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https://www.readbyqxmd.com/read/29777950/acceptance-and-commitment-therapy-for-prevention-of-chronic-post-surgical-pain-and-opioid-use-in-at-risk-veterans-a-pilot-randomized-controlled-study
#1
Lilian Dindo, M Bridget Zimmerman, Katherine Hadlandsmyth, Barbara StMarie, Jennie Embree, James Marchman, Toni Tripp-Reimer, Barbara Rakel
High levels of pain, significant anxiety, and/or depressive symptoms prior to surgery put patients at elevated risk forchronic pain and prolonged opioid use following surgery. The purpose of this preliminary study was to assess the efficacy of a one-day Acceptance and Commitment Therapy (ACT) workshop in "at-risk" Veterans for the prevention of chronic pain and opioid use following orthopedic surgery. In a randomized controlled trial, 88 at-risk Veterans undergoing orthopedic surgery were assigned to Treatment as Usual (TAU; N =44) or TAU plus a 1-day ACT workshop (N = 44)...
May 16, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29771395/glucosamine-and-chondroitin-sulfate-what-has-been-learned-since-the-glucosamine-chondroitin-arthritis-intervention-trial
#2
Nicholas DiNubile
Glucosamine and chondroitin sulfate, alone or in combination, are used worldwide by individuals suffering from osteoarthritis pain. They are by prescription in some countries but are available as over-the-counter dietary supplements in other countries, such as the United States. The inconclusive results of the National Institutes of Health-sponsored Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) did little to clarify the efficacy of these agents. However, some newer studies have provided a better perspective on the potential benefits that they can offer...
May 16, 2018: Orthopedics
https://www.readbyqxmd.com/read/29770175/neurologic-complications-in-common-wrist-and-hand-surgical-procedures
#3
Nicole Verdecchia, Julie Johnson, Mark Baratz, Steven Orebaugh
Nerve dysfunction after upper extremity orthopedic surgery is a recognized complication, and may result from a variety of different causes. Hand and wrist surgery require incisions and retraction that necessarily border on small peripheral nerves, which may be difficult to identify and protect with absolute certainty. This article reviews the rates and ranges of reported nerve dysfunction with respect to common surgical interventions for the distal upper extremity, including wrist arthroplasty, wrist arthrodesis, wrist arthroscopy, distal radius open reduction and internal fixation, carpal tunnel release, and thumb carpometacarpal surgery...
March 29, 2018: Orthopedic Reviews
https://www.readbyqxmd.com/read/29761067/current-therapies-in-treatment-and-prevention-of-fracture-wound-biofilms-why-a-multifaceted-approach-is-essential-for-resolving-persistent-infections
#4
REVIEW
Krystle A Blanchette, Joseph C Wenke
Traumatic orthopedic injuries, particularly extremity wounds, are a significant cause of morbidity. Despite prophylactic antibiotic treatment and surgical intervention, persistent infectious complications can and do occur. Persistent bacterial infections are often caused by biofilms, communities of antibiotic tolerant bacteria encased within a matrix. The structural and metabolic differences in this mode of growth make treatment difficult. Herein, we describe both established and novel, experimental treatments targeted at various stages of wound healing that are specifically aimed at reducing and eliminating biofilm bacteria...
2018: Journal of Bone and Joint Infection
https://www.readbyqxmd.com/read/29759257/developing-a-medical-scribe-program-at-an-academic-hospital-the-hennepin-county-medical-center-experience
#5
Marc L Martel, Brian H Imdieke, Kayla M Holm, Sara Poplau, William G Heegaard, Jon L Pryor, Mark Linzer
BACKGROUND: Medical scribes are frequently incorporated into the patient care model to improve provider efficiency and enable providers to refocus their attention to the patient rather than the electronic health record (EHR). The medical scribe program was based on four pillars (objectives): (1) provider satisfaction, (2) standardized documentation, (3) documentation components for risk adjustment, and (4) revenue enhancement. METHODS: The medical scribe program was deployed in nine non-resident-supported clinics (internal medicine, ophthalmology, orthopedics, hematology/oncology, urology), with the medical scribes (who have no clinical duties) supporting both physicians and advanced practice providers (nurse practitioners and physician assistants)...
