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Friday, August 26, 2011

Military medical officers from the US, Germany and UK to discuss new innovations in the treatment of combat casualties

battlefield_healthcareThe latest technologies and techniques being used to treat soldiers on the front line will be explored at Defence IQ’s Battlefield Healthcare Conference, taking place 21st-23rd November in Munich, Germany.

Results of medication studies in top medical journals may be misleading to readers

Studies about medications published in the most influential medical journals are frequently designed in a way that yields misleading or confusing results. The journals are the New England Journal of Medicine, the Journal of the American Medical Association, the Lancet, the Annals of Internal Medicine, the British Medical Journal and the Archives of Internal Medicine.  The findings are published online in the Journal of General Internal Medicine. PDF  Eurekalert!

Thursday, August 25, 2011

Consumer reports empowers patients with new Hospital Ratings app for iPhone & iPad

This week, Consumer Reports released an iPhone/iPad app aimed squarely at healthcare consumer — Hospital Ratings. It’s a relatively cheap app, $2.99, and enables patients to compare hospitals around them, and to look up detailed reports on those particular hospitals. iMedicalApps

Orthopedic boot camp: examining the effectiveness of an intensive surgical skills course.

The intensive skills course used in this study was highly effective at teaching and developing targeted surgical skills in first-year orthopedic residents. We predict that allowing residents to acquire key technical skills at the start of their training will enhance learning opportunities at later stages of training.
Sonnadara RR, Van Vliet A, Safir O, Alman B, Ferguson P, Kraemer W, Reznick R. Surgery. 2011 Jun;149(6):745-9. Epub 2011 Jan 14. PMID: 21236456

Use of vacuum-assisted closure (VAC™) in high-energy complicated perineal injuries: analysis of nine cases.

Our study reviewed nine patients who were treated with the VAC™ Abdominal Dressing System after suffering pelvic fractures and soft tissue loss after high-energy pelvic trauma. Between March 2008 and August 2009, our clinic treated nine patients with complicated perineal injuries from high-energy pelvic trauma with multiple irrigation and debridement procedures and broad-spectrum antibiotics. Protective ostomies were created for all nine patients. Ozer MT, Coskun AK, Ozerhan IH, Ersoz N, Yildiz R, Sinan H, Demirbas S, Kozak O, Uzar AI, Cetiner S. Int Wound J. 2011 Aug 19. doi: 10.1111/j.1742-481X.2011.00835.x. [Epub ahead of print] PMID: 21854547

Return to running and sports participation after limb salvage.

The ability to return to running and sports participation after lower extremity limb salvage has not been well documented previously. Although the ability to ambulate without pain or assistive devices is generally a criteria for a good limb salvage outcome, many patients at our institution have expressed a desire to return to a more athletic lifestyle to include running and sports participation. The purpose of this study was to investigate the types of athletic endeavors our high-energy lower extremity trauma patients were able to pursue after limb salvage. Owens JG, Blair JA, Patzkowski JC, Blanck RV, Hsu JR; Skeletal Trauma Research Consortium (STReC). J Trauma. 2011 Jul;71(1 Suppl):S120-4. PMID: 21795870

Orthopedic cast, “Bones”, keeps track of physical therapy and muscle healing

Here’s an interesting concept: Imagine an orthopedic cast with sensors that capture muscle activity, wirelessly broadcasting the information to social networks, including your physician and physical therapist — enabling them to see what type of mobility and therapy you are doing. iMedicalApps

Computer assisted surgery for knee ligament reconstruction.

 A favourable effect of computer assisted surgery for cruciate ligament reconstructions of the knee compared with conventional reconstructions could neither be demonstrated nor refuted. There is insufficient evidence to advise for or against the use of CAS. There is a need for improved reporting of future studies of this technology. Meuffels DE, Reijman M, Scholten RJ, Verhaar JA. Cochrane Database Syst Rev. 2011 Jun 15;(6):CD007601. Review. PMID: 1678367

Arthroscopy: The Journal of Arthroscopic & Related Surgery [In Press, Corrected Proof]

A Randomized Study of the Effectiveness of Suprascapular Nerve Block in Patient Satisfaction and Outcome After Arthroscopic Subacromial Decompression  Hans-Christian Jeske, Franz Kralinger, Markus Wambacher, Florian Perwanger, Rebecca Schoepf, Juergen Oberladstaetter, Dietmar Krappinger, Christian Dallapozza, Frank Hoffmann.  Arthroscopy: The Journal of Arthroscopic & Related Surgery, In Press, Corrected Proof, Available online 24 August 2011, ISSN 0749-8063, DOI: 10.1016/j.arthro.2011.05.016.

