- A Randomized, Double-Blind, Placebo-Controlled, Split-Face Study of the Efficacy of Topical Epidermal Growth Factor for the Treatment of Melasma. [Journal Article]
- JDJ Drugs Dermatol 2018 Sep 01; 17(9):970-973
- CONCLUSIONS: This study suggests that topical EGF is a safe, noninvasive, and effective treatment for melasma. J Drugs Dermatol. 2018;17(6):970-973.
- Locomotor adaptations to prolonged step-by-step frontal plane trunk perturbations in young adults. [Journal Article]
- PlosPLoS One 2018; 13(9):e0203776
- The purpose of this study was to quantify the magnitude and time course of dynamic balance control adaptations to prolonged step-by-step frontal plane forces applied to the trunk during walking. Heal...
The purpose of this study was to quantify the magnitude and time course of dynamic balance control adaptations to prolonged step-by-step frontal plane forces applied to the trunk during walking. Healthy young participants (n = 10, 5 female) walked on an instrumented split-belt treadmill while an external cable-driven device applied frontal plane forces to the trunk. Two types of forces were applied: 1) forces which accentuated COM movement in the frontal plane (destabilizing) and 2) forces which resisted COM movement in the frontal plane (stabilizing). We quantified dynamic balance control using frontal plane measures of (1) the extent of center of mass (COM) movement over a gait cycle (COM sway), (2) the magnitude of base of support (step width), and (3) cadence. During destabilizing force conditions, COM sway, step width, and cadence increased. In response to stabilizing force conditions, COM sway decreased. In addition, during destabilizing balance conditions participants made quicker adaptations to their step width compared to the time to adapt to stabilizing forces. Taken together, these results provide important insight into differences in dynamic balance control strategies in response to stabilizing and destabilizing force fields.
- Measuring Decrement in Change-of-Direction Speed Across Repeated Sprints in Basketball: Novel vs. Traditional Approaches. [Journal Article]
- JSJ Strength Cond Res 2018 Sep 17
- Scanlan, AT, Madueno, MC, Guy, JH, Giamarelos, K, Spiteri, T, and Dalbo, VJ. Measuring decrement in change-of-direction speed across repeated sprints in basketball: Novel vs. traditional approaches. ...
Scanlan, AT, Madueno, MC, Guy, JH, Giamarelos, K, Spiteri, T, and Dalbo, VJ. Measuring decrement in change-of-direction speed across repeated sprints in basketball: Novel vs. traditional approaches. J Strength Cond Res XX(X): 000-000, 2018-Approaches to quantify decrement in change-of-direction speed during repeated sprints in basketball players have traditionally used total performance time, which is strongly influenced by linear speed. The purpose of this study was to compare performance decrement across change-of-direction sprints using total performance time and a novel approach that better isolates change-of-direction speed, termed change-of-direction deficit (CODD). Semiprofessional basketball players (N = 8; 19.9 ± 1.5 years; 183.0 ± 9.6 cm; 77.7 ± 16.9 kg) completed 12 × 20-m change-of-direction sprints (Agility 5-0-5 trials) with 20-second recoveries between each sprint. Agility 5-0-5 performance time was taken as the duration to cover 5 m immediately before and after (10 m in total) a 180° directional change. Change-of-direction deficit was calculated as the difference between mean 10- and 20-m split time determined during reference 20-m linear sprints in a separate session and Agility 5-0-5 time in each sprint. Performance decrement was calculated for each approach as: ([total time/ideal time] × 100) - 100. Comparisons between approaches were made using a paired-sample t-test, effect size analyses, and magnitude-based inferences. A significantly greater (P < 0.001; effect size = 2.16, very large; almost certainly higher) performance decrement was apparent using CODD (5.99 ± 1.88%) than Agility 5-0-5 performance time (2.84 ± 0.84%). The present findings indicate that change-of-direction speed measured with CODD shows promise in providing different insight and deteriorates more than total performance time during repeated sprints in basketball players. Change-of-direction deficit has potential to better isolate decrements in change-of-direction speed across repeated sprints compared with total performance time.
