[Dorsally displaced intra-articular distal radius fractures treated by locked palmar plate. Technique and results].

Objectives: The purpose of this study was to evaluate the results and complications of locked palmar plating in patients with articular fracture of the distal radius.

Methods: Twenty-two patients were reviewed retrospectively. The average age was 68 years.

A prospective clinical study of the A1 pulley in trigger thumbs.

A prospective study was performed in 19 patients with trigger thumbs to define the anatomy of the A1 pulley of the thumb in this condition and to evaluate biomechanical parameters of the thumb after complete division of the A1 pulley. Pre- and postoperatively, flexion of the interphalangeal and metacarpophalangeal joints, key pinch strength and tip pinch strength were measured and compared with these measurements on the contralateral thumb. We identified three types of A1 pulley.

Myocardial perfusion defects after radiation therapy and anthracycline chemotherapy for left breast cancer: a possible marker of microvascular damage. Three cases and review of the literature.

Radiation therapy to the thorax may induce early and late cardiac adverse effects if large parts of the heart have been included in the irradiation field and particularly if anthracycline-containing chemotherapy is concomitantly administered. We describe 3 cases of cardiotoxicity in patients with left breast cancer treated with anthracycline-containing chemotherapy and left thoracic radiotherapy. In 2 cases we observed asymptomatic electrocardiographic abnormalities of ventricular repolarization mimicking anterior myocardial ischemia and SPECT reversible myocardial perfusion defects.

Four-corner arthrodesis: influence of the position of the lunate on postoperative wrist motion: a cadaveric study.

Purpose: Evaluate the influence of the position of the lunate on postoperative wrist motion in four-corner arthrodesis.

Methods: Six upper cadaveric limbs were evaluated, comparing the total arc of motion in each wrist after simulating four-corner arthrodesis. The lunate was fixed in 3 different positions: neutral (0 degrees ), extended (30 degrees ), and flexed (20 degrees ).

Transition from failing dentition to a fixed implant-supported restoration: a staged approach.

This article describes a staged approach to provide a fixed restoration to patients with a hopeless dentition without a removable provisional phase. The rehabilitation protocol, which includes initial conservative periodontal care, starts with strategic extraction of some of the remaining teeth. The aim of the first step is to permit implant placement and to strategically keep residual teeth as abutments for a provisional fixed denture during the implant healing period.

Influence of immediate implant loading on peri-implant soft tissue morphology in the edentulous maxilla.

Purpose: This study investigates the pre- and posttreatment morphology of the mucosa around immediately loaded implants in the edentulous maxilla.

Materials And Methods: Implants were placed and immediately loaded in edentulous maxillae; pre- and posttreatment impressions were obtained. The resulting casts were digitalized into 3-dimensional images, and the pre- and posttreatment images were superimposed.

Infected nonunion of the humerus treated with an antibiotic cement rod. Case report.

The authors present a case of an infected nonunion of the humerus treated initially with reaming of the medullar canal followed by the introduction of an antibiotic-impregnated intramedullary rod. Reconstruction of the humerus with bone fixation and bone graft was performed in a second stage. The final result was healing of the fracture and a good functional result with no evidence of recurrence of infection at a 25 months follow up.

Achieving natural-looking morphology and surface textures in anterior ceramic fixed rehabilitations.

This article describes a procedure to achieve natural-looking morphology and surface textures in anterior ceramic restorations. The natural dentition serves as an atlas to interpret and mimic the orientation and location of dental anatomic structures. Transition angles and ridges; proximal slopes; labial grooves; the cervical, middle, and incisal thirds of the buccal surface; the lingual central concavity; and the lingual transition ridges should all be mimicked by the prosthetic work to achieve esthetic integration.

Trapeziectomy and intermetacarpal ligament reconstruction with the extensor carpi radialis longus for osteoarthritis of the trapeziometacarpal joint: surgical technique and long-term results.

Purpose: To report the long-term results of excision of the trapezium and intermetacarpal ligament reconstruction with the extensor carpi radialis longus for thumb trapeziometacarpal osteoarthritis.

Methods: Fourteen women and 5 men were retrospectively reviewed after an average of 9 years of follow-up evaluation. Trapeziectomy was performed and the extensor carpi radialis longus was harvested by a dorsoradial approach to reconstruct the intermetacarpal ligament.

Morphologic, immunologic, and molecular methods to detect bacillus anthracis in formalin-fixed tissues.

Due to the importance of Bacillus anthracis as a cause of naturally occurring infection among humans and as an agent of bioterrorism, there is a vital need for rapid and specific assays, including immunohistochemistry (IHC) and polymerase chain reaction (PCR) assays, to detect the bacterium in formalin-fixed tissues. Colorimetric IHC assays were developed using a multistep indirect immunoalkaline phosphatase method with anti-B. anthracis cell wall (EAII-6G6-2-3) and anti-B.

