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Cureus 2021 Apr 11;13(4):e14417. Epub 2021 Apr 11.

Otolaryngology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MYS.

A snapping tendon on the dorsal aspect of the thumb is a rare condition as opposed to the common triggering on the volar aspect of the thumb. This condition is known as triggering of the extensor pollicis longus (EPL). A 21-year-old female presented with a clicking or snapping sensation that was felt on the dorsum of her thumb when it is extended. Read More

BMC Anesthesiol 2021 May 12;21(1):143. Epub 2021 May 12.

H. Lee Moffitt Cancer Center & Research Institute, University of South Florida Morsani College of Medicine, 12902 USF Magnolia Dr, Tampa, FL, 33612, USA.

Background: Epidural catheters are routinely placed for many surgical procedures and to treat various pain conditions. Known complications arising from epidural catheter equipment malfunction include epidural pump failure, epidural catheter shearing, epidural catheter connector failure, epidural filter connector cracking, and loss-of-resistance syringe malfunction. Practitioners need to be aware of these potentially dangerous complications and take measures to mitigate the chances of causing significant patient harm. Read More

Lancet Respir Med 2021 May 6. Epub 2021 May 6.

Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.

The zoonotic SARS-CoV-2 virus that causes COVID-19 continues to spread worldwide, with devastating consequences. While the medical community has gained insight into the epidemiology of COVID-19, important questions remain about the clinical complexities and underlying mechanisms of disease phenotypes. Severe COVID-19 most commonly involves respiratory manifestations, although other systems are also affected, and acute disease is often followed by protracted complications. Read More

Int J Spine Surg 2021 May 7. Epub 2021 May 7.

The Spinal Foundation, 17 Harley Street, London W1G 9QH.

Background: The aim of this study was to evaluate the safety and long-term clinical outcomes of transforaminal full endoscopic discectomy and foraminotomy performed with manual reamers under local anesthesia on soft and calcified herniated discs in the mid and lower thoracic spine.

Methods: Postoperative pain relief was self-evaluated by 16 patients using a visual analog scale (VAS) and Oswestry Disability Index (ODI). Patients were scored at 6, 12, 24, and 60 months after surgery. Read More

J Clin Anesth 2021 May 5;73:110329. Epub 2021 May 5.

Department of Anaesthesiology and Pain Medicine, Jessa Hospital, Hasselt, Belgium; UHasselt, Faculty of Medicine and Life Sciences, Diepenbeek, Belgium.

Study Objective: This study aimed to assess if a forearm (FA) intravenous regional anesthesia (IVRA) with a lower, less toxic, local anesthetic dosage is non-inferior to an upper arm (UA) IVRA in providing a surgical block in patients undergoing hand and wrist surgery.

Design: Observer-blinded, randomized non-inferiority study.

Setting: Operating room. Read More

World J Pediatr Congenit Heart Surg 2021 May 6:21501351211000367. Epub 2021 May 6.

Department of Paediatric Cardiac Intensive Care, Sri Sathya Sai Sanjeevani International Centre for Child Heart Care and Research, Palwal, Haryana, India.

Truncus arteriosus, also referred to as common arterial trunk (CAT), is generally classified as a cyanotic congenital heart disease characterized by a single arterial trunk arising from the heart and supplying both pulmonary and systemic circulations. Cyanosis exists by virtue of it being an admixture lesion. We report a 13-year-old boy diagnosed to have type 1 CAT who was acyanotic at presentation and had all features of an operable lesion even at this age. Read More

Rev Med Suisse 2021 May;17(737):885-888

Association 2nd Chance, Rue Ferdinand-Hodler 7, 1207 Genève.

Based in Geneva since 2010, 2 Chance's mission is the development of reconstructive surgery care in resource-limited countries with a focus on sub-Saharan Africa, through teaching and advocacy activities. We develop the surgical management of patients on the one hand, providing training for African surgical teams. On the other hand, we support surgical procedures for patients, in the areas of reconstructive surgery, giant goiters, obstetric fistulas and anesthesia so that quality care is guaranteed for the long term. Read More

BMC Surg 2021 May 4;21(1):233. Epub 2021 May 4.

