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https://www.readbyqxmd.com/read/29223632/comparative-morbidity-of-cubital-tunnel-surgeries-a-prospective-cohort-study
#1
Robert Staples, Dan London, Agnes Z Dardas, Charles A Goldfarb, Ryan P Calfee
PURPOSE: Randomized controlled trials have not identified a superior surgical approach to cubital tunnel syndrome surgery. This study evaluates the early morbidity of open in situ decompression and transposition. METHODS: This prospective cohort study enrolled 125 adult patients indicated for cubital tunnel surgery at a tertiary institution. Exclusion criteria included preoperative use of narcotics and concurrent elbow procedures. In situ decompressions (n = 47) and ulnar nerve transpositions (n = 78) were performed...
December 6, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29222289/what-is-the-role-of-screening-for-pulmonary-hypertension-in-adults-and-children-with-sickle-cell-disease
#2
REVIEW
Shaina M Willen, Mark T Gladwin
Patient case: An 18-year-old male patient with homozygous hemoglobin SS disease was evaluated for progressive dyspnea and elevated tricuspid regurgitant jet velocity (TRV) on echocardiography. The patient's case is described in detail in Lancet1 He had been treated with regular transfusions since childhood for stroke, had rare episodes of vaso-occlusive pain episodes, and did not take narcotic pain medications. He presented with progressive severe dyspnea on exertion and lower extremity edema. His laboratory tests were notable for a total hemoglobin level of 11...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29215840/rethinking-naloxone-overdose-drug-is-only-one-part-of-the-cycle-of-narcotic-abuse
#3
Neal J Richmond
No abstract text is available yet for this article.
February 2017: JEMS: a Journal of Emergency Medical Services
https://www.readbyqxmd.com/read/29215511/liposomal-bupivacaine-during-robotic-colpopexy-and-posterior-repair-a-randomized-controlled-trial
#4
Jennifer Yeung, Catrina C Crisp, Donna Mazloomdoost, Steven D Kleeman, Rachel N Pauls
OBJECTIVE: To evaluate the effect of liposomal bupivacaine on postoperative pain among patients undergoing robotic sacrocolpopexy with posterior repair. METHODS: This was a randomized, patient-blinded, placebo-controlled trial of women undergoing robotic sacrocolpopexy with posterior repair. Liposomal bupivacaine or normal saline placebo was injected into laparoscopic and vaginal incisions at completion of surgery. Perioperative care was standardized. Visual analog scales were collected at 4, 18, and 24 hours postoperatively in hospital...
December 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29210330/subcutaneous-local-anesthetic-infusion-could-eliminate-use-of-epidural-analgesia-after-the-nuss-procedure
#5
Sandra K Kabagambe, Laura F Goodman, Y Julia Chen, Benjamin A Keller, James C Becker, Gary W Raff, Rebecca A Stark, Jacob T Stephenson, Amy Rahm, Diana L Farmer, Shinjiro Hirose
AIM: To compare outcomes of continuous subcutaneous infusion of local anesthetic and epidural analgesia following the Nuss procedure. PATIENTS & METHODS: A retrospective chart review compared patients managed with subcutaneous local anesthetic infusion (n = 12) versus thoracic epidural (n = 19) following the Nuss procedure from March 2013 to June 2015. RESULTS: There was no difference in hospital length of stay or days on intravenous narcotics...
December 6, 2017: Pain Management
https://www.readbyqxmd.com/read/29208329/the-effects-of-body-mass-index-on-pain-control-with-liposomal-bupivacaine-in-hip-and-knee-arthroplasty
#6
Abigail L Campbell, Stephen Yu, Raj Karia, Richard Iorio, Steven A Stuchin
BACKGROUND: There is evidence to suggest that liposomal bupivacaine (LB) is an effective component of a multimodal pain regimen for total joint arthroplasty (TJA). Obesity has been associated with chronic pain following TJA. This study assessed whether early postoperative pain is affected by body mass index (BMI), and whether the standard LB dose has similar effects on obese vs nonobese patients. METHODS: A retrospective analysis of 2629 primary TJA over a 12-month period was conducted, with LB used in half of this group...
November 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29196901/an-improved-solvent-free-synthesis-of-flunixin-and-2-arylamino-nicotinic-acid-derivatives-using-boric-acid-as-catalyst
#7
Mahsa Yarhosseini, Shahrzad Javanshir, Zahra Dolatkhah, Mohammad G Dekamin
A simple solvent-free protocol for the preparation of flunixin, a potent non-narcotic, non-steroidal anti-inflammatory drugs is reported using boric acid as catalyst. Its salt, flunixin meglumine are then prepared under reflux in EtOH. This sustainable method are then extended for the synthesis of a series of 2-(arylamino) nicotinic acid derivatives. The present protocol combines non-hazardous neat conditions with associated benefits like excellent yield, straightforward workup, and use of readily available and safe catalyst in the absence of any solvent, which are important factors in the pharmaceutical industry...
