[Percutaneous endoscopic gastrostomy in a 42-year-old patient with suspected variant of Creutzfeld Jakob disease using a disposable bronchoscope].

Prion diseases pose a challenge for flexible reusable endoscopes. Especially for the new variant of Creutzfeld Jakob disease (vCJD) there is currently no suitable processing procedure. In these patients only disposable endoscopes are hygienically safe.

Surgical versus conservative treatment for odontoid fractures in older people: an international prospective comparative study.

Background: The optimal treatment for odontoid fractures in older people remains debated. Odontoid fractures are increasingly relevant to clinical practice due to ageing of the population.

Methods: An international prospective comparative study was conducted in fifteen European centres, involving patients aged ≥55 years with type II/III odontoid fractures.

Torticollis with Atlantoaxial Rotatory Subluxation in Children: A Clinical Review.

A small proportion of children with a sudden onset torticollis ("wry neck") presents with an atlantoaxial rotatory subluxation, usually after mild trauma or recent head or neck infection. Torticollis is a clinical diagnosis and imaging is usually not indicated, though often performed in clinical practice. Atlantoaxial rotatory subluxation on imaging is often a physiological phenomenon in torticollis, and concomitant neurological symptoms are therefore rare.

Empiric Esophageal Dilatation for Solid-Food Dysphagia: Presence of Mucosal Tear on Relook Endoscopy Predicts Symptomatic Response.

We hypothesized that a mucosal tear on relook endoscopy after empiric dilatation predicts symptomatic response. We evaluated symptomatic response (modified Ogilvie dysphagia score) after 161 consecutive esophageal dilatations. Comparing visible strictures, empiric dilatations with mucosal tear, and empiric dilatations without tear, baseline dysphagia scores were similar ( P = 0.

Relationship Between Sporadic Behavioral Variant Frontotemporal Dementia and Primary Psychiatric Disorders: A Study in Families.

Because the behavioral variant of frontotemporal dementia (bvFTD) shows major clinical overlap with primary psychiatric disorders (PPD) that affect similar neuroanatomical circuits, a common genetic vulnerability between FTD and PPD was hypothesized. We studied whether PPD are more prevalent in families of patients with sporadic frontotemporal dementia compared with healthy controls (HC), subjects with Alzheimer's disease (AD), and individuals with bipolar disorder (BD). In this case-control study performed between January 2013 and February 2019, we investigated the first-degree family history concerning depression, psychosis (including schizophrenia), BD, and autism spectrum disorder for 73 bvFTD patients, 153 patients with BD, 108 patients with AD, and 101 HC with a semistructured questionnaire (QFTD-NL 1.

Merkel Cell Carcinoma of the Hand in a Young Patient.

Merkle cell carcinoma (MCC) is a rare, malignant neuroendocrine skin cancer that typically affects patients in the seventh decade of life. Reports of MCC affecting young patients are limited, and there are few mentions of the management of these lesions when they present on the hand and fingers. Hand surgeons must be educated regarding the diagnosis of MCC and the multidisciplinary management required to achieve optimal results.

Evaluation of factors influencing surgical treatment costs for distal biceps rupture.

Background: Given the similar outcomes of various fixation constructs for single-incision distal biceps repair, a critical evaluation of the factors that drive the cost of the procedure is the key to optimizing treatment value. The purpose of this study was to quantify variation in costs for surgical treatment of complete distal biceps ruptures, as well as identify factors affecting costs.

Methods: We retrospectively identified adult patients consecutively treated surgically for complete distal biceps ruptures between July 2011 and January 2018 at a single academic medical center.

Impact of Early (<24 h) Surgical Decompression on Neurological Recovery in Thoracic Spinal Cord Injury: A Meta-Analysis.

The impact of surgical timing in neurological recovery in thoracic and thoracolumbar traumatic spinal cord injury (tSCI) is still a subject of discussion. While in cervical tSCI one may expect a beneficial effect of early intervention within 24 h, especially in complete cases, this has not yet been demonstrated clearly for thoracic tSCI. This study addresses neurological improvement after early and late surgery for thoracic and thoracolumbar tSCI.

Comparison of Direct Surgical Costs for Proximal Row Carpectomy and Four-Corner Arthrodesis.

