Suture Suspensionplasty Compared With Ligament Reconstruction and Tendon Interposition for Surgical Treatment of Thumb Carpometacarpal Arthritis.

Purpose: Thumb carpometacarpal (CMC) arthritis is the most common arthritis of the hand, with most studies demonstrating little difference in outcomes between various surgical treatment techniques. However, trapeziectomy, followed by ligament reconstruction and tendon interposition (LRTI), remains the technique of choice among hand surgeons in the United States. In 2009, suture suspensionplasty (SS) was first described as a less invasive alternative to LRTI.

A comparison of handheld versus cart-based ultrasound in the evaluation and diagnosis of carpal tunnel syndrome.

Background: Carpal tunnel syndrome (CTS) is responsible for over 90 % of median nerve neuropathies. Though a clinical diagnosis, evaluation of nerve conduction via electrodiagnostic studies (EDX) and median nerve cross sectional area (CSA) through sonographic imaging provides supporting evidence and insight into disease severity. The advent of handheld ultrasound devices offers a portable, cost-effective and non-invasive method for median nerve assessment, yet its accuracy compared to traditional cart-based ultrasound has not been assessed in this setting.

Chatbot Demonstrates Moderate Interrater Reliability in Billing for Hand Surgery Clinic Encounters.

Background: Artificial intelligence offers opportunities to improve the burden of health care administrative tasks. Application of machine learning to coding and billing for clinic encounters may represent time- and cost-saving benefits with low risk to patient outcomes.

Methods: Gemini, a publicly available large language model chatbot, was queried with 139 de-identified patient encounters from a single surgeon and asked to provide the Current Procedural Terminology code based on the criteria for different encounter types.

Characteristics of Patients Utilizing Telemedicine in Hand and Upper-Extremity Surgery.

Background: The impact of social determinants of health on patients' access to medical care and health outcomes is increasingly recognized. Telemedicine's rapid and widespread adoption altered the delivery of care. This study describes the characteristics of patients undergoing telemedicine visits with hand surgeons, without COVID-19 pandemic-related restrictions.

Potent pollen gene regulation by DNA glycosylases in maize.

Although DNA methylation primarily represses TEs, it also represses select genes that are methylated in plant body tissues but demethylated by DNA glycosylases (DNGs) in endosperm or pollen. Either one of two DNGs, MATERNAL DEREPRESSION OF R1 (MDR1) or DNG102, is essential for pollen viability in maize. Using single-pollen mRNA sequencing on pollen-segregating mutations in both genes, we identify 58 candidate DNG target genes that account for 11.

Diagnostic Accuracy of Neuromuscular Ultrasound vs. Electrodiagnostic Studies for Carpal Tunnel Syndrome: Systematic Review and Meta-analysis of Paired Accuracy Studies.

This systematic review with meta-analysis compared the diagnostic accuracy of neuromuscular ultrasound (NMUS) and electrodiagnostic studies (EDX) as confirmatory tests for carpal tunnel syndrome (CTS) diagnosis. We used bivariate random-effects models to estimate pooled sensitivity and specificity and generate hierarchical summary receiver-operating characteristic curves to assess diagnostic test accuracy. Nine paired accuracy studies were included, representing 1751 hands (743 clinically diagnosed CTS; 1008 without CTS) that underwent NMUS and EDX.

Investigating the Relationship Between Neighborhood Social Deprivation and Time to Specialty Orthopedic Care for Pediatric Trigger Thumb.

Purpose: Pediatric trigger thumb is a common condition resulting in referral from primary care to specialty care. Access to pediatric hand specialty care is a complex issue influenced by a multitude of social factors, including socioeconomic status. The aim of this study is to investigate the relationship between area deprivation and the time from primary care referral to presentation to specialty care for pediatric trigger thumb.

Distal Scaphoid Excision for Chronic and Nonchronic Scaphoid Fracture Nonunion.

Purpose: The indications for distal scaphoid excision are limited to localized wrist arthritis surrounding the scaphoid, as a result of scaphoid nonunion advanced collapse or scapho-trapezio-trapezoid joint arthritis. The procedure historically has led to relief of symptoms and improvement in strength. Our aim was to examine the outcomes of this procedure in patients with scaphoid fracture nonunion.

A Randomized-Controlled Trial Evaluating the Impact of a Web Tutorial on Perceptions and Usage of Opioids Post-Carpal Tunnel Release Surgery.

Purpose: The purpose of this study was to evaluate the efficacy of a web tutorial on perceptions of pain management and usage of opioids after carpal tunnel release surgery (post-CTR).

Methods: A web tutorial was developed by the authors, and patients were consented and enrolled if they were over the age of 18 years, could speak and understand English, and were having CTR. Patients were randomized to either view or not view the web tutorial before surgery, and all patients took a 19-question online survey approximately 2 weeks after surgery to assess their views on pain management and their self-reported opioid usage.

