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Saturday, December 31, 2011

Secrets of the Operating Room

Fragile egos, obese patients and talking organs: A surgeon's view of what happens under the scalpel. Wall Street Journal

Friday, December 30, 2011

New Ortho Related Kindle Books via Amazon

Best Evidence for Spine Surgery: 20 Cardinal Cases E-Book: 20 Cardinal Cases E-Book by Rahul Jandial and Steven R. Garfin (Feb 1, 2012)Kindle eBook

Presentation, Imaging and Treatment of Common Musculoskeletal Conditions E-Book: MRI-Arthroscopy Correlation by Timothy G. Sanders and Mark D. Miller (Dec 15, 2011)Kindle eBook

Shoulder Instability: A Comprehensive Approach E-Book: A Comprehensive Approach E-Book by Matthew T Provencher and Anthony A Romeo (Dec 15, 2011)Kindle eBook

Operative Techniques in Orthopaedic Surgery by Sam W. Wiesel (Dec 14, 2011)Kindle eBook

Orthopedic Imaging: A Practical Approach by Adam Greenspan (Dec 7, 2011)Kindle eBook

Master Techniques in Orthopaedic Surgery: Orthopaedic Oncology and Complex Reconstruction by Franklin H. Sim, Peter F.M. Choong and Kristy L. Weber (Dec 7, 2011)Kindle eBook

JSCM publishes revised International Standards for Neurological Classification of Spinal Cord Injury

The 2011 revision of the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) was published in the November 2011 issue of the Journal of Spinal Cord Medicine. The accompanying reference article by Steven Kirshblum et al clarifies the modifications to this newest revision. Both are available for free download via (#6, Nov 2011). Eurekalert!

Thursday, December 29, 2011

Despite enthusiasm from healthcare providers, hospitals are slow to adopt tablet systems

Its no secret that healthcare providers are adopting tablets at a rapid pace – one survey found that over 25% of physicians own a tablet and that was nearly nine months ago.

This trend, both with tablets and smartphones, has generally been bottom-up; physicians, PA’s, NP’s, nurses, and other healthcare providers are buying consumer devices and bringing them into the clinical world.
However, as Eric Yablonka, CIO of University of Chicago Hospitals put it, “This is not ‘nice to have stuff’ anymore, this is life saving stuff now.” iMedicalApps

The Year in Review: BMP-2 Saga Prompts Change

As part of the Year in Review series, MedPage Today reporters are revisiting major news stories and following up with an analysis of the impact of the original report, as well as subsequent news generated by the initial publication. Here's what has happened with the bone morphogenetic protein-2 saga (BMP-2) since last May when we published an article about a critical review of the product.  MedPage Today

Coursemart Neuroanatomy iPad e-book has some good features, but lacks in important areas


  • $47.95 for 540 days (rental)


  • Large number of medical titles
  • Can be viewed on multiple devices
  • Offline and online reading
  • Annotation and search functions


  • Poor image and text quality
  • Cannot ‘turn off’ labels on figures
  • No jump links in the text to figures or other parts of the book
  • No integrated media (videos) into the text
  • Book is rented, not owned
  • Not much different from reading a PDF iMedicalApps

Open source licensing defuses copyright law's threat to medicine

Enforcing copyright law could potentially interfere with patient care, stifle innovation and discourage research, but using open source licensing instead can prevent the problem, according to a physician – who practices both at the University of California, San Francisco and the San Francisco VA Medical Center – and a legal scholar at the UC Hastings College of Law.

“For a long time, doctors have been able to ignore copyright, but that is changing in a dramatic way,” said John Newman, MD, PhD, of UCSF and SFVAMC.

“The exercise of copyright is creating a threat to basic medical care,” said Robin Feldman, JD, professor of law and Director of the Law and Bioscience Project at UC Hastings.

They discuss the issue in a “Perspective” in the Dec. 29 issue of the New England Journal of Medicine. MedicalXpress

Wednesday, December 28, 2011

Wartime spine injuries: understanding the improvised explosive device and biophysics of blast trauma.

The improvised explosive device (IED) has been the most significant threat by terrorists worldwide. Blast trauma has produced a wide pattern of combat spinal column injuries not commonly experienced in the civilian community. Unfortunately, explosion-related injuries have also become a widespread reality of civilian life throughout the world, and civilian medical providers who are involved in emergency trauma care must be prepared to manage casualties from terrorist attacks using high-energy explosive devices. Treatment decisions for complex spine injuries after blast trauma require special planning, taking into consideration many different factors and the complicated multiple organ system injuries not normally experienced at most civilian trauma centers. Therefore, an understanding about the effects of blast trauma by spine surgeons in the community has become imperative, as the battlefield has been brought closer to home in many countries through domestic terrorism and mass casualty situations, with the lines blurred between military and civilian trauma. We set out to provide the spine surgeon with a brief overview on the use of IEDs for terrorism and the current conflicts in Iraq and Afghanistan and also a perspective on the biophysics of blast trauma.
Kang DG, Lehman RA Jr, Carragee EJ. Spine J. 2011 Dec 22. [Epub ahead of print] PMID: 22197184

"How did this ever get published?"

