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https://www.readbyqxmd.com/read/29325840/early-comparative-outcomes-of-unicompartmental-and-total-knee-arthroplasty-in-severely-obese-patients
#1
Zachary C Lum, David A Crawford, Adolph V Lombardi, Jason M Hurst, Michael J Morris, Joanne B Adams, Keith R Berend
BACKGROUND: Medial unicompartmental knee arthroplasty (UKA) may have advantages over total knee arthroplasty (TKA) in the setting of obesity. There has been no direct comparison between the two cohorts. This study compares outcomes and complications of severely obese patients undergoing medial UKA versus TKA. METHODS: Six hundred and fifty medial UKA and 1300 TKA were performed in patients with BMI >35kg/m2 (mean 41kg/m2) between 2007 and 2012. Pre- and postoperative ROM, Knee Society scores, perioperative factors, complications and reoperations were compared...
January 8, 2018: Knee
https://www.readbyqxmd.com/read/29319659/residual-neurological-symptoms-after-peripheral-nerve-blocks-for-pediatric-knee-surgery
#2
Robert J Tamai, Brian T Sullivan, Rushyuan J Lee
BACKGROUND: Peripheral nerve blocks (PNBs) provide excellent pain control and reduce the need for systemic analgesics in orthopaedic surgery. PNBs rarely cause complications; however, a few studies of adults have reported neurological complications during the early postoperative period. We investigated complications associated with the use of PNBs during pediatric knee surgery. METHODS: We reviewed the medical records of all 121 children (aged ≤18 y) who underwent knee surgery by 1 orthopaedic surgeon between October 2014 and September 2016...
January 9, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29318860/-effect-of-transcutaneous-acupoint-electrical-stimulation-on-hemodynamic-fluctuation-caused-by-loosing-tourniquet-in-elderly-patients-undergoing-knee-joint-replacement
#3
Han-Sheng Liang, Yi Feng
OBJECTIVE: To observe the effect of transcutaneous acupoint electrical stimulation (TAES) on hemodynamic fluctuation caused by loosing tourniquet in the elderly patients undergoing knee joint replacement. METHODS: A total of 60 ASA (America Society Anesthesiologist) I or II elderly patients for elective knee joint replacement surgery were randomly divided into control group (30 cases) and TAES group (30 cases). Patients of both groups were treated by intravenous anesthesia, and monitored with bispectral index (BIS, between 45-60) for anesthesia depth, stroke volume variation (SVV) for fluid management, mean arterial pressure (MAP) and cardiac index (CI) for hemodynamic fluctuation evaluation, and with analgesia nociception index (ANI, between 50-70) for remifentanil dosage adjustment...
December 25, 2017: Zhen Ci Yan Jiu, Acupuncture Research
https://www.readbyqxmd.com/read/29317069/blood-flow-restriction-training-as-a-prehabilitation-concept-in-total-knee-arthroplasty-a-narrative-review-about-current-preoperative-interventions-and-the-potential-impact-of-bfr
#4
Alexander Franz, Fina Pauline Queitsch, Michael Behringer, Constantin Mayer, Rüdiger Krauspe, Christoph Zilkens
Osteoarthritis of the knee is one of the most commonly diagnosed joint ailments and responsible for increased rates of total knee arthroplasty surgeries worldwide. Whereas the surgical approach is able to diminish the perceived knee pain of concerned patients', the postoperative recovery is often accompanied by persistent skeletal muscle dysfunctions and atrophy, which is responsible for functional deficits for up to several years. Recent findings indicate that surgery induced adverse effects on skeletal muscles are largely associated with the use of pneumatic tourniquets, wherefore several studies try to reduce tourniquet use in orthopedic surgery...
