A Daumillare, C Bosch, M Julia, B Coulet, O Mares, M Chammas
Although distal radius fractures (DRF) are frequent, the management of associated ulnar styloid process (USP) lesions is still controversial. According to recent studies, a fracture of the USP does not appear to affect functional outcomes after treatment of a DRF with plate fixation. We sought to compare the impact of a USP fracture on pronation and supination strength in isometric and isokinetic tests. We included patients with a DRF who underwent volar locking plate fixation. We divided our population into three groups: one group consisted of patients who had a fracture of the USP base, one group composed of patients without USP fracture or with a distal ulnar fracture only, and a control group composed of subjects with normal wrists...
November 12, 2019: Hand Surgery and Rehabilitation
V E Claydon, J P Moore, E R Greene, O Appenzeller, R Hainsworth
BACKGROUND: The upright posture imposes a significant challenge to blood pressure regulation that is compensated through baroreflex-mediated increases in heart rate and vascular resistance. Orthostatic cardiac responses are easily inferred from heart rate, but vascular resistance responses are harder to elucidate. One approach is to determine vascular resistance as arterial pressure/blood flow, where blood flow is inferred from ultrasound-based measurements of brachial blood velocity...
2019: PloS One
Yuyan Na, Yong Zhu, Yuting Shi, Yizhong Ren, Ting Zhang, Wanlin Liu, Changxu Han
BACKGROUND: The best treatment for lesions of the long head of the biceps tendon (LHBT) with concomitant reparable rotator cuff tears is still controversial. The purpose of the meta-analysis was to compare clinical outcomes of biceps tenotomy and tenodesis for LHBT lesions. METHODS: A literature retrieval was conducted in MEDLINE, Embase, and Cochrane Library from 1979 to March 2018. Comparative studies (level of evidence I or II) comparing tenotomy and tenodesis for LHBT lesions with concomitant reparable rotator cuff tears were included...
November 15, 2019: Journal of Orthopaedic Surgery and Research
Benjamin K Hendricks, Robert F Spetzler
This patient presented with a cavernous malformation in the inferior posterior third ventricle extending into the aqueduct. The patient was positioned supine on the operating room table with the head rotated into the horizontal plane. The choroidal fissure is opened lateral to the choroid plexus. This technique allows for the choroid plexus to serve as protection against forniceal manipulation. Rigid retraction was applied to the cerebral falx and corpus callosum to permit aqueductal visualization. The lighted instruments are paramount for adequate visualization of the third ventricle and during dissection of the lesion...
December 1, 2019: Operative Neurosurgery (Hagerstown, Md.)
Benjamin K Hendricks, Robert F Spetzler
This patient had a large left ventral thalamic cavernous malformation abutting the third ventricle with evidence of recent hemorrhage. The patient was placed supine with the head in the horizontal position with the dependent hemisphere down to permit use of the anterior interhemispheric transcallosal approach. The lateral ventricle is entered, and the septum pellucidum is opened to prevent it from obstructing the surgical field. The deep cavernous malformation is located with stereotactic neuronavigation and removed piecemeal with the aid of lighted suckers and bipolars...
December 1, 2019: Operative Neurosurgery (Hagerstown, Md.)
Veerajalandhar Allareddy, Ira M Cheifetz
The pediatric acute respiratory distress syndrome (PARDS), a description specific for children with acute respiratory distress syndrome (ARDS), was proposed in the recent Pediatric Acute Lung Injury Consensus Conference (PALICC, 2015). This recent standardization of PARDS diagnosis is expected to aid in uniform earlier recognition of the entity, enable use of consistent management strategies and potentially increase the ease of enrollment in future PARDS clinical trials-all of which are expected to optimize outcomes in PARDS...
October 2019: Annals of Translational Medicine
Luc Rubinger, Daniel Axelrod, Anthony Bozzo, Aaron Gazendam, Jamal Al-Asiri, Herman Johal
BACKGROUND: Femoral shaft fractures are common and severe injuries that often occur alongside other complex, high-energy injuries. Definitive internal fixation using reamed, locked intramedullary nailing (IMN) has become the standard of care in adequately resuscitated patients, commonly performed in the supine position with utilization of a fracture table. The lateral position, without the use of traction, offers an alternative that may be associated with lower complication rates. Given the lack of high-quality evidence in the area, this study was designed to assess the attitudes, knowledge base and preferences of Orthopaedic surgeons regarding patient positioning during antegrade IMN of femoral shaft fractures...
