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https://www.readbyqxmd.com/read/28594494/carpal-tunnel-syndrome-initial-management-and-the-treatment-of-recalcitrant-patients
#1
Karan Dua, A Lee Osterman, Joshua M Abzug
Carpal tunnel syndrome (CTS) is a focal compressive neuropathy of the median nerve at the level of the wrist. CTS is the most common type of compressive neuropathy that occurs in the upper extremity. Typically, patients with CTS have paresthesia, pain, and numbness in the radial three and one-half digits. Nighttime symptoms are more common earlier in the disease process, with daytime symptoms becoming more frequent as CTS progresses. Electrodiagnostic studies may be performed to confirm a diagnosis of CTS or to obtain a baseline before surgical treatment; however, electrodiagnostic studies may be normal in a subset of patients who have CTS...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28589215/utilities-of-scrotal-flap-for-reconstruction-of-penile-skin-defects-after-severe-burn-injury
#2
REVIEW
Le Guo, Minghua Zhang, Jizhang Zeng, Pengfei Liang, Pihong Zhang, Xiaoyuan Huang
OBJECTIVE: In the present study, we aimed to present our experience of an effective two-stage surgical approach using scrotal skin flap for patients with penile skin defects following severe burn injury. MATERIALS AND METHODS: A total of 17 patients with penile skin defects underwent scheduled two-stage reconstruction using scrotal skin flap from January 2004 to October 2016. Patients, who were selected as eligible candidates for scrotal flap, exhibited a wide range of indications, including iatrogenic injuries (e...
June 6, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28584515/circumareolar-incision-subdermal-tunneling-dissection-for-excision-of-multiple-breast-fibroadenomata
#3
S O Agodirin, G A Rahman, S A Olatoke, H J Akande
Excision of multiple fibroadenomas (MF) in separate breast quadrants presents difficulties of number and location of incision(s) and extent of tissue dissection and may be associated with more complications and poorer cosmetic outcome. This is a report of excision of MF in multiple quadrants of the breast using a modification of subcutaneous dissection technique dubbed the circumareolar incision and subdermal tunneling (CAST) dissection. After exposure of the superficial fascia with circumareolar incision, subdermal cone-wise dissection was made to allow mobilization of the segment bearing the lump(s)...
January 2017: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/28583617/totally-implantable-intravenous-treprostinil-therapy-in-pulmonary-hypertension-assessment-of-the-implantation-procedure
#4
Aaron B Waxman, Hugh T McElderry, Mardi Gomberg-Maitland, Martin C Burke, Edgar L Ross, Malcolm M Bersohn, Sanjog S Pangarkar, James H Tarver, Diane L Zwicke, Jeremy P Feldman, Murali M Chakinala, Robert P Frantz, Geoffrey B Thompson, Fernando Torres, Richard L Rauck, Kathy Clagg, Louise Durst, Pei Li, Marty Morris, Kara L Southall, Leigh Peterson, Robert C Bourge
BACKGROUND: Prostacyclins improve symptoms and survival in pulmonary arterial hypertension (PAH). In response to risks associated with external delivery systems, an implantable intravenous infusion system was developed. A multicenter, prospective, single-arm, clinical trial (DelIVery for PAH) was conducted to evaluate this system for treprostinil in PAH. This analysis describes the findings related to the implant procedure. METHODS: Patients (n=64) with PAH (WHO Group 1) receiving stable intravenous treprostinil were enrolled...
June 2, 2017: Chest
https://www.readbyqxmd.com/read/28576453/epidemiology-of-infections-and-antimicrobial-use-in-australian-haemodialysis-outpatients-findings-from-a-victorian-surveillance-network-2008-2015
#5
Leon J Worth, Tim Spelman, Steven G Holt, Judith A Brett, Ann L Bull, Michael J Richards
BACKGROUND: Patients with chronic renal failure who require haemodialysis are at high risk for infections. The objectives of this study were to determine the burden of bloodstream and local access-related infections and prescribing patterns for intravenous antibiotics in Australian haemodialysis outpatients. METHODS: A surveillance network was established following stakeholder consultation, with voluntary participation by haemodialysis centres and data collation by the Victorian Healthcare Associated Infection Surveillance System Coordinating Centre...
