Complications of open trigger finger release.

Purpose: Open release of A1 pulleys for trigger finger has been thought of as a relatively benign procedure with a low complication rate. Few studies have examined the rate of complications in trigger finger release. The objective of this study was to retrospectively review the complications documented for a cohort of patients who received open trigger finger releases.

Detection of RXFP1 receptors in skin biopsies from children with congenital adrenal hyperplasia: a preliminary report.

Objective: Relaxin may potentiate the effect of topical estrogen treatment to eradicate post-incisional scarring in congenital adrenal hyperplasia (CAH) patients undergoing genitoplasty. The aim of this study was to determine whether CAH skin is capable of responding to relaxin.

Patients And Methods: Skin biopsies were obtained from four female CAH patients (aged 2-9 years; Prader 4-5, salt-wasting, 21-hydroxylase deficiency, Caucasian) during routine genitoplasty surgery and screened for relaxin receptors.

Nonoperative treatment of distal biceps tendon ruptures compared with a historical control group.

Background: Few data are available regarding the results of nonoperative treatment of distal biceps ruptures. The present study was designed to assess the outcomes associated with unrepaired distal biceps tendon ruptures.

Methods: Eighteen patients with twenty unrepaired distal biceps tendon ruptures were assessed retrospectively.

Relaxin's involvement in extracellular matrix homeostasis.

Burgeoning evidence suggests that the hormone relaxin modulates collagen in the extracellular matrix of diverse tissues. In separate lines of study, we provide further substantiation of this hypothesis. Immunofluorescence was used to probe isolated fibroblasts derived from volar oblique ligament explant culture for vimentin, actin, RXFP1, and estrogen receptor beta.

Pseudoarthrosis in a hypertrophic nonunion of the humerus: a case report.

Nonunion of humerus fractures is an extensively reviewed topic in orthopedic literature. The current case describes the successful outcome of a hypertrophic nonunion in a patient who chose not to undergo any intervention when the nonunion was identified and the treatment options were discussed with him. Hence this case report is a good example of the transition of the medical world to the concept of patient-centered decision making having a successful outcome.

Meniscal repair of the knee.

Since King's research on knee degeneration, meniscal-sparing techniques and other significant advances have improved outcomes. The anatomy, classification, and biomechanics of menisci are reviewed. Although the majority of traumatic meniscal damage occurs to the medial meniscus during twisting-type injuries, modern surgeons should be prepared to deal with patients of all ages with varied symptoms and mechanisms of injury.

Fate of mu receptors during rat skeletogenesis.

Studies have intimated a role for endogenous opioids in skeletal ontogeny. We hypothesized that this role may be confined to the perinatal period. We, therefore, examined both fetal and postnatal rat long bones to determine the pattern, if any, of mu receptor expression.

A living will misinterpreted as a DNR order: confusion compromises patient care.

Background: Advance directives are becoming ever more commonplace in the United States. Correct interpretation of living wills and do-not-resuscitate (DNR) orders is essential if patient safety and autonomy are to be preserved.

Objectives: 1) To recount a case in which a living will was misinterpreted as a DNR order; 2) To make known the ramifications of this misinterpretation; 3) To advocate for improved education of health care professionals regarding the interpretation and implementation of advance directives.

TRIAD II: do living wills have an impact on pre-hospital lifesaving care?

Background: Living wills accompany patients who present for emergent care. To the best of our knowledge, no studies assess pre-hospital provider interpretations of these instructions.

Objectives: Determine how a living will is interpreted and assess how interpretation impacts lifesaving care.

Principles and core competencies of surgical palliative care: an overview.

The concept of palliation is as old as surgery itself, perhaps so old that it has been taken for granted rather than conceptualized as a primary framework for surgical care. The experience and success of the hospice movement in the United States and abroad was followed by the extension of its basic concepts to the much larger population of patients with advanced, but not necessarily terminal, illness. This collective experience has provided the necessary background and stimulus for developing a specific set of principles and competencies applicable to surgical palliative care.

Cancer of the neovagina.

Objective: Cancer of the neovagina has been documented, and found to occur at younger ages than cancer of the native vagina. A review of the world literature was performed to evaluate risk based on type of tissue used for replacement or reconstruction of the vagina, as well as signs and symptoms of tumor occurrence and follow-up possibilities for early detection/screening for cancer and precancerous changes.

Method: Comprehensive review of relevant published literature.

Biceps tendinitis in chronic rotator cuff tears: a histologic perspective.

Patients with chronic rotator cuff tears frequently have anterior shoulder pain attributed to the long head of the biceps brachii (LHBB) tendon. In this study, tenodesis or tenotomy samples and cadaveric controls were assessed by use of immunohistochemical and histologic methods to quantify inflammation, vascularity, and neuronal plasticity. Patients had moderate pain and positive results on at least 1 clinical test of shoulder function.

Acute respiratory failure associated with polymethyl methacrylate pulmonary emboli after percutaneous vertebroplasty.

We report a case of symptomatic polymethyl methacrylate pulmonary emboli after percutaneous vertebroplasty to alert clinicians to this potential cause of pulmonary emboli. A 77-year-old woman developed acute respiratory failure after multilevel percutaneous vertebroplasty. She received mechanical ventilatory support and anticoagulation with low-molecular-weight heparin and warfarin.

Does a living will equal a DNR? Are living wills compromising patient safety?

Living wills are thought to protect the medical decision-making capacity of patients. Presented are three case scenarios of patients with living wills presenting to health care facilities for treatment, and their hospital courses. Living wills have never been thought to compromise patient care or safety, but their use has not been adequately studied with respect to risks, benefits, or consequences.

The neurophysiology of sexual arousal.

Our understanding of the process and initiation of sexual arousal is being enhanced by both animal and human studies, inclusive of basic science principles and research on clinical outcomes. Sexual arousal is dependent on neural (sensory and cognitive) factors, hormonal factors, genetic factors and, in the human case, the complex influences of culture and context. Sexual arousal activates the cognitive and physiologic processes that can eventually lead to sexual behavior.

Gradual reduction of distal radial malunion using distraction osteogenesis.

Purpose: To evaluate gradual distraction lengthening or distraction osteogenesis as a technique for treating malunions of the distal radius.

Methods: Twenty patients with clinical and radiographic evidence of distal radius malunion were treated with osteotomy of the distal radius using distraction osteogenesis. At the follow-up evaluation each patient was evaluated for healing rates, complications, resolution of pain, and radiographic alignment.

Accuracy of injection into the basal joint of the thumb.

To investigate the accuracy of intra-articular injection of the basal joint and to determine the rate of soft-tissue extravasation of injected material in successful intra-articular injection, we injected the basal joint of 30 hands with radiopaque dye (with fluoroscopy guiding needle placement in 8 cases) and then used fluoroscopy to check injection accuracy. Results were recorded depending on the location of the injected dye on fluoroscopic examination. Rates of intra-articular accuracy and soft-tissue extravasation for successful intra-articular injections were 100% and 25% for the fluoroscopy-guided group and 81.

Quality of life after Roux-en-Y gastric bypass surgery.

The incidence of obesity is rising worldwide, leading to a related increase in obesity-associated comorbidities that directly affect longevity and quality of life. Surgical interventions, including the Roux-en-Y gastric bypass procedure, are available for those who have increased risk for morbidity and mortality as a result of repeatedly failed medical management of obesity. Three months after undergoing gastric bypass surgery, patients were sent a survey based on the Impact of Weight on Quality of Life-Lite instrument.