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[PMID]:28455277
[Au] Autor:Pastora-Bernal JM; Martín-Valero R; Barón-López FJ; Estebanez-Pérez MJ
[Ad] Endereço:Faculty of Health Sciences, Physiotherapy, University of Málaga, Malaga, Spain.
[Ti] Título:Evidence of Benefit of Telerehabitation After Orthopedic Surgery: A Systematic Review.
[So] Source:J Med Internet Res;19(4):e142, 2017 Apr 28.
[Is] ISSN:1438-8871
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In addition to traditional physiotherapy, studies based on telerehabilitation programs have published the results of effectiveness, validity, noninferiority, and important advantages in some neurological, cognitive, and musculoskeletal disorders, providing an opportunity to define new social policies and interventions. OBJECTIVES: The aim of this systematic review is to investigate the effects of telerehabilitation after surgical procedures on orthopedic conditions as well as to describe how interventions are designed and to determine whether telerehabilitation is comparable with conventional methods of delivery. This systematic review summarizes the levels of evidence and grades of recommendation regarding telerehabilitation intervention (synchronous or asynchronous provided via the telerehabilitation medium, either in conjunction with, or in isolation of, other treatment interventions) after surgical procedures on orthopedic conditions. METHODS: Study quality was assessed using the Physiotherapy Evidence Database (PEDro) scores and grade of recommendation following the recommendation of the Oxford Centre for Evidence-Based Medicine. RESULTS: We found 3 studies with PEDro scores between 6 and 8, which is considered as level 1 evidence (good; 20% [3/15]), 4 studies with a score of 5, which is considered as level 2 evidence (acceptable; 27% [4/15]), and the remaining 8 studies had scores of 4 or less, which is considered (poor; 53% [8/15]). A total of 1316 participants received telerehabilitation intervention in the selected studies, where knee and hip replacement were 75% of all the studies. Strong and moderate grades of evidence (grade of recommendation A-B) were found in knee and hip replacement interventions. Studies on the upper limb were 25% of the studies, but only 1 study presented a moderate grade of evidence (grade of recommendation B) and the rest were of poor methodological quality with weak evidence (grade of recommendation C). CONCLUSIONS: Conclusive evidence on the efficacy of telerehabilitation for treatment after an orthopedic surgery, regardless of pathology, was not obtained. We found strong evidence in favor of telerehabilitation in patients following total knee and hip arthroplasty and limited evidence in the upper limb interventions (moderate and weak evidence). Future research needs to be more extensive and conclusive. To the best of the authors' knowledge, this is the first attempt at evaluating the quality of telerehabilitation intervention research after surgical procedures on orthopedic conditions in a systematic review. Clinical messages and future research recommendations are included in the review.
[Mh] Termos MeSH primário: Medicina Baseada em Evidências/métodos
Ortopedia/métodos
Telemedicina/métodos
Telerreabilitação/métodos
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.2196/jmir.6836


  2 / 15779 MEDLINE  
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[PMID]:29196282
[Au] Autor:Chatfield C
[Ad] Endereço:The BMJ.
[Ti] Título:Reducing variations in care.
[So] Source:BMJ;359:j5574, 2017 12 01.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Assistência à Saúde/tendências
Ortopedia/economia
Qualidade da Assistência à Saúde/economia
Infecção da Ferida Cirúrgica/prevenção & controle
[Mh] Termos MeSH secundário: Inglaterra/epidemiologia
Seres Humanos
Avaliação de Resultados (Cuidados de Saúde)/economia
Padrões de Prática Médica/economia
Qualidade da Assistência à Saúde/normas
Infecção da Ferida Cirúrgica/complicações
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171203
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5574