Equine Pergolide Toxicity: A Case Series.

Veterinary medication exposure may result in human toxicity, with approximately 6,000 exposures to veterinary-only medications reported to poison centers in 2022. There is a paucity of literature on the management of poisoned patients secondary to pharmaceuticals intended for equine use. Pergolide is a dopamine and serotonin receptor agonist and is currently approved to treat equine Cushing's disease.

Ultrasound Measurements of the Ulnar Nerve at the Medial Epicondyle Correlate With Electrodiagnostic Studies.

Background: Cubital tunnel syndrome is the second most common compressive neuropathy in the upper extremity and is commonly evaluated with electrodiagnostic studies (EDS). Ultrasound (US) has emerged as a potentially more efficient alternative to EDS. The purpose of this study is to evaluate whether measurements of the cross-sectional area (CSA) of the ulnar nerve at the elbow correlate with EDS results.

Diabetes Increases Median Nerve Cross-Sectional Area but Not Disease Severity in Patients with Carpal Tunnel Syndrome.

Background: Ultrasonography (US) is a useful diagnostic modality for diagnosis of carpal tunnel syndrome (CTS). Diabetes mellitus is increasingly prevalent and is a risk factor for CTS. Given the increasing use of US in the diagnosis of CTS, our goal was to evaluate the influence of diabetes on CTS severity and the cross-sectional area (CSA) of the median nerve in patients with CTS.

Ultrasound Cross-Sectional Area in Median Nerve Axonal Loss and Demyelination in Carpal Tunnel Syndrome.

Introduction: Ultrasound is an effective diagnostic tool for carpal tunnel syndrome (CTS). However, it is unclear how ultrasound correlates with axonal loss and/or demyelination on electrodiagnostic studies (EDS). The objective of this study is to determine whether ultrasound cross-sectional area (CSA) of the median nerve varies between patients with axonal loss or demyelination.

The Diagnostic Utility of Ultrasound and Electrodiagnostic Studies in The Young and Old.

Purpose: Carpal tunnel syndrome is the most common compressive neuropathy. The diagnostic parameters currently used for the general adult population may not be valid in elderly or younger cohorts. The purpose of this study is to determine the diagnostic accuracy of nerve conduction studies (NCS) and ultrasound (US) in different age groups utilizing the 6-item Carpal tunnel syndrome (CTS) symptoms scale (CTS-6) as the reference standard.

Characteristics of Patients with Clinical Signs and Symptoms of Carpal Tunnel Syndrome but Negative Diagnostic Testing.

Background: Carpal tunnel syndrome (CTS) is a clinical diagnosis involving numerous confirmatory diagnostic tools, including patient questionnaires, ultrasound (US), and electrodiagnostic studies (EDX.) Patients may experience clinical symptoms of CTS with false negative diagnostic testing. The purpose of this study was to identify characteristics of patients with clinical symptoms of CTS with negative diagnostic testing.

Advancements in biologic therapy in eosinophilic asthma.

Introduction: Asthma encompasses a spectrum of phenotypes often categorized into two groups- type 2 high (T2 high) and type 2 low (T2 low). T2 high includes atopic and eosinophilic presentations whereas T2 low is non-atopic, non-eosinophilic, and oft associated with neutrophilic inflammation. Eosinophilic asthma is often driven by IgE, IL-4, IL-5, and IL-13 and TSLP.

Comparison of Fusion Rates/Complications Between Different Types of Thumb Metacarpophalangeal Fusion Techniques.

Background: Thumb metacarpophalangeal (MP) fusion is generally successful; however, complications have been reported to occur in 0% to 30% of cases, whereas nonunion rates vary by method but, overall, are reported to occur in 0% to 15% of cases. Many fixation techniques have been described, but there is no consensus on the optimal fusion technique. Our goal was to compare complication and union rates of different thumb MP arthrodesis techniques.

Potent pollen gene regulation by DNA glycosylases in maize.

Although DNA methylation primarily represses TEs, it also represses select genes that are methylated in plant body tissues but demethylated by DNA glycosylases (DNGs) in endosperm or pollen. Activity of either one of two DNGs, MDR1 or DNG102, is essential for pollen viability in maize. Using single-pollen mRNA sequencing on pollen segregating mutations in both genes, we identified 58 candidate DNG target genes that account for 11.

National training and development curriculum training program impact on placement, permanency, and stability.

Background: Resource parent trainings are an important factor in caregiver readiness and retention, which can improve placement stability and permanency achievement for children and youth, especially those who are marginalized.

Objective: Resource parents need access to evidence-based training programs attentive to caring for children and youth from a variety of diverse backgrounds. This study evaluates placement, permanency, and stability outcomes of children whose resource parents were trained in one such program: the National Training and Development Curriculum (NTDC).