Meals RA. J Hand Surg Am. 2012 Jan;37(1):1-2. No abstract available.  PMID: 22196289 PDF

The High Cost of Failing Artificial Hips

The most widespread medical implant failure in decades — involving thousands of all-metal artificial hips that need to be replaced prematurely — has entered the money phase.

Medical and legal experts estimate the hip failures may cost taxpayers, insurers, employers and others billions of dollars in coming years, contributing to the soaring cost of health care. The financial fallout is expected to be unusually large and complex because the episode involves a class of products, not a single device or just one company. NYTimes

Shoulderdoc App Fluidly Conveys A Heavy Dose of Shoulder Information

The Shoulderdoc app is the accompanying app to Shoulderdoc. This website is every shoulder surgeon’s guilty pleasure. It contains more information on shoulder surgery and treatments than one can find in one place on the web.

Shoulderdoc is the brainchild of Dr. Leonard Funk, a specialist shoulder surgeon in the UK. Dr. Funk has spent the last decade feeding his main website with a plethora of useful shoulder related content. I like the concept of having a “go to” shoulder site where I can quickly find all of the latest feeds of articles, patient education topics and latest trends. I’ve always found the site to be updated frequently, the content to be good and referenced well. I do have a few hang-ups about the site, though. iMedicalApps

NSF gives $1.2 million grant for diabetes app that uses smartphone camera to prevent limb amputations

Researchers at Worcester Polytechnic Institute (WPI) in Massachusetts recently received a $1.2 million grant from the National Science Foundation to develop a smartphone diabetes app.  This app will guide patients with diabetes as well as foot ulcers on how to manage their disease. iMedicalapps

Sepsis Guide is a well-designed and up-to-date app for critical care practitioners

Sepsis is the bread and butter of any critical care physician, hospitalist, and emergency room physician. In sepsis management, early diagnosis and aggressive intervention are critical. Guidelines like the Rivers protocol highlight the use of fluid rehydration, early antibiotics, and above all else recognition of sepsis at the earliest possible point. iMedicalApps

Tuesday, December 27, 2011

International Orthopaedics [Epub ahead of print]

1. Steps in the undertaking of a systematic review in orthopaedic surgery. Sambunjak D, Franić M. Int Orthop. 2011 Dec 24. [Epub ahead of print] PMID: 22198362
2. Infection and revision strategies in total disc arthroplasty. Gerometta A, Rodriguez Olaverri JC, Bittan F. Int Orthop. 2011 Dec 24. [Epub ahead of print] PMID: 22198361
3. The relevance of the anatomical basis of fracture for the subsequent treatment of the anterior humeral circumflex artery and the axillary nerve. Chen YF, Zhu NF, Zhang CQ, Wang L, Wei HF, Lu Y. Int Orthop. 2011 Dec 24. [Epub ahead of print] PMID: 22198360

Carpal tunnel syndrome diagnosed by general practitioners: an observational study.

In these 187 patients, EDX confirmed CTS clinical diagnosis in 180. In 40 (17%), the neurologists disagreed with the clinical diagnosis of CTS because signs and symptoms were not those of clinical CTS. We showed that general practitioners are very well capable of making a clinical diagnosis of CTS. Therefore, direct referral of patients by general practitioners for nerve conduction studies to have their diagnosis of CTS confirmed is a desirable and time-saving procedure. Claes F, Bernsen H, Meulstee J, Verhagen WI. Neurol Sci. 2011 Dec 24. [Epub ahead of print] PMID: 22198648

Position Change of the Neurovascular Structures around the Carpal Tunnel with Dynamic Wrist Motion.

It is appropriate to transect the ligament greater than 4 mm apart from the lateral margin of the hook of the hamate without placing the edge of the scalpel toward the ulnar side. We would also recommend not transecting the transverse carpal ligament in the ulnar flexed wrist position to protect the ulnar neurovascular structure. Kwon JY, Kim JY, Hong JT, Sung JH, Son BC, Lee SW. J Korean Neurosurg Soc. 2011 Oct;50(4):377-80. Epub 2011 Oct 31. PMID: 22200022

Monday, December 26, 2011

Indications for bullet removal: overview of the literature, and clinical practice guidelines for European trauma surgeons

In summary, there are only a few clear indications for bullet removal. These include bullets found in joints, CSF, or the globe of the eye. Fragments leading to impingement on a nerve or a nerve root, and bullets lying within the lumen of a vessel, resulting in a risk of ischemia or embolization, should be removed. Rare indications are lead poisoning caused by a fragment, and removal that is required for a medico-legal examination. In all other cases the indication should be critically reviewed.  T. Dienstknecht, K. Horst, R. M. Sellei, A. Berner, M. Nerlich and T. C. Hardcastle. European Journal of Trauma and Emergency Surgery. Online First Dec 2011

Journal of Orthopaedic Trauma: epub ahead of print