December 1, 2017: Chemistry Central Journal
https://www.readbyqxmd.com/read/29195848/does-surgical-approach-affect-outcomes-in-total-hip-arthroplasty-through-90-days-of-follow-up-a-systematic-review-with-meta-analysis
#8
REVIEW
Larry E Miller, Joseph S Gondusky, Samir Bhattacharyya, Atul F Kamath, Friedrich Boettner, John Wright
BACKGROUND: The choice between anterior approach (AA) and posterior approach (PA) in primary total hip arthroplasty (THA) is controversial. Previous reviews have predominantly relied on data from retrospective studies. METHODS: This systematic review included prospective studies comparing postoperative outcomes through 90 days of AA vs PA in primary THA. Outcomes were pain severity, narcotic usage, hip function using Harris Hip Score, and complications. Random effects meta-analysis was performed for all outcomes...
November 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29192877/impact-of-body-mass-index-on-surgical-outcomes-narcotics-consumption-and-hospital-costs-following-anterior-cervical-discectomy-and-fusion
#9
Ankur S Narain, Fady Y Hijji, Brittany E Haws, Krishna T Kudaravalli, Kelly H Yom, Jonathan Markowitz, Kern Singh
OBJECTIVE Given the increasing prevalence of obesity, more patients with a high body mass index (BMI) will require surgical treatment for degenerative spinal disease. In previous investigations of lumbar spine pathology, obesity has been associated with worsened postoperative outcomes and increased costs. However, few studies have examined the association between BMI and postoperative outcomes following anterior cervical discectomy and fusion (ACDF) procedures. Thus, the purpose of this study was to compare surgical outcomes, postoperative narcotics consumption, complications, and hospital costs among BMI stratifications for patients who have undergone primary 1- to 2-level ACDF procedures...
December 1, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29180115/deletion-of-girk2-subunit-containing-girk-channels-of-neurons-expressing-dopamine-transporter-decrease-immobility-time-on-forced-swimming-in-mice
#10
Ikutaro Honda, Kimi Araki, Sokichi Honda, Fumio Soeda, Min-Chul Shin, Shogo Misumi, Ken-Ichi Yamamura, Kazuo Takahama
We previously reported that non-narcotic antitussives possessing inhibitory actions on G protein-coupled inwardly rectifying potassium (GIRK) channels have antidepressant-like effects in the forced swimming test in normal and adrenocoticotropic hormone (ACTH) treated rats. Furthermore, the antidepressant-like effects of the antitussives such as tipepidine were blocked by dopamine D1 receptor antagonist, and inhibitory actions on GIRK channels of dopamine neurons may be involved in the antidepressant-like effects of tipepidine...
November 24, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/29179909/surgical-interns-preparedness-for-opioid-prescribing-before-and-after-a-training-intervention
#11
Michael J Nooromid, Neel A Mansukhani, Benjamin W Deschner, Simon Moradian, Nabil Issa, Karen J Ho, Jonah J Stulberg
INTRODUCTION: Exposure to pain management curriculum in medical school is currently variable. This paper reports on formal prescribing education, self-perceived prescribing readiness, and prescribing practices among incoming surgical residents before and after a pain management training session. METHODS: Pre-residency survey of thirty surgical interns at a single urban medical center, followed by a repeat survey after an educational session on prescription writing and opioid abuse...
November 20, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29175573/the-cost-effectiveness-of-post-operative-ketamine-in-chiari-decompression
#12
Michael M McDowell, Ahmad Alhourani, Beverly A Pearce-Smith, Anna Mazurkiewicz, Robert M Friedlander
INTRODUCTION: In Chiari I patients, post-operative pain and discomfort frequently slow the transition back to the home setting. OBJECTIVE: We sought to determine the effect of standardized ketamine infusion protocols on hospital length of stay. METHODS: This retrospective cohort study reviewed 100 consecutive adult patients undergoing Chiari I decompression. Fifty-nine patients were placed on a 2-3mg/hr ketamine drip until post-operative day one...
November 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29174758/a-proactive-approach-to-high-risk-delirium-patients-undergoing-total-joint-arthroplasty
#13
Andres F Duque, Zachary D Post, Fabio R Orozco, Rex W Lutz, Alvin C Ong
BACKGROUND: Delirium is a common complication among elderly patients undergoing total joint arthroplasty (TJA). Its incidence has been reported from 4% to 53%. The Centers for Medicare and Medicaid Services consider delirium following TJA a "never-event." The purpose of this study is to evaluate a simple perioperative protocol used to identify delirium risk patients and prevent its incidence following TJA. METHODS: Our group developed a protocol to identify and prevent delirium in patients undergoing TJA...
November 13, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29166347/prepectoral-breast-reconstruction-the-breast-surgeon-s-perspective
#14
REVIEW
Toni Storm-Dickerson, Noemi Sigalove
Prepectoral breast reconstruction has been reemerging as a technique for postmastectomy implant-based reconstruction. Due to its advantage in eliminating animation deformity, shortening length of hospital stay and decreasing the amount of narcotics used for pain control, the technique has been embraced by patients and surgeons alike. The authors examined the breast surgeon's perspective regarding prepectoral reconstruction taking into consideration oncologic criteria, breast cancer recurrence, surgical technique, and the team approach to patient care...
