Success of topiramate to slow progression of Blount disease in a toddler: A case study.

Rates of Blount disease and childhood obesity have increased in parallel, although the co-management of this acquired comorbidity and obesity is not well described. This report shares the course of a toddler with severe obesity who experienced rapid and persistent weight gain without success from nutrition and behavior changes. After repeat subspeciality evaluation, the patient was ultimately diagnosed with signs of early-onset Blount disease, urging the need for adjunct medical therapy.

Robot-Assisted Simple Prostatectomy: A Comparison of Primary Simple Prostatectomy Salvage Simple Prostatectomy in Treatment of Lower Urinary Tract Symptoms.

Simple prostatectomy is indicated in patients with enlarged glands (>80 ) who present with lower urinary tract symptoms (LUTS) attributed to benign prostatic hyperplasia. Salvage robotic simple prostatectomy (SSP) is defined as simple prostatectomy after failed transurethral procedure. The aim of this study is to evaluate the efficacy of primary robotic simple prostatectomy (PSP) SSP in ameliorating LUTS.

A Comparative Analysis of Short-term Patient Outcomes After Laparoscopic Versus Robotic Rectal Surgery.

Background: The popularity of robot-assisted colorectal surgery has risen over recent years; however, patient-related advantages over laparoscopic surgery remain uncertain.

Objective: The goal of this study was to compare short-term patient outcomes following robotic and laparoscopic partial or complete rectal resections.

Design: This was a retrospective cohort study.

Implementation science for the adductor canal block: A new and adaptable methodology process.

Background: Following the successful Perioperative Surgical Home (PSH) practice for total knee arthroplasty (TKA) at our institution, the need for continuous improvement was realized, including the deimplementation of antiquated PSH elements and introduction of new practices.

Aim: To investigate the transition from femoral nerve blocks (FNB) to adductor canal nerve blocks (ACB) during TKA.

Methods: Our 13-month study from June 2016 to 2017 was divided into four periods: a three-month baseline (103 patients), a one-month pilot (47 patients), a three-month implementation and hardwiring period (100 patients), and a six-month evaluation period (185 patients).

Population Management Approach to Kidney Stone Care Improves Patient Compliance to Preventive Measures and Reduces Resource Utilization in Patients at High Risk for Stone Recurrence.

Introduction: Nephrolithiasis is a chronic condition with 5 to 10-year recurrence rates as high as 50%. Stone recurrence can be reduced by implementing American Urological Association kidney stone medical management guidelines, which recommend additional metabolic testing for high risk, recurrent and interested first-time stone formers. However, clinician adherence to guidelines is variable, and patient compliance with preventive evaluations is low.

Effectiveness of onabotulinumtoxinA (BOTOX) in pediatric patients experiencing migraines: a randomized, double-blinded, placebo-controlled crossover study in the pediatric pain population.

Introduction: OnabotulinumtoxinA (OBTA) is approved for treating chronic headaches and migraines in adults, but there is limited scientific literature on the outcomes in pediatric patients. The aim of this study was to determine if subjects treated with OBTA reported a statistically significant improvement in the primary features (frequency, intensity, duration and disability scoring) associated with migraines compared with placebo at follow-up visits.

Methods: After obtaining approval by the appropriate local (HS# 2016-3108) and federal institutions, the principal investigator enrolled candidates aged 8 to 17 years old diagnosed with chronic migraines (at least 6 months), and 15 or more headache days in a 4-week baseline period.

Postoperative Physician Phone Calls as a Method to Decrease Urgent Care and Emergency Department Returns After Ambulatory General Surgery.

Unplanned returns after ambulatory surgery pose a burden to patients and health care providers alike. We hypothesized that a postoperative phone call by a physician would decrease avoidable returns to urgent care (UC) or the emergency department (ED) in the week after anorectal (AR), laparoscopic cholecystectomy (LC), inguinal hernia repair (IHR), and umbilical hernia repair (UHR) operations. A retrospective analysis from 1/2011 to 12/2015 across 14 Kaiser hospitals was conducted to determine baseline UC/ED return rates of patients pre-call.

Impact of Intraoperative Foley Catheters on Postoperative Urinary Retention after Inguinal Hernia Surgery.

Foley catheters (FCs) are often used during inguinal hernia operations; however, the impact of intraoperative FC use on postoperative urinary retention (POUR) is not well understood. We reviewed unplanned returns to the urgent care or ED for 27,012 inguinal hernia operations across 15 Southern California Kaiser Permanente medical centers over 6.5 years.

Unplanned Returns to Care within Seven Days after Anorectal Surgery: Can they be Avoided?

With rates up to 50 per cent, unanticipated returns after anorectal surgery remain a major issue. A retrospective analysis was performed on 5929 anorectal operations from January 2011 to December 2015 across 14 Kaiser Permanente Southern California medical centers. Data were gathered on the cause, frequency and timing of unplanned returns to the ED and urgent care.

An Analysis of Early Postoperative Returns after Inguinal Hernia Surgery.

Although inguinal herniorrhaphy is low risk, patients still return to the urgent care or ED. We performed a retrospective study on 19,296 inguinal hernia operations across 14 Southern California Kaiser Permanente medical centers over five years. Unplanned returns within the first postoperative week were evaluated focusing on four potentially avoidable diagnoses (AD): pain, constipation, urinary retention, and nausea/vomiting.

Ceruminous gland carcinomas: a clinicopathologic and immunophenotypic study of 17 cases.

Background: Ceruminal gland carcinomas are rare neoplasms confined to the skin lining the cartilaginous part of the external auditory canal.

Design: Retrospective.

Results: The patients included 11 men and 6 women, aged 33-82 years (mean, 59.