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المؤلفون: Munif Hatem, Hal David Martin
المصدر: Arthroscopy : the journal of arthroscopicrelated surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 37(5)
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Osteoarthritis, Patient Positioning, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Orthopedics and Sports Medicine, Femur, Aged, 030203 arthritis & rheumatology, 030222 orthopedics, Lumbar Vertebrae, business.industry, Minimal clinically important difference, Partial resection, Middle Aged, medicine.disease, Low back pain, Surgery, Oswestry Disability Index, Treatment Outcome, Lesser Trochanter, Dysplasia, Lumbar spine, Hip Joint, medicine.symptom, business, Low Back Pain, Follow-Up Studies
الوصف: To assess the effects of surgery for lesser trochanteric-ischial impingement (LTI) on low back pain.The records of patients with LTI who underwent endoscopic partial resection of the lesser trochanter (LT) between May of 2017 and February of 2019 were reviewed. Inclusion criteria were the presence of low back pain in association with hip pain, diagnosis of LTI, and partial resection of the LT to treat LTI. Exclusion criteria were less than 12 months of postoperative follow-up and hip or spine surgery after the LTI surgery. Patients were assessed before surgery and at the most recent follow-up with the modified Harris Hip Score and Oswestry Disability Index for lumbar spine.Thirty patients (31 hips) met the inclusion criteria. Four patients were lost to follow-up. Two patients with borderline dysplasia and grade 1 and 2 osteoarthritis underwent total hip arthroplasty after the partial resection of the LT. The results are presented considering the remaining 24 patients (25 hips). The average age at surgery was 51 years (range 32-65 years). The mean follow-up after the surgery for LTI was 19 months (range 12-35 months). The mean ± SD ODI improved from 48% ± 15 before the LTI surgery to 21% ± 22 (P.001) at the most recent follow-up. Improvement in the Oswestry Disability Index above the minimal clinical important difference was observed in 16 patients (67%) following the LTI surgery. The mean ± SD modified Harris Hip Score improved from 55.8 ± 14 before LTI surgery to 81.3 ± 14.3 (P.001).Decrease in low back pain above the minimal clinically important difference is observed in 2 of 3 patients after partial resection of the LT.Level IV, therapeutic case series.
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المصدر: Arthroscopy : the journal of arthroscopicrelated surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 37(1)
مصطلحات موضوعية: musculoskeletal diseases, Adult, Male, medicine.medical_specialty, Torsion Abnormality, Adolescent, medicine.medical_treatment, Osteotomy, Abnormal femoral torsion, 03 medical and health sciences, Arthroscopy, Disability Evaluation, Young Adult, 0302 clinical medicine, medicine, Humans, Orthopedics and Sports Medicine, Femur, Range of Motion, Articular, Decreased femoral torsion, Retrospective Studies, 030222 orthopedics, biology, business.industry, 030229 sport sciences, Middle Aged, musculoskeletal system, medicine.disease, biology.organism_classification, Spine, Oswestry Disability Index, Surgery, Increased femoral torsion, Valgus, Female, Hip Joint, Slipped capital femoral epiphysis, business, Follow-Up Studies
الوصف: To evaluate the outcomes of proximal femoral derotation osteotomy (PFDO) on the hip and spine function of patients with abnormal femoral torsion.This retrospective study included patients who underwent PFDO to treat increased or decreased femoral torsion between July 2014 and February 2019. The exclusion criteria were: previous fracture, fixation of slipped capital femoral epiphysis or osteotomy in the ipsilateral femur; PFDO associated to varus or valgus osteotomy; Tönnis grade 2 or 3 osteoarthritis; and PFDO performed to treat knee abnormalities. Hip function was assessed through the modified Harris Hip Score (mHHS). A subgroup of consecutive patients with low back pain before the PFDO and operated after 2017 had the spine function assessed through the Oswestry disability index (ODI).A total of 37 hips (34 patients) were studied: 15 hips with increased femoral torsion and 22 with decreased femoral torsion. Eight patients were male and 26 were female. The average age at PFDO was 33 years (range, 15-54 years). At a mean follow-up of 24 months (range, 12-65 months), the mean mHHS improved from 58.1 ± 14.3 before PFDO to 82 ± 15.6 at the most recent follow-up (P.001). Improvement in the mHHS above the minimum clinically important difference (MCID) was observed in 33 hips (89%). In the subgroup of 14 consecutive patients with ODI available, the ODI improved from a mean of 45% ± 16% before the PFDO to 22% ± 17% at the most recent follow-up (P = .001). Nine (64.3%) of the 14 patients presented improvement in the ODI above the MCID. Revision procedure with a larger intramedullary nail was necessary in 2 hips to treat nonunion.Proximal femoral derotation osteotomy improves the hip and spine function in patients with increased or decreased femoral torsion and nonarthritic hips.Level IV, therapeutic case series.
