Outcomes of an Emergency Department Observation Unit-Based Pathway for the Treatment of Uncomplicated Vaso-occlusive Events in Sickle Cell Disease.

Study Objective: This was a prospective, pre-post, 13-year observational study documenting the multiyear implementation of an observation unit sickle cell pathway for patients with uncomplicated vaso-occlusive events.

Methods: The sickle cell pathway begins with rapid triage to identify patients with uncomplicated vaso-occlusive events for immediate transfer to the observation unit and initiation of patient-controlled analgesia followed by repeated evaluations of pain and identification of other complications. Data were abstracted from the electronic medical record or observation unit database.

Classification of full-thickness rotator cuff lesions: a review.

Rotator cuff lesions (RCL) have considerable variability in location, tear pattern, functional impairment, and repairability.Historical classifications for differentiating these lesions have been based upon factors such as the size and shape of the tear, and the degree of atrophy and fatty infiltration. Additional recent descriptions include bipolar rotator cuff insufficiency, 'Fosbury flop tears', and musculotendinous lesions.

Subscapularis and deltoid preserving anterior approach for reverse shoulder arthroplasty.

Hypothesis: We hypothesize that performing a RSA using an anterior approach without cutting the subscapularis tendon and the deltoid muscle could provide patients with superior short-term clinical outcomes and immediate active range of motion (ROM) without immobilization.

Methods: Between August 2013 and June 2015, all patients who had a primary RSA were considered potentially eligible for inclusion in this prospective study.

Results: No immediate intra- or postoperative complications were noted.

Premature Growth Plate Closure in a Ballet Dancer en Pointe.

A 13-year-old ballet dancer who had been dancing en pointe (on the tips of the toes) since 10 years presented to the clinic with a shortened right second toe. She had no previous history of pain or trauma. She was diagnosed with premature growth arrest of the second metatarsal head physes resulting in a shortened metatarsal.

Biologic resurfacing arthroplasty with acellular human dermal allograft and platelet-rich plasma (PRP) in young patients with glenohumeral arthritis-average of 60 months of at mid-term follow-up.

Background: The treatment of young patients with glenohumeral arthritis has been challenging. Alternative treatment options include activity modification, arthroscopic débridement, and arthroplasty. Addressing the glenoid during arthroplasty in this population of patients continues to be a significant challenge.

Injuries in professional modern dancers: incidence, risk factors, and management.

Modern (or contemporary) dance has become increasingly popular, yet little has been reported with respect to modern dance injuries and their consequences. The purpose of this study is to define the incidence, risk factors, and management of musculoskeletal injuries in professional modern dancers. A total of 184 dancers in the United States completed an anonymous 17-page questionnaire on their injuries, including extensive details regarding the two most severe injuries that had occurred in the prior 12 months.

Carpal tunnel release using the MANOS CTR system: preliminary results in 52 patients.

Purpose: To describe a carpal tunnel release technique using the MANOS Carpal Tunnel Release device, with preliminary results in 52 patients.

Methods: The MANOS Carpal Tunnel Release device is a blade that divides the transverse carpal ligament using wrist and palm skin punctures. The awake patient provides feedback as the surgeon navigates a 2.

Hip arthroscopy by the lateral approach.

Performing hip arthroscopy with the patient in the lateral decubitus position is advantageous in aiding in visualization of the hip joint, in maneuvering instruments in obese patients, and in facilitating entry to the hip joint in patients with spurs on the anterolateral aspect of the acetabulum. The patient is placed in the lateral decubitus position with the hip on which the surgery is being performed on the top. The leg is placed in traction and a well-padded perineal post is applied for countertraction.

Meatless diets in female athletes: a red flag.

Physically active adolescent girls and young women may eliminate meat from their diets to achieve or maintain low body weight. By doing so, they risk developing protein, iron, and zinc deficiencies. Further, meatless diets in this population may signal the possibility of amenorrhea and/or disordered eating, with the attendant risk of osteoporosis.

Nurse writers internet and World Wide Web sites.

Nurse writers can use the Internet to find vast amounts of current information on topics for professional articles. The following excerpts are based on concepts in the Second Edition of the authors' book, How to Write and Publish Articles in Nursing, published by Springer Publishing Company. The Second Edition will is now available.

Overuse foot and ankle injuries in ballet.

Incorrect techniques repeated daily by a dancer can lead to overuse injuries. This article discusses the causes and treatment of foot and ankle injuries in the ballet dancer. The author also addresses skin lesions that are common in dancers who wear pointe shoes.

Managing ankle sprains: keys to preserving motion and strength.

The vast majority of ankle injuries involve one or more of the lateral supporting ligaments and can usually be managed successfully in the primary care setting. Important diagnostic variables include the mechanism of injury, the level of weight-bearing ability, and the presence or absence of bony tenderness. Early application of a focal compression device is the paramount measure for preserving range of motion and strength.

Teaching aesthetic surgery at the resident level.

The field of plastic and reconstructive surgery continues to broaden its scope while other fields continue to narrow theirs. The inability to teach aesthetic surgery is often confounded by the absence of an aesthetic surgery clinic for the chief resident, a reduced number of procedures and cases available, and a lack of faculty staff involvement. A close examination of the 19 western United States-based plastic surgery programs was performed in order to determine the most useful methods in teaching aesthetic surgery.

Lasers in orthopedic surgery.

Among surgical specialities; orthopedics has been the slowest to embrace the laser as a surgical tool. Although lasers have been used in ophthalmology for over two decades, and laser usage has become commonplace in gynecology, otorhinolaryngology, dermatology, plastic surgery, and general surgery, it is only within the past four years that lasers have attracted appreciable attention in orthopedics. The fact that much of the surgery in the majority of specialities is ablative in nature makes use of the laser particularly appealing, as lasers are the ultimate of ablative tools.

Synovial osteochondromatosis. A brief review.

An unusual clinical finding is presented with a brief review of the literature. Synovial osteochondromatosis is typically a benign process involving metaplasia of the synovial intima and the formation of cartilaginous nodules that may eventually become ossified. Synovial osteochondromatosis should always be considered as a differential diagnosis whenever a patient presents with pain, swelling, and loss of function at or around a joint.

A hierarchy of values in the design and construction of the ear.

A brief outline of the structure of the ear is presented, indicating that there is a hierarchy of importance to the various components of the ear in reconstruction. Consideration of fundamental shape, size, and position of the ear and its parts would be of use in various surgical procedures.

Delayed autograft loss in HIV-positive patients: two cases.

Two cases that show delayed autograft loss secondary to late polymicrobial infection in patients whose test results are positive for the human immunodeficiency virus (HIV-positive patients) are presented. Mechanisms of immune dysfunction in HIV-positive patients are reviewed, and speculation on the possible contribution of polymorphonuclear or other immune dysfunction to the graft failure in these patients is presented. Questions are raised regarding the prognostic importance of HIV positivity in patients with burns and the need for special surgical considerations in these patients.

Postpartum psychiatric syndromes.

Psychiatric symptoms after childbearing tend to arrange themselves into well-defined patterns or syndromes. When these syndromes are examined, each is found to have unique qualities and unique hazards. Confusion occurs in all syndromes.