October 23, 2019: Injury
Robin Volkmar, Strahinja Dosen, Jose Gonzalez-Vargas, Marcus Baum, Marko Markovic
BACKGROUND: The loss of a hand is a traumatic experience that substantially compromises an individual's capability to interact with his environment. The myoelectric prostheses are state-of-the-art (SoA) functional replacements for the lost limbs. Their overall mechanical design and dexterity have improved over the last few decades, but the users have not been able to fully exploit these advances because of the lack of effective and intuitive control. Bimanual tasks are particularly challenging for an amputee since prosthesis control needs to be coordinated with the movement of the sound limb...
November 14, 2019: Journal of Neuroengineering and Rehabilitation
Michael J Duncan, Alex Rowlands, Chelsey Lawson, Sheila Leddington Wright, Matt Hill, Martyn Morris, Emma Eyre, Jason Tallis
This study aimed to determine the optimal accelerometer wear-site specific cut-points for discrimination of sedentary time, light physical activity and moderate-to-vigorous physical activity in older adults. Twenty-three adults (14 females) aged 55 to 77 years wore a GENEActiv accelerometer on their non-dominant wrist, dominant wrist, waist and dominant ankle whilst undertaking eight, five-minute bouts of activity: lay supine, seated reading, slow walking, medium walking, fast walking, folding laundry, sweeping and stationary cycling...
November 14, 2019: European Journal of Sport Science
Ebeed S Yasin, Hosam E Amin, Hisham A Ghani
Tibialis anterior tendon transfer was described as an effective method in the management of dynamic supination as well as prevention of clubfoot relapse in children. Different successful methods were described for anchoring the transferred tibialis anterior tendon; however, each of which has its own complications that were avoided by using this novel technique. This study included 26 feet in 18 patients, who underwent tibialis anterior tendon transfer as a part of management of their congenital clubfoot. The mean age was 3...
November 12, 2019: Journal of Pediatric Orthopedics. Part B
Deborah Phipps, Erik Butler, Anne Mounsey, Michael M Dickman, David Bury, Ashley Smith, Nick Bennett, Ben Arthur, Bob Marshall
We typically take a blood pressure within 3 minutes of a patient rising from a supine to a standing position. But is that too long?
November 2019: Journal of Family Practice
Kensuke Yoshino, Junichi Nakamura, Shigeo Hagiwara, Takane Suzuki, Yohei Kawasaki, Seiji Ohtori
BACKGROUND: Femoral nerve palsy is a serious neurological complication following total hip arthroplasty (THA) via a direct anterior approach. One hypothesis is that the nerve injury is caused by malpositioning of retractors over the anterior wall of the acetabulum. The purpose of this cadaveric study was to clarify the anatomical features of the femoral nerve around the anterior acetabular rim and the potential risk of nerve injury during a direct anterior approach to THA. METHODS: We dissected 84 cadaveric hips from 44 formalin-embalmed cadavers...
November 12, 2019: Journal of Bone and Joint Surgery. American Volume
Miguel A Arias, Marta Pachón, Iván Sánchez-Iglesias, Gerard Loughlin, Cristina Martín-Sierra, Alberto Puchol, Fernando Sabatel, Luis Rodríguez-Padial
INTRODUCTION: Between 7-15% of patients with an indication for an implantable cardioverter-defibrillator (ICD) are not eligible for implantation of a subcutaneous implantable cardioverter-defibrillator (S-ICD) on the basis of the result of the conventional left parasternal electrocardiographic screening (LPES). Our objective was to determine the impact of systematically performing right parasternal electrocardiographic screening (RPES) in addition to conventional LPES, in terms of increasing both the total percentage of potentially eligible patients for S-ICD implantation and the number of suitable vectors per patient...
November 14, 2019: Journal of Cardiovascular Electrophysiology
Karl R Abi-Aad, Evelyn Turcotte, Devi P Patra, Matthew E Welz, Tanmoy Maiti, Ryan Hess, Brian Kalen, Chandan Krishna, Richard S Zimmerman, Bernard R Bendok
This is the case of an 86-yr-old gentleman who presented with left facial pain exacerbated by eating, drinking, chewing, and shaving (distribution: V2, V3). The patient was diagnosed with trigeminal neuralgia and was refractory to medications. Imaging showed a superior cerebellar artery (SCA) loop adjacent to the trigeminal nerve root entry zone and a decision to perform a microvascular decompression of the fifth nerve was presented to the patient. After patient informed consent was obtained, a standard 3 cm × 3 cm retrosigmoid craniotomy was performed with the patient in a supine head turned position and in reverse Trendelenburg...
