Anti-Rotational Plates with Intramedullary Nailing Stabilize Femoral Shaft Fracture Nonunion: A Biomechanical Study
Xianzhi Ma, Manyi Wang, Bosong Zhang, Zhendong Wang, Yunbang Lang and Xiaofeng Gong
Article Type: Research Article | First Published: December 28, 2015
Intramedullary nailing (IM) is the primary method for treating nonunion of femoral shaft fractures. However, with the advancement of IM technique and the increasing clinical indications, the incidence rate of femoral shaft fracture nonunion, according to the literature review, was 0.8-2%. Regarding its treatment, exchanging intramedullary nailing is considered as the golden standard treatment for femoral shaft fracture nonunion, with a cure rate of up to 70-100%....
Current Aspects of ABO-Incompatible Liver Transplantation
Naoki Kawagishi, Noriaki Ohuchi and Susumu Satomi
Article Type: Review Article | First Published: December 23, 2015
Liver transplantation is well recognized as treatment for patients with end-stage liver disease. Although the source of donors is limited, ABO blood type matched transplantation is commonly performed in deceased donor liver transplantation. On the other hand, where deceased donors are rarely available, a graft obtained from a family member of the recipient is mainly employed and thus ABO-incompatible (ABO-I) living donor liver transplantation (LDLT) becomes unavoidable. This review article describes the history and current aspects of ABO-I liver transplantation including our own Japanese exper...
Ranking and Rating Analyses of Barriers to Surgical Care for Children in Guatemala
Brian C Gulack, Shirin Heydari, Ligia Figueroa, Shannon Tew, Brad M Taicher, Sherry S Ross, David Boyd and Henry E Rice
Article Type: Original Article | First Published: November 20, 2015
Barriers to surgical care in low and middle-income countries (LMICs) remain poorly understood. This is particularly true of surgical care for children, where families are required to make complex decisions amidst multiple obstacles. Unmet surgical care contributes to at least 11% of the global burden of disease. For many disease processes in children, surgery is a cost-effective health intervention, as it results in a high degree of averted disability-adjusted life years (DALYs) with costs comparable to many other health interventions....
Vancomycin and Imipenem Release from Nails Covered with Antibiotic-Loaded Acrylic Cement
Jorge D Barla, Sancineto F Carlos, Luciano A Rossi, Gimenez I Maria, Visus M and Elizondo Cristina
Article Type: Research Article | First Published: November 17, 2015
There is a lack of information in the literature regarding pharmacokinetic properties of nails covered with antibiotic-loaded acrylic cement. The aim of this research work was to describe the release of vancomycin and imipenem from nails covered with ALAC over a period of 6 weeks. Furthermore, we analyzed if an increased nail diameter associated to a thicker ALAC coat could result in an increased antibiotic elution from the cement and if the combination of the two antibiotics in the same cement affects the amount of antibiotics released....
Shoichi D. Takekawa
Article Type: Short Commentary | First Published: December 31, 2015
Pathology and radiology have become pivotal in the clinical practice of daily medicine. Diagnostic radiology and pathology are indeed indispensable wheels of medical practice. Clinicians achieve tentative diagnoses based on laboratory data and medical images in addition to their physical findings and patient medical history. Based on all available findings and on patient characteristics, clinicians finally decide on further therapeutic management strategies, including medical and surgical therapies. Medical images are interpreted and reported by radiologists, yet with current hospital-wide ima...
Orbital Necrobiotic Xanthogranuloma: A Case Report
Hind M. Alkatan and Abdul Elah A. Al-Abdullah
Article Type: Case Report | First Published: December 24, 2015
Xanthogranulomatous ocular and periocular lesions in adults have been reported in 3 main forms: adult-onset xanthogranuloma (AXG), necrobiotic xanthogranuloma (NXG), and Erdheim-Chester disease. The three forms differ in regards to laterality, systemic associations, and prognosis. NXG is a rare chronic progressive disease considered to be systemic with mostly asymptomatic internal organ involvement. Ophthalmic manifestations include conjunctival, corneal and scleral involvement. We are presenting a case of NXG with initial presentation as bilateral scleritis and eventual posterior eye and orbi...
Squamous Morules (Microcarcinoids) in Gastroesophageal Polyps; a Mimicker of Invasive Carcinoma
Safia N Salaria and Elizabeth Montgomery
Article Type: Review Article | First Published: November 30, 2015
Colorectal lesions termed squamous morules or microcarcinoids display predominantly squamous and variable endocrine differentiation and are often found in colorectal adenomas with high grade dysplasia thus mimicking invasion. Herein, we describe histopathologic, immunohistochemical classification and clinical correlation of analogous lesions in the esophagus and stomach. We identified five cases (3 men, 2 women) from November 2004-March 2013 of gastric and gastroesophageal polyps with squamous morules. Four of the patients were white. The median age was 70 years (range 59-85 years). Two patien...
Maladaptive Perfectionism: A Potential Risk Factor for Smartphone Addiction?
Jiang Long and Tieqiao Liu
Article Type: Letter to the Editor | First Published: December 14, 2015
A Smartphone is a portable device that could be capable of various tasks on different occasions. With many powerful functions, smartphones permeate into our everyday lives at an astonishing pace. Surely, the smartphone could make our lives much more convenient, but it could also bring quite a few issues, especially when it is used improperly. Nowadays, smartphone addiction is not a novel construct any more. It could be defined as an inability to regulate one's use of the smartphone, which eventually involves negative consequences in daily life....
The Evaluation of 1-Physician Versus 2-Physician Deep Sedation with Propofol
Lindsay M Harmon, Anthony J Perkins, Beth Sandford and Christopher S Weaver
Article Type: Original Article | First Published: January 25, 2016
Emergency physicians routinely perform emergency department procedural sedation (EDPS) with propofol and its safety is well established. However, in 2009 the Centers for Medicare and Medicaid Services (CMS) enacted guidelines defining propofol as deep sedation and requiring administration by a physician. Common EDPS practice had been one-physician performing both the sedation and procedure. EDPS has proven safe under this 1-physician practice. However, the 2009 guidelines mandated separate physicians perform each....
Difficult Airway Management in Patients Submitted to General Anesthesia. Is it a Matter of Devices or Predictive Scores?
Lavinia Bergesio, Nadia Ruggieri, Orazio Difrancesco, Enrico Giustiniano and Franco Cancellieri
Article Type: Research Article | First Published: January 13, 2016
Airway management is mostly performed in the operating room, and unexpected difficult tracheal intubation may be a life-threatening event which incidence varies in a wide range with estimated pooled frequency of 6.8%. Difficulty at laryngoscopy or intubation, if inability to maintain a patient airway occurs, exposes the patient to the risk of complications basically related to hypoxia. Its incidence has been reported around 1-4% of patients with normal airway and, more recently, in a range of 1.5-8.5% of all general anesthesia....