May 30, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28558699/incidence-of-and-factors-associated-with-catheter-related-bloodstream-infection-in-patients-with-advanced-solid-tumors-on-home-parenteral-nutrition-managed-using-a-standardized-catheter-care-protocol
#6
Pankaj G Vashi, Natasha Virginkar, Brenten Popiel, Persis Edwin, Digant Gupta
BACKGROUND: Catheter-related bloodstream infections (CRBSIs) are associated with high morbidity and mortality as well as increased medical costs. Cancer patients, who are often immunocompromised, are susceptible to CRBSI while receiving home parenteral nutrition (HPN). We evaluated the incidence of and factors associated with CRBSIs in cancer patients undergoing HPN managed using a standardized catheter care protocol. METHODS: This is a retrospective cohort study of 335 cancer patients receiving HPN between January 2012 and July 2015...
May 30, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28540473/innovative-use-of-single-incision-internal-fixation-of-distal-clavicle-fractures-augmented-with-coracoclavicular-stabilisation
#7
Rajpal Nandra, Tomasz Kowalski, Socrates Kalogrianitis
INTRODUCTION: The management of displaced fractures of the distal clavicle remains controversial, particularly in younger patients where there is no consensus as to which surgical intervention is best. Each surgical method has unique surgical complications and rates of persistent pain and post-traumatic arthritis. We report an innovative surgical technique using a plate fixation augmented with minimally invasive tension slide coracoclavicular fixation using a cortical tenodesis button (8...
May 24, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28534038/analysis-of-mitochondrial-transfer-in-direct-co-cultures-of-human-monocyte-derived-macrophages-mdm-and-mesenchymal-stem-cells-msc
#8
Megan V Jackson, Anna D Krasnodembskaya
Mesenchymal stem/stromal cells (MSC) are adult stem cells which have been shown to improve survival, enhance bacterial clearance and alleviate inflammation in pre-clinical models of acute respiratory distress syndrome (ARDS) and sepsis. These diseases are characterised by uncontrolled inflammation often underpinned by bacterial infection. The mechanisms of MSC immunomodulatory effects are not fully understood yet. We sought to investigate MSC cell contact-dependent communication with alveolar macrophages (AM), professional phagocytes which play an important role in the lung inflammatory responses and anti-bacterial defence...
May 5, 2017: Bio-protocol
https://www.readbyqxmd.com/read/28514785/effect-of-age-on-the-association-of-vascular-access-type-with-mortality-in-a-cohort-of-incident-end-stage-renal-disease-patients
#9
Tarek Saleh, Keiichi Sumida, Miklos Z Molnar, Praveen K Potukuchi, Fridtjof Thomas, Jun Ling Lu, Geeta G Gyamlani, Elani Streja, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
BACKGROUND/AIMS: All hemodialysis (HD) patients are generally recommended to create a fistula first; but to create a mature arteriovenous fistula (AVF) can be challenging in elderly individuals. It is unclear if elderly incident HD patients derive a survival benefit from an AVF over an arteriovenous graft (AVG) or a tunneled central venous catheter (TDC). METHODS: We examined the association of vascular access type (AVF, AVG, and TDC with and without a maturing AVF/AVG at dialysis transition) at HD initiation with all-cause, cardiovascular (CV), and infection-related mortality in 46,786 US veterans using Cox models with adjustment for confounders...
