scholarly journals Functional and Aesthetic Tragal Reconstruction in the Age of Mobile Electronic Devices

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Colleen F. Perez ◽  
Curtis W. Gaball
Keyword(s):  
Electronic Devices ◽  
Modern Technology ◽  
Single Stage ◽  
Treatment Goal ◽  
Clinical Question ◽  
Level Of Evidence ◽  
Conchal Cartilage ◽  
History Of

We present a method to create a tragus using the patient’s conchal cartilage. It is a simplified, single-stage technique with well-hidden incisions, yet it maintains the rigidity of a natural tragus. This patient did not have a history of radiation to the area, which may compromise healing with this technique. The cosmetic importance of the tragus has been described, but its functionality in accommodating modern technology has not been previously discussed. The main treatment goal for this patient was to gain the ability to wear earphones (clinical question/level of evidence: therapeutic, V).

Revisiting the Natural History of Chronic Scaphoid Nonunions: A Retrospective Study of 20 Cases

2021 ◽  
Author(s):  
J. Terrence Jose Jerome
Keyword(s):  
Retrospective Study ◽  
Natural History ◽  
Functional Outcome ◽  
Grip Strength ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Degenerative Arthritis ◽  
Level Of Evidence ◽  
History Of ◽  
The Mean

Abstract Background The natural history of scaphoid nonunion is the development of degenerative arthritis. A lot of information is still unclear about this progression. The purpose of this study is to analyze patients with scaphoid nonunions who had not received any kind of treatment and to assess the functional outcome. Materials and Methods This is a retrospective study that analyzed the patients with chronic scaphoid nonunions between 2009 and 2019. None of the patients received any treatment. The age at the time of injury, examination, pattern of fracture, types of scaphoid nonunion, symptoms, and duration of nonunion were noted. Diagnosis was confirmed by radiographs, computed tomography (CT) scan, and magnetic resonance imaging (MRI). Scapholunate and radiolunate angles were recorded. Pain score, modified mayo wrist score, grip strength, range of movement, and the functional outcome of these scaphoid nonunions were analyzed. A statistical correlation between the scaphoid nonunion presentations and the functional outcome was assessed. Results The mean age of the patients was 62 years (range: 35–82 years.). There were 17 male and 3 female patients. There were 9 waist and 11 proximal pole scaphoid nonunions. The mean duration of scaphoid nonunion was 34 years (range: 10–62 years). None of the patients had avascular necrosis (AVN) of the proximal scaphoid. The age at examination, gender, side of injury, fracture pattern (waist/proximal pole), fracture displacement ≤ 1 mm or > 1 mm, nonunion duration, and radiographic arthritic parameters had no significant impact on the functional outcome. Conclusions Untreated chronic scaphoid nonunion leads to the development of degenerative arthritis over a period of years, which is still unpredictable. Most of the patients become aware of the nonunion following a precedent injury or other reasons. Most of the patients have fair/good functional outcome despite reduced range of movements and grip strength. Many do not favor surgical intervention in the course of nonunion. Chronic nonunions open a lot of unanswered questions. Clinical relevance There have been numerous studies on the treatment aspects of scaphoid nonunion, with little knowledge about certain people with nonunion who did not have any kind of treatment. The demographics, clinical findings, and radiological parameters do confirm the progression of these nonunion to arthritis, but most of them had fair-to-good outcome throughout their life. It opens our thinking about the real need of treatment in such nonunions and raises numerous questions about the disease. Level of evidence This is a Level IV study.

scholarly journals Older trauma patients are at high risk of delirium, especially those with underlying dementia or baseline frailty

2021 ◽  
Vol 6 (1) ◽  
pp. e000639
Author(s):  
Danielle Ní Chróinín ◽  
Nevenka Francis ◽  
Pearl Wong ◽  
Yewon David Kim ◽  
Susan Nham ◽  
...  
Keyword(s):  
Older Patients ◽  
Multivariable Analysis ◽  
Primary Outcome Measure ◽  
Hospital Length ◽  
Assessment Tools ◽  
Hospital Length Of Stay ◽  
Trauma Patients ◽  
Level Of Evidence ◽  
Increased Risk ◽  
History Of

