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https://www.readbyqxmd.com/read/29053904/a-direct-aspiration-first-pass-technique-adapt-for-acute-stroke-therapy-a-systematic-review-and-meta-analysis
#1
Benjamin Gory, Xavier Armoiry, Rotem Sivan-Hoffman, Michel Piotin, Mikael Mazighi, Bertrand Lapergue, Raphaël Blanc, Francis Turjman
BACKGROUND AND PURPOSE: ADAPT (A Direct Aspiration First Pass Technique), involving the first-line use of large-bore distal aspiration catheter, is a new strategy in the mechanical thrombectomy of acute ischemic stroke caused by large vessel occlusion. However, its impact on reperfusion rates, clinical outcomes, and complication rates is not fully examined. METHOD: We conducted a systematic review of the literature searching multiple databases for reports on thrombectomy of acute stroke with the ADAPT technique and performed meta-analyses of clinical and radiographic outcomes...
October 20, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29053497/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-phalangeal-fracture-pearls-and-pitfalls
#2
Joshua M Abzug, Charles T Mehlman
Pediatric phalangeal fractures are extremely common, especially among toddlers and older children/adolescents involved in sporting activities. The physical examination must include an assessment for deviation and malrotation. In addition, concomitant injuries must be assessed for such as tendon and/or neurovascular injuries. Plain radiographs are typically sufficient to make the diagnosis and determine the treatment. The majority of pediatric and adolescent phalangeal fractures can be treated with immobilization...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29053075/machine-learning-applied-to-neuroimaging-for-diagnosis-of-adult-classic-chiari-malformation-role-of-the-basion-as-a-key-morphometric-indicator
#3
Aintzane Urbizu, Bryn A Martin, Dulce Moncho, Alex Rovira, Maria A Poca, Juan Sahuquillo, Alfons Macaya, Malena I Español
OBJECTIVE The current diagnostic criterion for Chiari malformation Type I (CM-I), based on tonsillar herniation (TH), includes a diversity of patients with amygdalar descent that may be caused by a variety of factors. In contrast, patients presenting with an overcrowded posterior cranial fossa, a key characteristic of the disease, may remain misdiagnosed if they have little or no TH. The objective of the present study was to use machine-learning classification methods to identify morphometric measures that help discern patients with classic CM-I to improve diagnosis and treatment and provide insight into the etiology of the disease...
October 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29053073/chronic-subthreshold-cortical-stimulation-for-adult-drug-resistant-focal-epilepsy-safety-feasibility-and-technique
#4
Panagiotis Kerezoudis, Sanjeet S Grewal, Matthew Stead, Brian Nils Lundstrom, Jeffrey W Britton, Cheolsu Shin, Gregory D Cascino, Benjamin H Brinkmann, Gregory A Worrell, Jamie J Van Gompel
OBJECTIVE Epilepsy surgery is effective for lesional epilepsy, but it can be associated with significant morbidity when seizures originate from eloquent cortex that is resected. Here, the objective was to describe chronic subthreshold cortical stimulation and evaluate its early surgical safety profile in adult patients with epilepsy originating from seizure foci in cortex that is not amenable to resection. METHODS Adult patients with focal drug-resistant epilepsy underwent intracranial electroencephalography monitoring for evaluation of resection...