January 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29310457/pediatric-ganglion-cysts-a-retrospective-review
#5
Joseph Meyerson, Yangshu L Pan, Maya Spaeth, Gregory Pearson
BACKGROUND: Ganglion cysts are the most common type of soft tissue tumors of the hand. In the pediatric population, monitoring may be appropriate unless cysts are painful, interfering with range of motion or parental concerns exist. Reported recurrence rates after surgical removal of pediatric ganglion cysts vary widely in the literature. Notably, recurrence rates are higher for children than adults, ranging from as low as 6% to as high as 35%. METHODS: A retrospective review was performed of a single pediatric hand surgeon's patients undergoing excision of primary and recurrent ganglion cysts from 2010 to 2015...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29279485/clinical-condition-and-management-of-114-mamushi-gloydius-blomhoffii-bites-in-a-general-hospital-in-japan
#6
Takahito Chiba, Hidenobu Koga, Nanae Kimura, Maho Murata, Shunichi Jinnai, Asako Suenaga, Futoshi Kohda, Masutaka Furue
Objective Mamushi (Gloydius blomhoffii) snakebite is the most common type of snake injury in Japan and is also seen in China and Korea. Although the components of Mamushi venom have been investigated, epidemiological and clinical descriptions still remain limited in the English literature. The aim of this study was to review the clinical features and management of patients with injuries related to Mamushi snakebites. Methods We conducted a retrospective examination of 114 Mamushi snakebite cases encountered at a general hospital in Japan from January 2004 to November 2016...
December 27, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29273251/outcomes-and-complications-following-endoscopically-assisted-percutaneous-achilles-tendon-repair
#7
Chamnanni Rungprai, Phinit Phisitkul
PURPOSE: To review functional and clinical outcomes as well as complications in patients who underwent endoscopically assisted percutaneous Achilles tendon repair using 4-strand core suture configuration via a 6-portal technique. METHODS: A retrospective chart review with prospectively collected data was performed in 23 consecutive patients who underwent endoscopically assisted percutaneous Achilles tendon repair between 2008 and 2015. The minimum follow-up to be included in the study was 24 months...
December 19, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29245293/association-of-tourniquet-utilization-with-blood-loss-rehabilitation-and-complications-in-chinese-obese-patients-undergoing-total-knee-arthroplasty-a-retrospective-study
#8
Zhirui Li, Daohong Liu, Gong Long, Gong Ke, An Xiao, Peifu Tang, Jiyuan Dong
Obesity not only gives rise to more blood loss volume but also correlates with postoperative rehabilitation and complications in surgical patients. It is not clear at present whether tourniquet utilization is associated with blood loss, rehabilitation, and complications, and it is imperative to ascertain the tactics of utilizing tourniquet in obese patients undergoing total knee arthroplasty (TKA). The present study was designed to explore the association of tourniquet utilization with blood loss, rehabilitation, and complications, and ascertain the tactics of utilizing tourniquet in obese patients undergoing TKA...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29242798/anterior-elbow-pain-caused-by-compression-of-the-lateral-antebrachial-cutaneous-nerve
#9
Sean M Booth, Abdulbaset Abosala, Chris Peach
Introduction: The complex anatomy and biomechanics of the elbow joint can lead to diagnostic uncertainty when a clinician is determining the cause of a patient's anterior elbow pain. We present a case of anterior elbow pain with an uncommon and often overlooked etiology. Elbow pain due to compression of the lateral antebrachial nerve (LACN) has an unknown incidence or prevalence. Case Report: A 27-year-old left-hand dominant male presented to our orthopedic elbow clinic complaining of bilateral elbow clicking and discomfort which had been present for several years...
September 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29239852/management-specificities-for-abdominal-pelvic-and-vascular-penetrating-trauma
#10
E Hornez, F Béranger, T Monchal, Y Baudouin, G Boddaert, H De Lesquen, S Bourgouin, Y Goudard, B Malgras, G Pauleau, V Reslinger, N Mocellin, C Natale, L Meyrat, J-P Avaro, P Balandraud, S Gaujoux, S Bonnet
Management of patients with penetrating trauma of the abdomen, pelvis and their surrounding compartments as well as vascular injuries depends on the patient's hemodynamic status. Multiple associated lesions are the rule. Their severity is directly correlated with initial bleeding, the risk of secondary sepsis, and lastly to sequelae. In patients who are hemodynamically unstable, the goal of management is to rapidly obtain hemostasis. This mandates initial laparotomy for abdominal wounds, extra-peritoneal packing (EPP) and resuscitative endovascular balloon occlusion of the aorta (REBOA) in the emergency room for pelvic wounds, insertion of temporary vascular shunts (TVS) for proximal limb injuries, ligation for distal vascular injuries, and control of exteriorized extremity bleeding with a tourniquet, compressive or hemostatic dressings for bleeding at the junction or borderline between two compartments, as appropriate...
