Meniscus transplantation in skeletally immature patients
This study focuses on the surgical technique and short-term outcomes of meniscus transplantation in skeletally immature patients. We reviewed our clinical database for skeletally immature patients who had undergone meniscus transplantation with a minimum of 2 years of follow-up. Patients were contacted, invited for a physical exam, and asked to complete a Pedi-IKDC, Lysholm, and Tegner outcomes questionnaire. The study protocol was approved by the responsible institutional review board. Three patients (two females/one male) were eligible for the study, each of whom responded to our invitation indicating availability for physical exam and questionnaire. Two patients had undergone subtotal discoid meniscus resection, leading to early lateral compartment degeneration. One patient developed advanced degeneration after a delay in treatment for a medial bucket-handle tear associated with anterior cruciate ligament rupture. The mean age of the patients at the time of surgery was 12.6±2.3 years. At a mean follow-up of 31±20 months, the mean Pedi-IKDC score was 68.3±4, the mean Lysholm was 55.7±22.3, and the median Tegner was 7 points. There were no indications of growth deformity during the regular postoperative radiological assessments. One patient required subsequent lysis of adhesions along the lateral mini arthrotomy and mobilization under anesthesia. The other two patients were able to return to sports at the same level as before meniscus transplantat...
INFLAMMATORY myofibroblastic tumor (IMT), an uncommon lesion comprising spindle to stellate myofibroblasts, may involve many organs but rarely the heart.1,2 Although difficult to diagnose clinically, IMTs are detected by constitutional symptoms resulting in oversecretion of cytokines.3,4 Cardiac IMTs generally occur in children and commonly present as intracavitary masses of endocardial origin. Typically, cardiac IMTs are biologically inactive, but the mass may result in severe cardiac pump dysfunction and prove fatal.
LEFT VENTRICULAR assist devices (LVADs) are increasingly being used in patients with advanced heart failure as a bridge to transplant, destination therapy, and even as a bridge to recovery.1-3 The current contemporary second and third generation LVADs such as the HeartMate 2 and the newer generation HeartMate 3 and HeartWare have evolved to be valveless, which have markedly improved their durability, miniaturization, and reliability.4 However, an underappreciated consequence of the valveless design is that they can lead to marked left ventricular (LV) dilatation and irreversible cardiac injury when they are turned off in e...
For those who know or have some opinion about this subject. How competitive this Fellowship is? Is it worth doing it? My residency does not have a transplant experience at this time, but it looks like there is a growing need these days. Any input, guys?
Hi all, Hoping this message reaches mostly practicing attending anesthesiologists (or even CRNAs). I am on the interview trail and a number of very good programs cite their lack of trauma experience as a potential weakness. They tend to cite their strengths in liver transplantation and surgery as a reasonable alternative to the resuscitation needed in trauma. Do you feel like this is an accurate statement, and if so would you be willing or able to work in a level one trauma center despite... Does high liver volume make up for lack of trauma?
TEE-certified MDs needed for outstanding partner-track position. Partner-level money and vacation from day one! We are a fully democratic, busy private practice in Louisville, KY. We do lots of ortho, neuro, endo, OB/GYN, general surgery, and our cardiac program just keeps growing. Valves, complex aorta work, and an evolving structural heart program. No transplants or trauma. Do hearts and endo and some surgicenter work on your own, medically direct CRNAs for the rest. We work hard but are... Partner track position available in Louisville, Kentucky
CA-1 here. Obviously thinking about fellowships already as we have to apply so early. So far I have enjoyed all of my rotations, and can really see my future career as a generalist, doing some general OR, trauma, transplant, OB, regional, if thats feasible. My question is essentially, would doing a cardiac fellowship make me a better all around anesthesiologist and better suited for handling everything? Or is cardiac so specialized now that it is really just for coming off and on pump... Fellowship advice - Cardiac vs Regional vs None
In conclusion, increase in pulmonary capillary pressure with pulmonary venous resistance, associated with lung inflammatory process were partially prevented by tacrolimus BD-induced lung injury pig model.
CONCLUSIONS: NK was more frequent than previously reported in the literature. Delayed diagnoses indicated we must increase ophthalmologists' awareness of this disease for patients with decreased corneal sensitivity and abnormal epithelium. To improve prognosis and final CDVA, NK-specific treatment should be initiated as soon as the diagnosis is suspected. Patient-centered combinations of different therapeutic components and close monitoring achieved promising results. PMID: 31759182 [PubMed - as supplied by publisher]
CONCLUSIONS: Anesthetic preconditioning is a promising strategy to prevent I-R injury associated with transplantation. Our results suggest that sirtuin 2 is involved in the protective mechanisms of some commonly used anesthetics against I-R damage. PMID: 31726818 [PubMed - as supplied by publisher]
The gold standard treatment for end-stage heart failure, with 50% mortality within 5 years of diagnosis, is considered heart transplantation. Despite the improvements in immunosuppression, the period of highest mortality risk in the heart transplantation population is during the first year post-transplantation, with primary graft dysfunction being the leading cause of mortality. After adequate preoperative assessment of the recipient, including patients on mechanical support, the intraoperative care of heart transplantation patients requires extensive monitoring followed by proficient management of anesthesia induction and...