BackgroundGiven the increasing numbers of older patients presenting with trauma, and the potential influence of delirium on outcomes, we sought to investigate the proportion of such patients who were diagnosed with delirium during their stay—and patient factors associated therewith—and the potential associations between delirium and hospital length of stay (LOS). We hypothesized that delirium would be common, associated with certain patient characteristics, and associated with long hospital LOS (highest quartile).MethodsWe conducted a retrospective observational cohort study of all trauma patients aged ≥65 years presenting in September to October 2019, interrogating medical records and the institutional trauma database. The primary outcome measure was occurrence of delirium.ResultsAmong 99 eligible patients, delirium was common, documented in 23% (23 of 99). On multivariable analysis, adjusting for age, frailty and history of dementia, frailty (OR 4.09, 95% CI 1.08 to 15.53, p=0.04) and dementia (OR 5.23, 95% CI 1.38 to 19.90, p=0.02) were independently associated with likelihood of delirium. Standardized assessment tools were underused, with only 34% (34 of 99) screened within 4 hours of arrival. On univariate logistic regression analysis, having an episode of delirium was associated with long LOS (highest quartile), OR of 5.29 (95% CI 1.92 to 14.56, p<0.001). In the final multivariable model, adjusting for any (non-delirium) in-hospital complication, delirium was independently associated with long LOS (≥16 days; OR 4.81, p=0.005).DiscussionIn this study, delirium was common. History of dementia and baseline frailty were associated with increased risk. Delirium was independently associated with long LOS. However, many patients did not undergo standardized screening at admission. Early identification and targeted management of older patients at risk of delirium may reduce incidence and improve care of this vulnerable cohort. These data are hypothesis generating, but support the need for initiatives which improve delirium care, acknowledging the complex interplay between frailty and other geriatric syndromes in the older trauma patients.Level of evidenceIII.

scholarly journals Incidence and Risk Factors of Symptomatic Venous Thromboembolism Following Foot and Ankle Surgery

2018 ◽  
Vol 40 (1) ◽  
pp. 98-104 ◽  
Author(s):  
Johanna Marie Richey ◽  
Miranda Lucia Ritterman Weintraub ◽  
John M. Schuberth
Keyword(s):  
Risk Factors ◽  
Hormone Replacement ◽  
Case Series ◽  
Foot And Ankle ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Ankle Surgery ◽  
History Of ◽  
Low Incidence ◽  
Predictive Risk

Background: The incidence rate of venous thrombotic events (VTEs) following foot and ankle surgery is low. Currently, there is no consensus regarding postoperative prophylaxis or evidence to support risk stratification. Methods: A 2-part study assessing the incidence and factors for the development of VTE was conducted: (1) a retrospective observational cohort study of 22 486 adults to calculate the overall incidence following foot and/or ankle surgery from January 2008 to May 2011 and (2) a retrospective matched case-control study to identify risk factors for development of VTE postsurgery. One control per VTE case matched on age and sex was randomly selected from the remaining patients. Results: The overall incidence of VTE was 0.9%. Predictive risk factors in bivariate analyses included obesity, history of VTE, history of trauma, use of hormonal replacement or oral contraception therapy, anatomic location of surgery, procedure duration 60 minutes or more, general anesthesia, postoperative nonweightbearing immobilization greater than 2 weeks, and use of anticoagulation. When significant variables from bivariate analyses were placed into the multivariable regression model, 4 remained statistically significant: adjusted odds ratio (aOR) for obesity, 6.1; history of VTE, 15.7; use of hormone replacement therapy, 8.9; and postoperative nonweightbearing immobilization greater than 2 weeks, 9.0. The risk of VTE increased significantly with 3 or more risk factors ( P = .001). Conclusion: The overall low incidence of VTE following foot and ankle surgery does not support routine prophylaxis for all patients. Among patients with 3 or more risk factors, the use of chemoprophylaxis may be warranted. Level of Evidence: Level III, retrospective case series.

Clear cell carcinoma of Mullerian origin in the urinary bladder: A rare entity

2021 ◽  
pp. 205141582098766
Author(s):  
Harshit Garg ◽  
Brusabhanu Nayak ◽  
Tripti Nakra ◽  
Prabhjot Singh ◽  
Seema Kaushal
Keyword(s):  
Urinary Bladder ◽  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Rare Entity ◽  
Level Of Evidence ◽  
History Of ◽  
Carcinoma Of The Bladder