- Open Treatment of Radial Head Fractures. [Journal Article]
- JEJBJS Essent Surg Tech 2017 Dec 28; 7(4):e35
- Radial head fractures may commonly be treated by (1) open reduction and internal fixation (ORIF), (2) radial head excision, or (3) radial head replacement. If there is no associated elbow instability...
Radial head fractures may commonly be treated by (1) open reduction and internal fixation (ORIF), (2) radial head excision, or (3) radial head replacement. If there is no associated elbow instability with lateral ulnar collateral ligament (LUCL) injury, the preferred approach is via a split in the extensor digitorum communis (EDC) origin. This provides a wide exposure but limits the risk of injury to the LUCL and associated instability. The radial head is fixed, excised, or replaced. Open treatment of radial head fractures begins with the following steps: (1) a laterally based incision is centered over the radiocapitellar joint, (2) the EDC is split at the midline of the radial head and elevated off the bone anteriorly and superiorly, and dissection proceeds distally, splitting the extensor origin along its fibers, and (3) the capsule is opened and the radial head fracture, identified. For ORIF, provisional fixation is then obtained with Kirschner wires and small bone reduction clamps. Headless low-profile screws are preferred if possible. If a plate is used, the dissection proceeds distally and the posterior interosseous nerve may need to be identified and protected. Definitive fixation is applied in the safe zone for implant placement (i.e., a right angle based laterally when the forearm is in a neutral position). For excision of the radial head as definitive treatment or for radial head replacement, the fragments are removed and an oscillating saw is used to remove additional radial neck or other fragments. When radial head excision is the definitive treatment, the radial neck is planed to a smooth contour that allows for placement of the prosthesis or for smooth motion without impingement at the proximal radioulnar joint. An indication for radial head replacement is suspicion of an Essex-Lopresti-type injury or demonstration of longitudinal instability of the forearm with excessive motion when a "push-pull" test is performed under fluoroscopy of the wrist while traction is applied to the radial neck. The final step of open treatment of radial head fractures, before the wound is closed in layers, consists of assessment of the range of motion and use of fluoroscopy to confirm appropriate fixation, resection, or prosthetic position. Outcomes following radial head fixation, resection, or arthroplasty for isolated radial head fractures are generally favorable. Loss of motion is particularly problematic in the pronation-supination arc in the setting of plate fixation, and patients are generally counseled that implant removal is often necessary. Loss of motion in the flexion-extension arc, particularly loss of terminal extension, may be noted. Resection of the radial head results in radiographic evidence of degenerative changes along the ulnohumeral joint, but this may be well tolerated as symptoms develop slowly, particularly in older patients. Radial head replacement results in changes in the capitellum over time, but these are usually asymptomatic.
- SuperPath: The Direct Superior Portal-Assisted Total Hip Approach. [Journal Article]
- JEJBJS Essent Surg Tech 2017 Sep 28; 7(3):e23
- The supercapsular percutaneously assisted total hip (SuperPath; MicroPort) approach is a direct superior portal-assisted approach for total hip arthroplasty (THA) that utilizes the interval between t...
