Curēus
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Total knee arthroplasty (TKA) is among the most commonly performed orthopedic procedures. Controlling the pain of this patient population is essential in improving outcomes such as opioid consumption, hospital length of stay, overall function, and rehabilitation participation following their procedure. Local anesthetic infiltration of the interspace between the popliteal artery and capsule of the posterior knee, known as the IPACK block, combined with an adductor canal block (ACB) can be used to reduce pain in the challenging area of the posterior knee after knee surgery without compromising motor function of the quadriceps muscles. ⋯ Few studies have utilized the Dex-Dex combination. The combination, however, was previously proven to safely increase the analgesic duration of a caudal block prior to hypospadias surgeries in pediatrics. More studies are needed to understand a potential synergistic effect of Dex-Dex, which could have a substantial impact on postoperative analgesia for TKA patients.
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Introduction In the last 18 years, on three occasions, coronavirus has represented a challenge for global health. Between 2002 and 2003 with Severe Acute Respiratory Syndrome, in 2012 with Middle East Respiratory Syndrome, and since the end of 2019 with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the coronavirus disease 2019 (COVID-19) pandemic, which has challenged health care models and the way of doing research, placing bioethics at the center of discussion. Methods On August 19, 2020, a webinar organized by the Research Institute of Medical Science (IICIMED, for its acronym in Spanish), entitled 'Bioethical Implications in Vaccine Development, a COVID-19 Challenge' took place. Three experts spoke about the importance of bioethics in the race to develop a COVID-19 vaccine, the risk involved in shortening the terms of the clinical trial phases, and how the associated risks can be minimized, in order to expedite research results. Conclusion With the novel SARS-CoV-2 coronavirus, critical challenges have been posed not only for public health but for research and the scientific community. A safe and effective vaccine is urgently needed to prevent COVID-19 transmission, complications, and deaths; the adherence to ethical principles required by clinical research is mandatory and closer supervision is also essential.
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Background In the current coronavirus disease-2019 (COVID-19) pandemic, the pattern of hospital admissions for acute ST-elevation myocardial infarction (STEMI) is changing, and increased mortality and morbidity is being noted in these patients. Cardiac manifestations of COVID-19 are complex and include STEMI, myocarditis, myocardial injury, and cardiomyopathy. The objective of our study was to compare the data of patients with STEMI presenting in COVID-19 versus the non-COVID-19 era. Methods We analyzed the clinical and angiographic characteristics of STEMI patients undergoing primary percutaneous coronary intervention (PCI) at our center. ⋯ Conclusions A lower admission rate, higher TIT, and higher mortality rates were noted in patients with acute STEMI during the COVID-19 pandemic compared to the pre-COVID era. During the COVID-19 pandemic, physicians should bear in mind that patients with STEMI have increased mortality and morbidity. Where possible, efforts should be made for timely management of these critical patients to decrease mortality.
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Traumatic brain injury (TBI) is common, and the frequency of patients taking oral anticoagulants is increasing. However the optimal initial triage, management, and long term care plans of hemorrhagic TBI patients taking oral anticoagulants is not clear. ⋯ This limited data set did not show improved outcomes by giving reversal agents to hemorrhagic TBI patients taking oral anticoagulants. However, until more robust data is available, judicious use of reversal agents in this high-risk patient population should remain common practice.
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Background and objective Fractures of the proximal interphalangeal joint (PIPJ) of the hand have always been difficult to treat, often leading to less than satisfactory outcomes. The use of dynamic external fixator devices to treat these fractures is well established and it is based on the philosophy of minimal soft tissue injury and early joint mobilization. There has been a wide variety in their designs, surgical technique, and reported outcomes. ⋯ Four patients had cold intolerance and persistent swelling. Conclusion The results of the use of Ligamentotaxor® in this series are comparable to those of other dynamic external fixator devices reported in the literature. Thanks to its quick and easy surgical technique, the device provides an appealing option for the management of PIPJ fractures.