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Saturday, December 3, 2011

Adoption of a wiki within a large internal medicine residency program: a 3-year experience

To describe the creation and evaluate the use of a wiki by medical residents, and to determine if a wiki would be a useful tool for improving the experience, efficiency, and education of housestaff.

Materials and methodsIn 2008, a team of medical residents built a wiki containing institutional knowledge and reference information using Microsoft SharePoint. We tracked visit data for 3 years, and performed an audit of page views and updates in the second year. We evaluated the attitudes of medical residents toward the wiki using a survey.

Bradley H Crotty, Arash Mostaghimi, Eileen E Reynolds. Journal of the American Medical Informatics Association; doi:10.1136/amiajnl-2011-000391. Online First Dec 2011.

Friday, December 2, 2011

Recent Ortho Related Ultrasound Articles from PubMed

1.Bilateral Achilles tendon ossification: diagnosis with ultrasonography and Single Photon Emission Computed Tomography/Computed Tomography. Case report. Tamam C, Yildirim D, Tamam M, Mulazimoglu M, Ozpacaci T. Med Ultrason. 2011 Dec;13(4):320-2. PMID: 22132405
2.Obscure pathology of pulled elbow: dynamic high-resolution ultrasound-assisted classification. Diab HS, Hamed MM, Allam Y. J Child Orthop. 2010 Dec;4(6):539-43. Epub 2010 Oct 29. PMID: 22132031
3. Is there Light at the End of the Tunnel? Controversies in the Diagnosis and Management of Carpal Tunnel Syndrome. Prime MS, Palmer J, Khan WS, Goddard NJ. Hand (N Y). 2010 Dec;5(4):354-60. Epub 2010 Mar 23. PMID: 22131913
4. Lateral epicondylosis and calcific tendonitis in a golfer: a case report and literature review. Yuill EA, Lum G. J Can Chiropr Assoc. 2011 Dec;55(4):325-32. PMID: 22131570
5. Intraosseous ganglion cyst of the humeral head in a competitive flat water paddler: case report. Muir B, Kissel JA, Yedon DF. J Can Chiropr Assoc. 2011 Dec;55(4):294-301. PMID: 22131566
Eur J Radiol. 2011 Nov 28. [Epub ahead of print] PMID: 22130195
7. The impact of treatment with hylan G-F 20 on progression to total hip arthroplasty in patients with symptomatic hip OA: A retrospective study. Migliore A, Bizzi E, Massafra U, Bella A, Piscitelli P, Laganà B, Tormenta S. Curr Med Res Opin. 2011 Nov 30. [Epub ahead of print] PMID: 2126424
8. Effects of a 4-week static stretch training program on passive stiffness of human gastrocnemius muscle-tendon unit in vivo. Nakamura M, Ikezoe T, Takeno Y, Ichihashi N. Eur J Appl Physiol. 2011 Nov 29. [Epub ahead of print] PMID: 22124523
9. Ultrasonography in ulnar neuropathy at the elbow: a critical review. Endo Y. Ultrasound Q. 2011 Dec;27(4):273. No abstract available. PMID: 22124404
12. Efficacy of ultrasound-guided steroid injections for pain management of midfoot joint degenerative disease. Endo Y. Ultrasound Q. 2011 Dec;27(4):269. No abstract available. PMID: 22124391
13. Occult fractures of the scaphoid: the role of ultrasonography in the emergency department. Endo Y. Ultrasound Q. 2011 Dec;27(4):269. No abstract available. PMID: 22124390
14. Birth fracture of the clavicle. Mavrogenis AF, Mitsiokapa EA, Kanellopoulos AD, Ruggieri P, Papagelopoulos PJ. Adv Neonatal Care. 2011 Oct;11(5):328-31. PMID: 22123402
15. Functional Popliteal Entrapment Syndrome in the Sportsperson. Lane R, Nguyen T, Cuzzilla M, Oomens D, Mohabbat W, Hazelton S. Eur J Vasc Endovasc Surg. 2011 Nov 26. [Epub ahead of print]PMID: 22123206
16 .Non-uniform displacement within the Achilles tendon during passive ankle joint motion. Arndt A, Bengtsson AS, Peolsson M, Thorstensson A, Movin T. Knee Surg Sports Traumatol Arthrosc. 2011 Nov 27. [Epub ahead of print] PMID: 22120840
17. Practice of ultrasound-guided arthrocentesis and joint injection, including training and implementation in Europe: results of a survey of experts and scientific societies. Mandl P, Naredo E, Conaghan PG, D'Agostino MA, Wakefield RJ, Bachta A, Backhaus M, Hammer HB, Bruyn GA, Damjanov N, Filippucci E, Grassi W, Iagnocco A, Jousse-Joulin S, Kane D, Koski JM, Möller I, De Miguel E, Schmidt WA, Swen WA, Szkudlarek M, Terslev L, Ziswiler HR, Ostergaard M, Balint PV.
Rheumatology (Oxford). 2011 Nov 24. [Epub ahead of print] PMID: 22120466
18. A meta-analysis of common risk factors associated with the diagnosis of developmental dysplasia of the hip in newborns. Ortiz-Neira CL, Paolucci EO, Donnon T. Eur J Radiol. 2011 Nov 25. [Epub ahead of print] PMID: 22119556
19. Comparative bone status assessment by dual energy X-ray absorptiometry, peripheral quantitative computed tomography and quantitative ultrasound in adolescents and young adults with cystic fibrosis. De Schepper J, Roggen I, Van Biervliet S, Robberecht E, Gies I, De Waele K, De Wachter E, Malfroot A, De Baets F, Toye K, Goemaere S, Louis O. J Cyst Fibros. 2011 Nov 25. [Epub ahead of print] PMID: 22119452
20. The Lichfield Bone Study: The Skeletal Response to Exercise in Healthy Young Men. Eleftheriou KI, Rawal JS, Kehoe A, James LE, Payne JR, Skipworth JR, Puthucheary ZA, Drenos F, Pennell DJ, Loosemore M, World M, Humphries SE, Haddad FS, Montgomery HE. J Appl Physiol. 2011 Nov 23. [Epub ahead of print] PMID: 22114178
21.Prospective Morphologic and Dynamic Assessment of Deep Flexor Tendon Healing in Zone II by High-Frequency Ultrasound: Preliminary Experience. Puippe GD, Lindenblatt N, Gnannt R, Giovanoli P, Andreisek G, Calcagni M. AJR Am J Roentgenol. 2011 Dec;197(6):W1110-7. PMID: 22109327
22. Prevalence of and factors associated with posterior tibial tendon pathology on sonographic assessment. Jain NB, Omar I, Kelikian AS, van Holsbeeck L, Grant TH. PM R. 2011 Nov;3(11):998-1004. PMID: 22108227