Developing a model psychiatric treatment program for patients with intellectual disability in a community mental health center.

The Special Needs Clinic of the Johns Hopkins Bayview Medical Center in Baltimore, Maryland provides comprehensive treatment for patients with developmental or intellectual disability and psychiatric illness. This report describes the clinical characteristics and service utilization of patients attending this clinic. Factors that support quality mental health services that are both cost-effective and accessible are identified.

Carotid-cavernous sinus fistula: a case study.

Carotid-cavernous sinus fistulae are rare, but serious, vascular anomalies which may develop following traumatic injury to the skull base. Fractures or the shearing forces of severe head trauma may cause the internal carotid artery to be torn from its points of dural attachment and rupture, with resultant direct flow into the cavernous sinus. Current treatment options for carotid-cavernous sinus fistulae are surgery and coil embolization, with embolization being the most common.

Hand involvement in paraneoplastic syndrome: a case report.

Cutaneous paraneoplastic syndromes are skin and mucous membrane changes that are associated with cancer. We report a previously healthy 76-year-old man who developed marked finger and thumb contracture, pain, and hypersensitivity of both hands who was diagnosed subsequently as having gastric carcinoma with colonic metastasis. After the gastrointestinal tumors were resected the finger and thumb contracture lessened and the pain eased.

Cost-sharing requirements and access to mental health care among medicare enrollees with schizophrenia.

Objective: This study explored the association between Medicare cost-sharing requirements and the probability of use of various mental health outpatient services among Medicare enrollees with schizophrenia.

Methods: Multivariate logistic regression was used to estimate the probability of use of each of seven types of services over six months. Patients were recruited from public and private mental health treatment provider organizations in six states.

The ''central'' quadrantectomy. Introducing a new reconstruction technique after excision of the central sub- and periareolar portion of the breast.

A new method is presented for the closure of a central cylindrical breast exeresis, embracing, full thickness, the skin and the gland. For this reconstruction, performed without altering the original shape of the breast, without removing any additional healthy tissue, we used a skin-gland flap rotated from the inferior quadrant to correct the defect.

Impact of the wait for an initial appointment on the rate of kept appointments at a mental health center.

Failure to keep initial appointments at a community mental health center results in a burden on the staff and the center's financial resources. The authors studied referrals to an outpatient program and found that delay in scheduling appointments had a significant impact on rate of kept appointments. The impact was significant during the first week of delay and appeared to stabilize after day seven.

Treatment of completely edentulous patients with fixed implant-supported restorations: three consecutive cases of simultaneous immediate loading in both maxilla and mandible.

This article aims to: (1) describe the treatment of three consecutive completely edentulous patients with fixed implant-supported restorations, including simultaneous same-day immediate loading with fixed provisional restorations in both jaws; and (2) illustrate a step-by-step definitive restoration approach. All patients followed the same diagnostic protocol. One surgical intervention was performed for simultaneous implant placement in both maxilla and mandible.

Immediate loading with fixed screw-retained provisional restorations in edentulous jaws: the pickup technique.

Purpose: This article describes (a) an immediate loading technique in the treatment of edentulous arches with screw-retained provisional restorations and (b) the effort to determine whether the described technique is compatible with the predictable achievement of osseointegration.

Materials And Methods: Eight patients with either 1 or 2 edentulous arches were treated. A diagnostic tooth arrangement was carried out for each patient and was then duplicated twice to fabricate a provisional template and a surgical guide.

Linezolid-induced bradycardia: a case report.

We report an episode of severe bradycardia that occurred in a 49-year-old woman with fever and malignant jaundice during antibiotic therapy with linezolid, a new oxazolidinone with activity against Gram-positive cocci. In our case, the strict temporal dependence between bradycardia and linezolid therapy seems to provide strong evidence for a causal relationship. To our knowledge, this is the first report of linezolid-induced bradycardia.

Modeling and characterization of the CEJ for optimization of esthetic implant design.

This study evaluated the dimensions and characteristics of the cementoenamel junction (CEJ) of maxillary anterior teeth; the natural CEJ was compared to current implant design and used for design optimization. Standardized digital images of 137 extracted human teeth (45 central incisors, 46 lateral incisors, and 46 canines) were used to measure cervical dimensions, CEJ curvature, and distance from zenith of CEJ to interdental contact on proximal views. The x- and y-coordinates of the CEJ contour were digitized before mathematic processing to allow the representation of a single average curve for buccal, palatal, mesial, and distal surfaces for each tooth type.