The Management of Upper-Extremity Xylazine-Associated Wounds.

Purpose: Xylazine has been associated with necrotic soft tissue wounds that have placed a challenging burden on patients who inject drugs in the Philadelphia region's health care system over the last few years. An analysis of our initial experience is being presented to guide future treatment and directions for future research.

Methods: A retrospective review of 55 patients with patient-reported xylazine use and associated upper-extremity wounds at a single institution was performed.

Reoperation Rate Following Thumb Basal Joint Arthroplasty: A Minimum Follow-Up Period of 5 Years.

Purpose: Thumb basal joint arthroplasty (BJA) performed for thumb basal joint arthritis is associated with high patient satisfaction. However, complications requiring reoperation occur, with a previously reported early reoperation rate (within 2 years) of 1.5%.

Reducing Opioid Use in Orthopaedic Surgery.

The opioid crisis has been an issue in the United States since the mid-1990s, claiming numerous lives and presenting a significant challenge to health care clinicians. Various preoperative, intraoperative, and postoperative strategies aimed at reducing opioid consumption can be used by orthopaedic surgeons to help minimize this crisis. Preoperative screening tools can help identify patients at risk for prolonged opioid use, allowing for tailored interventions and counseling.

Understanding risk factors for revision surgery after cubital tunnel release: Analysis of patient selection, surgeon, and clinical factors.

Purpose: The purpose of this study was to identify and characterize factors that may contribute to revision surgery following primary cubital tunnel release (CuTR) surgery.

Methods: A retrospective study was performed by reviewing all patients who underwent CuTR at a single institution between 2014 and 2021. Only primary CuTR surgeries were included.

Cold Intolerance Following Digital Nerve Injury: A Multicenter Prospective Randomized Comparison of Decellularized Nerve Allograft Versus Nerve Conduits.

Background: Cold intolerance following digital nerve injury burdens patients significantly. To better understand how cold intolerance evolves in the setting of digital nerve injuries, a sub-analysis of a trial comparing conduit-based (CONDUIT) and processed nerve allograft (PNA) repairs was conducted. It was hypothesized that PNA repairs would alleviate cold intolerance more effectively, especially for longer nerve gaps.

Adult mental healthcare professionals' experiences of family centred conversations with patients who are parents: a qualitative study.

Background: Many parents with a mental illness report a desire for both recognition of their parental role and support for themselves and their children. However, parents are often fearful of negative judgements from professionals about their ability to be a parent, which inhibits raising concerns about their children with clinical teams. Consequently, an essential first step to supporting families is for professionals to proactively identify which patients are parents, although evidence indicates this is not consistently part of services.

Thick Ascending Limb Specific Inactivation of Myh9 and Myh10 Myosin Motors Results in Progressive Kidney Disease and Drives Sex-specific Cellular Adaptation in the Distal Nephron and Collecting Duct.

Our previous work established a role for actin associated myosin motor proteins MYH9 and MYH10 in the trafficking of thick ascending limb (TAL) specific cargoes, uromodulin (UMOD) and Na + K + 2Cl- cotransporter (NKCC2). Here, we have generated a TAL-specific Myh9&10 conditional knockout (Myh9&10 TAL-cKO) mouse model to determine the cell autonomous roles for MYH9&10 proteins in TAL cargo transport and to understand the consequence of TAL dysfunction in the adult kidney. Myh9&10 TAL-cKO mice develop progressive kidney disease with pathological tubular injury confirmed by histological changes, tubular injury markers, upregulation of ER stress/unfolded protein response pathway, and higher blood urea nitrogen and serum creatinine.

Epidemiology and outcomes of out of hospital cardiac arrest in Karachi, Pakistan - A longitudinal study.

Background: Out-of-hospital cardiac arrest (OHCA) is a major cause of morbidity and mortality globally, with survival outcomes remaining poor particularly in many low- and middle-income countries. We aimed to establish a pilot OHCA registry in Karachi, Pakistan to provide insights into OHCA patient demographics, pre-hospital and in-hospital care, and outcomes.

Methods: A multicenter longitudinal study was conducted from August 2015-October 2019 across 11 Karachi hospitals, using a standardized Utstein-based survey form.

Impact of Renal Replacement Therapy on Outcomes of Living Donor Liver Transplantation for Acute Liver Failure: A Cohort Study.

Despite the promising role of renal replacement therapy (RRT) in acute liver failure (ALF), high-risk patients need liver transplantation and remain at risk for death due to cerebral complications. The objective of this study was to report outcomes of living donor liver transplantation (LDLT) for ALF with perioperative RRT. This was a single-center retrospective cohort study.