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المؤلفون: David Martin, Gregory L. Falk, Philip A. Le Page, Simon C Gibson, Jennifer Wang, Craig J. Taylor, Himanshu Wadhawan
المصدر: Surgical Endoscopy. 32:2373-2380
مصطلحات موضوعية: Adult, Male, Sleeve gastrectomy, medicine.medical_specialty, Weakness, medicine.medical_treatment, 030209 endocrinology & metabolism, Cohort Studies, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Gastrectomy, Internal medicine, Weight Loss, medicine, Humans, Aged, business.industry, Age Factors, Reflux, Middle Aged, Hepatology, medicine.disease, Dysphagia, humanities, digestive system diseases, Surgery, Hernia, Hiatal, Gastroesophageal Reflux, Quality of Life, GERD, Female, Laparoscopy, 030211 gastroenterology & hepatology, medicine.symptom, business, Follow-Up Studies, Abdominal surgery, Cohort study
الوصف: Laparoscopic sleeve gastrectomy (LSG) has gained popularity as a treatment of choice for morbid obesity and associated comorbidities. There has been a concern about new onset or worsening of gastroesophageal reflux (GERD) following LSG. The objective of the study was to evaluate the effect of surgically treating hiatal weakness on GERD symptoms in patients undergoing LSG. Single tertiary referral institution, Sydney, Australia. A prospective observational cohort study was conducted with consecutive patients undergoing LSG. Hiatal findings, patient demographics, medications and reflux score were recorded prospectively. Patients were followed up post-operatively for a minimum of 12 months and assessed using GERD-HRQL score to quantify reflux symptoms. Data from 100 patients with a minimum of 1-year follow-up were analysed. Mean follow-up was 18.9 months. Overall, GERD-HRQL improved from mean 4.5 ± 5.8 pre-operatively to 0.76 ± 1.5 after 18.9 months (p = 0.0001). For those with pre-operative reflux, GERD-HRQL improved from mean (SD) 8.43 ± 6.26 pre-operatively to 0.94 ± 1.55 (p = 0.0001). All the nine patients with troublesome daily reflux significantly improved. For those without pre-operative reflux, GERD-HRQL improved from 0.88 ± 1.37 to 0.47 ± 1.25 (p-ns) post-operatively. On multivariate analysis, higher pre-operative reflux and dysphagia/bloat scores, younger age and lower percentage excess weight loss after 18.9 months were associated with GERD-HRQL improvement. In the medium term, GERD-HRQL improves following sleeve gastrectomy with meticulous hiatal assessment and repair of hiatal laxity and herniation.
