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https://www.readbyqxmd.com/read/27903758/oprm1-and-comt-gene-gene-interaction-is-associated-with-postoperative-pain-and-opioid-consumption-after-orthopedic-trauma
#1
Heba Khalil, Susan M Sereika, Feng Dai, Sheila Alexander, Yvette Conley, Gary Gruen, Li Meng, Peter Siska, Ivan Tarkin, Richard Henker
BACKGROUND: mu-opioid receptor (OPRM1) and catechol-O-methyltransferase (COMT) contribute to the neurotransmission pathway of pain. COMT affects mu receptor expression and density in the brain. The aim of this study was to explore the OPRM1 and COMT interaction effects on postoperative pain and opioid consumption. METHODS: This cross-sectional exploratory study used genotype and clinical data from 153 postoperative patients. Using multiple regression analyses, four single-nucleotide polymorphisms of COMT (rs6269, rs4633, rs4818, and rs4680), their haplotypes, and diplotypes were considered for their interactions with A118G of OPRM1 regarding postoperative pain and opioid consumption...
November 30, 2016: Biological Research for Nursing
https://www.readbyqxmd.com/read/27874908/rivaroxaban-for-thromboprophylaxis-after-nonelective-orthopedic-trauma-surgery-in-switzerland
#2
Pierre Hoffmeyer, Hanspeter Simmen, Marcel Jakob, Christoph Sommer, Andreas Platz, Thomas Ilchmann, Erik Grossen, Christian Ryf, Panayiotis Christofilopoulos, Michael Schueler, Michael Rud Lassen, Markus Rimle, Urs E Gasser
This study investigated the effectiveness and the outcomes of rivaroxaban vs the standard of care for venous thromboembolic prophylaxis in patients undergoing fracture-related surgery. A total of 413 patients undergoing fracture-related surgery from 9 Swiss orthopedic and trauma centers were enrolled. The authors selected the type of venous thromboembolic prophylaxis according to standardized medical practice at the participating centers before the inclusion of patients: 208 patients received rivaroxaban and 205 received the standard of care...
November 22, 2016: Orthopedics
https://www.readbyqxmd.com/read/27870674/impact-of-hospital-employed-physician-assistants-on-a-level-ii-community-based-orthopaedic-trauma-system
#3
Peter L Althausen, Steven Shannon, Brianne Owens, Daniel Coll, Michael Cvitash, Minggen Lu, Timothy J O'Mara, Timothy J Bray
OBJECTIVES: The American Academy of Orthopedic Surgeons and the Orthopedic Trauma Association have released guidelines for the provision of orthopedic trauma services such as adequate stipends, designated operating rooms, ancillary staff, and guaranteed reimbursement for indigent care. One recommendation included a provision for hospital-based physician assistants (PAs). Given current reimbursement arrangements, PA collections for billable services may not meet their salary and benefit expenses...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870673/financial-impact-of-dual-vendor-matrix-pricing-and-sole-source-contracting-on-implant-costs
#4
Peter L Althausen, Joan Lapham, Lisa Mead
Implant costs comprise the largest proportion of operating room supply costs for orthopedic trauma care. Over the years, hospitals have devised several methods of controlling these costs with the help of physicians. With increasing economic pressure, these negotiations have a tremendous ability to decrease the cost of trauma care. In the past, physicians have taken no responsibility for implant pricing which has made cost control difficult. The reasons have been multifactorial. However, industry surgeon consulting fees, research support, and surgeon comfort with certain implant systems have played a large role in slowing adoption of cost-control measures...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27858179/outcome-parameters-in-orthogeriatric-co%C3%A2-management%C3%A2-a%C3%A2-mini-review
#5
REVIEW
Radko Komadina, Klaus W Wendt, Gerold Holzer, Tomaž Kocjan
Recognizing hip and other fragility fractures as an adverse event of chronic geriatric conditions led to the concept of orthogeriatric co-management (OGC). OGC today represents various forms of structural cooperation between orthopedic trauma surgeons and multiprofessional geriatric teams taking care of frail elderly patients. The models are country specific. Despite several published models there are still no clear recommendations on how this service should be best organized. The 12 outcome parameters published by the Experts' Roundtable in 2013 were recommended to be used for the further assessment of different OCG models...
