BACKGROUND:: Several authors have documented the role of low-molecular-weight heparin injection techniques in bruising. However, few researchers have measured the influence of injection duration on the occurrence and extent of bruising. PURPOSE:: The aim of this study was to evaluate the influence of different durations of subcutaneous heparin injection on ...

Biomechanical studies suggest ulnohumeral chondral and ligamentous overload (UCLO) explains the development of posteromedial chondromalacia (PMC) in throwing athletes with ulnar collateral ligament (UCL) insufficiency. UCL reconstruction reportedly allows 90% of baseball players to return to prior or a higher level of play; however, players with concomitant posteromedial chondromalacia may ...

Conversion operations after vertical banded gastroplasty (VBG) are sometimes performed because of vomiting and/or acid regurgitation. Primary operation with gastric bypass (GBP) is known to reduce gastroesophageal reflux (GERD). Previous studies have not been designed to differentiate between the effects of the altered anatomy and of the ensuing weight loss. ...

To compare heparin (3 mL, 10 units/mL) and 0.9% sodium chloride (NaCl, 10 mL) flush solutions with respect to central venous catheter lumen patency. Single-center, randomized, open label trial. Medical intensive care unit and Surgical/Burn/Trauma intensive care unit at Barnes-Jewish Hospital, St. Louis, MO. Three hundred forty-one patients with multilumen ...

Meta-analysis of 4 prospective randomized controlled Food and Drug Administration (FDA) Investigational Device Exemption (IDE) clinical trials. To maximize the information available from 4 IDE studies by analyzing the combined outcomes of cervical arthroplasty versus fusion at 24-month follow-up. To date, 4 randomized clinical trials have been completed in the ...

To compare a computerized intraosseous anesthesia system with the conventional oral anesthesia techniques, and analyze the latency and duration of the anesthetic effect and patient preference. A simple-blind prospective study was made between March 2007 and May 2008. Each patient was subjected to two anesthetic techniques: conventional and intraosseous using ...

Steel's triple innominate osteotomy was created for correcting dysplastic acetabulum in adolescents and young adults. We modified Steel's triple innominate osteotomy with two anterior incisions and ramus cuts close to the acetabulum to improve the mobility of the fragment for better coverage of the hip. The purpose of this study ...

Children with spastic diplegia frequently show excessive knee extension (stiff-knee gait) throughout swing phase, which may interfere with foot clearance. Abnormal rectus femoris activity is commonly associated with a stiff-knee gait. Rectus femoris transfer has been recommended to enhance knee flexion during swing. However, recent studies suggest the transfer does ...

Down Syndrome can result in musculoskeletal abnormalities of the hip at an early age. Avascular necrosis of the femoral head can occur as a result of slipped capital femoral epiphysis causing the patient a great deal of pain, limiting the ability to ambulate. Despite the benefits that this patient group ...

To determine the therapeutic yield of on-demand chest radiographs in intubated patients experiencing acute oxygen desaturation/hypoxia. A retrospective study was conducted examining all intubated intensive care unit patients over a 2 ½-year period. Subjects were included only if the patient had undergone a comparison radiograph while intubated and if the ...

Bariatric surgery is the most effective weight loss treatment, yet few studies have reported on short- and long-term outcomes postsurgery. Using claims data from seven Blue Cross/Blue Shield health plans serving seven states, we conducted a non-concurrent, matched cohort study. We followed 22,693 persons who underwent bariatric surgery during 2003-2007 ...

To compare the anesthetic action of 0.5% bupivacaine in relation to 4% articaine, both with 1:200,000 epinephrine, in the surgical removal of lower third molars. As a secondary objective hemodynamic changes using both anesthetics were analyzed. Triple-blind crossover randomized clinical trial. Eighteen patients underwent bilateral removal of impacted lower third ...

External tibial torsion causes an abnormal axis of joint motion relative to the line of progression with resultant abnormal coronal plane knee moments and affects lever arm function of the foot in power generation at the ankle. However, it is unclear whether surgical correction of the tibial torsion corrects the ...

Short-term results after proximal interphalangeal joint arthroplasty with pyrolytic carbon (pyrocarbon) implant have shown that this implant has high complication rates, but patient satisfaction is high. The authors evaluated the effectiveness of the implant for use in proximal interphalangeal joint at a minimum of 2 years of follow-up. Thirteen consecutive ...

To determine whether the method of disease severity measurement influences the magnitude of knee extensor force deficits in knee osteoarthritis (OA). Data from the Osteoarthritis Initiative (n = 659) were analyzed. Knee extensor force was assessed with isometric contractions. Clinical severity was measured with the Western Ontario and McMaster Universities ...

Preliminary evidence suggests selective voluntary motor control (SVMC), defined as performance of isolated voluntary joint movement on request, may be an important factor affecting functional movement tasks. Individuals with poor SVMC are unable to dissociate hip and knee synergistic movement during the swing phase of gait and have difficulty extending ...

