- Management of the Irreparable Rotator Cuff Tear. [Journal Article]
- JAJ Am Acad Orthop Surg 2019 Jun 14
- When evaluating patients with irreparable rotator cuff tears, orthopaedic surgeons have an increasingly wide array of surgical options, including both established techniques and emerging technologies…
When evaluating patients with irreparable rotator cuff tears, orthopaedic surgeons have an increasingly wide array of surgical options, including both established techniques and emerging technologies. However, significant variability exists in the clinical evaluation and surgical indications in this subset, and definitions for pseudoparalysis and tear irreparability are inconsistent. In older patients with symptomatic rotator cuff arthropathy and relatively sedentary demands, the reverse total shoulder arthroplasty has been established as the preferred treatment option, producing reliable improvements in both pain and function. In younger patients without glenohumeral arthritis or pseudoparalysis, joint-preserving options are preferred, with recent literature highlighting alternative options including partial repair, bridging or interpositional graft placement, tendon transfers (ie, latissimus, trapezius, and pectoralis major), superior capsular reconstruction, and subacromial spacer placement. In this review article, we address the topic of irreparable rotator cuff tears, emphasizing the workup, indications for various treatment options, and clinical outcomes.
- Large Iatrogenic Tracheal Injury From Attempted Endotracheal Cuff Leak Remedy: A Case Report. [Journal Article]
- PA A Pract 2019 Jun 11
- Continuous insufflation of oxygen into the pilot balloon of an endotracheal tube has been documented as a viable method to fix an incompetent endotracheal tube cuff. We present a case of a large iatr…
Continuous insufflation of oxygen into the pilot balloon of an endotracheal tube has been documented as a viable method to fix an incompetent endotracheal tube cuff. We present a case of a large iatrogenic tracheal injury resulting from an improvised cuff leak management device. Valuable lessons are discussed to prevent similar incidents.
- Substantial Biomechanical Improvement by Extracorporeal Shockwave Therapy After Surgical Repair of Rodent Chronic Rotator Cuff Tears. [Journal Article]
- AJAm J Sports Med 2019 Jun 17; :363546519854760
- CONCLUSIONS: Clearly improved biomechanical results were shown in the single-application and repetitive ESWT groups. Furthermore, functional evaluation showed significantly improved intensity measurements for the repetitive ESWT group.
- Does Medial-Row Fixation Technique Affect the Retear Rate and Functional Outcomes After Double-Row Transosseous-Equivalent Rotator Cuff Repair? [Review]
- OJOrthop J Sports Med 2019; 7(5):2325967119842881
- CONCLUSIONS: Despite several theoretical advantages of knotless TOE repair, both knotless and knot-tying techniques reported considerable improvement in functional outcomes after rotator cuff repair. Although tendon failure rates showed a downward trend in knotless studies, additional prospective studies are warranted to better understand the role of medial-row fixation on tendon repair integrity and postoperative clinical outcomes.
- Urethral pressure profile assessment after artificial urinary sphincter implantation (FlowSecure™ and AMS-800™): A case series. [Case Reports]
- SOSAGE Open Med Case Rep 2019; 7:2050313X19851379
- The AMS-800™ artificial urinary sphincter has become the 'gold standard' in the treatment of male stress urinary incontinence. In 2006, the novel artificial urinary sphincter FlowSecure™ containing a…
The AMS-800™ artificial urinary sphincter has become the 'gold standard' in the treatment of male stress urinary incontinence. In 2006, the novel artificial urinary sphincter FlowSecure™ containing a stress relief balloon providing low cuff pressures at rest with conditional pressure elevation during periods of stress has been launched. We assessed the intraurethral pressure in the cuff area of the AMS-800 and the FlowSecure by urethral pressure profile in four patients each. Urethral pressure profile was performed at rest and during coughing. In addition, continence situation and patient satisfaction after artificial urinary sphincter implantation was assessed. At rest, median pressure in the cuff region was 74 (38-117, FlowSecure) cm H2O and 102 (95-110, AMS-800) cm H2O. During coughing, pressure peaks rose to 135 (54-162, FlowSecure) cm H2O and 202 (128-216, AMS-800) cm H2O. Median pad usage before artificial urinary sphincter implantation in the FlowSecure and the AMS-800 group was 4 (3-4) and 4.5 (2-6) pads/24 h, respectively. At the time of urodynamic investigation, median pad usage declined to 1.5 (0-4) pads/24 h in the FlowSecure and to 1 (1-2) pads/24 h in the AMS-800 group. Seven of eight patients reported on a satisfactory quality of life, and one patient remained unhappy after FlowSecure implantation. It remains unclear if the trade-off in favour of lower cuff pressures, and consecutively lower intraurethral pressures, holds truly long-term benefits regarding device revision, explantation and patient satisfaction.