Department of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China.

Background: The treatment of a displaced proximal humeral fracture is still a matter of controversy. The purpose of this study was to report outcomes at a long-term follow-up after fixation augmentation using peek (polyether-ether-ketone) cage and locking compression plate (LCP).

Methods: A total of 27 patients (average age 53. Read More

Indian J Orthop 2021 Apr 5;55(2):492-497. Epub 2020 Sep 5.

Department of Orthopaedics and Traumatology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.

Background: Trigger wrist is a relatively unusual condition, produced by wrist or finger motion. The various causes of trigger wrist can originate from flexor tendon, extensor tendon, bones, or tumour. A proper clinical approach is required to diagnose and manage patients with trigger wrist. Read More

Ann Vasc Surg 2021 Apr 24. Epub 2021 Apr 24.

Department of Surgery, Division of Transplantation Surgery, University Medical Center Groningen, Groningen, The Netherlands.

Background: Vascular surgery is considered a risk factor for the development of postoperative delirium (POD). In this systematic review we provide a report on the incidence and risk-factors of POD after vascular surgery.

Methods: A systematic literature search was conducted using Pubmed with the MeSH terms and key words "delirium" or "confusion", "vascular surgery procedures" and "risk factors or "risk assessment". Read More

J Med Toxicol 2021 Apr 27. Epub 2021 Apr 27.

Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy.

Introduction: Between early March 2020 and the end of May 2020, Italy issued strict measures to limit further spread of coronavirus disease 2019 (COVID-19) and became the first European country that imposed a lockdown on the population. The aim of this study was to assess the impact of these restricted conditions on the activity of the Poison Control Center (PCC) of Policlinico Umberto I Hospital-Sapienza University of Rome.

Methods: This was a retrospective analysis of calls received by the PCC during the lockdown period March 9, 2020 through May 31, 2020 compared to the same time period in year 2019 (reference). Read More

J Cereb Blood Flow Metab 2021 Apr 25:271678X211010353. Epub 2021 Apr 25.

Institute for Neurophysiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.

Deep anaesthesia may impair neuronal, vascular and mitochondrial function facilitating neurological complications, such as delirium and stroke. On the other hand, deep anaesthesia is performed for neuroprotection in critical brain diseases such as status epilepticus or traumatic brain injury. Since the commonly used anaesthetic propofol causes mitochondrial dysfunction, we investigated the impact of the alternative anaesthetic isoflurane on neuro-metabolism. Read More

Shoulder Elbow 2021 Apr;13(2):213-222

Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: Severe radiocapitellar pathologies represent a unique problem in the pediatric population, as radial head excision can lead to substantial long-term complications. We present a case series of four pediatric patients treated by a novel technique-radial head excision followed by Achilles allograft interposition arthroplasty.

Methods: Four children (ages 12-15 years) are described. Read More

Hand Surg Rehabil 2021 Apr 23. Epub 2021 Apr 23.

Department of Plastic and Reconstructive Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku Shinjuku-ku, Tokyo 160-0023, Japan. Electronic address:

Digital nerve block is a common procedure with several techniques, including the traditional digital nerve block, transthecal digital nerve block, and single subcutaneous palmar digital nerve block. This review aimed to evaluate the efficacy of these three methods. A systematic search was performed in the PubMed, Scopus, and Cochrane Library databases. Read More

J Cardiothorac Vasc Anesth 2021 Mar 20. Epub 2021 Mar 20.

Università degli Studi dell'Insubria, Varese, Italy; Ospedale di Circolo e Fondazione Macchi, Varese, ASST-Settelaghi, Varese, Italy.