May 18, 2017: Nephron
https://www.readbyqxmd.com/read/28485472/relevance-of-the-main-postharvest-handling-operations-on-the-development-of-brown-rot-disease-on-stone-fruits
#10
M Bernat, J Segarra, C Casals, N Teixidó, R Torres, J Usall
BACKGROUND: Brown rot caused by Monilinia spp. is one of the most important postharvest diseases of stone fruit. The aim of this study was evaluate the relevance of the main postharvest operations of fruit; hydrocooling, cold room, water dump, sorting and cooling tunnel in the development of M. laxa on peaches and nectarines artificially infected 48, 24 or 2 hours before postharvest operations. RESULTS: Commercial hydrocooling operation reduced incidence to 10 % in 'Pp 100' nectarine inoculated 2 and 24 hours before this operation however in 'Fantasia' nectarine incidence was not reduced, although lesion diameter was decreased in all studied varieties...
May 9, 2017: Journal of the Science of Food and Agriculture
https://www.readbyqxmd.com/read/28481066/-utility-of-ultrasonography-in-the-placement-of-long-term-venous-catheters-in-newborns-and-infants
#11
P Y Reyes Ríos, O Girón Vallejo, R Ruiz Pruneda, I Martínez Castaño, J Rojas Ticona, V Villamil, J I Ruiz Jiménez
OBJETIVES: The implantation of long duration intravenous catheters in pediatric population constitutes a challenge due to the size of vascular structures. Because of that, ultrasound is an important tool for vascular accesses in newborns and infants. The objective is to analyze our experience in ultrasound-guided implantation of reservoir type and tunneled catheters, as well as to compare it between both age groups. MATERIAL AND METHODS: Review of the ultrasound-guided implantable catheters placed from October 2010 to December 2014 in children under 18 months...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28455661/modified-laparoscopic-placement-of-peritoneal-dialysis-catheter-with-intra-abdominal-fixation
#12
Quanquan Shen, Xinxin Jiang, Xiaogang Shen, Fangyan Yu, Qiudi Tu, Wangfang Chen, Qing Ye, Tapas Ranjan Behera, Qiang He
PURPOSE: Peritoneal dialysis (PD) is a commonly accepted method of treating end-stage renal disease (ESRD). Various laparoscopic techniques for the placement of PD catheter have been described. In this study, we developed a novel modified laparoscopic technique for PD catheter placement and evaluated the early results. METHODS: A straight Tenckhoff PD catheter was placed employing the modified technique in 39 consecutive patients with ESRD from May 2013 to April 2016...
April 28, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28442933/drainage-of-malignant-ascites-patient-selection-and-perspectives
#13
REVIEW
Maciej Stukan
Malignant ascites (MA) is a sign of advanced cancer and poor prognosis. MA can result in impairment in quality of life (QOL) and significant symptoms. As a supportive treatment, ascites can be drained by paracentesis (PC), percutaneously implanted catheters (tunneled, untunneled, central venous catheters), or peritoneal ports, or peritoneovenous shunts. The aim of this study was to evaluate the effectiveness, safety, and patient-reported outcomes (PRO) of different drainage methods for the management of MA...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/28438411/magnetic-resonance-imaging-of-the-digital-nerves-of-the-hand-anatomy-and-spectrum-of-pathology
#14
REVIEW
Charles H Mitchell, Laura M Fayad, Shivani Ahlawat
Digital nerves are intrinsic to the sensory and motor function of the hand. These nerves represent the terminal ramifications of the ulnar, median, and radial nerves and are located distal to the carpal tunnel and Guyon canal. With magnetic resonance imaging, traumatic and nontraumatic abnormalities of the digital nerves can be shown with high contrast as well as high spatial resolution. Digital nerve abnormalities are most commonly posttraumatic in nature; however, infection, inflammatory, vascular malformations, and neoplasms can rarely occur...
March 6, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/28429519/the-incidence-and-costs-of-bacteremia-due-to-lack-of-gentamicin-lock-solutions-for-dialysis-catheters
#15
Tze Liang Goh, Jason Wei, David Semple, John Collins
The use of antibiotic lock solutions as prophylaxis for catheter-associated blood stream infection (CRBSI) has been shown to be effective in previous randomized controlled trials. However, the cost-effectiveness of this approach had not been studied. In 2012, the routine gentamicin-heparin lock solution used in Auckland City Hospital was withdrawn from the market, leading to a change to heparin-only lock. This was then replaced with gentamicin-citrate lock in 2014. This situation allowed review of the CRBSI rate and financial impact of different catheter lock solutions...
