Arthroscopy or arthrotomy for native knee septic arthritis: A systematic review.

Purpose: Septic arthritis of any joint is an orthopaedic emergency which requires prompt diagnosis and treatment. The knee is the commonest joint afflicted, and the primary objective of any treatment is complete source control. This commonly takes the form of antibiotic therapy and a washout of the infected joint by means of arthroscopy or arthrotomy.

Acetabular cup size trends in total hip arthroplasty.

Background: Total hip arthroplasty (THA) is a common procedure for end stage osteoarthritis. The learning curve for THA is complex and challenging. One of the most difficult skills to master is acetabular reaming.

Isolated Extensor Hallucis Longus Compartment Syndrome: A Case Report.

We present the case of an isolated extensor hallucis longus compartment syndrome following a diaphyseal fibular fracture. Our subject underwent syndesmotic fixation and experienced ongoing pain post-procedure. This was associated with an isolated loss of power in extension of the hallux.

Plain film of the abdomen remains a low sensitivity test in A&E.

Background: Plain film abdomens (PFA) are frequently used in the emergency department to help guide the management of patients presenting with abdominal symptoms. A plain film abdomen contributes minimally to clinical scenarios due to low sensitivity and specificity. Is a PFA useful in the emergency setting or does it serve to further complicate decision making?

Aim: We hypothesise that PFAs in the emergency department are over utilised to falsely reassure clinicians and patients alike.

Does previous fragility fracture impact upon mortality in a hip fracture cohort? a retrospective study.

Background: Fragility fractures are described as fractures resulting from low-energy trauma and are considered diagnostic of reduced bone mineral density or osteoporosis. They often present as hip fractures with hip fractures remaining a common but devastating injury among older patients. Many factors influence a patient's risk of hip fracture and their subsequent risk of death.

What is wrong with the training of general surgery?

The practice of surgery has undergone tumultuous changes over the last 30 years. Disease management, trauma volume, operative techniques, supervision requirements, and allocation of work hours have all changed, resulting in a substantial impact on general surgical training. Changes need to occur in the structure, assessment, and mentorship of future residents to prepare them to enter the marketplace and practice safe medicine with confidence and authority.

Laparoscopic sleeve gastrectomy is safe and effective in elderly patients: a comparative analysis.

Background: Laparoscopic sleeve gastrectomy (SG) is gaining widespread popularity as a definitive bariatric operation that provides satisfactory and durable weight loss as well as comorbidity resolution. Although SG is being increasingly offered to patients of all ages, there is a paucity of reported outcomes in patients ≥62 years of age. The purpose of this study was to perform a comparative analysis of the outcomes of SG in patients >62 years versus a younger age group, with an emphasis on safety and efficacy.

Laparoscopic transgastric gastroplasty: a novel technique for a large esophagogastric fistula.

Esophagogastric fistula is a rare complication related to severe inflammation at the gastroesophageal junction. Most causes are related to severe gastroesophageal reflux disease, previous surgery, or malignancy. This is the case of a 72-year-old man who had a laparoscopic Nissen fundoplication.

Revisional bariatric surgery is more effective for improving obesity-related co-morbidities than it is for reinducing major weight loss.

Background: Patients having previous bariatric surgery are at risk for weight regain and return of co-morbidities. If an anatomic basis for the failure is identified, many surgeons advocate revision or conversion to a Roux-en-Y gastric bypass. The aim of this study was to determine whether revisional bariatric surgery leads to sufficient weight loss and co-morbidity remission.

Incidence of gastrojejunostomy stricture in laparoscopic Roux-en-Y gastric bypass using an autologous fibrin sealant.

Background: Anastomotic leak at the gastrojejunostomy is a life-threatening complication of laparoscopic Roux-en-Y gastric bypass (LRYGB). Fibrin sealants have been used as topical adjuncts to reduce leaks at the gastrojejunostomy. Our clinical observations suggest that an unintended consequence may be the promotion of anastomotic stricture.

The effect of subgingival ozone and/or hydrogen peroxide on the development of peri-implant mucositis: a double-blind randomized controlled trial.

Purpose: This double-blind randomized controlled trial assessed the effect of subgingival ozone (O3, gaseous ozone, HealOzone MK II, KaVo) and/or hydrogen peroxide (H2O2) on the development of peri-implant mucositis.