November 24, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29239841/totally-intra-corporeal-pringle-maneuver-during-laparoscopic-liver-resection
#11
Andrea Laurenzi, Daniel Cherqui, Rodrigo Figueroa, René Adam, Eric Vibert, Antonio Sa Cunha
INTRODUCTION: Laparoscopic resection has gained a significant place in liver surgery. As in open liver resection, bleeding control during hepatic transection remains a major issue and it represents the main reason for conversion to laparotomy. Pringle maneuver (PM) remains the standard inflow occlusion technique and a specific step-by-step description of totally intracorporeal laparoscopic PM is described. METHODS: The technique includes placement of a tape around the hepatoduodenal which is then passed through a plastic drain...
November 24, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29239763/the-tourniquet-gap-a-pilot-study-of-the-intuitive-placement-of-three-tourniquet-types-by-laypersons
#12
Elliot M Ross, Julian G Mapp, Theodore T Redman, Derek J Brown, Chetan U Kharod, David A Wampler
BACKGROUND: The "Stop the Bleed" campaign in the United States advocates for nonmedical personnel to be trained in basic hemorrhage control and that "bleeding control kits" be available in high-risk areas. However, it is not clear which tourniquets are most effective in the hands of laypersons. OBJECTIVES: The objective of this pilot study was to determine which tourniquet type was the most intuitive for a layperson to apply correctly. METHODS: This project is a randomized study derived from a "Stop the Bleed" education initiative conducted between September 2016 and March 2017...
November 24, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29234658/blood-level-changes-in-total-knee-arthroplasty-with-and-without-a-tourniquet
#13
Marco Felipe Francisco Honorato de Barros, Evandro Junior Christovam Ribeiro, Rafael Gomes Dias
Objective: To evaluate the difference between the total blood loss in patients undergoing primary total knee arthroplasty with and without the use of tourniquet. Methods: A retrospective cohort study, with analysis of medical records of patients undergoing primary total knee arthroplasty in 2015, with and without the use of a tourniquet. Comparison was performed of hemoglobin (HB) and hematocrit (HT) variation in the complete blood count (CBC) during the pre- and post-operative period between the two groups...
November 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/29233761/the-new-digit-tourniquet-forgetmenot%C3%A2
#14
J J Hidalgo Díaz, L Muresan, S Touchal, N Bahlouli, P Liverneaux, S Facca
BACKGROUND: Digit tourniquets are widely used in the operating room and even more often in the emergency department to allow the exploration of injuries. A rolled surgical glove finger or silicone catheter placed at the base of the digit is a common method. However, rolled glove tourniquets are easily forgotten under the dressing and may then cause ischaemia, which may require amputation. Silicone catheters are expensive single-use devices that may fail to provide effective exsanguination and must be removed by cutting, which may result in skin lesions...
December 9, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29232398/remote-ischemic-preconditioning-attenuates-cardiopulmonary-bypass-induced-lung-injury
#15
Xiaona Zhou, Runzhu Jiang, Yucai Dong, Lifeng Wang
The use of cardiopulmonary bypass (CPB) in cardiac surgeries is known to induce pathological changes in vital organs such as lungs. Remote ischemic preconditioning (RIPC) is a protective strategy that has shown to be able to reduce tissue damage related to ischemia-reperfusion injury (IRI). The current study seeks to evaluate the beneficial effects of limb RIPC on lung tissues and function in a rat CPB model. RIPC, which consisted of three cycles of 5-min ischemia and subsequently 5-min reperfusion, was induced in the hind limbs of the animals via a tourniquet...
