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Thursday, January 5, 2012

Why humans choose running over walking

Other than Olympic race walkers, people generally find it more comfortable to run than walk when they start moving at around 2 meters per second – about 4.5 miles per hour. North Carolina State University biomedical engineers Dr. Gregory Sawicki and Dr. Dominic Farris have discovered why: At 2 meters per second, running makes better use of an important calf muscle than walking, and therefore is a much more efficient use of the muscle’s – and the body’s – energy.

Published online this week in Proceedings of the National Academy of Sciences, the results stem from a first-of-its-kind study combining ultrasound imaging, high-speed motion-capture techniques and a force-measuring treadmill to examine a key calf muscle and how it behaves when people walk and run. NC State University

Healthcare professionals becoming increasingly distracted by mobile devices

Distractions are nothing new for physicians. Managing the day to day activities of a medical practice or the rigors of a hospital are something that doctors learn to deal with. However, the era of the smartphone is also presenting new challenges for doctors, who are increasingly becoming distracted by the devices.

While there are not a wealth of studies that have looked at this particular issue, a study in the Journal of Medical Internet Research from August 29, 2011 asserts that doctors are interrupted nearly five times an hour by phone calls, emails, and face-to-face interactions. iMedicalApps

Of life and limb

When someone loses a limb to war, accident, or disease, she can get an artificial limb that restores some of her lost movement. But even the best prosthesis doesn’t restore the sense of touch. And touch is what lets you grip an egg tightly enough that it doesn’t fall but loosely enough that you don’t smash it. MedicalXpress

Who Benefits Most from Surgery for Herniated Discs?

 Some patient subgroups see greater improvement after surgery for herniated spinal discs relative to nonoperative outcomes—notably including married patients whose symptoms are getting worse, reports a study in the January 15, 2012, issue of SpineNewsWise

Recent Military or High-Energy Trauma Related Ortho Articles via PubMed

1. Epidemiology, imaging, and treatment of Lisfranc fracture-dislocations revisited. Kalia V, Fishman EK, Carrino JA, Fayad LM. Skeletal Radiol. 2012 Feb;41(2):129-36. Epub 2011 Mar 23. PMID: 21431438
2. Two-year outcomes of open shoulder anterior capsular reconstruction for instability from severe capsular deficiency. Dewing CB, Horan MP, Millett PJ. Arthroscopy. 2012 Jan;28(1):43-51. Epub 2011 Oct 5. PMID: 21978433
3. Sonographic evaluation of peripheral nerve injuries following the Wenchuan earthquake. Tang P, Wang Y, Zhang L, He C, Liu X. J Clin Ultrasound. 2012 Jan;40(1):7-13. doi: 10.1002/jcu.20895. Epub 2011 Nov 21. PMID: 22102338
4. Lunate fractures in the face of a perilunate injury: an uncommon and easily missed injury pattern. BriseƱo MR, Yao J. J Hand Surg Am. 2012 Jan;37(1):63-7. Epub 2011 Nov 3. PMID: 22051228
5. Plating of acute humeral diaphyseal fractures through an anterior approach in multiple trauma patients. Idoine JD 3rd, French BG, Opalek JM, Demott L. J Orthop Trauma. 2012 Jan;26(1):9-18. PMID: 21577147
7. The epidemiology of open fractures in adults. A 15-year review. Court-Brown CM, Bugler KE, Clement ND, Duckworth AD, McQueen MM. Injury. 2011 Dec 26. [Epub ahead of print] PMID: 22204774
8. Staged Posterior Tibial Plating for the Treatment of Orthopaedic Trauma Association 43C2 and 43C3 Tibial Pilon Fractures. Ketz J, Sanders R. J Orthop Trauma. 2011 Dec 23. [Epub ahead of print] PMID: 22207206
Kang DG, Lehman RA Jr, Carragee EJ. Spine J. 2011 Dec 22. [Epub ahead of print] PMID: 22197184
10. Associated injuries in casualties with traumatic lower extremity amputations caused by improvised explosive devices. Morrison JJ, Hunt N, Midwinter M, Jansen J. Br J Surg. 2011 Dec 21. [Epub ahead of print] PMID: 22190142

Use of acupuncture in the US military highlighted in special issue of Medical Acupuncture

The current issue of Medical Acupuncture, a peer-reviewed journal published by Mary Ann Liebert, Inc., explores how the U.S. military is incorporating medical acupuncture to assist in the medical care of military personnel serving in the war zones and the efforts underway to explore military applications of acupuncture. The issue is available free online at Eurekalert!

Clinical trial demonstrates that rilonacept significantly reduces gout flares

A phase II clinical trial found that rilonacept, an inhibitor of the protein interleukin-1 (IL-1), significantly reduced acute gout flares that occur when initiating uric acid-lowering therapy. Results of the trial—the first placebo-controlled study investigating IL-1 targeted therapy in prevention of gout flares—show rilonacept to be generally well tolerated with no serious infections or treatment-related serious adverse events reported. Full findings are published in Arthritis & Rheumatism, a journal of the American College of Rheumatology (ACR). MedicalXpress

Wednesday, January 4, 2012

Lateral epicondylitis and beyond: imaging of lateral elbow pain with clinical-radiologic correlation.

