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Development and Implementation of a National Canadian Spine Surgery Registry

Teaser: 

1Greg McIntosh,2Dr. Michael Craig, 3Dr. Charles Fisher,

1Director of Research Operations, Canadian Spine Outcomes and Research Network.
2Neurosurgery Resident at Vancouver General Hospital, University of British Columbia. 3Professor and Head of the Division of Spine Surgery, Combined Neurosurgical and Orthopaedic Spine Program, University of British Columbia.

CLINICAL TOOLS

Abstract:The goal of the Canadian Spine Outcomes and Research Network (CSORN) is to develop a registry for Canadian orthopaedic and neurosurgical spine surgeons to participate in prospective multi-centre trials and retrospective reviews utilizing multivariable analyses. The design allows ongoing research and contains clinical details necessary for epidemiological assessment. Currently, 21 hospital sites, representing 9 provinces, participate CSORN. A total of 81 investigators have enrolled over 11,000 spine patients; 78% thoracolumbar and 22% cervical. Predictive models, effectiveness of surgical procedures, wait time issues and patient-surgeon expectations are some of the specific topics already published with CSORN data.
Key Words: registry, spine surgery, data quality, outcomes.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

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Collection, feedback and publication of registry data is now a recognized way of informing clinical practice, driving quality improvement and improving patient outcomes.
The Canadian Spine Outcomes and Research Network (CSORN) is a multicentre national initiative that prospectively enrols consecutive patients with spinal pathology requiring surgical treatment.
The CSORN registry is designed to assess the value of operative techniques on patient outcomes.
Both patients and providers can feel powerless to enact any real change over the healthcare system. Patient participation in a properly designed registry gives them the opportunity to contribute to improving healthcare delivery.
The need for documentation of clinical outcomes is as important in spinal surgery as it is in other medical specialties.
If the value of spine surgery is not well established, then the cheapest options, rather than potentially better ones, are more likely to be endorsed.
Registries require fewer resources and often avoid the constraints of randomized clinical trials; as a result, registry findings usually have strong external validity and generalizability.
Collecting quality of life and patient-reported outcome measures data are essential for treatment evaluation.
Patients (and their physicians) should not fear participation in well-designed registries.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
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Percutaneous Vertebral Augmentation for the Treatment of Pathological Fractures of the Spine

Teaser: 

Ayoub Dakson, MBChB, MSc, FRCSC,1 Sean Christie, MD, FRCSC,2

1Clinical Fellow, Department of Surgery (Neurosurgery) QEII Health Sciences Centre, Halifax, Nova Scotia.2Professor, Department of Surgery (Neurosurgery), QEII Health Sciences Centre, Halifax, Nova Scotia.

CLINICAL TOOLS

Abstract:Pathological vertebral fractures (PVFs) occur commonly due to osteoporosis or a metastatic lesion to the spine, and present with acute back pain and loss of independent ambulation. Appropriate clinical assessment and radiographic evaluation are required to ensure optimal patient selection for a percutaneous vertebral augmentation procedure (PVA). This review explores the pathogenesis of PVFs and the efficacy of PVA in improving pain-related outcomes as well as health-related quality of life scores in both osteoporotic and metastatic PVFs.
Key Words: Osteoporosis; pathological vertebral fractures; vertebroplasty; kyphoplasty.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

You can take quizzes without subscribing; however, your results will not be stored. Subscribers will have access to their quiz results for future reference.

Pathological vertebral fractures occur commonly due to osteoporosis and metastatic disease to the spine.
Percutaneous vertebral augmentation procedures consist of vertebroplasty or balloon-kyphoplasty with the goals of increasing the strength of fractured vertebral body and restoring its height in order to alleviate back pain and increase ambulation.
Balloon-kyphoplasty has been shown to improve back pain associated with PVFs and health-related quality of life scores.
Appropriate consideration of ''red flag'' features in the clinical history and neurologic examination of a patient with back pain is crucial in screening for a potential sinister underlying etiology (i.e. malignant pathological vertebral fractures with spinal cord compression, infection, etc.).
MRI imaging (STIR) may provide useful information in deciding if the fracture has already healed.
Loss of the integrity of the dorsal wall of the fractured vertebral body increases the risk of leakage of the injected cement into the spinal canal, potentially causing spinal cord compression.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
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How to Understand and Prevent Knee Injuries in the Female Athlete