Arthroscopic-Assisted Repair of Avulsed Triangular Fibrocartilage Complex to the Fovea of the Ulnar Head: A 2- to 4-Year Follow-Up Study  Norimasa Iwasaki, Kinya Nishida, Makoto Motomiya, Tadanao Funakoshi, Akio Minami.  Arthroscopy: The Journal of Arthroscopic & Related Surgery, In Press, Corrected Proof, Available online 24 August 2011, ISSN 0749-8063, DOI: 10.1016/j.arthro.2011.05.020.

Arthroscopic Management of Femoroacetabular Impingement: Minimum 2-Year Follow-Up  J.W. Thomas Byrd, Kay S. Jones. Arthroscopic Management of Femoroacetabular Impingement: Minimum 2-Year Follow-Up, Arthroscopy: The Journal of Arthroscopic & Related Surgery, In Press, Corrected Proof, Available online 20 August 2011, ISSN 0749-8063, DOI: 10.1016/j.arthro.2011.05.018.

Defining the Origins of the Iliofemoral, Ischiofemoral, and Pubofemoral Ligaments of the Hip Capsuloligamentous Complex Utilizing Computer Navigation

This study demonstrates that there is significant variability in the size and location of the iliofemoral ligament origin versus the pubofemoral and ischiofemoral ligaments. Nam D, Osbahr D, Choi D, Ranawat A, Kelly B and Coleman S.  HSS Journal DOI: 10.1007/s11420-011-9214-3 Online First

Wednesday, August 24, 2011

Army to field tablets to manage medical records on battlefield

Army medics could soon be accessing an injured soldier's medical data using tablet computers.  Currently, medics use bulky Motorola hand-held devices to document administered care, injuries and illnesses to soldiers in combat zones, ranging from battlefield wounds to a stomach virus. But this technology, fielded four years ago, can only support a limited version of the military's electronic outpatient medical record. And medics complain that the device's keypad is a sand magnet.

Mobile technologies like the iPad, iPhone and Android smartphones can run a more robust version of outpatient and inpatient medical records, with features that alert users to potentially harmful impacts of certain drug interactions and a list of patient allergies. Although medics usually do not administer prescription drugs, these additional capabilities would give them greater insight into a soldier's medical history. Federal Times