Prevalence of Triangular Fibrocartilage Abnormalities on MRI Scans of Asymptomatic Wrists

Magnetic resonance imaging (MRI) of the wrist is increasingly used in the diagnosis of ulnar-sided wrist pain; however, its efficacy in this setting still needs clarification. The purposes of this study were to investigate the prevalence of abnormal MRI findings in the triangular fibrocartilage complex (TFCC) in asymptomatic volunteers and to provide the clinician with comparative data when interpreting MRI results. Sorin D. Iordache, Robert Rowan, Greg J. Garvin, Said Osman, Ruby Grewal, Kenneth J. Faber. The Journal of Hand Surgery; In Press, Corrected Proof Dec 2011. PDF

Link to: Articles in Press

Novel synthetic bone graft in running for national innovation award

MaxSiTM incorporates a unique chemical composition and physical properties. In specific combination, these have been shown to deliver clear benefits in bone fusion, correlating to early recovery for the patient, and cost benefits for healthcare funders. MedicalXpress

Thursday, December 1, 2011

Journal of Hand and Microsurgery 3(2) Dec 2011 - Open Access


Siemens Kinect Based Hands-Free Radiological Image Browser

At RSNA 2011 Siemens was showing off a concept product for hands-free navigation through CT/MRI/Ultrasound images.  The system utilizes Microsoft’s Kinect 3D camera for detection of hand gestures. MedGadget 

How To Monitor Orthopaedic Implants Wirelessly ?