The supercapsular percutaneously assisted total hip (SuperPath; MicroPort) approach is a direct superior portal-assisted approach for total hip arthroplasty (THA) that utilizes the interval between the gluteus minimus and the piriformis to access the hip capsule. The technique was developed to promote early mobilization, greater range of motion, and improved pain control. The major steps of this procedure are as follows: Step 1: Patient positioning. The patient is in the standard lateral decubitus position with the involved leg in the "home position," that is, 45° to 60° of flexion, 20° to 30° of internal rotation, and slight adduction by elevating the foot on a padded Mayo stand. Step 2: Surgical exposure. A skin incision is made from the tip of the greater trochanter 6 to 8 cm proximally in line with the femur in the home position, the gluteus maximus muscle is split by blunt dissection in line with the fibers, and the gluteus medius and minimus are retracted anteriorly and the piriformis tendon is retracted posteriorly to access to the capsule without dissecting any muscles. Step 3: Capsular incision. The capsule is incised along the path of the skin incision from the saddle of the femoral neck to 1 cm proximal to the acetabular rim. Step 4: Femoral preparation. A channel is created in the superior aspect of the femoral neck from the femoral canal to the center of the femoral head, using reamers, a round osteotome, and a curet. Step 5: Femoral broaching. Sequential femoral broaches are then used to complete the preparation and size the proximal femoral canal while the head and neck remain intact. Step 6: Neck resection. The femoral neck osteotomy is performed level with the broach neck, and Schanz pins are used to rupture the ligamentum teres and remove the femoral head. Step 7: Acetabular preparation and placement. Acetabular preparation and cup impaction are done through a portal without needing release of the iliotibial band or remaining external rotators. A sharp Romanelli self-retaining retractor (Innomed) and modified Zelpi self-retaining retractor (Life Instruments) are used. Step 8: Trial reduction. Trial reduction is completed using a bone hook and a T-handle to gently manipulate the femur. Step 9: Final implant assembly. Liner impaction is completed through the portal, and the remaining components are implanted. Step 10: Closure. Closure is limited to the capsule, fat, and skin, since no muscles are dissected during this procedure. A recent multicenter study describing nearly 500 SuperPath THAs noted a 30-day all-cause readmission rate of 2.3% and a transfusion rate of 3.3%5. The average length of stay was 1.6 days, with 91% of patients discharged home; 4.1%, to skilled nursing facilities; 3.8%, to home care; and 0.6%, to inpatient physical therapy facilities6.
- The effect of food and liquid pH on the integrity of enteric-coated beads from cysteamine bitartrate delayed-release capsules. [Journal Article]
- DDDrug Des Devel Ther 2018; 12:2795-2804
- CONCLUSIONS: The results from this in vitro dissolution study help in identifying additional foods that may be used for the administration of cysteamine bitartrate DR beads from opened capsules using the sprinkle method.
- Novel approach to discriminate left bundle branch block from nonspecific intraventricular conduction delay using pacing-induced functional left bundle branch block. [Journal Article]
- JIJ Interv Card Electrophysiol 2018 Sep 19
- CONCLUSIONS: We present a novel and practical method that might facilitate discrimination between patients with apparent LBBB and true LBBB by comparing Q-LV/QRS ratios during intrinsic activation and during RV stimulation. Although this method can already be directly applied, validation by 3D electrical mapping and prospective correlation to cardiac resynchronization therapy (CRT) response will be required for further translation into clinical practice.
- Clinical evaluation of non-surgical cleaning modalities on titanium dental implants during maintenance care: a 1-year follow-up on prosthodontic superstructures. [Journal Article]
- COClin Oral Investig 2018 Sep 19
- CONCLUSIONS: Treatment was necessary as inflammation was observed around newly placed superstructures within the first year of maintenance care. All tested treatment modalities yielded comparable clinical improvements.Early assessment and diagnosis of mucositis and regular maintenance can promote long-lasting implant health.
- Laryngo fiberscopy-guided suspension procedure for an ectopic lingual thyroid obstructing airway. [Journal Article]
- SCSurg Case Rep 2018 Sep 19; 4(1):122
- CONCLUSIONS: Our laryngo fiberscopy-guided suspension procedure can be an effective surgical procedure for the treatment of ectopic thyroid. This relatively simple surgical procedure could completely preserve the patient's thyroid tissue and resolve airway obstruction.
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- Public health experts split over deal with industry funded charity. [Journal Article]
- BMJBMJ 2018 Sep 19; 362:k3942