Evaluating Postoperative Pain Management Using the Detroit Interventional Pain Management Tool After Fracture Surgery: How Well Are We Really Doing?

Objectives: To assess patients' opioid prescription usage and pain management satisfaction after fracture surgery.

Design: An IRB-approved prospective prognostic cohort study for postoperative patients with fracture was conducted. Patients were evaluated by an independent observer at 2 weeks, 6 weeks, 3 months, and 6 months postoperatively where they were given Detroit Interventional Pain Assessment questionnaires regarding their postoperative pain and opioid usage.

Use of a haired angularis oris axial pattern flap in a dog to correct a large oronasal fistula secondary to resection of a hard palate multilobular osteochondrosarcoma.

A 6-year-old neutered male mixed-breed dog underwent curative-intent surgical resection of a hard palatal multilobular osteochondrosarcoma and closure of the defect using bilateral buccal mucosal flaps. However, failure of the flaps resulted in a massive hard palatal defect that was subsequently repaired using a haired skin angularis oris axial pattern flap. This report describes the clinical outcome using this surgical approach and novel complications encountered.

Detroit Interventional Pain Assessment Scale: A Pain Score and Method for Measuring and Evaluating Post-Operative Pain Management-A Prospective Study.

: Orthopedic surgeons commonly prescribe opioids, surpassing all medical specialties. Our objective was to develop a pain management scale that captures medication use, patient-reported pain scores, and helps orthopedic surgeons evaluate their post-operative prescribing practice. : An IRB-approved prospective study followed 502 post-operative orthopedic surgery patients over a six-month period.

Transparency films: intraoperative templating to prevent limb deformity.

Operative management of fractures and malunions can be challenging when restoring native anatomy is not straightforward. Comminuted fractures and managing deformity correction in the setting of osteolysis, callus, and even complete fracture healing must include careful planning. Preoperative planning has been popularized and taught as an integral part of a surgeon's skill set, with critical evaluation and assessment of the implemented plan being the final step in the process.

Systematic Review of Combined Pelvic Ring and Acetabular Injuries: What Do We Know From the Literature?

The purpose of this review is to examine the literature on combined pelvic ring and acetabular fractures. We hope to further define the classifications, severities (ISS & Mortality), healing, radiographic parameters, and functional outcomes of such injuries to report all potential recommendations based on findings. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and a systematic search on PubMed and Google Scholar was performed.

Effects of adolescent ethanol exposure on adult nondrug reward seeking behavior in male and female mice.

Background: Adolescent alcohol use is associated with an increased likelihood of developing an alcohol use disorder in adulthood, potentially due to the effects of alcohol exposure on reward-seeking behavior. However, it remains unclear whether adolescent drinking is sufficient to alter nondrug reward seeking in adulthood. As adolescence is a period of both brain and sexual maturation, which occur in a sex-dependent manner, males and females may be differentially sensitive to the consequences of adolescent alcohol exposure.

Application of a distant, direct, single-pedicle hinge flap for reconstruction of a circumferential cutaneous defect of the thoracic limb in a dog.

A 4-year-old, neutered male, mixed-breed dog initially presented to a tertiary referral center for suspected mushroom intoxication and subsequent necrotizing fasciitis of the right thoracic limb. One day after presentation, a fasciotomy was carried out to remove necrotic tissue, leaving an extensive cutaneous defect spanning from axilla to carpus and occupying 75 to 100% of the circumference of the limb. Following establishment of a bed of granulation tissue, a distant, direct, single-pedicle flap was performed using the lateral thoracoabdominal skin.

Antibiotic Cement-Coated Interlocked Intramedullary Nails for the Treatment of Infected Nonunion After Intramedullary Nailing.

Objective: To evaluate outcomes using an interlocking antibiotic cement-coated nail and culture-specific systematic antibiotics in the treatment of infected nonunion after intramedullary nailing.

Design: Retrospective observational cohort study.

Setting: Urban level I trauma center.

Pelvic Malunion: A Systematic Review, Dichotomy of Definitions and Treatment.

: Pelvic nonunion and malunion have been documented as rare complications in pelvic fractures and literature describing these topics is severely limited. Articles dedicated solely to pelvic malunion are nearly nonexistent. We conducted a literature search with the goal of providing a summary of the definition, causes, treatment strategies, and outcomes of pelvic malunion correction.

The IPA, a Modified Numerical System for Pain Assessment and Intervention.

Introduction: The objective of this study was to (1) construct a pain scale that improves communication between healthcare providers and patients (Interventional Pain Assessment [IPA] tool) and (2) to validate this new pain scale with the numeric rating scale of 0 to 10 Numerical Rating System (NRS).

Methods: The IPA uses only three categories: 0 = "I have no pain," 1 = "My pain is tolerable (no intervention needed)," and 2 = "my pain is intolerable, (intervention needed)." An Institutional Review Board-approved study was done on 322 consecutive patients who were recovering from fracture treatment.

The prevalence of posterolateral tibial baseplate overhang: An anatomical CT study.