  3 / 15779 MEDLINE  
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[PMID]:29285945
[Au] Autor:Szendroi M; Szoke G
[Ti] Título:[Dr. Tibor Vízkelety (1929-2017)].
[Ti] Título:Dr. Vízkelety Tibor (1929−2017)..
[So] Source:Orv Hetil;158(52):2086, 2017 Dec.
[Is] ISSN:0030-6002
[Cp] País de publicação:Hungary
[La] Idioma:hun
[Mh] Termos MeSH primário: Procedimentos Ortopédicos/história
Ortopedia/história
[Mh] Termos MeSH secundário: História do Século XX
História do Século XXI
Seres Humanos
Hungria
Médicos/história
[Pt] Tipo de publicação:BIOGRAPHY; HISTORICAL ARTICLE; JOURNAL ARTICLE
[Ps] Nome de pessoa como assunto:Vizkelety T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171230
[St] Status:MEDLINE
[do] DOI:10.1556/650.2017.HO2587


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[PMID]:29189626
[Au] Autor:Lyman B; Shaw L; Moore C
[Ad] Endereço:Bret Lyman, PhD, RN, Assistant Professor, College of Nursing, Brigham Young University, Provo, UT. Lindsey Shaw, BS, RN, Research Assistant, College of Nursing, Brigham Young University, Provo, UT. Carly Moore, Nursing Student and Research Assistant, College of Nursing, Brigham Young University, Provo, UT.
[Ti] Título:Organizational Learning in an Orthopaedic Unit: A Learning History.
[So] Source:Orthop Nurs;36(6):424-431, 2017 Nov/Dec.
[Is] ISSN:1542-538X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The purpose of this study was to explore organizational learning in an orthopaedic hospital unit. Skill in organizational learning is necessary to achieve high reliability in a dynamic healthcare environment, yet organizational learning in hospital units is not well understood. A learning history was conducted with a high-performing orthopaedic unit. Findings were interpreted in the context of a previous learning history conducted with a critical care unit. Despite contextual differences, each unit progressed through the same four developmental stages to achieve its current state of high reliability. On both units, psychological safety and a healthy work environment proved essential for developmental progression. Hospital units may progress through distinct developmental stages to achieve their desired outcomes. Psychological safety and a healthy work environment appear foundational to organizational learning in hospital units. Nursing leaders should work with team members to evaluate their unit's development and use suggested strategies to facilitate organizational learning.
[Mh] Termos MeSH primário: Modelos Organizacionais
Recursos Humanos de Enfermagem no Hospital/educação
Cultura Organizacional
Ortopedia/educação
[Mh] Termos MeSH secundário: Pesquisa sobre Serviços de Saúde
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1097/NOR.0000000000000403


  5 / 15779 MEDLINE  
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[PMID]:29265420
[Au] Autor:Lebaschi A; Nakagawa Y; Wada S; Cong GT; Rodeo SA
[Ad] Endereço:Orthopedic Soft Tissue Research Program, Hospital for Special Surgery, New York, New York.
[Ti] Título:Tissue-specific endothelial cells: a promising approach for augmentation of soft tissue repair in orthopedics.
[So] Source:Ann N Y Acad Sci;1410(1):44-56, 2017 Dec.
[Is] ISSN:1749-6632
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Biologics are playing an increasingly significant role in the practice of modern medicine and surgery in general and orthopedics in particular. Cell-based approaches are among the most important and widely used modalities in orthopedic biologics, with mesenchymal stem cells and other multi/pluripotent cells undergoing evaluation in numerous preclinical and clinical studies. On the other hand, fully differentiated endothelial cells (ECs) have been found to perform critical roles in homeostasis of visceral tissues through production of an adaptive panel of so-called "angiocrine factors." This newly discovered function of ECs renders them excellent candidates for novel approaches in cell-based biologics. Here, we present a review of the role of ECs and angiocrine factors in some visceral tissues, followed by an overview of current cell-based approaches and a discussion of the potential applications of ECs in soft tissue repair.
[Mh] Termos MeSH primário: Diferenciação Celular
Transplante de Células/métodos
Células Endoteliais/transplante
Ortopedia/métodos
[Mh] Termos MeSH secundário: Animais
Células Endoteliais/citologia
Células Endoteliais/metabolismo
Seres Humanos
Especificidade de Órgãos
Engenharia Tecidual/métodos
Vísceras/citologia
Vísceras/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180109
[Lr] Data última revisão:
180109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE
[do] DOI:10.1111/nyas.13575