October 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29052829/esin-and-k-wire-fixation-have-similar-results-in-pediatric-both-bone-diaphyseal-forearm-fractures
#5
Namık Şahin, Yavuz Akalın, Oğuz Türker, Güven Özkaya
BACKGROUND: The purpose of this study was to compare short-term radiographic and clinical results of pediatric both-bone diaphyseal forearm fractures treated with intramedullary nail fixation using titanium nails or K-wires. METHODS: This was a prospective comparative trial. In total, 43 patients with both-bone open or closed forearm fractures who underwent surgical treatment with intramedullary fixation were randomly classified into two groups. Three patients did not return for the follow-up and were excluded from the study...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29052827/primary-exploration-for-radial-nerve-palsy-associated-with-unstable-closed-humeral-shaft-fracture
#6
Soo Hong Han, In Tae Hong, Ho Jae Lee, Sang June Lee, Uk Kim, Dong Won Kim
BACKGROUND: The treatment of radial nerve palsy caused by closed humeral shaft fracture is a matter of debate. The purpose of this study is to evaluate the outcome of early surgical management of radial nerve palsy in patients with unstable closed humeral shaft fractures and to determine whether patients with this injury should be surgically explored. METHODS: Medical records of 15 consecutive patients who had undergone open reduction and internal fixation for unstable closed humeral shaft fractures were reviewed...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29052813/exploration-for-reliable-radiographic-assessment-method-for-hinge-like-hypermobility-at-atlanto-occipital-joint
#7
Shinjiro Kaneko, Ken Ishii, Kota Watanabe, Takashi Tsuji, Masaya Nakamura, Morio Matsumoto, Yoshiyuki Yato, Takashi Asazuma
PURPOSE: Hinge-like hyper-mobility is occasionally observed at the atlanto-occipital (O-C1) joint. However, it has not been clear if this kind of hinge-like hyper-mobility at the O-C1 joint should be regarded as "pathologic", or referred to as "instability". To solve this issue, we aimed to establish a reliable radiographic assessment method for this specific type of O-C1 instability and figure out the "standard value" for the range of motion (ROM) of the O-C1 joint. METHODS: To figure out the standard range of the O-C1 angle, we acquired magnetic resonance imaging (MRI) sagittal views of the cervical spine for 157 healthy volunteers [average: 37...
October 20, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29052774/intrathoracic-tuberculous-lymphadenopathy-in-children-a-guide-to-chest-radiography
#8
REVIEW
Anthony George, Savvas Andronikou, Tanyia Pillay, Pierre Goussard, Heather J Zar
Making the diagnosis of pulmonary tuberculosis in children can be difficult because microbiological confirmation is not often achieved. Diagnosis is therefore often based on clinical features in combination with chest radiograph findings. Chest radiographs can demonstrate lymphadenopathy of the hilar and para-tracheal regions on the anteroposterior view, and subcarinal lymphadenopathy on the lateral view. However poor interobserver agreement has been reported for radiologist and clinician assessment of lymphadenopathy...
September 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29052771/standardized-radiographic-interpretation-of-thoracic-tuberculosis-in-children
#9
REVIEW
Nathan David P Concepcion, Bernard F Laya, Savvas Andronikou, Pedro A N Daltro, Marion O Sanchez, Jacqueline Austine U Uy, Timothy Reynold U Lim
There is a lack of standardized approach and terminology to classify the diverse spectrum of manifestations in tuberculosis. It is important to recognize the different clinical and radiographic patterns to guide treatment. As a result of changing epidemiology, there is considerable overlap in the radiologic presentations of primary tuberculosis and post-primary tuberculosis. In this article we promote a standardized approach in clinical and radiographic classification for children suspected of having or diagnosed with childhood tuberculosis...
September 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/29052742/-triple-arthrodesis-for-correction-of-cavovarus-deformity
#10
REVIEW
A Barg, R Ruiz, B Hintermann
OBJECTIVE: The aim is to correct the underlying cavovarus deformity and to achieve a pain-free and stable hindfoot. INDICATIONS: Rigid neurologic, posttraumatic, congenital, and idiopathic cavovarus deformities. CONTRAINDICATIONS: General surgical or anesthesiological risks, infections, critical soft tissue conditions, neurovascular impairment of the lower extremity, noncompliance, patients with severely reduced bone quality, insulin-dependent diabetes mellitus, smoking...
