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https://www.readbyqxmd.com/read/29341846/primary-intra-medullary-nailing-of-open-tibia-fractures-caused-by-low-velocity-gunshots-does-operative-debridement-increase-infection-rates
#1
Chester J Donnally, Charles M Lawrie, Jonathan I Sheu, Meredith A Gunder, Stephen M Quinnan
BACKGROUND: Although gunshot-induced extremity fractures are typically not considered open fractures, there is controversy regarding wound management in the setting of operative fixation to limit infection complications. Previous studies have evaluated the need for a formal irrigation and debridement (I&D) prior to intra-medullary nailing (IMN) of gunshot-induced femur fractures but none have specifically evaluated tibias. By comparing primary IMN for tibial shaft fractures caused by low-velocity firearms additionally treated with a formal operative I&D (group 1) with those without an I&D (group 2), we sought to identify whether there are: differences in treatment group infection rates; particular fracture patterns more prone to infection; and patient characteristics more prone to infections...
January 17, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29339229/a-rare-case-of-c-glabrata-spondylodiscitis-case-report-and-literature-review
#2
REVIEW
Manfredi Gagliano, Costanza Marchiani, Giulia Bandini, Paolo Bernardi, Nicolas Palagano, Elisa Cioni, Martina Finocchi, Silvia Bellando Randone, Alberto Moggi Pignone
BACKGROUND: Spondylodiscitis are vertebral column infections whose incidence is rising due to an increase of the susceptible population and improved ascertainment. They have been associated with a wide range of microorganisms. Fungal spondylodiscitis is uncommon (0.5%-1.6%) and strongly associated with immunodepression and diabetes (Gouliouris et al., 2010). We present a rare case of Candida glabrata spondylodiscitis in a non neutropenic diabetic patient with the review of the literature...
January 12, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29338324/effect-of-vertical-or-beveled-chondral-defect-creation-on-rim-deformation-and-contact
#3
Adam B Yanke, Megan L Konopka, Davietta C Butty, Maximilian A Meyer, Eric J Cotter, Alejandro A Espinoza, Brian J Cole
Objective To determine biomechanical effects of knee cartilage defect perimeter morphology based on cartilage strain and opposing subchondral bone contact. Design Articular cartilage defects were created in 5 bovine femoral condyles: group 1, 45° inner bevel with 8-mm rim; group 2, vertical with 8-mm rim; and group 3, 45° outer bevel with 8-mm base. Samples were placed into a custom-machined micro-computed tomography tube and subjected to 800 N of axial loading. DICOM data were used to calculate cartilage thickness 4 and 6 mm from the center, distance between tibial cartilage surface and femoral subchondral bone, and contact width between tibial cartilage and subchondral bone...
January 1, 2018: Cartilage
https://www.readbyqxmd.com/read/29337715/labyrinthine-sequestrum-a-case-report-and-review-of-the-literature
#4
Julie B Guerin, Diana L Vork, Lourdes Eguiguren, Alexander P Marston, Colin L W Driscoll, Matthew L Carlson, Nancy K Henry, John I Lane
OBJECTIVE: To report the presentation, diagnosis, management, and convalescence of labyrinthine sequestrum (LS) and summarize all previously published cases. PATIENT(S): Eleven-year-old female with LS. INTERVENTION(S): Multidisciplinary diagnostic evaluation and treatment. MAIN OUTCOME MEASURES: Imaging and laboratory findings, medical and surgical treatment. RESULTS: We describe a case of LS secondary to medically recalcitrant suppurative otitis media in an 11-year-old female and review all eight previously reported cases...