Treatment of spastic planovalgus feet is challenging, especially in patients with severe and rigid deformities. The available techniques do provide some correction but not at the site of the deformity and sometimes the correction is lost over time. We describe a new surgical approach at the site of the deformity. ...

Multilevel orthopaedic surgery may improve gait in Type IV hemiplegia, but it is not known if proximal femoral osteotomy combined with adductor release as part of multilevel surgery in patients with hip dysplasia improves hip development. We asked whether varus derotational osteotomy of the proximal femur, combined with adductor release, ...

A number of studies have evaluated the buccodental health of patients with autism spectrum disorder (ASD), though most have involved children, and no specific oral manifestations have been described. The present study describes the buccodental disorders and hygiene habits in a group of adults with ASD. A prospective case-control study ...

Vocal process granuloma is a benign lesion that occurs on the arytenoid cartilage. It tends to recur locally, and there is a great diversity of methods to treat it. Here, we reviewed the effects of zinc sulfate therapy program in 16 patients with vocal process granulomas. Eleven patients had a ...

OBJECTIVE: Septic thrombosis of the sigmoid and lateral sinus is a rare complication of acute otitis media, mastoiditis and cholesteatoma. Hence, the aim of this chat review was to analyze the demographics, presenting symptoms, diagnosis, and therapeutic management of otogenic sigmoid sinus thrombosis. Especially the role of low molecular weight ...

We addressed the question of whether or not the currently available evidence base supports heparinization in the context of a patient requiring cardiovascular support with an intra-aortic balloon pump (IABP). A best evidence topic was written according to a previously defined structured protocol. A literature search returned 443 papers, 3 ...

The aim of this study was to simultaneously analyze the key components of the cerebral and systemic inflammatory response over time in cardiac arrest patients during mild therapeutic hypothermia and rewarming. Clinical observational study in a tertiary care university hospital. Ten comatose patients after out-of-hospital cardiac arrest. All patients were ...

Adequate management of postoperative pain after major spine surgery is often difficult to achieve. We investigated the efficacy of an antineuropathic pain drug, pregabalin (PG), on postoperative pain control and on improvement of quality of life (QoL). Sixty patients scheduled for elective decompressive spine surgery were enrolled. One hour before ...

Cough causes poor quality of emergence from anesthesia and risks of several complications. We compared fentanyl and an antitussive action of tramadol on the quality of emergence and postoperative outcome. A total of 110 adults (18 to 83 y) of American Society of Anesthesiologists physical status I-III undergoing elective lumbar ...

This study is meant to compare the direct and indirect cost of migraine headache care before and after migraine surgery and to evaluate any postoperative changes in patient participation in daily activities. Eighty-nine patients enrolled in a migraine surgery clinical trial completed the Migraine-Specific Quality-of-Life Questionnaire, the Migraine Disability Assessment ...

A number of studies suggest a relationship between generalized joint laxity (GJL) and increased risk of some musculoskeletal injuries. However, there are conflicting data on the association between GJL and traumatic recurrent shoulder instability (RSI). We therefore asked whether the incidence of GJL in patients with RSI was greater than ...

Surgeons have traditionally treated recurrent shoulder dislocation by open methods. With the advent of arthroscopic repair techniques some surgeons reported higher recurrence rates than with open methods but some of those reports included patients with a variety of problems, including bone loss and those continuing in contact sports. It is ...

Most authors believe the ACL does not spontaneously heal after a complete rupture. Although several studies have reported spontaneous healing of torn ACLs, it is difficult to determine its healing potential and whether patients will be able to return to sports activities. We therefore asked whether (1) a complete ACL ...

The glenohumeral joint is the most mobile articulation in the body and the most commonly dislocated diarthrodial joint with peaks in the incidence of dislocation occurring during the second and sixth decades. Age at the time of the initial dislocation is inversely related to the recurrence rate. Traumatic anterior instability ...

Repair of broken central venous catheters (CVCs) is common in pediatric patients. We hypothesized that this practice predisposes to bacteremia and central line-associated bloodstream infections (CLABSI). We conducted a retrospective case-crossover study of pediatric patients 1 month to 21 years of age with CVC breakages who underwent a first-time repair ...

To report long-term HIV treatment outcomes in 7 Caribbean countries. Observational cohort study. We report outcomes for all antiretroviral therapy (ART) naive adult patients enrolled on ART from program inception until study closing for cohorts in Barbados, the Dominican Republic, Haiti, Jamaica, Martinique, Trinidad, and Puerto Rico. Incidence and predictors ...

The pleiotropic effects of statins, 3-hydroxy-3 methylglutaryl coenzyme A reductase inhibitor, have been shown to modify inflammatory cell signaling on the immune response to infection. It was postulated that statins may be a good candidate as novel therapeutic agents for the treatment of sepsis. We investigated whether ongoing statin therapy ...

The 2010 international guidelines for cardiopulmonary resuscitation recently recommended an increase in the minimum compression depth from 38 to 50 mm, although there are limited human data to support this. We sought to study patterns of cardiopulmonary resuscitation compression depth and their associations with patient outcomes in out-of-hospital cardiac arrest ...