Ethnic Disparities in Access to Mental Health Services for Black and Asian Migrants in Major Resettlement Countries.

Ethnic inequalities in high-income countries result in higher risk of mental illness and lower access to healthcare services for migrant populations than the majority White populations. This literature review examined evidence of the responsible barriers. A systematic search of six databases (Psychology and Behavioral Sciences Collection; eBook Collection [EBSCOhost]; CINAHL; GreenFILE; Library, Information Science & Technology Abstracts; and MEDLINE) was done using search terms.

Understanding Changing Demographic and Treatment Trends of Distal Radius Fractures: A TriNetX Database Contemporary Analysis of 32,912 Patients.

Purpose: Distal radius fractures (DRF) are among the most commonly encountered fractures. The population of the United States is rapidly growing, aging, and diversifying. This study was undertaken to better understand current incidences and treatment trends across all ages, gender, and races to inform resource allocation and to potentially address treatment inequities.

Actin cytoskeleton and associated myosin motors within the renal epithelium.

This review highlights the complexity of renal epithelial cell membrane architectures and organelles through careful review of ultrastructural and physiological studies published over the past several decades. We also showcase the vital roles played by the actin cytoskeleton and actin-associated myosin motor proteins in regulating cell type-specific physiological functions within the cells of the renal epithelium. The purpose of this review is to provide a fresh conceptual framework to explain the structure-function relationships that exist between the actin cytoskeleton, organelle structure, and cargo transport within the mammalian kidney.

The Effect of Anticoagulant and Antiplatelet Medications on Wide-Awake Hand Surgery: An Analysis of 2,162 Cases.

Purpose: The purpose of the study was to determine if perioperative prescription anticoagulant (AC) or antiplatelet (AP) medication use increases the rate of revision surgeries or complications following wide-awake hand surgery performed under local anesthesia.

Methods: All patients who underwent outpatient wide-awake hand surgery under local anesthesia without a tourniquet by two fellowship-trained orthopedic hand surgeons at a single academic practice over a 3-year period were included. Prescription history was reviewed to determine if any prescriptions were filled for an AC/AP drug within 90 days of surgery.

Comparing Patient Comfort During Bronchoscopy Under Conscious Sedation and Monitored Anesthesia Care: A Prospective, Observational, Controlled Study.

Background: Flexible bronchoscopy (FB) often involves sedation, with the choice left to the bronchoscopist's discretion. Prior research on sedation in gastroscopic endoscopies yields conflicting information regarding the preferred method for FB. This study compares patient comfort levels during bronchoscopy with mindful sedation using fentanyl, nalbuphine, and midazolam versus monitored anesthesia care (MAC) using propofol, midazolam, and ketamine.

Preliminary Outcomes of Scapholunate Ligament Augmentation with Internal Brace Technique.

Purpose: Injury to the scapholunate (SL) interosseous ligament (SLIL) is a common cause of carpal instability. Internal brace augmentation has been used in various ligament repair procedures; however, further investigation of its outcomes in hand surgery is needed. This study aimed to examine outcomes for patients who underwent SLIL repair with internal brace augmentation.

Insights into the dynamic interactions of RNase a and osmolytes through computational approaches.

Osmolytes are small organic molecules that are known to stabilize proteins and other biological macromolecules under various stressful conditions. They belong to various categories such as amino acids, methylamines, and polyols. These substances are commonly known as 'compatible solutes' because they do not disrupt cellular processes and help regulate the osmotic balance within cells.

Orthopaedic Hand Surgical Simulation Training: A Review.

In recent years, new orthopaedic surgical simulation and virtual reality (VR) training models have emerged to provide unlimited education medium to an unlimited number of trainees with no time limit, especially in response to trainee work-hour restrictions. Surgical simulators range from simple wooden boxes to animal and cadaver models to three-dimensional-printed and VR simulators. The coronavirus disease 2019 pandemic further highlighted the need for at-home learning tools for orthopaedic surgical trainees.

Management of Lunate Facet Escape after Distal Radius Fracture Volar Plating: Surgical Technique.

Fractures involving the lunate facet of the distal radius (commonly called the volar ulnar corner or "critical corner") are often difficult to recognize radiographically. "Lunate facet escape" refers to the displacement of this fragment after attempted distal radius fracture closed or open reduction methods. Lunate facet escape can have severe consequences including carpal collapse with pain, instability, and arthritis.