- Comparison of Wide-Awake Local Anesthesia No Tourniquet With General Anesthesia With Tourniquet for Volar Plating of Distal Radius Fracture. [Journal Article]
- OOrthopedics 2018 Dec 11; :1-6
- Wide-awake local anesthesia no tourniquet (WALANT) is used for various hand surgeries, but there are no reports of its use for distal radius fractures. The authors compared perioperative variables an...
Wide-awake local anesthesia no tourniquet (WALANT) is used for various hand surgeries, but there are no reports of its use for distal radius fractures. The authors compared perioperative variables and clinical outcomes for volar plating for distal radius fractures with WALANT vs general anesthesia with tourniquet. This retrospective study included 47 patients who presented with distal radius fractures between January 2015 and February 2017. Twenty-one underwent surgical volar plating with WALANT, and 26 underwent surgical volar plating with general anesthesia with tourniquet. Patients were followed for 12 months. The 2 groups were compared regarding perioperative parameters and clinical outcomes, including perioperative field pain evaluated by visual analog scale score on postoperative day 1, range of motion 12 months postoperatively, and Mayo wrist score. The WALANT group had a lower mean visual analog scale score and a shorter mean hospitalization (both P<.001), but greater mean blood loss (P<.001). No significant differences were found regarding operative time (P=.214) or time to union (P=.180). At 12-month follow-up, no significant differences were found regarding wrist extension (P=.721), wrist flexion (P=.119), or Mayo wrist score (P=.223). Although both techniques permitted volar plating for distal radius fractures, WALANT allowed immediate intervention and led to less postoperative pain and shorter hospitalization. Although control of blood loss was worse with WALANT, blood loss was limited to a mean of 22.62 mL and did not interfere with the surgical field. [Orthopedics. 201x; xx(x):xx-xx.].
- Unusual Etiology of Acute Wrist Pain: Acute Calcific Tendonitis of the Flexor Carpi Ulnaris Mimicking an Infection. [Journal Article]
- CRCase Rep Orthop 2018; 2018:2520548
- Acute calcific tendonitis is a common cause of musculoskeletal pain. However, it seldom affects the hand and wrist. For that reason, it is frequently mistaken for more common etiologies. This study r...
Acute calcific tendonitis is a common cause of musculoskeletal pain. However, it seldom affects the hand and wrist. For that reason, it is frequently mistaken for more common etiologies. This study reports a case of acute calcific tendinitis of the flexor carpi ulnaris, which was initially misdiagnosed as cellulitis, in a 65-year-old woman, who was unnecessarily prescribed with antibiotics. However, further evaluation confirmed the correct diagnosis of acute calcific tendinitis and her symptoms were subsequently resolved within 2 weeks with rest, wrist immobilization, and an intake of anti-inflammatories. This case underscores the need for the physicians to be aware of this less common but important cause of acute wrist pain in order to prevent misdiagnosis and avoid unnecessary medical treatments.
- The Effect of Periarticular Injection of Methylprednisolone Acetate in Patients with Primary Osteoarthritis of the Proximal Interphalangeal Joints: A Case Controlled Study. [Journal Article]
- PRPain Res Treat 2018; 2018:7561209
- CONCLUSIONS: Subcutaneous periarticular injection of MPA + lidocaine at the PIP joints resulted in a small but significant improvement that gradually diminished with time across the week 10, among patients with primary OA of hands.
- Hand Grip Strength as a Clinical Biomarker for ME/CFS and Disease Severity. [Journal Article]
- FNFront Neurol 2018; 9:992
- Background: The diagnosis of myalgic encephalomyelitis (ME/CFS) in research and clinical practice has largely relied on clinical history, which can be subjective in nature. Clinical signs are often ...
Background: The diagnosis of myalgic encephalomyelitis (ME/CFS) in research and clinical practice has largely relied on clinical history, which can be subjective in nature. Clinical signs are often subtle, overlap with other conditions, and are not formally included as part of diagnostic workup. The characterization of clinical signs and biomarkers is needed for better diagnosis and classification of patients and to monitor treatment response. Hand grip strength (HGS) has been used as an objective measure of muscle strength and fatigue, which is a primary symptom of ME/CFS. We assessed the potential usefulness of HGS as a diagnostic marker in ME/CFS. Methods: We compared HGS measurements from participants in the UK ME/CFS Biobank, with groups consisting of people with ME/CFS of differing severity (n = 272), healthy (n = 136), multiple sclerosis (n = 76) controls, and others with chronic fatigue not meeting the diagnosis of ME/CFS (n = 37). We correlated the maximum and minimum of, and differences between, 3 repeated HGS measurements with parameters of disease severity, including fatigue and pain analog scales, and physical and mental component summaries from the SF-36v2TM questionnaire across recruitment groups. Results: HGS indicators were associated with having ME/CFS, with magnitudes of association stronger in severely affected than in mild/moderately affected patients. Compared with healthy controls, being severely affected was associated with a reduction in minimum HGS of 15.3 kg (95%CI 19.3-11.3; p < 0.001), while being mild/moderately affected was associated with a 10.5 kg (95%CI 13.2-7.8; p < 0.001) reduction. The association persisted after adjusting for age, sex and body mass index. ME/CFS cases also showed lower values of maximum HGS and significant drops in values from the first to second and third trials, compared to other study groups. There were significant correlations between HGS indicators and clinical parameters of disease severity, including fatigue analog scale (Spearman's Rho = -0.40, p < 0.001), pain analog scale (Rho = -0.38, p < 0.001), and physical component summary (Rho = 0.42, p < 0.001). Discussion: HGS is markedly reduced in ME/CFS, particularly in patients with more severe disease, and may indicate muscle and fatigue related symptoms. HGS is a potential diagnostic tool in ME/CFS, and could also be used to enhance patient phenotyping and as an outcome measure following interventions.