November 17, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27857495/the-impact-of-resident-involvement-on-outcomes-in-orthopedic-trauma-an-analysis-of-20-090-cases
#6
Phillip M Mitchell, Svetlana A Gavrilova, Ashley C Dodd, Basem Attum, William T Obremskey, Manish K Sethi
BACKGROUND: Involvement in patient care is critical in training orthopedic surgery residents for independent practice. As the focus on outcomes and quality measures intensifies, the impact of resident intraoperative involvement on patient outcomes will be increasingly scrutinized. We sought to determine the impact of residents' intraoperative participation on 30-day post-operative outcomes in the orthopedic trauma population. METHODS: A total of 20,090 patients from the American College of Surgeons National Surgical Quality Improvement Program database from 2006 to 2013 were identified...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27848054/incidence-and-predictive-risk-factors-of-postoperative-sepsis-in-orthopedic-trauma-patients
#7
Nikita Lakomkin, Vasanth Sathiyakumar, Brandon Wick, Michelle S Shen, A Alex Jahangir, Hassan Mir, William T Obremskey, Ashley C Dodd, Manish K Sethi
BACKGROUND: Postoperative sepsis is associated with high mortality and the national costs of septicemia exceed those of any other diagnosis. While numerous studies in the basic orthopedic science literature suggest that traumatic injuries facilitate the development of sepsis, it is currently unclear whether orthopedic trauma patients are at increased risk. The purpose of this study was thus to assess the incidence of sepsis and determine the risk factors that significantly predicted septicemia following orthopedic trauma surgery...
November 15, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/27779155/minimally-invasive-reduction-and-fixation-in-orthopedic-trauma
#8
Ying-Ze Zhang
No abstract text is available yet for this article.
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27768658/the-military-orthopedic-trauma-registry-the-potential-of-a-specialty-specific-process-improvement-tool
#9
Jessica C Rivera, Renee M Greer, Mary Ann Spott, Anthony E Johnson
BACKGROUND: The Military Orthopaedic Trauma Registry (MOTR) was designed to replicate the Department of Defense Trauma Registry's (DoDTR's) role as pillar for data-driven management of extremity war wounds. The MOTR continuously undergoes quality assurance checks to optimize the registry data for future quality improvement efforts. We conducted a quality assurance survey of MOTR entrants to determine if a simple MOTR data pull could provide robust orthopedic-specific information toward the question of causes for late amputation...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27755334/reliability-and-reproducibility-of-the-ota-ao-classification-for-humeral-shaft-fractures
#10
Kiran C Mahabier, Esther M M Van Lieshout, Boyd C Van Der Schaaf, Gert R Roukema, Bas J Punt, Michael H J Verhofstad, Dennis Den Hartog
OBJECTIVES: This study aimed to determine inter-observer reliability and intra-observer reproducibility of the OTA/AO classification for humeral shaft fractures, and to evaluate differences between fracture types, fracture groups, and surgical specializations. METHODS: 30 observers (25 orthopedic trauma surgeons and five general orthopedic surgeons) independently classified 90 humeral shaft fractures according to the OTA/AO classification. Patients of 16 years and older were included...
October 13, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27676726/the-fear-avoidance-model-to-predict-return-to-work-after-an-orthopedic-trauma
#11
Johanna Morgounovski, Philippe Vuistiner, Bertrand Léger, François Luthi
OBJECTIVE: The fear-avoidance model (FAM) is commonly used in musculoskeletal chronic pain (Vlaeyen 2012). Nevertheless, only few prospective studies have been conducted, especially on return to work (RTW). This study lays the hypothesis that the components of the FAM (catastrophizing, kinesiophobia and depression) can predict RTW 1 year after a vocational rehabilitation for orthopedic trauma patients. MATERIAL/PATIENTS AND METHODS: A total of 323 rehab orthopedic trauma inpatients (average time after accident: 9 months) were included...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27670536/association-between-blood-transfusion-transfusion-setting-and-the-risk-of-venous-thromboembolism-in-patients-with-isolated-orthopedic-trauma
#12
Kevin J McGurk, Bryan R Collier, Eric H Bradburn, Katie M Love, Daniel I Lollar, Christopher C Baker, Mark E Hamill
No abstract text is available yet for this article.
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27650374/rate-of-avascular-necrosis-and-time-to-surgery-in-proximal-humerus-fractures
#13
L A Archer, A Furey
PURPOSE: Avascular necrosis (AVN) of the humeral head is a devastating complication of proximal humeral fracture (PHF) that often results in long-term morbidity for the patient. Rates of AVN depend on the number of fracture fragments and are highly variable. The literature suggests that timely stable and anatomic reduction may decrease the rate at which AVN develops after PHF. To our knowledge, there is no literature published investigating a temporal relationship between the timing of PHF fixation and rates of AVN...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27646697/-the-evolution-of-3d-imaging-in-orthopedic-trauma-care-german-version
#14
S R Yarboro, P H Richter, D M Kahler
Three-dimensional (3D) imaging can enhance trauma care by allowing better evaluation of bony detail and implant position compared to conventional fluoroscopy or x‑ray. Intraoperative 3D imaging further improves this evaluation by allowing any necessary revisions to be made in the operating room prior to the patient emerging from anesthesia. This revision, if necessary, better achieves the surgical goals and alleviates the stressful situation of obtaining postoperative 3D imaging, where the benefit of revision must be balanced against the cost and risk of returning to the operating room...