January 15, 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29336293/using-the-nasoseptal-flap-for-reconstruction-after-endoscopic-debridement-of-radionecrosis-in-nasopharyngeal-carcinoma
#5
Gwanghui Ryu, Yoon Kyoung So, Min Young Seo, Woori Park, Hyo Yeol Kim, Hun-Jong Dhong, Seung-Kyu Chung, Sang Duk Hong
BACKGROUND: Radionecrosis is a complication of nasopharyngeal carcinoma (NPC) that is difficult to treat. Endoscopic debridement is the first-line treatment for radionecrosis. After debridement, however, either bone or the internal carotid artery is exposed and requires mucosal coverage. OBJECTIVES: This study sought to demonstrate the effectiveness of a nasoseptal flap (NSF) after endoscopic debridement of radionecrosis in the reconstruction of nasopharyngeal or skull base defects...
January 25, 2018: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/29335761/adjacent-intervertebral-space-infection-after-lumbar-fusion
#6
Hong-Kui Xin, Qing He
BACKGROUND: Surgical site infection is a catastrophic complication after spinal surgery, which seriously affects the progress of rehabilitation and clinical outcome. Currently the clinical reports on spinal surgical site infections are mostly confined to the surgical segment itself and there are few reports on adjacent segment infections after spinal surgery. STUDY DESIGN: Case report. OBJECTIVE: To report a clinical case with adjacent level infection after spinal fusion...
January 15, 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29334327/migration-of-a-kirschner-wire-into-the-spinal-cord-a-case-report-and-literature-review
#7
Ryogo Furuhata, Mitsuhiro Nishida, Midori Morishita, Shigeru Yanagimoto, Masaki Tezuka, Eijiro Okada
CONTEXT: A Kirschner wire (K-wire) is a stainless steel pin with at least one sharpened tip that is mainly used for the internal fixation of bone fractures. While some cases of K-wire dislocation and migration have been reported as complications after fracture surgery, the intraspinal migration of a K-wire is rare. Herein, we report a case in which a K-wire used for sternal fixation 7 years earlier migrated into the spinal canal. FINDINGS: A 68-year-old male suddenly sustained severe radiating pain and numbness in his left upper extremity, and walked to our hospital...
January 15, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29334176/the-effect-of-22-5-khz-low-frequency-contact-ultrasound-debridement-lfcud-on-lower-extremity-wound-healing-for-a-vascular-surgery-population-a-randomised-controlled-trial
#8
Christine Anne Murphy, Pamela Houghton, Tim Brandys, Gregory Rose, Dianne Bryant
The aim of this study was to compare changes in wound size and appearance and health complication rates in patients with vasculopathy and lower-extremity wounds treated with or without low-frequency contact ultrasound debridement (LFCUD) This study was a randomised controlled trial. The study was conducted in a vascular surgery service, including outpatient wound clinic and inpatient ward, in a tertiary care academic centre. In total, 70 patients with vasculopathy and lower-extremity wounds of mixed aetiology were enrolled in the trial; 68 completed the study...
January 15, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29334174/trichloroacetic-acid-80-as-a-chemical-debridement-method-for-chronic-venous-leg-ulcers-a-pilot-study
#9
Rita R Pinheiro, Bruno Duarte, Joana Cabete
Debridement is essential for the optimal care of venous leg ulcers. Several debridement methods with different limitations may be deployed. Trichloroacetic acid (TCA) is used for several dermatological purposes. Its application as a chemical debridement method for leg ulcers has never been explored. We designed a prospective study to determine the role of 80% TCA solution as a chemical debridement method for leg ulcers, regarding efficacy and procedure-associated pain. Chronic venous leg ulcers were treated with 3 cycles of 80% TCA solution or curettage over 1 week...
January 15, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29334018/pyoderma-gangrenosum-demographics-treatments-and-outcomes-an-analysis-of-2-273-cases
#10
Sarah E Sasor, Tahereh Soleimani, Michael W Chu, Julia A Cook, Peter J Nicksic, Sunil S Tholpady
OBJECTIVE: Pyoderma gangrenosum is a rare, neutrophil-mediated, auto-inflammatory dermatosis. This condition has clinical features analogous to infectious processes and must be quickly diagnosed to be properly treated. The purpose of this study was to characterise relevant clinical features associated with pyoderma gangrenosum based on a large inpatient cohort. METHOD: The National Inpatient Sample (US) was used to identify patients with the diagnosis of pyoderma gangrenosum using ICD-9 diagnosis code 686...