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المصدر: The American Journal of Surgery. 211:919-925
مصطلحات موضوعية: Male, Vitamin K, 030204 cardiovascular system & hematology, Severity of Illness Index, Cohort Studies, Factor IX, chemistry.chemical_compound, 0302 clinical medicine, Aged, 80 and over, Factor VII, General Medicine, Middle Aged, Blood Coagulation Factors, Drug Combinations, Venous thrombosis, Treatment Outcome, Anesthesia, Female, Prothrombin, medicine.drug, Hemorrhage, macromolecular substances, Risk Assessment, Drug Administration Schedule, Statistics, Nonparametric, Traumatic Hemorrhage, 03 medical and health sciences, Severity of illness, medicine, Coagulopathy, Humans, International Normalized Ratio, cardiovascular diseases, Aged, Retrospective Studies, Chi-Square Distribution, Dose-Response Relationship, Drug, business.industry, Warfarin, 030208 emergency & critical care medicine, Retrospective cohort study, medicine.disease, chemistry, Factor X, Wounds and Injuries, bacteria, Surgery, Emergencies, business, Chi-squared distribution, Follow-Up Studies
الوصف: Reversal of warfarin-induced coagulopathy after traumatic injury may be done exclusively with prothrombin complex concentrates (PCCs). No direct comparisons between different PCC regimens exist to guide clinical decision-making. Our institution has used 2 distinct PCC strategies for warfarin reversal; a 3-Factor PCC (Profilnine) combined with activated Factor VII (3F-PCC+rVIIa), and a 4-Factor PCC (Kcentra) given without additional factor supplementation.Retrospective review of all PCC administrations to trauma patients with acute bleeding who were taking warfarin before injury. Primary endpoints were international normalized ratio (INR) reduction, in-hospital mortality, and diagnosis of deep venous thrombosis (DVT).Eighty-seven patients were identified from 2011 to 2015. Fifty-three were treated with 3F-PCC+rVIIa and 34 with 4F-PCC. Patient demographics, injury severity, and presenting laboratory data were similar. The 3F-PCC+rVIIa produced a lower median (IQR) INR postreversal compared with 4F-PCC (.75 (.69, 1.00) vs 1.28 (1.13, 1.36), P.001). Both regimens were able to obtain an INR lower than 1.5 immediately after administration (3F+rVIIA 93.9% vs 4F 97.1%, P =.51). In the 4F-PCC group, there was a significant decrease in the incidence of DVT (2.9% vs 22.6%), P .01), and a nonsignificant reduction in mortality (2.9% vs 17.0%, P = .08).Use of 4F-PCC for warfarin reversal after traumatic hemorrhage is associated with a less severe decrease in INR, a significant reduction in DVT rates and a trend toward reduced mortality when compared with similar patients treated with 3F-PCC+rVIIa.
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المؤلفون: Ian James Palmer, Hal David Martin, Munif Hatem
المصدر: Arthroscopy: The Journal of Arthroscopic & Related Surgery. 31:239-246
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Adolescent, Radiography, Pain, Physical examination, Ischiofemoral impingement, Arthroscopy, Young Adult, Ischium, medicine, Humans, Orthopedics and Sports Medicine, Femur, Retrospective Studies, Hip, medicine.diagnostic_test, business.industry, Endoscopy, Magnetic resonance imaging, Middle Aged, Magnetic Resonance Imaging, Surgery, Lesser Trochanter, Female, Hip Joint, Bone Diseases, Complication, business, Quadratus femoris muscle, Follow-Up Studies
الوصف: Purpose The purposes of this study were to investigate the clinical and radiographic presentation of patients with ischiofemoral impingement (IFI) and to assess the outcomes of endoscopic treatment with partial resection of the lesser trochanter. Methods Five patients with IFI who underwent endoscopic treatment with partial resection of the lesser trochanter were retrospectively reviewed. The outcomes were assessed at a mean follow-up of 2.3 years (range, 2 to 2.5 years) through the modified Harris Hip Score and a visual analog scale score for pain. Physical examination tests provoking the impingement between the lesser trochanter and ischium were used for the diagnosis of IFI, including the IFI test and reproducible pain lateral to the ischium with the long-stride walking test. The presence of quadratus femoris muscle edema and a decreased ischiofemoral space on magnetic resonance imaging was also necessary for the diagnosis. Results The mean modified Harris Hip Score increased from 51.3 points (range, 34.1 to 73.7 points) preoperatively to 94.2 points (range, 78.1 to 100 points) at the final follow-up ( P = .003). The mean visual analog scale score for pain decreased from 6.6 (range, 6 to 7.3) before surgery to 1 (range, 0 to 4) at the final follow-up ( P = .001). The mean duration to return to sport after surgery was 4.4 months (range, 1 to 7 months) for the 5 patients in this study. No complication was observed. Conclusions The endoscopic treatment of IFI was effective at 2 years in 5 patients with consistent clinical and imaging diagnostic findings. Level of Evidence Level IV, therapeutic case series.