Introduction: Total Knee Arthroplasty (TKA) is used in patients with osteoarthritis who have failed conservative management to reduce pain, improve functional outcomes and ultimately quality of life. However, less than optimal patient satisfaction has led to continued improvements in design and technology of TKA. One factor that can limit patient satisfaction is postero-lateral overhang of the tibial baseplate.

Dual-Affinity Ratiometric Quenching (DARQ) Assay for the Quantification of Therapeutic Antibodies in CHO-S Cell Culture Fluids.

More than 100 monoclonal antibodies (mAbs) are in industrial and clinical development to treat myriad diseases. Accurate quantification of mAbs in complex media, derived from industrial and patient samples, is vital to determine production efficiency or pharmacokinetic properties. To date, mAb quantification requires time and labor-intensive assays.

Exosome and Biomimetic Nanoparticle Therapies for Cardiac Regenerative Medicine.

Exosomes and biomimetic nanoparticles have great potential to develop into a wide-scale therapeutic platform within the regenerative medicine industry. Exosomes, a subgroup of EVs with diameter ranging from 30-100 nm, have recently gained attention as an innovative approach for the treatment of various diseases, including heart disease. Their beneficial factors and regenerative properties can be contrasted with various cell types.

Musculoskeletal Education in Medical Schools: A Survey of Allopathic and Osteopathic Medical Students.

Background: Musculoskeletal (MSK) disorders are one of the most common causes of disability and emergency department and physician visits in the United States. However, there is very little consistency in how physicians in training are prepared to treat MSK disorders. On the basis of published reports, medical school graduates have a relative lack of cognitive mastery in MSK medicine, even with the recent increase in instruction.

Protocol changes to reduce implant-associated infection rate after tibial plateau leveling osteotomy: 703 dogs, 811 TPLO (2006-2014).

Objective: To determine the influence of a stricter aseptic protocol on implant-associated infection (IAI) rates after tibial plateau leveling osteotomy (TPLO).

Study Design: Retrospective cohort study.

Sample Population: Seven hundred three dogs (811 TPLO).

Mitochondrial proteome disruption in the diabetic heart through targeted epigenetic regulation at the mitochondrial heat shock protein 70 (mtHsp70) nuclear locus.

>99% of the mitochondrial proteome is nuclear-encoded. The mitochondrion relies on a coordinated multi-complex process for nuclear genome-encoded mitochondrial protein import. Mitochondrial heat shock protein 70 (mtHsp70) is a key component of this process and a central constituent of the protein import motor.

Prenatal exposure to methadone or buprenorphine: Early childhood developmental outcomes.

Background: Methadone and buprenorphine are recommended to treat opioid use disorders during pregnancy. However, the literature on the relationship between longer-term effects of prenatal exposure to these medications and childhood development is both spare and inconsistent.

Methods: Participants were 96 children and their mothers who participated in MOTHER, a randomized controlled trial of opioid-agonist pharmacotherapy during pregnancy.

Exploring the mitochondrial microRNA import pathway through Polynucleotide Phosphorylase (PNPase).

Cardiovascular disease is the primary cause of mortality for individuals with type 2 diabetes mellitus. During the diabetic condition, cardiovascular dysfunction can be partially attributed to molecular changes in the tissue, including alterations in microRNA (miRNA) interactions. MiRNAs have been reported in the mitochondrion and their presence may influence cellular bioenergetics, creating decrements in functional capacity.

Effect of lateralized design on muscle and joint reaction forces for reverse shoulder arthroplasty.

Background: Manufacturers of reverse shoulder arthroplasty (RSA) implants have recently designed innovative implants to optimize performance in rotator cuff-deficient shoulders. These advancements are not without tradeoffs and can have negative biomechanical effects. The objective of this study was to develop an integrated finite element analysis-kinematic model to compare the muscle forces and joint reaction forces (JRFs) of 3 different RSA designs.

Maternal-engineered nanomaterial exposure disrupts progeny cardiac function and bioenergetics.

Nanomaterial production is expanding as new industrial and consumer applications are introduced. Nevertheless, the impacts of exposure to these compounds are not fully realized. The present study was designed to determine whether gestational nano-sized titanium dioxide exposure impacts cardiac and metabolic function of developing progeny.

Nonserious adverse events in randomized trials with opioid-dependent pregnant women: direct versus indirect measurement.

Background And Objectives: How best to measure the occurrence of adverse events during a randomized clinical trial is an issue that has not been adequately examined in the research literature. Focus of this study was on the examination of the relative frequency of occurrence of adverse events directly recorded during the conduct of the trial compared to an indirect determination of adverse events derived from data collected as part of the trial.

Methods: A secondary analysis of nonserious adverse events that occurred in the Maternal Opioid Treatment: Human Experimental Research (MOTHER) Study was undertaken.

Induction of pregnant women onto opioid-agonist maintenance medication: an analysis of withdrawal symptoms and study retention.

Background: Induction onto buprenorphine during pregnancy may be more challenging than induction onto methadone. This study explores factors predicting withdrawal intensities and compares trajectories of withdrawal during the induction phase between opioid-dependent women randomly assigned to methadone or buprenorphine.

Methods: A secondary analysis was conducted on data from 175 opioid-dependent pregnant women inducted onto buprenorphine or methadone subsequent to stabilization on morphine sulfate.