Capitellar and Trochlear Fractures.

Fractures of the capitellum and trochlea account for a small proportion of elbow trauma. Clinicians need to be vigilant in their assessment as they are commonly associated with other injuries about the elbow. To optimize outcomes, the goals of management include a stable, anatomic reduction and early range of motion.

Emergency Point-of-Care Ultrasound Detection of Cancer in the Pediatric Emergency Department.

The use of point-of-care ultrasound in the pediatric emergency department is evolving beyond conventional applications as users become more expert with the technology. In this case series, we describe the potential utility of recognizing abnormal anatomy to impact care in the context of possible cancer in pediatric patients. We describe 4 patients with Langerhans histiocytosis, neuroblastoma, Wilms tumor, and rhabdomyosarcoma, in which point-of-care ultrasound was used to facilitate the diagnoses.

biotics: Prevention of evere neumonia and ndotracheal olonization rial-PROSPECT: protocol for a feasibility randomized pilot trial.

Background: Probiotics are defined as live microorganisms that may confer health benefits when ingested. Meta-analysis of probiotic trials suggests a 25 % lower ventilator-associated pneumonia (VAP) and 18 % lower infection rates overall when administered to patients in the intensive care unit (ICU). However, prior trials are small, largely single center, and at high risk of bias.

Determining the Minimally Important Difference in the Clinical Disease Activity Index for Improvement and Worsening in Early Rheumatoid Arthritis Patients.

Objective: Simplified measures to quantify rheumatoid arthritis (RA) disease activity are increasingly used. The minimum clinically important differences (MCID) for some measures, such as the Clinical Disease Activity Index (CDAI), have not been well-defined in real-world clinic settings, especially for early RA patients with low/moderate disease activity.

Methods: Data from Canadian Early Arthritis Cohort patients were used to examine absolute change in CDAI in the first year after enrollment, stratified by disease activity.

A blinded placebo-controlled randomized trial on the use of astaxanthin as an adjunct to splinting in the treatment of carpal tunnel syndrome.

Background: Nutritional supplementation is a potential adjunct in the conservative management of carpal tunnel syndrome (CTS). This study investigated whether astaxanthin (a beta-carotenoid) increased the effectiveness of splinting in managing CTS.

Methods: This is a triple-blinded randomized controlled trial where 63 patients with electrodiagnostically confirmed CTS were randomly allocated into either the experimental group (n = 32) (astaxanthin-4-mg capsules + splinting) or the control group (n = 31) (placebo + splinting).

A survey of practice patterns for rehabilitation post elbow fracture.

Background And Purpose: Elbow fractures amount to 4.3% of all the fractures. The elbow is prone to stiffness after injury and fractures can often lead to significant functional impairment.

Validity of the patient-reported Clinical Global Impression of Change as a measure of treatment response in men with premature ejaculation.

Introduction: The Clinical Global Impression of Change (CGIC) measures have high utility in clinical practice. However, it is unknown whether the CGIC is valued for assessing premature ejaculation (PE) symptoms and/or the relationship between CGIC and other validated PE patient-reported measures.

Aim: The study aims to assess the validity of the patient-reported CGIC measure in men with PE and to examine the relationship between CGIC ratings and assessments of control, satisfaction, personal distress, and interpersonal difficulty.

Hand therapist management of the lateral epicondylosis: a survey of expert opinion and practice patterns.

Unlabelled: Lateral epicondylosis (LE) is a common condition. Knowledge on practice patterns underlies identification of knowledge to practice gaps. The purpose was to determine the practice patterns and beliefs of hand therapists in managing LE.

A Search for subgroups of patients with ARDS who may benefit from surfactant replacement therapy: a pooled analysis of five studies with recombinant surfactant protein-C surfactant (Venticute).

Background: Studies to date have shown no survival benefit for the use of exogenous surfactant to treat patients with the ARDS. To identify specific patient subgroups for future study, we performed an exploratory post hoc analysis of clinical trials of recombinant surfactant protein-C (rSP-C) surfactant (Venticute; Nycomed GmbH; Konstanz, Germany).

Methods: We performed a pooled analysis of all five multicenter studies in which patients with ARDS due to various predisposing events were treated with rSP-C surfactant.

Chronic posttraumatic elbow disorders treated with metallic radial head arthroplasty.

Background: Metallic radial head arthroplasty is a proven technique for the treatment of complex radial head fractures. The purpose of this study was to evaluate the functional outcomes of a metallic radial head arthroplasty in patients with chronic posttraumatic elbow disorders.

Methods: The results of thirty-two metallic radial head arthroplasties in thirty-two consecutive patients were retrospectively reviewed.