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المؤلفون: Roy M. John, David Martin, Islam Bolad, Dilip Mathew, Thomas C. Piemonte, Sree Karanam
المصدر: Catheterization and Cardiovascular Interventions. 65:54-59
مصطلحات موضوعية: Adult, Male, Pacemaker, Artificial, Superior Vena Cava Syndrome, medicine.medical_specialty, Time Factors, Percutaneous, medicine.medical_treatment, Superior vena cava, Angioplasty, medicine, Humans, Radiology, Nuclear Medicine and imaging, Device Removal, Aged, Retrospective Studies, business.industry, Retrospective cohort study, Phlebography, General Medicine, Middle Aged, Implantable cardioverter-defibrillator, Defibrillators, Implantable, Surgery, Catheter, Female, Implant, Radiology, Tomography, X-Ray Computed, Cardiology and Cardiovascular Medicine, Complication, business, Follow-Up Studies
الوصف: The aim of this study is to assess the feasibility and safety of percutaneous treatment of superior vena cava (SVC) obstruction following transvenous device implantation. SVC obstruction is an uncommon but serious complication that can occur following permanent pacemaker or cardioverter defibrillator implantation utilizing transvenous endocardial leads. The treatment has traditionally been surgical but with the advent of stents, percutaneous approach is becoming popular. We report on the prevalence of SVC obstruction and the safety of its percutaneous catheter-based treatment. This is a retrospective study of SVC obstruction following device implantation in our institution from January 1993 through November 2003. A total of 1,850 permanent pacemaker and 1,200 implantable cardioverter defibrillator initial implants were performed during that period. Three patients developed SVC obstruction following implant (prevalence, 1/1,000 implant). Two patients were males and the mean age at implant was 57 ± 13 years. Laser lead extraction and SVC angioplasty with or without stenting were performed in all patients. In two of them, this was followed by reimplantation of new systems. There were no procedural complications or mortality. The patients remain free of SVC obstruction symptoms 24 ± 19 months after treatment. SVC obstruction prevalence after device implantation is low. Percutaneous treatment of SVC obstruction can be safely performed and appears to be effective in maintaining medium-term patency. © 2005 Wiley-Liss, Inc.
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المؤلفون: David Martin, Carlo Honrado, Robert F. Ward, Ashutosh Kacker
المصدر: International Journal of Pediatric Otorhinolaryngology. 53:1-7
مصطلحات موضوعية: Male, medicine.medical_specialty, Pediatrics, Beckwith-Wiedemann Syndrome, Esthetics, medicine.medical_treatment, Oral Surgical Procedures, Beckwith–Wiedemann syndrome, Tertiary care, Teaching hospital, Tracheotomy, Tongue, Macroglossia, Humans, Medicine, business.industry, Infant, General Medicine, medicine.disease, Surgery, Treatment Outcome, medicine.anatomical_structure, Otorhinolaryngology, El Niño, Evaluation Studies as Topic, Child, Preschool, Pediatrics, Perinatology and Child Health, Female, Tongue reduction, medicine.symptom, business, Follow-Up Studies
الوصف: Objective : To review our experience with patients with macroglossia as a component of Beckwith–Weidemann Syndrome (BWS). Design : Chart review of six patients treated with BWS. Setting : Tertiary care teaching hospital. Patients : Six patients diagnosed with BWS and macroglossia. Interventions : Four patients underwent at least one surgical procedure to address their macroglossia. The surgical options and potential complications are discussed. Results : Three patients who have undergone tongue reduction have a functioning tongue with normal mobility. Two patients have required tracheotomy as apart of their management and still have significant tongue enlargement. Conclusions : Macroglossia as a part of BWS may present a difficult management problem. Various methods of tongue reductions have been reported with mixed results.
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المؤلفون: Richard S. D’Agostino, David Martin, Gregory F. Michaud, Sree Karanam, Islam Bolad, David M. Shahian, Roy M. John, Carolyne MacLellan, Florence Parrella
المصدر: The American Journal of Cardiology. 94:376-378
مصطلحات موضوعية: Male, medicine.medical_specialty, Time Factors, Ventricular Tachyarrhythmias, Early Recurrence, Defibrillation, medicine.medical_treatment, Risk Assessment, Severity of Illness Index, Cardioverter-Defibrillator, Electrocardiography, Postoperative Complications, Internal medicine, medicine, Humans, Cardiac Surgical Procedures, Aged, Probability, Retrospective Studies, business.industry, Retrospective cohort study, Middle Aged, Survival Analysis, Defibrillators, Implantable, Surgery, Cardiac surgery, Patient population, Treatment Outcome, Tachycardia, Ventricular, cardiovascular system, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
الوصف: The effectiveness of implantable cardioverter defibrillators (ICDs) implanted in the early postoperative period after cardiac surgery for ventricular tachyarrhythmias is unknown, because all of the major trials excluded this patient population. Thus, a 10-year retrospective study was conducted of patients who had ICDs implanted for de novo postoperative ventricular tachyarrhythmias during the index admission for cardiac surgery. There was a high rate of early recurrence of ventricular tachyarrhythmia treated by defibrillators, and this finding questions the exclusion of this important patient population from large trials.