November 14, 2019: Operative Neurosurgery (Hagerstown, Md.)
Guo-Yue Yang, Yayue Li, Dian-Zhong Luo, Cheng Hui, Kai Xiao, Hong Zhang
OBJECTIVE: To explore the difference in pelvic tilt and hip joint parameters with developmental dysplasia of the hip (DDH) comparing the anteroposterior (AP) pelvic radiographs taken in supine and standing positions. METHODS: A prospective study of DDH patients undergoing Bernese periacetabular osteotomy (PAO) was conducted. AP pelvic radiographs were taken in supine and standing positions before surgery The pelvic tilt and hip joint parameters from the two radiographs were compared...
November 14, 2019: Orthopaedic Surgery
Aharon M Feldman, Ankit Modh, Carri Glide-Hurst, Indrin J Chetty, Benjamin Movsas
Background Stereotactic body radiation therapy (SBRT) is a proven and effective modality for treatment of hepatic primary and metastatic tumors. However, these lesions are challenging for planning and treatment execution due to natural anatomic changes associated with respiration. Magnetic resonance imaging (MRI) offers superior soft tissue contrast resolution and the ability for real-time image-guided treatment delivery and lesion tracking. Objective To evaluate the plan quality, treatment delivery, and tumor response of a set of liver SBRT cancer treatments delivered with magnetic resonance (MR)-guided radiotherapy on a MR-linear accelerator (MR-linac)...
September 26, 2019: Curēus
Karina Marshall-Goebel, Steven S Laurie, Irina V Alferova, Philippe Arbeille, Serena M Auñón-Chancellor, Douglas J Ebert, Stuart M C Lee, Brandon R Macias, David S Martin, James M Pattarini, Robert Ploutz-Snyder, L Christine Ribeiro, William J Tarver, Scott A Dulchavsky, Alan R Hargens, Michael B Stenger
Importance: Exposure to a weightless environment during spaceflight results in a chronic headward blood and tissue fluid shift compared with the upright posture on Earth, with unknown consequences to cerebral venous outflow. Objectives: To assess internal jugular vein (IJV) flow and morphology during spaceflight and to investigate if lower body negative pressure is associated with reversing the headward fluid shift experienced during spaceflight. Design, Setting, and Participants: This prospective cohort study included 11 International Space Station crew members participating in long-duration spaceflight missions ...
November 1, 2019: JAMA Network Open
Arie Oksenberg, Vlada Goizman, Edith Eitan, Kitham Nasser, Natan Gadoth, Timo Leppänen
OBJECTIVES: Obstructive sleep apnea (OSA) patients with breathing abnormalities only or mainly in the supine posture are designated positional patients (PPs), whereas nonpositional patients (NPPs) have many breathing abnormalities in both lateral and supine postures. Positional therapy (PT), the avoidance of the supine posture during sleep, is the obvious treatment for PPs. The stability over time of being PP and leading factors that are involved in converting a PP to an NPP are addressed...
November 13, 2019: Laryngoscope
Kyung Mi Kim, Jung Ju Choi, Dongchul Lee, Wol Seon Jung, Su Bin Kim, Hyun Jeong Kwak
Prolonged inspiratory to expiratory (I:E) ratio ventilation may improve arterial oxygenation or gas exchange and respiratory mechanics in patients with obesity. We performed a randomised study to compare the effects of the conventional ratio ventilation (CRV) of 1:2 and the equal ratio ventilation (ERV) of 1:1 on arterial oxygenation and respiratory mechanics during spine surgery in overweight and obese patients. Fifty adult patients with a body mass index of ≥25 kg/m2 were randomly allocated to receive an I:E ratio either l:2 (CRV; n = 25) or 1:1 (ERV; n = 25)...
November 12, 2019: Scientific Reports
Chun-Sheng Cheng, Ting-Ji Sun, Hou-de Zhang
BACKGROUND: Current magnet-controlled capsule endoscopy (MCE) for the stomach is not yet satisfactory with respect to navigation control, especially in the gastric fundus and cardia. A newly developed MCE system conducted in a standing rather than supine position may improve capsule maneuverability within the stomach. The aim of this phase 1 study was to assess the feasibility and safety of this system for examining the human stomach in healthy volunteers. METHODS: A cohort of 31 healthy volunteers were enrolled...
November 12, 2019: BMC Gastroenterology
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