May 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29750599/peri-operative-nasal-eradication-therapy-prevents-staphylococcus-aureus-surgical-site-infections-in-aortoiliac-surgery
#6
Jasper C M Langenberg, Jan A J W Kluytmans, Paul G H Mulder, Jannie Romme, Gwan H Ho, Lyckle Van Der Laan
BACKGROUND: Surgical site infections (SSIs) cause considerable morbidity and deaths among patients undergoing vascular surgery. Pre-operative screening and subsequent treatment of nasal Staphylococcus aureus carriers with mupirocin and chlorhexidine reduces the risk of SSIs in cardiothoracic and orthopedic surgery. The aim of this study was to investigate the effect of this screen-and-treat strategy on the development of SSI in patients undergoing aortoiliac surgery. METHODS: A prospective study was performed that enrolled an intervention cohort comprising all patients undergoing aortoiliac surgery from February 2013 to December 2016...
May 11, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29748911/patient-education-and-rehabilitation-after-hip-arthroplasty-in-an-italian-spa-center-a-pilot-study-on-its-feasibility
#7
Alfredo Musumeci, Giulia Pranovi, Stefano Masiero
Nowadays, some spa centers are suitable for providing rehabilitative and preventive treatment in association with traditional spa therapy. This study aims to evaluate the feasibility and the effectiveness of an intensive rehabilitation program after hip arthroplasty in an Italian spa center. Early after total hip arthroplasty for severe osteoarthritis (≤ 10 days after the intervention), 12 consecutive patients (5 males and 7 females) aged between 50 and 85 years were enrolled for this study. All the patients performed a 2-week thermal multimodal rehabilitation program, which consisted of education and physical rehabilitative measures...
May 11, 2018: International Journal of Biometeorology
https://www.readbyqxmd.com/read/29748103/gabapentin-as-an-adjunct-to-standard-postoperative-pain-management-protocol-in-lower-extremity-surgery
#8
REVIEW
P Andrew Crisologo, Erik K Monson, Said A Atway
Postoperative pain is a problem that plagues physicians and has since the dawn of the surgical arts. Many interventions are available and used as the standard such as preoperative local anesthetic blocks, opiates, both oral and intravenous, and nonsteroidal antiinflammatory drugs. Although the temptation often exists to increase the postoperative opiate dose, opiate abuse is an increasing problem. This abuse has fueled the search for nonopiate pain adjuncts. Gabapentinoids have been shown to both decrease postoperative pain and, secondarily, decrease opiate dependence...
May 7, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29744116/spinal-manipulation-and-therapeutic-exercises-in-treating-post-surgical-resurgent-lumbar-radiculopathy
#9
Vinicius Tieppo Francio, Chris Towery, Saeid Davani, Tony Brown
Lumbar radiculopathy due to disc herniation is one of the most common conditions seen in orthopedic practices worldwide. Surgical intervention is often necessary, and most patients improve without reoccurrences. The purpose of this case is to describe the successful outcome of post-surgical resurgent lumbar radiculopathy treated with spinal manipulation and therapeutic exercises. Here, we discuss the case of a 42-year-old male who received twelve treatments of spinal manipulation, in addition to therapeutic McKenzie methods exercises...
October 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29740783/anxiety-in-the-orthopedic-patient-using-promis-to-assess-mental-health
#10
Casey M Beleckas, Heidi Prather, Jason Guattery, Melissa Wright, Michael Kelly, Ryan P Calfee
PURPOSE: This study explored the performance of the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety assessment relative to the Depression assessment in orthopedic patients, the relationship between Anxiety with self-reported Physical Function and Pain Interference, and to determine if Anxiety levels varied according to the location of orthopedic conditions. METHODS: This cross-sectional evaluation analyzed 14,962 consecutive adult new-patient visits to a tertiary orthopedic practice between 4/1/2016 and 12/31/2016...