June 2017: Nephrology
https://www.readbyqxmd.com/read/28426468/indwelling-tunneled-pleural-catheters-for-the-management-of-hepatic-hydrothorax
#16
Kevin P Haas, Alexander C Chen
PURPOSE OF REVIEW: Hepatic hydrothorax is a complication of end-stage liver disease that may have significant associated morbidity. Sodium restriction and diuretic therapy are the mainstays of treatment, though up to a quarter of patients will become refractory to this and will require a pleural drainage procedure. Thoracentesis, transjugular intrahepatic portosystemic shunt, and chemical pleurodesis all have variable success rates and associated complications in the management of hepatic hydrothorax...
July 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28422870/case-report-the-first-case-of-achromobacter-xylosoxidans-related-tunnel-infection-in-a-patient-receiving-peritoneal-dialysis
#17
Jun-Li Tsai, Shang-Feng Tsai
RATIONALE: Achromobacter xylosoxidans infection is mostly reported in immunocompromised patients. Until now, it is still rarely reported in patients undergoing peritoneal dialysis. PATIENT CONCERNS: This is the 1st case of A xylosoxidans infection due to tunnel infection of a Tenckhoff catheter. DIAGNOSIS: The diagnosis was confirmed by the report of culture. INTERVENTIONS: Risk factors for this infection in peritoneal dialysis include uremia with an immunocompromised state, contamination due to inexperienced skills, and aqueous environment of the dialysate...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28419808/outcomes-after-1-stage-versus-2-stage-revision-anterior-cruciate-ligament-reconstruction
#18
Justin J Mitchell, Jorge Chahla, Chase S Dean, Mark Cinque, Lauren M Matheny, Robert F LaPrade
BACKGROUND: Revision anterior cruciate ligament reconstruction (ACLR) is becoming increasingly common as the number of primary ACLR cases continues to rise. Despite this, there are limited data on the outcomes of revision ACLR and even less information specifically addressing the differences in 1-stage revision reconstruction versus those performed in a 2-stage fashion after primary reconstruction. PURPOSE: To compare the outcomes, patient satisfaction, and failure rates of 1-stage versus 2-stage revision ACLR...
April 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28390069/antimicrobial-agents-for-preventing-peritonitis-in-peritoneal-dialysis-patients
#19
REVIEW
Denise Campbell, David W Mudge, Jonathan C Craig, David W Johnson, Allison Tong, Giovanni Fm Strippoli
BACKGROUND: Peritoneal dialysis (PD) is an important therapy for patients with end-stage kidney disease and is used in more than 200,000 such patients globally. However, its value is often limited by the development of infections such as peritonitis and exit-site and tunnel infections. Multiple strategies have been developed to reduce the risk of peritonitis including antibiotics, topical disinfectants to the exit site and antifungal agents. However, the effectiveness of these strategies has been variable and are based on a small number of randomised controlled trials (RCTs)...
April 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28389838/intramedullary-nail-versus-volar-locking-plate-fixation-for-the-treatment-of-extra-articular-or-simple-intra-articular-distal-radius-fractures-systematic-review-and-meta-analysis
#20
REVIEW
Bing Zhang, Hengrui Chang, Kunlun Yu, Jiangbo Bai, Dehu Tian, Guisheng Zhang, Xinzhong Shao, Yingze Zhang
AIMS: This study aims to compare the outcomes of intramedullary nail (IMN) and volar locking plate (VLP) fixation for treatment of extra-articular or simple intra-articular distal radius fractures. METHODS: PubMed, Embase, Medline and Cochrane Collaboration Central databases were searched for studies that compared the results of IMN and VLP fixation for the treatment of distal radius fractures up to March 2016. Stata 11.0 was used to perform the meta-analysis. RESULTS: Six randomized controlled trials (RCT) and two retrospective studies were included in this review, including 463 patients...
April 7, 2017: International Orthopaedics
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