparities-in-cervical-spine-fusion-procedures-utilization-in-the-new-york-state
#16
Rui Feng, Mark Finkelstein, Khawaja Bilal, Eric K Oermann, Michael Palese, John Caridi
STUDY DESIGN: A retrospective review of the Statewide Planning and Research Cooperative System database of the New York State. OBJECTIVE: This study examined the rate of increase of cervical spine fusion procedures at low-, medium-, and high-volume hospitals, and analyzed racial and socioeconomic characteristics of the patient population treated at these three volume categories. SUMMARY OF BACKGROUND DATA: There has been a steady increase in spinal fusion procedures performed each year in the US, especially cervical and lumbar fusion...
October 9, 2017: Spine
https://www.readbyqxmd.com/read/29016434/hypoalbuminemia-is-associated-with-septic-revisions-after-primary-surgery-and-post-operative-infection-after-revision-surgery
#17
Krishn Khanna, Paul H Yi, David C Sing, Erik Geiger, Lionel N Metz
STUDY DESIGN: Retrospective Database Review OBJECTIVE.: To determine (1) the relationship between hypoalbuminemia and body mass index (BMI); (2) the association between malnutrition and revision spine surgery for septic reasons; (3) the association between malnutrition and infection after aseptic revision spine surgery. SUMMARY OF BACKGROUND DATA: Although malnutrition has been suggested to increase the risk of infection after spine surgery, evidence supporting this hypothesis is conflicting...
October 9, 2017: Spine
https://www.readbyqxmd.com/read/28987945/simvastatin-exerts-antifibrotic-effect-and-potentiates-the-antischistosomal-effects-of-praziquantel-in-a-murine-model-role-of-il10
#18
Ahlam Elmasry, Nabil M Aladeeb, Amro Elkaref, Nora Aboulfotouh
Previous studies on simvastatin use in experimental schistosomiasis in mice did not provide a full explanation of its mechanism as antischisome. In this study, we tried to find out the role of IL-10 in the mechanism of action of simvastatin. We used 50 clear mice. Ten were used as normal not treated while 40 were infected with shistosome mansoni then divided into 4 groups; 3 treated groups by praziquantel, simvastatin and combined (praziquantel plus simvastatin) respectively and one group non-treated. The simvastatin treated group showed shortening and loss of the tubercles and disappearance of the spines with swelling and twisted shape of the worms...
October 6, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28987196/overview-of-neuroradiology
#19
Elna-Marie Larsson, Johan Wikström
Neuroradiology with computed tomography (CT) and magnetic resonance imaging (MRI) is essential for the initial evaluation of patients with a clinical suspicion of brain and spine disorders. Morphologic imaging is required to obtain a probable diagnosis to support the treatment decisions in pre- and perinatal disorders, vascular diseases, traumatic injuries, metabolic disorders, epilepsy, infection/inflammation, neurodegenerative disorders, degenerative spinal disease, and tumors of the central nervous system...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28986051/effect-of-intermediate-dose-dexamethasone-on-post-operative-pain-in-lumbar-spine-surgery-a-randomized-triple-blind-placebo-controlled-trial
#20
Aumjit Wittayapairoj, Kriangkrai Wittayapairoj, Atiporn Kulawong, Yuwadee Huntula
OBJECTIVES: Dexamethasone has demonstrated analgesic properties and is used as an adjunctive pain agent for many procedures. We evaluated the efficacy of a single, intermediate dose of dexamethasone on post-operative analgesic consumption, and pain scores for lumbar spine surgery. METHODS: Eighty patients aged between 18 and 70 scheduled for lumbar decompressive laminectomy were randomly allocated into two groups to receive either intravenous 0.2 mg/kg dexamethasone (group D = 40) or normal saline (group P = 40) before anesthetic induction...
September 18, 2017: Asian J Anesthesiol
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