May 8, 2018: Quality of Life Research
https://www.readbyqxmd.com/read/29736572/hyaluronic-acid
#11
Hélder Pereira, Duarte Andre Sousa, António Cunha, Renato Andrade, J Espregueira-Mendes, J Miguel Oliveira, Rui L Reis
In recent times, the field of tissue engineering and regenerative medicine (TERM) has considerably increased the extent of therapeutic strategies for clinical application in orthopedics. However, TERM approaches have its rules and requirements, in the respect of the biologic response of each tissue and bioactive agents which need to be considered, respected, and subject of ongoing studies. Different medical devices/products have been prematurely available on the market and used in clinics with limited success...
2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29735473/exercise-therapy-interventions-in-patients-with-hip-osteoarthritis-comparison-of-the-effects-of-dvd-and-website-based-interventions
#12
Yuko Uesugi, Junichiro Koyanagi, Keishi Takagi, Ryota Yamaguchi, Shinya Hayashi, Takashi Nishii
BACKGROUND: Prevalence of developmental hip dysplasia is high in Japan. Exercise therapy has been proven effective to treat certain aspects of hip osteoarthritis. Moreover, therapy provided via digital video discs (DVDs) and websites allows patients to exercise in the comfort of their own homes. However, no studies have evaluated the effectiveness of visual instructions in patients with hip disorders. OBJECTIVE: This study aimed to compare the effectiveness of exercise therapy administered via DVD and that administered via a website...
May 7, 2018: JMIR Rehabilitation and Assistive Technologies
https://www.readbyqxmd.com/read/29731814/morphology-of-the-lumbar-multifidus-muscle-in-lumbar-disc-herniation-at-different-durations-and-at-different-ages
#13
Zhi-Neng Chen, Xin-Miao Yao, Yi Lv, Bang-Jiang He, Jun-Cai Ye, Rong-Xue Shao, Huang-Wei Jiang
The aim of the present study was to evaluate the relative functional volume of bilateral lumbar multifidus (LM) muscles across different stages and ages of patients with lumbar disc herniation (LDH). The relative functional volumes of LM muscles in both non-affected and affected sides in the L4-L5 and L5-S1 segmental level were measured in a resting prone position, and visual analogue score (VAS) for pain and Japanese Orthopedic Association (JOA) scores were recorded. The correlation between changes in the relative net volume of LM muscles and times of onset, ages, VAS and JOA scores were analyzed...
May 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29729179/is-delayed-surgery-after-unsuccessful-conservative-treatment-beneficial-for-spinal-cord-injury-following-whiplash-a-retrospective-study-in-elderly-patients
#14
Tengfei Zhao, Bolaky Landish Yishmaan, Dasheng Lin, Kan Xu, Qiankun Zhou, Ge Yang
BACKGROUND The aim of this study was to investigate the clinical outcomes of early and delayed surgery in cervical spinal cord injury following whiplash in elderly patients. MATERIAL AND METHODS Our retrospective review identified elderly patients (≥65 years old) with spinal cord injury following whiplash injury from 2006 to 2015. The neck disability index (NDI), modify Japanese Orthopedics Association (mJOA) score, and visual analogue scale (VAS) score were used to evaluate clinical outcomes preoperatively and during follow-up...
May 5, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29720212/individualized-approach-to-the-surgical-management-of-fibrous-dysplasia-of-the-proximal-femur
#15
Bas C J Majoor, Andreas Leithner, Michiel A J van de Sande, Natasha M Appelman-Dijkstra, Neveen A T Hamdy, P D Sander Dijkstra
BACKGROUND: Fibrous dysplasia of the proximal femur presents with heterogeneous clinical manifestations dictating different surgical approaches. However, to date there are no clear recommendations to guide the choice of surgical approach and no general guidelines for the optimal orthopedic management of these lesions. The objective of this study was to evaluate treatment outcomes of angled blade plates and intramedullary nails, using as outcome indicators revision-free survival, pain, function and femoral neck-shaft-angle...