 Proximal row carpectomy (PRC) and four-corner arthrodesis (FCA) are common treatments for stage II scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC) wrists, with similar functional and patient-reported outcomes reported in the peer-reviewed literature.  Study questions included (1) whether surgical encounter total direct costs (SETDCs) differ between PRC and FCA, and (2) whether SETDC differs by method of fixation for FCA.  Consecutive adult patients (≥ 18 years) undergoing PRC and FCA between July 2011 and May 2017 at a single tertiary care academic institution were identified.

Epidemiology of Spinal Fractures in a Level One Trauma Center in the Netherlands: A 10 Years Review.

Study Design: Retrospective epidemiological study.

Objective: To describe the epidemiology of spinal fractures over a 10 years period in a level one trauma center in the Netherlands.

Summary Of Background Data: Spinal fractures may have large socioeconomic consequences.

Snapping at the Lateral Aspect of the Elbow: A Case Report and Review of the Literature.

Case: A 59-year-old man presented with snapping at the lateral aspect of the elbow and associated pain. Magnetic resonance imaging demonstrated extensor tendinopathy and thickening of the radial collateral ligament. Ultrasonography showed entrapment of a synovial fold in the radiohumeral joint.

Timing of surgery in traumatic spinal cord injury: a national, multidisciplinary survey.

Purpose: The optimal surgical timeframe for neurological recovery in traumatic spinal cord injury (tSCI) still remains unknown. Recent guidelines have recommended performing surgery within 24 h for all patients with tSCI regardless of initial neurological deficit. It remains unclear whether patients with complete, incomplete tSCI, or traumatic central cord injury (TCCI) will experience the same degree of improvement after urgent surgical intervention.

Local Modalities for Preventing Surgical Site Infections: An Evidence-based Review.

Surgical site infections remain a dreaded complication of orthopaedic surgery, affecting both patient economics and quality of life. It is important to note that infections are multifactorial, involving both surgical and patient factors. To decrease the occurrence of infections, surgeons frequently use local modalities, such as methicillin-resistant Staphylococcus aureus screening; preoperative bathing; intraoperative povidone-iodine lavage; and application of vancomycin powder, silver-impregnated dressings, and incisional negative-pressure wound therapy.

Comprehensive Review of Skiing and Snowboarding Injuries.

Skiing and snowboarding have increased in popularity since the 1960s. Both sports are responsible for a substantial number of musculoskeletal injuries treated annually by orthopaedic surgeons. Specific injury patterns and mechanisms associated with skiing and snowboarding have been identified.

Arthroscopic Quantification of Syndesmotic Instability in a Cadaveric Model.

Purpose: To investigate whether arthroscopy or stress radiography can identify instability resulting from single-ligament injury of the ankle syndesmosis and to determine whether either modality is capable of differentiating between various levels of ligament injury.

Methods: Syndesmotic/deltoid ligament sectioning was performed in 10 cadaver legs. Arthroscopic evaluation and fluoroscopic stress testing were completed after each sectioning.

Surgical Management of the Aging Athlete.

Epidemiologic data show that the number of middle aged (>40 yr) and elderly (>65 yr) individuals continues to increase steadily, creating an expanding need for sports medicine care. Management of injuries in this subset of patients is expanding well beyond sustaining a patient's ability to perform activities of daily living. In fact, many older individuals increasingly expect to maintain reasonably high activity levels throughout their lifespan as well as after musculoskeletal injury.

Nail Dynamization for Delayed Union and Nonunion in Femur and Tibia Fractures.

Femoral and tibial shaft fractures are common injuries in the United States. Since their introduction, reamed intramedullary nails have become the treatment of choice for most of these fractures. However, delayed union and nonunion can complicate treatment in up to 10% of patients.

Transfusion-Transmitted Babesiosis During Total Hip Arthroplasty.

Babesiosis is a potentially life-threatening zoonotic disease that is endemic to the northeastern United States and increasing in prevalence worldwide. Transmitted by the same Ixodes tick responsible for Lyme disease, the intraerythrocytic parasite Babesia causes a wide range of clinical presentations--from asymptomatic carriage to a fulminant course with rapid deterioration. Symptoms typically present 1 to 6 weeks after inoculation, with the gradual onset of fatigue, malaise, weakness, and intermittent or sustained fever as high as 40.