Barrerafoster2830
The purpose of this prospective study was to determine the accuracy of pedicular screw insertion without the use of fluoroscopy.
This study was conducted on patients with spinal diseases in need of pedicular screw fixation and fusion. The included patients suffered from such conditions as vertebral fracture, spinal stenosis, kyphosis, tumor, and pelvic fractures and were managed with triangular osteosynthesis fixation. However, those with scoliosis deformity were excluded from the study. A total of 760 pedicular screws were inserted in C7 to S1 vertebrae without using fluoroscopy. The locations of the screws were assessed by means of computed tomography scan after the surgery. The data were analyzed in SPSS software (version 22) using the Chi-square test.
Out of 387 thoracic screws and 373 lumbar screws, 65 (16.8%) and 34 (9.1%) screws perforated the pedicle wall or vertebral body, respectively. The most frequent locations of perforation in the thoracic and lumbar spine were the anterior cortex of the vertebral body and medial wall of the pedicle, respectively. Except for the perforation of the anterior vertebral body (
), there was no difference between the left and right sides or between thoracic and lumbar sites in terms of the preformation of the screw. No complication was observed due to screw perforation.
Our findings revealed the unnecessity of using fluoroscopy in spine surgeries for the insertion of pediculate screws. In this regard, the use of fluoroscopy for the placement of pedicular screw resulted in similar accuracy and complications, as compared to the free hand procedure.
Our findings revealed the unnecessity of using fluoroscopy in spine surgeries for the insertion of pediculate screws. In this regard, the use of fluoroscopy for the placement of pedicular screw resulted in similar accuracy and complications, as compared to the free hand procedure.
Conventional fixation methods of posterior wall acetabular fractures feature the use of plating and lag screws. However, fixation of posterior wall fractures with buttress plating alone offers potential advantages by avoiding the hardware complications related to hardware placement through the wall fragment. The purpose of this study was to examine if buttress plating alone, without screw fixation through the wall would be a viable method of treating these fractures. Our hypothesis was that this technique would not result in loss of reduction.
Consecutive series of patients with isolated posterior wall acetabular fractures treated by two independent surgeons at two Level I Trauma centers without screw fixation across the fracture (Boston Medical Center/Harborview Medical Center).
All 72 fractures treated without a screw through the posterior wall fragment maintained reduction at an average of 1.6 years post-operatively. For fractures fixed with buttress plating alone, 92 % were reduced within 2 mm of being anatomic compared to 94 % of fractures that had screws cross the fracture.
The described buttress plating technique without screw fixation in the wall is an acceptable form of fixation for posterior wall acetabular fractures without the theoretical risk of intra-wall screw fixation.
The described buttress plating technique without screw fixation in the wall is an acceptable form of fixation for posterior wall acetabular fractures without the theoretical risk of intra-wall screw fixation.
Given high rates of positive
(
) cultures in cases of both primary and revision shoulder surgery, the ramifications of positive
cultures remain uncertain. Next generation sequencing (NGS) is a molecular tool that sequences the whole bacterial genome and is capable of identifying pathogens and the relative percent abundance in which they appear within a sample. The purpose of this study was to report the false positive culture rate in negative control specimens and to determine whether NGS has potential value in reducing the rate of false positive results.
Between April 2017 and May 2017 swabs were taken during primary shoulder arthroplasty. After surgical time out, using sterile gloves, a sterile swab was opened and exposed to the air for 5 seconds, returned to its contained, and sealed. One swab was sent to our institution's microbiology laboratory for aerobic and anaerobic culture and held for 13 days. LXS-196 clinical trial The other sample was sent for NGS (MicroGen Dx, Lubbock, TX), where samples were amplified for nation can come from air in the operating room or laboratory contamination.
Polymethylmethacrylate antibiotic impregnated beads can be an effective treatment for chronic osteomyelitis or an adjuvant in the treatment of open fractures. It remains unclear however whether the beads cause long-term adverse events if not removed. The purpose of this study was to determine if removal of antibiotic beads was required in order to avoid long term complications.
A retrospective chart review was conducted on patients with an extremity or pelvis fracture that had implantation of polymethylmethacrylate (PMMA) antibiotic beads over a five-year period.
Fifty-one patients met inclusion criteria for this study; thirty-seven patients (73%) did not have complications after surgical debridement and placement of PMMA antibiotic beads necessitating removal.
Our findings suggest that polymethylmethacrylate antibiotic beads can be utilized as a means of delivering high-dose concentrations of local antibiotics and do not have to be removed in all patients.
Our findings suggest that polymethylmethacrylate antibiotic beads can be utilized as a means of delivering high-dose concentrations of local antibiotics and do not have to be removed in all patients.
