The Factors Influencing the Refracture of Pediatric Forearms.

Purpose: Pediatric forearm fractures are common and usually heal uneventfully. The purpose of this study was to review the refracture rate and to identify trends and risk factors that may lead to a refracture.

Methods: Using current procedure terminology code and subsequent chart review we retrospectively identified 2590 patients who sustained forearm fractures over the past 10 years (2000 to 2010) and were treated at a single, large pediatric orthopaedic practice.

The effect of Clostridium difficile infection on cardiac surgery outcomes.

Background: Clostridium difficile (CD) is a common cause of healthcare-associated infectious colitis that complicates about 1% of all hospital stays in the U.S. The impact of CD on outcomes after coronary artery bypass grafting (CABG) and valvular surgery (VS) is not well known.

Percutaneous treatment of a sacral metastasis with combined embolization, cryoablation, alcohol ablation and sacroplasty for local tumor and pain control.

Multiple treatment options have been introduced for the treatment of sacral tumoral bone pain. These options include pre-operative sacral embolization, percutaneous cryoablation, alcohol ablation, and sacroplasty. We intend to show that in the correct clinical scenario, a combination of the four procedures performed as a two-stage process can effectively treat tumoral bone pain refractory to medical therapy.

Percutaneous thrombin injection with a distal embolic protection device for treatment of a common carotid artery pseudoaneurysm.

Carotid artery pseudoaneurysm is a rare complication from placement of an internal jugular triple lumen catheter. Endovascular stenting is the favored treatment option in the setting of traumatic carotid injury. In other parts of the body, specifically the femoral artery, thrombin injection has become the standard of care.

Neuroembolization of metastatic Merkel cell cancer to the face for treatment of Kasabach-Merritt syndrome.

Kasabach-Merritt syndrome is defined as a consumptive thrombocytopenia in the presence of a highly vascular tumor. Multiple treatment options, including transarterial embolization, have been described. We demonstrate that transarterial embolization is a viable option in the treatment of a rapidly progressive and debilitating Merkel cell tumor metastasizing to the head and neck presenting with Kasabach-Merritt syndrome.

Neuroembolization of metastatic Merkel cell cancer to the face for treatment of Kasabach-Merritt syndrome.

Kasabach-Merritt syndrome is defined as a consumptive thrombocytopenia in the presence of a highly vascular tumor. Multiple treatment options, including transarterial embolization, have been described. We demonstrate that transarterial embolization is a viable option in the treatment of a rapidly progressive and debilitating Merkel cell tumor metastasizing to the head and neck presenting with Kasabach-Merritt syndrome.

Desensitization treatment for hypersensitivity reaction to octreotide in an acromegalic patient.

Octreotide is widely used as medical therapy for acromegaly. It is known to markedly reduce growth hormone levels, improve symptoms and reduce tumor size. Common side effects include gastrointestinal symptoms, hepatobiliary disorders, dizziness, headaches, bradycardia, hyperglycemia or hypoglycemia and thyroid dysfunction.

Acute radiation syndrome after endovascular AAA repair.

Acute radiation syndrome or radiation sickness is a serious illness that occurs after the body receives a high dose of radiation, typically over a short period of time. This condition may be underrecognized by interventionalists and must be considered whenever performing complex endovascular procedures.

Publication rates of registered clinical trials in macular degeneration.

Purpose: The purpose of this study was to evaluate the rate of publication of registered clinical trials concerning age-related macular degeneration (AMD).

Methods: The National Institutes of Health's ClinicalTrials.gov registry was searched to identify all trials concerning AMD.

Condyloma and other infections including human immunodeficiency virus.

Sexually transmitted diseases (STDs) are a common public health problem and as such may be more common in a surgical practice than is believed. The recognition that a virus can be responsible for a cancer has profound significant public health implications. This article reviews the presentation and management of the more common perianal STDs including human immunodeficiency virus, as well as the pathogenesis and management of anal intraepithelial neoplasia.

Physeal fractures of the distal tibia: predictive factors of premature physeal closure and growth arrest.

Background: A retrospective review of 124 patients was undertaken to determine the incidence of physeal growth arrest (premature physeal closure [PPC]) after physeal fractures of the distal end of the tibia in children. We also sought to identify clinical predictors of PPC.

Methods: We defined PPC as radiographic evidence of physeal closure as compared to the uninjured side in this patient population.

Institutional practices of withholding enteral feeding from intubated patients.

Objective: This study compared the practices of anesthesia, anesthesia critical care, surgical critical care, and medical critical care departments that have training programs for the length of time they withhold enteral feeding from intubated patients before seven scheduled procedures: 1) extubation; 2) tracheostomy; 3) abdominal surgery; 4) nonabdominal surgery; 5) magnetic resonance imaging or computerized tomography; or placing the patient in the 6) Trendelenberg or 7) prone position.

Design: One-time survey of 297 anesthesia and critical care training programs in the United States.

Measurements And Main Results: Eighty programs responded (27%).

Transition to a semiclosed surgical intensive care unit (SICU) leads to improved resident job satisfaction: a prospective, longitudinal analysis.

Objective: Patients, family members and ICU nurses have a higher level of satisfaction with the semiclosed ICU model. Whether or not resident physicians have this same reaction has not yet been investigated. We hypothesized that surgical residents would have improved job satisfaction with the transition from a mandatory consultation SICU to a semiclosed SICU model.

Placental mesenchymal dysplasia: a potential misdiagnosed entity.

Placental mesenchymal dysplasia is a rare condition characterized by enlarged multicystic placenta with anechoic regions on ultrasound. Gross examination shows grapelike vesicles which mimics molar pregnancy. Microscopic findings shows large edematous villi with cistern formation interspersed with normal villi.

Successful treatment of the idiopathic restless legs syndrome in a randomized double-blind trial of oxycodone versus placebo.

In a double-blind randomized crossover trial, oxycodone or placebo was given in divided night-time doses to 11 patients with idiopathic restless legs syndrome (RLS) for 2 weeks prior to appropriate polysomnographic studies. Under double-blinded conditions, patients were asked to do daily ratings of their leg sensations, motor restlessness and daytime alertness on a 1-4 scale for the 2 weeks prior to the polysomnographic studies and for the nights of the polysomnographic studies as well. Leg sensations (p < 0.

Subjective comparison of six different reduction mammoplasty procedures.

There are an increasing number of young patients seeking an ideal reduction mammoplasty. The ideal procedure must obtain a youthful-looking result, minimal scarring, preservation of lactation, erotic sensitivity, and no postoperative complications. We have done a subjective comparison of six different reduction mammoplasty procedures by using a mail questionnaire.