Micropuncture needles combined with ultrasound guidance for unusual central venous cannulation: desperate times call for desperate measures--a new trick for old anesthesiologists.

Central vascular access can be a very challenging task in patients with skeletal deformities such as ankylosing spondylitis, kyphosis, and chin-on-chest deformity. The use of traditional methods of accessing the central venous circulation in these patients can require multiple attempts and may lead to significant complications such as bleeding, pneumothorax, and vascular injury. Ultrasound-guided central venous access has become a very common procedure in the United States and Europe; its efficacy and safety have been demonstrated, and together with the use of micropuncture needles, the technique can facilitate central venous access in complicated cases.

Readability of spine-related patient education materials from subspecialty organization and spine practitioner websites.

Study Design: Analysis of spine-related websites available to the general public.

Objective: To assess the readability of spine-related patient educational materials available on professional society and individual surgeon or practice based websites.

Summary Of Background Data: The Internet has become a valuable source of patient education material.

Bilateral arthroscopic tendon interposition arthroplasty of the thumb carpometacarpal joint in a patient with Ehlers-Danlos syndrome: a case report.

A common finding in progressive osteoarthritis of the carpometacarpal joint of the thumb is ligamentous laxity. In patients with Ehlers-Danlos syndrome, which is a disorder characterized by generalized ligamentous laxity, splinting and arthrodesis have been recommended because of the random results achieved by other reconstructive procedures. We report a patient with thumb carpometacarpal joint osteoarthritis secondary to Ehlers-Danlos syndrome who was treated with bilateral arthroscopic tendon interposition arthroplasty.