• Paaske Gallegos posted an update 6 months, 3 weeks ago

    Despite recommendations for high-income countries to partner with low-income and middle-income countries to expand surgical access, little is known about the barriers that are faced by international surgeons (ISs) who participate in short-term clinical observerships in North America and the barriers that are encountered by their North American (NA) hosts.

    Surveys were distributed to ISs who participated in a pediatric orthopaedic observership in North America in 2009 to 2019 and their NA hosts to assess the perceived barriers that are faced by both partners and identify possible opportunities for improvement.

    Responses were received from 181 ISs and 46 NA hosts. The ISs reported facing a variety of barriers prior to, during, and after completion of their NA observerships, including financial burden, language and cultural barriers, and challenges with local accommodations and transportation. Only 49% of ISs reported that their NA hosts had sought feedback from them. Barriers noted by the NA hosts includemote learning for all participants. Additional studies are needed to investigate the value of clinical observerships for ISs, including the downstream impact of such opportunities on capacity-building, bidirectional learning, and improving patient care.

    The ISs who participated in a pediatric orthopaedic clinical observership and their NA hosts identified limited funding as a major barrier. There are several opportunities for enhancing this unique learning experience and exploring the role of contextual remote learning for all participants. Additional studies are needed to investigate the value of clinical observerships for ISs, including the downstream impact of such opportunities on capacity-building, bidirectional learning, and improving patient care.

    Paranasal sinus mucocele is a mostly benign disease but can cause irreversible complications depending on its location. A sphenoethmoidal mucocele (SEM) can cause compressive neuropathy due to its proximity to the optic nerve. Urgent endoscopic marsupialization is considered the treatment of choice for SEM. However, there is a scarcity regarding recurrence or operative size. Herein, the authors report a case of SEM that recurred after small endoscopic drainage. The patient was reoperated with wide cyst removal and nasal cavity ventilation expansion. Vision was partially resolved, and no recurrence was reported in the 6-month follow-up period.

    Paranasal sinus mucocele is a mostly benign disease but can cause irreversible complications depending on its location. A sphenoethmoidal mucocele (SEM) can cause compressive neuropathy due to its proximity to the optic nerve. Urgent endoscopic marsupialization is considered the treatment of choice for SEM. However, there is a scarcity regarding recurrence or operative size. Herein, the authors report a case of SEM that recurred after small endoscopic drainage. The patient was reoperated with wide cyst removal and nasal cavity ventilation expansion. Vision was partially resolved, and no recurrence was reported in the 6-month follow-up period.

    Substance use, including alcohol and drugs, has been found to amplify the risks associated with cycling. Our purpose was to determine the relationship between alcohol or drug use and facial injuries in a nationwide population of patients experiencing cycling trauma.

    The authors report a cross-sectional study of patients reported to the National Electronic Injury Surveillance System from January 1, 2019 to December 31, 2019, in the United States. Patients were included in our study if they were evaluated in the emergency department for a cycling-related injury. Primary outcome was facial injury.

    There were a total of 6499 adult patients who experience an injury after cycling trauma reported by the National Electronic Injury Surveillance System-participating emergency departments during the study period. A total of 553 (553/6499; 8.5%) patients had a facial injury and 82 patients with facial injuries had alcohol/drug use recorded (82/553; 14.8%). this website The proportion of males with facial injuries was higher in the alcohol/drug group than the no alcohol/drug group (86.6% versus 76.4%, respectively; P = 0.04). Injured cyclists in the alcohol/drug group experienced greater odds of sustaining a facial injury (odds ratio 2.21, 95% confidence interval 1.71-2.84, P < 0.0001) and a facial fracture (odds ratio 2.75, 95% confidence interval 1.83-4.13, P < 0.0001) than injured cyclists in the no alcohol/drug group.

    Substance use while cycling is not safe and significantly increases the likelihood of a facial injury and of facial fractures. This prevalence of injuries would suggest that cycling under the influence should always be illegal, and the law strictly enforced.

    Substance use while cycling is not safe and significantly increases the likelihood of a facial injury and of facial fractures. This prevalence of injuries would suggest that cycling under the influence should always be illegal, and the law strictly enforced.

    Bilateral cleft lip deformities makeup 10% of orofacial clefts and are uncommon when compared to unilateral cleft lip.1,2 These cleft deformities have significant physical and long-term psychosocial effects on not only the patient but their family. With bilateral cleft lip deformity, the cutaneous approximation of the lateral lip segments are dependent on a sufficient prolabium to reconstruct the philtrum.3,4 Deficient skin equates to tight midline closure and subsequent unsightly scarringIn the subclinical phenotype of bilateral cleft lip and palate, where the patient has an absent or deficient prolabium, achieving tension free closure in the primary surgical setting is a reconstructive dilemma.5 This clinical report describes the use of a full-thickness skin graft to reconstruct the philtrum in a 12-month-old boy with bilateral cleft lip deformity, absent prolabium, absent columella and absent nasal septum to provide an aesthetic subunit repair.

    Bilateral cleft lip deformities makeup 10% of orofacial clefts and are uncommon when compared to unilateral cleft lip.1,2 These cleft deformities have significant physical and long-term psychosocial effects on not only the patient but their family. With bilateral cleft lip deformity, the cutaneous approximation of the lateral lip segments are dependent on a sufficient prolabium to reconstruct the philtrum.3,4 Deficient skin equates to tight midline closure and subsequent unsightly scarringIn the subclinical phenotype of bilateral cleft lip and palate, where the patient has an absent or deficient prolabium, achieving tension free closure in the primary surgical setting is a reconstructive dilemma.5 This clinical report describes the use of a full-thickness skin graft to reconstruct the philtrum in a 12-month-old boy with bilateral cleft lip deformity, absent prolabium, absent columella and absent nasal septum to provide an aesthetic subunit repair.

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