Pacemaker Dependency after Cardiac Surgery: A Systematic Review of Current Evidence.

Background: Severe postoperative conduction disturbances requiring permanent pacemaker implantation frequently occur following cardiac surgery. Little is known about the long-term pacing requirements and risk factors for pacemaker dependency in this population.

Methods: We performed a systematic review of the literature addressing rates and predictors of pacemaker dependency in patients requiring permanent pacemaker implantation after cardiac surgery.

Meta-Analysis of the Relation of Ventricular Arrhythmias to All-Cause Mortality After Implantation of a Left Ventricular Assist Device.

Ventricular arrhythmias (VAs) are commonly reported after implantation of left ventricular assist devices (LVADs). Their relation to all-cause mortality and potential risk factors remains unclear. We conducted a meta-analysis of observational studies with the primary objective of evaluating the association of post-LVAD VAs with all-cause mortality at 60, 120, and 180 days.

Endothelial dysfunction in chronic inflammatory diseases.

Chronic inflammatory diseases are associated with accelerated atherosclerosis and increased risk of cardiovascular diseases (CVD). As the pathogenesis of atherosclerosis is increasingly recognized as an inflammatory process, similarities between atherosclerosis and systemic inflammatory diseases such as rheumatoid arthritis, inflammatory bowel diseases, lupus, psoriasis, spondyloarthritis and others have become a topic of interest. Endothelial dysfunction represents a key step in the initiation and maintenance of atherosclerosis and may serve as a marker for future risk of cardiovascular events.

Acute carpal tunnel syndrome caused by diffuse giant cell tumor of tendon sheath: a case report.

A 46-year-old male developed spontaneous acute carpal tunnel syndrome of the right wrist without any antecedent trauma. Surgical exploration revealed hemorrhage secondary to diffuse giant cell tumor of tendon sheath as the underlying cause.

The prevalence of hereditary neuropathy with liability to pressure palsies in patients with multiple surgically treated entrapment neuropathies.

Purpose: Hereditary neuropathy with liability to pressure palsies (HNPP) is an autosomal-dominant peripheral neuropathy that results from deletion of a 1.5-Megabase pair (Mb) segment of the short arm (p) of chromosome 17. Hereditary neuropathy with liability to pressure palsies increases susceptibility of peripheral nerves to pressure and trauma and can be associated with symptoms at multiple anatomic entrapment sites.

The effects of graded compression of the median nerve in the carpal canal on grip force.

The relationship between tactile hypoesthesia and precision grip force was examined using compression of the median nerve in healthy adults. Hypoesthesia was graded by varying the pressure that an external clamp exerted over the carpal canal. Electrical stimulation of the median nerve in the forearm evoked a compound sensory nerve action potential (SNAP) that we recorded from the digital nerves of the index finger.

Recurrent carpal tunnel syndrome.

Persistent or recurrent symptoms following carpal tunnel release surgery are an infrequent but challenging clinical problem. A thorough evaluation of these patients is mandatory and must confirm the accuracy of the original diagnosis and rule out the presence of concurrent conditions or disorders that may cause persistent symptoms that mimic carpal tunnel syndrome. If an alternative explanation of the patients' symptoms cannot be identified, and if conservative care is ineffective, then surgical treatment should be considered.

A new articulated elbow external fixation technique for difficult elbow trauma.

Articulated external fixation of the elbow allows aggressive elbow range of motion while protecting the joint and periarticular structures from excessive forces. A technique for aligning a monolateral-hinged fixator to the rotational axis of the elbow without the use of an invasive axis pin has been developed. Thirteen patients with acute and chronic post-traumatic elbow problems were treated over a four year period with this technique.

Radiographic determinants of the elbow rotation axis: experimental identification and quantitative validation.

This study identifies new radiographic indices to approximate the location of the elbow rotational axis. With use of electromagnetic motion tracking source data, the average rotational axis of the ulnohumeral articulation was calculated in seven cadaveric specimens. Quasi-lateral radiographs of the elbow specimens were then analyzed to identify radiographic landmarks of the elbow axis in the lateral view.

Localization of dominantly inherited isolated triphalangeal thumb to chromosomal region 7q36.

Triphalangeal thumb is an autosomal dominantly inherited form of abnormal preaxial skeletal development. In most families, however, the triphalangeal thumb phenotype coexists with a spectrum of limb deformities, including polydactyly and syndactyly. We describe two Iowa kindreds with triphalangeal thumb.

Assessment of elbow joint kinematics in passive motion by electromagnetic motion tracking.

This research provides a detailed analysis of the kinematics of passive elbow motion. It quantifies how closely humeroulnar kinematics approximates rotation around a fixed axis. The results are clinically relevant for emerging treatment modalities that impose an artificial hinge to the elbow joint, such as total elbow arthroplasty and articulated external fixation.

Hinged external fixation of the elbow: optimal axis alignment to minimize motion resistance.

Objective: To establish an optimal single hinge axis position for application of hinged external fixation to the elbow joint.

Design: Cadaveric biomechanical investigation.

Setting: A customized motion transducer applied passive elbow motion to six cadaveric upper extremities.

Nail gun injuries of the hand.

Nail gun injury of the hand is commonly encountered among workers in the construction industry. Successful management requires a thorough understanding of this unique injury, the recognition of nail shaft barbs, and appropriate nail removal and wound care, with referral when indicated. If barbs are encountered, nail removal involves cutting off the head of the nail and extracting the nail in the direction of entry.

Hand injuries in rock climbing: reaching the right treatment.

Rock climbers' grip techniques may result in a variety of hand injuries. Minor injuries such as soft-tissue damage, flexor tendon strain, tendinitis or tenosynovitis, joint contractures, and carpal tunnel syndrome may be treated by a primary care physician. Patients who have pulley ruptures should be referred if there is any uncertainty about the diagnosis.

Carpal tunnel release with and without epineurotomy: a comparative prospective trial.

A prospective, comparative study of epineurotomy as an adjunctive procedure to transverse carpal ligament release for the treatment of carpal tunnel syndrome was conducted. Eighty-six patients with 117 involved hands were entered into the study. After entry, all patients completed an extensive preoperative questionnaire, a detailed physical examination, and preoperative neurophysiologic testing.

Classification of distal radius fractures: an analysis of interobserver reliability and intraobserver reproducibility.

The Frykman, Melone, Mayo, and AO classification systems for distal radius fractures were evaluated for interobserver reliability and intraobserver reproducibility in a clinical setting using initial plain radiographs. Two attending orthopedic hand surgeons and two attending radiologists classified 55 sets of distal radius fractures. kappa-statistics were used to establish a relative level of agreement between observers for the two readings and between separate readings by the same observer.

Practical Management of Carpal Tunnel Syndrome.

Carpal tunnel syndrome can result from occupational or recreational overuse. Cycling, rowing, and weight lifting are examples of sports that can provoke or exacerbate the syndrome. A detailed sensory examination, motor testing, and provocative tests such as Phalen's maneuver are essential.

Outcome after free flap reconstruction of the heel.

We reviewed six free flap reconstructions of the weight-bearing surface of the heel. Patients were seen for clinical evaluation at a mean follow-up of 4.7 years (range 2.

Anatomy of the oblique retinacular ligament of the index finger.

The available literature includes conflicting descriptions of the anatomy and function of the oblique retinacular ligament. We have studied this ligament in the index finger to better define its presence, configuration, points of attachment, length, and relationship to the proximal interphalangeal joint axis. Twenty fresh frozen index fingers were dissected.