Teaser: 

Dr. Aly Abdulla, MD, CCFP, FCFP, DipSportMed CASEM, CTH, CCPE, McPL,

is a family doctor with specialties in sports medicine, palliative care, and cosmetic medicine. He can be found on Twitter, LinkedIn and https://ihopeyoufindthishumerusblog.wordpress.com/

CLINICAL TOOLS

Abstract: Knee injuries in female athletes is more common than in male athletes. There are many theories. Using these theories, prevention strategies are provided to ensure the incidence of such injuries decrease over time.
Key Words: knee injuries, athletes, prevention, exercise.
The incidence of significant knee injury among females is five times higher per player hour than for males.
Investigation shows that a large proportion of female knee injuries are non-contact.
Poor eating habits and eating disorders are more common in females so review this in prevention.
It is best to wear low heels to reduce weakening calf muscles and hamstrings.
Consider strength training to aerobic training at 50/50 and doing stretching after strength training.
Practice proper landing techniques with pliometrics, deceleration training and proprioceptive techniques.
To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.
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Caregivers Creating a Safe Home for Those with Dementia

Teaser: 

Holly Clark, Holly Clark is a freelance writer and works as a content manager for various international brands. When Holly is not researching and writing she loves nothing more than heading out into the country for some downtime. Holly is currently writing for Be in Health at https://www.beinhealth.com/

Caring for someone with dementia is never easy. In fact, many people often ask for support from other individuals who are also taking care of dementia patients. The first thing you should do is make some modifications in your home. People with dementia often see the world as a new and confusing place. Things can be scary every day. Therefore, it helps to adjust the environment to suit their needs and make them feel as comfortable as possible. Here is a guide on how individuals can create a danger-free home for those with dementia.

Ask for Guidance from Local Aging Agency

Often, these professionals have experience in taking care of people with Alzheimer's or other diseases related to dementia. They can recommend certified aging experts to come inspect your house and advise accordingly on safety issues in your home. It, therefore, helps to give them a call before modifying your house.

Inspect Areas of Your House That May be Unsafe
Check out areas in your house that you suspect may compromise the safety of your loved one. And when doing that, it helps to inspect them from the patient's point of view. So you have to remember that this condition affects one's balance, cognitive abilities, memory as well as perception. According to Jane Byrne, Project Coordinator at FirstCare nursing home Wicklow, "Someone with this condition has a difficult time interpreting and remembering information as well as making sound decisions." It, therefore, helps to modify your house in a way that will give them an easy time. And when doing that, you also should be careful. Redecorating or redesigning your home and other significant changes can be unsettling. On the other hand, simple moves like furniture rearrangement can also be alarming. Therefore, be cautious and give them time to adjust.

Follow the AARP Checklist for Home Safety
For those who don't have any idea on where to start, having this list will be useful. It outlines all the safety measures caregivers should take in order to make a home danger-free for loved ones with dementia. This list will serve as a guide on how to create a safe environment. Some of the things homeowners are advised to do, include:
Decluttering the walkway of any substance. Even if there is ice, snow, or debris, individuals should make sure it is removed. It's essential that you move bikes, chalks, lawn ornaments, or jump ropes to other rooms.

Marking Step Edges Using Neon Glow in the Dark Tape

Providing sufficient lighting, both indoors and outdoors. Sometimes people with dementia may perceive shadows as demons or burglars. Placing bright outdoor lighting, therefore, helps reduce falls, fear, as well as anxiety.

Repairing uneven bricks or cracked pavements as they serve as tripping points.

Designate a Danger Zone
Dementia people forget how things are used quickly. They can even drink wiper juice or touch a hot grill with bare hands. Therefore, individuals should convert one room, either the garage or outdoor shed, into storing substances such as sharp knives, as well as cutters, bleach, washing products, paint, insecticides, and other substances that might be confused. It also helps to have a combination of locks on rooms that contain hazardous items.

Creating a safe home for seniors with dementia is about identifying areas in your house that may pose dangers and modifying them so that they're safe. It also helps that individuals do a pantry patrol regularly since patients may eat spoiled or moldy foods.

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