January 1, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29334015/efficacy-of-hyperbaric-oxygen-therapy-in-bacterial-biofilm-eradication
#11
Nicholas E Sanford, Jeremy E Wilkinson, Hao Nguyen, Gabe Diaz, Randall Wolcott
OBJECTIVE: Chronic wounds typically require several concurrent therapies, such as debridement, pressure offloading, and systemic and/or topical antibiotics. The aim of this study was to examine the efficacy of hyperbaric oxygen therapy (HBOT) towards reducing or eliminating bacterial biofilms in vitro and in vivo. METHOD: Efficacy was determined using in vitro grown biofilms subjected directly to HBOT for 30, 60 and 90 minutes, followed by cell viability determination using propidium monoazide-polymerase chain reaction (PMA-PCR)...
January 1, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29332930/bullosis-diabeticorum-a-rare-presentation-with-immunoglobulin-g-igg-deposition-related-vasculopathy-case-report-and-focused-review
#12
Hardik Sonani, Sohail Abdul Salim, Vishnu V Garla, Anna Wile, Venkataraman Palabindala
BACKGROUND Bullosis diabeticorum (BD) is a condition characterized by recurrent, spontaneous, and non-inflammatory blistering in patients with poorly controlled diabetes mellitus. While etiopathogenesis remains unclear, roles of neuropathy, vasculopathy and UV light are hypothesized. Most literature reports negative direct and indirect immunofluorescence findings in diabetics with bullous eruptions. Porphyria cutanea tarda, bullous pemphigoid, epidermolysis bullosa, and pseudoporphyria are other differential diagnoses of bullous lesions, and they must be excluded...
January 15, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29332187/human-bite-injuries-to-the-head-and-neck-current-trends-and-management-protocols-in-england-and-wales
#13
Glyndwr W Jenkins, Robert Isaac, Shakir Mustafa
INTRODUCTION: Human bite injuries can be challenging in their presentation to the examining physician. In a study by Merchant et al., 18% of patients presenting with a human bite injury had suffered wounds to the head and neck region. Current trends in their initial management at presentation to emergency departments throughout England and Wales will be discussed in this paper. MATERIALS AND METHOD: A postal survey was sent out to 100 A&E lead clinicians. This was followed up by telephone enquiries to improve the response rate...
January 14, 2018: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29330673/vacuum-assisted-closure-therapy-of-paradoxical-reaction-in-tuberculous-lymphadenopathy-caused-by-mycobacterium-africanum
#14
H F Geerdes-Fenge, P Pongratz, J Liese, E C Reisinger
A 26-year-old HIV-negative male from Ghana was treated for cervical, intrathoracic and abdominal lymph node tuberculosis (TB) and tuberculous hepatitis. Penetration of the thoracic trachea by a mediastinal lymph node had caused bronchomucosal TB. Sputum culture grew M. africanum, sensitive to all first-line antituberculous drugs. Four weeks after the beginning of directly observed treatment with isoniazid, rifampin, pyrazinamide and ethambutol, the right cervical lymph node increased in size, liquefied and caused a spontaneous fistula...
January 12, 2018: Infection
https://www.readbyqxmd.com/read/29330670/treatment-of-partial-thickness-rotator-cuff-tears-in-overhead-athletes
#15
REVIEW
Joseph N Liu, Grant H Garcia, Anirudh K Gowd, Brandon C Cabarcas, Michael D Charles, Anthony A Romeo, Nikhil N Verma
PURPOSE OF REVIEW: To review the etiology, classification, presentation, evaluation, treatment strategy, and outcomes in overhead athletes with partial thickness rotator cuff tears. RECENT FINDINGS: Despite advances in surgical repair techniques, return to play following surgical repair of partial rotator cuff tears remains modest at best. Overhead athletes may be particularly prone to rotator cuff pathology due to the supraphysiological strains within the tendon during the throwing motion, as well as mechanical stress with contact between the undersurface of the rotator cuff and the glenoid...