December 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29166187/cognitive-behavioral-and-family-psychoeducational-therapies-for-adolescent-inmates-experiencing-anxiety-in-a-narcotics-correctional-facility
#15
Madepan Mulia, Budi Anna Keliat, Ice Yulia Wardani
Illicit substance use is becoming a major global issue. In Indonesia, inmates imprisoned for illicit substance offences accounted for 40% of the total inmate population. This study aimed to identify the effects of cognitive behavioral and family psychoeducational therapies on inmates' anxiety in the narcotics correctional facility. Quasi-experimental pre-test-post-test with control group was employed in this study. Intervention Group 1 received a general nursing intervention whereas Intervention Group 2 received a combination of general nursing intervention with cognitive behavioral and family psychoeducational therapies...
2017: Comprehensive Child and Adolescent Nursing
https://www.readbyqxmd.com/read/29160727/a-review-of-perioperative-complications-of-outpatient-total-ankle-arthroplasty
#16
Todd R Borenstein, Kapil Anand, Quanlin Li, Timothy P Charlton, David B Thordarson
BACKGROUND: Total ankle arthroplasty (TAA) is commonly pursued for patients with painful arthritis. Outpatient TAA are increasingly common and have been shown to decrease costs compared to inpatient surgery. However, there are very few studies examining the safety of outpatient TAA. In this study, we retrospectively reviewed 65 consecutive patients who received outpatient TAA to identify complication rates. METHODS: The medical records of 65 consecutive outpatient TAA from October 2012 to May 2016 with a minimum 6-month follow-up were reviewed...
November 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29160561/can-overnight-stenting-be-safely-eliminated-following-a-pharyngeal-flap-a-matched-comparison-study
#17
Andre M Wineland, Jareen Meinzen-Derr, Paul Willging
OBJECTIVE: Determine if overnight stenting is warranted after pharyngeal flap for management of velopharyngeal insufficiency (VPI) in pediatric patients METHODS: This is a retrospective age-matched cohort study from a single tertiary pediatric facility. Patients who underwent a posterior pharyngeal flap for VPI from January 1, 2013, to December 31, 2016, were included. Two equal groups were constructed based on when their nasal stents were removed, that is, postoperative day (POD) 0 or POD 1...
November 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29158174/impact-of-cystectomy-with-urinary-diversion-upon-tracked-receipt-of-opioid-prescriptions-among-patients-with-interstitial-cystitis-bladder-pain-syndrome
#18
David S Koslov, Fernandino Vilson, Marc Colaco, Ryan P Terlecki, Robert J Evans
OBJECTIVES: To compare opioid requirements before and after cystectomy for end stage Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) using a statewide tracking system. METHODS: Narcotic prescriptions were captured using the North Carolina Controlled Substance Reporting System for patients at a single institute undergoing cystectomy with urinary diversion (CWUD) for refractory, end stage IC/BPS between 2010-2017. Values were documented for the year before and the year after surgery (excluding 30 days postoperatively to account for surgical pain) and converted to Morphine Equivalents (ME)...
November 17, 2017: Urology
https://www.readbyqxmd.com/read/29155224/medical-encounter-mental-health-diagnoses-non-fatal-injury-and-polypharmacy-indicators-of-risk-for-accident-death-in-the-us-army-enlisted-soldiers-2004-2009
#19
Lisa Lewandowski-Romps, Heather M Schroeder, Patricia A Berglund, Lisa J Colpe, Kenneth Cox, Keith Hauret, Jeffrey D Hay, Bruce Jones, Roderick J A Little, Colter Mitchell, Michael Schoenbaum, Paul Schulz, Murray B Stein, Robert J Ursano, Steven G Heeringa
Accidents are a leading cause of deaths in U.S. active duty personnel. Understanding accident deaths during wartime could facilitate future operational planning and inform risk prevention efforts. This study expands prior research, identifying health risk factors associated with U.S. Army accident deaths during the Afghanistan and Iraq war. Military records for 2004-2009 enlisted, active duty, Regular Army soldiers were analyzed using logistic regression modeling to identify mental health, injury, and polypharmacy (multiple narcotic and/or psychotropic medications) predictors of accident deaths for current, previously, and never deployed groups...
November 16, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/29155035/utility-of-anesthetic-block-for-endometrial-ablation-pain-a-randomized-controlled-trial
#20
Jordan S Klebanoff, Nima R Patel, Nancy L Sloan
BACKGROUND: Second-generation endometrial ablation has been demonstrated safe for abnormal uterine bleeding treatment in premenopausal women, who have completed childbearing, in short-stay surgical centers and in physicians' offices. However, no standard regarding anesthesia exists and practice varies depending on physician or patient preference and hospital policy and setting. OBJECTIVE: To evaluate whether local anesthetic, in combination with general anesthesia, affects postoperative pain and associated narcotic use following endometrial ablation...
November 15, 2017: American Journal of Obstetrics and Gynecology
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