This systematic review aimed to investigate the effectiveness of proprioceptive neuromuscular facilitation (PNF) training on back pain intensity and functional disability in people with low back pain (LBP).
Totally, five electronic databases, including PubMed/Medline (NLM), Scopus, Google Scholar, PEDro, and Cochrane Central Register of Controlled Clinical Trials were searched up to October 31, 2018. Clinical trials with a concurrent comparison group (s) that compared the effectiveness of PNF training with any other physical therapy intervention were selected. link2 Publication language was restricted to English language articles. Methodologic quality was assessed using the PEDro scale. The measures of continuous variables were summarized as Hedges's
.
In total, 20 eligible trials were identified with 965 LBP patients. A large effect size (standardized mean difference [SMD]=-2.14, 95% confidence interval [CI]=3.23 to -1.05) and significant effect were observed favoring the use of PNF training to alleviate b clinical trials regarding long-term effects of PNF training versus validated control intervention in a clinical setting is recommendable.Total knee arthroplasty is considered as the treatment of choice for those with end stage hemophilic arthropathy. Compared to other patients undergoing TKA, these patients have specific features such as bleeding tendency, younger age, pre-operative restricted range of motion (ROM), altered anatomy, and increased complications. This narrative review of literature is going to investigate several issues regarding the TKA in hemophilic patients including indications, perioperative factor replacement, surgical challenges, postoperative rehabilitation, outcomes, and complications.
This case report aims to assess a potential association between cranial asymmetry, brain deformation, and associated developmental delay.
Two infants born at ≥37 weeks pursuing cranial orthotic treatment for severe Deformational Plagiocephaly (DP) (cranial vault asymmetry index >8.75%) underwent developmental assessment using Mullen Scales of Early Learning (MSEL) and non-sedated brain structural and diffusion magnetic resonance imaging (MRI) prior to and following cranial orthotic treatment.
In both infants with DP, tractography results revealed alterations in the white matter pathways of the brain. Both infants also had low to low/normal visual receptivity and fine motor skills. After cranial orthotic treatment, cranial asymmetry improved but did not completely resolve, tractography demonstrated a change toward normalized white matter pathways, and visual receptivity and fine motor skills improved.
These preliminary findings suggest a potential link between DP, altered brain structures, and developmental assessment. Further investigation with a larger sample is warranted.
These preliminary findings suggest a potential link between DP, altered brain structures, and developmental assessment. link3 Further investigation with a larger sample is warranted.
In Louisiana, deaths related to COVID-19 have disproportionately occurred in Black persons. Granular data are needed to better understand inequities and develop prevention strategies to mitigate further impact on Black communities.
We conducted a retrospective study of patients admitted to an urban safety net hospital in New Orleans, Louisiana, with reactive SARS-CoV-2 testing from March 9 to 31, 2020. Clinical characteristics of Black and other racial/ethnic group patients were compared using Wilcoxon rank-sum test and Fisher exact tests. The relationship between race and outcome was assessed using day 14 status on an ordinal scale.
This study included 249 patients. The median age was 59, 44% were male, and 86% were age ≥65 years or had ≥1 comorbidity. Overall, 87% were Black, relative to 55% Black patients typically hospitalized at our center. Black patients had longer symptom duration at presentation (6.41 vs 5.88 days;
= .05) and were more likely to have asthma (
= .008) but less likely to haveion efforts should include strategies to limit SARS-CoV-2 exposures and transmission in Black communities as one step toward reducing COVID-19-related racial inequities.
Though in-person delivery of the Diabetes Prevention Program (DPP) has demonstrated medical cost savings, the economic impact of digital programs is not as well understood.
This study examines the impact of a digital DPP program on reducing all-cause health care costs and utilization among 2027 adult participants at 12 months.
A longitudinal, observational analysis of health care claims data was conducted on a workforce population who participated in a digital diabetes prevention program. Differences in utilization and costs from the year prior to program delivery through 1 year after enrollment were calculated using medical claims data for digital DPP participants compared to a propensity matched cohort in a differences-in-differences model.
At 1 year, the digital DPP population had a reduction in all-cause health care spend of US$1169 per participant relative to the comparison group (
= 0.01), with US$699 of that savings coming from reduced inpatient spend (
= 0.001). Cost savings were driven by fewer hospital admissions and shorter length of stay (
< 0.001). No other significant results in cost differences were detected. There was a trend toward savings extending into the second year, but the savings did not reach statistical significance.
These results demonstrated significant short-term health care cost savings at 1 year associated with digital DPP program delivery.
These results demonstrated significant short-term health care cost savings at 1 year associated with digital DPP program delivery.