Canadian Society for the Study of the Aging Male: response to health Canada's position paper on testosterone treatment.

Introduction: Testosterone treatment of older symptomatic men with reduced testosterone availability is increasing. There is an expanding body of literature to support such treatment in a large subset of aging men, but there has not yet been a long-term placebo-controlled double-blind study of several thousand men to confirm the efficacy and safety of this treatment as indicated by shorter-term studies. The absence of a long-term study has been used by governmental agencies as a limiting factor in providing full access and payment for this treatment in government-sponsored health care plans.

The treatment of erectile dysfunction study: focus on treatment satisfaction of patients and partners.

Objective: To assess patient and partner preferences for, and satisfaction with, tadalafil or sildenafil (phosphodiesterase type 5 inhibitors) in routine clinical practice for treating erectile dysfunction (ED), as these are important outcomes that might influence treatment adherence.

Patients And Methods: In a multicentre, prospective observational trial in Canada, patients with ED were eligible if they planned to change treatment from tadalafil to sildenafil or vice versa. Data were collected at baseline and 4-12 weeks later (endpoint).

Evaluating organizational readiness for change: a preliminary mixed-model assessment of an interprofessional rehabilitation hospital.

We conducted a Functional Organizational Readiness for Change Evaluation (FORCE) to assess the characteristics of readiness for change across two programs (N=216 employees) in an interprofessional rehabilitation hospital that was about to undergo strategic changes as part of a planned physical merger within the next two years. The study used a mixed-method approach: a quantitative survey, previously validated in a drug rehabilitation setting, followed by key informant interviews to further enlighten survey findings. Statistical analyses identified correlations between demographic variables (age, education and experience) and readiness for change, as well as the prevalence of specific organizational characteristics (motivation for change, access to resources, staff attributes, organizational climate, and exposure/ use of training opportunities) that facilitate or impede change.

Nonpalpable scarring of the penile septum as a cause of erectile dysfunction: an atypical form of Peyronie's disease.

Introduction: Men with nonpalpable isolated septal scars (ISS) identified with color duplex ultrasonography (CDU) comprise a group of previously unrecognized patients with wide-ranging sexual concerns.

Aim: We aim to identify the clinical characteristics of patients presenting with this atypical form of Peyronie's disease characterized by the absence of palpable deformity.

Materials And Methods: Of 482 consecutive patients who presented to a tertiary care erectile dysfunction (ED) clinic and underwent CDU after satisfying inclusion criteria, 27 (5.

Changes in tissue water content measured with multiple-frequency bioimpedance and metabolism measured with 31P-MRS during progressive forearm exercise.

Multiple-frequency bioimpedance analysis (MFBIA) has been used to determine the cellular water composition in the human body. It is noninvasive and has demonstrated good correlations with other invasive measures of tissue water. However, the ability of this method to study transient changes in tissue water in specific muscle groups has not been explored.

Disordered control of the urinary bladder after human spinal cord injury: what are the problems?

Spinal cord injury has a profound impact on the storage and voiding functions of the urinary bladder. Loss of autonomic and somatic control mechanisms leads to hypo- or hyperactivity of the bladder wall and sphincters causing problems that range from incontinence to complete loss of the capacity to empty the bladder. This chapter outlines the types of bladder dysfunction that occur after spinal cord injury, their relative prevalence and current practices used to manage the problems.

Intracavernous pharmacotherapy for erectile dysfunction.

With the advent of phosphodiesterase type-5 inhibition as oral therapy, intracavernous injection of vasoactive agents has been relegated to second-line therapy for most patients with erectile dysfunction. However, the future of this category of agents remains bright as an ever-expanding number and combination of agents in use and under investigation will likely make intracavernous injection more appealing as greater efficacy, tolerability, and more rapid onset is attained. In this article, functional anatomy and physiology of human penile erection is reviewed, as are current clinical vasoactive agents including prostaglandin E-1, papaverine, and phentolamine.

Tadalafil in the treatment of erectile dysfunction.

Oral phosphodiesterase-5 inhibitors have emerged as the preferred first-line treatment for erectile dysfunction worldwide because of patient convenience, efficacy, and safety. Clinical trials have shown that tadalafil significantly enhances erectile function across a wide range of etiologies and provides a prolonged period of effectiveness independent of food or alcohol. In this review, the pharmacokinetic and pharmacodynamic characteristics, efficacy, and safety of tadalafil are discussed.

Muscle fiber number in the biceps brachii muscle of young and old men.

We have compared the number of muscle fibers in the biceps brachii muscle (BB) of six old men (82.3 +/- 4.3 years) and six young men (21.