The Journal of Arthroplasty: Epubs

1. The flexion-extension axis of the knee and its relationship to the rotational orientation of the tibial plateau. Lawrie CM, Noble PC, Ismaily SK, Stal D, Incavo SJ. J Arthroplasty. 2011 Sep;26(6 Suppl):53-58.e1. Epub 2011 Jul 1.PMID: 21723702
2. Readmission and length of stay after total hip arthroplasty in a national medicare sample. Vorhies JS, Wang Y, Herndon J, Maloney WJ, Huddleston JI. J Arthroplasty. 2011 Sep;26(6 Suppl):119-23. Epub 2011 Jul 1. PMID: 21723700
3. Metal-on-Metal vs Metal-on-Improved Polyethylene Bearings in Total Hip Arthroplasty. Molli RG, Lombardi AV Jr, Berend KR, Adams JB, Sneller MA. J Arthroplasty. 2011 Sep;26(6 Suppl):8-13. Epub 2011 Jul 1. PMID: 21723699
4. Prospective randomized comparison of high-flex and standard rotating platform total knee arthroplasty. Hamilton WG, Sritulanondha S, Engh CA Jr. J Arthroplasty. 2011 Sep;26(6 Suppl):28-34. Epub 2011 Jul 1. PMID: 21723697
5. Benefits of prolonged postoperative cyclooxygenase-2 inhibitor administration on total knee arthroplasty recovery a double-blind, placebo-controlled study. Schroer WC, Diesfeld PJ, Lemarr AR, Reedy ME. J Arthroplasty. 2011 Sep;26(6 Suppl):2-7. Epub 2011 Jul 1. PMID: 21723695
6. Early adverse results with bicompartmental knee arthroplasty a prospective cohort comparison to total knee arthroplasty. Morrison TA, Nyce JD, Macaulay WB, Geller JA. J Arthroplasty. 2011 Sep;26(6 Suppl):35-9. Epub 2011 Jun 24. PMID: 21704484
7. Comparison of surgical outcomes and implant wear between ceramic-ceramic and ceramic-polyethylene articulations in total hip arthroplasty. Amanatullah DF, Landa J, Strauss EJ, Garino JP, Kim SH, Di Cesare PE. J Arthroplasty. 2011 Sep;26(6 Suppl):72-7. Epub 2011 Jun 15. PMID: 21680138
8. Prosthetic joint infection caused by gram-negative organisms. Zmistowski B, Fedorka CJ, Sheehan E, Deirmengian G, Austin MS, Parvizi J. J Arthroplasty. 2011 Sep;26(6 Suppl):104-8. Epub 2011 Jun 8. PMID: 21641762
9. Gender is a Significant Factor for Failure of Metal-on-Metal Total Hip Arthroplasty. Latteier MJ, Berend KR, Lombardi AV Jr, Ajluni AF, Seng BE, Adams JB. J Arthroplasty. 2011 Sep;26(6 Suppl):19-23. Epub 2011 Jun 8. PMID: 21641761
10. Optimal Irrigation and Debridement of Infected Joint Implants An In Vitro Methicillin-Resistant Staphylococcus aureus Biofilm Model. Schwechter EM, Folk D, Varshney AK, Fries BC, Kim SJ, Hirsh DM. J Arthroplasty. 2011 Sep;26(6 Suppl):109-13. Epub 2011 Jun 8. PMID: 21641757
11. Distal fixation of proximally coated tapered stems may predispose to a failure of osteointegration. Cooper HJ, Jacob AP, Rodriguez JA. J Arthroplasty. 2011 Sep;26(6 Suppl):78-83. Epub 2011 May 23. PMID: 21602026
12. The reliability and variation of acetabular component anteversion measurements from cross-table lateral radiographs. Nunley RM, Keeney JA, Zhu J, Clohisy JC, Barrack RL. J Arthroplasty. 2011 Sep;26(6 Suppl):84-7. Epub 2011 May 13. PMID: 21570805
13. Molecular markers for diagnosis of periprosthetic joint infection. Jacovides CL, Parvizi J, Adeli B, Jung KA. J Arthroplasty. 2011 Sep;26(6 Suppl):99-103.e1. Epub 2011 May 13. PMID: 21570803 
14. Revision for Recurrent Instability What are the Predictors of Failure? Carter AH, Sheehan EC, Mortazavi SM, Purtill JJ, Sharkey PF, Parvizi J. J Arthroplasty. 2011 Sep;26(6 Suppl):46-52. Epub 2011 May 8. PMID: 21550768
15. Initial experience of the journey-deuce bicompartmental knee prosthesis a review of 36 cases. Palumbo BT, Henderson ER, Edwards PK, Burris RB, GutiĆ©rrez S, Raterman SJ. J Arthroplasty. 2011 Sep;26(6 Suppl):40-5. Epub 2011 May 8. PMID: 21550763

104-year-old lady undergoes orthopaedic surgery

A major orthopaedic surgery was recently carried out in the district on a 104-year-old-lady who suffered a hip fracture. Mariyam Beevi of Dar ul Huda, Navaikulam, the great grandmother of five generations, survived this intricate procedure, which made her able to move about with the help of walker on the very seventh day after surgery. IBN Live

Dried Plums for Bone Loss

In a new study, researchers randomly assigned 160 postmenopausal women not receiving hormone replacement therapy or any other medications known to affect bone mass to one of two treatment groups. The first group received 100 grams of dried plums daily, and the second group received 100 grams of dried apple daily. The dried apple was used as the comparative control.

Participants from both groups also received 500 milligrams of calcium and 400 international units of vitamin D daily. Bone density was measured before and after the study for the spine, forearm, hip and whole body. Blood samples were also taken before and at various points throughout the study to assess bone biomarkers. Natural Standard

Physicians' exposure to radiation prompt cellular changes that may protect the body from harm

Cardiologists who perform heart operations using x-ray guided catheters are exposed to ionising radiation at levels two to three times higher per year than those experienced by radiologists. Now, new research has found the first evidence that these constant, high levels of exposure cause changes at cell level that might represent the body's way of protecting itself against the harmful effects of radiation.

The research, published online today in the European Heart Journal, found that among ten interventional cardiologists who were regularly exposed to x-rays for their work, levels of two chemicals rose: one, glutathione, an anti-oxidant that protects against cell damage from oxygen-containing molecules called 'reactive oxygen species' (ROS), and the other, hydrogen peroxide, which indicates the amount of oxidative stress caused by the ROS. MedicalXpress

Tuesday, August 23, 2011

Coracoid Fractures: Therapeutic Strategy and Surgical Outcomes.

