Onsite Primary Care to Address Medical Needs Among Permanent Supportive Housing Tenants: A Feasibility Demonstration Project.

Background: There is limited evidence on interventions to address the health needs of vulnerable patients in permanent supportive housing (PSH).

Aim, Setting, Participants: Evaluate the feasibility of Project HOPE, a weekly onsite primary care pilot intervention for tenants of a single-site PSH program.

Program Description: Physicians, nursing, and pharmacy providers work with existing case managers to provide onsite routine and acute care, outreach, and care coordination.

The Utility of Advanced Lower-Extremity Duplex Using Pedal Acceleration Time in the Management of the Threatened Diabetic Foot.

Background: Patients with diabetes and diffuse infrageniculate arterial disease who present with chronic limb-threatening ischemia require an exact anatomical plan for revascularization. Advanced pedal duplex can be used to define possible routes for revascularization. In addition, pedal acceleration time (PAT) can predict the success or failure of both medical and surgical interventions.

Resuscitative Endovascular Balloon Occlusion of the Aorta in Penetrating Trauma.

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) achieves temporary hemorrhage control via aortic occlusion. Existing REBOA literature focuses on blunt trauma without a clearly defined role in penetrating trauma. This study compared clinical/injury data and outcomes after REBOA in penetrating vs blunt trauma.

Is there a role for REBOA? A system assessment.

Introduction: To analyze our experience to quantify potential need for resuscitative endovascular balloon occlusion of the aorta (REBOA).

Methods: Retrospective review of patients over a three-year period who presented as a trauma with hemorrhagic shock. Patients were divided into two groups: REBOA Candidate vs.

Effect of Addition of a Statin to Warfarin on Thromboembolic Events in Japanese Patients With Nonvalvular Atrial Fibrillation and Diabetes Mellitus.

Statins have been shown to decrease stroke risk in patients with cardiovascular risk factors but not to prevent recurrence of ischemic stroke in patients with atrial fibrillation (AF). The present subanalysis aimed to clarify the efficacy of combined use of warfarin and statins in patients with nonvalvular AF (NVAF) with coronary artery disease, diabetes mellitus (DM), or hypertension. The effects of adding statins to warfarin were compared with those of warfarin alone in patients with NVAF with the data set of J-RHYTHM Registry, a prospective, observational study with a 2-year follow-up.

Selective patellar resurfacing in total knee arthroplasty: a prospective, randomized, double-blind study.

350 knees were evaluated in a prospective, randomized, double-blinded study of selective patellar resurfacing in primary total knee arthroplasty. Knees with exposed bone on the patellar articular surface were excluded. 327 knees were evaluated at a mean follow-up of 7.

Negative-pressure wound therapy with instillation: international consensus guidelines.

Background: Negative-pressure wound therapy with instillation is increasingly utilized as an adjunct therapy for a wide variety of wounds. Despite its growing popularity, there is a paucity of evidence and lack of guidance to provide effective use of this therapy.

Methods: A panel of experts was convened to provide guidance regarding the appropriate use of negative-pressure wound therapy with instillation.

Pasturella multicoda infection of an abdominal aortic endograft.

Both surgical and endovascular grafts have the rare risk of late secondary infection. Treatment varies based on the clinical setting, but in general the recommendations are that infected endografts be removed and reconstruction performed. In the abdominal aorta this may vary from homograft or other impregnated grafts to excision and extra-anatomic bypass.

"Kissing stents" as an adjunct to thoracic endovascular aortic repair: warts and all.

A 75-year-old man presented with symptomatic thoracic aneurysm involving the origin of the left subclavian artery. To obtain an adequate landing zone, a simultaneous stent was placed in the left common carotid artery. Until fenestrated and branch graft technology is more available, snorkel approaches may be an acceptable approach for patients with contraindications to open repair.

Uniportal endoscopic gastrocnemius recession for treatment of gastrocnemius equinus with a dedicated EGR system with retractable blade.

This study examined the effectiveness and safety of a uniportal endoscopic gastrocnemius recession with a specifically designed uniportal endoscopic system. Fifty-three patients underwent 60 endoscopic gastrocnemius recessions. Their mean range of ankle dorsiflexion changed from a preoperative value of -2.

Evaluation of an ultra-lightweight, single-patient-use negative pressure wound therapy system over dermal regeneration template and skin grafts.

As the use of negative pressure wound therapy (NPWT) over skin grafts has increased, traditional methods of NPWT system reimbursement and application are increasingly being challenged. A simplified method of accessing and operating NPWT in the outpatient setting is needed, particularly in cases where immediate outpatient use of NPWT is optimal. We evaluated use of a new ultra-lightweight, off-the-shelf, disposable, single-patient-use NPWT system (SP-NPWT; V.

Evolving role of alloderm in breast surgery.

The adjunctive use of acellular dermal matrices in breast surgery is expanding. The purpose of this article is to provide an overview of the various applications of acellular dermal matrices in breast surgery, the benefits and complications associated with their use, and best practices to optimize outcomes using a human acellular dermal matrix (AlloDerm [LifeCell Corp., Branchburg, NJ]) as an example.

Management of pulmonary embolism with rheolytic thrombectomy.

Background: Catheter thrombectomy combining thrombus destruction with local thrombolysis has been used in patients with pulmonary embolism (PE) who are unstable or have significant right heart dysfunction, but have contraindications to systemic thrombolytic therapy.

Objectives: To assess the outcomes of patients who underwent pulmonary embolectomy using a commercially available thrombectomy device.

Methods: A retrospective chart review of patients who underwent pulmonary embolectomy between March 2007 and August 2009 was performed.

Endovascular repair compared with operative repair of traumatic rupture of the thoracic aorta: a nonsystematic review and a plea for trauma-specific reporting guidelines.

Background: Thoracic endovascular aortic repair (TEVAR) has become the preferred intervention for managing traumatic thoracic aortic injury. The literature suggests that TEVAR is associated with reduced mortality and paraplegia compared with open repair (OR). The lack of guidelines for reporting results and the paucity of patient follow-up make interpretation of the literature difficult.

Enoxaparin once daily vs. twice daily dosing for the treatment of venous thromboembolism in cancer patients: a literature summary.

Current anticoagulation guidelines for cancer patients are largely based upon studies done in the general population. Anticoagulation studies in cancer patients with venous thromboembolism (VTE) have compared varying doses of different low molecular weight heparins (LMWH) to warfarin or unfractionated heparin (UFH) regimens, and most guidelines recommend LMWH as the preferred agent over vitamin K antagonists. However, very few studies compare different dosing regimens of the LMWH itself.

The Haiti earthquake: the provision of wound care for mass casualties utilizing negative-pressure wound therapy.

Many months after the devastating earthquake in January 2010, wounds remain a major disease burden in Haiti. Since January 2010, through the efforts of corporations, nonprofit charitable organizations, and medical professionals, advanced wound care techniques, including negative-pressure wound therapy (NPWT), have been introduced into the wound care regimens of various hospitals in Haiti. In June 2010, the authors completed their second volunteer trip at a Haitian hospital specializing in orthopedic wounds.