October 20, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29052522/predictors-of-diffuse-alveolar-damage-in-patients-with-acute-respiratory-distress-syndrome-a-retrospective-analysis-of-clinical-autopsies
#11
Arnaud W Thille, Oscar Peñuelas, José A Lorente, Pilar Fernández-Segoviano, José-Maria Rodriguez, José-Antonio Aramburu, Julian Panizo, Andres Esteban, Fernando Frutos-Vivar
BACKGROUND: Although diffuse alveolar damage (DAD) is considered the typical histological pattern of acute respiratory distress syndrome (ARDS), only half of patients exhibit this morphological hallmark. Patients with DAD may have higher mortality than those without DAD. Therefore, we aimed to identify the factors associated with DAD in patients with ARDS. METHODS: We analyzed autopsy samples of 356 patients who had ARDS at the time of death. DAD was assessed by two pathologists, and ARDS criteria were evaluated by two intensivists...
October 20, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29052336/radiographic-and-clinical-outcomes-of-rooted-platform-switched-microthreaded-implants-with-a-sandblasted-large-grid-and-acid-etched-surface-a-5-year-prospective-study
#12
Dong Mei Mei, Baodong Zhao, Hao Xu, Yanhui Wang
BACKGROUND: There is no data available on the long-term outcomes of a rooted, platform-switched, microthreaded implant with a sandblasted, large-grid, and acid-etched surface. PURPOSE: This prospective, longitudinal study evaluated the clinical and radiographic outcomes of rooted, platform-switched, microthreaded and sandblasted, large-grid, and acid-etched (SLA) surface implants for 5 years. MATERIALS AND METHODS: Sixty implants were placed in sixty patients with partially edentulous maxillae or mandibles...
October 20, 2017: Clinical Implant Dentistry and related Research
https://www.readbyqxmd.com/read/29052037/effects-of-mirror-placement-on-sagittal-alignment-of-the-spine-during-acquisition-of-full-spine-standing-x-rays
#13
Shin Oe, Daisuke Togawa, Go Yoshida, Tomohiko Hasegawa, Yu Yamato, Tatsuya Yasuda, Tomohiro Banno, Hideyuki Arima, Yuki Mihara, Hiroki Ushirozako, Yukihiro Matsuyama
PURPOSE: The line of sight when whole-spine radiographs are taken has not been defined. In our 2012 health screening study (TOEI study), whole-spine radiographs were taken with the volunteers in the most relaxed position and with a horizontal gaze. However, in the TOEI 2014 study, a mirror was placed in front of their faces to unify their line of sight. To our knowledge, there are no reports on how the sagittal alignment changes when radiographs are taken using a mirror. The purpose of this study was to investigate how mirror placement impacted sagittal spinal alignment in whole-spine radiographs taken while standing...
October 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29052011/the-smartphone-inclinometer-a-new-tool-to-determine-elbow-range-of-motion
#14
Frédéric Vauclair, Abdulaziz Aljurayyan, Fahad H Abduljabbar, Bardia Barimani, Patrick Goetti, Fiona Houghton, Edward J Harvey, Dominique M Rouleau
BACKGROUND: There are easily accessible tools on smartphones (APP) for measuring elbow range of motion (ROM). The purpose of this study is to evaluate the validity of a particular APP in determining elbow ROM in comparison with the commonly used goniometer (GON), surgeon estimation of range (EST) and measurement on X-ray (XR). METHODS: The study included 20 patients (40 elbows). Flexion, extension, pronation and supination were measured using three different methods: EST, GON and APP...
October 19, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29051921/effectiveness-of-schroth-exercises-during-bracing-in-adolescent-idiopathic-scoliosis-results-from-a-preliminary-study-sosort-award-2017-winner
#15
Kenny Yat Hong Kwan, Aldous C S Cheng, Hui Yu Koh, Alice Y Y Chiu, Kenneth Man Chee Cheung
BACKGROUND: Bracing has been shown to decrease significantly the progression of high-risk curves to the threshold for surgery in patients with adolescent idiopathic scoliosis (AIS), but the treatment failure rate remains high. There is evidence to suggest that Schroth scoliosis-specific exercises can slow progression in mild scoliosis. The aim of this study was to evaluate the efficacy of Schroth exercises in AIS patients with high-risk curves during bracing. METHODS: A prospective, historical cohort-matched study was carried out...