It has been always difficult to find the details and condition of the orthopedic devices which have been implanted within the subject’s feet, knee, hip, shoulder or elbow. The essential data for the physicians such as size, model, age, serial numbers or manufacturers are found by the harmful X-rays. How about Ortho-tagging ? The Rohan Aurora

Smartphone App Use Among Medical Providers in ACGME Training Programs

Here's an abstract from a recent journal article around smartphone adoption in residency programs. Over 85% using smartphones and the iPhone is still the most popular device. No surprises here. Medical Smartphones

From: Franko OI, Tirrell TF. Smartphone App Use Among Medical Providers in ACGME Training Programs.
J Med Syst. 2011 Nov 4

Wednesday, November 30, 2011

Researchers find possible breakthrough to relieve pain following spinal cord injury

Fibronectin – a protein that exists naturally in humans – supports the survival, growth and communication of neurons in the brain and spinal cord. The researchers discovered, through testing in an animal model, that an injection of fibronectin into the spinal cord activates specific signaling pathways and results in pain-curbing effects. MedicalXpress

JAMA using QR codes to make its content more interactive and accessible

The Journal of the American Medical Association (JAMA) recently moved to make its content more interactive, engaging, and accessible by inserting QR codes into its articles. QR codes (or quick response codes) were originally designed by a Toyota subsidiary for tracking cars throughout the manufacturing process, but have more recently found application as marketing tools for everyone from Walmart to small mom-and-pop shops. iMedicalApps

Buprenorphine Equals Morphine for Fracture Pain (CME/CE)

Buprenorphine is as effective as morphine in managing fracture pain in the emergency department, according to the results of a double-blind, double-dummy randomized controlled trial.

Adverse effects seen within the first 30 minutes following administration were nausea (14% for those receiving buprenorphine versus 12% for those receiving morphine, P=0.73), dizziness (14% versus 22%, P=0.32), and hypotension (4% versus 18%, P=0.02), the authors wrote online in the Annals of Emergency Medicine. MedPage Today

Surgeons perform better with eye movement training

Surgeons can learn their skills more quickly if they are taught how to control their eye movements. Research led by the University of Exeter shows that trainee surgeons learn technical surgical skills much more quickly and deal better with the stress of the operating theatre if they are taught to mimic the eye movements of experts. This research, published in the journal Surgical Endoscopy, could transform the way in which surgeons are trained to be ready for the operating theatre. PDF Eurekalert!

Military Related Ortho Articles from PubMed

1. A Biomechanical Comparison of a Novel Thoracic Screw Fixation Method: Transarticular Screw Fixation vs Traditional Pedicle Screw Fixation. Yu Y, Xie N, Song S, Zhang W, Guo Q, Ni B, Luo J. Neurosurgery. 2011 Dec;69(2 Suppl Operative):ons141-6. PMID: 22051729
2. Management of the Schatzker VI fractures with lateral locked screw plating. Spagnolo R, Pace F. Musculoskelet Surg. 2011 Nov 27. [Epub ahead of print] PMID: 22120784
3. Practice of ultrasound-guided arthrocentesis and joint injection, including training and implementation in Europe: results of a survey of experts and scientific societies. Mandl P, Naredo E, Conaghan PG, D'Agostino MA, Wakefield RJ, Bachta A, Backhaus M, Hammer HB, Bruyn GA, Damjanov N, Filippucci E, Grassi W, Iagnocco A, Jousse-Joulin S, Kane D, Koski JM, Möller I, De Miguel E, Schmidt WA, Swen WA, Szkudlarek M, Terslev L, Ziswiler HR, Ostergaard M, Balint PV. Rheumatology (Oxford). 2011 Nov 24. [Epub ahead of print] PMID: 22120466
4. Hand reconstruction using heterotopic replantation of amputated index and little fingers. Zhang GL, Chen KM, Zhang JH, Wang SY. Chin J Traumatol. 2011 Oct 1;14(5):316-8. PMID: 22118490
5. Physical and psychological stressors linked with stress fractures in recruit training. Moran DS, Evans R, Arbel Y, Luria O, Hadid A, Yanovich R, Milgrom C, Finestone AS. Scand J Med Sci Sports. 2011 Nov 23. doi: 10.1111/j.1600-0838.2011.01420.x. [Epub ahead of print] PMID: 22107354
6. Foot salvage after loss of the first and second metatarsal rays with a free fibular osteocutaneous flap.
Salgado CJ, Lin CH, Fuller DA, Duncan AN, Camison L, Mardini S. J Am Podiatr Med Assoc. 2011 Nov;101(6):531-6. PMID: 22106202

Tuesday, November 29, 2011

MRSA: From a nosocomial pathogen to an omnipresent source of infection

In German hospitals, each year 132 000 patients contract infection with methicillin-resistant Staphylococcus aureus (MRSA). For more than a decade, different countries have reported an increasing incidence of MRSA infections in the general population ("community associated" [CA-] MRSA). In the current issue of Deutsches Ärzteblatt International, Robin Köck from the Münster University Hospital and coauthors provide an overview of the epidemiological situation with regard to MRSA in Germany. They present the status quo in institutions within the healthcare sector, but also potential transmission routes in the general population (Dtsch Arztbl Int 2011; 108[45]: 761-7). (PDF) Eurekalert!