2017: PloS One
https://www.readbyqxmd.com/read/29232194/persistent-ventricular-bigeminy-during-anesthesia-in-pediatric-patients-a-case-report-of-an-11-year-old-child
#16
Sheetal Dalal, Vikas Chaudhari
An 11-year-old male child with fractures in both bones in his left forearm presented for open reduction and internal fixation. The pre-anesthetic check-up and investigations did not reveal any pre-existing underlying cardio-respiratory disease. The patient had an uneventful peri-operative period during the operation and was comfortable without any anxiety or restlessness. After an uneventful induction and intubation as per routine protocol, the patient received 600 mg of amoxicillin+clavunate intravenously as an antibiotic...
December 12, 2017: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/29223604/robot-assisted-retrohepatic-inferior-vena-cava-thrombectomy-first-or-second-porta-hepatis-as-an-important-boundary-landmark
#17
Baojun Wang, Hongzhao Li, Qingbo Huang, Kan Liu, Yang Fan, Cheng Peng, Liangyou Gu, Xintao Li, Gang Guo, Rong Liu, Minggen Hu, Guodong Zhao, Hongguang Wang, Fengyong Liu, Jiang Xiong, Xu Zhang, Xin Ma
BACKGROUND: Robot-assisted retrohepatic inferior vena cava (IVC) thrombectomy (RA-R-IVCTE) has been reported only for limited series. OBJECTIVE: To describe in detail the techniques for RA-R-IVCTE with regard to the relationship of a proximal thrombus to either the first porta hepatis (FPH) or second porta hepatis (SPH). DESIGN, SETTING, AND PARTICIPANTS: From May 2013 to July 2016, 22 patients with R-IVC tumor thrombi were admitted to our hospital...
December 6, 2017: European Urology
https://www.readbyqxmd.com/read/29218290/critical-upper-limb-ischemia-due-to-brachial-tourniquet-in-misdiagnosed-thoracic-outlet-syndrome-after-carpal-tunnel-decompression-a-case-report
#18
Cesare Tiengo, Andrea Monticelli, Stefano Bonvini, Valentina Wassermann, Erica Dalla Venezia, Franco Bassetto
We present the case of a 68-year-old woman, referred to our department for critical upper limb ischemia, which had occurred a few days after homolateral surgical ligamentotomy for carpal tunnel syndrome, diagnosed and confirmed by electromyography, and performed with a brachial tourniquet. The patient was later admitted for subsequent progressive necrosis of the first three fingers of the left hand, accompanied by signs of upper limb ischemia. An accessory cervical rib was identified, completely obliterating the subclavian artery distally at the origin of the suprascapular artery...
September 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29214626/a-descriptive-analysis-of-data-from-the-department-of-defense-joint-trauma-system-prehospital-trauma-registry
#19
Stephen G Schauer, Michael D April, Jason F Naylor, Joshua J Oliver, Cord W Cunningham, Andrew D Fisher, Russ S Kotwal
The active battlefield is an environment of chaos and confusion. Depending on the scale of combat, the chaos and confusion often extend into the prehospital combat setting with multiple personnel and units involved in the chain of care of casualties. The chaos of the prehospital combat setting has led to limitations in the availability of data for performance improvement and research. The Department of Defense (DoD) Joint Trauma System (JTS) Prehospital Trauma Registry (PHTR) was developed in conjunction with the updated Tactical Combat Casualty Care (TCCC) card and a TCCC after action report (AAR), and currently serves as the prehospital repository and module of the DoD Trauma Registry (DoDTR)...
October 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/29202993/wide-awake-foot-and-ankle-surgery-a-retrospective-analysis
#20
A Luke MacNeill, D Joshua Mayich
BACKGROUND: The "wide-awake" approach to foot and ankle surgery is characterized by a surgeon-administered mixture of local anesthetic and epinephrine. No tourniquet, sedation, or general anesthesia are required for surgery. This paper describes a retrospective survey of the initial patients to undergo wide-awake foot and ankle surgery at our center. METHODS: Thirty former wide-awake patients were surveyed about their perioperative anxiety, pain, and satisfaction...
December 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
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