Materials And Methods: Twenty subjects (mean age, 60 ± 7.7 years) with 80 implants (4 implants each) were recruited.

Iatrogenic intestinal and mesenteric injuries with small bowel volvulus following use of barbed suture during laparoscopic myomectomy.

This is a case report of a patient who developed major intestinal complications after the utilization of barbed sutures for an off-label indication. The report serves as a warning for patients and surgeons of the potential injuries that may be caused by the use of new products in unapproved indications.

Deep sedation in natural orifice transluminal endoscopic surgery (NOTES): a comparative study with dogs.

Background: Natural orifice transluminal endoscopic surgery (NOTES) has been mostly performed with the animal under general and inhalational anesthesia (IA-NOTES). To date, NOTES using propofol sedation (PS-NOTES) has not been investigated. This study aimed to assess the feasibility and safety of PS-NOTES for transgastric oophorectomy with carbon dioxide insufflation and to compare its success rates with those of conventional IA-NOTES.

Management of children undergoing cardiac transplantation with high Panel Reactive Antibodies.

Highly sensitised children in need of cardiac transplantation have overall poor outcomes because of increased risk for dysfunction of the cardiac allograft, acute cellular and antibody-mediated rejection, and vasculopathy of the cardiac allograft. Cardiopulmonary bypass and the frequent use of blood products in the operating room and cardiac intensive care unit, as well as the frequent use of homografts, have predisposed potential recipients of transplants to allosensitisation. The expansion in the use of ventricular assist devices and extracorporeal membrane oxygenation has also contributed to increasing rates of allosensitisation in candidates for cardiac transplantation.

Lessons learned from 119 consecutive cardiac transplants for pediatric and congenital heart disease.

Background: This manuscript reviews all patients who underwent orthotopic heart transplantations (OHT) at our program (116 patients underwent 119 OHT) to describe their diagnostic characteristics and to assess risk factors for mortality.

Methods: Median age at OHT was 179 days (mean, 1,446.6 ± 188.

Gastrointestinal symptoms and patient satisfaction more than 1 year after laparoscopic Nissen fundoplication.

Background: Symptoms from poorly controlled gastroesophageal reflux disease (GERD) such as heartburn and regurgitation often resolve after laparoscopic Nissen fundoplication. Unfortunately, new gastrointestinal symptoms such as bloating may occur for some patients. Accurate data regarding the gastrointestinal symptoms experienced by patients who have had a laparoscopic fundoplication may help patients to make more informed decisions about pursuing surgery for their reflux disease.

Gastric electrical stimulation is an effective and safe treatment for medically refractory gastroparesis.

Background: Gastroparesis is characterized by delayed gastric emptying in the absence of obstruction. Common symptoms include nausea, vomiting, and abdominal pain. Severe gastroparesis can result in recurrent hospitalizations, malnutrition, and even death.

Ultrasonic evidence of placental calcification at 36 weeks' gestation: maternal and fetal outcomes.

Background: To determine the significance of an inappropriately mature placenta on ultrasound examination (Grannum classification), in a low-risk obstetric population. Scans were performed at 36 weeks' gestation. The study group comprised patients demonstrating a grade III placenta, and the control group comprised patients not demonstrating a grade III placenta.

Helicobacter pylori infection and dyspepsia in pregnancy.

Objective: To investigate the relationship of Helicobacter pylori infection with dyspeptic symptoms in early and late pregnancy. Infection with H pylori and pregnancy outcome were also assessed.

Methods: H pylori seropositivity was determined in 416 antenatal patients at 10 to 14 weeks' gestation.

A case of lymphoma occurring in an ovarian teratoma.

Background: We describe the discovery, by pathology, of a totally unexpected diagnosis involving an ovarian teratoma.

Case: A middle-aged woman underwent routine total abdominal hysterectomy and bilateral salpingoophrectomy for ultrasonically diagnosed uterine fibroids and a coexistent benign right ovarian cyst. The operative findings were of fibroid uterus and right ovarian teratoma.

A randomized trial using ultrasound to identify the high-risk fetus in a low-risk population.

Objective: To evaluate the effect of introducing two biophysical ultrasound examinations in a low-risk antenatal population. Scans were performed at 30-32 weeks' gestation and 36-37 weeks' gestation.

Methods: Scans assessed placental maturity, amniotic fluid volume, and estimated fetal weight.