January 13, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29330343/treatment-of-osteomyelitis-defects-by-a-vancomycin-loaded-gelatin-%C3%AE-tricalcium-phosphate-composite-scaffold
#16
J Zhou, X G Zhou, J W Wang, H Zhou, J Dong
OBJECTIVE: In the present study, we aimed to assess whether gelatin/β-tricalcium phosphate (β-TCP) composite porous scaffolds could be used as a local controlled release system for vancomycin. We also investigated the efficiency of the scaffolds in eliminating infections and repairing osteomyelitis defects in rabbits. METHODS: The gelatin scaffolds containing differing amounts of of β-TCP (0%, 10%, 30% and 50%) were prepared for controlled release of vancomycin and were labelled G-TCP0, G-TCP1, G-TCP3 and G-TCP5, respectively...
January 2018: Bone & Joint Research
https://www.readbyqxmd.com/read/29326852/unusual-course-of-crystalline-keratopathy-in-a-patient-with-graft-versus-host-disease
#17
Başak Bostancı, Yonca Aydın Akova
We present a case of infectious crystalline keratopathy in a patient with Graft-versus-Host disease (GVHD) who developed satellite fungal keratitis. A 51-year-old man was referred for bilateral total persistent corneal epithelial defects with severe dry eye. Although persistent epithelial defect healed with medical therapy, he developed stromal keratitis with satellite lesions confirmed to be secondary to Candida albicans. After three months of antifungal treatment and debridement, improvement of the infiltrates was obtained...
December 2017: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/29326127/skill-sets-required-for-the-management-of-military-head-face-and-neck-trauma-a-multidisciplinary-consensus-statement
#18
John Breeze, R Blanch, J Baden, A M Monaghan, D Evriviades, S E Harrisson, S Roberts, A Gibson, N MacKenzie, D Baxter, A J Gibbons, S Heppell, J G Combes, R F Rickard
INTRODUCTION: The evolution of medical practice is resulting in increasing subspecialisation, with head, face and neck (HFN) trauma in a civilian environment usually managed by a combination of surgical specialties working as a team. However, the full combination of HFN specialties commonly available in the NHS may not be available in future UK military-led operations, necessitating the identification of a group of skill sets that could be delivered by one or more deployed surgeons. METHOD: A systematic review was undertaken to identify those surgical procedures performed to treat acute military head, face, neck and eye trauma...
January 10, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29325193/stabilization-of-olecranon-fractures-by-tension-band-wiring-or-plate-osteosynthesis-a-retrospective-study-of-41-cases
#19
Alexandre Fournet, Jean-François Boursier, Solène Corbeau, Adeline Decambron, Véronique Viateau, Pascal Fayolle, Anne-Sophie Bedu, Dimitri Leperlier, Mathieu Manassero
OBJECTIVES:  This article aimed to describe olecranon fracture in dogs and cats and their stabilization with tension band wiring or plate osteosynthesis, and to evaluate complications associated with each technique. METHODS:  Medical records of cats and dogs that had been surgically treated for olecranon fractures with either tension band wiring or plate osteosynthesis were retrospectively reviewed. The surgical technique, complications and long-term outcomes were assessed...
January 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/29324877/impact-of-extra-articular-pathologies-on-groin-pain-an-arthroscopic-evaluation
#20
Mitsunori Kaya
PURPOSE: For patients who have anterior hip pain evaluated by Patrick's test and tenderness at Scarpa's triangle, we perform periarticular debridement based on the hypothesis that extra-articular pathologies are responsible for the hip pain. The purpose of this study was to categorize the endoscopic extra-articular findings and to evaluate the clinical significance of periarticular pathologies in anterior hip pain. METHODS: Arthroscopic findings of 77 patients who underwent periarthritic debridement were evaluated...
2018: PloS One
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