Mullerian neoplasms of the urinary system are rare but complex tumor-like lesions. The identification of the Mullerian neoplasm is crucial for patient management owing to its etiology, natural history, and prognosis. We present a case of a 42-year-old female with a history of three lower segment cesarean sections presenting with complaints of dysmenorrhea and suprapubic pain with no history of hematuria or any urinary symptoms. Magnetic resonance imaging revealed a 2 cm×2 cm exophytic lesion suspicious of being either a bladder lesion or an endometrial lesion infiltrating the urinary bladder. Cystoscopy and transurethral biopsy of this suspicious bladder tumor revealed a malignant tumor with papillary and tubulocystic architecture. Based on the overall histomorphological and immunohistochemical features, a diagnosis of clear cell carcinoma of Mullerian origin was made, and the patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy and partial cystectomy. The patient was kept on regular surveillance and showed no signs of recurrence at the one-year follow-up. Clear cell carcinoma of the bladder of Mullerian origin is a rare entity and is established on histopathology. Prompt diagnosis and a multidisciplinary approach are indispensable for management. Level of evidence: Level 4.

Hemangioblastoma diagnosis and surveillance in von Hippel–Lindau disease: a consensus statement

2021 ◽  
pp. 1-6
Author(s):  
Kristin Huntoon ◽  
Matthew J. Shepard ◽  
Rimas V. Lukas ◽  
Ian E. McCutcheon ◽  
Anthony B. Daniels ◽  
...  
Keyword(s):  
Age At Onset ◽  
Benign Tumors ◽  
Expert Committee ◽  
Level Of Evidence ◽  
Von Hippel Lindau ◽  
Assessment Development ◽  
History Of ◽  
Von Hippel Lindau Disease ◽  
The Central Nervous System ◽  
Cancer Network

OBJECTIVE Hemangioblastomas are a frequent underlying cause of neurological morbidity and death in patients with von Hippel–Lindau disease (VHL). Although these benign tumors can cause significant neurological debility when undetected and untreated, unified evidence-based surveillance recommendations for VHL patients have not been established. To develop consensus recommendations, the VHL Alliance established an expert committee, named the International VHL Surveillance Guidelines Consortium, to define surveillance recommendations. METHODS The Central Nervous System (CNS) Hemangioblastoma Subcommittee of the Guidelines Consortium was formed as a multidisciplinary team of experts in the diagnosis and management of hemangioblastomas. Recommendations were formulated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) and National Comprehensive Cancer Network Categories of Evidence and Consensus categorization after a comprehensive literature review. RESULTS Published studies (n = 49) that discussed age at onset, MRI frequency, natural history of VHL, and the risks and benefits of surveillance were analyzed. Based on this analysis, the authors recommend that clinical evaluation (yearly) be used as the primary screening tool for hemangioblastomas in VHL. The subcommittee suggests that screening be performed between the ages of 11 and 65 years, or with the onset of symptoms, for synchronicity with other testing regimens in VHL. The subcommittee also recommends that baseline MRI be first performed at the age of 11 years (suggested 2B, level of evidence D) or after identification of neurological symptoms or signs (if earlier) and continue every 2 years (recommended 2A, level of evidence A). CONCLUSIONS The CNS Hemangioblastoma Subcommittee of the International VHL Surveillance Guidelines Consortium here proposes guidelines that aim to increase the early detection of VHL-associated hemangioblastomas to reduce their morbidity and mortality.

scholarly journals A Review: Electrospinning and Electrospinning Nanofibre Technology, Process & Application

2020 ◽  
Vol 5 (6) ◽  
pp. 528-538
Author(s):  
Somesh S. Bhagure ◽  
Dr. Adarsh R. Rao
Keyword(s):  
Electronic Devices ◽  
Early History ◽  
Comprehensive Overview ◽  
Thin Fiber ◽  
Filtration Membranes ◽  
Technology Process ◽  
Recent Developments ◽  
History Of ◽  
Catalytic Supports ◽  
Remarkable Progress

Electrospinning is a versatile and viable technique for ultra-thin fiber generation. Remarkable progress has been made with regard to the development of Electrospinning methods and the engineering of Electrospinning Nanofibre to suit or enable different applications. We aim to provide a comprehensive overview of Electrospinning, including principles, methods, materials and applications. We begin with a brief introduction to the early history of Electrospinning, followed by a discussion of its principle and its typical apparatus. Subsequently, we discuss the applications of electrospun Nanofibre, including their use as smart mattresses, filtration membranes, catalytic supports, energy harvesting / conversion / storage components, and photonic and electronic devices, as well as biomedical scaffolds. We highlight the most relevant and recent developments in the application of electrospun Nanofibre by focusing on the most representative examples.

scholarly journals THE MISSING LINK IN THE HISTORY OF THE LOCKED INTRAMEDULLARY NAIL

