MHRA drug safety update
The Medicines and Healthcare-products Regulatory Agency (MHRA) has issued a drug safety update covering restrictions on use of daclizumab (Zinbryta), which may cause liver injury; advice on prescribing co-dydramol; and reporting procedure for suspected adverse reactions to herbal medicines.
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This article shares some practical tips for surviving your first night on pediatric orthopaedic call.
Starting a new rotation during orthopaedic residency can be stressful, especially if that rotation is in pediatrics, as treatment often is quite different in children than adults. Knowing what to expect on this rotation can help alleviate some of the concern. With the overwhelming amount of literature covering pediatric orthopaedics, finding out where to begin often is frustratingly time consuming. The goal of this article is to offer a starting point in reading for junior residents before they enter their pediatric orthopaedic rotation. It reviews the top ten articles this author found to be the most helpful. The reading ...
This article highlights surgical procedures with which orthopaedic residents entering a pediatric rotation should be familiar. Closed reduction and percutaneous pinning of supracondylar humeral fractures, in situ pinning of slipped capital femoral epiphysis, and flexible intramedullary nailing of long bone fractures are described. Although these are just a few of many procedures a resident will learn while on a pediatric rotation, they probably are the most utilized while on call at a pediatric hospital.
Conclusions: Most proximal both-bone forearm fractures in children, including olecranon and radial neck fractures, Monteggia type IV fractures, and nonspecific proximal both-bone forearm fractures, have good-to-excellent results. In our study, older age, defined as 10 yr of age or older at the time of injury, resulted in more frequent need for operative intervention, a higher rate of return to the operating room, and greater risk of nerve injury. The older children were not more likely to have range of motion deficits despite a more involved course, which contradicts previous reports, and older age at the time of ...
Conclusions: Contrary to trends identified in an earlier publication, the annual frequency of CA-MRSA infections has stabilized at roughly 40% of all cases. Our data suggest that MSSA infections have become more virulent because these patients now have similar rates of complications and operative interventions to patients with CA-MRSA infections. Level of Evidence: Prognostic level II study (retrospective).
Conclusions: OCF is rare in children but is associated with head, thoracic, and abdominal trauma. Type I and II fractures predominate. Although operative treatment rarely is necessary, it is required in patients with atlantooccipital dislocation. Ligamentous structures should be assessed with MRI.
Conclusions: Despite finding that the rate of parent-child bed-sharing was 50% in our growing pains population, when we controlled for age, there was no difference from our control. Parent-child bed-sharing does not seem to be a significant component of growing pains. Bed-sharing could be a possible mechanism to manage a child’s growing pains.
Conclusions: Our study found a mean 7 mm clinical height measurement variation between surreptitious measurements by SRS surgeons and standard clinical protocol. This variability can lead to inappropriate treatment decisions if growth is used as an indication for brace treatment. With such variability in clinical height measurement, one may want to consider using criteria for bracing independent of height measurement.
Background: Patients with adolescent idiopathic scoliosis (AIS) are typically healthy and yet hospital stay after posterior spinal fusion (PSF) remains lengthy. Methods: A review of patients undergoing PSF for AIS by four pediatric orthopaedic surgeons was performed. Patients were divided based on their surgery occurring before or after the implementation of an accelerated discharge pathway (AD). Patients treated prior to the AD pathway were managed using a less standardized traditional (TD) pathway. Results: Four surgeons performed 99 PSF for AIS using the TD pathway and 81 PSF after implementation of the AD pathw...