October 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27639655/experimental-investigation-and-statistical-modeling-of-temperature-rise-in-rotary-ultrasonic-bone-drilling
#15
Vishal Gupta, Pulak M Pandey
Thermal necrosis is one of the major problems associated with the bone drilling process in orthopedic/trauma surgical operations. To overcome this problem a new bone drilling method has been introduced recently. Studies have been carried out with rotary ultrasonic drilling (RUD) on pig bones using diamond coated abrasive hollow tools. In the present work, influence of process parameters (rotational speed, feed rate, drill diameter and vibrational amplitude) on change in the temperature was studied using design of experiment technique i...
September 14, 2016: Medical Engineering & Physics
https://www.readbyqxmd.com/read/27619985/the-evolution-of-3d-imaging-in%C3%A2-orthopedic-trauma-care
#16
S R Yarboro, P H Richter, D M Kahler
Three-dimensional (3D) imaging can enhance trauma care by allowing better evaluation of bony detail and implant position compared to conventional fluoroscopy or x‑ray. Intraoperative 3D imaging further improves this evaluation by allowing any necessary revisions to be made in the operating room prior to the patient emerging from anesthesia. This revision, if necessary, better achieves the surgical goals and alleviates the stressful situation of obtaining postoperative 3D imaging, where the benefit of revision must be balanced against the cost and risk of returning to the operating room...
September 12, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27587339/the-impact-of-the-increasing-burden-of-trauma-in-malawi-on-orthopedic-trauma-service-priorities-at-kamuzu-central-hospital
#17
Sven Young, Leonard Banza, Boston S Munthali, Kumbukani G Manda, Jared Gallaher, Anthony Charles
Background and purpose - The burden of road traffic injuries globally is rising rapidly, and has a huge effect on health systems and development in low- and middle-income countries. Malawi is a small low-income country in southeastern Africa with a population of 16.7 million and a gross national income per capita of only 250 USD. The impact of the rising burden of trauma is very apparent to healthcare workers on the ground, but there are very few data showing this development. Patients and methods - The annual number of femoral fracture patients admitted to Kamuzu Central Hospital (KCH) in the Capital of Malawi, Lilongwe, from 2009 to 2014 was retrieved from the KCH trauma database...
December 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27581506/the-prophylaxis-of-venous-thromboembolism
#18
Albrecht Encke, Sylvia Haas, Ina Kopp
BACKGROUND: Venous thromboembolism (VTE) is the third most common cardiovascular condition, after myocardial infarction and stroke. Prophylactic measures in accordance with current guidelines can significantly reduce the risk of VTE and the associated morbidity and mortality. Until now, the German interdisciplinary, evidence- and consensus-based (S3) clinical practice guideline on VTE prophylaxis was based on a complete review of all pertinent literature available in MEDLINE up to January 2008...
August 8, 2016: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/27567095/the-impact-of-pain-management-with-opioids-among-older-adults-post-orthopedic-trauma
#19
Barbara Resnick, Elizabeth Galik, Chris L Wells, Marie Boltz, Cynthia L Renn, Susan G Dorsey
Pain has a significant effect on physical and psychological outcomes for older adults post orthopedic trauma. The purpose of this study was to describe the management of pain among older trauma patients and consider differences between those who received 3 or more dosages daily of opioids versus those who did not. This was a secondary data analysis using data from an intervention study testing the effect of Function Focused Care among older orthopedic trauma patients (FFC-AC). The FFC-AC study was done on trauma units in two acute care settings designated as Level I or II trauma centers from September 2014 to September 2015...
October 2016: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/27528837/construct-choice-for-the-treatment-of-displaced-comminuted-olecranon-fractures-are-locked-plates-cost-effective
#20
Edward M DelSole, Kenneth A Egol, Nirmal C Tejwani
BACKGROUND: Cost effective implant selection in orthopedic trauma is essential in the current era of managed healthcare delivery. Both locking and non-locking plates have been utilized in the treatment of displaced fractures of the olecranon. However, locking plates are often more costly and may not provide superior clinical outcomes. The primary aim of the present study is to assess the clinical and functional outcomes of olecranon fractures treated with locked and non-locking plate and screw constructs while providing insight into the cost of various implants...
2016: Iowa Orthopaedic Journal
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