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المؤلفون: Hal David Martin, RobRoy L. Martin, Ian James Palmer
المصدر: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 20(6)
مصطلحات موضوعية: musculoskeletal diseases, Adult, Joint Instability, Male, Models, Anatomic, medicine.medical_specialty, Arthroscopy, medicine, Humans, Orthopedics and Sports Medicine, Clinical significance, Retrospective Studies, Rupture, Retrospective review, medicine.diagnostic_test, business.industry, Anatomy, Middle Aged, musculoskeletal system, Functional description, Biomechanical Phenomena, body regions, Orthopedic surgery, Ligaments, Articular, Squatting position, Surgery, Biomechanical model, Female, Hip Joint, business, human activities, Surgical patients, Follow-Up Studies, Hip Injuries
الوصف: The primary purpose of this study was to investigate the role the ligamentum teres has in providing hip stability using a biomechanical model. The second purpose was to review arthroscopic findings in those with a complete ligamentum teres rupture and question them regarding instability to determine how clinical findings related to the biomechanical model. A string model was created to examine ligamentum teres excursion during various hip positions. A retrospective review of 350 consecutive surgical patients identified 20 subjects with a complete ligamentum teres rupture that was not repaired at the time of surgery. The model found the ligamentum teres to have the greatest excursion when the hip was externally rotated in flexion (ER/FLEX) and internally rotated in extension (IR/EXT). During operative assessment, it was noted that all 20 subjects had laxity during dynamic impingement testing when their hip was in a position of ER/FLEX. Nine (45%) of the 20 subjects with ligamentum teres rupture were available for follow-up (mean 31 months post-op). Five out of these 9 subjects noted instability: 5 of 9 with squatting (ER/FLEX) and 4 of 9 with crossing one leg behind of the other (IR/EXT). These 5 subjects had osseous risk factors that compromised hip stability including inferior acetabular insufficiency. The ligamentum teres may contribute to hip stability when the hip is in ER/FLEX and IR/EXT. Individuals with osseous risk factors for instability, including inferior acetabular insufficiency, may have instability with squatting (ER/FLEX) and crossing one leg behind of the other (IR/EXT). IV.
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المؤلفون: Mark E. Whitten, David Martin, Bruce S. Bleiman, Arthur L. Schwartz
المصدر: Ophthalmology. 88(3)
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Intraocular pressure, Trabeculoplasty, genetic structures, Open angle glaucoma, medicine.medical_treatment, Population, Mean pressure, chemistry.chemical_element, law.invention, law, Trabecular Meshwork, Medicine, Humans, Argon, education, education.field_of_study, business.industry, Glaucoma, Middle Aged, Laser, eye diseases, Surgery, Ophthalmology, medicine.anatomical_structure, chemistry, Female, sense organs, Trabecular meshwork, Laser Therapy, business, Follow-Up Studies
الوصف: Thirty-five phakic eyes from a predominantly black population with clinically uncontrolled open angle glaucoma underwent argon laser treatment to 360 degrees of the trabecular meshwork. The intraocular pressure in the untreated eye was used as a control whenever possible. The mean pressure change in the treated eye at four months showed a decrease of 10.0 mm Hg (P less than 0.001). This effect was maintained throughout the 18-month follow-up period. Thirty-four of the 35 eyes (97%) were clinically controlled with pressures averaging less than 20 mm Hg. The procedure appears to function by improving outflow facility as manifested by a statistically significant increase in outflow for six months post-treatment. The major complication was the formation of peripheral anterior synechiae. These synechiae were localized and did not affect the success of the procedure. Argon laser trabecular surgery appears to be effective in lowering intraocular pressure with many advantages over standard filtering surgery.
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