The majority of type I coracoid fractures set out in Ogawa's classification constitute double disruption of the superior shoulder suspensory complex (SSSC) as proposed by Goss, frequently resulting in healing delay and adverse functional consequences. However, there are few reports alluding to strategies or concrete treatment methods of such injuries. The purpose of this report is to introduce our surgical strategy for treating the type I coracoid fracture with concurrent injuries and to describe our treatment method with their outcomes. Ogawa K, Matsumura N, Ikegami H. J Trauma. 2011 Aug 17. [Epub ahead of print] PMID: 21857259

Arthroscopic acromioclavicular joint reconstruction using a synthetic ligament device

ACJ dislocations can effectively be treated with arthroscopy-assisted procedure. Since this procedure has given uniformly good to excellent results comparable to open reconstructive procedures, it can be a good treatment option for symptomatic ACJ dislocations. Kany J, Amaravathi R, Guinand R, Valenti P. European Journal of Orthopaedic Surgery & Traumatology. [Epub Ahead of Print]

Revision Surgery for Patellofemoral Problems: Should We Always Resurface?

Bicompartmental knee arthroplasties had higher revision rates than TKAs. Femoral component design did not influence the cumulative revision rate. Secondary patella resurfacing in a bicompartmental knee arthroplasty carried an increased revision risk compared to resurfacing at the time of index TKA. To reduce the probability of reoperation for patellofemoral problems, our data suggest the patella should be resurfaced at the time of index surgery. Johnson TC, Tatman PJ, Mehle S, Gioe TJ. Clin Orthop Relat Res . 2011 Aug 20. [Epub ahead of print]PMID: 21858641 PDF

Free vascularized metacarpal bone graft combined with extended dorsal metacarpal artery flap for phalangeal bone and soft tissue loss: case report.

A 45-year-old man suffered from a complex bone and soft tissue defect of the middle phalanx of his left middle finger after an electric saw injury. Here, we present the patient's clinical and radiological outcomes after reconstruction with a free vascularized metacarpal II bone graft and an extended distally based second dorsal metacarpal artery skin flap (DMCA). To our knowledge, this is the first description of a free vascularized metacarpal bone graft combined with DMCA for distal finger reconstruction.
Saalabian AA, Unglaub F, Horch RE, Kneser U. Arch Orthop Trauma Surg. 2011 Aug 21. [Epub ahead of print] PMID: 21858662

Hip Implant Complaints Surge, Even as the Dangers Are Studied

The federal government has received a surge in complaints in recent months about failed hip replacements, suggesting that serious problems persist with some types of artificial hips even as researchers scramble to evaluate the health dangers.  An analysis of federal data by The New York Times indicates that the Food and Drug Administration has received more than 5,000 reports since January about several widely used devices known as metal-on-metal hips, more than the agency had received about those devices in the previous four years combined. NYT

Suture anchor versus screw fixation for greater tuberosity fractures of the humerus—a biomechanical study

Suture anchors and screws are commonly used for fixation of humeral greater tuberosity (GT) fractures in either arthroscopic or open surgeries, but no biomechanical studies have been performed to compare the strength of fixation constructs using these two implants. This cadaveric study aimed to compare the biomechanical strength of three different fixation constructs in the management of GT fractures: Double-Row Suture Anchor Fixation (DR); Suture-Bridge Technique using suture anchors and knotless suture anchors (SB); and Two-Screw Fixation (TS). Lin CL, Hong CK, Jou IM, Lin CJ, Su FC, Su WR.
J Orthop Res. 2011 Aug 19. doi: 10.1002/jor.21530. [Epub ahead of print] PMID: 21858857 PDF

Emergent Management of Trauma is a decent but expensive trauma handbook for the iPhone and iPad


  • $59.99


  • Detailed yet concise summaries of a wide range of trauma injuries
  • Clinical algorithms to assist in decision making
  • Biography


  • Expensive for a relatively niche area of medicine

Overall Rating

  • Emergent Management of Trauma is a fine introduction to the trauma environment and this app ensures that this is accessible to all levels of healthcare professional; from student to nurse to attending. iMedicalApps

Monday, August 22, 2011

A 40-month multicentre, randomised placebo-controlled study to assess the efficacy and carry-over effect of repeated intra-articular injections of hyaluronic acid in knee osteoarthritis: the AMELIA project.