New hip implants no better than traditional implants

New hip implants appear to have no advantage over traditional implants, suggests a review of the evidence published on today. (PDF)

And some evidence shows that new implants may be associated with higher rates of revision surgery. Eurekalert!

Body rebuilding: Researchers regenerate muscle in mice

A team of scientists from Worcester Polytechnic Institute and CellThera, a private company, have regenerated functional muscle tissue in mice, opening the door for a new clinical therapy to treat people who suffer major muscle trauma.

In the current study, the WPI/CellThera team combined two novel technologies to try to prevent scar formation and prompt muscle re-growth. The first was a method they had developed previously for reprogramming mature human skin cells without employing viruses or extra genes (Cloning, Stem Cells. 2009 Jul 21). The reprogrammed cells express stem cell genes and multiply in great numbers, but don't differentiate into specific tissues. The second was the use of biopolymer microthreads as a scaffold to support the cells. Developed by George Pins, associate professor of biomedical engineering at WPI, the threads--about the thickness of a human hair--are made of fibrin, a protein that helps blood clot. Eurekalert!

WSU researchers use a 3-D printer to make bone-like material

Washington State University researchers have used a 3D printer to create a bone-like material and structure that can be used in orthopedic procedures, dental work, and to deliver medicine for treating osteoporosis. Paired with actual bone, it acts as a scaffold for new bone to grow on and ultimately dissolves with no apparent ill effects.

The authors report on successful in vitro tests in the journal Dental Materials and say they're already seeing promising results with in vivo tests on rats and rabbits. It's possible that doctors will be able to custom order replacement bone tissue in a few years, says Susmita Bose, co-author and a professor in WSU's School of Mechanical and Materials Engineering. Eurekalert!

Video of Bose discussing her work can be found at

Growth hormone increases bone formation in obese women

In a new study presented today at the annual meeting of the Radiological Society of North America (RSNA), growth hormone replacement for six months was found to increase bone formation in abdominally obese women.

"This is the first time that the effects of growth hormone on bone have been studied in obesity," said the study's lead author, Miriam A. Bredella, M.D., a radiologist at Massachusetts General Hospital and assistant professor of radiology at Harvard Medical School in Boston. "Growth hormone is extremely important for bone health, and women with increased belly fat have weaker bones and reduced growth hormone levels."  Eurekalert!

Monday, November 28, 2011

Hip International [epub ahead of print]

1. Atypical pseudotumour after metal-on-polyethylene total hip arthroplasty causing deep venous thrombosis. Picardo NE, Al-Khateeb H, Pollock RP. Hip Int. 2011 Nov 24:0. [Epub ahead of print] PMID: 22117263
2. Dual-mobility cup and cemented femoral component: 6 year follow-up results. Prudhon JL. Hip Int. 2011 Nov 24:0.  [Epub ahead of print] PMID: 22117262
3. Arthroscopic repair of delaminated acetabular articular cartilage using fibrin adhesive. Results at one to three years. Stafford GH, Bunn JR, Villar RN. Hip Int. 2011 Nov 24:0. [Epub ahead of print] PMID: 22117261
4. Fluid extravasation during hip arthroscopy. Stafford GH, Malviya A, Villar RN. Hip Int. 2011 Nov 24:0. [Epub ahead of print] PMID: 22117260
5. Wound problems following hip arthroplasty before and after the introduction of a direct thrombin inhibitor for thromboprophylaxis. Gill SK, Theodorides A, Smith N, Maguire E, Whitehouse SL, Rigby MC, Ivory JP. Hip Int. 2011 Nov 24:0. [Epub ahead of print] PMID: 22117258
6. Troponin T in hip fracture patients: prognostic significance for mortality at one year. Spurrier E, Wordsworth D, Martin S, Norris R, Parker MJ. Hip Int. 2011 Nov 24:0. [Epub ahead of print] PMID: 22117257
Leichtle UG, Leasure J, Martini F, Leichtle CI. Hip Int. 2011 Nov 24:0. [Epub ahead of print] PMID: 22117256