2021 ◽  
Vol 29 (4) ◽  
pp. 228-231
Author(s):  
FLÁVIO PIRES DE CAMARGO ◽  
GUILHERME PELOSINI GAIARSA ◽  
OLAVO PIRES DE CAMARGO ◽  
PAULO ROBERTO DOS REIS ◽  
JORGE DOS SANTOS SILVA ◽  
...  
Keyword(s):  
Standard Treatment ◽  
Femoral Shaft ◽  
Reference Level ◽  
Intramedullary Nails ◽  
Level Of Evidence ◽  
Femoral Shaft Fractures ◽  
Interlocking Nail ◽  
Major Development ◽  
The World ◽  
History Of

ABSTRACT Femoral Shaft intramedullary nails were first described by the Aztecs in 16th century, but the modern use of intramedullary nails as the gold standard treatment for femoral shaft fractures began with Gerald Kuntcher in 1939. From the first Kuntcher’s study in 1939, to the creation of interlocking nail, a long and some minor developments were described around the world. However, a major development is missing: the first nail to have a rotational and vertical stability locking system was described by Flavio Godoy Moreira, but was never published on an indexed journal for the correct historical reference. Level of Evidence V, Therapeutics Studies, Expert Opinion.

scholarly journals Tempo Digital: Quando a escola invade o smartphone

2020 ◽  
pp. 62-67
Author(s):  
Maria Luísa Luís Duarte
Keyword(s):  
Young People ◽  
Creative Process ◽  
Electronic Devices ◽  
School Context ◽  
Digital Natives ◽  
Work Of Art ◽  
History Of ◽  
Current Context ◽  
History Of Culture ◽  
Object Of Study

This article derives from the master’s research in which it seeks to understand what uses the teenagers of this generation, known as millennials (or digital natives), are giving to their smartphones in a given Portuguese school context. Bearing in mind that our young people (as well as adults) spend a large part of their time “clinging” to small electronic devices, the present investigation looks at this problem as an opportunity to produce artistic content through a didactic use. At the same time, it helps young “producer / consumer” students to recognize themselves in the production of subjectivity inherent in certain work proposals carried out within the scope of the History of Culture and Arts. Starting from the concepts inherent to the disciplines of Artistic Education and the selection and study of a work of art, and having self-representation as the object of study, the student (re) creates (the work selected by himself) through the use of the smartphone, mobilizing skills transversal (technical, aesthetic and methodological) in a process that wants to be creative. In the creative process several aspects are contemplated that can, and should, be deepened, namely the question of time. The time we live in is an unexpected time! Time of seclusion, distance, confinement! We seek to ask whether the current context of confinement can provide an opportunity to reflect on the didactic use of the smartphone to produce artistic content while maintaining the principles of equality and equity.

scholarly journals Making Modern Knowledge of Traditional Carpentry in China and Japan: Myth, Reality and Transmission

2021 ◽  
Vol 15 (2) ◽  
pp. 34-62
Author(s):  
Ren Congcong
Keyword(s):  
New Technologies ◽  
Modern Technology ◽  
Building Industry ◽  
Heritage Culture ◽  
History Of ◽  
China And Japan ◽  
Yingzao Fashi ◽  
Historical Trajectory ◽  
Building Practice ◽  
Building Standards

Abstract Carpentry skills were among the most important elements of building practice in premodern China and Japan, and traditional carpentry skills continue in use in both countries to the present day. Although their importance has been greatly marginalised in building practice, in both countries some master carpenters have gained public recognition. This paper compares the modernisation of traditional building knowledge in China and Japan, and the fate of carpentry knowledge as the building industry and the formal discipline of architecture evolved. It distinguishes three phases in this historical trajectory: the period during the introduction of Western architecture as a discipline, when traditional knowledge was rejected or used selectively in the construction of national histories of building; the period when modern technology took over the main building industry and traditional craftsmen had to confront the realities of new technologies of production; and the period, still unfolding today, where heritage movements are promoting the recuperation and development of traditional craft knowledge. For each country, the paper traces how the nation’s history of building was selectively fashioned into an orthodox narrative; explores the content of key early technical works (for China, the official handbook Yingzao fashi [Building standards] and the craftsman’s manual Lu Ban jing [Carpenters’ Canon], and for Japan kikujutsu [literally, “compass and ruler techniques”] books); and shows how a talented master carpenter succeeded in creating a niche for himself within the contemporary heritage culture. It concludes that differences in the cultural respect accorded to carpentry knowledge in the two countries are rooted in the contrasting status of craftsmen in the premodern era.

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