Postoperative pulmonary complications and acute respiratory failure are among the leading causes of adverse postoperative outcomes. Noninvasive ventilation may safely and effectively prevent acute respiratory failure in high-risk patients after cardiothoracic surgery and after abdominal surgery. Moreover, noninvasive ventilation can be used to treat postoperative hypoxemia, particularly after abdominal surgery. Read More

Hand Clin 2021 May;37(2):205-214

Department of Orthopaedic Surgery, Washington University in St. Louis, 660 Euclid Avenue, Campus Box 8233, St Louis, MO 63110, USA. Electronic address:

Operative intervention for distal radius fractures is typically reserved for patients with displaced fractures that may result in bothersome compromises in function, although patient-specific factors (age, activity level, and preference) are considered. Operative intervention is associated with earlier improvement in function but exposes the patient to the risk of anesthesia and surgery. Although surgery is associated with an initial increase in cost of care, the benefits of earlier return to activity may offset these increases. Read More

Hum Vaccin Immunother 2021 Apr 22:1-5. Epub 2021 Apr 22.

Department of Clinical Pharmacy, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.

This study explored the safety of COVID-19 vaccine (Aikewei) and the role of clinical pharmacists in the implementation of COVID-19 vaccination. A total of 2305 hospital employees in Children's Hospital of Fudan University in Shanghai, China received the COVID-19 vaccine. The whole process of vaccination was monitored by clinical pharmacists, and the occurrence, types, severity of adverse reactions were recorded in detail. Read More

Hand (N Y) 2021 Apr 21:15589447211008558. Epub 2021 Apr 21.

Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USA.

Background: Orthopedic procedures concerning the upper extremity commonly use a brachial plexus nerve block to achieve postoperative analgesia. The addition of dexamethasone to peripheral nerve blocks has been shown to significantly prolong its effect. We hypothesize that 1 mg doses of dexamethasone will prolong brachial plexus nerve block with similar efficacy to 4 mg and better than ropivacaine alone. Read More

Hand Surg Rehabil 2021 Apr 18. Epub 2021 Apr 18.

Université de Picardie - Jules Verne, 1-3 rue des Louvels, 80000 Amiens, France. Electronic address:

We describe an innovative mini-open technique for reinsertion of the flexor digitorum profundus tendon under Wide Awake Local Anesthesia No Tourniquet (WALANT) with ultrasound assistance. Ultrasound-aided detection at the surgeon's practice is used to plan the surgical tendon repair procedure so that tendon reinsertion can be performed with the smallest incision possible. Passage of the tendon through the digital sheath was accomplished with the help of a compressive tendon guide to avoid a surgical approach. Read More

Recenti Prog Med 2021 Apr;112(4):250-261

In the common clinical practice the perioperative risk assessment of an acute surgical patient with advanced chronic comorbidities is carried out independently by surgeon and anesthesiologist, usually in two different steps. While the surgeon evaluates the risk mainly in relation to the surgical outcome, the perioperative risk assessment regarding the weight of the coexisting medical condition on the quality of recovery in the short- mid- and long-term is all about the anesthesiologist evaluation. When frailty and/or comorbidities are so serious that will make surgery seem futile, the patient's assessment on one hand, and the decisions regarding the further clinical waypoint on the other, have to be discussed firstly between surgeons and anesthesiologists before being shared with the patients and their relatives. Read More

Arch Phys Med Rehabil 2021 Apr 16. Epub 2021 Apr 16.

University of California San Francisco, Department of Physical Therapy and Rehabilitation Science; University of California San Francisco, Department of Physical Therapy and Rehabilitation Science and Department of Physiological Nursing. Electronic address:

Objective: Evaluate the efficacy of negative pressure massage treatment (NPMT) compared to manual lymphatic drainage (MLD) in women with chronic breast cancer-related lymphedema (LE). We hypothesized that NPMT would result in greater improvements in LE and upper limb function.

Design: Pilot single-blinded randomized controlled trial (RCT) SETTING: Health sciences university PARTICIPANTS: Of 64 women screened, 28 met eligibility requirements (i. Read More

J Hand Surg Eur Vol 2021 May;46(4):438-439

J Healthc Eng 2021 1;2021:5529798. Epub 2021 Apr 1.

Department of Hand and Foot Surgery, Affiliated Hospital of Beihua University, Jilin 132012, China.