- Extravasation of fluid in arthroscopic shoulder surgery requiring prolonged intubation: a case report. [Case Reports]
- PSPatient Saf Surg 2019; 13:21
- CONCLUSIONS: This case highlights the risk factors and clinical course of a patient with airway compromise caused by extravasation of fluid during shoulder arthroscopy. Although shoulder arthroscopy is a safe procedure, surgeon familiarity with the risk factors for this complication and close monitoring can aid in its identification and allow for appropriate treatment.
- Clinical and radiological outcomes of osteoarthritis twenty years after rotator cuff repair. [Journal Article]
- OTOrthop Traumatol Surg Res 2019 Jun 13
- CONCLUSIONS: Twenty years after open rotator cuff repair, the rate of osteoarthritis was 29%. Massive rotator cuff tears were significantly associated with a higher rate of osteoarthritis. Less osteoarthritis was observed when suprasupinatus healed.
- Hypotestosteronemia is an important factor for the development of hypertension: elevated blood pressure in orchidectomized conscious rats is reversed by different androgens. [Journal Article]
- EEndocrine 2019 Jun 15
- CONCLUSIONS: These in vivo experimental findings reveal that hypotestosteronemia is a determining factor for the development of hypertension which is powerfully reduced by androgen administration, and 5β-DHT induces a potent and effective antihypertensive response by a NO-independent mechanism.
- Metformin exhibits its therapeutic effect in the treatment of pre-eclampsia via modulating the Met/H19/miR-148a-5p/P28 and Met/H19/miR-216-3p/EBI3 signaling pathways. [Journal Article]
- IIInt Immunopharmacol 2019 Jun 13; 74:105693
- Metformin (Met) has been found to modify the methylation of H19 and to alter its expression. In addition, IL-27, one of the downstream factors in the H19 signaling pathway, plays an important role in…
Metformin (Met) has been found to modify the methylation of H19 and to alter its expression. In addition, IL-27, one of the downstream factors in the H19 signaling pathway, plays an important role in the pathogenesis of pre-eclampsia (PE). In this study, we investigated the molecular mechanism underlying the therapeutic effect of Met in the management of PE both in vivo and in vitro. The role of H19 signaling pathway in PE was validated using online bioinformatics tools, luciferase assays, real-time PCR and Western Blot. A tail-cuff method was used to examine the blood pressures in PE rats with or without Met treatment. Cells exhibited a dose-dependent increase of H19 methylation, which inhibited the expression of H19. Additionally, upon the Met treatment, levels of miR-148-5p and miR-216-3p were both elevated in a dose-dependent manner while levels of p28 mRNA and EBI3 mRNA were both inhibited by Met treatment. Also, H19 was found to regulate the expression of miR-148a-5p and miR-216-3p, while P28 and EBI3 were respectively identified as target genes of miR-148a-5p and miR-216-3p. Therefore, the Met/H19/miR-148a-5p/P28 and Met/H19/miR-216-3p/EBI3 signaling pathways were implicated in the pathogenesis of PE. Met was implicated in the pathogenesis of PE via modulating the H19 signaling pathway. The methylation of H19 reduced H19 expression, which in turn could up-regulate the expression of miR-148-5p/miR-216-3p. And the expressions of subunits of IL-27, P28 and EBI3, were thus suppressed. Therefore, Met-induced inhibition of H19 also led to the reduction of IL-27 expression, TNF-α and IL-6 in vivo.
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- Practical Dose Parameter Values for the Prediction of the Adverse Effect of Neuro-interventional Radiation: Relationships between the Dose Parameters and Temporary Alopecia after Intracranial Coil Embolization. [Journal Article]
- WNWorld Neurosurg 2019 Jun 13
- To present values for the dose parameters predictive of alopecia as an adverse effect induced by neuroembolization using a biplane fluoroscopy.
To present values for the dose parameters predictive of alopecia as an adverse effect induced by neuroembolization using a biplane fluoroscopy.