  6 / 15779 MEDLINE  
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[PMID]:29257016
[Au] Autor:Duchman KR; Westermann RW; Glass NA; Bedard NA; Mather RC; Amendola A
[Ad] Endereço:Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa.
[Ti] Título:Who Is Performing Hip Arthroscopy?: An Analysis of the American Board of Orthopaedic Surgery Part-II Database.
[So] Source:J Bone Joint Surg Am;99(24):2103-2109, 2017 Dec 20.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hip arthroscopy utilization has increased dramatically over the last decade. However, the lack of a formal training curriculum raises concern that inconsistent technical performance may be an issue for early-career hip arthroscopists. The purpose of the present study was to investigate hip arthroscopy utilization by early-career orthopaedic surgeons while focusing on fellowship training status to better guide future development of a hip arthroscopy training curriculum. METHODS: The American Board of Orthopaedic Surgery (ABOS) Part-II database was used to identify candidates who had performed ≥1 hip arthroscopy procedures between 2006 and 2015. Procedures were categorized using Common Procedural Terminology (CPT) codes, and candidates were categorized by fellowship training experience. Trends in hip arthroscopy utilization were evaluated using univariate and regression analyses while stratifying by fellowship training experience. RESULTS: Overall, 9.2% (643) of 6,987 ABOS candidates had performed ≥1 hip arthroscopy procedures. Over the study period, both the proportion of candidates performing hip arthroscopy and the proportion of hip arthroscopy procedures performed (relative to all procedures performed, of any type) increased (p < 0.001). Candidates performing hip arthroscopy most frequently reported sports medicine fellowship training (74.5%; 479 of 643). Also, among the candidates who performed hip arthroscopy, the proportion who had sports medicine fellowship training increased over the study period (p = 0.001). The majority of candidates performing hip arthroscopy (67.2%; 432 of 643) performed ≤5 hip arthroscopy procedures, while a small number of high-volume hip arthroscopists (6.5%; 42 of 643) performed 34.6% (1,403 of 4,054) of all hip arthroscopy procedures. CONCLUSIONS: The increase in hip arthroscopy utilization in this cohort appears to have been driven primarily by the increased number of candidates performing hip arthroscopy and less by an increasing number of hip arthroscopy procedures being performed by individual candidates. The majority of candidates performing hip arthroscopy were sports-medicine-fellowship trained. This information is valuable for both trainees and educators interested in improving education and defining a curriculum for future hip arthroscopy training.
[Mh] Termos MeSH primário: Artroscopia/educação
Artroscopia/estatística & dados numéricos
Competência Clínica
Cirugiões Ortopédicos/estatística & dados numéricos
Ortopedia/educação
[Mh] Termos MeSH secundário: Bases de Dados Factuais
Seres Humanos
Incidência
Internato e Residência
Cirugiões Ortopédicos/educação
Padrões de Prática Médica
Estudos Retrospectivos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171227
[Lr] Data última revisão:
171227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.17.00342