The rapid development of intelligent computer technology has promoted the improvement of people's living standards and the application of the entire intelligent system. In modern medicine, doctors use their accumulated experience and medical knowledge to diagnose diseases and draw conclusions. In order to effectively inherit the diagnosis experience accumulated by doctors, R&D personnel put forward the idea of using artificial intelligence technology to develop an intelligent auxiliary medical diagnosis system. Read More

J Hand Microsurg 2021 Apr 9;13(2):95-100. Epub 2020 Apr 9.

Department of Orthopaedic Surgery, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, Larissa, Greece.

 Wide awake open carpal tunnel decompression is a procedure performed under local anesthesia. This study aimed to present the effect of various local anesthetics in peri and postoperative analgesia in patients undergoing this procedure.  A total of 140 patients, with 150 hands involved, underwent carpal tunnel release under local anesthesia. Read More

Rehabilitacion (Madr) 2021 Apr 14. Epub 2021 Apr 14.

Departamento de Educación, Hospital Virtual Valdecilla, Santander, Cantabria, España. Electronic address:

We described the use of clinical simulation for hand therapy in an anesthesiologist that accidentally suffered from entrapment with the surgical table in the right thumb and underwent a partial toe-to-hand autograft. At week 14 after surgery, the patient practiced anesthetic tasks and clinical scenarios using a patient simulator instead undergoing a regular occupational therapy regimen. Quantifiable physical, functional and psychological measures improved during and after the simulation intervention, and there was no decline one month after the patient returned to work. Read More

Handchir Mikrochir Plast Chir 2021 Apr 16. Epub 2021 Apr 16.

Spital Thurgau AG, Hand- und Plastische Chirurgie.

Aetiologically, prilocaine-induced methaemoglobinaemia is a rare form of acquired methaemoglobinaemia, which occurs rarely in the first place. The following report highlights a potentially dangerous complication arising after application of prilocaine during liposuction.A young female visited the Accident and Emergency Department following a pre-syncopal fall. Read More

Plast Reconstr Surg Glob Open 2021 Apr 8;9(4):e3513. Epub 2021 Apr 8.

Division of Plastic and Reconstructive Surgery, Université de Montréal, Montréal, Québec, Canada.

Background: Carpal tunnel syndrome and trigger finger are two of the most common conditions treated by the hand surgeon. During these procedures, a tourniquet is often used to minimize bleeding and improve visualization of the operative field. However, it may be associated with pain and discomfort. Read More

Orthopade 2021 May 13;50(5):415-424. Epub 2021 Apr 13.

Bereich für Plastische, Ästhetische und Spezielle Handchirurgie, Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, Haus 4, 04103, Leipzig, Deutschland.

Wide awake local anesthesia no tourniquet (WALANT) refers to an anesthesia technique with low bleeding and complication rates, which enables interventions on the hand in an awake patient without the use of a tourniquet. Bleeding control is achieved through addition of vasoconstrictors to the infiltration solution. Since the motor function of the extremity is not affected, it offers the additional possibility of intraoperative active function testing. Read More

J Anaesthesiol Clin Pharmacol 2020 Oct-Dec;36(4):483-488. Epub 2021 Jan 18.

Department of Anesthesia and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Background And Aims: Successful intubation with video laryngoscopes necessitates good hand-eye coordination and the use of intubation adjuncts like bougie and stylet. We proposed this study to find whether using Frova introducer with C-MAC video laryngoscope will reduce the intubation time in trainee anesthesiologists.

Material And Methods: We enrolled 140 adults without any difficult airway predictors. Read More

Indian J Orthop 2021 Apr 3:1-10. Epub 2021 Apr 3.

University College of Medical Sciences (University of Delhi), New Delhi, India.

Covid-19 is a respiratory disease caused by coronavirus 2 (SARS-CoV-2) first identified in Wuhan, China (December 2019). The disease rapidly crossed the barrier of countries, continents and spread globally. Non-pharmaceutical measures such as social distancing, face mask, frequent hand washing and use of sanitizer remained the best available option to prevent the spread of disease. Read More