May 2, 2018: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/29719413/intermittent-pneumatic-compression-is-a-cost-effective-method-of-orthopedic-postsurgical-venous-thromboembolism-prophylaxis
#16
Rhodri Saunders, Anthony J Comerota, Audrey Ozols, Rafael Torrejon Torres, Kwok Ming Ho
Background: Venous thromboembolism (VTE) is a major complication after lower-limb arthroplasty that increases costs and reduces patient's quality of life. Using anticoagulants for 10-35 days following arthroplasty is the standard prophylaxis, but its cost-effectiveness after accounting for bleeding complications remains unproven. Methods: A comprehensive, clinical model of VTE was created using the incidences, clinical effects (including bleeding), and costs of VTE and prophylaxis from randomized controlled trials, meta-analyses, and large observational studies...
2018: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29716640/tranexamic-acid-versus-placebo-to-prevent-blood-transfusion-during-radical-cystectomy-for-bladder-cancer-tact-study-protocol-for-a-randomized-controlled-trial
#17
Rodney H Breau, Luke T Lavallée, Sonya Cnossen, Kelsey Witiuk, Ilias Cagiannos, Franco Momoli, Gregory Bryson, Salmaan Kanji, Christopher Morash, Alexis Turgeon, Ryan Zarychanski, Ranjeeta Mallick, Greg Knoll, Dean A Fergusson
BACKGROUND: Radical cystectomy for bladder cancer is associated with a high risk of needing red blood cell transfusion. Tranexamic acid reduces blood loss during cardiac and orthopedic surgery, but no study has yet evaluated tranexamic acid use during cystectomy. METHODS: A randomized, double-blind (surgeon-, anesthesiologist-, patient-, data-monitor-blinded), placebo-controlled trial of tranexamic acid during cystectomy was initiated in June 2013. Prior to incision, the intervention arm participants receive a 10 mg/kg loading dose of intravenously administered tranexamic acid, followed by a 5 mg/kg/h maintenance infusion...
May 2, 2018: Trials
https://www.readbyqxmd.com/read/29716605/integration-of-the-work-related-online-aftercare-intervention-gsa-online-plus-healthy-and-without-stress-at-the-workplace-into-clinical-practice-study-protocol-for-an-implementation-study
#18
Rüdiger Zwerenz, Katja Böhme, Astrid Wirth, Nicole Labitzke, Sergei Pachtchenko, Manfred E Beutel
BACKGROUND: In a previous RCT we established the efficacy of the psychodynamic online aftercare programme 'GSA-Online' ('Health Training Stress Management at the Workplace') for rehabilitants with work-related stress facing return to work after long-term sickness absence. The purpose of this trial is to implement it into routine care. METHODS/DESIGN: The study is performed in rehabilitation clinics with patients of different medical indications (psychosomatic, orthopedic and cardiological diseases)...
May 2, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29703017/osteochondroma-of-ventral-scapula-associated-with-chest-pain-due-to-rib-cage-compression-a-case-report
#19
Dong-Il Chun, Jae-Ho Cho, In Ho Choi, Young Yi, Jun Yong Kim, Jae Heon Kim, Sung Hun Won
RATIONALE: The scapula is relatively rare site for osteochondroma. Scapula osteochondroma is usually asymptomatic, however it may present with features such as pseudowinging, snapping scapula, bursa formation, chronic pain, and cosmetic deformities. To our best knowledge, this is the first report in the English literature about osteochondroma of ventral scapula associated with chest pain due to rib cage compression. PATIENT CONCERNS: A 14-year-old boy was transferred to the orthopedic clinic from thoracic surgery department with a complaint of intermittent, dull, and diffuse aching pain around left chest wall and back from the past 2 months...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29696210/factors-influencing-the-enrollment-in-randomized-controlled-trials-in-orthopedics
#20
Christopher T Lim, Heather J Roberts, Jamie E Collins, Elena Losina, Jeffrey N Katz
Background: Low enrollment rates are a threat to the external validity of clinical trials. The purpose of this study was to identify factors associated with lower enrollment rates in randomized controlled trials (RCTs) involving orthopedic procedures. Methods: We performed a search in PubMed/MEDLINE for RCTs that involved any orthopedic surgical procedure, compared different intraoperative interventions, were published in English in a peer-reviewed journal between 2003 and 2014, and reported the numbers of both enrolled and eligible subjects...
December 2017: Contemporary Clinical Trials Communications
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