Measuring value in medicine is an increasingly important issue as healthcare spending continues to rise and cost containment becomes even more important. However, value assessments can be affected by patient factors and comorbidities. We therefore quantified the approximate value of total hip arthroplasty and determined if patient age and Charnley ...

Uninterrupted oral anticoagulation (OAC) therapy can be the preferred strategy in patients with atrial fibrillation at moderate to high risk of thromboembolism undergoing percutaneous coronary intervention (PCI). To evaluate the need for additional heparins in addition to therapeutic peri-PCI OAC, we assessed bleeding complications and major adverse cardiac and cerebrovascular ...

OBJECTIVE: To evaluate and compare the effectiveness of magnesium sulfate (MgSO(4)) and mannitol in the treatment of posterior reversible encephalopathy syndrome (PRES) in eclamptic women. STUDY DESIGN: This retrospective analysis includes 62 eclamptic women between 22 and 40 weeks of gestation who were diagnosed with PRES in a tertiary care center. ...

PURPOSE: There is an increasing number of patients being dialyzed with permanent catheters (PC). In the majority of cases, heparin is used to maintain PC patency. This practice causes clotting disturbances due to heparin leakage and may predispose the patient to bleeding episodes. It has not been well studied whether ...

Background:  There is no randomized controlled trial (RCT) evaluating the efficacy and safety of low molecular weight heparin (LMWH) compared to unfractionated heparin (UFH) in cerebral venous sinus thrombosis (CVST). In this RCT, we have evaluated the efficacy and safety of LMWH versus UFH in CVST. Methods:  Consecutive patients with ...

ABSTRACT: INTRODUCTION: Despite evidence-based guidelines for venous thromboembolism prevention, there is substantial variability in practice. Many economic evaluations of new drugs for thromboembolism prevention do not occur prospectively with efficacy studies, and are sponsored by the manufacturers, raising the possibility of bias. We performed a systematic review of economic analyses ...

Background: Three meta-analyses conducted in the 1990s concluded that the effect of intermittent flushing with heparin at low concentration (10 U/mL) was equivalent to that of 0.9% sodium chloride flushes in preventing occlusion or superficial phlebitis. No firm conclusion was reached on the safety and efficacy of heparin concentrations of ...

This study recorded and evaluated the intra- and inter-group agreement degree by different examiners for the classification of lower third molars according to both the Winter's and Pell & Gregory's systems. An observational and cross-sectional study was realized with forty lower third molars analyzed from twenty digital panoramic radiographs. Four ...

To evaluate the anaesthetic properties and tolerance of articaine versus lidocaine at equal vasoconstrictor concentration. A total of 96 male and female patients who underwent surgical treatment of the lower third molar participated. Patients were randomly assigned to articaine hydrochloride with epinephrine 1:100,000 and lidocaine hydrochloride with epinephrine 1:100,000. The ...

Despite a number of studies comparing postoperative stability and function after anatomic double-bundle and single-bundle anterior cruciate ligament reconstruction (ACLR), it remains unclear whether double-bundle reconstruction improves stability or function. We therefore asked whether patients having single- and double-bundle ACLR using semitendinosus (ST) alone differed with regard to (1) postoperative ...

Cutaneous leishmaniasis is an endemic disease in developing countries caused by different species of leishmania parasite, and if left untreated, it will result in a deformed scar after a relatively long period. Although various systemic and topical treatments have been proposed for leishmaniasis, pentavalent Antimony compounds remain the first-line treatment ...

We developed the rectangular tunnel ACL reconstruction (RT ACLR) using a 10-mm wide bone-patellar tendon-bone (BTB) graft through rectangular tunnels with a rectangular aperture to reduce tunnel size: the cross-sectional area of the tunnels of 50 mm(2) (5 × 10 mm) in RT ACLR is less than that of 79 ...

The main static stabilizers of the medial knee are the superficial medial collateral and posterior oblique ligaments. A number of reconstructive techniques have been advocated including one we describe here. However, whether these reconstructions restore function and stability is unclear. This anatomic reconstruction technique consisted of reconstruction of the proximal ...

This report documents the authors' experience with 95 hypertelorism corrections performed since 1971. The authors note their findings regarding outcomes, preferred age at surgery, technique, and stability of results with growth. Patients were classified into three groups: midline clefts (with or without nasal anomalies, Tessier 0 to 14); paramedian clefts ...

To correlate the initial ocular presentation with bacterial identification in 100 patients with acute postcataract endophthalmitis. This was a prospective multicenter study. Demographic data, medical history, and the initial eye examination data were recorded on a standardized form. The relationship between bacterial identification and clinical factors at baseline was studied ...

The aim of this study was to evaluate and compare the effects of rapid maxillary expansion (RME) and surgically assisted RME (SARME) in the sagittal, vertical, and transverse planes. Orthodontic records of 28 patients were selected retrospectively and divided into two treatment groups. Group 1 comprised 14 patients (4 boys, ...