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[PMID]:28463814
[Au] Autor:Bahraminasab M; Ghaffari S; Eslami-Shahed H
[Ad] Endereço:Department of Tissue Engineering and Applied Cell Sciences, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran. Electronic address: m.bahraminasab@yahoo.com.
[Ti] Título:Al O -Ti functionally graded material prepared by spark plasma sintering for orthopaedic applications.
[So] Source:J Mech Behav Biomed Mater;72:82-89, 2017 Aug.
[Is] ISSN:1878-0180
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Orthopaedic prostheses still suffer from limited lifetime which imposes revision surgery with the associated risks involved. This, to some extent, is related to the vulnerability of the biomaterials used for their fabrication that are commonly single-constituent and uniform. Therefore, hybrid biomaterials such as composites and functionally graded materials (FGMs) are being developed to overcome the shortcomings of available biomaterials. The present paper focuses on the study of the structural, physical and mechanical properties of a FGM made of alumina-titanium fabricated by spark plasma sintering (SPS). The corresponding composites of the individual FGM layer were also fabricated. After sintering, the structural, mechanical and physical tests were carried out. The microstructural analysis using X-ray diffraction revealed the presence of Ti Al and TiAl in the composites, particularly with the increase of titanium content. Scanning electron micrographs revealed good adhesion and bonding between the two phases and between the FGM layers. The hardness and bending strength of the composites and FGM samples were tested and it was found that the increase in amount of Ti volume fraction decreases these properties monotonically. Furthermore, the sintering behaviour and fracture mechanisms of the FGM sample were studied and discussed.
[Mh] Termos MeSH primário: Óxido de Alumínio/análise
Materiais Biocompatíveis/análise
Ortopedia
Titânio/análise
[Mh] Termos MeSH secundário: Teste de Materiais
Desenho de Prótese
Difração de Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biocompatible Materials); D1JT611TNE (Titanium); LMI26O6933 (Aluminum Oxide)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171225
[Lr] Data última revisão:
171225
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


  8 / 15779 MEDLINE  
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[PMID]:28448921
[Au] Autor:Hollensteiner M; Fürst D; Esterer B; Augat P; Schrödl F; Hunger S; Malek M; Stephan D; Schrempf A
[Ad] Endereço:Research Group for Surgical Simulation Linz, Upper Austria University of Applied Sciences, School of Applied Health and Social Sciences, Garnisonstr. 21, 4020 Linz, Austria; Institute of Biomechanics, Trauma Clinic (BGU) Murnau and Paracelsus Medical University Salzburg, Prof. Küntscher Straße 8, 82
[Ti] Título:Novel bone surrogates for cranial surgery training.
[So] Source:J Mech Behav Biomed Mater;72:49-51, 2017 Aug.
[Is] ISSN:1878-0180
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Parietal graft lifts are trained on human or animal specimens or are directly performed on patients without extensive training. In order to prevent harm to the patient resulting from fast rotating machinery tools, the surgeon needs to apply appropriate forces. Realistic haptics are essential to identify the varying parietal bone layers and to avoid a penetration of the brain. This however, requires experience and training. Therefore, in this study, bone surrogate materials were evaluated with the aim to provide an anatomically correct artificial skull cap with realistic haptic feedback for graft lift training procedures. Polyurethane composites made of calcium carbonate and calcium phosphate were developed and were used to create customized bone surrogates, imitating both cancellous and cortical bone. Mechanical properties of these surrogates were validated for drilling, milling and sawing by comparison with human parietal bones. For that, surgical tool tips were automatically inserted into artificial and human bones in a customized test bench and the maximum axial insertion forces were analyzed. Axial tool insertion measurements in human parietal bones resulted in mean maximum forces of 1.8±0.5N for drilling, 1.7±0.3N for milling and 0.9±0.1N for sawing. Calcium carbonate-based materials achieved higher forces than the human bone for drilling and milling, and lower forces for sawing. The calcium phosphate-based bone surrogates showed comparable axial insertions forces for all investigated tools and were identified as a suitable surrogate for drilling (p=0.87 and 0.41), milling (p=0.92 and 0.63) and sawing (p=0.11 and 0.76) of the cortical layer and the cancellous bone, respectively. In conclusion, our findings suggest, that a suitable material composition for artificial parietal bones has been identified, mimicking the properties of human bone during surgical machinery procedures. Thus, these materials are suitable for surgical training and education in simulator training.
[Mh] Termos MeSH primário: Poliuretanos/química
Crânio/cirurgia
[Mh] Termos MeSH secundário: Retroalimentação
Cirurgia Geral/métodos
Seres Humanos
Fenômenos Mecânicos
Ortopedia/métodos
Treinamento por Simulação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Polyurethanes)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171225
[Lr] Data última revisão:
171225
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE


  9 / 15779 MEDLINE  
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[PMID]:29206799
[Au] Autor:Butler BA; Lawton CD; Burgess J; Balderama ES; Barsness KA; Sarwark JF
[Ad] Endereço:Department of Orthopedic Surgery, Northwestern Memorial Hospital, Chicago, Illinois.
[Ti] Título:Simulation-Based Educational Module Improves Intern and Medical Student Performance of Closed Reduction and Percutaneous Pinning of Pediatric Supracondylar Humeral Fractures.
[So] Source:J Bone Joint Surg Am;99(23):e128, 2017 Dec 06.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Simulation-based education has been integrated into many orthopaedic residency programs to augment traditional teaching models. Here we describe the development and implementation of a combined didactic and simulation-based course for teaching medical students and interns how to properly perform a closed reduction and percutaneous pinning of a pediatric supracondylar humeral fracture. METHODS: Subjects included in the study were either orthopaedic surgery interns or subinterns at our institution. Subjects all completed a combined didactic and simulation-based course on pediatric supracondylar humeral fractures. The first part of this course was an electronic (e)-learning module that the subjects could complete at home in approximately 40 minutes. The second part of the course was a 20-minute simulation-based skills learning session completed in the simulation center. Subject knowledge of closed reduction and percutaneous pinning of supracondylar humeral fractures was tested using a 30-question, multiple-choice, written test. Surgical skills were tested in the operating room or in a simulated operating room. Subject pre-intervention and post-intervention scores were compared to determine if and how much they had improved. RESULTS: A total of 21 subjects were tested. These subjects significantly improved their scores on both the written, multiple-choice test and skills test after completing the combined didactic and simulation module. Prior to the module, intern and subintern multiple-choice test scores were significantly worse than postgraduate year (PGY)-2 to PGY-5 resident scores (p < 0.01); after completion of the module, there was no significant difference in the multiple-choice test scores. After completing the module, there was no significant difference in skills test scores between interns and PGY-2 to PGY-5 residents. Both tests were validated using the scores obtained from PGY-2 to PGY-5 residents. CONCLUSIONS: Our combined didactic and simulation course significantly improved intern and subintern understanding of supracondylar humeral fractures and their ability to perform a closed reduction and percutaneous pinning of these fractures.
[Mh] Termos MeSH primário: Pinos Ortopédicos
Fixação Interna de Fraturas/educação
Fraturas do Úmero/cirurgia
Ortopedia/educação
Treinamento por Simulação
[Mh] Termos MeSH secundário: Adulto
Competência Clínica
Currículo
Educação de Pós-Graduação em Medicina
Educação de Graduação em Medicina
Avaliação Educacional
Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171208
[Lr] Data última revisão:
171208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.17.00425


  10 / 15779 MEDLINE  
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[PMID]:28470377
[Au] Autor:Page AE
[Ad] Endereço:Musculoskeletal Health Care Solutions, 3750 Convoy Street, Suite 116, La Jolla, CA, 92111, USA. alexe.page@gmail.com.
[Ti] Título:Gendered Innovations in Orthopaedic Science: Standing on the Shoulders of iGIANTs.
[So] Source:Clin Orthop Relat Res;475(7):1786-1788, 2017 07.
[Is] ISSN:1528-1132
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Procedimentos Ortopédicos
Cirugiões Ortopédicos
Ortopedia
Médicas
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Difusão de Inovações
Publicidade Direta ao Consumidor
Feminino
Identidade de Gênero
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Masculino
Marketing de Serviços de Saúde
Cirugiões Ortopédicos/psicologia
Relações Médico-Paciente
Médicas/psicologia
Fatores Sexuais
Sexismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1007/s11999-017-5373-y



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