The results of AMELIA offer pioneer evidence that repeated cycles of intra-articular injections of HA not only improve knee osteoarthritis symptoms during the in-between cycle period but also exert a marked carry-over effect for at least 1 year after the last cycle. In this respect, it is not possible to establish if this carry-over effect reflects true osteoarthritis remission or just a modification of the disease's natural course. number, NCT00669032. Navarro-Sarabia F, Coronel P, Collantes E, Navarro FJ, Rodriguez de la Serna A, Naranjo A, Gimeno M, Herrero-Beaumont G; on behalf of the AMELIA study group. Ann Rheum Dis. 2011 Aug 17. [Epub ahead of print] PMID: 21852252   PDF

Wounded Warriors Move Into New Barracks at Bethesda

BETHESDA, Md. (NNS) -- Wounded warriors began moving into new specialized barracks on board Naval Support Activity, Bethesda (NSAB) Aug. 20 following the official opening of the Tranquility Hall barracks.

The barracks will service outpatient military members from both the Walter Reed Army Medical Center and National Naval Medical Center (NNMC).

The new 306-bed facility features 153 two-bedroom, two-bath suites equipped with common kitchens and seating areas, washer and dryer units, flat screen televisions

Arthroscopy: The Journal of Arthroscopic & Related Surgery [articles in press]

Evaluation of Intra-Articular Mesenchymal Stem Cells to Augment Healing of Microfractured Chondral Defects

The much anticipated UpToDate iPhone app is finally here


  • Nothing matches UpToDate when it comes to updated medical references
  • Comprehensive, peer-reviewed, reference-oriented, illustrated, and pharm-free
  • Smooth user interface with easy dynamic searching and impressive navigation


  • Pricing: UpToDate will cost you, as noted above, for its considerable resources
  • While eagerly awaited by many residents and medical students, institutional subscribers do NOT yet have access to the iPhone App version
  • While the offline version of the UpToDate App is set to debut later this year, this current version can sometimes take several moments to load topics

Sunday, August 21, 2011


Gamification of healthcare gets its due recognition from academic elite Proponents of the gamification of healthcare have had a summer filled with accomplishments to support the their cause, particularly in recent weeks as a couple leading academic institutions have made it abundantly clear they believe the gamification trend is more than just a passing fad. iMedicalApps

New Journal for Review of Science of Gaming in Healthcare  A new peer-reviewed journal, Games for Health from Mary Ann Leibert publishers, has just been unveiled. The journal will focus on the topic of games and how they can impact healthcare.
More from the publishers: Games are rapidly becoming an important tool for improving health behaviors ranging from healthy lifestyle habits and behavior modification to self-management of illness and chronic conditions to motivating and supporting physical activity. Games are also increasingly used to train health care professionals in methods for diagnosis, medical procedures, patient monitoring, as well as for responding to epidemics and natural disasters. G4H is a must for anyone interested in the research and design of health games that integrate well-tested, evidence-based behavioral health strategies to help improve health behaviors and to support the delivery of care. MedGadget

Posterior Tibial Tendon Tear After 4-Cortex Syndesmotic Screw Fixation: A Case Report and Literature Review

We describe a previously unreported problem of a patient who underwent errant 4-cortex syndesmotic screw fixation with resultant posterior tibial tendon tear necessitating removal of hardware and repair of a tendon tear. Kwon JY, Campbell JT, Myerson MS. J Orthop Trauma. 2011 Aug 12. [Epub ahead of print] PMID: 21849910

A Comparison of 2 Methods for Scaphoid Central Screw Placement From a Volar Approach

Our data suggest that a volar transtrapezial approach can be an alternative for optimum central placement in volar percutaneous fixation of scaphoid fractures. Meermans G, Verstreken F. J Hand Surg Am. 2011 Aug 15. [Epub ahead of print] PMID: 21849237

US and Vietnamese medics join forces to heal old wounds

Vietnam and the United States have signed their first military-to-military co-operation agreement since the end of the Vietnam War and the normalisation of diplomatic relations.

The statement of intent (SOI) between the US Department of Defense (DoD) and the Vietnamese Ministry of National Defence outlines how the countries will interact in matters of military medicine, according to the US Navy (USN) Bureau of Medicine and Surgery. Janes

Treatment for distal tibial fractures with intramedullary nails and blocking screws

Blocking screws helped to achieve better reduction and alignment with intramedullary nailing of distal tibial fractures by decreasing the effective diameter of the medullary canal. The use of blocking screws enabled to use the intramedullary nailing as an alternative while treating distal tibial fractures.  Seyhan M, Kocaoglu B, Gereli AU  A, Nalbantoglu U, Turkmen M. [Epub Ahead of Print] Springer