Venous Thromboembolism in Foot and Ankle Trauma.

Every surgeon may have experienced a tragic event associated with death or debilitation secondary to deep vein thrombosis (DVT) or pulmonary embolism (PE) after foot and ankle trauma and surgery. Nevertheless, the prevention of such a tragic event needs to be carefully evaluated rationally with currently available epidemiologic data. With great postoperative protocols and access to care, most PE events can be prevented.

Posterior Arthroscopic Subtalar Joint Arthrodesis (Pasta).

The arthroscopic approach provides a manageable postoperative course in terms of wound healing, pain control, and bone healing when compared with an open procedure. In particular, posterior arthroscopic subtalar joint arthrodesis (PASTA) allows a reproducible and viable alternative to standard lateral-portal subtalar joint (STJ) arthrodesis without violating sinus or canalis tarsi neurovascular structures. Additionally, those patients who have undergone previous total ankle arthroplasty, arthrodesis, or talonavicular joint arthrodesis may be better served with PASTA over open arthrodesis if STJ fusion becomes necessary.

Effect of a "feedback prompt" from a disinfection tracking system on portable medical equipment disinfection.

Background: Portable medical equipment (PME) may contribute to transmission of multidrug-resistant organisms without proper disinfection. We studied whether a Disinfection Tracking System (DTS) with feedback prompt, attached to PME, can increase the frequency of PME disinfection.

Methods: DTS devices were placed on 10 workstations-on-wheels (WOWs) and 5 vitals machine (VM).

Clinical Considerations to Reduce Saphenous Neurovascular Bundle Injury During Suture Button Fixation of Syndesmosis Injuries.

Objective: To document angles, from 2 difference starting points, or danger zones that should be avoided to minimize risk of injury or irritation to the saphenous neurovascular bundle (SNVB) during suture button (SB) fixation for distal tibiofibular syndesmosis injuries.

Design: Retrospective imaging study.

Setting: Academic Level 1 trauma center.

The utility of the triage electrocardiogram for the detection of ST-segment elevation myocardial infarction.

Introduction: Current AHA/ACC guidelines on the management of ST-elevation myocardial infarction (STEMI) suggest that an ECG is indicated within 10minutes of arrival for patients arriving to the Emergency Department (ED) with symptoms concerning for STEMI. In response, there has been a creep towards performing ECGs more frequently in triage. The objectives of this study were to quantify the number of triage ECGs performed at our institution, assess the proportion of ECGs performed within current hospital guidelines, and evaluate the rate of STEMI detection in triage ECGs.

Incidental 131I Activity in the Deltoid Region on Posttherapy Radioiodine Scan.

A 71-year-old woman underwent a posttherapy radioiodine scan after I administration for papillary thyroid carcinoma. On day 1 of the posttreatment hospital isolation, the patient received a Pneumovax injection in the left deltoid muscle. A localized hypersensitivity reaction ensued with development of soft tissue edema and erythema at the Pneumovax injection site.

Effect of Citalopram for the Treatment of Neurocardiogenic Syncope.

Background: Neurocardiogenic syncope (NCS) is a common form of syncope. Although selective serotonin reuptake inhibitors and other medications have been used to treat NCS with variable success, there is no consensus regarding a first-line therapy.

Study Question: To assess the effects of citalopram in NCS and to examine the effect of diagnostic use of the head-up tilt table (HUTT) versus empirical diagnosis on patient outcome.

Low-Dose-Rate Brachytherapy Versus Cryotherapy in Low- and Intermediate-Risk Prostate Cancer.

Purpose: Cryotherapy and brachytherapy are definitive local treatment options for low- to intermediate-risk prostate cancer. There are both prospective and retrospective data for brachytherapy, but the use of cryotherapy has been limited primarily to single-institution retrospective studies. Currently, no published evidence has compared low-dose-rate brachytherapy versus cryotherapy.

Nitrous oxide-induced vitamin B12 deficiency.

Nitrous oxide is a gas that is odorless, colorless, and has a sweet taste at room temperature. Nitrous oxide has several uses, including in surgery and dentistry (referred to as "laughing gas"), in automotive racing, and in aerosol spray propellants. The aerosol spray propellants that typically use nitrous oxide are whipped cream canisters and cooking sprays.

ST-elevation acute myocardial infarction due to arterial thrombosis in a 29-year-old woman with normal coronary arteries.

Acute myocardial infarction (AMI) is rare in young adults. We present a case of a 29-year-old black woman who presented with an acute onset of chest pain while sleeping. Anterior wall ST-elevation AMI was diagnosed based on clinical presentation, electrocardiographic findings, and elevated cardiac biomarkers.

Elevations in growth hormone and glucagon-like peptide-2 levels on admission are associated with increased mortality in trauma patients.

Background: Burn and trauma patients present a clinical challenge due to metabolic derangements and hypermetabolism that result in a prolonged catabolic state with impaired healing and secondary complications, including ventilator dependence. Previous work has shown that circulating levels of growth hormone (GH) are predictive of mortality in critically ill adults, but few studies have examined the prognostic potential of GH levels in adult trauma patients.

Methods: To investigate the utility of GH and other endocrine responses in the prediction of outcomes, we conducted a prospective, observational study of adult burn and trauma patients.

Cardiotoxicity associated with targeted cancer therapies.

Compared with traditional chemotherapy, targeted cancer therapy is a novel strategy in which key molecules in signaling pathways involved in carcinogenesis and tumor spread are inhibited. Targeted cancer therapy has fewer adverse effects on normal cells and is considered to be the future of chemotherapy. However, targeted cancer therapy-induced cardiovascular toxicities are occasionally critical issues in patients who receive novel anticancer agents, such as trastuzumab, bevacizumab, sunitinib and imatinib.