The diagnosis of lateral epicondylitis is often straightforward and can be made on the basis of clinical findings. However, radiological assessment is valuable where the clinical picture is less clear or where symptoms are refractory to treatment. Demographics, aspects of clinical history, or certain physical signs may suggest an alternate diagnosis. Knowledge of the typical clinical presentation and imaging findings of lateral epicondylitis, in addition to other potential causes of lateral elbow pain, is necessary. Kotnis NA, Chiavaras MM, Harish S. Skeletal Radiol. 2011 Dec 30. [Epub ahead of print] PMID: 22205505 PDF

Transtibial ACL reconstruction technique fails to position drill tunnels anatomically in vivo 3D CT study

The purpose of this study was to visualize and quantify the positions of femoral and tibial tunnels in patients who underwent traditional transtibial single-bundle ACL reconstruction, as performed by multiple surgeons, utilizing 3D CT models, and to compare these positions to our previously reported anatomical tunnel positions. Sebastian Kopf, Brian Forsythe, Andrew K. Wong, Scott Tashman, James J. Irrgang and Freddie H. Fu. Knee Surgery, Sports Traumatology, Arthroscopy 31 Dec 2011. PDF

Tuesday, January 3, 2012

Effect of the new standards for case logging on resident operative volume: doing better cases or better numbers?

Although some operative cases newly classified as major are technically advanced procedures (eg, Roux-en-Y gastric bypass), other cases are not (eg, breast lesion excision), which raises the issue as to whether the major case category has been diluted by less demanding case types. The implications of these findings may suggest preservation of case volumes at the expense of case quality. Murthy R, Shepard A, Swartz A, Woodward A, Reickert C, Horst M, Rubinfeld I. J Surg Educ. 2012 Jan;69(1):113-7. PMID: 22208842 PDF

A computed tomography-based feasibility study of translaminar screw placement in the pediatric thoracic spine.

Translaminar screws (TLSs) were originally described as a safer alternative to pedicle and transarticular screw placement at C-2 in adult patients. More recently, TLSs have been used in both the cervical and thoracic spine of pediatric patients as a primary fixation technique and as a bailout procedure when dysplastic pedicle morphology prohibits safe pedicle screw placement. Although authors have reported the anatomical characteristics of the cervical and thoracic lamina in adults as well as those of the cervical lamina in pediatric patients, no such data exist to guide safe TLS placement in the thoracic spine of the pediatric population. The goal of this study was to report the anatomical feasibility of TLS placement in the thoracic spine of pediatric patients. Molina C, Sciubba DM, Chaput C, Tortolani PJ, Jallo GI, Kretzer RM. J Neurosurg Pediatr. 2012 Jan;9(1):27-34. PMID: 22208317

How work tells muscles to grow

We take it for granted, but the fact that our muscles grow when we work them makes them rather unique. Now, researchers have identified a key ingredient needed for that bulking up to take place. A factor produced in working muscle fibers apparently tells surrounding muscle stem cell "higher ups" that it's time to multiply and join in, according to a study in the January Cell Metabolism, a Cell Press journal. Eurekalert!

Research identifies how time heals all wounds

Wound healing requires interactions between cells resident at the damaged site and infiltrating immune cells. Endothelial progenitor cells (EPCs) come from the bone marrow and are key to the production of new vessels. Here, Toshikazu Kondo and colleagues demonstrate that the chemokine CCL5 helps to direct the recruitment of EPCs to sites of wounding by acting on the chemokine receptor CCR5. These findings identify the CCR5/CCL5 axis as a potential target to promote healing. Eurekalert!

Monday, January 2, 2012

Apple’s top five iPhone & iPad medical apps of 2011

Apple, like many companies, has produced a list of its top apps in many categories found in iTunes called Apple Rewind 2011.

While the criteria for picking the winners is probably loosely based on the amount of downloads and the overall popularity, the picks are still solely chosen by Apple’s editorial staff, and thus there is probably an element of bias in the choices.  You might remember the criticism we levied at Apple recently about their “Apps for Healthcare Section” — a section in iTunes that made an attempt at categorizing the medical category.  Although we personally wouldn’t rank these apps as the top 5, they do list some great medical apps. iMedicalApps

iTunes Links to Apple’s top medical apps for the iPhone and iPad:

Sunday, January 1, 2012

European Journal of Trauma and Emergency Surgery - open access articles

Original Article
Results of the femur fractures treated with the new selfdynamisable internal fixator (SIF)Milorad Mitkovic, S. Milenkovic, I. Micic, D. Mladenovic and Milan Mitkovic; Online First™, 28 October 2011

Original Article
Outcomes following operative and non-operative management of humeral midshaft fractures: a prospective, observational cohort study of 47 patients. J. J. van Middendorp, F. Kazacsay, P. Lichtenhahn, N. Renner and R. Babst, et al.; 2011, Volume 37, Number 3, Pages 287-296

Original Article

Original Article
Evaluation of admissions to the Major Incident Hospital based on a standardized protocolG. M. H. Marres, J. van der Eijk, M. Bemelman and L. P. H. Leenen; 2011, Volume 37, Number 1, Pages 19-29

European Orthopaedics and Traumatology - open access articles

Case Report
Range of motion implications of proximal humerus fractures: a case studyAnne J. H. Vochteloo, Peter R. Krekel, Michiel A. J. van de Sande and Jochem Nagels; 2011, Volume 2, Numbers 5-6, Pages 153-156


Case Report
The traumatized ischiopubic synchondrosis: a rare cause of acute hip pain. Justus H. W. Jansen, Aernout R. J. Langeveld and J. A. Niesten2011, Volume 2, Numbers 3-4, Pages 79-81

The proof for new oral anticoagulants: clinical trial evidence. Menno V. Huisman 2011, Volume 2, Numbers 1-2, Pages 7-14

Battlefield Acupuncture and Other Stories

The Worst Quackery of 2011: Battlefield Acupuncture - Forbes

Hospitals are Making Room for Alternative Therapies - LA Times

The Power of Acupuncture: Part 1 of 3 (from Navy Medicine Live)

The Power of Acupuncture: Part 2 of 3 (from Navy Medicine Live)