Team Approach: Treatment of Traumatic Dislocations of the Knee.

»: Traumatic knee dislocations are complex injuries that can be associated with compromise of the neurovascular structures about the knee.

»: Various classification systems for knee dislocations exist in the literature but should be used with caution as a prognostic tool because many knee dislocations fit into more than 1 category.

»: Special populations of knee dislocations, such as obese patients and high-velocity mechanism injuries, require additional caution during the initial evaluation for possible vascular injuries.

Multidisciplinary Management of Collegiate Sports-Related Concussions.

Purpose:  Collegiate varsity athletes are at risk for sustaining a sports-related concussion, which can negatively impact performance during academic, social, work, and athletic endeavors. Because of the complex nature of concussions and high rates of underreporting by athletes, concussion education, identification, and postinjury care require a collaborative, multidisciplinary approach. Therefore, the purpose of this paper is to describe the specific responsibilities of the team members along with the established pre- and postconcussion procedures of one of the oldest university-based multidisciplinary concussion management programs that is coordinated by speech-language pathology.

Can a transient exertion-related carotid (TERC) murmur heard during a symptom-limited exercise test be used as a means for managing sports concussion?

We hypothesize that a transient exertion-related carotid (TERC) murmur flow murmur similar in nature to a "bruit" heard best at the carotid artery during exercise in healthy individuals can be used as a means for assessing post-concussion injury exertion tolerance. Typically there are no arterial sounds heard at the carotid artery in healthy individuals. Bruit, heard at rest, is an indicator of cardiovascular disease.

Health-related quality of life outcomes after robot-assisted and open radical cystectomy using a validated bladder-specific instrument: a multi-institutional study.

Objective: To evaluate health-related quality of life (HRQL) using validated bladder-specific Bladder Cancer Index (BCI) and European Organization for Research and Treatment of Cancer Body Image scale (BIS) between open radical cystectomy (ORC) and robot-assisted radical cystectomy (RARC).

Methods: This was a retrospective case series of all patients who underwent radical cystectomy. Patients were grouped based on surgical approach (open vs robot assisted) and diversion technique (extracorporeal vs intracorporeal).

Complications associated with single-dose, perioperative mitomycin-C for patients undergoing bladder tumor resection.

Objectives: To better understand the risk of short-term complications associated with perioperative intravesical mitomycin-C (MMC) therapy for patients undergoing endoscopic management of non-muscle invasive bladder cancer.

Methods And Materials: Using an institutional database of patients with bladder cancer, we performed a retrospective case-control study of patients receiving perioperative MMC after tumor resection (2008-2012). MMC cases were matched by clinical stage to controls receiving endoscopic resection alone.

HR-MAS NMR tissue metabolomic signatures cross-validated by mass spectrometry distinguish bladder cancer from benign disease.

Effective diagnosis and surveillance of bladder cancer (BCa) is currently challenged by detection methods that are of poor sensitivity, particularly for low-grade tumors, resulting in unnecessary invasive procedures and economic burden. We performed HR-MAS NMR-based global metabolomic profiling and applied unsupervised principal component analysis (PCA) and hierarchical clustering performed on NMR data set of bladder-derived tissues and identified metabolic signatures that differentiate BCa from benign disease. A partial least-squares discriminant analysis (PLS-DA) model (leave-one-out cross-validation) was used as a diagnostic model to distinguish benign and BCa tissues.

Hospital design and construction: song of the sirens.

Hospital and health system executives charged with overseeing a facility design-and-build project should follow the examples of organizations that have successfully completed such projects. Here are just a few lessons learned from fruitful projects: Simplistic cost comparisons do not define value. Alternative design solutions offer a hospital the opportunity to test the value of its original design thinking.

An in vitro study comparing the effects of Hextend, Hespan, normal saline, and lactated ringer's solution on thrombelastography and the activated partial thromboplastin time.

Objective: The purpose of this study was to determine if 6% HES 450/0.7 (hydroxyethyl starch 450/0.7) in normal saline (Hespan) and 6% HES 450/0.

Anesthesia for the Injured Hand.

In brief When an active patient sustains a hand or finger injury, a digital nerve block is often the appropriate anesthetic technique. A thorough knowledge of the area's anatomy, the materials needed, the proper technique, and the potential complications can help the primary care physician perform the procedure smoothly.

Head Injuries in Soccer.

In brief Two soccer goalies, a 20-year-old woman and a 28-year-old man, sustained head injuries as they fielded shots on goal. One was kicked, the other kneed by another player. The female goalie suffered a mild concussion.