- Developing a five-step training model for transperineal prostate biopsies in a naïve residents' group: a prospective observational randomised study of two different techniques. [Journal Article]
- WJWorld J Urol 2018 Dec 10
- CONCLUSIONS: Within the TPPB, FH is associated with a higher detection rate in patients with prostate < 40 cc compared to an FT when performed by inexperienced trainees. Standardised training organised in consecutive steps seems to contribute to the achievement of overall high detection rates with both methods.
- Enhanced expression of gene coding for β-endorphin in human monocytic cells exposed to pulsed radio frequency electric fields through thermal and non-thermal effects. [Journal Article]
- JPJ Pain Res 2018; 11:2887-2896
- CONCLUSIONS: A simple experimental system using human monocytic cells in culture demonstrated that a 15 minute elevation of temperature above 37°C enhanced gene expression for POMC in THP-1 cells, while a 15 minute application of PRF to these cells incubated at 37°C or lower, also enhanced gene expression, indicating that temperature-independent mechanisms as well as thermal effects may be involved in such gene expression.
- Arthroscopic Transosseous Repair for both Proximal and Distal Components of Peripheral Triangular Fibrocartilage Complex Tear. [Journal Article]
- IJIndian J Orthop 2018 Nov-Dec; 52(6):596-601
- CONCLUSIONS: Arthroscopic one-tunnel transosseous TFCC foveal repair and simulatneous transosseous capsular repair of distal component can be a safe and effective strategy for repair of complete TFCC tear combined with DRUJ instability.
- Identifying the pathways required for coping behaviours associated with sustained pain. [Journal Article]
- NatNature 2018 Dec 10
- Animals and humans display two types of response to noxious stimuli. The first includes reflexive defensive responses that prevent or limit injury; a well-known example of these responses is the quic...
Animals and humans display two types of response to noxious stimuli. The first includes reflexive defensive responses that prevent or limit injury; a well-known example of these responses is the quick withdrawal of one's hand upon touching a hot object. When the first-line response fails to prevent tissue damage (for example, a finger is burnt), the resulting pain invokes a second-line coping response-such as licking the injured area to soothe suffering. However, the underlying neural circuits that drive these two strings of behaviour remain poorly understood. Here we show in mice that spinal neurons marked by coexpression of TAC1Cre and LBX1Flpo drive coping responses associated with pain. Ablation of these spinal neurons led to the loss of both persistent licking and conditioned aversion evoked by stimuli (including skin pinching and burn injury) that-in humans-produce sustained pain, without affecting any of the reflexive defensive reactions that we tested. This selective indifference to sustained pain resembles the phenotype seen in humans with lesions of medial thalamic nuclei1-3. Consistently, spinal TAC1-lineage neurons are connected to medial thalamic nuclei by direct projections and via indirect routes through the superior lateral parabrachial nuclei. Furthermore, the anatomical and functional segregation observed at the spinal level also applies to primary sensory neurons. For example, in response to noxious mechanical stimuli, MRGPRD- and TRPV1-positive nociceptors are required to elicit reflexive and coping responses, respectively. Our study therefore reveals a fundamental subdivision within the cutaneous somatosensory system, and challenges the validity of using reflexive defensive responses to measure sustained pain.
- [Balloon angioplasty of the radial artery in critical hand ischaemia]. [Journal Article]
- ASAngiol Sosud Khir 2018; 24(4):64-68
- CONCLUSIONS: Timely restoration of blood flow in this situation reduces the frequency of amputation. Percutaneous balloon angioplasty may become a method of choice in treatment of patients with critical hand ischaemia caused by occlusive lesions of arteries of the forearm.
New Search Next
- Serum endothelin-1 levels, radiographic and ultrasonographic evaluations, and clinical parameters in patients with knee and/or hand osteoarthritis. [Journal Article]
- JBJ Back Musculoskelet Rehabil 2018 Nov 30
- CONCLUSIONS: This is the first study evaluating the relationship between serum ET-1 levels and cartilage morphology and clinical parameters, which did not show any conclusive result. Future studies, overcoming the limitations of this study, might provide a better understanding of the role of ET-1 in the pathogenesis of OA.