2017: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/29051906/intra-articular-physeal-fractures-of-the-distal-femur-a-frequently-missed-diagnosis-in-adolescent-athletes
#16
Andrew T Pennock, Henry B Ellis, Samuel C Willimon, Charles Wyatt, Samuel E Broida, M Morgan Dennis, Tracey Bastrom
BACKGROUND: Intra-articular physeal fractures of the distal femur are an uncommon injury pattern, with only a few small case series reported in the literature. PURPOSE: To pool patients from 3 high-volume pediatric centers to better understand this injury pattern, to determine outcomes of surgical treatment, and to assess risk factors for complications. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A multicenter retrospective review of all patients presenting with an intra-articular physeal fracture between 2006 and 2016 was performed...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29051901/fresh-osteochondral-allograft-transplantation-for-spontaneous-osteonecrosis-of-the-knee-a-case-series
#17
Luís E P Tírico, Samuel A Early, Julie C McCauley, William D Bugbee
BACKGROUND: Spontaneous osteonecrosis of the knee (SONK) is a clinical entity identified by acute knee pain usually associated with joint effusion, with radiographic findings of a radiolucent defect on the weightbearing area of the femoral condyle. Conservative treatment is initially undertaken; however, surgical procedures are often necessary. Historically, surgical options have included core decompression, cartilage repair, high tibial osteotomy, or joint arthroplasty. Few studies in the literature have reported the use of fresh osteochondral allograft (OCA) for the treatment of SONK lesions...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29051898/accuracy-of-the-lever-sign-test-in-the-diagnosis-of-anterior-cruciate-ligament-injuries
#18
Keith A Jarbo, David E Hartigan, Kelly L Scott, Karan A Patel, Anikar Chhabra
BACKGROUND: The lever sign test is a new physical examination tool to diagnose anterior cruciate ligament (ACL) tears. Preliminary results suggest almost 100% sensitivity and specificity to diagnose acute and chronic complete ACL tears and clinically significant partial tears as compared with magnetic resonance imaging (MRI). PURPOSE: To assess the sensitivity and specificity of the lever sign test for the diagnosis of acute ACL injuries, as compared to MRI. We also aimed to determine the accuracy of the lever sign test compared with 3 other tests (anterior drawer, Lachman, and pivot shift) when performed by providers of various training levels, and with the patient awake or under anesthesia...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29051895/chronic-lymphocytic-leukemia-a-rare-cause-of-pathological-fracture-of-the-femur
#19
Parita Soni, Nidhi Aggarwal, Anand Rai, Vivek Kumar, Kamholz Stephan, Yoon Taek, Kupfer Yizhak
The incidence rate of chronic lymphocytic leukemia (CLL) in the United States is approximately 0.005%; men are at slightly higher risk than women. Bony involvement or pathological fracture rarely occurs in CLL, and it may be the initial presentation. An 85-year-old woman presented with acute respiratory failure secondary to pneumonia. Symptomatology included dyspnea. She was found to have pathological fracture of the femur caused by CLL. The diagnosis of CLL had been made 6 years previously, but the patient had refused therapy...
October 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29051894/a-diagnostic-surprise-primary-hodgkin-s-lymphoma-of-the-lung
#20
Ankur Sinha, Ravikaran Patti, Prabhsimranjot Singh, William Solomon, Yizhak Kupfer
An 81-year-old male presented to the emergency room with a 3-month history of progressive shortness of breath, productive cough with white sputum, and generalized weakness with 10-pound weight loss in 2 months. On presentation, the patient was afebrile, with blood pressure of 93/55 mm Hg and oxy-hemoglobin saturation of 92% on 2 liters of oxygen via nasal cannula. Complete blood count with differential was significant for white count of 12 400/mL. Brain natriuretic peptide level was 454 ng/mL. Postero-anterior chest radiograph showed multiple round opacities in the lung fields...
October 2017: Journal of Investigative Medicine High Impact Case Reports
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